Treatments

Question 1

Asthma

Answer 1

1. )SABA
2. )Add inhaled corticosteroid
3. )Add LABA and assess control
4. )Add LTRA or increase steroid
5. )Add daily steroid tab

Emergency:
Oral/IV steroids
Nebulise

Question 2

COPD

Answer 2

Smoking cessation
Inhalers
Vaccines
Pulmonary rehabilitation
Long term O2 therapy
Nutritional assessment
Psychological support
Exacerbations may require antibiotics and steroids

Question 3

ARDS

Answer 3

Mechanical ventilation

Question 4

Hypersensitivity Pneumonitis

Answer 4

Avoid allergen
Alter working practice
Manage symptoms with corticosteroids

Question 5

Sarcoidosis

Answer 5

NSAIDs

Systemic and topical steroids

Question 6

Idiopathic pulmonary fibrosis

Answer 6

Corticosteroids
Lung transplant
Pulmonary rehabilitation

Question 7

Pleural Effusion

Answer 7

Drain fluid if symptomatic
Pleurodesis if recurrent
Surgery

Question 8

Pneumothorax

Answer 8

If tension, do not x-ray and insert chest drain immediately.

Question 9

Pulmonary embolism

Answer 9

LMW Heparin until INR 2-3
Start warfarin >3 months
Thrombolysis if massive PE

Question 10

DVT

Answer 10

LMW Heparin until INR 2-3
Start warfarin for >3 months
Graduated compression stockings
Thrombolysis

Question 11

Pulmonary Hypertension

Answer 11

Remain active
Warfarin
O2
Diuretics
CCB
Pulmonary endarterectomy if referred

Question 12

Tonsilitis/Pharyngitis

Answer 12

Resting

Oral penicillin if severe and bacterial

Question 13

Otitis Media

Answer 13

Painkillers

Antibiotics if severe or bilateral

Question 14

Croup

Answer 14

Oral steroids

O2 Therapy

Question 15

Epiglottitis

Answer 15

Augmentin/Cephalosporin

May require intubation

Question 16

Glandular Fever

Answer 16

Paracetamol/Ibuprofen

Question 17

Coryza (common cold)

Answer 17

OTC medication

Question 18

Sinusitis/Rhinitis

Answer 18

OTC medications
Nasal decongestants
Cleaning inside of nose with saline
Antihistamine
Avoidance of allergens

Question 19

Acute bronchitis

Answer 19

Often spontaneous recovery
Antibiotics if severe
Minimal intervention, maximal observation

Question 20

Pneumonia

Answer 20

Assess severity with CURB

Question 21

Bronchiectasis

Answer 21

Chest physio
Prompt infection treatment with antibiotics
May require inhaled B2 agonist/corticosteroid

Question 22

Lung abscess

Answer 22

Guided by available culture results

Surgical drainage is sometimes needed

Question 23

Empyema

Answer 23

Drain fluid immediately
Extend antibiotic period
Thoracic surgical intervention in severe cases

Question 24

Small cell carcinoma

Answer 24

Chemo

+maybe palliative

Question 25

Non-small cell carcinoma

Answer 25

Surgery

Chemo

Question 26

Cystic Fibrosis

Answer 26

Physio supported by chest clearance device
Frequent prophylactic antibiotics for bronchial infections
Flu vaccine
Regular use of inhaled beta agonists
Nebulised DNase and hypertonic saline slow lung function decline
Psychological support
Lung and/or heart transplant

Question 27

TB

Answer 27

Multidrug therapy for at least 6 months
Rifampacin, Isoniazid, Ethambutol and Pyrazinamide for 2 moths (given as one drug)
Rifampacin and Isoniazid for a further 4 months

Question 28

Sleep Apnoea

Answer 28

Weight reduction
Avoid tobacco/alcohol
CPAP
Mandibular repositioning splint

Question 29

Narcolepsy

Answer 29

Modafinil
Clomipramine - for cataplexy
Sodium Oxybate