Respiratory

Question 1

Differential: Cavitating lung lesion

Answer 1

Abscess (Staph aureus, Klebsiella and Pseudomonas)
Squamous cell lung cancer
Tuberculosis
Wegener’s granulomatosis
Pulmonary embolism
Rheumatoid arthritis
Aspergillosis, histoplasmosis, coccidioidomycosis=

Question 2

Causes of pulmonary eosinophilia

Answer 2

Churg-Strauss syndrome
Allergic bronchopulmonary aspergillosis (ABPA)
Loffler's syndrome
Eosinophilic pneumonia
Hypereosinophilic syndrome
Tropical pulmonary eosinophilia
Drugs: nitrofurantoin, sulphonamides 
Less common: Wegener's granulomatosis

Question 3

Risk factors for lung cancer

Answer 3

Smoking (by factor of 10)
Asbestos (by factor of 5)
Arsenic
Radon
Nickel
Chromate
Aromatic hydrocarbon
Aryptogenic fibrosing alveolitis

Factors that are NOT related = Coal dust

Question 4

Respiratory manifestation of rheumatoid arthritis

Answer 4

Pulmonary fibrosis
Pleural effusion
Pulmonary nodules
Bronchiolitis obliterans
Complications of drug therapy e.g. methotrexate pneumonitis
Pleurisy
Caplan’s syndrome - massive fibrotic nodules with occupational coal dust exposure
Infection (possibly atypical) secondary to immunosuppression

Question 5

Causes of bronchiectasis

Answer 5

Post-infective: tuberculosis, measles, pertussis, Pneumonia
Cystic fibrosis
Bronchial obstruction e.g. lung cancer/foreign body
Immune deficiency: selective IgA, Hypogammaglobulinaemia
Allergic bronchopulmonary aspergillosis (ABPA)
Ciliary dyskinetic syndromes: Kartagener’s syndrome, Young’s syndrome
Yellow nail syndrome

Question 6

CI to surgical management of small cell lung cancer

Answer 6

Assess general health
Stage IIIb or IV (i.e. metastases present)
FEV1 < 1.5 litres is considered a general cut-off point
Malignant pleural effusion
Tumour near hilum
Vocal cord paralysis
SVC obstruction