Capsule cases

Question 1

_______is caused by reduced blood flow to the skin

what does it indicate?

Answer 1

Livedo Reticularis

severe sepsis or disseminated intravascular coagulopathy

Question 2

what are end organ damage signs?

Answer 2

reduced urine output

confusion

Question 3

flat line with a wandering baseline?

what is CPR guidelines for this?

Answer 3

asystole, non shockable rhythm sign
no pulse
adrenaline 3/5 mins
cpr

Question 4

ongoing resus for asystole ?

Answer 4

fluid bolus that is like plasma - hartmans - crystalloid
100% oxygen
adrenaline 3/5mins

Question 5

what can cause a cavitating lung mass?

gas-filled spaces surrounded by consolidation, a lung mass or nodule.

Answer 5

Squamous cell carcinoma
lung abscess
Granulomatosis with polyangiitis
mesothelioma

Question 6

what is mesothelioma associated with?

Answer 6

asbestos exposure

Question 7

meningitis what common pathogens?

bacterial?

Answer 7

neisseria meningitis

strep pneumoniae

Question 8

neonates bacterial meningitis?

Answer 8

group b streptoccous

listeria

Question 9

viral meningitis?

Answer 9

enteroviruses / hsv / HIV

Question 10

what is kernigs sign ? what condition is indicated?

what other sign beginning with B indicates this diagnosis?

Answer 10

hips flexed pain and resistance on passive knee

brudzinskis sign
flexion of hips on neck
flexion

Question 11

skin rash -petechiae with

_____

Answer 11

meningococcal septicaemia

Question 12

csf fluid appearance in bacterial meningitis?

Answer 12

turbid

Question 13

encephalitis most commonly viral or bacterial?

Answer 13

viral

Question 14

In many cases, ____ is a mild self-limiting illness.
Subacute onset (hours to days) headache, fever, vomiting, neck stiffness, photophobia, i.e.
symptoms of _____(_______ with behavioural changes, drowsiness
and confusion.
There is often a history of seizures.
Focal neurological symptoms (e.g. dysphasia and hemiplegia) may be present.
It is important to obtain a detailed travel history.

what condition

Answer 14

encephalitis

Question 15

what virus commonly causes encephalitis?

Answer 15

HSV

herpes zoster
mumps
adenovirus
EBV 
HIV

Question 16

Lumbar puncture results for encephaltis

Answer 16

: “ Lymphocytes, “ monocytes, “ protein, glucose usually normal. CSF
culture is difficult, viral PCR is now first line.

135.3 - 9471

Question 17

management of encephalitis?

Answer 17

IV aciclovir

consider dexamethasone

Question 18

lumbar meningitis

Answer 18

Cloudy CSF, “ neutrophils, “ protein, # glucose (CSF: serum glucose ratio of <0.5).

Question 19

normal aciclovir dosing?

Answer 19

700mg 8 hourly

Question 20

viral meningitis signs

Answer 20

lymphocytes would be high
protein would be high
glucose would be normal

Question 21

‘Global’ T wave inversion what does this make you think?

Answer 21

(not fitting a coronary artery territory) - think non-cardiac cause of abnormal ECG

Question 22

ecg findings with hypothermia

Answer 22

qt prolongation

Question 23

myocardial ischaemia
digoxin toxicity
subarachnoid haemorrhage
arrhythmogenic right ventricular cardiomyopathy
pulmonary embolism ('S1Q3T3')

all of these cause what to T waves?

Answer 23

t wave inversion

Question 24

peaked t wave

Answer 24

hyperkalaemia

myocardial ischaemia

Question 25

reversible causes of cardiac arrest

Ts

Answer 25

tension pneumothorax
thrombosis
tamponade
toxins

Question 26

reversible causes of cardiac arrest

the Hs

Answer 26

hypothermia
hypoxia
hypo/hyperkalaemia
hypovolaemia

Question 27

pulmonary stenosis murmur?

Answer 27

Pulmonary stenosis causes an ejection systolic murmur that is louder on inspiration. This is due to blood flowing through the narrow pulmonary valve throughout systole. It is affected by inspiration as this increases venous blood return to the right side of the heart.

Question 28

pan systolic murmur on expiration?

Answer 28

mitral regurg

Question 29

pansystolic murmur heard loudest on inspiration

Answer 29

tricuspid regurg

Question 30

aortic stenosis murmur?

loudest on inspiration or expiration?

Answer 30

ejection systolic

Question 31

diastolic murmur?

Answer 31

mitral stenosis

This patient suffers from progressive cardiac failure secondary to mitral stenosis. She presents with exertional dyspnoea, orthopnoea and paroxysmal nocturnal dyspnoea, in keeping with left-sided heart failure. Findings upon auscultation of the heart are in keeping with mitral stenosis, which is most commonly caused by rheumatic fever.

Question 32

CHA2DVASC2 score

Answer 32

congestive heart failure
hypertension
age
75-2
65-74-1
diabetes
s2
prior stroke, tia, thromboembolism
vascular disease
gender - female

Question 33

why would you give ARBs when ACEi is indicated?

Answer 33

if ACEi is poorly tolerated because of cough