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Finals Revision > Day 2 > Flashcards

Day 2 Flashcards

1
Q

How is an anion gap calculated?

A

(sodium + potassium) - (bicarbonate + chloride)

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2
Q

What is a normal anion gap?

A

8-14 mmol/L

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3
Q

What causes raised anion gap metabolic acidosis?

A
  • lactate : shock, hypoxia
  • ketones: DKA, alcohol
  • urate: renal failure
  • acid poisoning: salicylates, methanol
  • 5-oxoproline : chronic paracetamol use
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4
Q

Causes of a normal anion gap or hyperchloraemic metabolic acidosis

A
  • GI bicarbonate loss: diarrhoea
  • Renal tubular acidosis
  • Drugs: acetazolamide
  • ammonium chloride injection
  • addisons disease
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5
Q

Renal dysfunction can cause a raised?

A

serum natriuretic peptide

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6
Q

What is BNP?

A

Hormone produced by left ventricular myocardium in response to strain

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7
Q

What are the effects of BNP?

A
  • vasodilation
  • diuresis and natriuretic
  • suppresses sympathetic tone and RAAS system
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8
Q

What is the most common cause of superior vena cava obstruction?

A

Small cell lung cancer

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9
Q

What are the features of superior vena cava obstruction?

A
  • dyspnoea
  • swelling of face, neck and arms
  • headache
  • visual disturbance
  • pulseless JVP distension
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10
Q

If a woman vomits within 3 hours of taking levonorgestrel or ulipristal acetate what should she do?

A

Take a 2nd dose of emergency contraception ASAP

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11
Q

Levonogestrel and ulipristal are effective for how many hours?

A 
L= 72
U = 120
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12
Q

Which form fluids is indicated in patients with severe hyponatraemia?

A

Hypertonic saline if less than 120mmol/L

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13
Q

What is the preferred term for trochanteric bursitis?

A

Greater trochanteric pain syndrome

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14
Q

Which drugs can cause SIADH?

A

Carbamazepine, sulfonylureas, SSRIs, tricyclics

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15
Q

How is SIADH characterised?

A

Hyponatraemia secondary to dilutional effects of water retention

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16
Q

How is SIADH managed?

A
  • correction done slowly to prevent pontine myelinolysis
  • fluid restriction
  • demeclocycline
  • ADH receptor antagonists
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17
Q

Which antibiotic should patients with ascities and protein >15g/L be given?

A

Oral ciprofloxacin or norfloxacin as prophylaxis against SBP

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18
Q

How is SBP managed?

A

IV cefotaxime

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19
Q

What antibiotics should be avoided with statins?

A

Macrolides- erythrymycin P450 inhibtor

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20
Q

The gold standard for stopping oral contraceptive pill prior to surgery is…..

A

one month

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21
Q

What are common first presentations of hereditary haemochromatosis?

A

Lethargy and arthralgia

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22
Q

How to confirm diagnosis of haemochromatosis?

A

Serum ferritin

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23
Q

What is 1st line for ank spon?

A

Exercise regimes and NSAIDs

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24
Q

What is the first-line investigation for suspected osteoporotic vertebral fracture?

A

X-ray of spine

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25
Q

Parainfluenza

A

croup

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26
Q

respiratory syncitial virus

A

bronchiolitis

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27
Q

bordetella pertussis

A

whooping cough

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28
Q

Management of angina

A
  1. aspirin and statin
  2. sublingual GTN
  3. B-blocker, CCB
    (CCB= verapamil or diltiazem if used as monotherapy)
    (CCB + B-blocker= nifedipine)
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29
Q

How does biliary atresia present?

A

In the first few weeks of life with jaundice, appetite and growth disturbance

  • high conjugated bilirubin
  • hepatomegaly
  • raised GGT
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30
Q

Investigation of narcolepsy

A

Multiple sleep latency EEG

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31
Q

What is associated with narcolepsy

A

HLA-DR2

Low levels of orexin

32
Q

Patients with polymyalgia rheumatica typically respond dramatically to _____, failure to do so should prompt consideration of an alternative diagnosis

A

Patients with polymyalgia rheumatica typically respond dramatically to steroids, failure to do so should prompt consideration of an alternative diagnosis

33
Q

Antidote for TCA overdose

A

IV bicarbonate

34
Q

what does any change in vision with thyroid eye disease require?

A

Referral to eye casualty

35
Q

What must be ruled out before starting azathioprine

A

thiopurine methyltransferase deficiency (TPMT) before treatment
- they need it to metabolise azathioprine

36
Q

What is the investigation for a patient on warfarin/a DOAC/ or has a bleeding disorder and they are suspected of having a TIA?

