Respiratory

Question 1

List the CURB-65 criteria

Answer 1

C - confusion
U - urea over 7mmol/l
R - respiratory rate over or equal to 30
B - BP systolic less than 90, BP diastolic less than or equal to 60
65 - age over to or equal to 65

Question 2

Asymptomatic primary spontaneous pneumothorax can be managed how? How long after occurring should patients be followed up?

Answer 2

Conservatively; within 2-4 days

Question 3

Asymptomatic secondary spontaneous pneumothorax should be managed how?

Answer 3

Conservatively with inpatient monitoring, if stable follow up as outpatient after 2-4 weeks

Question 4

What is the difference between simple and tension pneumothorax?

Answer 4

Simple - does not shift mediastinal structures
Tension - does shift mediastinal structures

Question 5

No visible lung markings on CXR is indicative of what pathology?

Answer 5

Pneumothorax

Question 6

Name 3 high risk characteristics of pneumothorax

Answer 6

Any of:
Haemodynamic instability, significant hypoxia, bilateral pneumothorax, underlying lung disease, over to or equal to 50 years of age with significant smoking history, haemothorax

Question 7

Presence of high risk characteristics in pneumothorax cases should prompt treatment with what?

Answer 7

Chest drain insertion

Question 8

Symptomatic patients with a lack of high risk characteristics in pneumothorax means can be treated with what?

Answer 8

Needle aspiration

Question 9

Once pneumothorax patients are stable, how long after occurrence should they be followed up in outpatients?

Answer 9

2-4 weeks

Question 10

Recurrent episodes of pneumothorax or persistent air leak is indication for what?

Answer 10

Video assisted thoracoscopic surgery (VATS)

Question 11

Vocal hoarseness is suggestive of what type of tumour? Compression of which nerve is responsible for this sign?

Answer 11

Lung Pancoast tumour compression recurrent laryngeal nerve

Question 12

Which type of lung cancer is most likely to be found in non-smokers?

Answer 12

Adenocarcinoma

Question 13

Fill in the blanks:
Patients should be referred urgently for suspected lung cancer if they are aged __+ and have unexplained __.

Answer 13

40+
Unexplained haemoptysis

Question 14

Which 3 paraneoplastic syndromes are associated with small cell lung cancer?

Answer 14

ADH secretion
ACTH secretion
Lambert-Eaton syndrome

Question 15

Paraneoplastic ADH secretion may result in what blood finding?

Answer 15

Hyponatraemia

Question 16

Which type of lung cancer may present with a Cushing’s syndrome?

Answer 16

Small cell

Question 17

Which antibodies are present in small cell lung cancer related Lambert Eaton syndrome?

Answer 17

Antibodies against voltage gated calcium channels

Question 18

Which type of lung cancer is associated with hypercalcaemia?

Answer 18

Squamous

Question 19

Which type of lung cancer is associated with gynaecomastia?

Answer 19

Adenocarcinoma

Question 20

Which type of lung cancer is most commonly associated with non smokers?

Answer 20

Adenocarcinoma

Question 21

Which type of lung cancer is most commonly associated with asbestos exposure?

Answer 21

Mesothelioma

Question 22

Mesothelioma is a cancer of which part of the lung?

Answer 22

Pleura

Question 23

Mesothelioma may present with what CXR findings?

Answer 23

Pleural effusion and pleural thickening