Respiratory diagnosis

Question 1

How to diagnose ILD

Answer 1

combination of clinical features and high resolution CT (HRCT) of the thorax
HRCT shows ‘ground glass’ appearance
When diagnosis is unclear lung biopsy can be used to take samples of the lung and confirm with histology

Question 2

how to test for hypersensitivity pneumonitis

Answer 2

by bronchoalveolar lavage (involves collecting cells from the airway during bronchoscopy by washing the airways with fluid and then collecting that fluid for testing)

Question 3

what would a bronchoalveolar lavage show if someone had hypersensitivity pneumonitis

Answer 3

raised lymphocytes and mast cells

Question 4

clinical presentation of acute bronchitis

Answer 4

typically children but can be any age
hacking cough
yellow/clear sputum production
wheeze
SOB
chest pain
headache - sinus symptoms

Question 5

typical triggers of asthma

Answer 5

cold/damp
evening/early morning
animals
exercise
strong emotions
infection
dust

Question 6

typical asthmatic presentation

Answer 6

diurnal variability
bilateral widespread polyphonic wheeze
dry cough with wheeze and SOB
episodic symptoms
history of atopic conditions
FH

Question 7

NICE first line investigations for someone presenting with asthma

Answer 7

fractional exhaled nitric oxide
spirometry with bronchodilator reversibility