Block 5 - repiratory/ transplant

Question 1

How is trigeminal neuralgia treated?

Answer 1

NICE guidelines recommend starting carbamazepine 100mg twice daily for trigeminal neuralgia and titrating up as required to prevent symptoms.

Question 2

What are the first line treatment for cluster head ache prophylaxis?

Answer 2

Verapamil

Question 3

What classification is there for breathlessness?

Answer 3

MRC breathlessness scale

1 - no problems 
2 - SoB on uphill
3 - has to rest every 1/2 miles or every 15 mins 
4 - SoB after 100 yards
5 - cannot leave the house

Question 4

Aspergilosis

Answer 4

Fungi found in the lungs, becomes pathological in Immuno supressed (transplant), leakaemia, lymphoma. Managed with antibiotics but not eradicated.

Question 5

How is aspergilloma formed

Answer 5

Necrotised lung tissue from TB, HIV etc. forms a cavity where a ball of aspergillosis is present.

Question 6

What is ABPA?

Answer 6

Hypersensitivity to aspergillosis. Aspergillosis is present in everyone so the alleged source is with in the bronchioles, this is unlike an external allergen like in asthma.

Question 7

Are night sweats normal in pneumonia?

Answer 7

Normal for a few days, longer would indicate a red flag or other cause

Question 8

Why do COPD patients get headaches?

Answer 8

CO2 retention causes headaches.

Question 9

When doe LFTs ALT and AST become significant?

Answer 9

When they are twice there normal value

Question 10

What does a Cannon A waves in the JVP indicate?

Answer 10

Heart blocks where the Ventricle dissociation from the Atria contraction

Question 11

What are giant V waves of the JVP indicate?

Answer 11

Tricuspid regurgitation

Question 12

What heart sound is quiet due to a mumur?

Answer 12

AS causes quiet S2

MR causes quiet S1

Question 13

What peripheral signs of AR are there?

Answer 13

Quinkes sign
Collapsing pulse
Nodding head
Pistol shot fedoras

Question 14

What symptoms are there of AS?

Answer 14

Angina
SoB
Syncope

Question 15

What does the A waves of the JVP indicate?

Answer 15

End of Atria contraction

Question 16

What does the C waves of the JVP indicate?

Answer 16

TriCuspid closure and Ventricular contraction

Question 17

What does X descent indicate?

Answer 17

Filling of the atrium as it relaxes and enlarges

Question 18

What does the V wave of the JVP indicate?

Answer 18

Venous filling of the atrium

Question 19

What des Y descent of the JVP indicate?

Answer 19

Emptying of the atria during contraction

Question 20

Why doe PE not always cause infarction of tissue?

Answer 20

Some people have insufficient bronchial arteries for oxygenation of their lung tissue. Therefore when they depend on pulmonary veins for oxygenation as well which cess to flow during PE.

Question 21

What are the causes for heamatourea?

Answer 21

O - bstruction 
N - nephritic syndrome 
N - Neoplasm
I - infective 
T - trauma

Question 22

Causes for increased platelets (thromocythemia)

Answer 22

Bleeding, inflammation infection and malignancy