Buzzwords Flashcards
Metronidazole + what = bad?
Alcohol.
Statin plus what = bad!
Grapefruit juice.
Warfarin + what = bad?
Cranberry juice.
Warfarin + what = bleed?
NSAID.
Ace inhibitor + what = hyperkalaemia?
Spironolactone.
Digoxin + what = digoxin toxicity?
Verapamil.
Patient has a fever and a pleuritic chest pain that is relieved by sitting up and leaning forward?
Pericarditis.
Irregularly irregular pulse means?
Atrial fibrillation.
An ECG with a saw tooth baseline and a pulse of over 150 means what?
Atrial flutter.
What 5 things should we see on X-ray with pulmonary oedema?
Alveolar bats wings. Kerley B lines. Cardiomegaly. Dilated prominent upper lobe vessels. Pleural effusion. Remember ABCDE.
What does a raised JVP mean?
Right sided heart failure.
What gives a sense of impending doom?
MI
What gives a saddle shaped ST elevation?
Pericarditis.
What gives a broad complex tachycardia?
A ventricular problem.
What can we hear and feel with mitral stenosis?
Mid diastolic murmur with a tapping displaced apex beat.
What gives a broad QRS with slurred upstroke on the R wave (delta wave) on ECG?
Wolff Parkinson white syndrome.
What gives tall tented t waves?
Hyperkalaemia (also gives wide QRS complexes).
What does a patient have if they get pericarditis 4-6 weeks post MI?
Dressler’s syndrome.
What gives a patient a blurred yellowing vision headache?
Digoxin toxicity.
When do we see janeway lesions or oslers nodes?
Subacute bacterial endocarditis.
What causes a continuous machine like heart murmur?
Patent ductus arteriosus.
What makes us see rib notching on CXR?
Coarction of the aorta.
What gives a crescendo descendo murmur?
Aortic stenosis.
What gives diminished absent lower limb pulses?
Coarction of the aorta.
What gives stony dull percussion?
Pleural effusion.
What gives right sided pleuritic chest pain?
Usually pneumonia.
What two things show a ground glass appearance on chest X-ray?
Pulmonary fibrosis and respiratory distress of the newborn.
What gives a positive ziehl-Nielsen staining?
TB.
What shows caseous necrosis in the lungs?
TB
What is the most likely cause of apical lung disease and what is the lesion called?
Most likely secondary TB.
Called an assmann focus.
How does miliary TB spread?
Organism spreads into bloodstream. If it spreads via the pulmonary artery, miliary dissemination into the lung occurs. If organism is spread via the pulmonary vein, there is systemic dissemination to the liver, spleen and kidneys.
What gives anti-glomerular basement membrane antibodies?
Good pastures syndrome.
What is likely to have caused a chest infection if the patient has a parrot/pigeon as a pet?
Chlamydophila psittaci.
What is likely to have caused a dry cough and diarrhoea after a holiday abroad, with some indication of water spread?
Legionella pneumonia. Test urine for antigens.
What does a tall thin young man who indulges in marijuana likely have?
Probably a pneumothorax. Marfans.
What does a person with bilateral hilar lymphadenopathy, erythema nodosum, granulomas, fatigue, uveitis and weight loss have?
Sarcoidosis.
What is the diagnosis of we see a bronchioles wider than the neighbouring arterioles on CT scan? What is this sign called?
Bronchiectasis
Signet ring sign.
What gives a D sign on X-ray?
Empyema.
What gives a steeple sign on X-ray?
Croup.
What does a child with a barking cough have?
Croup.
What underlying disease do patients with pneumocystis pneumonia generally have?
How do we treat the above?
HIV
Co-tramoxazole +/- prednisolone if severe.
What is samsters triad?
Asthma, nasal polyps and salicylate sensitivity.
What types of pneumonia are alcoholics prone to?
What organism commonly causes it?
Aspiration.
Klebsiella pneumoniae.
What organism gives red jelly sputum?
Klebsiella pneumoniae.
What organisms gives mucoid sputum?
