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Year 3 Medicine > 2020+1 Paper > Flashcards

2020+1 Paper Flashcards

1
Q

What is required for a diagnosis of Ulcerative Colitis?

A

A negative stool culture

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2
Q

Why is flexible sigmoidoscopy preferred to colonoscopy in ulcerative colitis?

A

It is less expensive, less invasive, doesn’t require sedation and can be performed in practise

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3
Q

What is hyperventilation syndrome?

A

Recurrent palpitations and dysponea commonly due to anxiety

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4
Q

What is the fastest diagnostic test for TB?

A

Zheil-Neelson staining or Auramine test

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5
Q

What is the Auramine stain?

A

An alternative to the Zhiel-Neelson stain for TB, both of which yield results within 24 hours

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6
Q

What is the Mantoux test?

A

A test for latent TB (aka Tuberculin test)

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7
Q

Which organisms cause aspiration pneumonias?

A
  • Klebsiella
  • Staph aureus
  • Haemophilus influenzae
  • Strep pneumoniae
  • Anaerobes
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8
Q

What is the first line pain medication for sickle cell crisis?

A

Paracetamol and then NSAIDs

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9
Q

What is the most common cause of basal actelectasis?

A

Surgery, particularly abdominal surgery

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10
Q

Why is surgery a risk factor for actelectasis?

A
  1. Patients are under anaesthetic and therefore are unable to breathe deeply/ cough increasing risk of basal collapse
  2. Patients are often in pain after surgery which may be exacerbated by breathing deeply therefore breaths may be more shallow
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11
Q

What are the most effective treatments of atelectasis?

A
  • Physiotherapy
  • Breathing exercises
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12
Q

What haematological abnormality can iron deficiency anaemia cause?

A

Thrombocytosis as erythropoieten is increased due to the anaemia which in turn increases WBCs

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13
Q

How can meningitis and encephalitis be differentiated?

A

Meningitis will rarely cause neurological symptoms such as a seizure, whereas encephalitis commonly presents with seizure

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14
Q

How long should PPIs be stopped before endoscopy?

A

3-4 weeks

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15
Q

What is the cut off for referring patients for endoscopy with suspected GORD without alarm symptoms?

A

>55 without any red flags

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16
Q

What type of haemorrhoids would be painful?

A

External thrombosed haemorrhoids (grade 3/4)

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17
Q

What is the most common causative organism of infective endocarditis?

A

Staph aureus

  • Strep viridans is associated with dental proceedures
  • Staph epidermidis is associated with IVDU and medical proceedures
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18
Q

What is the mechanism of palmar erythema in alcoholic cirrhosis?

A

There’s increased circulating oestrogen which would have been metabolised in the liver

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19
Q

What are the life threatening O2 stats?

A
  • <92 % non-COPD
  • <88% COPD
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20
Q

When would rate control over rhythm control be given in AF?

A

If the patient has been in AF >48hrs or the time-course is unknown

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21
Q

What is a fragility fracture?

A

A fracture due to a fall from standing height or less

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22
Q

What is deficient in Gilbert’s syndrome?

A

UDP glucuronosyltransferase

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23
Q

What is the inheritance pattern of Guilbert’s syndrome?

A

Autosomal recessive

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24
Q

What is the management of PBC?

A

Ursodeoxycholic acid

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25
Q

What is the diagnostic test for carpal tunnel syndrome?

A

Nerve conduction studies or EMG

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26
Q

What is an important side effect of carbimazole?

A

Agranulocytosis, therefore patients with new onset illnesses after commencing treatment should have a FBC taken

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27
Q

What are the common causative organisms of acute epididymitis?

A
  • <35 Neisseria gonorrhoea, Chlamydia trachomatis
  • >35 E.coli
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28
Q

Which electrolytes should be checked before starting theophylline?

A
  • Us and Es, especially K+
  • LFTs
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29
Q

What type of haematuria do kidney stones commonly cause?

A
  • 80ish% microscopic
  • 20ish% macroscopic
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30
Q

What are the two most common causes of DKA?

A
  • Pneumonia
  • UTI
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31
Q

How long should patients with medication overuse headache stop taking medications for?

A

At least one month

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32
Q

What is the INR target for first episode VTE?

A

2-3

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33
Q

What is a normal INR?

A

1-1.5

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34
Q

What is the difference in presentation between large and small bowel obstruction?

A

Large bowel

  • Distention common
  • With or without pain
  • Faceulent vomiting
    • May not be present
  • More gradual onset

Small bowel

  • Distention less common
  • Painful
  • Vomiting an early sign
    • Bilious

Sigmoid volvulus

  • Acute onset
  • Colicky pain
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35
Q

What is the main cause of large bowel obstruction?

A

Colorectal cancer

36
Q

What is the presentation of sigmoid volvulus?

A

Acute colicky pain

37
Q

What is the management of anal fissures?

A
  1. Conservative (constipation reducing)
  2. Topical GTN (Diltiazem if GTN causes headaches)
  3. Botox injection (recurrent)
  4. Surgical sphincterectomy (recurrent)
38
Q

What is the Waterlow score?

A

A score used to estimate the risk of development of pressure ulcers

39
Q

What is the Ranson criteria?

A

A score used to assess the severity of acute pancreatitis

40
Q

What are the scores for acute pancreatitis?

A
  • Glasgow score
  • Ranson criteria
  • APACHE II
41
Q

What is the HAS-BLED score?

A

The one year risk of bleeding for patients who have AF

42
Q

What is polymorphic ventricular tachycardia?

A

Torsades de Pointes

Managed with IV MgSO4

43
Q

When should adults with a bowel habit change be urgently referred?

