Medicine Tips 7

Question 1

Atrial myxoma

Answer 1

Benign tumour occurring in the left atrium

Mitral valve obstruction + systemic embolisation + constitutional symptoms

Question 2

Pulmonary fibrosis

Answer 2

Upper zones - CHARTS - coal worker’s pneumoconiosis/progressive massive fibrosis, hypersensitivity pneumonitis (AKA extrinsic allergic alveolitis), histiocytosis, ankylosing spondylitis (rare), tuberculosis, silicosis, sarcoidosis
Lower zones - idiopathic pulmonary fibrosis, connective tissue disorders (except ankylosing spondylitis) e.g. SLE, drug-induced - amiodarone, bleomycin, methotrexate
asbestosis

Question 3

Respiratory acidosis

Answer 3

Life-threatening asthma (decompensated), COPD, neuromuscular disease, opiate overdose, benzodiazepines overdose, obesity hypoventilation syndrome

Question 4

Respiratory alkalosis

Answer 4

Pulmonary embolism, anxiety leading to hyperventilation, CNS disorders (e.g. stroke, subarachnoid haemorrhage, encephalitis), salicylate poisoning (initial stages), pregnancy, altitude