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Practice Exams > 14/10/21 > Flashcards

14/10/21 Flashcards

1
Q

Clinical Diagnosis of COPD (3 points)

A
  1. Symptoms of exertional breathlessness, cough and sputum
  2. History of smoking, or exposure to other noxious agents
  3. Post-Bronchodilator FEV1/FVC <0.7
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2
Q

What constitutes a positive bronchodilator response?

A

Adults: 12% or 200ml change
Children: 12% change

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3
Q

Causes of Obstructive Lung Disease (6 points)

A
  • COPD
  • Asthma
  • Bronchiectasis
  • Cystic Fibrosis
  • Bronchiolitis
  • Alpha1-Antitrypsin Deficiency
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4
Q

Causes of Restrictive Lung Disease (8 points)

A
  • Pulmonary Fibrosis
  • Neuromuscular Disorders
  • Congestive Cardiac Failure
  • Sarcoidosis
  • Obesity
  • Interstitial Lung Disease (ILD)
  • Pneumonia
  • Pleural Disease → pleural effusion or diffuse pleural thickening
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5
Q

What stage of COPD do you use ICS?

A

Moderate

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6
Q

Examples of LAMA and LABA. 1 each

A

LAMA - tioptropium

LABA - salmeterol

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7
Q

Ranges for overt and subclinical hypothyroidism in pregnancy?

A

Overt -> TSH >2.5 with increased T4 or TSH >10 irrespective of T4
Subclinical -> TSH 2.5-10 with normal T4

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8
Q

Investigations in hypothyroidism in pregnancy. Why are these two tests important?

A

TSH and T4 -> all the risk associated with hypothyroidism (prematurity, low birth weight and miscarriage)
TPO Antibodies -> thyroid peroxidase antibody → may increase the risk of pregnancy complications INCLUDING IN WOMEN WITH A TSH IN THE NORMAL RANGE.

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9
Q

Management steps for overt hypothyroidism diagnosed in pregnancy?

A
  1. commence thyroixine 50-100microg/day
  2. refer to endocrinologist
  3. consider TPO Antibody testing
  4. repeat TFTs in 4 weeks
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10
Q

What is a keratoacanthoma? What are the clinical features?

A

Benign squamoproliferative lesion → can appear suddenly and grow rapidly

  • same sites as SCC
  • presents over weeks to a few months → enlarging nodule with a central keratotic core
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11
Q

Differential Diagnoses for Keratoacanthoma

A
  • Squamous Cell Carcinoma
  • Nodular Basal Cell Carcinoma
  • Merkel Cell Carcinoma
  • Prurigo Nodule
  • Giant Molluscum Contagiosum
  • Deep Fungal Infection
  • Nodular Kaposi’s Sarcoma
  • Cutaneous Metastases
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12
Q

Treatment for Keratoacanthoma. What is the significance of this?

A
  • Surgical Excision → 3-5mm margin

- difficult to distinguish between a keratoacanthoma and an SCC on clinical diagnosis or partial biopsies

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13
Q

Differential Diagnosis for 2nd and 3rd Trimester PV bleeding in pregnancy (9 points)

A
  1. Bloody Show associated with labour
  2. Placenta Previa
  3. Placental Abruption
  4. Uterine Rupture (rare)
  5. Vasa Previa (rare)
  6. Cervical Pathology - cervicitis
  7. Vaginal Pathology
  8. Uterine Pathology - polyps, infection/inflammation, trophoblastic disease
  9. Non-Tubal Ectopic Pregnancy
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14
Q

Investigations in 2nd or 3rd trimester PV bleeding (5 points)

A
  • FBE
    • RhesusD negative → need anti-D immune globulin → protects against RhD alloimmunisation
  • Obstetric U/S
  • Group and Hold
  • Coagulation Studies
  • Fetal Fibronectin (fFN)
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15
Q

Discuss the fetal fibronectin test. What is it and what are the associated benefits?

A
  • glycoprotein found at boundary between the amniotic sac and the uterus
  • performed in women with suspected premature labour
  • Cervical or Vaginal fluid sample → sample collected to be analysed for fFN
  • Positive fFN → can be related to causes other than risk of pre-term delivery
  • Negative fFN → highly predictive that preterm delivery will not occur within in the next 7-14 days
    • therefore can reduce unnecessary hospitalisations and drug therapies
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16
Q

What is a infantile haemangioma? How common is it?

A

aka Strawberry Naevus

Common benign vascular tumour → affects 10% of neonates

  • more common in girls and in premature babies
17
Q

Timeline of an infantile haemangioma?

A
  1. Not usually present at birth
  2. Appears within the first month
  3. Proliferates until the child is 5-9 months old
  4. Enters a slow involution phase which can take several years
    1. after involution → larger lesions often leave excess skin, telangiectasia and textural change
18
Q

Treatment of infantile haemangioma? Criteria for referral (4 points)

A
  • most small, non-facial haemangiomas DO NOT need treatment

Consider referral to dermatologist or paediatrician:

  • rapidly proliferating facial haemangiomas
  • segmental facial haemangiomas → can be associated with intracranial, ocular or CV problems)
  • ulcerated lesions
  • large number of haemangiomas

Practice Exams (45 decks)

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