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Finals Revision > Concepts > Flashcards

Concepts Flashcards

1
Q

What are the STEMI criteria

A

ECG features in two contiguous leads of;

  • 2.5mm (2.5 small squares) ST elevation in leads V2-3 in men under 40 or >2.0mm in men over 50
  • 1.5mm ST elevation in V2-V3 in women
  • 1 mm ST elevation in other leads
  • new LBBB
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2
Q

What drugs can be used to ease passage of a renal stone

A

a-adrenergic blockers

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3
Q

Management of prostatitis

A

quinolone for 14 days

ciprofloxacin

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4
Q

MEN 1

A

three P’s
Parathyroid
Pituitary
Pancreas

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5
Q

Men 2a

A

Medullary thyroid
hyperparathyroid
phaeochromocytoma

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6
Q

Men 2b

A

Medullary thyroid
phaeochromocytoma
Marfanoid body habitus
Neuroma

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7
Q

Characterisation of empyema

A

pH < 7.2
Low glucose (<3.4 mmol/L)
LDH > 200

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8
Q

What is a normal osmol gap

A

<10

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9
Q

How to calculate osmolalitty

A

2Na + 2k + urea + blood glucose

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10
Q

What rules out pseudohyponatraemia

A

normal osmolar gap

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11
Q

What are the causes of urinary sodium > 20

A

hypovolaemic

  • diuretics: thiazides, loop diuretics
  • addisons disease
  • diuretic stage of renal failure

Euvolaemia
- SIADH
hypothyroidism

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12
Q

What are the causes of urinary sodium < 20

A

sodium depletion, extra-renal loss

  • diarrhoea, vomitting, sweating
  • burns, adenoma of rectum

water excess

  • secondary hyperaldosteronism
  • nephrotic syndrome
  • IV dextrose
  • psychogenic polydipsia
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13
Q

Treatment of choice for biliary atresia

A

Early surgical treatment

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14
Q

PSGN develops ________ after URTI

A

1-2 weeks

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15
Q

Management of VT

A

if BP <90mmHg systolic= cardioversion

drug therapy
> amiodarone
> lidocaine
> procainamide

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16
Q

Subacute thyroiditis causes ….

