Respiratory

Question 1

Causes of bronchiectasis

Answer 1

• Post-infective → TB, ABPA & childhood infection (pertussis, measles)
• Immunodeficiency → HIV & hypogammaglobulinaemia
• Congenital → cystic fibrosis, Kartagener’s & yellow nail syndrome
• Mechanical → cancer, fibrosis (traction) & bronchial obstruction
• Autoimmune → rheumatoid arthritis & SLE
• COPD

PICMAC

Question 2

Lateral thoracotomy scar differentials

Answer 2

• Lobectomy → cancer, localised bronchiectasis, abscess, aspergilloma, TB, infarct & haemorrhage
• Pneumonectomy → cancer, bronchiectasis & multiple abscesses
• Open lung biopsy
• COPD → volume reduction & bullectomy
• Single lung transplant
• Pleurectomy → recurrent effusion
• Thoracoplasty → TB
• Decortication → empyema

Question 3

Indications for lung transplant

Answer 3

• Alpha-1-antitrypsin
• Bronchiectasis
• Cystic fibrosis
• COPD
• Pulmonary fibrosis
• Pulmonary arterial hypertension

ABCCPPS

Question 4

Requirements for lung transplantation

Answer 4

• FEV1 > 1.5
• TF > 50%
• Good WHO functional status
• No severe pulmonary hypertension
• No metastases

Question 5

Complications of lung transplantation

Answer 5

• Rejection
• Infection → CMV, PCP, HSV, aspergillus & pneumonia
• Obliterative bronchiolitis

RIB

Question 6

Causes of transudative pleural effusion

Protein?

Answer 6

• Cirrhosis
• Hypoalbuminaemia
• CCF
• Nephrotic syndrome
• Myxoedema
• Meig’s syndrome

The failures

Protein < 30g/dL

Question 7

Causes of exudative pleural effusion

Protein?

Answer 7

• Malignancy
• Infection → parapneumonic, empyema & TB
• Connective tissue disease → rheumatoid arthritis & SLE
• Sarcoidosis
• Yellow nail syndrome
• Pancreatitis
• PE
• Asbestosis
• Drugs (same as the causes of pulmonary fibrosis)
• Dressler’s

MICSY PAD

Protein > 30g/dL

Question 8

Differential diagnoses of pulmonary fibrosis (upper)

Answer 8

• Coal workers’ pneumoconiosis
• Histiocytosis
• Ankylosing spondylitis
• Allergic bronchopulmonary aspergillosis
• Radiation
• Tuberculosis
• Silicosis (progressive massive fibrosis)
• Sarcoidosis

CHARTS

Question 9

Differential diagnoses of pulmonary fibrosis (lower)

Answer 9

• Rheumatoid arthritis
• Asbestosis
• SLE
• Sjögren’s
• Scleroderma
• Idiopathic pulmonary fibrosis
• Drugs → bleomycin, methotrexate, amiodarone, cyclophosphamide, phenytoin & nitrofurantoin

RASID