Respiratory Conditions

Question 1

Aetiology COPD

Answer 1

Smoking

alpha-1 trypsin deficiency

Question 2

Pathology COPD

Answer 2

Chronic inflammatory condition causing progressive airflow obstruction

Question 3

Symptoms COPD

Answer 3

SOB, Cough, sputum, wheeze
Little diurnal variation
Weight loss, peripheral oedema

Question 4

Investigations COPD

Answer 4

CXR, FBC, BMI, ECG
Spirometry - FEV1 <80%, FEV1/FVC <0.7
CO transfer
ABG

Question 5

Signs COPD

Answer 5

Cyanosis, CO2 flap, decreased breathing sounds

Question 6

Treatment COPD

Answer 6

Avoid RFs
SABA, LABA
Inhaled glucocorticoids
Long term oxygen - if paO2 less than 7.3/oedema

Question 7

Types of obstructive airway diseases

Answer 7

Chronic bronchitis
Emphysema
Asthma
COPD

Question 8

What is cor pulmonale

Answer 8

Pulmonary HT causing hypertrophy of LV and RHF

Question 9

Types of restrictive lung diseases

Answer 9

Sarcoidosis

Idiopathic pulmonary fibrosis

Question 10

Pleural causes of restrictive lung disease

Answer 10

Pleural effusions (fluid between visceral and parietal pleura)
Pneumothorax (accumulation of air in pleura)
Pleural thickening (scarring)

Question 11

Presentation of restrictive lung diseases

Answer 11

Abnormal chest x-ray
SOB
Respiratory and heart failure
Normal FEV1/FVC ratio

Question 12

RFs for asthma

Answer 12

Genetic
Occupation (paints, solder, animals, grains)
Smoking
Gender

Question 13

Pathophysiology of asthma

Answer 13

Chronic reversible inflammation of airways caused by increased sensitivity leading to airway obstruction (variable)

Question 14

Symptoms of asthma

Answer 14

Wheeze, SOB, Chest tightness, dry cough (nocturnal)

Question 15

Signs of asthma

Answer 15

Tachypnoea, tachycardia, cyanosis, wheeze

Question 16

Investigations of asthma

Answer 16

FBC, U+E, spirometry, PEFR, trial of treatment

Question 17

Treatment of asthma

Answer 17

SABA, LABA, ICS, steroid tablet

Question 18

Treatment of acute asthma

Answer 18

Oxygen, steroids, nebulisers

Question 19

Aetiology of Lung Cancer

Answer 19

Smoking, asbestos, radon, occupational exposure, pollution, pulmonary fibrosis

Question 20

Symptoms of lung cancer

Answer 20

Haemoptysis, recurrent infection, cough, SOB, pain weight loss, lump, chest pain, hoarseness

Question 21

Signs of lung cancer

Answer 21

Clubbing, lymphadenopathy, Stridor, collapsed lung, reduced expansion, reduced percussion, reduced breath sounds

Question 22

Local effects of lung cancer

Answer 22

Pleural effusion
Collapse 
Pneumonia
Infection
Abscess
Bronchiectasis
SVC syndrome

Question 23

Investigations of lung cancer

Answer 23

CXR, bronchoscopy, biopsy, CT, PFTs, PET, sputum cytology,

Question 24

DDx of lung cancer

Answer 24

Infection, lung abscess, benign tumour, granuloma, fibrosis

Question 25

Treatment lung cancer

Answer 25

Surgery, radiotherapy, chemotherapy

Question 26

Subtypes of lung cancer

Answer 26

Small cell | Non small cell - squamous cell, adenocarcinoma, large cell carinoma

Question 27

Pleural effusion aetiology

Answer 27

Transudate - HF, cirrhosis, PE, hypoalbuminaemia | Exudate - SLE, TB, carcinoma, RA

Question 28

Symptoms pleural effusion

Answer 28

SOB | Pleuritic chest pain

Question 29

Signs pleural effusion

Answer 29

Tracheal deviation, decreased expansion, stony dull percussion, diminished breath sounds

Question 30

Investigations pleural effusion

Answer 30

CXR, bronchoscopy, HRCT | Aspirate

Question 31

Treatment pleural effusion

Answer 31

Underlying cause Pluerocentesis Chest drain

Question 32

Pneumothorax causes

Answer 32

Spontaneous | Traumatic - stab wound, iatrogenic

Question 33

Symptoms pneumothorax

Answer 33

Asymptomatic SOB Pleuritic chest pain

Question 34

Tension pneumothorax treatment

Answer 34

Thoracostomy

Question 35

Treatment pneumothorax

Answer 35

Aspiration or chest drain

Question 36

Investigation pneumothorax

Answer 36

CXR

Question 37

CF aetiology

Answer 37

Genetic - AR

Question 38

Pathophysiology CF

Answer 38

Abnormal Cl channels causing increased Na reabsorption causing increased viscosity secretions

Question 39

Symptoms CF

Answer 39

Recurrent childhood chest infections, FTT, meconium ileum, steatorrhea

Question 40

Signs CF

Answer 40

Clubbing, purulent sputum, central cyanosis, bilateral crackles

Question 41

Investigations CF

Answer 41

Sweat testing, genetic testing

Question 42

Treatment CF

Answer 42

Physio, antibiotics, steroids, nutritional support, transplants

Question 43

Virchow's triad

Answer 43

stasis, abnormal vessels, hypercoaguable states

Question 44

Aetiologies PE

Answer 44

Immobility, trauma, recent surgery, pregnancy, malignancy

Question 45

Symptoms PE

Answer 45

Dyspnoea, tachypnoea, pleuritic pain, haemoptysis, cough

Question 46

Signs PE

Answer 46

Tachycardia, hypotension, increased JVP

Question 47

Investigations PE

Answer 47

Bloods, ECG, V/Q scan, Doppler

Question 48

Treatment PE

Answer 48

Anticoagulation, thrombolysis, oxygen

Question 49

Pulmonary hypertension pathophysiology

Answer 49

increased pulmonary aftery pressure

Question 50

Aetiology PHT

Answer 50

COPD, PE, Cardiac disesse

Question 51

Symptoms PHT

Answer 51

SOB, fatigue, chest tightness,

Question 52

Signs PHT

Answer 52

Peripheral oedema

Question 53

Investigations PHT

Answer 53

CXR, ECG, PFTs, ECHO, CT chest

Question 54

Treatment PHT

Answer 54

Warfarin, oxygen, diuretics, CCBS, surgery

Question 55

RFs TB

Answer 55

DM, previous TB, alcohol, poor social circumstances

Question 56

Investigations TB

Answer 56

Mantoux test, 3 sputum samples, CXR

Question 57

Symptoms TB

Answer 57

Cough, sputum, haemoptyis, pleuritic pain, SOB, systemically unwell

Question 58

Treatment TB

Answer 58

2 months rifampicin, isoniazid, pyrazinamide, ethambutol then 4 months rifampicin and isoniazid Notifiy health board and contact tracing

Question 59

Side effect of rifampicin

Answer 59

red-orange urine