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1st years stuffs Flashcards

1
Q

acute sinus bradycardia

A

atropine

if haemodynamically compromised - pace

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2
Q

acute SVT

A

vagal manœuvres, carotid massage, IV adenosine (small half life), IV verapamil

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3
Q

Which is the worst ventricular tachycardia or ventricular fibrillation

A

fibrillation

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4
Q

treatment for HF

A

ACEI and BB (alaprenolol)
thiazide diuretic if mild
chronic HF - loop diuretic

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5
Q

Chronic HF in africans

A

isosorbide mononitrate/hydralazine

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6
Q

when should digoxin be given in HF

A

still symptomatic despite optimal treatment with diuretics

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7
Q

Fever, pleurisy, herpes, lobar consolidation, rusty sputum

A

pneumococcal pneumonia

amox (doxyc)

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8
Q

IVDU, bilateral cavitating bronchopneumonia

A

staphylococcus

fluc (MRSA - vanc)

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9
Q

elderly/DM/alcoholic
aspiration pneumonia
cavitating in upper lobes
red jelly sputum

A

klebsiella

cefotaxime

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10
Q

common pathogen in bronchiectasis, CF

A

pseudomonas

ceftrizidime/ciprofloxacin and aminoglycide

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11
Q

pharyngitis, hoarseness, otitis

A

chlamydia pneumonia

doxy/clarithro/tetra

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12
Q

birds
mucous sputum
patch consolidation

A

chlamydia pistacchi

doxy/clarithro/tetra

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13
Q

epidemics

dry cough

A

mycoplasma

clarithro/tetra/cipro

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14
Q

treatment for legionella

A

clarithro/leflo/cipro 2-3 weeks

rifampicin PO

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15
Q

how to dx and rx viral pneumonia

A

viral culture and PCR

cipro and co amoxiclav

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16
Q

HIV, immunosuppressed, bilateral peripheral interstitial shadowing

A

PCP - pneumocytic

co-tramoxazole

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17
Q

the difference between LFTs - AST, ALP, ALT, GGT

and tru liver function tests - prothrombin, bilirubin, albumin

A

high damage to the liver

liver function

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18
Q

AST
ALT
ALP

A

AST found in muscles as well as liver
ALT found only in liver
ALP slight raise normal in children, pregnancy, bone pathologies

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19
Q

lone rise in GGT is what

A

alcohol abuse

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20
Q

AST + ALT > ALP + GGT
ALP + GGT > AST + ALT
AST:ALT

A

acute alcohol hep, cirrhosis
PBC, gallstones
NAFLD

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21
Q

increased conjugated bilirubin means what

A

liver its doing its job but too much - obstruction?

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22
Q

increased unconjugated bilirubin means what

A

too much conjugate being produced
liver cannot conjugate due to damage
gilberts

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23
Q 
draw out ECG
what is P how long does it last 
what is PR how long does it last 
what is QRS how long does it last 
ST
T
TP
A

draw
atrial depolarisation 0.08-0.1s
AV nodal delay 0.12-0.2s
ventricular depolarisation less than 0.1s
ST maintains ventricular depolariation systole (contract)
T ventricular repolarisation
TP diastole (relax)

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24
Q

calibration of ECG

How to work out the HR

A

25mm/sec
300/number of large squares between R-R
number of QRS complexes in 30 x10

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25
Q

what is the normal axis of an ECG

A

-30 +90

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26
Q

what are the stages of hypertension

A

1- 140/90 monitor 130/80
2 - 160/100 monitor 150/95
3 - 180/100
malignant is DBP >130

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27
Q

in stage 1 why would drugs be started

A

if target end organ damage present of 10 year risk of CVD disease over 20%

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28
Q

treatment for hypertension

A

55/black - CCB/thiazide diuretic
A+C/A+D
A+C+D
BB or AB

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29
Q

target for hypertension

A

under 80 140/90 over 80 150/90

DM/renal/CV - 130/85

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30
Q

angina treatment

A

GTN + aspirin/ACEi/statin

bisoprolol or verapamil

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31
Q

unstable angina and NSTEMI treatment for low risk and high risk

A

low risk - aspiring, clopidegrol, nitrates

high risk - PCI, thrombolysis, CABG

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32
Q

treatment for a STEMI

A

MONAC - sublingual nitrate
PCI within 90 minutes
thrombolyse if PCI unavailable - streptokinase and aspirin

