respiratory

Question 1

cough, central weight gain, easy bruising, abdominal striae and hyperpigmentation
what is the most likely type of lung cancer affecting this patient

Answer 1

small cell carcinoma

Question 2

death from bronchopneumonia, secondary to a tumour that encases the left lung, obliterating the pleural space.due to industrial exposure. what substance might have caused this?

Answer 2

asbestos

Question 3

symptoms of LRTI, treated with co-amoxiclav. describe the indication for the use of co-amoxiclav

Answer 3

is is commonly used in the treatment of severe CAP

Question 4

what blood gas change would lead central chemoreceptors to be stimulated

Answer 4

an increase in arterial PCO2

Question 5

finger clubbing, fine end inspiratory crackles at both lung bases. what is the most likely

Answer 5

interstitial lung disease

Question 6

left basal consolidation and is found to have CAP. what is the most likely causative organism

Answer 6

streptococcus pneumoniae

Question 7

what inhaler has the highest carbon footprint

Answer 7

hydrofluorocarbon propellant in the metered dose inhaler

Question 8

FEV1 1.8L (55% predicted)
FVC 3.6L 88% predicted
what is the appropriate interpretation of these results?

Answer 8

1.8/3.6= 0.5 hence obstructive lung defect

Question 9

what is like route of transmission of TB

Answer 9

droplets from the resp tract

Question 10

what is the most appropriate investigation to monitor anticoagulation

Answer 10

INR (lower value = blood clots more quickly, vice versa)

Question 11

when PCO2 is within normal limits and PO2 is low. what does this mean in ABG
+ low pH

Answer 11

metabolic acidosis

Question 12

what is an example of b2-adrenoceptor agonist drug and a corticosteroid

Answer 12

salbutamol and prednisolone

Question 13

what part of the respiratory tract is most likely to be affected from this history:
severe pulmonary emphysema

Answer 13

alveolar sacs

Question 14

what drug should be administered after treating an asthmatic with high flow oxygen

Answer 14

beta 2 agonist

Question 15

dullness on percussion of her chest at the left base. vocal resonance is increased in the same area and breath sounds are bronchial. what is the most likely diagnosis?

Answer 15

lower lobe consolidation

Question 16

worsening SOB, cough productive 4-5 tablespoons of sputum per day. history of childhood pneumonia and recurrent chest infections, coughed up blood on two occasion years ago
what is the diagnosis

Answer 16

bronchiectasis

Question 17

how can an animal cause an allergic reaction

Answer 17

protein derived from cat skin and hair

Question 18

haemoptysis mixed with sputum, no chest pain, wt loss, smoker, temp 37.5, xray shows left lower lobe collapse.
what is the diagnosis

Answer 18

carcinoma of the bronchus

Question 19

what is the most appropriate initial management of pneumothorax - SaO2 98%, 4cm rim, no mediastinal shift

Answer 19

perform aspiration

Question 20

pain on swallowing, history of asthma that is well controlled using metered dose slbutamol and beclometasone dipropionate inhalers. she has white plaques in her mouth. an anti-fungal oral suspension is prescribed. what is the most appropriate management for the beclometasone?

Answer 20

take using a larger vol spacer

Question 21

collapsed patient with exaggerated chest movement, no audible respiration at the mouth or nose and bounding regular pulse

Answer 21

upper airway obstruction

Question 22

LRTI, what are the likely organisms to cause HAP

Answer 22

gram negative bacteria

Question 23

former shipyard worker, weight loss, never smoked. xray shows large left sided pleural effusion which is blood stained on pleural aspiration. what is the diagnosis

Answer 23

mesothelioma due to asbestos exposure

Question 24

what drugs can be used to treat influenza A and B viruses

Answer 24

oseltamivir

Question 25

history of eczema presents with 3 month history of non-productive cough and wheeze, worse at night and on exercise

Answer 25

asthma

Question 26

which parameter is added to the cumulative NEWS score

Answer 26

systolic BP

Question 27

when would you wash your hands with liquid soap and water as opposed to using alcohol based hand gel

Answer 27

after contact with a patient known to have infective diarrhoea and vomiting

Question 28

reduced air entry in the right lower zone with crepitations and bronchial breathing. You diagnose a right-sided chest infection. What is the most likely causative organism?

Answer 28

Mycoplasma pneumoniae

Question 29

A 3-year-old child presents to the GP with a chronic cough for the last month. He had previously been fit and well since he suffered a severe pertussis infection when he was 1 month of age. He has subsequently been fully immunized but was noted to be on the 0.4th centile for height. What is the most likely cause for his cough?

Answer 29

Bronchiectasis