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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
Q

What type of arthritis has a characteristic under 30 mins of morning stiffness?

A

Osteoarthritis

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26
Q

Joints most commonly affected in OA?

A

Distal interphalangeal joints (DIPJs - HEBERDEN’S NODES) and the first carpometacarpal joints (base of thumb)

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27
Q

What are Bouchard’s nodes and when are they seen?

A

Bouchard’s nodes are hard, bony outgrowths or gelatinous cysts on the proximal interphalangeal joints. Seen in OA and occasionally RA

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28
Q

X-ray signs of OA?

A

LOSS: -Loss of joint space -Osteophytes -Subarticular sclerosis -Subchondral cysts

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29
Q

What are the genetic factors in RA?

A

Human leucocyte antigen; HLA-DR4 & HLA-DRB1

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30
Q

What is characteristic about RA morning pain?

A

Lasts over 30 (or 60) mins and is worse in the morning/cold

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31
Q

Hand deformities in RA

A

Ulnar deviation Swan neck/Z thumb Boutonniere deformity

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32
Q

Give 3 examples of systemic RA symptoms/complicaitons

A

Fibrosing Alveolitis Amyloidosis Peripheral sensory neuropathies

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33
Q

X-ray signs for RA:

A

Soft tissue swelling in early disease Joint space narrowing in late disease PERI-ARTICULAR EROSIONS

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34
Q

Give an example of a DMARD

A

Methotrexate Sulfasalazine Leflunomide (anti T cell)

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35
Q

Give some examples of biologics used alongside DMARDs to treat RA.

A

Infliximab - TNF-alpha blocker Rituximab - B cells (CD20 protein)

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36
Q

What is the name of the Osteoporosis precursor?

A

Osteopenia

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37
Q

What is the definition of osteoporosis?

A

Bone mineral density (BMD) MORE than 2.5 standard deviations BELOW the young adult mean value (T score < 2.5)

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38
Q

What is the T-score?

A

Dual Energy X-ray absorptiometry (DEXA) scan - Which is then compared with the gender-matched young adult average (peak bone mass

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39
Q

What does SHATTERED stand for and what is it used for?

A

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,

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40
Q

SLE: main clinical signs

A

Arthralgia and rashes

41
Q

SLE treatment

A

Hydralazine, isoniazid, procainamide and penicillamine

42
Q

Possible SLE triggers

A

EBV flare up by UV

43
Q

KEY SLE features:

A

RA like symptoms Erythema in butterfly pattern Photosensitive rash Glomerulonephritis with persistent proteinuria Seizures Mouth ulcers ESR raised but CRP normal

44
Q

Scleroderma (systemic sclerosis) main presentation:

A

Reynaud’s

45
Q

What is CREST when considering scleroderma (LcSSC - limited cutaneous SSC)?

A

Calcinosis - calcium deposition in subcutaneous tissue -Raynauds -Eosophageal dysmotility or strictures -Sclerodactyly - local thickening/tightness of skin on fingers/toes -Telenagiectasia - spider vein

46
Q

Infective endocarditis signs

A

Roth’s spots Janeway lesions Osler’s nodes

47
Q

What does eGFR do?

A

Predict creatinine generation based on age, sex, race

48
Q

What can cause hypokalaemia?

A

Loop diuretics Thiazide diuretics

49
Q

What can cause hyperkalaemia?

A

Spironolactone (aldosterone antagonist)-Amiloride (acts on eNac channels)-ACE inhibitors-Angiotensin receptor blockers (ARB)-Trimethoprim (acts on eNac channels but milder)

50
Q

Describe vitamin D hydroxylation

A

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
Q

Function of LUT

A

To convert the continuous process of excretion (urine production) to an intermittent, controlled volitional process - micturition

52
Q

What are the parasympathetic nerve roots for bladder voiding (cholinergic)?

A

spinal root S3,4,5

53
Q

What are the sympathetic nerve roots for bladder storage (noradrenergic)?

A

T10, L1,2

54
Q

What are the spondyloarthropathies?

A

ankylosing spondylitis psoriatic arthritis reactive arthritis undifferentiated spondyloarthropathy, inflammatory bowel disease-associated arthritis

55
Q

What is the key tissue type in SPA?

A

HLA-B27

56
Q

What is amaurosis fugax?

