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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
What is the treatment for sarcoidosis?
Oral prednisolone
26
What is Wegeners granulomatosis and how is it diagnosed?
Granulomas affecting small arteries | Dx: CXR (nodular masses)
27
What is Churg-Strauss syndrome, how does it present, how is it diagnosed and what is the treatment?
Eosinophillic infiltration - mainly 40y/o males Px: cough, cold peripheries, SOB (asthma), fever/sweats/fatigue, difficulty passing urine Dx: cANCA increased Tx: prednisolone
28
What type of reaction is SLE?
Connective tissue disorder | Type III hypersensitivity
29
What is the treatment for idiopathic pulmonary fibrosis?
Prednisolone + anti-fibrotic
30
What is the treatment of hypersensitivity pneumonitis and how is it diagnosed?
Tx: Avoidance, Steroids, immunosuppressants Dx: CXR (upper zone mottling/fibrosis/honey-comb lung/ground glass), restrictive spirometry
31
What is pneumoconiosis and how is it treated?
Occupational lung disease | No treatment: steroids help symptoms
32
How is an empyema treated?
Surgical drainage in 5th intercostal space mid axillary line
33
What is the difference between a transudate and an exudate?
Transudate (benign): <30g/L | Exudate (malignant): >30g/L
34
How are type I and type II respiratory failure treated?
Type I: 15L O2 non-rebreather | Type II: 24% O2 - check ABGs after 20 mins
35
What is ARDS and what is its treatment?
Stuff lungs - reduced pulmonary compliance | Tx: treat underlying condition, diuretics, NO (vasodilator)
36
What is cor pulmonale?
Right heart failure due to pulmonary hypertension
37
How is a PE treated?
If haemodynamically stable: anticoagulant | IF unstable: thrombolyse for massive PE (tPA/streptokinase)
38
How is pulmonary oedema diagnosed and treated?
Dx: CXR (ABCDE) Tx: diuretics + O2
39
Which lung cancers produce which hormones?
SCLC: ADH and ACTH (increase cortisol) SCC: PTH, hypercalcaemia
40
What are the classification software hypertension?
Stage 1: >140/90 Stage 2: >160/100 Severe: >180/110
41
What is the target blood pressure for under and over 80?
<80: 140/90 | >80: 150/90
42
What is the investigations for angina?
ECG (to exclude anything worse) | Exercise ECG
43
What is the progression of treatment for angina?
``` B-blocker GTN Isosorbide mononitrate Amlodipine PCI/CABG ```
44
What is acute coronary syndrome and how is it investigated?
Unstable angina, NSTEMI, STEMI | Ix: ECG + cardiac troponins
45
What is the difference in ECG/troponins in different acute coronary syndromes?
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
46
What is the treatment for unstable angina?
Aspirin + clopidogrel | Nitrates
47
What are the different types of heart block?
``` 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) ```
48
How is heart block treated?
Atropine | Pacing (temporary/permanent)
49
How are right and left bundle branch block identified?
Left: W in V1, M in V6 Right: M in V1, W in V6 (WilliaM MorroW)
50
When is anticoagulation given in AF?
CHAD-VASC score: 0 = none 1 = consider in males 2 = offer to both
51
What is the acute treatment of symptomatic AF?
DC cardio version and anticoagulation
52
How is the rate and rhythm controlled in AF?
Rate: B-blocker Ca channel blocker (diltiazem) Digoxin Rhythm: Electrical cardioversion Amiodarone
53
How is atrial flutter treated?
Curative = radio frequency ablation | Otherwise the same as AF (rate, rhythm and anticoagulation)
54
What are the ECG changes in ventricular tachycardia?
Broad monomorphic QRS or torsades de point
55
How is VT treated if pulseless or if cardiac output is acceptable?
Pulseless VT = defib | CO/BP fine = amiodarone
56
How does ventricular fibrillation appear on an ECG and what is the treatment?
Complete disorder with a wide QRS | Tx: defibrillator and implantable cardiac defibrillator (ICD) long term
57
Which murmur is not caused by rheumatic disease?
Aortic regurgitation
58
What are the factors you would want to know about a murmur?
``` Systolic or diastolic? Type (ejection/pansystolic) Where its loudest? Any radiation? Grade? Respiratory influence? ```
59
What is the treatment for Strep viridans, Staph aureus, Staph epidermidis and MRSA infective endocarditis?
