Respiratory

Question 1

What is pneumonia?

Answer 1

Inflammation of the lung characterised by exudation into the alveoli

Question 2

Consolidation is a sign of?

Answer 2

Lobar pneumonia

Question 3

Symptoms of pneumonia?

Answer 3

Cough, fever, rigors, pleuritic chest pain, dyspnoea, tahcycardia, confusion

Question 4

Pneumonia: chest expansion, vocal fremitus, percussion, breath sounds, additional sounds, vocal resonance?

Answer 4

Reduced chest expansion
Increased vocal fremitus
Dull percussion
Bronchial breath sounds
Medium/late or pan-inspiratory crackles as the pneumonia resolves
Increased vocal resonance

Question 5

Top causes of CAP?

Answer 5

S.pneumoniae
M. pneumoniae
Chlamydia pneumoniae
Legionella pneumoniae

Question 6

Signs of atelectasis?

Answer 6

Tracheal deviation towards collapsed side
Reduced chest expansion
Dull percussion
Absent breath sounds

Question 7

Intramural, mural and extramural causes of atelectasis?

Answer 7

Intramural- CF, foreign body, aspiration
Mural- bronchial carcinoma
Extramural- aortic aneurysm, peribronchial lymphadenopathy

Question 8

What criteria used for differentiating transudate vs. exudate?

Answer 8

Light’s criteria:

- comparison of pleural LDH to serum LDH, and pleural protein to serum protein content

Question 9

Causes of transudative pleural effusion?

Answer 9

Either increased venous pressure (e.g. LVH) or hypoalbuminemia (nephrotic syndrome, CLD)

Question 10

Causes of exudative pleural effusion?

Answer 10

Infection (pneumonia, TB), inflammation (RA, SLE), malignancy, drugs e.g. cytotoxics, irradiation, trauma, Meig’s syndrome

Question 11

What are the 5 types of pleural effusion?

Answer 11

Transudate
Exudate
Haemothorax
Chylothorax
Empyema

Question 12

What are classic signs of yellow nail syndrome?

Answer 12

Distorted, yellow nails
Lymphoedema of legs
Pleural effusions and bronchiectasis

Question 13

Primary vs. secondary pneumothorax?

Answer 13

Primary- spontaneous rupture of subpleural bullae in tall, healthy young males

Secondary- to trauma, iatrogenic causes or emphyesematous bullae rupture

Question 14

Signs of bronchiectasis?

Answer 14

Fever, cachexia, sinusitis, voluminous sputum, coarse pan-inspiratory (widespread) crackles, clubbing, cyanosis, haemoptysis, signs of respiratory failure

Question 15

What are some causes of bronchiectasis?

Answer 15

Congenital: PCD, CF

Acquired: childhood infections, TB, ABPA

Question 16

What is COPD?

Answer 16

Characterised by chronic and progressive obstruction of airway outflow, which affects normal breathing, with little/no reversibility. FEV1<80% predicted and FEV1/FVC < 0.7.

Question 17

What is the definition of emphysema?

Answer 17

A pathological increase beyond normal in the size of air spaces distal to the terminal bronchioles; diagnosed histologically

Question 18

What is chronic bronchitis?

Answer 18

Daily production of sputum for 3 months a year for at least 2 consecutive years; diagnosed clinically

Question 19

Upper lobe predominant fibrosis?

Answer 19

Silicosis
Coal worker's pneumoconiasis
Ankylosing spondylitis
Radiation
TB

Question 20

Lower lobe predominant fibrosis?

Answer 20

Rheumatoid arthritis
Asbestosis
Scleroderma
Idiopathic
Other e.g. drugs (busulfan)

Question 21

Causes of mediastinal compression?

Answer 21

Lung carcinoma
Other tumours e.g. lymphoma, thymoma
Aortic dissection
Large retrosternal goitre

Question 22

What are signs of mediastinal compression?

Answer 22

SVC obstruction
RLN palsy
Tracheal compression (stridor)
Horner's syndrome
Phrenic nerve paralysis

Question 23

Signs of PE?

Answer 23

Sudden and unexplained dyspnoea
Tachycardia
Tachypnoea
Fever, pleuritic chest pain & haemoptysis (with infarction only)
Pleural friction rub if infarction occurred
Elevated JVP and RV heave if massive PE