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YR3: MM FC Ed. > DPD: Amir Sam 5 > Flashcards

DPD: Amir Sam 5 Flashcards

1
Q

In what cases would you give IV or IM adrenaline?

A

IV: Cardiac arrest
IM: Anaphylaxis

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2
Q

What antibiotic would you give in add-on to amoxicillin to cover the atypical organisms causing pneumonia?

A

Clarithromycin (Macrolide)

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3
Q

List 3 atypical organisms that cause pneumonia

A

Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumophila

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4
Q

What investigations are performed in patients with microcytic anaemia?

A

Haematinics (Ferritin, B12, folate)
Coeliac screen (TTG Ab)
Top (OGD) + Tail (colonoscopy)

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5
Q

Give 5 differentials for bloody diarrhoea

A 
Infection: Infective colitis
Inflammation: UC/ Crohns (Younger pts)
Ischaemia: Ischaemic colitis (Older pts)
Malignancy
Diverticulitis
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6
Q

How do you treat a patient with AF within and after 48 hours of onset?

A

<48 hours: DC Cardioversion

>48 hours: Rate control (Digoxin/ Metoprolol) + Anticoagulation (Reduce risk of thromboembolism)

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7
Q

What is Trousseau syndrome? In which disease is it seen?

A

Acquired blood clotting disorder that results in migratory thrombophlebitis (inflammationof a vein due to a blood clot).
Pancreatic cancer

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8
Q

What is Troisier’s sign? What does it indicate?

A

Presence of Virchows node= lymphadenopathy in supraclavicular fossa
Abdominal Malignancy

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9
Q

Give 4 signs of portal hypertension

A

Encephalopathy
Ascites
Spontaneous bacterial peritonitis (>250 WCC)
Variceal bleeds

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10
Q

Give 3 causes of microangiopathic haemolytic anaemia

A

Disseminated Intravascular Coagulation (DIC)
Haemolytic Uraemic Syndrome (HUS)
Thrombotic Thrombocytopenic Purpura (TTP)

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11
Q

Give 3 haematological features of DIC

A

Low platelets + fibrinogen (as forming clots)
High PT + APTT (as used clotting factors)
High D-dimer + fibrin degradation products (as start breaking clots)

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12
Q

Give 3 haematological features of HUS

A

Low Hb + High BR (haemolysis)
Uraemia
Low platelets (using in clotting process)

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13
Q

Give 3 features of TTP

A

HUS
Fever
Neurological manifestations

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14
Q

Give 3 hereditary causes of haemolytic anaemia

A

Red cell membrane (hereditary spherocytosis)
Enzyme deficiency (G6PD deficiency)
Haemoglobinopathy (SCD, Thalassemias)

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15
Q

Give 4 acquired causes of haemolytic anaemia

A

AI
Drugs
Infection
Microangiopathic haemolytic anaemia (MAHA)

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16
Q

What 2 features on a blood film indicate MAHA?

A

Schistocytes

Anaemia

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17
Q

How do haustra and valvulae conniventes differ?

A

Haustra: In Large bowel. Don’t traverse bowel

Valvulae conniventes: In Small bowel. Traverse small bowel

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18
Q

What do prominent valvulae conniventes indicate?

A

Small bowel obstruction

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19
Q

What are the 3 states hyponatraemia can arise in?

A

Hypovolaemia
Euvolaemia
Hypervolaemia

20
Q

What occurs in hypovolaemic hyponatraemia? How may you detect this?

A

Hypovolaemia stimulates ADH secretion
Kidneys re-absorb salt + water
Low urine Na+
Postural hypotension

21
Q

List 3 causes of euvolaemic hyponatraemia. How do you test for each of these?

A

Hypothyroidism: TFTs (low T4)
Adrenal insufficiency: Short synACTHen test
SIADH: plasma (low)+ urine (high) osmolality

22
Q

How does cardiac failure cause hypervolaemic hyponatraemia? How may you detect this?

A

Less renal perfusion- body thinks its hypovolaemic, activates RAAS, increases aldosterone, increases water + Na+ retention
Low urine Na+ due to secondary hyperaldosteronism
Peripheral oedema

23
Q

List 3 causes of hypovolaemic hyponatraemia.

