Week 8

Question 1

4 endotypes of COPD

Answer 1

1. eosinophilic
2. alpha 1 anti trypsin
3. persistent bacterial colonisation
4. persistent systematic inflammation

Question 2

3 COPD phenotypes

Answer 2

1. frequent exacerbations
2. persistent breathlessness
3. chronic bronchitis

Question 3

3 T1RF signs

Answer 3

pursed lips
accessory muscles
wheeze

Question 4

3 T2RF signs

Answer 4

flapping tremor
increased JVP
warm peripheries
cyanosis

Question 5

3 treatments for pneumothorax

Answer 5

1. aspiration
2. intercostal drain
3. VAT
   talc pleurodises
   pleural abrasion
   staple blebs

Question 6

3 pleural effusion examination signs

Answer 6

clubbing
ascites
lymphadenopathy

Question 7

3 features of parapneumoic effusion

Answer 7

1. LDH over 1000
2. Glucose less than 2.2
3. ph less than 7.2

Question 8

4 management of pleural infection

Answer 8

antibiotics
fibrinolytic
drain
surgery

Question 9

5 clinical signs of pleural effusion

Answer 9

1. decreased chest expansion
2. decreased tactile fremitis
3. quiet breath
4. rub
5. stony dull percussion

Question 10

OSA defintion

Answer 10

recurrent partial or complete airflow obstruction during sleep, intermittent hypoxia and sleep fragmentation

Question 11

measure for OSA

Answer 11

apnoea hypoxia index
ap+hypop / total time asleep

normal 0-4
moderate 15-29

Question 12

OSA symtoms

Answer 12

excessive daytime sleepiness with 2 +:
choking
decreased concentration 
recurrent awaking 
fatigue 
unrefreshing sleep

Question 13

apnoea

Answer 13

decreased airflow of over 90% for at least 10 seconds

Question 14

hypopnea

Answer 14

dressed airflow of over 30% for at least 10 seconds

Question 15

pathophysiology of OSA

Answer 15

pharyngeal narrowing
negative thoracic pressure
increases BP
decreases sleep

Question 16

epworth sleepiness score

Answer 16

0 to 10 = normal range of sleepiness in healthy adults.
11 to 14 = mild sleepiness.
15 to 17 = moderate sleepiness.
18 to 24 = severe sleepiness

Question 17

2 quizzes in OSA

Answer 17

stop bang

berlin

Question 18

oxygen desaturation index

Answer 18

no of times per hour that spo2 goes less than 4% from baseline

Question 19

compliance in CPAP

Answer 19

over 4 hours for over 70 days

Question 20

what is wheeze

Answer 20

narrowing

allergy

Question 21

what is stridor

Answer 21

whistling inspiration

Question 22

4 histological changes in asthma

Answer 22

1. subepithalial fibrosis
2. smooth muscle hypertrophy
3. thick BM
4. mast cell

Question 23

bronchial hyper responsiveness

Answer 23

drop of over 20% FEV1 by less than 8mg/ml of histamine or mannitol

Question 24

reversible airflow obstruction

Answer 24

over 15% improvement in FEV1 after 5mg nebulised salbutamol

Question 25

4 triggers of extrinsic allergic alveolitis

Answer 25

moulds humidifiers lung organic dust pigeon fanciers lung

Question 26

in EEA which type of hypersensitivity acute

Answer 26

3

Question 27

in EEA which type of hypersensitivity subacute

Answer 27

4

Question 28

4 clinical consequences of EEA

Answer 28

septa thickening loss of O2 with normal CO2 airspace shadowing T1RF

Question 29

management of EEA

Answer 29

1. avoid trigger 2. corticosteroids 3. oxygen

Question 30

4 lung cancer risks

Answer 30

1. smoking 2. HPV 3. radiation 4. polymorphisms in p450

Question 31

2 lung cancers in smoking

Answer 31

small cell and squamous cell

Question 32

2 consequences of a central tumour

Answer 32

hemoptisis | bronchial obstruction

Question 33

1 consequences of a peripheral tumour

Answer 33

pain

Question 34

3 consequences of a tumour in mediastinum

Answer 34

SVC obstruction and increased JVP recurrent laryngeal phrenic nerve paralysis

Question 35

3 non metatsic effects of lung cancer

Answer 35

ACTH - cuhsings ADH - SIADH PTH related peptide - hypercalcemia

Question 36

4 appearance of small cell

Answer 36

- oval to spindle shaped - inconspicuous nuclei - scant cytoplasm - nuclear moulding

Question 37

who gets adenocarcinoma and where is it

Answer 37

in periphery | non smoking females

Question 38

4 appearance of adenocarcinoma

Answer 38

glandular muslin production solid papillary

Question 39

squamous cell carcinoma where

Answer 39

major bronchi

Question 40

3 appearance of squamous cell carcinoma

Answer 40

cavitation intracellular bridges keratinisation

Question 41

diagnose of large cell carcinoma

Answer 41

diagnosis of exclusion | sheets of malignant undifferentiated cells

Question 42

6 other lung tumours

Answer 42

``` carcinoid mesenchymal salivary gland germ cell lymphatic ```

Question 43

non small cell lunger cancer med

Answer 43

EML 4 ALK

Question 44

what are 5 sarcoidosis symptoms

Answer 44

``` fever night swetas weight loss hemoptysis iritis cough chest apin ```

Question 45

3 physical findings of sarcoid

Answer 45

nodules on skin cardiac rub non specific neurological

Question 46

4 stages of sarcoid

Answer 46

1. bilateral hilar lympahdenopathy no infiltration 2. bel with infilled 3. infiltration alone 4. fibrotic bands, bull, hilarious retraction

Question 47

non nectrosing granulomatous

Answer 47

sarcoidosis

Question 48

2 treatment of sarcoid

Answer 48

NSAIDs | steroids

Question 49

4 histological of sarcoid

Answer 49

mastoid body cytokeritin calcification nuclei with giant cell

Question 50

idiopathic pulmonary fibrosis 6 features

Answer 50

``` breathlessness clubbing periperal linterstital pattern sub pleural honeycombing clubbing bibasalr crackles ```

Question 51

5 clinical presentation of IPF

Answer 51

``` bretahless hacking dry cough featigue weight loss clubbing ```

Question 52

4 causes of non IPF

Answer 52

CTD cocaine sarcoid genetic

Question 53

2 diagnose of IPF

Answer 53

HRCT | VATS

Question 54

treatment of IPF

Answer 54

pirfenidone

Question 55

fibroblastic foci spatial heterogeneity chicken wire

Answer 55

UIP