Respiratory

Question 1

what are common antituberculous drugs and their side effects?

Answer 1

Rifampicin: hepatitis, flu-like illness
Isoniazid: hepatitis, fever, peripheral neuropahty
Streptomycin: ototoxicity , renal impairment
Ethambutol: optic neuritis
Pyrazinamide: hepatitis

Question 2

non metastatic features of lung carcinoma

Answer 2

1. anorexia, weight loss, cachexia, fever
2. Endocrine:
   a. hypercalcemia (increased parathyroid H in squamou)
   b. hyponatraemia(SIADH- small cell)
   c. ectopic adrenocorticotrophic hormone (small cell)
   d. gynaecomastia (all types ca by ectopic gonadotrophin)
   e. carcinoid syndrome (small cell)
   f. insulin-like activity (squamous cell)
3. skeletal
   a. clubbing (rare in samll)
   b. hyeprtrophic pulmonary osteoarthropathy, ( more common with adenocarcinoma)
   4 Neurological
   a. eaton lambert syndorme
   b. peripheral neuropathy or autonomic neuropathy
   c. subactue cerebellar degeneration
   d. polymyositis
   e. crotical degeneration wit demnetia
   f. acute transverse myelopathy
   5 haematology:
   migraing venous throm, arterail throm
   diffuse intravascular coagulation
   anaemia, leucoerythroblastosis, red cell aplasia, polycythaemia,eosinophilia
4. skin: acanthosis nigricans, fibrinolytic purpura
5. renal: nephrotic syndorme
6. opportunistic infections ( more in chemo therapy

Question 3

Indications for lung transplant

Answer 3

COPD: FEV55mmhg
cystic fibrosis, bronchiectasis - FEV150mmHg , PaO2 55mmHg, cardiac index s syndorme- severe symptomatic impairment, the 2-year prognosis is not improved for these patients.

Question 4

Contraindications for lung transplant

Answer 4

relative:
Diabetes, osteoporosis, alcohol excess, still smoking, likely compliance problems, atypical mycobacterial colonisaton of lungs, weight 130% of ideal or < contra70% of ideal
Absolute:
HIV, hepatitis B, hepatitis C and liver disease
malignnancy, other organ failure