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Y1 Mixed > Disease profiles > Flashcards

Disease profiles Flashcards

1
Q

How long should patient be in isolation for after diagnosis with C diff?

A

48 hours

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2
Q

Closure of which valves equates to which heart sound?

A 
S1 = mitral and tricuspid closure
S2 = aortic and pulmonary closure
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3
Q

What causes a third heart sound?

A

Physiological <30y/o (caused by diastolic filling of the ventricle)
Left ventricular failure
Constrictive pericarditis (pericardial knock)

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4
Q

What is the progression of treatment in Angina?

A 
B-blocker
GTN
Isosorbide mononitrate
Amlodipine 
PCI/CABG
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5
Q

What is the treatment for unstable angina?

A

Aspirin + clopidogrel

Nitrates

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6
Q

What pharmaceutical management is given post-MI?

A

Dual anti platelet therapy
ACEI
B-blocker
Statin

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7
Q

When does a patient receive PCI following an NSTEMI

A

GRACE score is calculated and based upon that either in the same admission or at a later date

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8
Q

What is the treatment of heart failure and how is it progressed?

A

B-blocker
ACEI
Loop diuretic

Increased:
Spironolactone
Digoxin

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9
Q

What is the investigations of arrhythmias?

A

ECG,
Exercise ECG,
24hr ECG

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10
Q

What is the treatment of coryza?

A

Bed rest and supportive management

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11
Q

What is sinusitis, how does it present, how is it investigated and how is it treated?

A

Bacterial or fungal infection of sinuses
Px: frontal headache/pain, fever, runny nose
Ix: CT of sinuses or MRI
Tx: nasal decongestants, broad spec antibiotics (co-amoxiclav)

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12
Q

How is rhinitis treated?

A

Antihistamines
Monteleukast
Sodium cromoglycate

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13
Q

What type of infection is pharyngitis?

A

Adenovirus

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14
Q

How does pharyngitis present and how is it treated?

A

Sore throat, fever, tonsillar enlargement

Tx: phenomethylpenicillin

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15
Q

What organism causes epiglottitis and how is it treated?

A

Haemophilus Influenzae

Tx: Endotracheal intubation, IV fluids, DO NOT inspect until airway clear

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16
Q

What is the difference between influenza A and influenza B?

A

Influenza A = pandemics

Influenza B = local outbreaks (epidemics)

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17
Q

How are mild and severe CAP and mild and severe HAP treated?

A

CAP:
Mild - amoxicillin/doxycycline
Severe - Co-amoxiclav + doxycycline

HAP:
Mild - metronidazole + amoxicillin
Severe - gentamicin + amoxicillin + metronidazole

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18
Q

How long after admission is pneumonia considered to be hospital acquired?

A

48 hours

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19
Q

What is the progression of treatment for COPD?

A

SABA/SAMA

FEV1 >50%
LABA/LAMA
LABA+ICS

FEV1 <50%
LAMA/ LABA+ICS
LAMA + LABA+ICS

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20
Q

What is the progression of treatment for asthma?

A 
SABA
ICS
LTRA
LABA
Increase ICS
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21
Q

How is obstructive sleep apnoea diagnosed?

A

Epworth sleepiness scale

Overnight pulse oximetry

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22
Q

What are the symptoms of a lung abscess?

A

Swinging fever,
Persistent pneumonia
Malaise

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23
Q

How is CF diagnosed?

A

Sweat test (gene testing)

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24
Q

What are the side effects of the TB treatments?

A

Rifampicin: orange bodily fluids
Isoniazid: neuropathy
Pyranizamide: hepatic toxicity
Ethambutol: optic neuritis (colour blindness)

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25
Q

What is the treatment for sarcoidosis?

A

Oral prednisolone

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26
Q

What is Wegeners granulomatosis and how is it diagnosed?

A

Granulomas affecting small arteries

Dx: CXR (nodular masses)

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27
Q

What is Churg-Strauss syndrome, how does it present, how is it diagnosed and what is the treatment?

A

Eosinophillic infiltration - mainly 40y/o males
Px: cough, cold peripheries, SOB (asthma), fever/sweats/fatigue, difficulty passing urine
Dx: cANCA increased
Tx: prednisolone

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28
Q

What type of reaction is SLE?

A

Connective tissue disorder

Type III hypersensitivity

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29
Q

What is the treatment for idiopathic pulmonary fibrosis?

A

Prednisolone + anti-fibrotic

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30
Q

What is the treatment of hypersensitivity pneumonitis and how is it diagnosed?

A

Tx: Avoidance, Steroids, immunosuppressants
Dx: CXR (upper zone mottling/fibrosis/honey-comb lung/ground glass), restrictive spirometry

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31
Q

What is pneumoconiosis and how is it treated?

