these

Question 1

Budd-Chiari syndrome

Answer 1

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

Question 2

Shifting dullness

Answer 2

Ascites

Question 3

Helper T cells

Answer 3

Recognise antigens presented by MHC II molecules, CD4+

Question 4

T cells develop in

Answer 4

Thymus

Question 5

First antibody to be released in infection

Answer 5

IgM

Question 6

Interferon y

Answer 6

Cytokine released from Th1 cells and activates macrophages

Question 7

B Cells

Answer 7

Responsible for antibody productio

Question 8

IgA

Answer 8

Provides protection on mucous membranes, breast milk

Question 9

Cytotoxic T cells

Answer 9

Recognise antigens presented by MHC class I molecules, CD8

Question 10

Opsonisation

Answer 10

Making a foreign cell more susceptible to phagocytosis

Question 11

Obstructive spirometry

Answer 11

FEV1/ FVC < 0.7

Question 12

COPD FEV1 >80

Answer 12

Mild

Question 13

COPD FEV1 50 -80%

Answer 13

Mod

Question 14

COPD FEV1 30-50

Answer 14

Severe

Question 15

COPD FEV1 <30%`

Answer 15

V. severe oopsie nono breathing well

Question 16

Dyspnoea scale

Answer 16

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

Question 17

COPD management

Answer 17

SAVIM

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

Question 18

Greater effect on exacerbations - LABA or LAMA?

Answer 18

LAMA

Question 19

ICS in COPD what does tommy fardon want you to remember

Answer 19

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

Question 20

Oral glucocorticoids in COPD

Answer 20

Na

Question 21

Reasons you wouldn’t prescribe a silly COPD triple therapy

Answer 21

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

Question 22

A on the cheeky gold square

Answer 22

Bronchodilator

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

Question 23

B GOLD square

Answer 23

LABA or LAMA

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

Question 24

D GOLD square

Answer 24

LAMA or LAMA/LABA or ICS/LABA

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

Question 25

C GOLD square

Answer 25

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

Question 26

COPD surgical management

Answer 26

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

Question 27

Only option for patients with pulmonary hypertension

Answer 27

Lung transplantation

Question 28

Long term oxygen therapy offered when

Answer 28

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

Question 29

Chronic t2 respiratory failure

Answer 29

Metabolic compensation for chronic respiratory acidosis

Question 30

Acute on chronic t2 respiratory failure

Answer 30

Chronic T2 respiratory failure shifted to acidaemia as pCO2 rises

Question 31

Releases from postganglionic fibres causing airways smooth muscle to relaxxxx

Answer 31

NO and VIP

Question 32

Which receptors mediate ASM contraction and mucus secretion?

Answer 32

M3 receptors

Question 33

Chronic asthma pathology

Answer 33

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

Question 34

Asthma management summary

Answer 34

``` 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 ```

Question 35

Montelukast

Answer 35

Leukotriene receptor antagonist

Question 36

Asthma exacerbation

Answer 36

If infection signs - antimicrobials | Oral steroids and increase ICS

Question 37

Type of response in mild to moderate asthma

Answer 37

Th2

Question 38

Type of response in severe asthma

Answer 38

Th1 and Th2

Question 39

Aspergillosis

Answer 39

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

Question 40

Allergic Broncho-pulmonary aspergillosis

Answer 40

Allergic response to apergillus

Question 41

Childhood onset, asthma, eczema and rhinitis

Answer 41

Allergic asthma

Question 42

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

Answer 42

Eosinophilic asthma

Question 43

Treatment of eosinophilic asthma

Answer 43

Mepolizumab or benralizumab - anti Il-5 s

Question 44

Hydrostatic pressure

Answer 44

Pressure pushing fluid out of capillaries

Question 45

Oncotic pressure

Answer 45

Pressure pushing fluid into capillaries

Question 46

Most likely bronchiolitis cause

Answer 46

Respiratory synctial virus

Question 47

Most common cause of croup

Answer 47

Parainfluenza virus