A

hyper then hypothyroidism

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17
Q

Hashimotos + viral infection

A

De quervains

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18
Q

Eosinophilic casts

A

Tubulointerstitial nephritis

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19
Q

Management of trigeminal neuralgia

A

Carbamazepine

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20
Q

Signs of supraspinatus tendonitis

A

Rotator cuff injury
Painful arc of abduction
Tenderness over acromion

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21
Q

Management of uveitis

A

Steroid and cycloplegic (mydriatic) eye drops

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22
Q

Drugs causing pupillary constriction

A

Acetazolamide and pilocarpine

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23
Q

Acute tubular necrosis =

A

urine osmolality < 350 mOsm/kg

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24
Q

Prerenal uraemia

A

kidneys hold on to sodium to preserve volume

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25
Q

brown granular casts

A

acute tubular necrosis

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26
Q

Management of acute reactive arthritis

A

NSAIDs

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27
Q

What is the mackler triad

A

Booerhave ( oesophageal rupture)
vomiting
thoracic pain
subcutaenous emphysema

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28
Q

What is kussmauls sign

A

JVP rising on inspiration- kussmaul’s sign

sign of constrictive pericarditis

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29
Q

mneumonic for cardiac tamponade

A

TAMponade= TAMpaX

absent Y descent

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30
Q

Gynaecomastia in lung cancer

A

adenocarcinoma

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31
Q

paraneoplastic syndrome from SCLC

A

SIADH
ectopic ACTH
lambert-eaton myasthenic

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32
Q

What is quincke’s sign

A

nailbed pulsation

aortic regurgitatoin

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33
Q

De musset sign

A

head bobbing in aortic regurgitation

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34
Q

features of ank spon

A

lower back pain and stiffness of insidious onset

stiffness worse in morning and improves with exercise

pain at night

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35
Q

Investigation of Lung cancer

A

1) CXR
2) non-contrast CT chest, liver adrenals
3) bronchoscopy
4) PET scanning

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36
Q

Hyponatraemia correction

A

osmotic demyelination syndrome

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37
Q

hypernatraemia correction

A

cerebral oedema

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38
Q

Correction of hyponatraemia rate

A

4-6mmol/l in 24 hr

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39
Q

secondary vs primary hypothyroid

A

primary- High TSH, Low T4

secondary- Low TSH, low T4

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40
Q

investigation for 2ry hypothyroidism

A

MRI

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41
Q

Management of primary pneumothorax with SOB or >2cm rim of air

A

aspiration

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42
Q

Murphys sign

A

acute cholecystitis

arrest of inspiration on palpation of RUQ

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43
Q

In 1ml of standard insulin there are ____ units

A

100

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44
Q

Diagnostic test for guillain barre

A

Lumbar puncture

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45
Q

guillan barre

A

autoimmune dymelination of PNS due to campylobacter jejuni

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46
Q

symptoms of guillan barree

A

back/leg pain in initial stages of illness

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47
Q

Presentation of placental abruption

A

constant pain
shock out of keeping with visual loss
tender and tense uterus

48
Q

RF for placental abruption

A

chronic hypertension

49
Q

dose of amiodarone in ALS

A

300mg

50
Q

what should be stopped in acute c.diff infection

A

anti-peristaltic drugs
> opioids

antibiotics if possible

51
Q

NICE criteria for reffering patients to 2ry care for treatment of varicose veins

A
  • heavy or aching legs
  • skin changes (venous eczema, haemosiderin deposition)
  • superficial vein thrombosis
  • venous leg ulcer
52
Q

Measurement of PSA should be delayed for _____ after prostatitis

A

1 month

53
Q

Features of focal seizures with impaired awareness

A

automatism

tiredness

54
Q

Management of hypomagnesaemia

A

IV magnesium is usually given if <0.4 mmol/L or tetany, arrhythmias, or seizures

> 0.4 mmol/l
oral magnesium salts (10-20 mmol orally per day in divided doses)
diarrhoea can occur with oral magnesium salts

55
Q

Recommendations for patients with CKD

A

prescribe ACEi if urinary ACR 70 +

statin therapy

try not to give NSAIDs

56
Q

Causes of anterior mediastinal mass

A 
4T'S
Teratoma
Terrible lymphadenopathy
Thymic Mass
Thyroid mass
57
Q

What is the issue with st johns wort

A

P450 inducer, decrease ciclosporin levels, leading to transplant rejection

58
Q

treatment for wilsons

A

penicillamine

59
Q

disproportionate microcytic anaemia

A

beta-thalassaemia trait

60
Q

management of sudden onset SNHL

A

high dose oral corticosteroids

61
Q

anaesthetic for haemodynamically unstable patient

A

ketamine

62
Q

sensitive scan for DAI

A

MRI

63
Q

difference between SS and NML

A 
ss presents over hours rather than days
SS
- profuse sweating
- myocolonus
-diarrhoea
-hyperreflexia
64
Q

features of NML

A
  • pyrexia
  • muscle rigidity
  • autonomic lability
  • agitated delirium with confusion
65
Q

management of organophsophate insectiside poisoning

A

atropine

66
Q

features of organophosphate poisoning

A 
slud
S- alivation
L- acrimation
U- rination
D- efecatio/diarrhoea
Cv- Hypotension, bradycardia
small pupils
muscle fasciculation
67
Q

high risk of hepatotoxicity in paracetamol overdose

A

chronic alcohol use
HIV
anorexia
P450 inducers

68
Q

elevated JVP
hypotension
tachycardia
despite resus

A

cardiac tamponade

69
Q

lower than expected HbA1c

A

sickle cell
GP6D deficiency
hereditary spherocytosis

70
Q

higher than expected HbA1c

A

vitamin B12/folic acid deficiency anaemia

splenectomy

71
Q

postmenopausal woman has fracture

A

she should be put on bisphosphonates- no need for DEXA

72
Q

hypercalcaemia

A

hydration

iv bisphosphonate if Ca above 3

73
Q

Drugs causing galactorrhoea

A

NOT THE SAME AS GYNAECOMASTIA

  • metoclopramide, domperidone
  • phenothiazine
  • haloperidol
  • SSRI, opioids
74
Q

Management of variceal haemorrhage

A

FFP, Vit K
terlipression
octerotide
prophylactic IV antibiotics

75
Q

GPA serology

A

ANCA

76
Q

management of perforated tympanic membrane

A

no treatment review in 2 weeks then in 6 weeks

77
Q

presentation of TTP

A 
fever
neuro signs
thrombocytopenia
haemolytic anaemia
renal failure
78
Q

PTEN mutation

intestinal hamartomas

A

cowdens

79
Q

intestinal hamartomas

pigmentation around mouth

A

peutz-jeghers

80
Q

L5 radiculopathy

A

weakness of hip abduction and foot drop

no reflex lost

81
Q

S1 nerve root compression

A

sensory loss of posterolateral aspect of leg and lateral aspect of foot

weakness of plantar flexion and reduced ankle reflex

82
Q

L2 nerve root compression

A

back, groin, anterior thigh pain

83
Q

L3 nerve root compression

A

sensory loss over anterior thigh, weakened quadriceps, reduced knee reflex

84
Q

L4 nerve root compression

A

sensory loss over anterior aspect of knee, weakened quadriceps
reduced knee reflex

