Respiratory Formative

Question 1

The maximum vol of air that can be voluntarily exhaled following inspiration is called?

Answer 1

Vital capacity

Question 2

Air flows into the lungs during inspiration because

Answer 2

The EXTERNAL intercostals and diaphragm contract and the volume increases

Question 3

If Your ma has a respiratory rate of 10 breathes perminute and a tidal volume of 700ml. If his residual volume measures 1000ml and his dead space volume measures 200 ml what is her alveolar vent?

Answer 3

(700-200) X 10

=5000ml/min

Question 4

The partial pressure of oxygen in mixed venous blood is typically around ?

Answer 4

40mmhg (5.3kpa)

Question 5

Arterial partial pressure of oxygen will be reduced in which of the following conditions?

Answer 5

Emphysema- O2 conc in solution will be reduced

Question 6

What is not safe to use fro individuals with chronic lung disease?

Answer 6

Nitrous oxide

Question 7

Shunt is a term when?

Answer 7

Perfusion exceeds ventilation in L/min

Question 8

What happens to haemoglobin curve when asthma attack occurs?

Answer 8

Bronchoconstriction will decrease ventilation meaning CO2 will rise, and pH will fall causing the haemoglobin curve will shift to the right

Question 9

What happens to oxygen association curve during hypothermia?

Answer 9

Decrease in body temo shitfs curve to the left making it difficult to offload oxygen to peripheral tissues

Question 10

What happens the oxygen dissociation curve during respiratory alkalosis?

Answer 10

decrease in [H+] pulls CO2 equilibrium to the right reducing PCO2 so shifts haemoglobin binding curve to the left

Question 11

The articulation of the rib with vertbrae allows for respiratory mvmts. A the costovertebral joints the head of the 9th rib articulates with?

Answer 11

T9 and T8

Question 12

What is the costotranverse joint?

Answer 12

tubercle of rib 9 articules with tranverse process of vertebrae T9 only

Question 13

What is the left lung characterised by?

Answer 13

Upper and lower lobes separated by oblique fissure

Question 14

A 59 y/o man with known squamous carcinoma of the lung is admitted to hospital as an emergency with abdominal pain, constipation and confusion. What is the most appropriate investigation ?

Answer 14

Serum calcium:
Squamous cell lung cancer associated with hypercalcaemia due to parathyroid hormone related protein. Symptoms in this case classic for hypercalecaemia

Question 15

A 79 y/o woman with a peripheral spiculated opacity on chest x-ray and an enlarged supraclavicular lymph node. What is the most appropriate treatment?

Answer 15

Fine needle aspiration (FNA) lymph node

A sample is neeede for pathology to give a tissue diagnosis for cancer type. This offers an easily accessible option for this.

Question 16

A 55y/o obese buissness man complains of excessive daytime somnolence, snoring and frequent napping. He undergoes overnight oximerty which shows 10 destaturations per hour.

Answer 16

Mild ( 5-15 desaturations per hour is classes as mild OSA)

Question 17

A 35- old man has CF. What is his most likely organism infecting his lungs?

Answer 17

Pseudomonas aeurginosa

Question 18

A 50 y/o man has lobar pneumonia.. Most likely bacteria?

Answer 18

Streptococcus pneumoniae

Question 19

A 39 y/o with exacerbation of asthma is too tired to speak or do a peak flow? what are his blood gas results most likely to be?

Answer 19

pH 7.22
PaO2 7.8 kPA,
Pa CO2 8.6kPa

Question 20

What do night time sypmtoms indicate the need for?

Answer 20

Inhaled corticosteroids and inhaled beta-2-agonists

Nightime symptoms=== Corticosteroids

Question 21

32 y/o is recovering from a bad attack of pnuemonia. develops rigors, a persistently poor apetitie and increasing shortness of breathe on exterion. What is the most likely diagnosis?

Answer 21

Empyema thoracis

Will require IV antibiotics and a chest drain

Question 22

What is Haman-Rich syndrome?

Answer 22

Acute interstitial pneumonitis - super rare

Question 23

Whate are clinical signs might you might look for with lung carcinoma?

Answer 23

Finger clubbing
Hepatomegaly
Lymphadenopathy, SVC obstruction, tracheal deviation

Question 24

Give two imaging techniques which would be useful to define the extent of a lesion

Answer 24

Chest radiography
CT
MRI

CXR
PET

Question 25

What does lung cancer most often spread to?

Answer 25

Lymphnodes, 
adrenal gland,
 lung, 
liver, #
brain,
 bone

Question 26

List possible clinical signs in a patient with left lower lobe pneumonia/consoildation

Answer 26

• Tachypnoea
• Tachycardia
• Fever
• Cyanosis
• Reduced expasion
• Dullness to left lobe
• Bronchial breathing at left base
• Crackles
• Increased vocal resonance

Question 27

Name the micro organisms which may cause pneumonia in a young previously healthy individual?

Answer 27

• Chlamydia psittace
• Strep Pneumonia
• Haemophilus Influenza
• Staph aureus
• Mycoplasma pneumoniae

Question 28

List Four investigations that should be taken for someone with pneumonia?

Answer 28

Chest radiography
Sputum culture
Acute and convalescent serology
Mycoplasma IgM
Full Blood count
CRP/ESR
Blood culture

Question 29

What two classes of antibiotics should be used to treat someone with pneumonia?

Answer 29

• Beta-lactams

- Macrolides