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Zero to Finals Flashcards

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1
Q

61 year old smoker with haemotysis?

Diagnosis and types?

A

Lung cancer

Adenocarinoma (40%)
Squamous cell carincoma (20%)
Small cell lung cancer (20%)

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2
Q

61 year old smoker with haemotysis.

Cause of a hoarse voice?

A

Recurrent laryngeal nerve palsy

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3
Q

61 year old smoker with haemotysis.

Cause of partial ptosis, anhidrosis and miosis?

A

Horner’s syndrome -> Pancoast’s tumour

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4
Q

61 year old smoker with haemotysis.

Cause of hyponatraemia?

A

SIADH -> SCLC

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5
Q

61 year old smoker with haemotysis.

Investigation for getting histological diagnosis?

A

Bronchoscopy with EBUS and biopsy

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6
Q

61 year old smoker with haemotysis.

Scan for increased metabolic activity in metastasis?

A

Position emission tomography (PET-CT)

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7
Q

61 year old smoker with haemotysis.

Malignancy associated with asbestos

A

Mesothelioma

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8
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Diagnosis?

A

Pneumonia

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9
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Criteria for hospital acquired pneumonia?

A

> 48hrs after admission

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10
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Scoring system?

A

CURB 65

Confusion 
Urea >7 
Resp rate >/ 30 
Blood pressure <90 systolic/< or equal to 60 diastolic 
Over 65 years old
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11
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Most common cause?

A

Streptococcus pneumoniae

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12
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with hyponatraemia?

A

Legionella pneumoniae

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13
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with erythema multiforme?

A

Mycoplasma

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14
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with farmer?

A

Coxiella burnetti (Q-fever)

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15
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with parrot breeder?

A

Chlamydia psittaci

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16
Q

72 year old presents with a productive cough, fever and breathlessness. A CXR shows a right sided, middle zone consolidation.

Atypical cause with chronic wheezy child?

A

Chlamydophilia

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17
Q

19 year old with chronic nocturnal cough and wheezing episode.

Diagnosis?

A

Asthma

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18
Q

19 year old with chronic nocturnal cough and wheezing episode.

First line testing with NICE guidelines?

A

Fractional exhaled nitrous oxide (DeNO)

Spirometry with reversibility testing

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19
Q

19 year old with chronic nocturnal cough and wheezing episode.

Treatment step 1 & 2?

A

Step one: SABA

Step two: Low dose inhaled corticosteroids

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20
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of salneterol?

A

Long acting beta 2 agonist

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21
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of tiotropium?

A

Long acting muscarinic antagonist

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22
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mechanism of action of montelukast?

A

Leukotriene receptor antagonist

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23
Q

19 year old with chronic nocturnal cough and wheezing episode.

Mediations used in moderate attack?

A

Nebulised salbutamol
Nebulised ipratropium bromide
Steroids

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24
Q

Long term smoker with a chronic cough and recurrent chest infections?

Diagnosis?

