Respiratory

Question 1

Stony dull percussion

Answer 1

Pleural effusion

Question 2

Right-sided pleuritic chest pain

Answer 2

Pneumonia usually

Question 3

ABCDE of pulmonary oedema?

Answer 3

Alveolar bats-wing shadows

Kerley B lines

Cardiomegaly

Dilated upper lobe vessels

Pleural effusions

Question 4

CXR:“Ground glass appearance”

Answer 4

Pulmonary fibrosis

Newborn ARDS

Question 5

Ziehl-Neelson stain is positive for acid-fast bacilli

Answer 5

TB

Question 6

“Caseous necrosis”

Answer 6

TB

Question 7

Apical disease / Assman focus

Answer 7

Secondary TB

Question 8

Miliary tuberculosis

Answer 8

TB spread in the bloodstream

Question 9

Positive for anti-glomerular basement membrane antibodies

Answer 9

Goodpasture’s syndrome

Question 10

Chest infection with parrot/pigeon as a pet

Answer 10

Chlamydophila psitacci atypical pneumonia

Question 11

Dry cough + diarrhoea after holiday abroad, some indication of air conditioning / water spread

Answer 11

Legionella pneumoniae atypical pneumonia

Question 12

Tall, young, thin man +/- drugs with chest pain and breathlessness

Answer 12

Pneumothorax

secondary to Marfan’s syndrome

Question 13

Bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis, weight loss

Answer 13

Sarcoidosis

Question 14

Bronchiole wider than neighbouring bronchioles on CT (“signet ring sign”)

Answer 14

Bronchiectasis

Question 15

“D sign” on CXR

Answer 15

Empyema

Question 16

“Steeple sign” on CXR

Answer 16

Croup

Question 17

Child with “barking” cough

Answer 17

Croup

Question 18

HIV patient with pneumonia

(causal organism and treatment)

Answer 18

Pneumocystis spp.

Co-trimoxazole

Question 19

Asthma + nasal polyps + salicylate sensitivity

Answer 19

Aspirin-induced asthma

(Samter’s triad)

Question 20

Alcoholic w/ pneumonia

(mechanism of infection + causal organism)

Answer 20

Aspiration

Klebsiella pneumoniae

Question 21

“Red jelly sputum”

Answer 21

Klebsiella pneumonia

Question 22

“Mucoid sputum”

Answer 22

Chlamydophila psitacci pneumonia

Question 23

“Rusty sputum”

Answer 23

Pneumococcal (Streptococcus pneumoniae) pneumonia

Question 24

Cannonball metastates + weight loss + haematuria

Answer 24

Renal carcinoma

Question 25

**Morning headache**

Answer 25

**1. Hypercapnia** **2. Nitrates**

Question 26

**Secretes ACTH** Producing Cushing's syndrome

Answer 26

**Small cell carcinoma**

Question 27

**Secretes PTH**

Answer 27

**Squamous cell carcinoma**

Question 28

**NEUROENDOCRINE** and **highly malignant**

Answer 28

**Small cell cancer**

Question 29

**Increased serum ACE** and **Ca²**⁺

Answer 29

**Sarcoidosis**

Question 30

**Eggshell calcification at hilar region**

Answer 30

**Silicosis**

Question 31

**Found in TB, area of infection + caseating necrosis @ lung periphery**

Answer 31

**Ghon focus**

Question 32

**Apical lesion of secondary TB**

Answer 32

**Assman focus**

Question 33

**Symptoms of Horner's syndrome**

Answer 33

**Ptosis (droopy eyelid)** **Enophthalmos (sunken eyes)** **Miosis (small pupils)** **Ipsilateral loss of sweating**

Question 34

**Acute management of asthma**

Answer 34

**OSHIT MAN:** Oxygen Salbutamol NEB Hydrocortisone IV or prednisolone PO Ipratropium NEB Theophylline or aminophylline IV Magnesium get help!

Question 35

**"Thumbprint sign"** on HXR

Answer 35

**Epiglottitis**

Question 36

**Inspiratory whoop / barking cough**

Answer 36

**Pertussis**

Question 37

**"Snow storm" appearance on CXR**

Answer 37

**Baritosis** **Silicosis**

Question 38

**Management of acute exacerbation of COPD**

Answer 38

**ISOAP:** Ipratropium Salbutamol Oxygen Amoxicillin Prednisolone

Question 39

**Non-smoker with lung cancer**

Answer 39

**PERIPHERAL adenocarcinoma**

Question 40

Position of **squamous** and **small cell cancers**

Answer 40

**CENTRAL**

Question 41

**High D-dimers**

Answer 41

**Suspect PE**

Question 42

**Low D-dimers**

Answer 42

**Exclude PE**

Question 43

Treatment for **large PE**

Answer 43

**Thrombolysis** (e.g streptokinase)

Question 44

Treatment for **small PE**

Answer 44

**LMWH**

Question 45

**TB treatment regime**

Answer 45

**2 RIPE 4 RI:** 2 months of rifampicin, isoniazid, pyrazinamide and ethambutol then 4 months of rifampicin and isoniazid

Question 46

**TB drug side effects**

Answer 46

**Rifampicin** - orange bodily fluids **Isoniazid** - peripheral neuropathy (tingling) **Pyrazinamide** - joint pain **Ethambutol** - vision problems