CHHD Flashcards
What is the difference between stroke and transient ischaemic attack (TIAs)?
stroke causes permanent damage to the brain due to block of blood supply for a prolonged period
TIA causes temporary loss of focal CNS functions due to a temporary block/reduction in blood supply to the brain
Which part of the brain is primarily affected in Parkinson’s disease?
a) medulla oblongata
b) substantia nigra
c) globus pallidus
d) corpus callosum
e) amygdala
b) substantia nigra
Why should LA with adrenaline be avoided for a patient suffering from Parkinson’s?
adrenaline can interact with L-DOPA and carbidopa and COMT inhibitors
What may present orally for a patient with Parkinson’s who takes anticholenergics eg Benzotropine ?
present with dry mouth
What is multiple sclerosis?
MS is the demyelination and scarring of white matter of the brain resulting in reduced conduction velocity and loss of information conveyed
Which statement regarding herpes Zoster is incorrect?
a) lies dormant in dorsal root ganglia cells
b) reactivation of VZV leads to shingles
c) bilateral vesicular rash affecting a single dermatome
d) localised pain and itching
e) treated with acyclovir
c) bilateral vesicular rash affecting a single dermatome
causes UNILATERAL rash affecting a single dermatome
What is Ramsays Hunt Syndrome?
VZV infection of facial nerve causing lower motor neurone facial palsy
Which agents are used in the treatment of trigeminal neuralgia?
a) carbamazepine, bromide, phenytoin
b) phenytoin, gabapentin, benzotropine
c) carbamazepine, gabapentin, lamotrigine
d) carbodipa, adrenaline, benzotropine
e) entacapone, gabapentin, carbidopa
c) carbamazepine, gabapentin, lamotrigine
A patient complains of regular nose bleeds, dizziness, fatigue and eye changes. The patients blood pressure reading is 150/95mmHg.
What is the possible condition leading to these symptoms?
a) hypothyroidism
b) hypertension
c) arteriosclerosis
d) pericarditis
b) hypertension
What is NOT a complication of hypertension?
a) arteriosclerosis of small arteries eg in eye and kidneys
b) left ventricular hypertrophy
c) thoracic aortic dissection
d) decreased total peripheral resistance
e) abdominal aortic aneurysms
d) decreased total peripheral resistance
the peripheral resistance is INCREASED due to narrowing of arteriolar lumen in kidneys
What category pf drugs are used to prevent/reduce future cardiac ischaemic attacks ?
calcium channel blockers
and
long acting nitrates
What is infective endocarditis?
microbial infection of the endocardium surface of heart, in particular the heart valves
Which statement is incorrect regarding acute bacterial endocarditis?
a) common in elderly
b) common in IV drug users
c) staphylococcus most common offending organism
d) within 7 days of bacteraemia
e) streptococcus most common offending organism
e) streptococcus most common offending organism
Why is there no prophylaxis for infective endocarditis patients?
no strong evidence for improvement in IE episodes and intervention procedures
adverse reactions (eg anaphylaxis) from antimicrobials possible
death from anaphylaxis 5-6 times greater than by IE
increased risk of bacterial resistance in society
What is the pathogenesis of left ventricular heart failure?
left ventricular dysfunction ↓ decreased cardiac output ↓ increased sympathetic tone and RAS system ↓ increased afterload ↓ further myocardial deterioration ↓ cardiac failure
What are the clinical features of left ventricular heart failure?
reduced pulmonary compliance = increased work of breathing
increased pulmonary venous pressure
pulmonary oedema
difficulty breathing whilst lying flat and during exertion
decreased systemic arterial oxygenation
cyanosis
What are the clinical features of right ventricular heart failure?
- hepatomegaly
- splenomegaly
- abdominal distension ( fluid build up in peritoneal cavities)
- oedema
- swelling of hands and fingers
What is the difference between Osler’s nodes and Janeway’s lesions?
Osler’s nodes:
- tender, red-purple lumps
- often found on fingers/toes
- last for hours/days
- usually due to subacute IE
Janeway’s Lesions:
- non-tender
- often on palms/soles
- last for days/weeks
- usually due to acute IE
What are the clinical presentations of IE?