A

CT head

37
Q

What pattern is asbestosis on PFT?

A

Restrictive

38
Q

What is lynch syndrome?

A

Autosomal dominant

get colonic and endometrial cancer at young age

39
Q

what is kartagener’s syndrome?

A

The primary problem is of immotile cilia syndrome. When associated with situs inversus Kartagener’s syndrome is diagnosed.

40
Q

What tends to be the presenting feature of MEN ii

A

medulary carcinoma of thyroid

41
Q

What autoantibodies are found in schirmers?

A

Anti-RO and anti La

42
Q

Suspected PE in pregnant women with a confirmed DVT

A

treat with LMWH first then investigate to rule in/out

43
Q

Which systolic murmur is louder with inspiration?

A

Tricuspid regurgitation

44
Q

What is takotsubo cardiomyopathy?

A

apical ballooning of myocardium (resembling an octopus pot)

45
Q

asthma PEFR < 33%

A

ITU

46
Q

What can falsely lower BNP?

A

ACEi, aldosterone antagonists, angiotensin-II receptor antagonists, B-blocker and diuretics

47
Q

What ECG sign is seen in mitral stenosis?

A

P Mitrale (left atrial hypertrophy)

48
Q

What is the first line investigation in suspected primary hyperaldosteronism?

A

Plasma aldosterone/renin ratio

49
Q

COPD categories

A

All post bronchodilator <0.7

Stage 1= FEV1 >80
Stage 2= 50-79
Stage 3= 30-49
Stage 4= >30

50
Q

How does Kaposi’s sarcoma present?

A

Raised purple lesions

51
Q

What can cause membranous glomerulonephtopathy in patients with wilsons disease?

A

penicillamine

52
Q

What is FSGS associated with?

A

Heroin and HIV

53
Q

What kind of lung cancer causes cushings syndrome?

A

Small cell lung carcinoma secreting ACTH

54
Q

How to treat otitis externa in diabetics?

A

Ciprofloxacin to cover pseudomonas

55
Q

What must be ruled out in status epilepticus?

A

Hypoxia and hypoglycaemia

56
Q

What should be offered to patients with reduced ejection fraction heart failure?

A

Annual influenza vaccine and once-only pneumococcal vaccination

57
Q

What medication causes orang tears/urine?

A

Rifampicin

58
Q

What is used to control rate in AF?

A

Beta- blockers

59
Q

What is containdicated by nitrates and nicorandil?

A

PDE 5 inhibitors

sildenafil

60
Q

What do patients who will be taking long term hydrocychoroquine require?

A

Baseline ophthalmologic examination

61
Q

What is the first step in infant resus?

A

Dry baby

62
Q

Poorly controlled hypertension, already taking a calcium channel blocker - add ….

A

an ACE inhibitor or an angiotensin receptor blocker or a thiazide-like diuretic

63
Q

Acute dystonia secondary to antipsychotics is usually managed with

A

procyclidine

64
Q

Pregnant women with a UTI should be treated with an antibiotic for….

A

7 days

65
Q

What are the features of ank spon?

A

the ‘A’s

  • Apical fibrosis
  • Anterior uveitis
  • Aortic regurgitation
  • Achilles tendonitis
  • AV node block
  • Amyloidosis
66
Q

Post-void volumes

A

50

67
Q

What can occur in chronic myeloid leukaemia?

A

thrombocytosis

68
Q

Cushings syndrome causes what findings on blood gas?

A

Hypokalaemic metabolic alkalosis

Excess aldosterone which increases acid and potassium excretion in the kidney

69
Q

All patients with non-ST elevation myocardial infarction should receive ….

A

300mg aspirin

70
Q

Dysphagia affecting both solids and liquids from the start

A

achalasia

71
Q

Patients with a BMI that classifies them as morbidly obese (> 40) are grade ASA ….

A

III

72
Q

What is the treatment for wilsons disease?

A

Penicillamine (chelates copper)

73
Q

What is trousseau’s sign?

A

inflating the blood-pressure cuff to a level above the systolic blood pressure for 3 minutes or more. This causes the patient’s hand to spasmodically contract (hypocalcaemia)

74
Q

Chvostek’s sign is seen in hypocalcemia; what is it?

A

tapping over the facial nerve causes twitching of the facial muscles

75
Q

What causes subdural haemorrhage?

A

Damage to bridging veins between cortex and venous sinuses

76
Q

ADPKD is associated with

A

hepatomegaly

Finals Revision (29 decks)

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