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WorksheetsEast Coast Medical Update Quiz session 3
Total questions: 8
Worksheet time: 5mins
The following is FALSE with regards to lung cancer diagnosis and management.
Liquid biopsy is a known test to diagnose T790M mutated lung cancer.
ALK positivity in NSCLC is assessed via FISH test.
Osimertinib is only indicated as 2nd line treatment for EGFR positive advanced NSCLC.
Pneumonitis is a known adverse effect of immunotherapy.
Which of the following is accurate regarding the treatment of severe asthma?
Routine prevention of exacerbations in severe asthma through the use of macrolide antibiotics is encouraged in all adult patients.
Antibiotic is indicated for all neutrophilic phenotype of asthma during acute exacerbation.
Methotrexate is among the recommended first-line treatment for adult severe asthma.
Mepolizumab is indicated for use as an add-on treatment for adult asthmatic with an eosinophilic phenotype of severe asthma.
Force exhaled nitric oxide (FeNO) measurement is recommended in uncontrolled asthma who did not respond to a combination of ICS and LABA therapy.
A 45 years old gentleman with a past history of intermittent asthma now presents with recurrent wheezing poorly controlled with formoterol/budesonide twice a day inhaler. He has a 20 pack-year history of tobacco smoking. Physical examination reveals a mild emphysematous chest and wheezing. Family history for asthma and allergic is positive.
The most correct statement is?
the diagnosis is eosinophilic phenotype asthma overlaps chronic obstructive pulmonary syndrome (ACOS).
the next step of treatment is add-on oral theophylline.
sputum eosinophil count is helpful to guide the next step of treatment.
repeat spirometer after three months add-on thiotropium bromide inhaler.
long term macrolide antibiotic reduces exacerbation.
A 31-year-old obese female with a history of asthma came for follow-up at Klinik Kesihatan. She is complaining of shortness of breath and dry cough. On assessment the finding is consistent with the diagnosis of moderate to severe exacerbation. She is on beclomethasone metered + salmeterol MDI and Montelukast daily. She tells you that she has been hospitalized many times for asthma flares and ICU admission once in the past.
Which of the following is the most beneficial management of this patient?
Obtain a chest radiograph to rule out pneumonia
Obtain a peak flow estimate
Salbutamol nebulizer therapy
Continue medications and add-on proton pump inhibitor for gasteroesophageal reflux associated obesity
Refer the patient to the local emergency room for evaluation and treatment
The following are causes of anterior mediastinal mass except.
Lymphoma
Thyroid mass
Terrible ganglioma
Thymic carcinoma
Chronic cough is defined as cough more than
2 weeks
4 weeks
6 weeks
8 weeks
12 weeks
A 45-year-old man with diabetes mellitus, hypertension and chronic kidney disease presented to emergency department with dyspnea for 2 days duration. On examination, blood pressure was 180/100 mmHg, heart rate was 95/min and respiratory rate of 20/min. The jugular venous pressure was elevated, apex beat displaced with bilateral pitting pedal edema
Chest radiograph revealed bilateral pleural effusion.
What is the best test to diagnose the cause of pleural effusion?
Pleural fluid LDH / Serum LDH ratio
Pleural fluid NT-pro BNP
Pleural fluid protein/ serum protein ratio
Pleuroscopy and biopsy
Transthoracic echocardiogram
Which disorder is not a part of Sleep Related Breathing Disorders?
Obstructive Sleep Apnea
Central Sleep Apnea
Sleep related hypoventilation disorders
Insomnia
Sleep related hypoxaemic disorders
