Respiratory Clinical Questions

Question 1

What medication is contraindicated in asthma patients?

Answer 1

Beta-Blockers

Question 2

Whats step 1 asthma treatment?

Answer 2

SABA

Question 3

What’s step 2 asthma treatment?

Answer 3

add 800ug ICS to SABA

200-400 for 5-12s

Question 4

Whats step 3 asthma treatment?

Answer 4

Add LABA to current treatment

If that fails add LTRA or Oral Theophylline

Question 5

Whats step 4 asthma treatment?

Answer 5

Increase ICS up to 2000ug

Question 6

Step 5 asthma treatment?

Answer 6

40mg prednisolone

Question 7

What is the treatment for acute severe asthma?

Answer 7

Oral/ IV steroids
Oxygen (94-98%)
Nebulised bronchodilators
Consider MgSo4 if no response

Question 8

What is the timing for surfactant production?

Answer 8

Starts 25 weeks and complete by 36 weeks

Question 9

What are the causative organisms for rhinitis?

Answer 9

Rhinovirus

coronavirus, RSV

Question 10

What are the symptoms for the common cold?

Answer 10

Malaise,
sore throat,
watery nasal discharge which turns mucopurulent after a few days

Question 11

What is the most common causative organism for acute pharyngitis?

Answer 11

Viruses from the adenovirus group

Question 12

Causative organisms for croup?

Answer 12

Parainfluenza virus

measles virus

Question 13

Infectious mononucleosis

Answer 13

Epstein-Barr Virus

Question 14

Epiglottitis

Answer 14

Group A beta haemolytic streptococci

Question 15

What investigations would you do with COPD?

Answer 15

Lung Function tests
CXR
High Resolution CT
ABG
Alpha-1 antitrypsin serum levels

ECG and Echo (if cor pulmonale

Question 16

What spirometry results show significant reversibility?

Answer 16

Increase of 200ml and >15% baseline FEV1

Question 17

Treatment of COPD

Answer 17

Cessation of smoking
Pulmonary rehabilitation
ICS and Bronchodilators
Flu vaccination yearly
Long Term Oxygen therapy if severe

Question 18

What are the treatments for bronchiectasis?

Answer 18

Respiratory physiotherapy
Influenza vaccinations
Antibiotics ASAP
Smoking cessation
ICS and bronchodilators

Question 19

Common causes of TB?

Answer 19

Mycobacterium Tuberculosis

Question 20

What are the drug treatments for TB?

Answer 20

Rifampicin (4 months)
Isoniazid (4 months)
Pyrazinamide (2 months)
Ethambutol (2 months)

Question 21

What are the side effects of Rifampicin?

Answer 21

Stains urine and body secretions orange
Induces liver enzymes (OCP)
Hepatitis

Question 22

Side effects of isoniazid?

Answer 22

Peripheral neuropathy (pyridoxine prevents this)
Hepatitis

Question 23

Pyrazinamide side effects?

Answer 23

Gout

Question 24

Ethambutol side effects?

Answer 24

Optic neuropathy

Question 25

Investigations for TB?

Answer 25

Tuberculin test
CXR
Sputum microscopy
Sputum culture
Bronchoscopy

HIV testing

Question 26

What are the infective organisms in CF?

Answer 26

Pseudomonas auruginosa 
Staphylococcus aureus
Haemophilus influenza
Stenotrophomonas Maltophilia
Burkholderia Cepacia
Mycobacterium Abscessus

Question 27

What are the signs and symptoms of CF?

Answer 27

Frequent respiratory infections in newborn
Sinusitis and nasal polyps
Infertility in males

Clubbing
Meconium illeus
Pancreatic insufficiency (steatorrhea)

Question 28

what are the tests for CF?

Answer 28

Sweat test
Blood DNA analysis of gene defect
Radiology

Question 29

What are the tests for pneumonia?

Answer 29

Urine (U+Es, Urinary legionella antigen)

Bloods (Venous: FBC, CRP, Liver profile, Renal profile,