Chlamydia psittaci.
What gives rusty sputum?
Pneumococcal pneumoniae.
What classically gives cannonball metastasis, weight loss and haemoturia?
Primary renal cell carcinoma.
What can give a morning headache?
Hypercapnia or side effects of organic nitrates.
What is an ACTH secreting lung tumour?
Small cell carcinoma of the lung.
What lung cancer is PTH secreting?
Squamous cell carcinoma of the lung.
What kind of cancer may be assorted with ectopic endocrine syndromes?
Why?
Small cell carcinoma.
It is a highly malignant neuro endocrine tumour.
What condition do we have with increased ACE and Ca2+?
Sarcoidosis.
What condition has eggshell calcification at the hilar lymph nodes?
Silicosis.
What are heart failure cells seen in the alveolar spaces?
When are they seen?
Macrophages that have absorbed haemosiderin.
Found in chronic pulmonary oedema, severe left ventricular heart failure and long standing pulmonary hypertension.
What is a Ghon focus?
Area of infection and caseous necrosis at the periphery of the lung beneath the pleura found in TB infection.
What will Ghon focus rupture cause and how common is it?
Ruptures through the visceral Pleura into the pleural cavity will produce tuberculosis pleurisy.
Rare.
What is an assman focus?
Apical lesion of secondary tuberculosis infection.
What are coin lesions on CXR?
What commonly causes them?
A solitary round lesion.
Primary bronchial or lung carcinoma, metastatic tumour especially of the kidneys, bronchial hamartoma, carcinoid tumour, granulomatous inflammation and lung abscess.
What can cause horners syndrome?
Can occur when there is a local spread of cancer to the intrathoracic node or a pancoast tumour.
What are the signs of Horners syndrome?
Why do these happen?
Ptosis, enopthalmos (sunken eye), miosis, lack of sweating on ipsilateral side.
Due to invasion of the cervical sympathetic chain.
What is the acute management of asthma?
OSHITMAN Oxygen 100% through a non rebreather mask. Salbutamol nebuliser back to back. Hydrocortisone IV or prednisolone PO. Ipratropium bromide nebuliser hourly. Theophylline IV or aminophylline IV. Magnesium and call an Anaesthetist.
What causes a thumb print sign on head X-ray?
Epiglotitis.
What causes an inspiratory whoop or barking cough?
Pertussis.
What causes a snow storm appearance on X-ray?
Baritosis or silicosis.
What is the management for an infective exacerbation of COPD?
iSOAP ipratropium Salbutamol Oxygen Amoxicillin Prednisolone.
What type of lung cancer does a non smoker commonly get?
Peripheral adenocarcinoma.
What lung cancers are central?
Squamous and small cell.
What respiratory condition should we expect with high D dimers?
What else should we do to confirm?
PE suspected but not diagnosed.
Send for CTPA or VQ scan.
What respiratory condition do low D Dimers exclude?
PE.
What treatment do we give for large and small PE’s?
Large - thrombolysis.
Small - LMWH.
What is a swinging fever indicative of?
Abscess.
What is a useful tip to remember what type of X-ray and AP X-ray is?
A Portable.
What treatment do we give for TB?
2RIPE 4 RI 2months of : Rifampicin Isoniazid Pyramzinamide Ethambutol
4 months:
Rifampicin
Isoniazid.
What is the sepsis 6 bundle?
BUFALO Blood cultures and any other relevant cultures. Urine output measurement Fluids (IV) Antibiotics LDH (lactase dehydrogenase) and FBC. O2 high flow.
What are the causes of pancreatitis?
GET SMASHED Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion stings Hyperlipidaemia/hypercalcaemia ERCP Drugs.
What are the bones of the wrist?
Some lovers try positions that they cannot handle. Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate.
What are the causes of clubbing?
CLUBBING Cyanosis heart disease Lung disease (hypoxia, cancer, CF, idiopathic pulmonary fibrosis) UC/Crohn's Biliary cirrhosis Birth defect Infective endocarditis Neoplasm (especially hodgkins) GI malabsorption
What are the adrenal secretions from the different layers?
