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SBA guy > 118-126 > Flashcards

118-126 Flashcards

1
Q

Young man, otherwise fit and well. Rusty sputum, bronchial breath sounds and crackles. Likely organism?

A

Streptococcus pneumonia (most common form of CAP)

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2
Q

Man with COPD, alcoholic, current jelly sputum, pneumonia. Likely organism?

A

Klebsiella

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3
Q

Green sputum, cystic fibrosis, pneumonia. Likely organism?

A

Pseudomonas

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4
Q

Water tanks, deranged LFTs, pneumonia. Likely organism?

A

Legionella

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5
Q

Parrots, pneumonia. Likely organism?

A

Chlamydia psittaci

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6
Q

Upper lobe cavitation, IV drugs, pneumonia. Likely organism?

A

Staphylococcus

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7
Q

Which lung cells make surfactant?

A

Type 2 pneumocytes

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8
Q

Which lung cells provide the large surface area?

A

Type 1 pneumocytes

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9
Q

Hyaline membrane disease?

A

Dysfunction in type 2 pneumocytes. Can be given steroids prior to delivery

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10
Q

What type of cell is a foam cell?

A

Macrophage

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11
Q

If cholesterol is high in angina patient what lipid lowering agent and how does it work?

A

Simvastatin, acts on HMG CoA reductase

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12
Q

What is the mechanism of GTN spray?

A

Guanylyl cyclase activator (vasodilation in smooth muscle)

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13
Q

Prophylactic angina treatment in stable angina?

A

Aspirin 75mg

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14
Q

Mechanism of aspirin?

A

COX 1 (cyclooxgenase) inhibitor

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15
Q

What is bisoprolol?

A

Beta blocker (antagonises beta adrenaoreceptors)

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16
Q

Name a potassium channel activator/

A

Nicorandil, Ivabradine

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17
Q

What are the vasodilator classes you can use in angina?

A

GTN, beta blockers and calcium channel blockers

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18
Q

What are the contra-indications for beta blockers?

A

Asthma, bradycarida, COPD, decompensated heart failure,

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19
Q

Causative organism of Lyme disease?

A

Borrelia

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20
Q

Toddler with erythematous macules and papule on their face. Koplik spots on soft palate. Likely organism?

A

Measles virus

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21
Q

Child: pink to red papules and macules which begin on the face and spread to the neck, trunk and extremities over 24hrs. Forchheimer’s sign (small red spots on soft palate preceding rash). Likely organism?

A

Rubella (German Measles)

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22
Q

Child: bright red cheeks, as the facial rash fades over 1-4 days a symmetric erythematous, reticular, eruption appears on the trunk and extremities. Likely organism?

A

Erythema Infectiosum

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23
Q

Child: Pink macules and papule surrounded by white halos. Begins on the trunk, spread to neck and proximal extremities. Likely organism?

A

Roseola Infantum

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24
Q

A mother confers immunity to child via breast milk. Immunoglobulin responsible is?

A

IgA (also in saliva, tears)

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25
Q

A mother confers immunity to child via the placenta. Immunoglobulin responsible is?

A

IgG

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26
Q

What is responsible for gram staining in bacteria?

A

A thicker peptidoglycan wall, retains staining

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27
Q

Transference of antiobiotic resistance happens how?

A

Plasmids between bacteria

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28
Q

What WBCs are raised in response to parasitic worm infection?

A

Eosinophils

29
Q

Baby, cyanotic, O2 sats 55% on air. No murmur. What defect most likely?

A

Transposition of the great arteries

30
Q

Baby, shock, poor perfusion of distal limbs, and absent femoral pulses. Most likely congenital lesion?

A

Coarctation of the aorta (thinning of descending aorta)

31
Q

Machine like murmur, radiates to back, in newborn is caused by what?

A

Patent ductus arteriosus

32
Q

What is tetralogy of Fallot? Often cyanotic, often a murmur

A

pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, an overriding aorta.

33
Q

6mo born on 50th gentile, now 2nd. No GI symptoms, some chest infections. What investigation?

A

Sweat teat for cystic fibrosis

34
Q

4yo, growth has tailed off since 1yo. What investigation?

A

Growth hormone test (short stature, delayed bone age, normal growth for 6-12months)

35
Q

2yo, 6 week history of foul smelling diarrhoea with weight loss. Abdomen full and slightly distended. What investigation?

