Respiratory: Misc

Question 1

Restrictive Ventilatory Pattern

Answer 1

FVC and FEV1 are reduced proportionately so the FEV1/FVC is normal
FVC reduced <70%
FEV1 reduced

Question 2

Obstructive Ventilatory Pattern

Answer 2

The FVC and FEV1 are reduced disproportionately so the FEV1/FVC reduced (<70%)
FVC normal or reduced
FEV1 reduced <80%

Question 3

What does a reduced TLCO mean?

Answer 3

Impaired gas exchange

Question 4

Transudate vs Exudate

Answer 4

Transudate <25
Exudate >25

Question 5

Lights criteria

Answer 5

Exudate if:
- Effusion lactate dehydrogenase (LDH) level greater than 2/3 the upper limit of serum LDH
- Pleural fluid LDH divided by serum LDH >0.6
- Pleural fluid protein divided by serum protein >0.5

Question 6

Occupations at risk of sillicosis?

Answer 6

Coal mining

Question 7

What are patients with sillicosis at risk of?

Answer 7

TB

Question 8

XR features of sillicosis?

Answer 8

upper zone fibrosing lung disease
‘egg-shell’ calcification of the hilar lymph nodes

Question 9

Sarcoidosis: Lofgren’s syndrome

Answer 9

Acute form of sarcoidosis characterised by:
- bilateral hilar lymphadenopathy
- erythema nodosum
- fever
- polyarthralgia

Question 10

Sarcoidosis: Heerfordt’s syndrome

Answer 10

parotid enlargement
fever
uveitis

secondary to sarcoidosis

Question 11

Sarcoidosis: skin manifestation

Answer 11

Erythema nodosum
Lupus pernio

Question 12

Sarcoidosis: bloods

Answer 12

Hypercalcaemia
ACE levels: sensitivity of 60% and specificity of 70% - used to monitor disease progression

Question 13

Sarcoidosis: diagnosis

Answer 13

Tissue biopsy showing non-caseating granulomas, combined with relevant clinical findings

Question 14

Sarcoidosis: management

Answer 14

Asymptomatic/Mild: nil - usually spontenous remission
Symptomatic or progressive: steroids
Immunosuppressants/Biologics if no response to steroids