Strep viridans: amoxicillin + gentamicin Staph aureus: flucloxacillin Staph epidermidis: vancomycin + gentamicin MRSA: vancomycin + gentamicin
60
What is intermittent claudication and how is it investigated?
Chronic lower limb ischaemia | Ix: ABPI (ankle brachial pressure index), duplex ultrasound, CT angiography
61
What is the treatment for chronic and acute lower limb ischaemia?
Chronic: antiplatelets or surgery (if severe) Acute: anticoagulation, angioplasty, surgery
62
How is supraventricular tachycardia treated?
Vagal manoeuvres, IV adenosine, Iv verapamil
63
What are the signs of acute lower limb ischaemia?
6P's | Pallor, pain, pulseless, perishingly cold, paralysis, paraesthesia
64
What are the signs and investigations of an AAA?
Asymptomatic, abdominal pulsatile mass or severe pain radiating to the back if perforated Ix: ultrasound
65
What is the treatment of an AAA?
<5.5cm: monitoring/lifestyle advice | >5.5cm: surgery/stenting
66
How is DVT investigated and treated?
Ix: doppler ultrasound, low D-dimers (exclusion) Tx: anticoagulation, TED stockings
67
What causes varicose veins?
Back pressure due to incompetent valves causing pooling of blood in the superficial veins
68
What is the most common congenital heart malformation?
VSD
69
What re the general signs of congenital malformation?
Cyanosis and clubbing
70
What are the signs of coarctation fo the aorta?
Rib notching om CXR | Diminished lower pulses
71
How is a stroke investigated?
Non-contrast CT or an MRI
72
What is the treatment for an ischaemic or a haemorrhage stroke?
Ischaemic: Thombolysis, aspirin/clopidogrel Statin upon recovery Haemorrhagic: Supportive, stop any anticoagulation
73
What is the investigation and treatment of hypertrophic cardiomyopathy?
Ix: ECG (LVH and Q waves), Echocardiogram Tx: ICD (defibrillator)
74
What are the investigations and results of myocarditis?
CXR (cardiomegaly) | Troponin (increased)
75
What is the treatment of myocarditis?
ACEI B-blockers Antibiotics where appropriate
76
What are the types are treatments of shock?
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
How is GORD treated?
Omeprazole, ranitidine, antacids (gavescon)
78
What is the investigation and treatment of gastritis?
Ix: H pylori breath test Tx: omeprazole/ranitidine, lifestyle, surgery
79
What is gastroparesis and what are the signs, investigations and treatments?
Delayed gastric emptying not due to obstruction Sx: bloating, abdo pain, N&V Ix: OGD Tx: pro kinetic agent (metoclopramide), anti-emetic
80
Where are peptic ulcers most commonly found and what causes them?
Duodenum | Caused by acid/pepsin attack
81
How are peptic ulcers diagnosed and treated?
Ix: OGD Tx: antacids (gaviscon), omeprazole, ranitidine, H pylori eradication therapy
82
What is H pylori eradication therapy?
2 weeks of triple therapy - omeprazole + amoxicillin + metronidazole/clarithromycin
83
How is intestinal failure diagnosed and what is the treatment?
Ix: FBC, serum electrolytes Tx: nutritional support
84
What is the treatment of small bowel obstruction?
Drip + suck: fluids and NG tube draining
85
What are the signs of meckels diverticulum?
Asymptomatic or malaena
86
How are campylobacter, salmonella, E coli 0157, norovirus and rotavirus investigated?
Stool culture: campylobacter, salmonella Stool toxin: E coli 0157 Stool PCR: norovirus, rotavirus
87
What causes dysentry (bloody diarrhoea)?
Campylobacter, E coli 0157, shigella
88
What is the progression in treatment for IBD?
``` 5-ASA (mesalazine) - UC only Corticosteroid (prednisolone) Immunosuppressant (azathioprine) Anti-TNF (inflixumab) Surgery ```
89
Where does diverticular disease mainly affect?
Sigmoid colon
90
What are the symptoms of diverticulitis?
Diarrhoea, abdo pain, fever, vomiting, altered bowel habit
91
What is the treatment for diverticulitis?