A

Occupational lung disease

No treatment: steroids help symptoms

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32
Q

How is an empyema treated?

A

Surgical drainage in 5th intercostal space mid axillary line

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33
Q

What is the difference between a transudate and an exudate?

A

Transudate (benign): <30g/L

Exudate (malignant): >30g/L

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34
Q

How are type I and type II respiratory failure treated?

A

Type I: 15L O2 non-rebreather

Type II: 24% O2 - check ABGs after 20 mins

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35
Q

What is ARDS and what is its treatment?

A

Stuff lungs - reduced pulmonary compliance

Tx: treat underlying condition, diuretics, NO (vasodilator)

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36
Q

What is cor pulmonale?

A

Right heart failure due to pulmonary hypertension

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37
Q

How is a PE treated?

A

If haemodynamically stable: anticoagulant

IF unstable: thrombolyse for massive PE (tPA/streptokinase)

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38
Q

How is pulmonary oedema diagnosed and treated?

A

Dx: CXR (ABCDE)
Tx: diuretics + O2

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39
Q

Which lung cancers produce which hormones?

A

SCLC: ADH and ACTH (increase cortisol)
SCC: PTH, hypercalcaemia

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40
Q

What are the classification software hypertension?

A

Stage 1: >140/90
Stage 2: >160/100
Severe: >180/110

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41
Q

What is the target blood pressure for under and over 80?

A

<80: 140/90

>80: 150/90

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42
Q

What is the investigations for angina?

A

ECG (to exclude anything worse)

Exercise ECG

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43
Q

What is the progression of treatment for angina?

A 
B-blocker
GTN
Isosorbide mononitrate 
Amlodipine
PCI/CABG
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44
Q

What is acute coronary syndrome and how is it investigated?

A

Unstable angina, NSTEMI, STEMI

Ix: ECG + cardiac troponins

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45
Q

What is the difference in ECG/troponins in different acute coronary syndromes?

A

Unstable angina:
No ECG changes and no changes in cardiac markers

NSTEMI:
ST depression, T wave inversion, elevated troponin

STEMI:

ST elevation, T wave inversion, Q waves, elevated troponin

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46
Q

What is the treatment for unstable angina?

A

Aspirin + clopidogrel

Nitrates

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47
Q

What are the different types of heart block?

A 
Type 1: long PR interval
Type 2 (I): progressive lengthening of PR interval until dropped QRS
Type 2 (II): dropped QRS without change in PR
Type 3: No associations between P and QRS (lonely P waves)
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48
Q

How is heart block treated?

A

Atropine

Pacing (temporary/permanent)

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49
Q

How are right and left bundle branch block identified?

A

Left: W in V1, M in V6
Right: M in V1, W in V6
(WilliaM MorroW)

50
Q

When is anticoagulation given in AF?

A

CHAD-VASC score:
0 = none
1 = consider in males
2 = offer to both

51
Q

What is the acute treatment of symptomatic AF?

A

DC cardio version and anticoagulation

52
Q

How is the rate and rhythm controlled in AF?

A

Rate:
B-blocker
Ca channel blocker (diltiazem)
Digoxin

Rhythm:
Electrical cardioversion
Amiodarone

53
Q

How is atrial flutter treated?

A

Curative = radio frequency ablation

Otherwise the same as AF (rate, rhythm and anticoagulation)

54
Q

What are the ECG changes in ventricular tachycardia?

A

Broad monomorphic QRS or torsades de point

55
Q

How is VT treated if pulseless or if cardiac output is acceptable?

A

Pulseless VT = defib

CO/BP fine = amiodarone

56
Q

How does ventricular fibrillation appear on an ECG and what is the treatment?

A

Complete disorder with a wide QRS

Tx: defibrillator and implantable cardiac defibrillator (ICD) long term

57
Q

Which murmur is not caused by rheumatic disease?

A

Aortic regurgitation

58
Q

What are the factors you would want to know about a murmur?

A 
Systolic or diastolic?
Type (ejection/pansystolic)
Where its loudest?
Any radiation?
Grade?
Respiratory influence?
59
Q

What is the treatment for Strep viridans, Staph aureus, Staph epidermidis and MRSA infective endocarditis?

A

Strep viridans: amoxicillin + gentamicin
Staph aureus: flucloxacillin
Staph epidermidis: vancomycin + gentamicin
MRSA: vancomycin + gentamicin

60
Q

What is intermittent claudication and how is it investigated?

A

Chronic lower limb ischaemia

Ix: ABPI (ankle brachial pressure index), duplex ultrasound, CT angiography

61
Q

What is the treatment for chronic and acute lower limb ischaemia?

A

Chronic: antiplatelets or surgery (if severe)
Acute: anticoagulation, angioplasty, surgery

62
Q

How is supraventricular tachycardia treated?

