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Leeds MBCHB Year 4 ACC > Acute medicine > Flashcards

Acute medicine Flashcards

1
Q

Difference between stable and unstable angina

A

Relieved by rest OR GTN spray

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2
Q

Gold standard investigation for stable angina

A

CT coronary angiogram

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3
Q

3 parts of medical management of stable angina

A

Immediate symptomatic relief - GTN spray
Long term symptomatic relief - BB or CCB
Secondary prevention - Aspirin, statin, ACEI, (BB or CCB)

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4
Q

4 drugs patient with stable angina should be on

A

ACEI
BB or CCB
Statin
GTN

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5
Q

What is the GRACE score after a NSTEMI

A

The 6 month risk of death or a repeat MI

  • Medium or high risk (>5%) PCI within 4 days
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6
Q

When does Dresslers syndrome occur

A

2-3 weeks after MI

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7
Q

Management of Dresslers syndrome

A

NSAIDS ?steroids and occasionally pericardiocentesis

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8
Q

Secondary prevention of an MI

A

6 A’s

Aspirin
Another anti-platelet for up to 12 months
Atorvastatin (75mg)
Ace inhibitor
Atenolol or other BB

Aldosterone antagonist if heart failure

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9
Q

Artery affected in anterolateral MI

A

Left coronary

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10
Q

Artery affected in anterior MI

A

LAD

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11
Q

Artery affected in lateral MI

A

Circumflex

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12
Q

Artery affected in inferior MI

A

RCA

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13
Q

Other causes of raised troponin

A 
Renal failure
Sepsis 
Myocarditis
Aortic dissection
PE
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14
Q

3 features of pneumonia on examination of chest

A

Bronchial breath sounds
Fine course crackles
Dull ness to percussion (thicker due to collapse or consolidation)

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15
Q

Score for CAP

A

CURB-65

Confusion
Urea >7
RR >30
BP<90 s
>65
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16
Q

Most common cause of pneumonia in UK healthy (ish) people

A

Streptococcus pneumoniae

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17
Q

What is the definition of atypical pneumonia

A

Organism that cannot be cultured in a normal way or detected by gram stain

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18
Q

30s male presents unwell after a cheap holiday and is hyponatraemic

A

Legionella

SIADH

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19
Q

How does mycoplasma pneumoniae present

A

Young patient with neurological symptoms
Erythema multiform - target lesions
Mild pneumonia

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20
Q

MCQ about a farmer with a flu like illness

A

Coxiella burnetill (Q fever)

Linked to animal exposure

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21
Q

Pneumonia associated with birds and parrots

A

Chlamydia psitacia

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22
Q

Two most common classes of ABX for pneumonia

A

Amoxicillins or macrolides

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23
Q

When can a DVT present as a stroke

A

Patients with an ASD

24
Q

Main contraindication for anti-embolic compression stockings

A

PAD

25
Q

What is a significant difference in calf sizes in the context of DVT

A

Greater than 3 cm

26
Q

When should a DVT USS be repeated

A

If positive d dimer and wells score: likely

7 days after negative USS

27
Q

How may management change for a illofemoral DVT

A

Catheter thrombolysis directly to clot

28
Q

When may IVC filters be used

A

IN recurrent PEs

Patients unsuitable for anticoagulation

29
Q

What should patients with an unprovoked DVT have after they finished treatment

A

Physical exam and bloods

Antiphospholipid antibodies
Thrombophilias if have a first line relative with a DVT or PE

30
Q

What is Budd Chari syndrome

A

Thrombosis in hepatic vein

Abdominal pain, hepatomegaly and ascites

Acute hepatitis

31
Q

3 most common causes of cellulitis

A

Staph A

Group A and group C strep

32
Q

Classification of cellulitis and range

A

ERON

1-4

4= sepsis

33
Q

DKA criteria

A

Glucose >11
Ketosis >3
Acidosis <7.3

34
Q

Treating DKA

A

FIG PICK

Fluids
Insulin
Glucose

Potassium
Infection
Chart
Ketones

35
Q

T1DM patient presents with little hard lumps on their abdomen

A

lipodystrophy

36
Q

Alcohol dependance effect on FBC MCV

A

Raised MCV

37
Q

Treatment for acute alcoholic hepatitis

A

Steroids

38
Q

4 stages of alcohol withdrawal by time

A

6-12: tremor, sweating, headache and craving
12-24: hallucinations
24-48: seizures
24+: DT

39
Q

Symptoms of DT

A 
Acute confusion
Severe agitation
Delusions and hallucinations 
Tremor
Tachycardia, HTN, hyperthermia
Ataxia
40
Q

Assesment scale for alcohol withdrawal

A

CIWA-Ar

41
Q

Which vitamin does alcohol excess lead to deficiency in

A

B1

42
Q

What comes first Wernickes or korsakoffs

A

W then K

43
Q

3 features of Wernickes

2 features of Korsakoff’s

A

Confusion, oculomotor disturbances, ataxia

Memory impairment and behavioural changes

44
Q

What causes vasodilation in sepsis

A

Nitrous oxide

45
Q

What causes oedema and capillary leaking in sepsis

A

Cytokines: interlukins and TNF

46
Q

What may thrombocytopenia concerning in a septic patient

A

Possible DIC

47
Q

What should be measured during a anaphylactic attack

A

Serum mast cell tryptase within 6 hours

48
Q

COPD dyspnoea scale

A

MRC 1-5

5 cannot leave house

49
Q

What is PESI score

A

PE severity index

1-2 get sent home same day

50
Q

PE treatment

A

DOAC

51
Q

Can pregnancy or breast feeding women have DOACs

A

Not good data so LMWH used instead

52
Q

When can a PERC be used and what score rules out a PE

A

When clinically unlikely

0 = very low risk

53
Q

Other than TTTW what else can be seen in hyperkalemia

A

Flat p waves
Sloping ST
Broad QRS

54
Q

Management and doses of hyperkalemia

A

Calcium glutinate 30ml 10% bolus

Then

5mh salbutamol or 10 units in 50ml 50% insulin dextrose

55
Q

Best initial delirium test

A

SQID

” is this patient more confused”

56
Q

What is AMT4

A

Test for delirium in patients with acute confusion

57
Q

High level of epithelial cells on urine culture dx:

A

Contamination, do not treat

Leeds MBCHB Year 4 ACC (5 decks)

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