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first year med > check yoself > Flashcards

check yoself Flashcards

1
Q

causes of secondary hypertension

A

R - renal disease, renal artery stenosis
O - obesity
P - pregnancy / pre-eclampsia
E - endocrine, hyperaldosteronism (conns)

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2
Q

stage 2 + 3 hypertension

A

2
clinic = >160/100
AB = >150/95

3
clinic = >180/120

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3
Q

long term angina treatment

A

beta blocker - bisoprolol
CCB - amlodipine

others (not 1st line)
long acting nitrates (isosorbide mononitrate)
ivabradine
nicorandil
ranolazine
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4
Q

secondary prevention angina

A

aspirin
atorvastatin
acei
already on beta blocker

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5
Q

MI complications

A 
D - death
R - rupture of heart septum or papillary muscles
E - edema (heart failure)
A - aneurysm / arrhythmia
D - Dresslers
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6
Q

AAA screening

A

men age 65-74

<3 normal
>3 monitored

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7
Q

homans sign

A

pain in calf on dorsiflexion of foot

DVT

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8
Q

common causes of AF

A

SMIRTH

S- sepsis / infection
M - mitral / mechanical valve [athology
I - intoxication (alcohol)
R - rheumatic heart disease
T- thyrotoxicosis
H - Hypertension
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9
Q

AF rate control (first line)

A

BB (atenolol)
CCB (dil / vera)

** never together verapaKILLLLL !!!!

digoxin if fails - take a while to kick in, dangerous if hypokalaemic, slows AV conduction (more time to fill ventricle)

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10
Q

what anticoag if mitral stenosis associated AF

A

warfarin

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11
Q

when would you DC cardiovert in AF

A

if symptoms <48hrs or anticoagulated prior

do echo first to look for emboli

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12
Q

AF HR

A

300 - 600 bpm

irregularly irregular

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13
Q

atrial flutter HR

A

220-240bpm

regularly irregular

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14
Q

symptoms / causes of VT

A

dizziness / syncope
hypotension

usually triggered - hypoxia, electrolyte abnormalities

common in CHD or previous MI

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15
Q

mode of inheritance of brugada syndrome

A

autosomal dominant
ST elevation in RBBB in leads V1-3

cjanges may be seen after flecainide

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16
Q

2nd + 3rd heart block treatment

A

atropine IV
no improve - other inotropes = noradrenalin
defibrillate

long term = pacemaker

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17
Q

acute HF / oedema / cardiogenic shock

A

morphine
NIV / CPAP
inotropes - noradenalin infusion

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18
Q

dresslers pathophysio

A

AUTOIMMUNE response to cardiac damage - damaged heart muscle release previously encountered material that stimulates an immune response

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19
Q

HOCM management

A

high risj = ICD
low = amiodarone

genetic analysis

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20
Q

mode of inheritance of familial dilated cardiomyopathy

DCM

A

autosomal dominant

DCM can be sporadic - toxins, autoimmune
echo, CXR (cardiac enlargement)

same Mx as HF

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21
Q

drugs to close/open ductus arteriosus

A

open - prostaglandin E2

close - indomethacin

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22
Q

hereditary condition associated with coarctation of aorta

A

turner syndrome - monosomy X

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23
Q

corctation of aorta symptoms

A

headaches / nosebleeds - due to hypertension
claudication
delayed pulses

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24
Q

clinical features of tetralogoy of fallot

A

spasms of sub pulmonary muscles
episodes of severe cyanosis

cyanosis develops due to increased right sided pressure - right-to-left shunt

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25
Q

tetralogy of fallot conditions

A

VSD
overriding aorta
pulmonary stenosis
RV hypertrophy

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26
Q

tetralogoy of fallot treatment

A

treat each

spasms relieved by increasing systemic resitance using postural manoeuvres – squatting

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27
Q

marfans mode of inheritance

A

autosomal dominant - FBN1 mutation

50/50 - each child of one affected parent

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28
Q

marfans clinical features

A

heart - aortic aneurysm + dissection, mitral valve prolapse

eye - dislocated lenses, retinal detachment

tall, long arms, scoliosis

high arched palate

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29
Q

marfans management

A

BB (atenolol) - slows rate of dilation of aortic root
ARB
lifestyle - avoid long exercise, sedentary job
monitoring

genetic screening, counselling

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30
Q

normal ejection fraction

A

> 50%

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31
Q

ADH + angiotensin II - vasodilators/constrictors?

A

vasoconstrictors

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32
Q

chemical vasoconstrictors

A

serotonin
thromboxane A2
leukotrienes

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33
Q

what is pacemaker potential due to?