85
Q

HRT in high risk of DVT

A

transdermal HRT doesnt increase VTE risk

86
Q 
Which of the following medications cant be used in pregnancy
> paracetamol
> lamotrigine
> simvastatin
> metformin
>insulin
A

> simvastatin

87
Q

treatment for bronchopulmonary aspergillosis

A

oral glucocorticoids

88
Q

recommendation after WLE

A

whole breast radiotherapy

89
Q

what is aplastic anaemia

A

characterised by pancytopenia and hypoplastic bone marrow

90
Q

causes of aplastic anaemia

A
  • idiopathic
  • congenital- faconi, dyskeratosis
  • drugs: cytotoxics, chloramphenicol, sulphonamides, phenytoin, gold
  • toxins: benzene
  • infectons: parvovirus, hepatitis
  • radiation
91
Q

management of acne vulgaris

A
  • single topical therapy (topical retinoids, benzoyl peroxide)
    -topical combination therapy (topical antibiotic, benzoyl peroxide, topical retinoid)
    -oral antibiotics:
    >tetracyclines: lymecycline, oxytetracycline, doxycycline
    tetracyclines
    > erythromycin may be used in pregnancy

a single oral antibiotic for acne vulgaris should be used for a maximum of three months

-a topical retinoid (if not contraindicated) or benzoyl peroxide should always be co-prescribed with oral antibiotics to reduce the risk of antibiotic resistance developing.

> Topical and oral antibiotics should not be used in combination

  • Gram-negative folliculitis may occur as a complication of long-term antibiotic use - high-dose oral trimethoprim is effective if this occurs

-combined oral contraceptives (COCP) are an alternative to oral antibiotics in women
as with antibiotics, they should be used in combination with topical agents
-Dianette (co-cyrindiol) is sometimes used as it has anti-androgen properties. However, it has an increased risk of venous thromboembolism compared to other COCPs, therefore it should generally be used second-line, only be given for 3 months and women should be appropriately counselled about the risks

-oral isotretinoin: only under specialist supervision
pregnancy is a contraindication to topical and oral retinoid treatment

92
Q

management of graves

A

carbimazole

93
Q

Causes of bronchiectasis

A

CF
pertussis
hypogammaglobulinaemia
young syndrome

94
Q

common presenting feature of wilms tumour

A

abdominal mass

95
Q

what should be offered to all patients with HF anually

A

influenza vaccine

96
Q

1st line in HF with stable impaired LV function

A

ACE + BB

97
Q

reduces mortality in HF with ACEi

A

spironolactone

98
Q

Primary dysmenorrhoea management

A

NSAID such as mefanamic acid

COCP

99
Q

What differentiates vestibular neuronitis from labyrinthitis?

A

unaffected hearing in vestibular neuronitis

100
Q

What is suggestive of nephrotic syndrome?

A

heavy proteinuria and gross oedema

hypoalbuminaemia from proteinurea causes increased oedema

101
Q

Most common cause of nephrotic syndrome in kids

A

minimal change glomerulonephritis

102
Q

Causes of MCG

A
  • idiopathic
  • drugs: NSAIDs, rifampicin
  • Hodgkin’s lymphoma, thymoma
  • infectious mononucleosis
103
Q

Pathophysiology of MCG

A
  • T-cell and cytokine-mediated damage to the glomerular basement membrane → polyanion loss
  • the resultant reduction of electrostatic charge → increased glomerular permeability to serum albumin
104
Q

Features of MCG

A

> nephrotic syndrome
normotension - hypertension is rare
highly selective proteinuria
–only intermediate-sized proteins such as albumin and transferrin leak through the glomerulus
renal biopsy
–normal glomeruli on light microscopy
—electron microscopy shows fusion of podocytes and effacement of foot processes

105
Q

Management of MCG

A

80% steroid responsive

Cyclophosphamide if steroid resistant

106
Q

what is candesartan

A

ARB

107
Q

MOA of alteplase

A

activates plasminogen to form plasmin

108
Q

how to diagnose ank spon

A

sacro-ilitis on pelvic X-ray

109
Q

What is LES

A

rare autoimmune disorder in which antibodies are formed against pre-synaptic voltage-gated calcium channels in the neuromuscular junction. A significant proportion of those affected have an underlying malignancy, most commonly small cell lung cancer. It is therefore regarded as a paraneoplastic syndrome.

110
Q

INR 5.0-8.0 (no bleeding) -

A

withhold 1 or 2 doses of warfarin, reduce subsequent maintenance dose

111
Q

african patient taking CCB requiring second agent

A

ARB

112
Q

persistent ST elevation following MI, no chest pain

A

left ventricular aneurysm

113
Q

scaphoid abdomen + bilious vomiting

A

intestinal malrotation and volvulus

114
Q

psoriasis exacerbating factor

A

> trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

115
Q

confusion in asthma attack

A

life threatening

Finals Revision (29 decks)

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