Lectures

Question 1

How do cromones work? e.g. cromoglycate

Answer 1

Mast cell stabiliser

Question 2

Which drug is effective in atopic children?

Answer 2

Cromoglycate

Leukotriene receptor antagonists

Question 3

Which leukotriene plays a big role in asthma?

Answer 3

LTD4

Question 4

How is montelukast taken?

Answer 4

Orally, once daily

Question 5

What is omalizumab?

Answer 5

Anti-IgE monoclonal antibody

Question 6

How is omalizumab given?

Answer 6

Given as an injection every 2-4 weeks

Question 7

What are Mepolizumab and Reslizumab?

Answer 7

Anti-IL5

Injection every 4 weeks

Question 8

Name a mucolytic

Answer 8

Carbocisteine, ersoteine

reduce sputum viscosity, aid sputum expectoration

Question 9

Is asthma better in the morning or night?

Answer 9

Better in the night

Question 10

Raised ACE and Ca

Answer 10

Sarcoid

Question 11

Erythema nodosum
Non-caseating granuloma
Bilateral hilar lymphadenopathy

Answer 11

Sarcoidosis

Question 12

Which drugs could you use for bronchial challenge testing?

Answer 12

Metacholine, histamine, mannitol

Question 13

How do you test static lung volume?

Answer 13

Use helium dilution/N2 washout
Increased total lung capacity in emphysema (hyperinflation)
Decreased total lung capacity in restrictive lung disease

Question 14

How would you monitor treatment in interstitial lung disease?

Answer 14

TLCO

Question 15

How would you measure airway resistance?

Answer 15

Either with whole body plethysmography or impulse oscillometry

Question 16

What do high levels of exhaled NO mean?

Answer 16

Reflect uncontrolled asthmatic inflammation

Question 17

Why can you not use exhaled nitric oxide in COPD?

Answer 17

Nitric oxide suppressed by smoking

Question 18

Thermophilic bacteria

Answer 18

Farmers lung

Question 19

Avian proteins

Answer 19

Bird fanciers lung

Question 20

Fungi EAA

Answer 20

Malt workers lung

Question 21

Blood finding in sarcoidosis

Answer 21

Hypercalcemia

Question 22

What is pneumoconiosis

Answer 22

Lung disease caused by mineral dust (e.g. asbestos, coal workers lung, silicosis)

Question 23

Which type of asbestos is highly dangerous

Answer 23

Amiphibole (straight fibres)

Question 24

What is Cor pulmonale?

Answer 24

Pulmonary hypertension complicating lung disease

Question 25

PTH

Answer 25

Sqaumous cell cancer

Question 26

ACTH

Answer 26

Small cell lung cancer

Question 27

Keratinising cancer

Answer 27

Squamous cell

Question 28

Gland forming

Answer 28

Adenocarcinoma

Question 29

Lung cancer treatment

Answer 29

Small cell - chemotherapy | All others - surgery

Question 30

Which type of cancer expresses TTF (thyroid transcription factor)

Answer 30

Adenocarcinoma

Question 31

Which type of cancer expressed p63 and high molecular weight cytokeratins?

Answer 31

Squamous cell

Question 32

Name 3 oncogenes

Answer 32

myc K-ras Her2(neu)

Question 33

Name a tumour suppressor gene

Answer 33

P53

Question 34

Talk to me about the EGFR gene mutation

Answer 34

Seen almost exclusively in adenocarcinomas (especially in non smokers and in asian populations) These tumours respond to tyrosine kinase inhibitors (erlotinib)

Question 35

What type of hypersensitivity reaction is sarcoidosis?

Answer 35

Type IV

Question 36

Non-caseating granuloma

Answer 36

Sarcoidosis

Question 37

Activity marker for Sarcoidosis?

Answer 37

ACE (activity level not diagnostic test)

Question 38

Treatment for sarcoidosis

Answer 38

Usually self-limiting | Steroids if vital organ affected/chronic

Question 39

What type of hypersensitivity reaction is EAA?

Answer 39

Type III (immune complex deposition)

Question 40

CXR - pulmonary fibrosis most commonly in the upper zones

Answer 40

EAA

Question 41

reticulonodular fibrotic shadowing, worse at the lung bases, and periphery. Traction bronchiectasis. Honey-combing cystic changes

Answer 41

Idiopathic pulmonary fibrosis

Question 42

What is Caplans syndrome?

