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Question 1

Examples of lung damage causing pulmonary fibrosis

Answer 1

Infarction, Infection e.g. pneumonia, TB

Question 2

Examples of irritants causing pulmonary fibrosis

Answer 2

Coal dust, silica

Question 3

Examples of diffuse parenchymal lung disease casuing pulmonary fibrosis

Answer 3

Hypersensitivity pneumonitis

Question 4

Examples of connective tissue diseases causing pulmonary fibrosis

Answer 4

RA, SLE, systemic sclerosis, Sjogren’s syndrome

Question 5

Examples of drug-induced pulmonary fibrosis

Answer 5

Amiodarone, Nitrofurantoin (especially older women with recurrent UTIs), Bleomycin, Methotrexate, Cyclophosphamide

Question 6

Name 2 signs visible on hands that indicate IPF

Answer 6

Finger clubbing
Acrocyanosis

Question 7

Signs that could be present on X-Ray showing IPF

Answer 7

Honeycombing
Ground glass opacities
Reticulations
Distribution - predominantly lower zone fibrosis in IPF

Question 8

What two medications are licensed for use in the treatment of IPF?

Answer 8

Pirfenidone - TGFβ Inhibitor; reduces fibroblast activity
Nintedanib – monoclonal antibody against tyrosine kinase; interferes with fibroblast proliferation, migration and differentiation

Question 9

Symptoms of hypocalcaemia

Answer 9

● C - convulsions
● A - Arrhythmias
● T - Tetany (intermittent involuntary muscle contractions)
● S - spasms
● Numb - numbness

Question 10

Two signs of hypocalcaemia

Answer 10

Chvostek’s sign - tapping facial nerve causes muscle spasm
Trousseau’s sign - inflated blood pressure cuff causes wrist flexion and finger adduction

Question 11

Which two LFT’s when raised indicate biliary pathology?

Answer 11

ALP, GGT

Question 12

What is the most common type of gallstone?

Answer 12

Cholesterol

Question 13

What two eponymous signs indicate haemorrhagic pancreatitis?

Answer 13

○ Grey Turner’s Sign- flank bruising
○ Cullen’s Sign - periumbilical bruising (central)

Question 14

What autoantibody indicates Addison’s?

Answer 14

Anti-21-hydroxylase

Question 15

What toll-like receptor reacts to viral double stranded DNA?

Answer 15

TLR3

Question 16

What would you seen upon X-Ray of a patient with Multiple Myeloma?

Answer 16

Raindrop skull

Question 17

What is chipmunk face indicative of?

Answer 17

Beta thallasaemia major

Question 18

What medication should be given in opiod overdose?

Answer 18

Naloxone

Question 19

What is Wenckebach phenomenon?

Answer 19

PR interval becomes progressively more prolonged until a QRS complex is missed, then the pattern resets

Question 20

How should you treat emergency severe hypoglycaemia?

Answer 20

IM glucagon

Question 21

Describe CKD staging

Answer 21

1 GFR >90
2 GFR 60-89
3A GFR 45-59
3B GFR 30-44
4 GFR 15-29
5 GFR <15

Question 22

Describe AKI staging

Answer 22

1. Increase in serum creatine 1.5-1.9 x baseline within 7 days
2. Increase in serum creatine 2.0-2.9 x baseline within 7 days
3. Increase in serum creatine >3.0 x baseline within 7 days

Question 23

Cystic fibrosis’ effect on the pancreas

Answer 23

Normal enzyme production, but channel dysfunction causes dehydration of secretions -> enzyme stagnation

Question 24

Cystic fibrosis’ effect on the biliary tree

Answer 24

Decreased movement of water -> concentrated bile -> damage

Question 25

Cystic fibrosis' effect on the GI tract

Answer 25

Low volume secretions -> increased viscosity, intraluminal water deficiency

Question 26

Cystic fibrosis' effect on the Respiratory tract

Answer 26

Airway dehydration -> Decreased mucocilliary clearance + increased risk of bacterial colonisation -> Inflammatory lung damage due to neutrophil response

Question 27

What ages does ALL present?

Answer 27

Under 5s & over 45s

Question 28

What type of anaemia does hypothyroidism cause?

Answer 28

Megaloblastic macrocytic

Question 29

What is the most common subtype of MND?

Answer 29

ALS

Question 30

Which IBD has apthous uclers?

Answer 30

Crohn's

Question 31

What is thrombophilia?

Answer 31

A condition in which the blood has an increased tendency to form clots

Question 32

Which autoantibodies are associated with PSC?

Answer 32

pANCA and Anti-smooth muscle

Question 33

What does raised ALT, ASM and IgG indicate?

Answer 33

Autoimmune hepatitis

Question 34

What can be perscribed to manage pruritus in patients with PBC?

Answer 34

Cholestyramine