Exam (elaborations)
ROYAL COLLEGE OF SURGEONS IRELAND-CARDIORESPIRATORY MEDICINE PAST YEAR PAPERS
- Module
- Institution
MAY 2008 MCQ AND ESSAY QUESTIONS
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IC1 CardiorespiratoryMay 2008
Duration: 1 hour, 45 minutes
All 5 questions to be answered in separate answer books
Section A: CPC
1. A 14-year old male returns to the cystic fibrosis clinic after a 2-year absence
complaining of increased productive cough, yielding thick green sputum,
breathlessness, generalized lethargy and weight loss. He was diagnosed with
cystic fibrosis at 2 years of age, but apart from occasional respiratory infections,
he has remained well in the intervening period.
A. What is the underlying defect in cystic fibrosis?
Abnormal apical membrane chloride channel defect resulting in reduced volume
and increased hyperviscosity of mucosal secretions leading to end –organ
damage.
B. List four major complications of cystic fibrosis?
Recurrent Pulmonary Infection w P.aeruginosa and S. Aureus
Chronic Bronchitis
Pulmonary Hypertension
Malabsorption
Gastro Oesophageal Reflux Disease
Meconium ileus
C. How is a diagnosis of cystic fibrosis confirmed?
Sweat test will have elevated level of NaCl
DNA probe test
At the clinic he is apyrexial but has widespread rhonchi and crepitations
throughout both lung fields. His pulmonary function tests are as follows: forced
vital capacity (FVC) 45%, forced expiratory volume in one second (FEVI) 50%.
A chest X-ray reveals diffuse shadowing with bronchiectatic changes throughout
both lung fields. A sample of sputum is obtained for culture and he is admitted
to the cystic fibrosis unit for further management.
D. Explain the terms underlined in the text.
Rhonchi- coarse rattling sound somewhat like snoring, usually caused by secretion in
bronchial airways
Crepitation- rattling or crackling sound like that made by rubbing hair between the
fingers close to the ear
E. What is bronchiectasis?
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