Week 4

Question 1

Which part of the lung is affected in TB? What does TB cause?

Answer 1

The top of the lungs, causes tissue damage, scarring

Question 2

What are some of the clinical presentations of TB?

Answer 2

Weight loss
Malaise
Coughing blood
Breathlessness
Crackles in upper

Question 3

How can you diagnose TB?

Answer 3

PCR, ziel neeson stain, tuberculin test

Question 4

What is the treatment for TB?

Answer 4

Antibiotics for 6 months

RIPE
Rifampicin isonazid pyrazinamide ethanbutol

Question 5

What is the side effects of rifampicin

Answer 5

Turns urine pink

Question 6

What are the potential side effects of isoniazid

Answer 6

Cause renal failure, hepatitis, neropathy

Question 7

What causes TB?

Answer 7

Mycobacterium

Question 8

Who is at risk of developing pleural infection?

Answer 8

Those with type 1 diabetes, the immunosuppresed (corticoid steroids), alcoholics, drug users

Question 9

What is a ghon focus?

Answer 9

Consolidation of the lung in the periphery of the mid lung

Question 10

What organism usually causes community acquired pneumonia? What is it alpha or beta haemolytic?

Answer 10

Streptococcus pneumoniae
HAEMOphillis influenza
Klebsiella pneumonia (causing red jelly)
Alpha haemolytic

Question 11

How can you treat pneumonia

Answer 11

Amoxicillin
Doxycyline
Co-amoxiclav

Question 12

What does moraxella catarrhalis effect?

Answer 12

Can affect whole resp system and cause sinitis

Question 13

What are the common micro-organisms to cause an exacerbation of asthma or COPD

Answer 13

Haemophilus influenzae

Moraxella catarrhalis

Streptococcus pneumoniae

Question 14

Someone presents with an inspiratory whooping sound, they are also vomiting and coughing. What microorganism is cause?

Answer 14

Whooping cough caused by bordetella pertussis

Question 15

What is first line antibiotic for community acquired pneumonia?

Answer 15

Amoxicillin or doxycycline

Question 16

What are the antibiotics used to treat hospital acquired pneumonia?

Answer 16

Amoxicillin metronidazole gentamicin

Question 17

Young male presents with repeated chest infections, salty sweat, coughing up thick mucus, pancreatic obstruction and chronic colonisation of pseudomonas aeruginosa and burkholderia cepacia and he is infertile. What does he have?

Answer 17

Cystic fibrosis

Question 18

What is the term for chronic dilation of the bronchus?

Answer 18

Bronchiectasis

Question 19

What are the two main causative organisms for TB?

Answer 19

Mycobacterial tuberculosis and M. Bovis (cows)

Question 20

Name some clinical features of immunodeficiency

Answer 20

Weight loss
Skin rash
Diarrhoea
Ulcers in mouth 
Recurrent infections

Question 21

Child 3 days old presents with serious infection, blood samples taken and no wbcs are detected. What autoimmune disease do they have?

Answer 21

Recticular dysgenesis

Stem cells dont differentiate into WBCs

Question 22

Young child presents with recurrent infections, bloods show T and B cells are normal but neutrophil count is low. What is diagnosis?

Answer 22

Kostmann syndrome

Inability to produce neutrophils

Question 23

Young child presents with failure to thrive, has recurrent infections. Bloods show normal B cells, T cells, and WBCs. Diagnosis?

Answer 23

Chronic granulomatous disease

Where ROS isn’t produced so chronic inflammation

Question 24

Child presents with low set ears, cleft pallet, small mouth and jaw. Poorly developed oesophagus and heart. What condition? What chromosome

Answer 24

Digeorge syndrome

Chromosome 22

Question 25

What can a narrowing of the supraglottis or subglottis region cause?

Answer 25

Stridor- an inspiratory wheeze

Question 26

Child presents with barking cough, stridor and a hoarse voice. What is it? Caused by ?

Answer 26

Croup Influenza A and B

Question 27

What is gout

Answer 27

Inflammatory arthritis (red hot tender swollen joints)

Question 28

An obese man presents to you with poor sleeping pattern, claims to be snoring and finds himself falling asleep during the day. What is his diagnosis?

Answer 28

Obstructive sleep apnoea Upper airway problem due to relaxation of pharyngeal dilatory muscles causing flopping

Question 29

A immunodeficiency causing impariment of cillia

Answer 29

Kartenagers

Question 30

What is the umbrella term for a combination of syndromes including bronchiectasis, rhinosinusitis, reduced fertility?

Answer 30

Young’s syndrome

Question 31

What type of organism usually cause intrapulmonary abscess? How would you treat?

Answer 31

Gram negative organisms like ecoli- treat with gentamycin Also streptococcus and staphylococcus which treat with levofloxacin

Question 32

A man has an X-ray and shows a D shapped opaqueness, what is diagnosis

Answer 32

Empyema (puss in pleural space)

Question 33

What is the pump in cystic fibrosis that causes the secretions to be dry? Treatment of cystic fibrosis?

Answer 33

CTFR pump which pumps Cl- ions out of the cell, but in this case it is broken so cl- remains intracellularly so the cl- Na+ symport then doesnt work causing sodium to be absorbed into the cell dragging water with it. Ivacaftor and lumacaftor

Question 34

What cell type can you test for with NBT test?

Answer 34

Neutrophils

Question 35

What organism commonly infects children peaking in winter, can be secondary to another infection? Confirmed by PCR

Answer 35

Metapneumovirus

Question 36

What is the commonest organism causing bronchiolitis? The diagnosis is with PCR and treatment supportive

Answer 36

Respiratory syncytial virus

Question 37

What organism is a sexually transmitted infection that can cause infiantile pneumonia by vertical transmission?

Answer 37

Chlamydia trachomatis

Question 38

What is eaton lamber syndrome?

Answer 38

A paraneoplastic chenge involving hyproflexia (absent reflexes), limb weakness, and reduced autonomic activity

Question 39

What is the emergency treatment for a pneumothorax

Answer 39

Insertion of a large bore cannula into 2nd intercostal space mid clavicular line

Question 40

What is the managemet for a non severe pneumothorax?

Answer 40

Chest drain inserted into 4th/5th intercostal mid axillary line

Question 41

What is a possible condition you can get as a side effect of arthiritis drugs?

Answer 41

TB

Question 42

What is a mast cell degradation product that can be measured during an acute episode of anaphylaxis?

Answer 42

Serum tryptase

Question 43

What cell type is a common infiltrate and seen in high quantities in chronic type I hypersensitivity reactions

Answer 43

Eosinophils

Question 44

What condition involves a paraneoplastic change also known as myasthenic syndrome, involving hyporeflexia, proximal limb weakness and reduced autonomic activity?

Answer 44

Eaton lambert syndrome

Question 45

You suspect a neutrophil deficiency in a child. What test do you run to check for their function?

Answer 45

NBT (nitroblue tetrazdium)

Question 46

What organism causes Q fever? And pneumonia?

Answer 46

Coxiella burnetti

Question 47

What organism is gram negative, cultured on chocolate agar and causes pneumonia?

Answer 47

Haemophilus influenzae