- splinter haemorrhages
- Osler’s nodes
- Janeway’s lesions
- Conjuctival petechiae
- Flu-like symptoms
Define dysphagia
difficulty swallowing
Define cachexia
the wasting of muscle due to severe chronic illness
The degeneration of the myenteric plexus leading to failure of the lower oesophageal sphincter relaxing is called:
a) Paterson-Kelly syndrome
b) Alachasia
c) Retrosternal goitre
d) Globus Hystericus
e) Myesthesia Gravis
b) Alachasia
A female patient finds it difficult to swallow, complains of fatigue and has glossitis, what could the possible disease be?
a) Paterson-Kelly syndrome
b) Alachasia
c) Retrosternal goitre
d) Globus Hystericus
e) Myesthesia Gravis
a) Paterson-Kelly syndrome
A 28 year old male patient complains of frequent heart burn ( 2-3 times week), a chronic cough, acid reflux and occasionally suffers from asthma-like symptoms at night and fatigue. What could the patient possibly be suffering from?
a) Asthma
b) Gastro-oesophageal reflux disease
c) Diabetes
d) Paterson-Kelly Syndrome
e) Peptic ulcers
b) Gastro-oesophageal reflux disease
What medication can be given to someone suffering from Gastro-oesophageal reflux disease?
a) Anticholinergics
b) tricyclics
c) NSAIDs
d) nitrates
e) proton pump inhibitors
e) proton pump inhibitors
What’s the difference between sliding hiatus hernia and rolling hiatus hernia?
SLIDING:
- gastro-oesophageal junction slides into chest
- acid reflux
- lower oesophageal sphincter less competent
ROLLING;
- gastro-oesophageal junction remains in abdomen
- bulge of stomach herniates into chest
- no acid reflux
Which statement is false regarding rolling hiatus hernias?
a) 20% of cases
b) gastro-oesophageal junction remains in abdomen
c) acid reflux
d) bulge of stomach herniates into chest
e) may strangulate
c) acid reflux
Which statement is false regarding Barret’s oesophagus?
a) squamous epithelium is replaced by columnar epithelium
b) associated with Helicobactor pylori
c) risk of adenocarcinoma
d) a risk factor of GORD
e) may be continuous or patchy
b) associated with Helicobactor pylor
it is NOT associated with it
Define dyspepsia
nonspecific group of symptoms related to upper GI tract
A patient complains of difficulty swallowing, pain behind the sternum (heartburn), and hoarseness and upon inspection, palpable lymph nodes. What is the likely diagnosis ?
a) Barret’s oesophagus
b) Oesophagitis
c) Oesophageal carcinoma
d) Hiatus hernia
e) Achalasia
c) Oesophageal carcinoma
A 78 year old patient complains of pain in the stomach shortly after eating a meal and has noticed weight loss. What could be a possible diagnosis?
a) Gastric cancer
b) GORD
c) Gastric ulceration
d) Duodenal ulceration
e) Hernia
c) Gastric ulceration
A 67 year old male patient with a yellowish complexion complains of painful swallowing and difficulty in swallowing which is getting worse. Dark stool and persistent vomiting.
Upon inspection of lymph nodes, the left supraclavicular lymph node is palpable.
What could be possible diagnosis?
a) Gastric cancer
b) GORD
c) Gastric ulceration
d) Duodenal ulceration
e) Hernia
a) Gastric cancer
Define dysphonia
hoarseness of voice
Define haemoptysis
blood upon coughing
Define dyspneoa
difficulty breathing
Define stridor
high-pitched sound caused by disrupted airflow - heard most upon inspiration
What is the difference between intrinsic and extrinsic asthma?
INTRINSIC:
- adult onset
- non allergic
- no family history
- associated with chronic bronchitis
- due to mast cell instability and airway hyper-responsiveness
- worsens over time
EXTRINSIC:
- childhood onset
- allergic
- family history
- allergens causing IgE mediated mast cell degranulation
- improves over time
A parent is worried that her child still has no teeth erupted. The child suffers from cystic fibrosis. What is the possible reason?
cystic fibrosis delays development and eruption of dentition
In which part of the lower GIT is iron and folate absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
a) duodenum
In which part of the GIT is vitamin B12 absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
c) ileum
In which part of the GIT are fat soluble vitamins absorbed?
a) duodenum
b) jejenum
c) ileum
d) ascending colon
e) stomach
c) ileum
What is the role of Gastric intrinsic factor?
produced by parietal cells in the stomach, it is necessary for the absorption of vitamin B12
Define steatorrhoea
fatty stools
Which one is NOT a feature of malabsorption?
a) steatorrhoea
b) failure to thrive
c) lassitude
d) weight gain
e) anaemia
d) weight gain
theyll LOSE WEIGHT