A

>60

44
Q

What are labyriniths?

A

An inflammatory disorder affecting the vestibular and cochlear organs causing sensorineural hearing loss and balance impairment

  • Attacks last hours to days
  • Viral or bacterial
45
Q

What is vestibular neuritis?

A

An inflammatory disorder affecting just the vestibular organs

  • Attacks last hours to days
  • No hearing impairment
46
Q

When should mastitis be treated?

A
  • Symptoms fail to improve 12-24 hrs
  • Culture indicates an infection
  • Nipple fissure is present
  • Systemically unwell
47
Q

What is the definitive imaging modality in ruptured AAA?

A

CT

Ultrasound if not ruptured

48
Q

When is surgery indicated for AAA?

A

>5.5cm or 4cm and growing more than 1cm per year

Or ruptured

49
Q

What is the strongest risk factor for diverticular disease?

A

Age >50

50
Q

Why does tanning occur in haemochromatosis?

A

Due to the accumulation of iron in the sweat glands

51
Q

What is the inheritance pattern of essential tremor?

A

Autosomal dominant

52
Q

What are the risk factors for C.diff infection?

A
  • Broad spectrum antibiotic use
  • Hospitalisation
  • Residency in a nursing home
  • Use of acid suppressing drugs, eg. PPI
53
Q

What is the most common cause of hypercalcaemia?

A

Primary hyperparathyroidism

54
Q

How long is the latent period of asbestosis?

A

15-30 years

55
Q

What are the CT changes in asbestosis?

A
  • Pleural thickening
  • Ground glass opacities
  • Lower lobe fibrosis
56
Q

What does sarcoidosis imaging show?

A
  • Bilateral hilar lymphadenopathy
  • Upper lobe scarring
57
Q

What can skin tags reflect in patients with PCOS?

A

Hyperinsulinaemia

Usually found in the neck region

58
Q

What is the presentation of chronic venous disease?

A

Oedema on standing and new varicose veins

59
Q

Which types of inguinal hernias are more common?

A

Indirect

60
Q

Where does the pain radiate in pneumothorax?

A

Shoulder tip

61
Q

What are the causes of pleuritic chest pain?

A
  • Pneumonia
  • PE
  • Pleural effusion
  • Pneumothorax
  • Pericarditis
62
Q

What is the management of acute heart failure?

A
  • A-E
  • Treat the cause
  • Furosemide

  • Consider GTN or another vasodilator if there is a hypertensive crisis*
  • Consider ionotopic drug if there is cardiogenic shock*
63
Q

What is the management of trigeminal neuralgia?

A

Carbamazepine

64
Q

When would carotid doppler be used?

A

To investigate cause of TIA or anterior circulation stroke

65
Q

When should patients with temporal arteritis urgently be referred to an opthalmologist?

A

If there is any visual disturbance, but prednisolone is ALWAYS commenced first

Without visual disturbance, referral is made to rheumatology and patients are seen within 3 days

66
Q

What’s the standard dose of prednisolone for GCA patients without visual loss?

A

40-60mg

67
Q

What is the mechanism of statins?

A

They inhibit endogenous formation of cholesterol in the liver by inhibiting HMG-CoA reductase

68
Q

Is colonoscopy or flexible sigmoidoscopy necessary for a diagnosis of IBS?

A

No

69
Q

What is the main risk factor for hepatocellular carcinoma?

A

Cirrhosis

70
Q

What is the usual presentation of amoebic liver abscess?

A

Usually asymptomatic, but can present with fever and RUQ pain

71
Q

What is the cut off for upper GI symptoms and urgent 2ww referral?

A

>55

72
Q

What are the possible surgical treatments for varicose veins?

A
  • Endothermal ablation
  • Foam sclerotherapy
  • Ligation or stripping of the veins
    • Surgical
73
Q

What is the difference between hot and cold nodules on thyroid uptake scan?

A

Hot nodules will uptake lots of iodine as they’re hyperactive, cold nodules will not uptake iodine and are usually cancerous

74
Q

What is the guidance on managing diabetes during surgery?

A

Patients on variable rate insulin infusion until they are able to eat and drink again post surgery without vomiting

75
Q

What is the management of non-haemolytic febrile reaction?

A
  1. Stop the transfusion
  2. Give paracetamol
  3. Restart the transfusion
76
Q

What is the managment of acute haemolytic transfusion reaction?

A
  1. Stop the transfusion
  2. Check patient details
  3. A-E
77
Q

What are the features of acute haemolytic transfusion reaction?

A
  • Fever
  • Abdominal pain
  • Hypotension
78
Q

What is the management of transfusion associated circulatory overload?

A

IV furosemide

79
Q

How does transfusion associated circulatory overload present?

A
  • Hypertension
  • Pulmonary oedema

Usually in patients with previously existing heart failure

80
Q

Can fibroadenomas fluctuate during menses?

A

Yes

81
Q

What is the most common cause of cauda equina syndrome?

A

Lumbar disc herniation

82
Q

Which cortisol levels would prompt short synACTHen test to be performed?

A

100-500 nmol/L 9am cortisol

83
Q

What is the gold standard diagnostic tool for bladder outlet obstruction?

A

Urianry outflow studies

84
Q

When should patients be referred on suspected bowel cancer?

A

Any bowel habit change or anaemia in >60

85
Q

How does hep C usually present?

A

With a flu prodrome, but it rarely causes symptoms

86
Q

What are the warfarin INR guidelines?

A

Between 2-3

87
Q

What is fibromyalgia?

A

Abnormal sensory processing in the CNS, making people more receptive to muscle pain

Year 3 Medicine (22 decks)

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