PassMED: Medical Finals Examination Revision

Common Conditions

Fibrosing Alveolitis

Pleural Effusion

Valvular Disease

Chronic Liver Disease

Polycystic Kidneys

Renal Transplant

Motor Neuron Disease

Multiple Sclerosis

Peripheral Neuropathy

Ankylosing Spondylitis

Rheumatoid Arthritis

Systemc Sclerosis

Cushing's Disease

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Fibrosing Alveolitis

Incidental findings	?Rheumatoid arthritis (RA)/scleroderma
+ve signs	Clubbing, Dyspnoea, raised RR, Cyanosis, Fine end insp bibasal creps
Function	?Pulmonary hypertension: raised JVP, loud P2, right ventricular heave
Tests	Raised ESR, ANA, Rheumatoid Factor CXR - basal reticular shadowing ABG - hypoxaemia PFT - restrictive, desaturation after exercise High resolution CT ± lung biopsy

Causes

Upper
Extrinsic allergic alveolitis
Ankylosing Spondylitis
Old TB

Middle
Sarcoid
Beryllium

Lower
CFA
Connective tissue disease
Pneumoconioses
Drugs

Extensions

Look for splenomegaly (amyloidosis)

Notes

Connective tissue diseases = RA, systemic sclerosis, SLE, polymyositis/dermatomyositis, ankylosing spondylitis (upper lobe). In RA, fibrosis can also be caused by methotrexate.
Drug causes = Methotrexate, amiodarone, nitrofurantoin
Types of pneumonitis: Usual interstitial pneumonia (UIP), desquamative IP, Non-specific IP, lymphoid IP, giant cell IP.
Treatment: Trial of steroids for all, but taper if no response

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