Go Find Rex Make Good Sex
Glomerulosa Mineralcorticoids.
Fasciculata Glucocorticoids
Reticularis Sex hormones
What causes DKA?
Infection Ischaemia Infarction Intoxication Ignorance.
What are the reversible causes of cardiac arrest?
4 Hs and 4 T's Hypovolaemia Hypothermia Hyper or hypokalaemia Hypoxia Tamponade Tension pneumothorax Thromboembolism Toxin
What will we see in acute limb ischaemia?
Pale, pulseless, painful, paralysed, paraesthetic and perishingly cold limb
What are the causes of liver disease?
A to I Autoimmune Hepatitis B Hepatitis C Drugs e.g. Paracetamol Ethanol Fatty liver disease Growth e.g. Cancer Haemodynamic e.g. Congestive heart failure. Infiltration e.g iron (haemochromatosis or wilsons) or infective.
What is raised in alcoholic liver disease?
wASTed
AST.
What is more specific to the liver than AST?
aLt is more specific to Liver disease than AST.
What are the 6 causes of abdominal distension?
Fat Flatus Foetus Feces Fluid Fucking massive tumour.
What can gingival hypertrophy be caused by?
Biting on gums or side affect of calcium channel blockers or phenytoin.
What gives a bird beak appearance and distended oesophagus?
Achalasia.
If in lower GI Xray it is a sign of bowel obstruction.
What are two visible signs of pancreatitis?
Grey turners syndrome - lumbar redness
Cullens sign - umbilical redness.
What sign is positive in cholecystitis?
Murphys sign positive.
What do pail stools, jaundice and abdominal pain indicate?
Biliary obstruction.
What are the signs of portal hypertension and ascites?
Abdominal distension, caput medusae and shifting dullness.
If we see pyoderma gangrenous and erythema nodosum what disease should we think of?
IBD
What type of bowel sounds do we get in an obstruction?
Tinkling bowel sounds.
What is a vesicular rash and weight loss indicative of?
Coeliac disease.
What lymph node may be palpable if the patient has gastric cancer?
Virchows node (left supraclavicular)
What non invasive test do we do for H pylori?
Urea breath test
What test do we do for bacterial overgrowth?
14C breath test.
What infection gives rice water like stools?
Vibrio cholera
What antibodies are present in primary biliary cirrhosis?
AMA anti mitochondrial antibodies.
What hormones are present in autoimmune hepatitis?
ASMA anti smooth muscle antibodies.
What does alpha feto protein assay indicate?
Hepatocellular carcinoma or teratoma.
What disease is cobblestone mucosa found in and what is it?
Crohn’s
Indicating deep fissuring ulceration of mucosa.
What diuretic do we use for ascites due to cirrhosis?
Spironolactone.
What causes a corkscrew oesophagus on barium swallow?
Diffuse oesophageal spasm.
What bacteria causes severe abdo pain and D and V after raw milk?
Campylobacter.
What does Russell’s sign indicate?
Self induced vomiting.
What do Mallorca hyaline bodies indicate?
Alcoholic liver disease (acute hepatitis) and chronic active hepatitis.
What are crypt abscesses and cryptitis indicative of?
Crohn’s.
What causes onion skinning fibrosis and beading of the bile ducts?
Primary sclerosing cholangitis.
What causes signet ring cells to be seen on biopsy?
Linitis plastica from diffuse stomach cancer.
What condition can cause thumb printing on X-ray typically at the splenic flexure?
Ischaemic colitis.
What is charcots triad?
Acute cholangitis I.e fever, jaundice and abdominal pain secondary to cholelithiasis.
What are the causes of abdominal mass?
A CHEMICAL AAA Crohn's Hernia Enlarged organ Malignancy Intersusception Cysts or abscess Appendicitis Lymphadenopathy
What are the causes of bowel obstruction?
BATH VIPS Bolus Adhesions Tumour Hernia Volvulus Intersussception Pseudo obstruction Stricture
