Condition questions

Question 1

What is Cor Pulmonale

Answer 1

Right sided heart failure caused by respiratory distress

Question 2

Causes of Cor Pulmonale

Answer 2

main one is COPD
PE
Interstital lung disease
cystic fibrosis
primary pulmonary hypertension

Question 3

presentation of someone with Cor Pulmonale

Answer 3

hypoxia
cyanosis
raised JVP 
peripheral oedema
3rd heart sounds
murmur
hepatomegaly

Question 4

Management of Cor Pulmonale

Answer 4

treat symptoms
treat underlying cause
long term O2 therapy

Question 5

Management of antiphospholipid syndrome

Answer 5

long term warfarin with INR range 2-3

LMWH for pregnant women

Question 6

what is antiphospholipid syndrome

Answer 6

where the patient is in a hypercoagulable state

can occur secondary to SLE

Question 7

Cushing syndrome

Answer 7

prolonged elevation of cortisol

Pituitary adenoma secretes elevated levels of ACTH

Question 8

signs of Cushing syndrome

Answer 8

moon face
central obesity
abdominal striae
fat pad on upper back
proximal limb wastage

Question 9

Causes of Cushing syndrome

Answer 9

Cushing disease
exogenous steroids
adrenal adenoma
paraneoplastic cushings

Question 10

Polymyalgia rhuematica

Answer 10

inflammatory condition that causes pain and stiffness in shoulders, pelvic girdle and neck

Question 11

polymyalgia reumatica is associated with what condition

Answer 11

giant cell arteritis

Question 12

Core features of polymalgia rheumatica

Answer 12

bilateral shoulder pain
bilateral pelvic girdle pain
worse with movement
interferes with sleep
stiffness > 45 mins in morning

Question 13

what does anti-nuclear antibody (ANA) test for

Answer 13

SLE

Question 14

what does anti-CCP (anti-cyclic citrullinated peptide) test for

Answer 14

rheumatoid arthritis

Question 15

calcium levels in hyperparathyroidism

Answer 15

increased

Question 16

calcium levels in osteomalacia

Answer 16

decreased

Question 17

main complications of hyperkalaemia

Answer 17

cardiac arrhythmia = ventricular fibrillation

Question 18

conditions that cause hyperkalaemia

Answer 18

AKI
CKD
rhabdomyolisis
adrenal insufficiency 
tumour lysis syndrome

Question 19

medications that cause hyperkalaemia

Answer 19

aldosterone antagonists 
ACE inhibitors
Arbs 
NSAIDs
K+ supplements

Question 20

Nephrogenic diabetes insipidus and water deprivation test results

Answer 20

problem with the kidneys themselves
low urine osmolality before
low urine osmolality after synthetic ADH
because kidney cannot respond to it

Question 21

Causes of nephrogenic diabetes insipidus

Answer 21

Drugs: lithium in BPD
intrinsic kidney disease
Electrolyte disturbances

Question 22

Cranial diabetes insipidus and water deprivation test results

Answer 22

hypothalamus does not produce ADH
low urine osmolality before
high urine osmolality after synthetic ADH

Question 23

inherited causes of haemolytic anaemia

Answer 23

hereditary spherocytosis
thalassaemia
sickle cell anaemia

Question 24

acquired causes of haemolytic anaemia

Answer 24

autoimmune
alloimmune
MAHA
prosthetic valve related

Question 25

Features of haemolytic anaemia

Answer 25

anaemia
splenomegaly (full of destroyed RBCs)
Jaundice - raised bilirubin from destruction of RBCs

Question 26

investigations and findings in haemolytic anaemia

Answer 26

FBC - normocytic anaemia
Blood film - schistocytes (broken RBCs)
Coombs test - if positive means it is autoimmune caused

Question 27

what is MAHA

Answer 27

microangiopathic haemolytic anaemia

small blood vessels have structural abnormalities that cause haemolysis of RBC’s that travel through them

Question 28

causes of MAHA

Answer 28

haemolytic uraemia syndrome (HUS)
DIC
TTP
SLE
cancer

Question 29

what is TTP

Answer 29

thrombotic thrombocytopenic purpura

tiny blood clots develop throughout small vessels of the body which uses up platelets and so causes thrombocytopenia

Question 30

What happens in TTP

Answer 30

problem with protein ADAMTS13

shortage of it causes increase in vWF and formation of clots

Question 31

what does ADAMTS13 typically do

Answer 31

normally inactivates vWF and decreases platelet adhesion to vessel walls

Question 32

what is nephrotic syndrome

Answer 32

occurs when basement membrane in the glomerulus becomes highly permeable to proteins, allowing them to leak from blood to urine

Question 33

classic triad of nephrotic syndrome

Answer 33

low serum albumin
oedema
high urine protein content

Question 34

features of nephrotic syndrome

Answer 34

pallor
frothy urine
generalised oedema
deranged lipid profile (increase cholesterol and TAG decreased LDL)
hypertension
hyper-coagulability

Question 35

causes of nephrotic syndrome

Answer 35

secondary to intrinsic kidney disease

secondary to underlying systemic illness: diabetes, HIV, Hepatitis, Malaria

Question 36

what is haemochromatosis

Answer 36

iron storage disorder that results in excessive loss of iron and deposition in tissues
(most cases problem with gene on chromosome 6)

Question 37

symptoms of haemachromatosis

Answer 37

chronic fatigue
joint pain
bronze discoloration
hair loss
erectile dysfunction
amenorrhoea
cognitive symptoms
most present after age of 40

Question 38

diagnosis of haemachromatosis

Answer 38

serum ferritin and transferrin because ferritin alone is an acute phase reactant (up in inflammation and alcoholic fatty liver disease)

if both high then diagnosis of haemochromatosis

Question 39

describe renin-angiotensin system

Answer 39

renin secreted by juxtaglomerular cells in afferent arterioles of kidneys
renin converts angiotensin(released by liver) to angiotensin I
angiotensin I converts to angiotensin II in the lungs with help of ACE
angiotensin II causes vasoconstriction and stimulates release of aldosterone from adrenal glands
aldosterone is a mineralocorticoid and acts on nephrons in kidneys to:
-increase sodium reabsorption
-increase potassium secretion
-increase hydrogen ion secretion
to increase BP