Respiratory medicine

Question 1

what is cystic fibrosis?

4

Answer 1

autosomal recessive condition
chromosome 7 CTRF mutation
multisystem disorder affecting lungs, pancreas, liver and intestine
impairs normal mucus clearance from lungs

Question 2

how do you diagnose cystic fibrosis?

2

Answer 2

sweat test - chloride >60mmol/L
gene test

Question 3

how do you manage cystic fibrosis?

4

Answer 3

antibiotics
airway clearance techniques
regular exercise
heart-lung transplant

Question 4

what are the main two types of lung cancer?

Answer 4

non-small cell carcinoma
small cell carcinoma

Question 5

what are the three types of non-small cell carcinomas?

Answer 5

adenocarcinoma
squamous cell carcinoma
large cell carcinoma

Question 6

what are the symptoms of lung cancer?

7

Answer 6

asymptomatic (50%)
unexplained cough (>=3weeks)
unintended weight loss
new onset dyspnoea (difficultly breating)
pleuretic chest pain
bone pain
fatigue

Question 7

what are the signs of cancer?

4

Answer 7

cachexia (wasting syndrome)
finger clubbing
cervical lymphadenopathy
wheeze

Question 8

how do you invesetigate lung cancer?

4

Answer 8

chest x-ray
CT scan chest-abdomen-pelvis
bronchoscopy and biopsy
PET CT scan for staging (spread)

Question 9

what are the treatments for non and small cell carcinomas?

Answer 9

non-small cell carcinoma:
* surgery
* targeted therapy
* immunotherapy
* chemotherapy
* palliative care
small cell carcinoma:
* chemotherapy
* radiotherapy

Question 10

what is pneumonia (community acquired)?

Answer 10

bacterial infection that causes the alveoli in the lungs to fill with fluid or pus, making it difficult to breathe
streptococcus pneumoniae

Question 11

what are the signs and symptoms of pneumonia?

6

Answer 11

cough
breathlessness
pheuritic pain
pyrexia (high temperature)
tachypnoea (rapid breathing)
tachycardia (rapid heart rate)

Question 12

what groups of people have increased severity of pneumonia?

5

Answer 12

old age
cardiorespiratory comorbidities
low socioeconomic groups
new weight loss/cachectic state
immunocompromised

Question 13

what is tuberculosis?

Answer 13

bacterial infection that usually afects the lungs

Question 14

what are the signs and symptoms of tuberculosis?

9

Answer 14

asymptomatic
malaise
weight loss
fever
night sweats
productive cough
shortness of breath
chest pain
extrapulmonary disease (in organs outside the lungs)

Question 15

what is the pathology of tuberculosis?

3

Answer 15

mycobacterium tuberculosis
reactivation of infection when immune system is impaired
miliary tuberculosis (brain, kidney, bone etc.)

Question 16

how do you diagnose tuberculosis?

6

Answer 16

chest x-ray
sputum sample
blood tests
HIV serology
brain MRI (miliary TB)
lumbar puncture

Question 17

what is a pulmonary embolus?

Answer 17

blood clot from a vein, originating in the venous sinuses of the calf or femoral vein or pelvis, detaches and becomes lodged in the pulmonary arterial tree

Question 18

what are the risk factors of pulmonary embolus?

11

Answer 18

age
obesity
previous VTE (venous thromboembolism)
malignancy
HRT/COCP
pregnancy
immobility
hospitalisation
cancer
atrial fibrillation
factor V laiden deficiency

Question 19

how do you treat a pulmonary embolus?

2

Answer 19

acute - thrombolysis, percutaneous catheter removal of clot
anticoagulation - DOAC, warfarin, LMWH

Question 20

what drugs are used in respiratory diseases?

Answer 20

corticosteroids - inhaled, oral, intravenous e.g. becotide
beta-2 anagonists - inhaled, oral, intravenous e.g. salbutamol
leukotrine receptor antagonists - oral e.g. montelukast
muscarinic antagonists - inhaled e.g. ipratropium
theophylline - oral
oxygen - inhaled