Week 5

Question 1

What are some main causes of occupational causes of lung disease?

Answer 1

Coal mining, shipyard, building person

Asbestos, mould, coal miners lung

Question 2

What are some environmental causes of lung disease?

Answer 2

Smoking, smog, air pollution, deprivation,

Question 3

A farmer comes in with hypersensitivity pneumonitis (Chronic inflammation of lung ) what microorgansim is likely responsible?

Answer 3

Coxiella burenetti (q fever)

Question 4

A bird keeper comes in with hypersensitivity pneumonitis (Chronic inflammation of lung ) what microorgansim is likely responsible?

Answer 4

Avian or animal proteins.

Chlamydia psittaci

Question 5

What is smog composed of ?

Answer 5

Comprised of ozone from poor combustion of fossil fuels in cars

Question 6

Calculate the curb score for a 65 year old man presenting with no confusion, BP of 130/ 95, resp rate of 32 and urea output of 8mmol/L

What is CURB used in? Pneumonia

Answer 6

Age > 65=1
Urea>7mmol/L =1
Confusion =1
Resp rate > 30 =1
BP, systolic <90 or diastolic <60 =1

Hence; 3

If 2 or more monitor or inpatient

Question 7

In hyper sensitivity reactions what drugs are used to treat ?

Answer 7

Sodium cromoglycate as it is a mast cell stabiliser

Leukotriene receptor antagonists; to prevent eosinophil attraction

Glucocorticoids; To suppress inflammation

Question 8

Give an example of a type 4 hypersensitivity reaction?

Answer 8

Sarcoidosis (?due to granumlomas)

Question 9

What is caplans syndrome?

Answer 9

Inbetween rhumatoids and pneumocitis causing Nodules in upper lobes of lungs that may calcify

Question 10

Where are the complement proteins produced?

Answer 10

The liver

Question 11

A man presents with tachycardia and increased respiratory rate following a blood transfusion of the wrong type. What hypersensitivity reaction is occuring?

Answer 11

Type 2 as antibodies are directly binding and causing cell lysis

Question 12

Describe the events leading to drug induced haemolysis. How can this present?

Answer 12

Pencillin is injected, this binds to regular RBCs forming a complex the body recognises as foreign, causing antibodies to attack and kill the cells.

Lower back pain (spleen), decreased BP, increased resp rate

Question 13

What are the symptoms of hypersensitivity pneumonitis? (Type 3 hyper sensitivity)

Answer 13

Rashes wheeze, breathlessness, malaise, pyrexia (fever)

Inflammation of the alveoli

Question 14

What term time is considered safe for a baby to be born?

Answer 14

37-42 weeks

Question 15

What is considered normal resp rate for neonates?

Answer 15

60 breaths per minute

Question 16

What is respiratory distress syndrome in babies?

Answer 16

When they are born preterm and surfactant hasn’t been produced from the type 2 pneumocytes (alveolar cells) so lungs collapse

Question 17

In term babies what is transient tachypnoea caused by?

Answer 17

When there is still amniotic fluid in the lungs due to caesaren causing persistent infection

Question 18

Female presents with uveitis (inflammation of eye), erthema nodosum (swollen red lumps), lymphadenopathy and hypercalcaemia. What disease does she have?

Answer 18

Sarcoidosis

Question 19

What can cause pneumoconiosis?

Answer 19

( inflammation and fibrosis of lung)

Asbestos, coal worker lung, silicon, inhaled pathogens inable to be cleared by body

Question 20

Women with HIV presents with a chest infection, what is the most likely causative organism? How would you treat?

Answer 20

Pneumocystis jirovecci pneumonia

Co-trimoxazole

Question 21

Known alcoholic presents with chest infection. Most likely organsim? Treatment?

Answer 21

Klebsiella pneumoniae

Red jelly sputum

Cefotaxime

Question 22

Young girl with cystic fibrosis presents with chest infection. Most likely organism?

Answer 22

Pseudomonas aeruginosa

Question 23

What does a raised serum ACE level indicate?

Answer 23

Sarcoidosis

Question 24

Chest x-ray should ground-glass appearance with pleural thickening. Diagnosis?

Answer 24

Asbestosis

Question 25

Women presents with butterfly rash across her face, mouth ulcers and thrombocytopenic (low platelets). Autoantibody screening shows ds-DNA and ANA antibodies. Diagnosis?

Answer 25

Systemic lupus erythematosus

ANA antibodies test for lupus of rheumatoid arthritis

Question 26

Women presents with worsening breathlessness, problems with her eyes, joints and skin. An has autoantibodies present, anti-CCP. Diagnosis?

Answer 26

Rheumatoid arthritis

Question 27

What is reactive airways dysfunction syndrome

Answer 27

Asthma like syndrome after exposure to high levels of an irritating vapor, fume or smoke. E.g swimming pool chlorine

Question 28

Man presents with honeycomb lung, the lung spaces are enlarged stiff and fibrous. No evidence of inflammation. Diagnosis?

Answer 28

Idiopathic pulmonary fibrosis

Question 29

What is churg-strauss syndrome?

Answer 29

Allergic granulomatosis

Autoimmune condition inflamming blood vessels in the airways, commonly eosinophils present

Raised pANCA

Question 30

What is caplans syndrome a combination of?

Answer 30

Rheumatoid arthiritis and pneumoconiosis

Making intrapulmonary nodules

Question 31

Women presents with SOB, rash on lower legs, investigations show raised serum ACE and BIHILAL LYMPHADENOPATHY on chest xray. What is the diagnosis

Answer 31

Sarcoidosis

If bihilal lymphadenopathy then likely sarcoidosis