Respiratory Medicine

Question 1

Define vital capacity?

Answer 1

The maximum volume of air that can be expired after a maximal inspiration

Question 2

Define inspiratory reserve volume?

Answer 2

The maximum volume of air that can be inspired at the end of a normal tidal inspiration

Question 3

Define functional residual capacity?

Answer 3

The volume of air that remains in the lung after a normal tidal expiration

Question 4

Define expiratory resave volume?

Answer 4

The maximum volume of air that can be expired after a normal tidal expiration

Question 5

Define residual volume?

Answer 5

The volume of air remaining after maximal expiration

Question 6

Define total lung capacity?

Answer 6

The total volume of air in the lungs following a maximal inspiration

Question 7

Which condition most commonly causes epiglottitis?

Answer 7

Haemophilus influenzae B

Question 8

Describe the pathophysiology of epiglottitis?

Answer 8

• Organisms reside in the nasopharynx and infiltrate towards the epiglottis
• Inflammation and oedema begin on the submucosa of the lingual surface of the epiglottis
• The swelling narrows the airway and spreads to involve the aryepiglottic folds, arytenoids and the supraglottic larynx
• These areas are highly vascularised with a large volume of lymphoid tissue, contributing to the rapid progression of swelling

Question 9

What is the pathophysiology of hearing?

Answer 9

• Sound enters the external auditory canal and causes the ear drum to vibrate
• The malleus, incus and stapes amplify the sound of the cochlea
• Causes movement of fluid within the cochlea which stimulates hair cells on top of the basilar membrane
• The auditory nerve connects the cochlea to the brain which sends these impulses to be heard as sound

Question 10

What is the meaning of forced vital capacity (FVC)?

Answer 10

The volume of air expired after full inspiration with maximum expiratory effort

Question 11

What is the meaning of forced expiratory volume in 1 second (FEV1)?

Answer 11

The volume of air expired after full inspiration with maximum expiratory effort in 1 second

Question 12

What is the meaning of FEV1/FVC ratio?

Answer 12

The percentage of viral capacity which is expired in the first second of the maximum expiration

Question 13

What spirometer findings would be seen in a restrictive pulmonary condition?

Answer 13

Normal/ high FEV1/FVC ratio
Low FVC

Question 14

What spirometry findings would be seen in obstructive pulmonary conditions?

Answer 14

Low FEV1/FVC ratio
Normal FVC

Question 15

What type of respiratory condition would a concave flow volume loop suggest?

Answer 15

Obstructive

Question 16

Where is the level of obstruction if inspiratory stridor is heard?

Answer 16

Above the glottis

Question 17

Where is the level of obstruction if biphasic stridor is audible (inspirstory and expiratory)?

Answer 17

At or immediately below the glottis

Question 18

Which respiratory condition can be associated with right sided aortic arch or double aortic arch?

Answer 18

Vascular Ring

Question 19

Which associated cardiac condition should patients with vascular ring be investigated for?

Answer 19

DiGeorge Syndrome

(Chromosome 22p11 deletion)

Question 20

How does vocal cord paralysis present?

Answer 20

Weak cry - at birth this should be considered as vocal cord paralysis until proven otherwise
Biphasic stridor - improves when lying down on the affected side

Question 21

Which investigation is used to look for vocal cord problems?

Answer 21

Flexible laryngoscope

Question 22

What is a laryngeal web?

Answer 22

Incomplete recanalisation of the laryngeal lumen during embryogenesis

Question 23

What is the treatment of laryngeal haemangioma?

Answer 23

Propranolol for months to years

Question 24

What is the most common cause of respiratory neoplasm in children?

Answer 24

Laryngeal papillomas

Question 25

What is the most common viral cause of croup (laryngotracheobronchitis)?

Answer 25

Parainfluenza virus

Question 26

Where is the location of the narrowing in croup?

Answer 26

Subglottic (below the glottis)

Question 27

On which day of life is it acceptable for the pCO2 parameters to be changed in premature infants?

Answer 27

Day 4

Increased from 4.5-8.5kPa to 4.5-10kPa