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3b Past Papers > 2015 > Flashcards

2015 Flashcards

1
Q

rate limiting drugs AF

A

bb (not soltalol)
rate limiting CCB - diltiazem, verapamil. U FORGOT THIS!!
digoxin

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2
Q

rhythm control AF

A

soltalol

amiodarone

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3
Q

MOA amiodarone

A

Like other antiarrhythmic drugs of this class, amiodarone works primarily by blocking potassium rectifier currents

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4
Q

causes of facial nerve palsy

A 
infection affecting nerve directly
ramsey hunt
lyme disease
meningitis/encephalitis
syphillis
COMPRESSION
vestibular schwannoma
cholesteatoma
facial newrve tumour
NF2
parotid tumour
rhabdomyosarcoma
VASCULAR
AV malformation
carotid artery aneurysm
haematoma
temporal arteritis
stroke

SWELLING FROM INFECTION
otitis media and externa
mastoiditis

GENERAL NEURO
guillain barre
MS
MG

sarcoidosis

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5
Q

2 things important to assess in #

A

open/closed
neurovascular status
stable or unstable

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6
Q

salter harris clarification

A

1 along metaphysis
through growth plate and physis
3-growth plate and epiphysis (into joint)
4-both

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7
Q

treatment of ramsey hunt

A

PRED WITHIN 73 HRS!!!!!!!!!11

acyclovir

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8
Q

symptoms of ramsey hunt

A 
vertigo
tinnitis
HL/hyperacuisis
facial nerve palsy
otalgia
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9
Q

what do osteoclasts do

A

breakdown

blasts build

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10
Q

3 functions of PTH

A
  1. regulate serum Ca (increase osteoclast activity,, increases Ca reabsorption in kindey, stimulation of conversion of 25 hydroxyvit d to 1,25dihydroxy which stimulates uptake from the intestine)
  2. reduces resoprtion of phsophate from the proximal tubule of kindey. more phospate is excreted through the urine. phosphates bind with Ca and take it out of the circ so PTH stops this
  3. vit di synthesis
    upregulates activity of 1 alpha hydroxylase which activitates vit d
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11
Q

complications of hyperpara

A

osteoporosis
kindey stones
CVS disease - HTN (mechanism unclear)

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12
Q

beta thalassaemia investigations

A 
FBC 
serum iron (often elevated)
ferritin raised
DIAGNOSIS = Hb electrophoresis
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13
Q

child with beta thalass. what disease do parents have

A

beta thalassaemia minor/trait

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14
Q

public health intiatives to test for thalassaemia

A

screening of pregnant women

newborn blood spot test

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15
Q

screening of preg women and babies

A

MUM
screening for infectious diseases (hepatitis B, HIV and syphilis)
screening for inherited conditions (sickle cell, thalassaemia and other haemoglobin disorders)
screening for Down’s syndrome, Edwards’ syndrome and Patau’s syndrome
screening for 11 physical conditions (20-week scan)

BABY
newborn physical examination
newborn hearing screening
newborn blood spot screening

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16
Q

treatment of beta thalassaemia major

A 
Regular hypertransfusion
Iron chelation (prevent iron overload symptoms)

consider spenectomy if hypersplenism
Folate supplements

17
Q

iron overload sx

A

cardiac iron overload -> reduced exercise tolerance or R HF
cirrhosis
arthralgia
diabetes due to deposition in the pancreas

18
Q

mechanism of hydrops foetalis

A

Compensatory mechanisms for maintaining homeostasis
anaemia -> hypoxia ->
a)redistribution of blood to brain/ehart/adrenal causing renal tubular damage
during hypoxia that results from underlying disease include increased efficiency of oxygen extraction; redistribution of blood flow to the brain, heart, and adrenals, thus causing renal tubular damage; volume augmentation to enhance cardiac output; and marked activation of the renin-angiotensin system. Unfortunately, these mechanisms also increase venous pressure and ultimately produce interstitial fluid accumulation and characteristic hydropic changes in the fetus.

19
Q

type 1 hypersensitivity pathophysiology

A

B cells produce IgE specific to an antigen. The IgE binds the the surface of mast cells and basophils - they become sensitised.

when re-exposed to the antigen, the antigen binds to the IgE antibodies coating mast cells and basophils

This causes cell degranulation and release of histamine and other inflammatory mediators

20
Q

3 main risk factors of head and neck Ca

A

Heavy smoking, heavy alcohol consumption (the two act synergistically) and poor dentition

others =
Cantonese-style salted fish
HPV16

21
Q

oropharyngeal Ca Ix

A

With the exception of persistent hoarseness (urgent CXR to decide where to refer), investigations in primary care are not recommended, as they can delay referral.

LFTs - could suggest abdo mets
CXR - mets/hoarse
baseline - U+E, TFTs, pulm func
biopsy. fine needle aspiration is preferred?
CT/MRI of primary tumour and to stage for nodes/mets
PET if px w/ cervical lymph node mets and can’t find primary on CT/MRI

22
Q

MRI instead of CT when in head and neck Ca

A
  • oropharyngeal and oral tumours
  • assessment of tumour involvement of the skull base, orbit, cervical spine or neurovascular structures.

NB all should have CT thorax

23
Q

blood mixed in with stool ddx

A

infections, IBD, diverticula, or tumour

24
Q

Ix to diagnose renal colic

A

non-enhanced CT

(replaced intravenous pyelogram)
plain X-ray is useful to see passage of stones but is not used for dx - remember suspected pt with stone in flexi clinic had to be admitted to have the CT that day

25
Q

when to manage renal pts conservatively

A

for up to 3 weeks unless the pt is unable to manage the pain OR there is infection/obstruction

stones larger than 1 cm in diameter usually require intervention

(majority of stones will pass spontaneously but may take 1-3 weeks) - patients who have not passed a stone or who have continuing symptoms should have the progress of the stone monitored at a minimum of weekly intervals to assess the progression of the stone.

26
Q

what drug is used in renal stones to manage conservatively

A

CCB or tamulosin (alpha blocker)

27
Q

indication for admission with stone

A

fever, one kidney, inadequate pain relief, can’t keep fluids down, anuria, preg
>60 - if you think could be leaky AA

28
Q

surgical options

A 
-extracorporeal shock wave lithotripsy (ESWL)
percutaneous neprolithotomy (large stones)
ureterscopy - laser to break stones

3b Past Papers (4 decks)

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