A

Temporary loss of vision in both eyes, seen in SLE and MS

57
Q

SCA treatment

A

Transfusion Hydroxycarbamide Stem cell transplant

58
Q

What is the most common enzymopathy

A

G6PD

59
Q

Pernicious anaemia

A

Pernicious anaemia leads to a loss of parietal cells -> reduced intrinsic factor production -> vitamin B12 malabsorption

60
Q

What assessment is used for risk of cardiac disease in the next 10 years?

A

QRisk-2

61
Q

What condition is ANA positive?

A

SLE

62
Q

What condition is ANCA positive?

A

Wegener’s Granulomatosis

63
Q

ANA means?

A

Anti-nuclear antibody

64
Q

ANCA means?

A

Anti-Neutrophil Cytoplasmic Antibody

65
Q

What is the specific auto-antibody associated with SLE?

A

Anti-dsDNA

66
Q

What could an shortened QT interval indicate?

A

Hypercalcaemia

67
Q

Describe the stages of CKD in terms of GFR level

A
68
Q

Requirements to diagnose diabetic ketoacidosis

A

Ketonaemia, Acidosis, hyperglcaemia

69
Q

Describe the Thyroid hormone axis

A
70
Q

What is a diagnositc technique for Hypertension?

A

Ambulatory blood pressure monitor

71
Q

Guuve 5 causes of hypertension

A

Hyperthyroidism

Glomerulonephritis

Acromegaly

Conn’s Syndrome

Cushing’s disease

72
Q

Tests to exclude secondary hypertension

A

FBC

U&Es

Hba1c

Serum renin and aldosterone

73
Q

What are the first line treatments for hypertension in those under 55 and over 55?

A

Under, ACE-i

Over CCB

74
Q

Bedside resp investigations (two)

A

PEF

Pulse oximetry

ECG

ABG

75
Q

Name an anticholinergic

A

Ipratropium bromide

76
Q

Name an anti-IgE

A

Omalizumab

77
Q

Marker for HIV infecction

A

CD4 T lymphocytes

HI|V viral load

78
Q

Active and passive immunity

A

Active: pathogens etc, stimulates immune response,

Passive: injection of antibodies

79
Q

What disease is not more likely in smokers (of the bowel)

A

Ulcerative colitis

80
Q

Describe what Crohn’s and UC look like on a colonoscopy

A

UC: Continuous lesion

Crohn’s: Skip lesion

81
Q

What does a corticosteroid do?

A

Down-regulate pro-inflammatory genes, and upregulate anti-inflammatory genes

82
Q

Describe lymphoma staging

A
83
Q

In what time frame post-stroke can thrombolysis be used?

A

4-4.5 hours

84
Q

Investigation for confirming potential stroke presentation

A

CT head

85
Q

Contraindication for thrombolysis

A

Heparin use

clotting disorder

86
Q

Give 5 extra-articular features of RA

A

Vasculitis

IPF

Pericarditis

Pericardial effusion

Lymphadenopathy

Anaemia

87
Q

Three physiological changes in asthma

A

Bronchoconstriction

Inflammation of the mucosa

Increased mucus secretion

88
Q

Most common causes of hypothyroidism

A

Worldwide: Iodine deficiency

UK: iatrogenic, or autoimmune such as Hashimoto’s thyroiditis or atrophic thyroiditis

89
Q

Give common causative organisms of UTI

A

E.coli, Klebsiella, enterococci

90
Q

Definition of a UTI

A

a pure growth of more than 10^5 organisms per ml collected from a fresh clean catch urine sample

91
Q

First line UTI treatment

A

Trimethoprim

92
Q

Pyelonephritis pathophys

A

An ascending infection from the bladder and is infeciton of the renal parenchyma

93
Q

Wilson and Jungner Criteria - give 4 examples

A

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
Q

Investigation for hiatus hernia

A

Barium swallow

95
Q

Side effects of TB treatments

A

Rifampicin - red urine

Isoniazid - Hepatitis

Pyrazinamide - Hepatitis

Ethambutol - optic neuritis

96
Q

Give a cardiac rate control technique

A

Cardioversion

Amiodarone

flecainide (not if there is a structural defect)

97
Q

What is antiphospholipid antibody syndrome

A

SE of SLE - aemolytic anaemia

98
Q

Classification of peripheral vascular disease

A

Fontaine stages (1-4)

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