Each one of the following is a risk factor for lung cancer, except:
Correct Answer C:
Lung cancer: risk factors:
Smoking:
Other factors:
Factors that are NOT related:
Smoking and asbestos are synergistic, i.e. a smoker with asbestos exposure has a 10 * 5 = 50 times increased risk.
A 42-year-old woman presents with pyrexia and a productive cough. Around 10 days ago she developed symptoms consistent with a flu-like illness. For around 4-5 days she was in bed with myalgia, fever and lethargy. Initially there was an improvement in her condition but over the past three days she has developed a cough productive of thick pink-yellow sputum. On examination there are scattered crackles in the right base. Her symptoms are not severe enough to warrant admission and oral amoxicillin is prescribed.
Which other medication should also be given?
Correct Answer D: There is a high incidence of Staphylococcus aureus pneumonia in patients following influenza. As a result the BNF advises the co-prescription of flucloxacillin in such a situation.
Pneumonia: community-acquired:
Community acquired pneumonia (CAP) may be caused by the following infectious agents:
Klebsiella pneumoniae is classically in alcoholics.
Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia.
Characteristic features of pneumococcal pneumonia:
Management:
The British Thoracic Society published guidelines in 2009:
You review a 28-year-old woman with no past medical history of note. For the past week she has being experiencing left sided pleuritic chest pain. Her GP treated her for pleurisy with amoxicillin but there has been no improvement in her symptoms. She denies any shortness of breath and oxygen saturations on room air are 98%. A chest x-ray shows a 20% pneumothorax on the left side.
What is the most appropriate management?
Correct Answer C: Questions sometimes discuss the size of the pneumothorax in percentage terms rather than giving the interpleural distance. A variety of formulas have been proposed to convert between the two.
As a very general rule of thumb:
A pneumothorax of 20% if therefore within the 2 cm limit suggested by the British Thoracic Society for observation, if the patient is not short of breath.
Pneumothorax:
The British Thoracic Society (BTS) published updated guidelines for the management of spontaneous pneumothorax in 2010. A pneumothorax is termed primary if there is no underlying lung disease and secondary if there is.
1- Primary pneumothorax:
Recommendations include:
2- Secondary pneumothorax:
3- Iatrogenic pneumothorax:
What is the mode of inheritance of alpha-1 antitrypsin deficiency?
Correct Answer D: Alpha-1 antitrypsin deficiency - autosomal recessive / co-dominant.
Alpha-1 antitrypsin deficiency is also sometimes listed as being an autosomal co-dominant condition. Unfortunately trusted sources vary - how would you classify A1AT?
Alpha-1 antitrypsin deficiency:
Alpha-1 antitrypsin (A1AT) deficiency is a common inherited condition caused by a lack of a protease inhibitor (Pi) normally produced by the liver. The role of A1AT is to protect cells from enzymes such as neutrophil elastase.
Genetics:
Features:
Investigations:
*Trusted sources are split on which is a more accurate description.
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