Passmedicine

Question 1

Three ways to help with smoking cessation

Answer 1

nicotine replacement therapy
varenciline
buproprion

Question 2

what is varenciline

Answer 2

a nicotinic receptor partial agonist
should be started 1 week before the patients target date to stop
the recommended course of treatment is 12 weeks (but patients should be monitored regularly and treatment only continued if not smoking)
has been shown in studies to be more effective than bupropion
nausea is the most common adverse effect. Other common problems include headache, insomnia, abnormal dreams
varenicline should be used with caution in patients with a history of depression or self-harm. There are ongoing studies looking at the risk of suicidal behaviour in patients taking varenicline
contraindicated in pregnancy and breast feeding

Question 3

what is buproprion

Answer 3

a norepinephrine and dopamine reuptake inhibitor, and nicotinic antagonist
should be started 1 to 2 weeks before the patients target date to stop
small risk of seizures (1 in 1,000)
contraindicated in epilepsy, pregnancy and breast feeding. Having an eating disorder is a relative contraindication

Question 4

which side are you more likely to get an aspiration pneumonia

Answer 4

right

Question 5

keratin pearl

Answer 5

squamous cell carcinoma of the lung

Question 6

psammoma bodies

Answer 6

papillary thyroid cancer

Question 7

owls eye nuleus

Answer 7

CMV infection

Question 8

epitheloid histocytes

Answer 8

sign of granuloma - TB

a macrophage which becomes elongated to look like an epithelial cell.

Question 9

kartengers syndrome

Answer 9

dextrocardia and bronchietesis
recurrent sinusitis and reduced fertility
genetic condition resulting in immotile cilia

Question 10

high ACE levels

Answer 10

sarcoidosis

Question 11

signs of heart failure on chest x ray

Answer 11

Alveolar oedema (bats wing)
B kerley B lines
Cardiomegaly
Dilated prominent upper lobe vessels
Effusions

Question 12

treatment of legionella pneumonia

Answer 12

erythromycin

Question 13

diagnosis of legionella

Answer 13

urinary antigen

Question 14

diagnosis of mycoplasma pneumonia

Answer 14

serology

Question 15

characteristic feature of PCP

Answer 15

desaturation on exercise

Question 16

what type of bacteria is klebiella

Answer 16

gram negative rod

Question 17

who gets klebsiella pneumonia

Answer 17

alchohilics and diabetics

Question 18

features of klebiseilla

Answer 18

RED CURRENT JELLY SPUTUM
upper lobes
commonly causes lung absesses and emphyema
high mortality

Question 19

indications for long term oxygen therapy in COPD

Answer 19

Offer LTOT to patients with a pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following:
secondary polycythaemia
nocturnal hypoxaemia
peripheral oedema
pulmonary hypertension

Question 20

cannonball mets are usually caused by

Answer 20

renal cell carcinoma

Question 21

what atypical is associated with cold agglutination

Answer 21

mycoplasma

Question 22

what atyipical pneumonia is stained with india ink

Answer 22

cryptococcus