A

COPD

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25
Long term smoker with a chronic cough and recurrent chest infections? Dyspnoea scale?
MRC Dyspnoea Scale
26
Long term smoker with a chronic cough and recurrent chest infections? Diagnostic test?
Spirometry
27
Long term smoker with a chronic cough and recurrent chest infections? FEV1/FVC ratio?
< 0.7
28
Long term smoker with a chronic cough and recurrent chest infections? Step 1 of treatment?
Short-acting bronchodilators
29
Long term smoker with a chronic cough and recurrent chest infections? Step two of treatment if asthmatic?
LABA + inhaled corticosteroids
30
Long term smoker with a chronic cough and recurrent chest infections? Step 2, no asthmatic features?
LABA + LAMA
31
Long term smoker with a chronic cough and recurrent chest infections? Treatment of an acute exacerbation?
- Bronchodilators (eg Ipratropium) - Steroids (eg Prednisolone) - Antibiotics if infection)
32
Long term smoker with a chronic cough and recurrent chest infections? Target sats when retaining CO2?
88-92%
33
Long term smoker with a chronic cough and recurrent chest infections? Criteria for non-invasive ventilation (NIV)?
pH < 7.35 | PaCO2 > 6 despite treatment
34
74 year old non-smoker with bibasal fine inspiratory crackles? Fingernail changes?
Clubbing
35
74 year old non-smoker with bibasal fine inspiratory crackles? Diagnosis?
Idiopathic pulmonary fibrosis
36
74 year old non-smoker with bibasal fine inspiratory crackles? Diagnostic test?
High resolution CT
37
74 year old non-smoker with bibasal fine inspiratory crackles? Characteristic test finding?
"Ground glass" appearance to lungs
38
74 year old non-smoker with bibasal fine inspiratory crackles? Life expectancy post diagnosis?
2-5 years
39
74 year old non-smoker with bibasal fine inspiratory crackles? Medication to slow disease progression?
- Pirfendione | - Nintedanib
40
74 year old non-smoker with bibasal fine inspiratory crackles? Medication that cause similar lung pathology?
- Amiodarone - Cyclopathosphamide - Methotrexate - Nitrofurantoin
41
21 year old tall slim male with sharp chest pain on inspiration and shortness of breath. Diagnosis?
Pneumothorax
42
21 year old tall slim male with sharp chest pain on inspiration and shortness of breath. Investigations?
Chest X-ray
43
21 year old tall slim male with sharp chest pain on inspiration and shortness of breath. Cutoff for treatment if not short of breath?
More than 2cm rim of air on CXR
44
21 year old tall slim male with sharp chest pain on inspiration and shortness of breath. Treatment options?
- Aspiration | - Chest Drain
45
56 year old with progressive shortness of breath? Diagnosis?
Pulmonary hypertension
46
56 year old with progressive shortness of breath? 5 groups of causes?
1. Primary pulmonary hypertension 2. Left sided heart failure 3. Chronic lung disease (eg COPD) 4. Pulmonary vascular disease (eg PE) 5. Miscellaneous (eg sarcoidosis)
47
56 year old with progressive shortness of breath? Clinical skills?
- Tachycardia - Hepatomegaly - Raised JVP - Peripheral oedema
48
56 year old with progressive shortness of breath? ECG changes?
- Right ventricular hypertrophy - Right axis deviation - Right bundle branch block
49
56 year old with progressive shortness of breath? Chest Xray?
- Dilated pulmonary veins | - Right ventricular hypertrophy
50
56 year old with progressive shortness of breath? Raised blood test?
NR-PRO BNP
51
30 year old black woman with a dry cough and shortness of breath? Diagnosis?
Sarcoidosis
52
30 year old black woman with a dry cough and shortness of breath? What are granulomas?
Nodules of inflammation full of macrophages
53
30 year old black woman with a dry cough and shortness of breath? Tender lumps on shins?
Erythema nodosum
54
30 year old black woman with a dry cough and shortness of breath? Screening blood test?
Serum ACE
55
30 year old black woman with a dry cough and shortness of breath? Electrolyte abnormality?
Hypercalcaemia
56
30 year old black woman with a dry cough and shortness of breath. CXR finding?
Hilar lymphadenopathy
57
30 year old black woman with a dry cough and shortness of breath? Gold standard investigation?
Histology (biopsy)
58
30 year old black woman with a dry cough and shortness of breath? First line treatment?
Steroids
59
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Diagnosis?
Obstructive Sleep Apnoea
60
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Risk factors not mentioned?
- Smoking | - Alcohol
61
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Key morning symptom?
Headache
62
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Scale?
Epworth sleepiness scale
63
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Refer to?
ENT/Sleep clinic
64
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Step after correcting risk factors?
Continuous positive airway pressure (CPAP) machine used during sleep
65
57 year old obese man presents with snoring and daytime sleepiness. His wife reports episodes where he stops breathing during sleep. Surgical prodecure?
Uvulopalatopharyngoplasty | UPPP

Respiratory (32 decks)

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