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Commonly forgotten Flashcards

1
Q

Antacid example

A

Magnesium Trisilicate mixture

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2
Q

H2 Receptor blocker example

A

Ranitidine

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3
Q

Asthma Breath test

A

FENO - Fraction exhaled NO, eosinophil marker

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4
Q

Scoring system for PE likelihood

A

Wells score (max 6)

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5
Q

Scoring for likelihood of TIA re-occurance

A

ABCD^2

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6
Q

System for risk of mortality with Pneumonia?

A

CURB-65

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7
Q

Acute pancreatitis scoring?

A

Abbreviated Glasgow Scoring System

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8
Q

Microcytic Anaemia causes:

A

Iron Deficiency anaemia, Thalassaemia Chronic disease Vitamin B6 deficiency

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9
Q

Normocytic anaemia causes:

A

Acute blood loss Anemia secondary to chronic disease B6 deficiency

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10
Q

Macrocytic anaemia causes:

A

Folate or B12 deficiency Alcohol excess Hypothyroidism

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11
Q

A special feature of Hodgkin’s Lymphoma:

A

Reed-sternberg cells

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12
Q

Special features of myeloma:

A

Previous MGUS paraprotein Rouleaux formations Light chains in urine/kidney CRAB

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13
Q

An identifying feature of Chronic myeloid Leukemia:

A

Philadelphia chromosome (Reciprocal translocation on 22)

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14
Q

Seedhouse ethical grid layers?

A

Individuals layer, duties and motives, consequential layer, external

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15
Q

Whitehall studies showed?

A

Income - health inequalities

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16
Q

What did the Black report show?

A

It showed widespread health inequality, largely caused by income inequality

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17
Q

What did The Acheson report show?

A

Inequalities are growing, decline in mortality is more rapid in higher classes

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18
Q

What is Gillick/Fraser competence ?

A

child under 16 being able to make their own healthcare decisions

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19
Q

Describe the treatment stages for asthma

A

SABA (Salbutamol) SABA + corticosteroid (prednisolone) SABA + corticosteroid + LABA (Salmeterol) SABA + corticosteroid + LABA + addition of a fourth drug eg leukotriene receptor antagonist (montelukast), SR theophylline, β2 agonist tablet (Ipratropium bromide)

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20
Q

Anti-fibrotic

A

Pirfenidone

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21
Q

Anti-fibroblast

A

Nintedanib

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22
Q

The Bradford Hill criteria

A

A group of minimal conditions necessary to provide adequate evidence of a causal relationship. - some examples are: Strength, specificity, consistency, Coherence, Plausibility, Experiment

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23
Q

What are osteophytes?

A

Abnormal sclerotic subchondral bone which has been calcified

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24
Q

Main pathological features of OA?