A

Vagal manoeuvres, IV adenosine, Iv verapamil

63
Q

What are the signs of acute lower limb ischaemia?

A

6P’s

Pallor, pain, pulseless, perishingly cold, paralysis, paraesthesia

64
Q

What are the signs and investigations of an AAA?

A

Asymptomatic, abdominal pulsatile mass or severe pain radiating to the back if perforated
Ix: ultrasound

65
Q

What is the treatment of an AAA?

A

<5.5cm: monitoring/lifestyle advice

>5.5cm: surgery/stenting

66
Q

How is DVT investigated and treated?

A

Ix: doppler ultrasound, low D-dimers (exclusion)
Tx: anticoagulation, TED stockings

67
Q

What causes varicose veins?

A

Back pressure due to incompetent valves causing pooling of blood in the superficial veins

68
Q

What is the most common congenital heart malformation?

A

VSD

69
Q

What re the general signs of congenital malformation?

A

Cyanosis and clubbing

70
Q

What are the signs of coarctation fo the aorta?

A

Rib notching om CXR

Diminished lower pulses

71
Q

How is a stroke investigated?

A

Non-contrast CT or an MRI

72
Q

What is the treatment for an ischaemic or a haemorrhage stroke?

A

Ischaemic:
Thombolysis, aspirin/clopidogrel
Statin upon recovery

Haemorrhagic:
Supportive, stop any anticoagulation

73
Q

What is the investigation and treatment of hypertrophic cardiomyopathy?

A

Ix: ECG (LVH and Q waves), Echocardiogram
Tx: ICD (defibrillator)

74
Q

What are the investigations and results of myocarditis?

A

CXR (cardiomegaly)

Troponin (increased)

75
Q

What is the treatment of myocarditis?

A

ACEI
B-blockers
Antibiotics where appropriate

76
Q

What are the types are treatments of shock?

A

An Old Virign Hides, Cause Other Virgins Slag Adult Abstinence, Its Chilling

ABCDE
Oxygen
Vol replacement - Hypovolaemic
Chest drain - Obstructive
Vasopressors - Septic
Adrenaline - Anaphylaxis
Inotropes - Cardiogenic

Inotropes = digoxin/amiodarone

77
Q

How is GORD treated?

A

Omeprazole, ranitidine, antacids (gavescon)

78
Q

What is the investigation and treatment of gastritis?

A

Ix: H pylori breath test
Tx: omeprazole/ranitidine, lifestyle, surgery

79
Q

What is gastroparesis and what are the signs, investigations and treatments?

A

Delayed gastric emptying not due to obstruction
Sx: bloating, abdo pain, N&V
Ix: OGD
Tx: pro kinetic agent (metoclopramide), anti-emetic

80
Q

Where are peptic ulcers most commonly found and what causes them?

A

Duodenum

Caused by acid/pepsin attack

81
Q

How are peptic ulcers diagnosed and treated?

A

Ix: OGD
Tx: antacids (gaviscon), omeprazole, ranitidine, H pylori eradication therapy

82
Q

What is H pylori eradication therapy?

A

2 weeks of triple therapy - omeprazole + amoxicillin + metronidazole/clarithromycin

83
Q

How is intestinal failure diagnosed and what is the treatment?

A

Ix: FBC, serum electrolytes
Tx: nutritional support

84
Q

What is the treatment of small bowel obstruction?

A

Drip + suck: fluids and NG tube draining

85
Q

What are the signs of meckels diverticulum?

A

Asymptomatic or malaena

86
Q

How are campylobacter, salmonella, E coli 0157, norovirus and rotavirus investigated?

A

Stool culture: campylobacter, salmonella
Stool toxin: E coli 0157
Stool PCR: norovirus, rotavirus

87
Q

What causes dysentry (bloody diarrhoea)?

A

Campylobacter, E coli 0157, shigella

88
Q

What is the progression in treatment for IBD?

A 
5-ASA (mesalazine) - UC only
Corticosteroid (prednisolone)
Immunosuppressant (azathioprine)
Anti-TNF (inflixumab)
Surgery
89
Q

Where does diverticular disease mainly affect?

A

Sigmoid colon

90
Q

What are the symptoms of diverticulitis?

A

Diarrhoea, abdo pain, fever, vomiting, altered bowel habit

91
Q

What is the treatment for diverticulitis?

A

Drainage and antibiotics

92
Q

Which inherited condition causes a carpet of polyps through the bowel?

A

Familial adenomatous polyposis (FAP)

93
Q

What is the treatment for IBS?

A

FODMAP diet and loperamide

94
Q

What is the difference between pre-hepatic, hepatic and post-hepatic jaundice?

