Resp

Question 1

Risk of lung cancer with

smoking?
Asbestos ?
Both?

Answer 1

10 fold.
5 fold.
50 due to synergistic effects

Question 2

Lofgrens syndrome?

Answer 2

BHL, polyarthritis, low grade fever

Type of sarcoid with excellent prognosis

Question 3

Causes of resp alkalosis

Answer 3

PE
Salicylate poisoning (often mixed)
Anxiety/hyperventilation
Pregnancy
Altitude
CNS - Stroke, SAH

Question 4

What is the commonest cause of ECOPD?

Answer 4

Haemophilus influenza

Question 5

Lab results suggestive of asthma in adults?

Answer 5

Eosinophils >0.5
FENO >50

Question 6

Where does lung cancer commonly metastasise to?

Answer 6

Supraclavicular and anterior cervical nodes.

Adrenals

Bone

Liver

Brain

Skin

Question 7

What is lamber eaton syndrome?

Answer 7

Assoc with SCLC

Proximal myopathy + reduced reflexes + autonomic features

Question 8

Where does a pancoast tumour typically occur?

Symptoms of pancoast syndrome?

Answer 8

Superior sulcus

Pain from 8th cervical and 1st thoracic nerve roots down medial side of UL and forearm to hand

Atrophy of small muscles of hand

Horners syndrome

Question 9

Treatment with which medication can predispose to Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

Answer 9

Leukotriene receptor antagonists (MontelukasT)

Question 10

Eggshell calcificantion

Answer 10

Sillicosis

Question 11

Commonest organism for bronchiectasis?

Answer 11

Haemophilus influenza

Question 12

Causes of reduced Transfer factor (TLCO)?

Answer 12

Pulmonary fibrosis
PE
Pulmonary oedema
Pneumonia
Emphysema
Anaemia
Low CO

Question 13

Causes of raised TF (TLCO)?

Answer 13

Asthma
Pulmonary haemorrhage
Left to right cardiac shunt
Male gender, exercise
Polycythaemia

Question 14

Cavitating upper lobe pneumonia in alcoholic?

Answer 14

Klebsiella

Question 15

FeNO level required to diagnose asthma in kids aged 5-16?

Answer 15

-/> 35

Question 16

Brittle asthma and bronchiectasis (tram track changes)?

Management?

Answer 16

Allergic bronchopulmonary aspergillosis.

Glucocorticoids/itraconazole

Question 17

Normal Po2 but low O2 sats

Answer 17

Think methaemoglobinaemia

Question 18

Bacteria in malt workers lung?

Answer 18

Aspergillus clavitus

Question 19

Bacteria in farmers lung?

Answer 19

Saccharopolyspora rectivirgula

Question 20

Mushroom workers lung?

Answer 20

thermophilic actinomycetes (Micropolyspora faeni)

Question 21

Causes of upper zone lung fibrosis

Answer 21

Hypersensitivity pneumonitis
Coal workers pneumoconiosis
Silicosis
Sarcoidosis
Ank spon
TB
Radiation induced fibrosis
Histiocytosis

Question 22

Causes of lower zone fibrosis?

Answer 22

Idiopathic pulmonary fibrosis
CTD (except ank spon)
Drug induced
Asbestosis

Question 23

Contraindications to lung cancer surgery?

Answer 23

FEV1 <1.5
SVC obstruction
Malignant effusion
Vocal cord paralysis

Question 24

Gene associated with bronchiectasis

Answer 24

HLA- DR1

Question 25

Features of transudate effusion

Answer 25

Protein <30g/l

Question 26

Protein in exudate effusion?

Answer 26

>30g/l

Question 27

Lights criteria for exudate effusion if protein 25-30

Answer 27

Pleural LDH/serum LDH >0.6 Pleural LDH > 2/3rds upper limit of normal serum LDH Pleural protein/serum protein >0.5

Question 28

Criteria for ARDS

Answer 28

Acute onset (< 1 week of a known risk factor). Pulmonary oedema: bilateral infiltrates on chest x-ray ('not fully explained by effusions, lobar/lung collapse or nodules) non-cardiogenic (pulmonary artery wedge pressure needed if doubt) pO2/FiO2 < 40kPa (300 mmHg)

Question 29

Altitude related disorders

Answer 29

Altitude sickness Altitude related pulmonary oedema - uneven hypoxic pulmonary vasoconstriction >> uneven blood flow to lungs. Altitude related cerebral oedema - cerebral vasodilation