A

Loss of (articular) cartilage Disordered bone repair

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25
What type of arthritis has a characteristic under 30 mins of morning stiffness?
Osteoarthritis
26
Joints most commonly affected in OA?
Distal interphalangeal joints (DIPJs - HEBERDEN’S NODES) and the first carpometacarpal joints (base of thumb)
27
What are Bouchard's nodes and when are they seen?
Bouchard's nodes are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints. Seen in OA and occasionally RA
28
X-ray signs of OA?
LOSS: -Loss of joint space -Osteophytes -Subarticular sclerosis -Subchondral cysts
29
What are the genetic factors in RA?
Human leucocyte antigen; HLA-DR4 & HLA-DRB1
30
What is characteristic about RA morning pain?
Lasts over 30 (or 60) mins and is worse in the morning/cold
31
Hand deformities in RA
Ulnar deviation Swan neck/Z thumb Boutonniere deformity
32
Give 3 examples of systemic RA symptoms/complicaitons
Fibrosing Alveolitis Amyloidosis Peripheral sensory neuropathies
33
X-ray signs for RA:
Soft tissue swelling in early disease Joint space narrowing in late disease PERI-ARTICULAR EROSIONS
34
Give an example of a DMARD
Methotrexate Sulfasalazine Leflunomide (anti T cell)
35
Give some examples of biologics used alongside DMARDs to treat RA.
Infliximab - TNF-alpha blocker Rituximab - B cells (CD20 protein)
36
What is the name of the Osteoporosis precursor?
Osteopenia
37
What is the definition of osteoporosis?
Bone mineral density (BMD) MORE than 2.5 standard deviations BELOW the young adult mean value (T score \< 2.5)
38
What is the T-score?
Dual Energy X-ray absorptiometry (DEXA) scan - Which is then compared with the gender-matched young adult average (peak bone mass
39
What does SHATTERED stand for and what is it used for?
Osteoporosis: Steroid use Hyperthyroidism/parathyroidism Alcohol Thin - BMI \< 22:-Reduced skeletal loading Testosterone decreased Early menopause - oestrogen drop Renal or liver failure Erosive/Inflammatory bone disease Dietary calcium decrease/malabsorption,
40
SLE: main clinical signs
Arthralgia and rashes
41
SLE treatment
Hydralazine, isoniazid, procainamide and penicillamine
42
Possible SLE triggers
EBV flare up by UV
43
KEY SLE features:
RA like symptoms Erythema in butterfly pattern Photosensitive rash Glomerulonephritis with persistent proteinuria Seizures Mouth ulcers ESR raised but CRP normal
44
Scleroderma (systemic sclerosis) main presentation:
Reynaud's
45
What is CREST when considering scleroderma (LcSSC - limited cutaneous SSC)?
Calcinosis - calcium deposition in subcutaneous tissue -Raynauds -Eosophageal dysmotility or strictures -Sclerodactyly - local thickening/tightness of skin on fingers/toes -Telenagiectasia - spider vein
46
Infective endocarditis signs
Roth's spots Janeway lesions Osler's nodes
47
What does eGFR do?
Predict creatinine generation based on age, sex, race
48
What can cause hypokalaemia?
Loop diuretics Thiazide diuretics
49
What can cause hyperkalaemia?
Spironolactone (aldosterone antagonist)-Amiloride (acts on eNac channels)-ACE inhibitors-Angiotensin receptor blockers (ARB)-Trimethoprim (acts on eNac channels but milder)
50
Describe vitamin D hydroxylation
It takes 25-hydroxy vitamin D and hydroxylates it to form 1,25-dihydroxy vitamin D (calcitriol) - this is the active form of vitamin D
51
Function of LUT
To convert the continuous process of excretion (urine production) to an intermittent, controlled volitional process - micturition
52
What are the parasympathetic nerve roots for bladder voiding (cholinergic)?
spinal root S3,4,5
53
What are the sympathetic nerve roots for bladder storage (noradrenergic)?
T10, L1,2
54
What are the spondyloarthropathies?
ankylosing spondylitis psoriatic arthritis reactive arthritis undifferentiated spondyloarthropathy, inflammatory bowel disease-associated arthritis
55
What is the key tissue type in SPA?
HLA-B27
56
What is amaurosis fugax?
Temporary loss of vision in both eyes, seen in SLE and MS
57
SCA treatment
Transfusion Hydroxycarbamide Stem cell transplant
58
What is the most common enzymopathy
G6PD
59
Pernicious anaemia
Pernicious anaemia leads to a loss of parietal cells -\> reduced intrinsic factor production -\> vitamin B12 malabsorption
60
What assessment is used for risk of cardiac disease in the next 10 years?
QRisk-2
61
What condition is ANA positive?
SLE
62
What condition is ANCA positive?
Wegener's Granulomatosis
63
ANA means?
Anti-nuclear antibody
64
ANCA means?
Anti-Neutrophil Cytoplasmic Antibody
65
What is the specific auto-antibody associated with SLE?
Anti-dsDNA
66
What could an shortened QT interval indicate?
Hypercalcaemia
67
Describe the stages of CKD in terms of GFR level
68
Requirements to diagnose diabetic ketoacidosis
Ketonaemia, Acidosis, hyperglcaemia
69
Describe the Thyroid hormone axis
70
What is a diagnositc technique for Hypertension?
Ambulatory blood pressure monitor
71
Guuve 5 causes of hypertension
Hyperthyroidism Glomerulonephritis Acromegaly Conn's Syndrome Cushing's disease
72
Tests to exclude secondary hypertension
FBC U&Es Hba1c Serum renin and aldosterone
73
What are the first line treatments for hypertension in those under 55 and over 55?
Under, ACE-i Over CCB
74
Bedside resp investigations (two)
PEF Pulse oximetry ECG ABG
75
Name an anticholinergic
Ipratropium bromide
76
Name an anti-IgE
Omalizumab
77
Marker for HIV infecction
CD4 T lymphocytes HI|V viral load
78
Active and passive immunity
Active: pathogens etc, stimulates immune response, Passive: injection of antibodies
79
What disease is not more likely in smokers (of the bowel)
Ulcerative colitis
80
Describe what Crohn's and UC look like on a colonoscopy
UC: Continuous lesion Crohn's: Skip lesion
81
What does a corticosteroid do?
Down-regulate pro-inflammatory genes, and upregulate anti-inflammatory genes
82
Describe lymphoma staging
83
In what time frame post-stroke can thrombolysis be used?
4-4.5 hours
84
Investigation for confirming potential stroke presentation
CT head
85
Contraindication for thrombolysis
Heparin use clotting disorder
86
Give 5 extra-articular features of RA
Vasculitis IPF Pericarditis Pericardial effusion Lymphadenopathy Anaemia
87
Three physiological changes in asthma
Bronchoconstriction Inflammation of the mucosa Increased mucus secretion
88
Most common causes of hypothyroidism
Worldwide: Iodine deficiency UK: iatrogenic, or autoimmune such as Hashimoto's thyroiditis or atrophic thyroiditis
89
Give common causative organisms of UTI
E.coli, Klebsiella, enterococci
90
Definition of a UTI
a pure growth of more than 10^5 organisms per ml collected from a fresh clean catch urine sample
91
First line UTI treatment
Trimethoprim
92
Pyelonephritis pathophys
An ascending infection from the bladder and is infeciton of the renal parenchyma
93
Wilson and Jungner Criteria - give 4 examples
The condition being screened for should be an important health problem The natural history of the condition should be well understood There should be a detectable early stage Treatment at an early stage should be of more benefit than at a later stage A suitable test should be devised for the early stage The test should be acceptable Intervals for repeating the test should be determined Adequate health service provision should be made for the extra clinical workload resulting from screening The risks, both physical and psychological, should be less than the benefits The costs should be balanced against the benefits
94
Investigation for hiatus hernia
Barium swallow
95
Side effects of TB treatments
Rifampicin - red urine Isoniazid - Hepatitis Pyrazinamide - Hepatitis Ethambutol - optic neuritis
96
Give a cardiac rate control technique
Cardioversion Amiodarone flecainide (not if there is a structural defect)
97
What is antiphospholipid antibody syndrome
SE of SLE - aemolytic anaemia
98
Classification of peripheral vascular disease
Fontaine stages (1-4)

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