Questions
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0votes
1ans
317
views
What is the diagnostic approach to interstitial lung disease - when is HRCT sufficient vs surgical lung biopsy needed?
60-year-old male with progressive exertional dyspnea, dry cough for 1 year. HRCT shows basal bilateral honeycombing with traction bronchiectasis. No identifiable cause. How do I ap…
0votes
0ans
382
views
When should asthma therapy be stepped up from ICS alone to ICS/LABA, and what triggers biologics?
25-year-old with diagnosed asthma. Currently on moderate-dose ICS, still using SABA 3x/week, waking at night twice a month. What step is this and when should I add LABA vs refer fo…
0votes
1ans
279
views
How is spontaneous pneumothorax managed - needle aspiration vs chest tube, and when is surgery indicated?
25-year-old tall male, first episode of right-sided pneumothorax, 3 cm on CXR. Mildly symptomatic. Do I observe, aspirate or insert a chest tube? And at what point should VATS be c…
0votes
1ans
264
views
What is the initial management of massive hemoptysis and when is bronchial artery embolization indicated?
Patient with TB history now coughing up >200 mL blood in 24 hours. SpO2 dropping. Is this massive hemoptysis? What are the immediate airway/positioning steps and when should we pro…
0votes
1ans
208
views
How is pulmonary arterial hypertension classified and what are treatment options for WHO Group 1 PAH?
35-year-old woman with progressive exertional dyspnea, mPAP 45 mmHg on right heart catheterization, no secondary cause found. How is PAH classified and what drugs should be started…
0votes
1ans
233
views
When should BiPAP/NIV be started in COPD exacerbation with hypercapnic respiratory failure?
COPD patient ABG: pH 7.29, pCO2 68, pO2 55 on controlled O2. Currently on nebulized bronchodilators and IV steroids. Drowsy but rousable. What are the criteria for NIV initiation a…
0votes
1ans
203
views
Which severity score is better for community-acquired pneumonia - CURB-65 or PSI? And what are ICU admission criteria?
70-year-old with fever, productive cough, RR 28/min, BUN 28, confusion, SpO2 90%. How do I score severity and determine hospitalization vs ICU admission?
0votes
1ans
187
views
How do you diagnose pulmonary embolism - when is D-dimer enough vs when is CTPA needed?
35-year-old post-surgery patient with sudden onset pleuritic chest pain and tachycardia. Wells score 4. D-dimer is elevated. Should I go straight to CTPA or is VQ scan better here?
0votes
1ans
167
views
How do you approach diagnosis of a unilateral pleural effusion — when is thoracentesis mandatory?
45-year-old with unilateral dullness on percussion and reduced breath sounds at left base. CXR shows left-sided opacity. No prior known disease. How do I differentiate transudative…
0votes
1ans
168
views
What is the stepwise management of acute COPD exacerbation in the ED?
65-year-old with COPD (FEV1 40% predicted) presents with increased dyspnea, purulent sputum, and SpO2 84% on room air. RR 28/min. What are the immediate and subsequent management s…
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