A

decrease K+ efflux

34
Q

neurotransmitter + receptor in negative chronotropic effect

A

acetylcholine via muscarinic M2 receptors

35
Q

erbs point

A

3rd ICS left sternal edge

36
Q

role of aldosterone

A

(steroid hormone) acts on kidneys to increase sodium + water retention

-> increasing PV + BP

37
Q

natriuretic peptides

A

made by heart - also brain + others
released in response to cardiac distension

decrease renin secretion - decreasing BP
(vasodilators - decrease SVR + BP)

38
Q

antidiuretic hormone

A

(vasopressin)
increases reabsorption of water (conserves it) - concentrates urine

–> increases extracellular + PV - increase CO+BP = vasoconstriction

39
Q

where oesophagus begins

A

C6

40
Q

barretts is premalignant condition to what

A

adenocarcinoma

**ablation only if dysplastic

41
Q

what must happen prior to H pylori testing

A

2 weeks PPI free

42
Q

how would bacillus cereus appear on a gram stain

A

purple rod - gram positive bacillus (so would listeria monocytogenes)

has heat resistant spores

43
Q

what can campylobacter be precursors of

A

guillan barre = 1-2 weeks post infection

travellers diarrhoea

44
Q

biggest risk factor for E coli 0157 progressing to HUS

A

antibiotics - AVOID

45
Q

upper GI bleeds scorng

A

glasgow blatchford - risk of having upper GI bleed

rockall score - post endoscopy for risk of rebleed / overall mortality

46
Q

management of bowel obstruction

A 
ABC
analgesia IV
fluids - usually hypokalaemic + alkalotic
NG tube - drain stomach
nil by mouth
catheterise

IV fluids to hydrate the patient and correct electrolyte imbalances

47
Q

commonest site of diverticular disease

A

sigmoid

related to low fibre diet

48
Q

treatment of diverticulitis

A

mild = ciprofloxacin + metronidazole

severe = IV fluids, IV antibiotics + bowel rest

49
Q

mallorys hyaline antibodies

A

alcoholic liver disease (acute hepatitis)

chronic active hepatitis

50
Q

hep b incubation

A

1-6months

51
Q

mrker of viral replication in hep b

A

HBeAg

Ag NOT Ab

52
Q

hep c treatment

A

protease inhibitors for 8-12 weeks

daclarasvir + sofosbuvir
or
sofosbuvir + simeprevir

always 2+ drugs - reduces resistance
no vaccine available

53
Q

IBD screening

A

faecal calprotectin -

released due to inflammation of intestines

54
Q

genetic predisposition to crohns

A

NOD2/CARD15 - involved in mucosal defences

55
Q

prior to coeliac testing

A

must be on gluten diet for 6 weeks prior

56
Q

why do coeliac get vaccines

A

pneumoccocal + annual flu

–> due to hyposplenism

other complications - vit deficiency, osteoporosis, subfertility, small bowel adenocarcinoma

57
Q

2nd line ix in cholecystitis

A

cholescintography - HIDA scan

58
Q

pancreatits scoring

A

glasgow score - PANCREAS mneumonic

59
Q

pancreatitis management

A

ABCDE
IV fluids
analgesia
monitoring - treat underlying causes/complications

60
Q

cirrhosis scoring

A

child-pugh

MELD - percentage 3 month mortality

61
Q

diet for people with cirrhosis

A

high protein

low sodium

62
Q

stable varices treatment

A

propanolol - non-selective BB
band ligation
injection of sclerosant

maybe TIPSS

63
Q

bleeding varices treatment

A

terlipressin
vit K + fresh frozen plasma
prophylactic broad-spectrum antibiotics

urgent endoscopy - sclerosant / banding

sengstaken-blakemore tube if fails - balloon inflates to stop bleeding

64
Q

management of spontaneous bacterial peritonitis (SBP)

A

culture then antibiotics

usually IV cephalosporin - cefotaxime

65
Q

fatty liver investigations

A

raised gamma-GT
elevated MCV
elevated (ALT/AST)

US + CT show fatty infiltration
–> fatty changes on US = increased echogenicity

66
Q

what vitamin is sometimes given to patients with fibrosis

A

vit E

67
Q

cholangiocarcinoma tumour

A

CA19-9

68
Q

bowel cancer screening in scotland

A

50-72 y/o home FIT every 2 years

FAP, HNPCC, IBD - regular colonoscopy

  • FIT can be used in GP for those who dont meet 2 week referral
69
Q

difference between anterior resection + APR

A

anterior - sigmoid + upper rectum (faecal incontinence)

APR - rectum + anus (permanent colostomy, anus sutured)

70
Q

difference between zero and first order kinetics

A

zero - elimination of a constant AMOUNT of a drug (alcohol, eg 4g every hour) - metabolic pathway is saturated

first - elimination of a constant PERCENTAGE (eg always half)

71
Q

% bioavailability of an IV drug

A

100%

bioavailability = amount of drug which enters the systemic circulation - will always be 100% for an IV preparation

72
Q

first line drug in reducing cholesterol

A

statins

73
Q

overwhelming compensatory mechanism thats activated to combat volume loss

A

increased sympathetic activity

74
Q

most likely group of oraganisms to cause hospital acquired pneumonia

A

gram negative

75
Q

trisomy 13

A

pateau

76
Q

how does intracellular calcium contribute to cell death

A

by increasing mitochondrial permeability

77
Q

where do robertsonian translocations take place on the chromosome

A

near or at centromeres

78
Q

lectin-like molecules function

A

as PRRs

79
Q

2 cell types predominantly found in granulation tissue

A

endothelial cells

myofibroblasts

80
Q

yellow sharps bin with blue lid

A

medicine vials with residual medicines

81
Q

red bag

A

soiled laundry

first year med (15 decks)

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