Respiratory

Question 1

What are symptoms of an Aspergilloma?

Answer 1

• SOB
• Haemoptysis
• Undelrying lung disease - especially TB, but also COPD
• Occurs in immunocompromised patients e.g. HIV

Question 2

Features of bronchiectasis

Answer 2

• chronic cough with sputum production
• recurrent respiratory tract infections
• haemoptysis
• COARSE inspiratory crackles
• wheeze can occur during an exacerbation

Question 3

What are the features of Mesothelioma

Answer 3

• malignancy of mesothelioma cells of pleura of the lungs associated with asbestos exposure
  Typically presents with:
• chest pain
• SOB
• weight loss
• pleural effusion
• CT pleural thickening

Question 4

What is sarcoidosis?

Answer 4

• multi-system inflammatory disease
• Non-necrotising, non-caseating granulomatous disease

Question 5

What is the presentation of sarcoidosis?

Answer 5

• Pulmonary fibrosis
• erythema nodosum
• hypercalaemia (PTH suppressed)
• cough
• raised ACE

Question 6

What is the classic CXR findings in sarcoidosis?

Answer 6

BILATERAL HILAR LYMPHADENOPATHY

Question 7

Why do you get hypercalcaemia in sarcoidosis?

Answer 7

Due increased production of 1,25-dihydroxyvitamin D by activated macrophages in the granulomas.

Question 8

What is the second line treatment for COPD after salbutamol inhaler?

Answer 8

Inhaled tiotropium and salmeterol

Question 9

What is atelectasis?

Answer 9

Alveolar are deflated/collapsed

Most commonly occurs after surgery due to splinting, i.e. restricted breathing after abdominal surgery. Atelectasis develops in 75–90% of people undergoing general anesthesia for a surgical procedure

Symptoms
- SOB
- Cough
- Low O2 sats
- Fever

Question 10

What is the presentation of a fat embolism?

Answer 10

• associated with fractures of long bones
  Hypoxia
• SOB
• petechiae over chest and upper extremities
• neurological symptoms - confusion, altered level of consciousness, seizures