G

A 78-year-old male with longstanding acromegaly comes in with his

wife to the respiratory clinic for follow-up. He had been recently

diagnosed with obstructive sleep apnoea. Despite various lifestyle

modifications which he has undertaken such as losing weight and

exercising regularly he still reports being tired when he comes home

from work, he has restless sleep during the night with his wife often

been disturbed by his loud snoring.What would be the next step to consider in the management of his

obstructive sleep apnoea?

GA 65-year-old man is admitted with fever and dyspnoea. A chest x-ray

shows extensive shadowing in the right lower zone. Which one of the

following is associated with a poor prognosis in patients with

community-acquired pneumonia?

oWhich one of the following interventions is most likely to increase

survival in patients with COPD?

GA 72-year-old man presents with gradually increasing shortness-of-

breath on exertion over the past six months. He stopped smoking

around 20 years ago and had a number of jobs including a builder and

miner when he was younger. On auscultation of his chest fine crackles

can be heard in both bases. Oxygen saturations are 95% on room air.A number of tests are arranged:(cid:127) spirometry: normal

(cid:127) chest x-ray: diffuse reticular shadowing suggestive of fibrosis affecting the lower zones. Heart size normal. What is the most likely diagnosis?

漏Which of the following is not a recognised cause of pulmonary

eosinophilia?