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33
Q

1st degree HB
2nd degree HB
3rd degree HB

A

prolongation of PR interval >0.22s
mobitz 1 prolongation of PR then dropped QRS
mobitz 2 dropped QRS
no correlation between the two

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34
Q

BBB

treatment

A

WiLLiam
MaRRow
IV atropine, pacing

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35
Q

pan systolic to axilla

displaced apex

A

MR

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36
Q

mid diastolic rumble

tapping apex malar rash

A

MS

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37
Q

ejection systolic -> carotids
slow rising pulse
heaving apex

A

AS

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38
Q

early diastolic

displaced apex

A

AR

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39
Q

CURB65

A

confusion
urea >19
RR>30
SBP60

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40
Q

CAP mild/mod
severe
HAP non severe
severe

A

amox PO (doxy) and clarithro for 7 days
IV amox (levoflox) and clarithro for 10 days
amox and metro for 7 days
amox, metro and gen for 7-10days

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41
Q

treatment of COPD

A

salbutamol - formerarol/salmetarol

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42
Q

acute COPD

A 
iSOAP
ipratroprium and neb salbutamol 
oxygen 
AB is purulent sputum 
oral pred
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43
Q

asthma treatment stages

A 
salbutamol 
beclometasone
LABA
increase dose of beclo
montelukast/theophylline
oral steroids
44
Q

acute asthma

A 
OSHITMAN
oxygen 
neb salbutamol 
IV hydrocortisone 
neb ipratroprium 
oral theophylline 
Mg sulphate 
anaesthetic
45
Q

TB treatment

A

2 months RIPE

4 months RI

46
Q

TB drugs side effects

A

R - orange piss
I - neuropathy, agranulocytis
P - hep, gout
E - colour blind

47
Q

Sarcoid - h/s, increase in what, treatment

A

4
Ca and ACE
oral pred

48
Q

CXR showing ground glass to honey comb

A

IPF

49
Q

a pneumothorax treatment

A

needle aspirate 2nd ICS mid clavicular

50
Q

Pleural effusion drain where

A

5th mid axillary

drain if empyema

51
Q

pleural effusion transudate under 30

exudate over 30

A

pericarditis, HF, nephrotic syndrome

pneumonia, TB, MI, cancer, pancreatitis

52
Q

difference between type 1 rest failure and type 2

A

type 1 decrease in O2 and normal or low co2

type 2 low o2 and increase co2

53
Q

treatment of a small and a large PE

A

small herparin/warfarin

large - thrombolyse

54
Q

central. rapid mets. increase cortisol decreased sodium

A

SCLC

55
Q

non smoker

mucous secreting glandular cells

A

adenocarcinoma

56
Q

cavities

central necrosis, increased calcium and increase PTH

A

squamous

57
Q

poorly differentiated. mets early

A

large cell

58
Q

non nauseating granulomas

nauseating granulomas

A

sarcoid

TB

59
Q

symptoms and treatment for GORD

A

heartburn aggravated by lying down, regurg, nocturnal cough, water brash
gaviscon, ranitidine, omeprazole

60
Q

what is gastroperesis and the treatment

A

delayed gastric emptying not due to an obstruction

liquid diet, gastric pacemaker

61
Q

treatment of gastric adenocarcinoma

A

if proximal do total resection

if distal do partial resection

62
Q

55-65 yr olds

defect of pacemaker cells

A

gastrointestinal stromal tumours

63
Q

dx of H pylori

A

stool antigen
breath test
serology IgG

64
Q

treatment of h pylori

A

omeprazole, amoxicillin (metro) and clarithro for 2 weeks

65
Q

coeliac HLA
blood test
histology

A

HLA DQ2 and DQ8
tTGA IGA
villous atrophy, crypt hyperplasia and increase lymphocytes

