Respiratory

Question 1

Mechanism by which LTOT prolongs survival in COPD

Answer 1

Reduction of arterial hypoxia reduces pulmonary arterial pressure.

Suitable candidates are those with FEV1 of <1.5L and PaO2 of <7.3 kPa, measured 2 weeks apart when well.

Question 2

Which is better for pleural space/pleura imaging? Ultrasound or CT?

Answer 2

Ultrasound. Then drainage can be performed and sent for testing: cultures, pH, glucose, LDH

Question 3

What is MacLeod Syndrome?

Answer 3

Unilateral emphysema following childhood bronchiolitis

Question 4

What conditions could predispose to the development of bronchiectasis?

Answer 4

1. Allergic bronchopulmonary aspergillosis
2. Hypogammaglobulinaemia
3. Bronchial adenoma
4. IBD (inc Chron’s)
5. Infections (e.g. TB, prev pneumonia)
6. Congenital syndromes (e.g. cystic fibrosis, immotile cilia syndrome, Kartagener’s syndrome)

In general, bronchiectasis can occur as a consequence of bronchial obstruction by either intrinsic or extrinsic pathology and in states of chronic inflammation of the airways/pleura.