Drainage and antibiotics
92
Which inherited condition causes a carpet of polyps through the bowel?
Familial adenomatous polyposis (FAP)
93
What is the treatment for IBS?
FODMAP diet and loperamide
94
What is the difference between pre-hepatic, hepatic and post-hepatic jaundice?
Pre-hepatic; excess haemolysis (unconjugated bilirubin) Hepatic: liver damage (conjugated + unconjugated bilirubin) Post-hepatic: bile duct obstruction (conjugated bilirubin)
95
Which viral hepatitis is DNA rather than RNA?
HepB
96
What are the different tests which indicate current infection, natural immunity and highly infectious individuals with respect to HepB?
HepB s Ag: infection HepB s Ab: immunity HepB e Ag: highly infectious
97
Which types of viral hepatitis are acute and chronic?
Acute: HepA, HepE, HepB Chronic: HepB, HepC
98
What is the treatment for HepA, HepB and HepC?
HepA: supportive management HepB: adefovir, tenofovir, peg interferon HepC: peginterferon, ribarvirin
99
What is haemochromatosis and what are its signs and treatment?
Autosomal recessive condition with abnormal iron absorption Sx: hepatomegaly, slate grey, joint pain Tx: venesection
100
What is Wilsons disease and what are its signs and treatment?
Excess copper due to autosomal recessive disorder Sx: Kayser-fleisher rings, signs of liver disease Tx: penicillamine
101
What is Budd-Chiari syndrome?
Hyper-coagulation in the hepatic vein (clotting means obstruction and thrombosis)
102
What is the investigation progression and treatment for gallstones?
``` LFTs Ultrasound MRCP ERCP Tx: ERCP or cholecystectomy ```
103
What is the treatment of acute pancreatitis?
NJ feeding IV fluids Analgesia (supportive)
104
What are the clinical signs of acute pancreatitis?
Cullens and Grey Turners (bruising in umbilical and lumbar regions) Fever Severe pain radiating to back N&V
105
What are the treatments of chronic pancreatitis?
CREON, Insulin, Surgery
106
What type of pancreatic cancer is the most common?
Exocrine (adenocarcinoma) - usually at ampulla of Vater
107
What are the endocrine tumours of the pancreas and what effects do they have?
Insulinoma (hypoglycaemia) Glucagonoma (hyperglycaemia) Gastrinoma (acid hypersecretion)
108
What group of people mainly get umbilical hernias and why?
Children - due to a weakness in the line alba
109
Which side of the inferior epigastric vessels are direct and indirect hernias and who gets them?
Direct: medial (old men) Indirect: Lateral (young men)
110
What is the treatment of haemorrhoids?
Band ligation, Asymptomatic = nothing, Analgesia (gel/ice/cream)
111
What is a rectal prolapse?
A protruding mass from the rectum associated with defecation
112
What is an anal fissure and what is its treatment?
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
What is a fistula in ano and what is its treatment?
Abnormal connection between the anal canal and perianal skin causing abscess formation Tx: drainage (cut it open)
114
What are the causes of liver disease?
``` 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
What does raised cANCA indicate?
Granulomatosis with polyangiitis (Wegeners granulomatosis)
116
What does raised pANCA indicate?
Microscopic polyangiitis and eosinophilic granulomatosis (Churg-Stauss syndrome)
117
What is the difference between Wegeners granulomatosis and Churg-Strauss syndrome?
Wegeners = granulomas affecting small arteries Churg-Strauss: Eosinophilic inflammation and granulomas (both resp related)
118
What are the causes of abdominal distension?
``` 6Fs Fat Faeces Fluid Flatus Foetus Fucking massive tumour ```
119
Causes of abdominal mass?
A CHEMICAL A - AAA ``` C - Crohns H - hernia E - enlarged organ M - malignancy I - intersusception C - cyst/abscess A - appendicitis L - lymphadenopathy ```
120
Causes of bowel obstruction?
BATH VIPS (bowel = B) B - bolus A - adhesion T - tumour H - hernia V - volvulus I - intersusception P -psuedoobstruction S - stricture
121
What do amoxicillin, metronidazole and gentamicin target?
Amoxicillin: enterococcus (strep/staph) Metronidazole: anaerobes Gentamicin: enterobacteriacea

Y1 Mixed (7 decks)

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