A

Pre-hepatic; excess haemolysis (unconjugated bilirubin)
Hepatic: liver damage (conjugated + unconjugated bilirubin)
Post-hepatic: bile duct obstruction (conjugated bilirubin)

95
Q

Which viral hepatitis is DNA rather than RNA?

A

HepB

96
Q

What are the different tests which indicate current infection, natural immunity and highly infectious individuals with respect to HepB?

A

HepB s Ag: infection
HepB s Ab: immunity
HepB e Ag: highly infectious

97
Q

Which types of viral hepatitis are acute and chronic?

A

Acute: HepA, HepE, HepB
Chronic: HepB, HepC

98
Q

What is the treatment for HepA, HepB and HepC?

A

HepA: supportive management
HepB: adefovir, tenofovir, peg interferon
HepC: peginterferon, ribarvirin

99
Q

What is haemochromatosis and what are its signs and treatment?

A

Autosomal recessive condition with abnormal iron absorption
Sx: hepatomegaly, slate grey, joint pain
Tx: venesection

100
Q

What is Wilsons disease and what are its signs and treatment?

A

Excess copper due to autosomal recessive disorder
Sx: Kayser-fleisher rings, signs of liver disease
Tx: penicillamine

101
Q

What is Budd-Chiari syndrome?

A

Hyper-coagulation in the hepatic vein (clotting means obstruction and thrombosis)

102
Q

What is the investigation progression and treatment for gallstones?

A 
LFTs
Ultrasound
MRCP
ERCP
Tx: ERCP or cholecystectomy
103
Q

What is the treatment of acute pancreatitis?

A

NJ feeding
IV fluids
Analgesia
(supportive)

104
Q

What are the clinical signs of acute pancreatitis?

A

Cullens and Grey Turners (bruising in umbilical and lumbar regions)
Fever
Severe pain radiating to back
N&V

105
Q

What are the treatments of chronic pancreatitis?

A

CREON,
Insulin,
Surgery

106
Q

What type of pancreatic cancer is the most common?

A

Exocrine (adenocarcinoma) - usually at ampulla of Vater

107
Q

What are the endocrine tumours of the pancreas and what effects do they have?

A

Insulinoma (hypoglycaemia)
Glucagonoma (hyperglycaemia)
Gastrinoma (acid hypersecretion)

108
Q

What group of people mainly get umbilical hernias and why?

A

Children - due to a weakness in the line alba

109
Q

Which side of the inferior epigastric vessels are direct and indirect hernias and who gets them?

A

Direct: medial (old men)
Indirect: Lateral (young men)

110
Q

What is the treatment of haemorrhoids?

A

Band ligation,
Asymptomatic = nothing,
Analgesia (gel/ice/cream)

111
Q

What is a rectal prolapse?

A

A protruding mass from the rectum associated with defecation

112
Q

What is an anal fissure and what is its treatment?

A

Tear in the anal margin distal to the dentate line - associated with massive pain upon defecation and bleeding
Tx: GTN ointment, topical diltiazem, botox injections

113
Q

What is a fistula in ano and what is its treatment?

A

Abnormal connection between the anal canal and perianal skin causing abscess formation
Tx: drainage (cut it open)

114
Q

What are the causes of liver disease?

A 
ABCDEFGHI
A - autoimme
B - HepB
C - HepC
D - drugs (paracetamol)
E - ethanol
F - fatty liver disease
G - growth (cancer/mets)
H - haemodynamic (CCF)
I - iron
115
Q

What does raised cANCA indicate?

A

Granulomatosis with polyangiitis (Wegeners granulomatosis)

116
Q

What does raised pANCA indicate?

A

Microscopic polyangiitis and eosinophilic granulomatosis (Churg-Stauss syndrome)

117
Q

What is the difference between Wegeners granulomatosis and Churg-Strauss syndrome?

A

Wegeners = granulomas affecting small arteries
Churg-Strauss: Eosinophilic inflammation and granulomas
(both resp related)

118
Q

What are the causes of abdominal distension?

A 
6Fs
Fat
Faeces
Fluid
Flatus
Foetus
Fucking massive tumour
119
Q

Causes of abdominal mass?

A

A CHEMICAL

A - AAA

C - Crohns
H - hernia
E - enlarged organ 
M - malignancy
I - intersusception
C - cyst/abscess
A - appendicitis
L - lymphadenopathy
120
Q

Causes of bowel obstruction?

A

BATH VIPS (bowel = B)

B - bolus
A - adhesion
T - tumour
H - hernia

V - volvulus
I - intersusception
P -psuedoobstruction
S - stricture

121
Q

What do amoxicillin, metronidazole and gentamicin target?

A

Amoxicillin: enterococcus (strep/staph)
Metronidazole: anaerobes
Gentamicin: enterobacteriacea

Y1 Mixed (7 decks)

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