Answer 42

Rheumatoid pneumoconiosis (pulmonary nodules)

Question 43

What is simple pneumoconiosis?

Answer 43

chest X-ray abnormality only (no impairment of lung function - often associated with chronic obstructive pulmonary disease)

Question 44

Egg shell calcification of hilar nodes

Answer 44

Silicosis

Question 45

Chemotherapy side effects

Answer 45

``` Nausea and vomiting Tiredness Bone marrow suppression (infection/anaemia) Hair loss Pulmonary fibrosis ```

Question 46

Most common type of lung cancer in non-smokers

Answer 46

adenocarcinoma | i think adenocarcinoma is also the most common type overall now

Question 47

Most common type of lung cancer in smokers

Answer 47

Sqaumous

Question 48

Which nerve involved in hoarseness?

Answer 48

Recurrent laryngeal nerve

Question 49

What causes a pancoast tumour?

Answer 49

Brachial plexus invasion - wasting of the muscles of the hand etc

Question 50

Why might you get distended external jugular vein, puffy eyelids and headache in lung cancer?

Answer 50

Involvement of the SVC

Question 51

Which type of lung cancer most frequently associated with paraneoplastic syndrome?

Answer 51

Small cell

Question 52

Why might you see thrombophelbitis in cancer patients?

Answer 52

because their blood is hypercoagulable

Question 53

What investigation MUST you do in anyone with new onset finger clubbing?

Answer 53

MUST do a CXR

Question 54

Which type of lung cancer would you usually see hypercalcaemia in?

Answer 54

Squamous cell

Question 55

Which type of cancer would you usually see SIADH in?

Answer 55

Small cell

Question 56

Treatment for SIADH in lung cancer

Answer 56

Treat underlying cause Fluid restriction (1.5L/day) Sometimes need demeclocycline

Question 57

Frist line investigation of DVT

Answer 57

Ultrasound doppler scane

Question 58

Name 2 direct inhibitors of Xa

Answer 58

Rivaroxiban | Apixaban

Question 59

ABG in PE

Answer 59

Type 1 resp failure = decreased PaO2, decreased SaO2, normal or low PaCO2

Question 60

Good test for small peripheral emboli

Answer 60

V/Q scan

Question 61

Name three type of granulocyte?

Answer 61

BEN Basophils Eosinophils Neutrophils

Question 62

Name two type of agranulocytes

Answer 62

Lymphocytes, monocytes

Question 63

What do developing red cells need?

Answer 63

Developing red cells still have a nucleus and need vitamin B12 and folate for the nucleus to mature before its removal

Question 64

Microcytic anaemia

Answer 64

Iron deficiency (i.e. chronic blood loss)

Question 65

Macrocytic anaemia

Answer 65

Vitamin B12/folate deficiency (nuclear defects) | Alcohol excess, liver disease, hypothyroidism

Question 66

Normocytic anaemia

Answer 66

Acute blood loss | Anaemia of chronic disease (e.g. inflammation, infection)

Question 67

Causes of raised platelets

Answer 67

Acute or chronic blood loss Inflammation Malignancies

Question 68

Causes of low platelets

Answer 68

Liver disease Consumption (autoimmune or fibrin clot) "trapping" (enlarged spleen)

Question 69

Target cells

Answer 69

Liver disease

Question 70

Red cell fragments

Answer 70

Valvular heart disease

Question 71

What is secondary haemostasis

Answer 71

Fibrin clot formation

Question 72

What is primary haemostasis?

Answer 72

When a platelet plug forms

Question 73

Innate immune system

Answer 73

Macrophages Neutrophils Mast cells Natural killer cells Complement proteins Acute phase proteins Cytokines

Question 74

Acquired immune system

Answer 74

T lymphocytes | B lymphocytes

Question 75

What is Kostmann syndrome?

Answer 75

Severe congenital neutropenia

Question 76

The most severe form of SCID?

Answer 76

Reticular dysgenesis (primary failure to produce neutrophils)

Question 77

Kostmann syndrome inheritance pattern

Answer 77

Autosomal recessive

Question 78

Kostmann syndrome management

Answer 78

Prophylactic antibiotics, antifungals Stem cell transplantation Granulocyte colony stimulating factor

Question 79

Characteristic finding of diptheria

Answer 79

Diptheria

Question 80

What is a normal Epworth scale?

Answer 80

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