Respiratory

Question 1

eligibility for thrombolysis in PE?

Answer 1

right heart strain

haemodynamic instability

Question 2

type 1 resp failure on ABG?

Answer 2

Hypoxia and nomral paCO2

Question 3

interpretateion of CURB65

Answer 3

0 or 1 - manage at home with ABs

2 - hospital as non-severe CAP

3 or more - hospital as severe CAP

Question 4

most common causes of CAP in UK?

Answer 4

Strep Pneumonia

Haem Influenzae

Question 5

most common HAP in UK?

Answer 5

Staph Aureus
Legionella
pseudomonas aeruginosa (ventilation associated)

Question 6

antibiotics for severe pneumonia?

Answer 6

Co-amoxiclav (levoflaxacin) + doxycycline

Question 7

initial management of vena cava obstruction?

Answer 7

Dexamethasone

Question 8

managment of sarcoidosis involves what drug?

Answer 8

corticosteroids

Question 9

gram negative asscoiated with COPD?

Answer 9

haem influenzae

Question 10

carcinoid syndrome symptoms?

Answer 10

facial flushing, diarrhoea and asthma

Investigation = urinary 5-HIAA excretion

Question 11

one pack year =

Answer 11

20 cigarettes per day for a year

Question 12

how might a COPD person lose apex beat?

Answer 12

Emphysema causing hyper expanded chest

Question 13

features of severe asthma?

Answer 13

<92%
33-50%
RR >30
HR >125
can't feed or talk
audible wheeze
accessory muscles

Question 14

atypical pneumonia CXR?

Answer 14

patchy consolidation often bilateral

Question 15

useful invx for bronchiectasis and interstitial lung disease?

Answer 15

High Res CT

Question 16

how is pleural tap done and how do we determine the fluid?

Answer 16

under US guidance

Exudative = protein >30g/L
Transudate = <30g/L

Question 17

drugs whihc can trigger asthma?

Answer 17

NSAIDs

Beta blockers

Question 18

which atypical causes desaturation on exertion?

Answer 18

pneumocystis pneumonia (treat co-trimoxazole)

immunosuppressed

Question 19

pneumonia associated with herpes labialis?

Answer 19

strep pneumonia

Question 20

left shift oxyhaemoglobin dissociation curve?

Answer 20

LESS oxygen delivery

low H+ (high Ph)
Low PCO2
Low 2,3 DPG
Low Temp

Question 21

pleural effusion on CXR?

Answer 21

blunting of costophrenic angle

Question 22

Asthma Diagnosis?

Answer 22

Obstructive spirometry (FEV1/FVC - <70%)

> 20% diurnal PEFR variability
15% improvement PEFR after SABA/ICS
Increased lung volumes

Question 23

in acute asthma when should we have ITU input?

Answer 23

Hypoxic and CO2 raising

Get Ventilated!

Question 24

Asthma Managment

Answer 24

SABA
\+ low ICS
\+ LABA
\+ LTRA OR medium ICS
refer to specialist

Question 25

when should antibiotics be given in COPD?

Answer 25

increased sputum purulence + clinical signs of pneumonia

Question 26

COPD managment?

Answer 26

SAMA or SABA

• LABA+ ICS/LAMA
• LABA + LAMA + ICS

Question 27

MRC dyspnoae scale:

Answer 27

1 - SOB on strenuous exertion
2 - SOB Hurrying on level
3 - stops after 15 mins
4 - stops aftercouple of minutes
5 - cannae leave the hoose