Data

Question 1

What will the percussion note be on the side of a tension pneumothorax?

Answer 1

Hyper-resonant

Question 2

What is the emergency treatment for a tension pneumothorax?

Answer 2

Venflon in 2nd ICS, mid-clavicular line

Question 3

What would cause increased hilar markings on a CXR?

Answer 3

Enlarged lymph nodes

Question 4

Give 2 reasons you might see air under the diaphragm on an x-ray

Answer 4

1) Normal post-op sign if patient had laparoscopy 2) Perforation of bowel or ulcer

Question 5

How can you tell if you are seeing small or large bowel on AXR?

Answer 5

Small: Valvular connvientes go all the way across, central, no faeces Large: Haustra go part of the way across, ‘window frame’, faeces present

Question 6

Name 3 causes of small bowel dilatation

Answer 6

1) Obstruction from adhesions 2) Hernias 3) Peritoneal malignancy

Question 7

Name 2 causes of large bowel dilataion

Answer 7

1) Carcinoma -> apple core lesion 2) Diverticular disease

Question 8

Thumb printing is a radiological sign suggestive of what?

Answer 8

Intestinal ischaemia or inflammation

Question 9

Pneumothorax, asthma and COPD (if emphysematous) all cause what percussion note?

Answer 9

Hyper resonant

Question 10

Lobar collapse, pulmonary fibrosis, bronchiectasis and stridor cause what percussion note?

Answer 10

Resonant

Question 11

What condition causes a stoney dull note on percussion?

Answer 11

Pleural effusion

Question 12

What ulcers are typically medial - venous or arterial?

Answer 12

Venous

Question 13

Describe 3 points that suggest an ulcer is venous

Answer 13

1) Medial 2) Shallow and large 3) Surrounded by dry skin 4) Haemosiderin deposit surrounding 5) Flat margins 6) Itchy 7) Normal pulses

Question 14

Describe 4 points that suggest an ulcer is arterial

Answer 14

1) Lateral 2) Deep 3) Nil/faint pulses 4) Painful 5) Black necrotic tissue 6) Well defined edges

Question 15

Name a cause of flame haemorrhages

Answer 15

Hypertension

Question 16

What are hard exudates caused by?

Answer 16

Protein leakage from blood vessels

Question 17

What are 3 potential causes of papilloedema?

Answer 17

1) MS 2) Head injury if it causes increased ICP 3) Uncontrolled Htn

Question 18

Malaena indicates haemorrhage where in the GI tract?

Answer 18

Upper GI tract

Question 19

Which rhythms are non-shockable? What do you do in this situation?

Answer 19

Pulseless electrical activity (PEA) Asystole Resume CPR for 2 minutes and then reassess rhythm

Question 20

What are the shockable rhythms?

Answer 20

Pulseless VT and VF

Question 21

If someone has a shockable rhythm when do you give adrenaline?

Answer 21

1mg given after 3rd shock and then every 3-5 mins

Question 22

Give 4 Hs that are potential causes of cardiac arrest

Answer 22

1) Hypoxia 2) Hyperkalaemia (metabolic disorders) 3) Hypothermia 4) Hypovolaemia

Question 23

What are the 4 Ts (causes of cardiac arrest)?

Answer 23

1) Tension pneumothorax 2) Toxic substances 3) Tamponade 4) Thromboembolic event

Question 24

What are 2 relative contraindication to an ABG? (Use other arm)

Answer 24

Mastectomy Dialysis shunt

Question 25

Before doing an ABG what test should you do?

Answer 25

Allen's test

Question 26

For how long do you maintain pressure after doing an ABG?

Answer 26

10 minutes

Question 27

How quickly must an ABG sample be analysed?

Answer 27

Within 10 minutes -\> if it is likely to take longer put it in ice

Question 28

What are 2 obstructive lung disorders?

Answer 28

COPD Asthma

Question 29

Give 3 restrictive lung disorders

Answer 29

Chest wall deformity Pulmonary fibrosis Pulmonary oedema

Question 30

In what category are lung function tests unreliable?

Answer 30

Under 5s

Question 31

What does FEV1 stand for/mean?

Answer 31

Forced expiratory volume over 1 second following a maximum inhalation - total volume you can blow out quickly

Question 32

What is forced vital capacity?

Answer 32

Total volume you can expire following a maximum inhalation

Question 33

What is peak expiratory flow rate?

Answer 33

Maximum flow rate from a forced expiration following a full inspiration

Question 34

Give 3 indications for carrying out a PEFR

Answer 34

1) Screening for obstruction 2) Monitoring asthma 3) Help assessment in asthma attack

Question 35

In a severe asthma attack what is PEFR?

Answer 35

35-50%

Question 36

In a moderate asthma attack what is the PEFR?

Answer 36

\>50-75%

Question 37

What is the FEV1:FVC in a restrictive lung disease?

Answer 37

Normal/increased

Question 38

When can you use a capnograph?

Answer 38

To check you have correctly inserted the ET tube

Question 39

Intravenous isotonic fluid will increase what volume?

Answer 39

Extracellular fluid volume

Question 40

What is a precordial thump and when can it be given?

Answer 40

Blow to the sternum given in first few seconds of a shockable rhythm

Question 41

What can be used to visualise the cornea? What colour lamp is needed to view the vessels?

Answer 41

Fluorescein Green lamp

Question 42

What is a hyphema? What does it indicate?

Answer 42

Haemorrhage in the bottom of the anterior chamber of the eye. Indicates ocular contusion

Question 43

Give 3 causes of ptosis in children

Answer 43

Myasthenia Horner's III CN palsy Trauma Congenital

Question 44

What cell type has protruded in a cervical ectropion?

Answer 44

Columnar epithelium has protruded through the cervical os and undergoes squamous metaplasia

Question 45

Give 2 causes of bronchial breath sounds

Answer 45

Pneumonia Fibrosis

Question 46

What can cause loud vocal resonance?

Answer 46

Consolidation

Question 47

Stridor can indicate what problem?

Answer 47

Obstructed upper airway - e.g. epiglottitis

Question 48

Give 2 causes of an increased JVP

Answer 48

Right sided heart failure Raised intra thoracic pressure

Question 49

Give 3 signs you might see in the eye in a patient with diabetic retinopathy

Answer 49

1) Dot and blot haemorrhages 2) Cotton wool spots 3) Neovascularisation

Question 50

When looking at a fundus, if the optic nerve is on the left (medial - closer to the nose than the temporal side) which eye are you looking at?

Answer 50

The left eye

Question 51

AV nipping, silver wiring, haemorrhages (flame, dot and blot), cotton wool spots (soft exudates), hard exudates and optic disc oedema can all be seen in what condition?

Answer 51

Uncontrolled hypertension

Question 52

What might you see on fundoscopy with optic atrophy?

Answer 52

Sharp disc margin and very pale disc

Question 53

What signs might you see in fundoscopy in someone with diabetes mellitus?

Answer 53

Microaneurysms Haemorrhages (flame, dot, blot) Cotton wool spots Hard exudates neovascularisation Optic disc oedema

Question 54

Name 3 ways you could treat a haemorrhoid

Answer 54

1) conservatively - give laxatives to avoid straining 2) creams to shrink 3) rubber band ligation

Question 57

![]() What is this?

Answer 57

Melanocytic naevus

Question 58

![]() What is this?

Answer 58

SCC

Question 59

![]() What is this?

Answer 59

Plaque psoriasis

Question 60

![]() What is this? What causes it?

Answer 60

Erythema multiforme Drugs, e.g. aspirin, sulphonamides, TB, IBD, pregnancy, etc