A

Coeliac disease screen- TTG IgA

36
Q

If you suspect gallstones, what is the appropriate investigation?

A

Abdominal ultrasound

37
Q

What drugs cause cholestasis? What is cholestasis?

A

Decrease in bile flow due to impaired secretion or obstruction. COPE- clauivanic acid, oestrogen, penicillin, erythromycin

38
Q

Patients presents with jaundice, weight loss, decreased appetite, dark urine, and painful pale stools. Painless mass in upper right quadrant. What is most appropriate investigation?

A

Ultrasound, then CT to stage tumour. CA 19-9 tumour marker

39
Q

What biomarker for pancreatic cancer?

A

CA 19-9

40
Q

Patient diagnosed with gallstones, now upper abdominal pain, radiates to the back and gets worse with eating and better with leaning forward. Diagnosis?

A

Acute pancreatitis

41
Q

Most specific test for acute pancreatitis?

A

Serum lipase (will be elevated for a long period)

42
Q

Chemotherapy for pancreatic cancer?

A

Gemcitabine

43
Q

What is Courvoisier’s law and what is it most likely to be a sign of?

A

Enlarged gallbladder, mild jaundice, non-tender, case unlikely to be gallstones. => More likely to be malignancy, (chronic gallstones shrink the bladder)

44
Q

What is Charcot’s Triad and what is it a sign of?

A

Jaundice, pyrexia RUQ pain. => ascending cholangitis

45
Q

What type of cell are erythrocytes formed from?

A

Common myeloid progenitor

46
Q

Basophils, monocytes, neutrophils and eosinophils are all formed from which cell immediately?

A

Myeloblast (all leukocytes)

47
Q

What does a megakaryocyte form?

A

Platelets

48
Q

What are the contraindications for giving a vaccine?

A

Egg allergy, live vaccines delayed until after pregnancy or illness, imunnosuppression (live vaccines)

49
Q

Patient, lost of a lot of blood, blood pressure down, raised HR. What will increase?

A

Systemic vascular resistance

50
Q

Example of isometric contraction?

A

Secretory diarrhoea - cholera. Fluid lost same osmolality as ECF so no fluid shift between ECF and ICF

51
Q

Example of hyperosmotic contraction?

A

Sweating. Diabetic ketoacidosis. Diabetes insipidus- lack of ADH so urine can’t be concentrated, more water lost. ECF osmolality increases, contraction of ECF and ICF volumes.

52
Q

Example of hypoosmotic contraction?

A

Addison’s disease- lack of ACTH, less aldosterone. More salt in urine, osmolality of ECF decreases, fluid moved form ECF to ICF.

53
Q

Example of isometric expansion?

A

Giving 0.9% saline - ECF volume increases, but osmolality between ECF and ICF stays the same, no fluid shift

54
Q

Example of hyperosmotic expansion?

A

Giving 2% saline - greater osmolality than ECF, fluid shifts from ICF to ECF.

55
Q

Example of hypo osmotic expansion?

A

SIADH - syndrome of inappropriate ADH. Too much ADH, ECF osmolality decreases, volume increases in ECF and ICF

56
Q

Bolus of fluid in resuscitation of man?

A

20ml/kg.

57
Q

Sodium reference range?

A

135-145mmol/l

58
Q

Potassium reference range?

A

3.5-5mmol/l

59
Q

Minimal renal perfusion would result in what urine output?

A

0.5ml/kg/hr

60
Q

If someone has had breast surgery and subsequently has winging of the scapula, what nerve has been damaged?

A

Long thoracic nerve - innervates the serratus anterior which protracts shoulder

61
Q

What muscle needed for abducting shoulder from 0 to 20 degrees?

A

Supraspinatus

62
Q

What is the predominant collagen type in articular cartilage?

A

Type 2 (94%)

63
Q

What is the predominant collagen type in bone ECM?

A

Type 1

64
Q

What shoulder test for suspected AC joint dislocation?

A

Scarf test

65
Q

What shoulder test for nerve impingement?

A

Empty can

66
Q

What shoulder test for rotator cuff damage?

A

Drop arm

67
Q

Loss of sensation around regimental badge area of left arm. Which nerve likely to have been affected?

A

Axillary nerve

68
Q

Painful arm, internally rotated, and adducted position. Active and passive external rotation is limited. Axillary and anterior views reveal empty lightbulb sign. Diagnosis?

A

Posterior shoulder dislocation

SBA guy (2 decks)

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