Simple med questions

Question 1

Which symptom is most commonly the first to appear in Chronic Obstructive Pulmonary Disease (COPD)?

Question 2

What type of respiratory failure does a patient with PE have?

Answer 2

Type 1 respiratory failure: low paO2 with normal or low CO2

Question 3

What would an arterial blood gas for a patient with a PE show?

Answer 3

Respiratory alkalosis

Question 4

The immediate inflammatory phase of asthma is an example of which type of hypersensitivity reaction?

Answer 4

A type I hypersensitivity reaction is caused by reaction to an allergen, as seen by the triggers in asthma.

Question 5

What type of respiratory failure is found in mild to moderate asthma?

Answer 5

Type I because there is a decreased partial pressure of both oxygen and carbon dioxide.

Question 6

What type of respiratory failure takes place in near-fatal asthma?

Answer 6

Type II respiratory failure - more extensive involvement of the airways and so oxygen cant be breathed in and so there is a decreased PO2 and an increased PCO2

Question 7

Why is the dry cough associated with asthma more common at night?

Answer 7

The vagus nerve is more active at night.

Question 8

Which type of antibody causes mast cell degranulation in asthma?

Answer 8

IgE

Question 9

What type of pattern of asthma is seen in spirometry of someone with asthma?

Answer 9

Obstructive

Question 10

What are the symptoms of near-fatal asthma?

Answer 10

Raised PaCO2 and mechanical ventilation

Question 11

If a patient is hypercapnic after being diagnosed with an acute exacerbation what is the next management step?

Answer 11

Refer to the intensive treatment unit - the patient is acutely unwell and this is shown by the hypercapnea, this leads to respiratory acidosis and other complications.

Question 12

By which mechanism does chronic bronchitis cause damage to the lungs?

Answer 12

Inflammation of the airways causes a hypersecretion of mucus

Question 13

As part of the disease process, what kind of cell replace the ciliated cells that should normally line the respiratory tract?

Answer 13

These goblet cells cause increased stasis of mucus, of which there is also hypersecretion.

Question 14

Which of the following imaging methods is most commonly used to help form a diagnosis of Chronic Obstructive Pulmonary Disease (COPD)? (1 mark)

Answer 14

Chest X-Ray

Question 15

By which mechanism does emphysema cause damage to the lungs?

Answer 15

Breakdown of elastase

Question 16

Which symptom is most commonly the first to appear in Chronic Obstructive Pulmonary Disease (COPD)?

Answer 16

A cough that is worse in the mornings

Question 17

Which organism causes bronchiolitis?

Answer 17

Respiratory synctial virus

Question 18

Describe CURB 65.

Answer 18

C - confusion 
U - Urea < 7mmol
R - Respiratory rate > 25
B - Blood pressure: < 90/60
65 = older than 65 years of age

Question 19

What is a classical sign of pneumonia on the chest radiograph?

Answer 19

Shadowing on the infected area

Question 20

What CURB score requires admission to hospital?

Answer 20

> 2

Question 21

What CURB score required admission to the intensive care unit?

Answer 21

> 4