66
Q

what is meckels diverticulum and the symptoms

A

tubular structure 60cm from ileocaecal value
remenant of omphalomesenteric duct
painless melanoma

67
Q

commonest cause of food poisoning

A

campylobacter

68
Q

what food poisoning is outbreaks

A

E Coli 0157 and salmonella

69
Q

commonest cause of viral diahrroae in under 3s

A

rotavirus

70
Q

explosive vom

A

noravirus

71
Q

which 2 organisms have the longest incubation periods for food poisoning

A

camp and EColi

72
Q

toxin producing organisms

A

SA, perfringes, bacillus cereus, EColi

73
Q

causes of bloody diahroha

A

camp, shigella, EColi

74
Q 
ix for typhoid
salmonella, camp, shigella
giardia, amoeba, parasites
Cliff, Coli
norovirus
A 
blood culture
stool culture
stool micro
soon toxin
stool PCR
75
Q

non severe CDiff

severe CDIff

A

oral metro

oral vanc

76
Q

treatment of IBD

A

5ASA mesalazine, steroids, immunosuppreiosn, anti TNF

77
Q

crohns v UC

A

mouth to anus, fissures, non nauseating granulomas

involving rectum and up, crypts, cx is toxic megacolon, PSC

78
Q

Hep A

A

rna, gay sex, IVDU

Hep A IgM

79
Q

Hep B

A

DNA, blood-blood, sex

80
Q

Hep C

A

RNA, blood-blood, sex
chronic liver disease
fatigue
Hep C AB and DNA

81
Q

Hep D

A

relies on Hep B

82
Q

Hep E

A

face-oral, zoo

83
Q

AI hep

A

young women on the pill
fatigue discomfort, myalgia, loss of appetite
ANA, SMA, anti LKM, increase IgG

84
Q

what is PBC

A

chronic inflam and destruction of intra and extra hepatic ducts
middle aged women
AMA and ANA increase IgM

85
Q

non cirrhotic, well demarcated echogenic spot on US

A

hemangioma

86
Q

central scar, bile ducts, kuppfer cell, young/middle aged women

A

focal nodular hyplasia

87
Q

women, glycogen storage disease, pill

A

hepatic adenoma

88
Q

farmer, sheep parasites

A

hydatid cysts

89
Q

haemachromatosis

A

bronzed diabetic

increased iron - mutation in HFE

90
Q

willsons

A

lots of copper

kesser Fleischer rings

91
Q

PSC

A

UC
ANA pANCA
men
pred, metho

92
Q

below and lateral to inguinal ligament

above and medial

A

femoral

inguinal

93
Q

hyperkalaemia in VT

A

CaCl

94
Q 
native valve
prosthetic valve
SA
MRSA
strep viridian's
enterococcus
staph epidermis
A 
amox, gent
vanc, gent, rifampicin 
fluc
vanc, gent
benzylpenicillin, gent
amox/vanc, gent
vanc, gent, rifampicin
95
Q

tetralogy of fallot

A

VSD, overriding aorta, RV outflow obstruction, RV hypertrophy

96
Q

on an antibody where is the Fab and where is the Fc

A

FAB top

FC bottom

97
Q 
ventricular diastole (relaxation)
ventricular systole (contraction)
A
  1. 5s

0. 3s

98
Q

IgA

A

dimeric
in milk
2nd most abundant

99
Q

IgD

A

low levels

100
Q

IgE

A

type 1 hs

101
Q

IgM

A

pentameric

first Ig produced

102
Q

IgG

A

crosses placenta

most abundant

103
Q

Type 1 hs

A

IgE and mast cell degeneration

104
Q

Type 2 hs

A

AB mediated IgG/IgM

105
Q

Type 3

A

immune complex

106
Q

Type 4

A

T cell mediated

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