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1
Q

Budd-Chiari syndrome

A

Hepatic vein obstruction - triad: severe abdominal pain, ascites and tender hepatomegaly

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2
Q

Shifting dullness

A

Ascites

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3
Q

Helper T cells

A

Recognise antigens presented by MHC II molecules, CD4+

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4
Q

T cells develop in

A

Thymus

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5
Q

First antibody to be released in infection

A

IgM

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6
Q

Interferon y

A

Cytokine released from Th1 cells and activates macrophages

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7
Q

B Cells

A

Responsible for antibody productio

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8
Q

IgA

A

Provides protection on mucous membranes, breast milk

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9
Q

Cytotoxic T cells

A

Recognise antigens presented by MHC class I molecules, CD8

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10
Q

Opsonisation

A

Making a foreign cell more susceptible to phagocytosis

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11
Q

Obstructive spirometry

A

FEV1/ FVC < 0.7

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12
Q

COPD FEV1 >80

A

Mild

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13
Q

COPD FEV1 50 -80%

A

Mod

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14
Q

COPD FEV1 30-50

A

Severe

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15
Q

COPD FEV1 <30%`

A

V. severe oopsie nono breathing well

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16
Q

Dyspnoea scale

A 
Breathless when 
1 - strenuous exercise 
2 - speed walk or hill 
3 - normal walk 
4 - 100 m 
5 - putting on socks type vibe
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17
Q

COPD management

A

SAVIM

  • smoking cessation
  • active lifestyle
  • vaccination
  • initial pharmacotherapy
  • manage comorbidities
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18
Q

Greater effect on exacerbations - LABA or LAMA?

A

LAMA

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19
Q

ICS in COPD what does tommy fardon want you to remember

A

ICS/LAMA/LABA triple therapy if eosinophils are >300 cells per microL

20
Q

Oral glucocorticoids in COPD

A

Na

21
Q

Reasons you wouldn’t prescribe a silly COPD triple therapy

A

Repeated pneumonia, Low blood eosinophils <100 cells/microL, Mycobacterial infection history

22
Q

A on the cheeky gold square

A

Bronchodilator

0-1 exacerbations a year, CAT less than 10 mMRC 0-1

23
Q

B GOLD square

A

LABA or LAMA

0-1 exacerbations a year 0-1 mMRC, CAT 10 or more

24
Q

D GOLD square

A

LAMA or LAMA/LABA or ICS/LABA

CAT 10 or more, mMRC 2 or more, 2+ exacerbations or 1 hospitalisation

25
Q

C GOLD square

A

LAMA

2 or more exacerbations a year/ 1 hospitalisation, mMRC 0-1 CAT less than 10

26
Q

COPD surgical management

A

Lung volume reduction, bullectomy, transplantation, bronchoscopic interventions - lung coils, vapor ablation

27
Q

Only option for patients with pulmonary hypertension

A

Lung transplantation

28
Q

Long term oxygen therapy offered when

A

Patient has stopped smoking for 3 months, SaO2 < 92, COPD management optimised w/ no improvement and ABG taken

29
Q

Chronic t2 respiratory failure

A

Metabolic compensation for chronic respiratory acidosis

30
Q

Acute on chronic t2 respiratory failure

A

Chronic T2 respiratory failure shifted to acidaemia as pCO2 rises

31
Q

Releases from postganglionic fibres causing airways smooth muscle to relaxxxx

A

NO and VIP

32
Q

Which receptors mediate ASM contraction and mucus secretion?

A

M3 receptors

33
Q

Chronic asthma pathology

A 
1 - Increased ASM mass 
2 - Accumulation of interstitial fluid 
3 - Increased secretion of mucus
4 - Epithelial damage (exposed nerve endings) 
5 - Sub-epithelial fibrosis
34
Q

Asthma management summary

A 
SABA and ICS 
Still bad?
LABA i.e. formetarol 
Still bad?
No LABA response or isnt enough stop it and increase ICS, trial methylxanthines/LAMA/leukotriene receptor antagonist
35
Q

Montelukast

A

Leukotriene receptor antagonist

36
Q

Asthma exacerbation

A

If infection signs - antimicrobials

Oral steroids and increase ICS

37
Q

Type of response in mild to moderate asthma

A

Th2

38
Q

Type of response in severe asthma

A

Th1 and Th2

39
Q

Aspergillosis

A

Life-threatening fungal infection that generally only occurs in very immunosuppressed patient

40
Q

Allergic Broncho-pulmonary aspergillosis

A

Allergic response to apergillus

41
Q

Childhood onset, asthma, eczema and rhinitis

A

Allergic asthma

42
Q

Asthma, females, adult onset, steroid resistant, prednisolone treated, anti-allergy not effective

A

Eosinophilic asthma

43
Q

Treatment of eosinophilic asthma

A

Mepolizumab or benralizumab - anti Il-5 s

44
Q

Hydrostatic pressure

A

Pressure pushing fluid out of capillaries

45
Q

Oncotic pressure

A

Pressure pushing fluid into capillaries

46
Q

Most likely bronchiolitis cause

A

Respiratory synctial virus

47
Q

Most common cause of croup

A

Parainfluenza virus

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