Respiratory

Question 1

Causes of Upper Lobe fibrossis

CHARTS

Answer 1

Coal worker pneumoconiosis

Histiocytosis/hypersensitivity pneumonitis

Ank Spind

Radiation

TB

Silicosis/sarcoidosis

Question 2

Drug induced lung fibrosis

Answer 2

Amiodarone

Bleomycin

MTX

Question 3

Churg strauss

Answer 3

Eosinophillic granulomatosis with polyangitis

small-medium vessel vasculitis

pANCA +ve

Px:

• Asthma
• Eosinophilia
• Paranasal sinusitis
• mononeuritis multiplex

LTRA –> precipitate disease

Question 4

Primary pneumothorax

Answer 4

Rim of air <2cm (30%) and no sx –> discharge

Sx or >2cm –> Aspirate –> Fx –> chest drain

Following aspiration if air <2cm –> discharge with outpatient review.

Post - No fly 2 weeks.

Stop smoking (RR of recurrence 10% vs 0.1%)

Question 5

Secondary pneumothorax

Answer 5

> 50 + >2cm +/or SOB –> Chest drain

Otherwais if >1cm –> aspirate –> chest drain (>1cm)

All should be admitted for 24 hrs.

<1cm –> Admit and observe + O2 for 24 hrs

AVOID SCUBA

Question 6

Iatrogenic pneumothorax

Answer 6

less iikelihood of recurrence.

Observe.

Ventilated –> chest drain as may have some with COPD

Question 7

Factors improving prognosis in COPD

Answer 7

Smoking cessation - most important

LTOT

Lung vol reduction surgery

Question 8

Altitude sickness

Answer 8

Prevention:

• Slow ascent
  = Carbonic anhydrase inhibitor - Acetazolamide

HAPE:
- O2
Descent
PDE Type V inhib 
Acetazolamide
Nifedipine 
Dex

HACE:

• Descent
• Dex

Question 9

CF - psuedomonas aeurginosa treatment

Answer 9

Ceftazidime and tobramycin

Question 10

Middle Eastern respiratory sybdrome

Answer 10

Assoc with Camels

Middle Eastern