A

Diarrhoea
Vomiting
Diuretics

24
Q

List 3 causes of hypervolaemic hyponatraemia.

A

Cardiac failure
Cirrhosis
Nephrotic syndrome

25
Q

List 2 sites of pathology where cause of SIADH may be found

A

CNS pathology: infection, malignancy, drugs

Lung pathology: infections, malignancy, drugs

26
Q

List 5 drugs that can cause SIADH

A 
SSRI
TCA
Opiates
PPIs
Carbamazepine
27
Q

List 4 conditions that onycholysis can be a feature of

A 
Drugs (e.g. tetracyclines, OCP, diabetes drugs)
Reactive arthritis, Reiter’s syndrome
Psoriais
Infection (especially fungal)
Trauma
Hyper + Hypothyroidism
Sarcoidosis, Scleroderma
28
Q

Give 2 features of left ventricular hypertrophy on ECG. What valvular disease may this be a result of?

A

Deep S in V1
Tall R in V6
Aortic stenosis

29
Q

Which condition causes widespread saddle-shaped ST elevation in an ECG?

A

Pericarditis

30
Q

What investigation should you perform if you suspect renal colic?

A

CT KUB

31
Q

What physiological picture is seen in primary hyperparathyroidism? What is seen in secondary?

A

Primary: High PTH, high Ca2+
Secondary: High PTH, low Ca2+

32
Q

List 3 causes hypercalcaemia when PTH is low

A

Malignancy
Sarcoidosis
Myeloma

33
Q

What are the 2 sources of ALP? What can cause elevated ALP?

A

Liver: Obstructive liver disease (+raised GGT)
Bone: Malignancy, Fracture, Paget’s Disease

34
Q

Why is ALP normal in myeloma?

A

In the bone, ALP is produced by osteoblasts

Plasma cells in myeloma SUPPRESS the osteoblasts

35
Q

What cancer causes ALP to rise?

A

Metastases to bone

36
Q

Give 4 features of multiple myeloma

A

Calcium high
Renal impairment
Anaemia
Bone pains

37
Q

List 4 causes of cavetating lung lesions

A

Infection: TB, Staph aureus, Klebsiella (e.g. alcoholics)
Inflammation: RA
Infarction: PE
Malignancy: SqCC

38
Q

List 3 broad causes of oedema. How would you test for each?

A

Heart failure: Echocardiogram
Albumin loss in bowel: Endoscopy
Albumin loss in urine: Urinalysis

39
Q

What is nephrotic syndrome?

A

increased permeability of the glomerular basement membrane to protein
Proteinuria > 3.5 g/day
hypoalbuminaemia (<30 g/L)
Peripheral oedema

40
Q

What are those with nephrotic syndrome prone to?

A 
Thromboembolic disease (lose natural anticoagulants in urine along with protein). 
May present with renal vein thrombosis
41
Q

What is the inheritance pattern of hereditary haemorrhagic telangiectasia? What does it cause?

A 
Autosomal dominant  
Abnormal blood vessels in: 
Skin 
Mucous membranes  
Lungs  
Liver  
Brain
42
Q

What condition would cause hyperkalaemia, hyponatraemia and a failed short synACTHen test?

A

Primary adrenal insufficiency

43
Q

What would cause a high prolactin, low testosterone, low FSH and low LH?

A

Prolactinoma

Prolactin inhibits reproductive axis, suppresses LH + FSH thus testosterone will be low

44
Q

What would cause high IGF1, high prolactin and a failed OGTT?

A

Acromegaly

45
Q

What would cause high FSH and LH, with low oestradiol ?

A

Premature ovarian insufficiency

Reduced negative feedback on LH + FSH

46
Q

What would cause low T4, high TSH and high prolactin?

A

Myxoedema (hypothyroidism)
TSH high (reduced negative feedback)
TRH is also high due to reduced negative feedback
High TRH stimulates prolactin

YR3: MM FC Ed. (46 decks)

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