PassMedicine

Question 1

which asthma medication may affect growth in young children

Answer 1

inhaled corticosteroids

Question 2

what would be found in spirometry from a patient with asthma

Answer 2

FEV1 - reduced
FVC - normal
FEV1:FVC ratio <70%

Question 3

example of SABA

Answer 3

salbutamol

Question 4

example of inhaled corticosteroid

Answer 4

beclometasone

Question 5

example of LABA

Answer 5

salmeterol

Question 6

example of LRA

Answer 6

monteleukast

Question 7

which organism causing pneumonia is associated with recent influenza infection

Answer 7

s. aureus

Question 8

which organism causing pneumonia is associated with a PMH of COPD

Answer 8

haemophilus influenzae

Question 9

what is the most common cause of pneumonia

Answer 9

streptococcus pneumoniae (80%)

Question 10

what organism causing pneumonia is associated with alcoholics

Answer 10

klebsiella pneumoniae

Question 11

what is first line with an exacerbation of asthma

Answer 11

SABA

Question 12

what is commonly referred to as the ‘reliever’ in asthmatics

Answer 12

SABA/blue pump/salbutamol

Question 13

what type of blood gas abnormality does life-threatening asthma cause

Answer 13

respiratory acidosis

Question 14

what level does the aorta and oesophagus perforate the diaphragm

Answer 14

oesophagus T10

aorta T12

Question 15

what are common causes of respiratory alkolosis

Answer 15

anxiety leading to hyperventilation
PE
CNS disorders (stroke, SAH, encephalitis)
pregnancy

Question 16

what does salicylate poisoning cause

Answer 16

mixed respiratory alkolosis + metabolic acidosis
early - resp alkalosis
late - metabolic acidosis

Question 17

what are common causes of respiratory acidosis

Answer 17

COPD
asthma
sedative drugs (benzodiazepines, opiates)

Question 18

what is the MOA for theophylline

Answer 18

non specific inhibitor of phosphodiesterase resulting in increased cAMP

Question 19

what are common causes of fibrosis affecting the upper zones

Answer 19

hypersensitivity pneumonitis (EAA)
coal workers pneumoconiosis
silicosis
sarcoidosis
TB

Question 20

what are common causes of fibrosis affecting the lower zones

Answer 20

idiopathic pulmonary fibrosis
most CTDs (RA) (except ankylosing spondylitis)
amiodarone, methotrexate, bleomycin
asbestosis

Question 21

what does Left shift on the oxygen dissociation curve mean

Answer 21

Lower oxygen delivery to tissues

Question 22

what does Right shift on the oxygen dissociation curve mean

Answer 22

Raised oxygen delivery to tissues

Question 23

what are causes of left shift (lower oxygen delivery)

Answer 23

HbF, methaemoglobin, carboxyhaemoglobin
low H+ alkalosis
low pCO2
low 2,3-DPG
low temp

Question 24

what are causes of right shift (raised oxygen delivery)

Answer 24

raised H+ (acidosis)
raised pCO2
raised 2,3-DPG
raised temp

Question 25

what are paraneoplastic features of small cell lung carcinoma

Answer 25

ADH secretion causing hyponatraemia | ACTH secretion

Question 26

what are paraneoplastic features of squamous cell lung carcinoma

Answer 26

hypercalcaemia secondary to PTH-rp hyperthyroidism due to ectopic TSH clubbing

Question 27

what are paraneoplastic features of adenocarcinoma

Answer 27

gynaecomastia

Question 28

is PSC more associated with UC or CD

Answer 28

UC

Question 29

what sort of condition is PBC

Answer 29

an autoimmune condition interlobar bile ducts become damaged by a chronic inflammatory processes which causes cholestasis and eventually cirrhosis

Question 30

what are the clinical features of PBC

Answer 30

a cholestatic picture (raised ALP, bilirubin) cholestatic jaundice hyperpigmentation (esp over pressure points) xanthelasmas + xanthomatas clubbing hepatosplenomegaly

Question 31

what are complications of PBC

Answer 31

malasorption | hepatocellular cancer

Question 32

what are retroperitoneal structures

Answer 32

``` duodenum (2nd/3rd/4th parts) ascending + descending colon pancreas kidneys ureters aorta IVC ```

Question 33

what are intraperitoneal structures

Answer 33

``` stomach duodenum (1st part) jejunum ileum transverse colon sigmoid colon ```

Question 34

what forms part of the mucosa of the GI tract

Answer 34

epithelium lamina propria muscularis mucosae

Question 35

what are the four layers of the GI tract

Answer 35

mucosa submucosa muscularis externa serosa or adventitia

Question 36

what is in the submucosa of the GI tract

Answer 36

meissners (submucosal) plexus which is used for secretion and blood flow

Question 37

what is in the muscularis externa of the GI tract

Answer 37

aeurbachs (myenteric) plexus which is used for motility of the GI smooth muscle

Question 38

An elderly man complains of dysphagia, halitosis, regurgitation and cough

Answer 38

pharyngeal pouch

Question 39

a 75-year-old man who used to work in a foundry presents with progressive dyspnoea. A chest x-ray shows upper zone interstitial lymph nodes with 'egg-shell' calcification of the hilar lymph nodes

Answer 39

silicosis

Question 40

a 50-year-old farmer presents with recurrent episodes of dyspnoea, cough and fever. A chest x-ray taken during one of these episodes shows mid-zone fibrosis

Answer 40

Extrinsic allergic alveolitis

Question 41

what is churg-strauss syndrome

Answer 41

``` an ANCA (anti-neutrophil cytoplasmic antibodies) associated small-medium vessel vasculitis lungs and kidneys are most affected ```

Question 42

what are features of churg-strauss syndrome

Answer 42

asthma eosinophilia sinusitis pANCA positive (is most cases)

Question 43

what is kartageners syndrome associated with

Answer 43

bronchiestatsis infertility situs inversus (organs swap sides)

Question 44

what are features of granulomatosis with polyangitis (wegeners granulomatosis)

Answer 44

autoimmune condition sinusitis, haemoptysis, haematuria cANCA

Question 45

what do cANCA and pANCA indicate

Answer 45

cANCA indicates wegeners granulomatosis | pANCA indicates churg-strauss syndrome

Question 46

Alcoholic/diabetic, 'red-currant jelly' sputum is associated with which condition

Answer 46

klebsiella pnuemoniae pneumonia

Question 47

what can klebsiella pneumoniae cause

Answer 47

pneumonia and urinary tract infections

Question 48

who are klebsiella infections common in

Answer 48

alcoholics and diabetes