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Final year > Dr Clarke revision > Flashcards

Dr Clarke revision Flashcards

1
Q

Name 5 features of endocarditis.

  • 2 in hand
  • 1 in heart
  • 2 in abdomen
A
  • splinter haem and clubbing
  • changing murmurs
  • splenomegaly and haematuria (due to GN)
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2
Q

Name the 4 stages of clubbing.

A
  • inc fluctuancy of nail bed
  • loss of angle
  • inc curvature of nail
  • expansion of terminal phalanx
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3
Q

What is corrigans sign and corrigans/waterhammer pulse and which condition is it seen in?

A

C sign-distension and collapse of carotids (appear as if they are dancing)

WH pulse-bounding forceful then collapse of pulse when arm lifted
Seen in AR

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4
Q

Name 5 causes of AF.

A 
IHD
rheumatic heart disease
thyrotoxicosis
HTN
Alcohol
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5
Q

In AF, why might there be a difference between the pulse at the wrist and heart rate timed at apex?

A

Pulse deficit-As rate inc, filling time decreases. Enough filling for valves to close but not enough to maintain a CO

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6
Q

What 2 situations is warfarin preferred over a DOAC?

A

mitral stenosis

metal valve

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7
Q

Name 4 causes of pressure overload in LV.

A

HTN
AS
H(O)CM
CoA

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8
Q

Name 3 sx of AS. Name 2 rx and which situations they are used.

A

Syncope
Angina
breathlessness

Valve replacement-healthy
TAVI-unfit for surgery

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9
Q

In one sentence, what is the diff between aortic stenosis and sclerosis?

A

sclerosis-no pulse signs, normal apex, no carotid radiation…just MURMUR

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10
Q

Name 3 causes of MR.

A 
congenital valve
endocarditis
degenerative change
marfans
rupture of papillary muscle with MI
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11
Q

What 2 diseases can mitral stenosis cause and how?

A

RHF due to back pressure

AF

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12
Q

What 2 things can make a murmur louder?

A

holding inspiration/expiration (RILE)

exercise patient

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13
Q

Name 3 complications of valve replacement.

A

Valvular leakage
Endocarditis
Obstruction (thrombus)
Valve failure

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14
Q

Name the 6 qualities of pericardial pain.

A

2x lung- sharp and worse on inspiration
2x heart- central, retrosternal and radiates to left shoulder
2x other- worse on lying flat, eased with sitting forward

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15
Q

State the 4 radiological changes seen in heart failure.

A 
Alveolar oedema
B lines (kerley)
Cardiomegaly
Dilated upper lobe vessels
Effusions (pleural)
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16
Q

Name 3 comps of MI. Use mnemonic sudden death on PRAED st.

A 
Sudden death!
Pump failure
Rupture of muscle papillae
Arrhythmia, aneurysm
Embolism
Dresslers (pericarditis post MI)
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17
Q

Name the ABCDE management of STEMI for long term.

A 
ACE-i
B blockers
Cholesterol lowering
Dual antiplatelet (aspirin+clop/ticag)
Echo to assess LV
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18
Q

Name some causes of LVF/HF. Use mnemonic CHAMP.

A 
Coronary syndrome
Hypertension 
Arrhythmia
Mechanical (valve, heart defect)
Pulm embolism
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19
Q

Name the treatment for HF. Use LMNOP

A 
Loop duiretic (furosemide)
Morphine
Nitrates
Oxygen
Position (sit up)/CPAP
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20
Q

Name some causes of LVF/HF. Use mnemonic CHAMP.

A 
Coronary syndrome
Hypertension 
Arrhythmia
Mechanical (valve, heart defect)
Pulm embolism
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21
Q

Name the treatment for HF. Use LMNOP

A 
Loop duiretic (furosemide)
Morphine
Nitrates
Oxygen
Position (sit up)/CPAP
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22
Q

Name 4 indications of pacemaker. Use SCAR

A

Sick sinus syndrome
Complete heart block
AV node ablation
Resynchronisation therapy for HF

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23
Q

What is the most common causative organism of inf endocarditis? Name the 2 abx used to treat.

A

strep viridans

penicillin+gentamicin IV

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24
Q

Name 2 imaging techniques when inf endocarditis is suspected.

A

transthoracic echo

trans oesophageal echo

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25
Q

Name 4 nephrotoxic drug classes. ‘ Stop the DAMN drugs’

A

Duiretics
Ace-i/ARB
Metformin
NSAIDS

26
Q

Name 5 indications of dialysis in AKI. Use AEIOU

A

Acidosis
Electrolyte disturbance (e.g. hyperkalaemia)
Intoxication wit drugs (aspirin, lithium)
Overload of fluid
Uraemic symptoms (encephalopathy)

27
Q

What are some causes of CKD. Mnemonic: HIDDEN

A 
Hypertension
Infection
Diabetes
Drugs
Exotica (SLE. vasculitis)
Nephritis (GN)
28
Q

If a pt experiences pain, pallor, parasthesia and diminished pulses distal to fistula, what syndrome has occured?

A

steal syndrome

Ischaemia due to thrombosis/narrowing distal to fistula

29
Q

Name 3 features of peritoneal dialysis peritonitis.

A

fever
cloudy fluid in bag
port site infection
abdo pain

30
Q

Name the triad of symptoms in nephrotic syndrome.

A

odema
hypoalbuminaemia
proteinuria

31
Q

Name 4 symptoms of nephritic syndrome. abnormal HOST response

A

HTN
Oliguria
Smoky brown haematuria
Traces of oedema

32
Q

Name 3 causes of nephritic syndrome.

A

Post strep infection
IgA nephropathy
Vasculitis

33
Q

Name the 3 functions of the DCML pathway. ‘Find Vivians Pathway’.
Where does it decussate?

A

Fine touch
Vibration
Proprioception

MEDULLA (dcMl)

34
Q

Where does the second order neurone meet the third order neurone in DCML and spinothalamic pathways?

A

thalamus

35
Q

Nam 4 functions of the spinothalamic tracts. Where does it decussate?

A

crude touch
pain
temperature
pressure

spinal cord

36
Q

What is the name of the tracts that supply the cerebellum, provide unconscious info and assist with co-ordination and motor movements?

A

spinocerebellar tracts

37
Q

Name 2 causes of DCML pathway destruction. What sensory functions are lost and which side?

A 
Vit B12 deficiency
Tabes dorsalis (consequence of syphylis causing demyelination of DCML)

Fine touch, vibration and proprioception lost
Ipsilateral due to decussation in medulla

38
Q

What loss of function is seen in brown sequarde syndrome?

A

DCML-loss of fine touch, vibration and proprioception on ipsilateral side
Spinothalamic-loss of crude touch, pain and temp on contralateral side
Descending motor-hemiparesis on ipsilateral side

39
Q

Which tract supplies the musculature of the:

  • body
  • head and neck
A

Body-corticospinal

H&N-corticobulbar

40
Q

Name 5 UMN signs.

A 
Hypertonia
Hyperreflexia
Clonus
Babinski +ve
muscle weakness
41
Q

Which 2 cranial nerves receive only unilateral innervation from corticobulbar tracts?

A

hypoglossal

facial

42
Q

Name 5 causes of a positive prayer sign.

A 
Diabetes
RA
Scleroderma
Ulna nerve palsy
Dupuytren's contracture
43
Q

What is scleroderma/systemis sclerosis (can be divided into limited and diffuse)?
sclero-hard
derma-skin

A

AI connective tissue disorder characterised by overproduction of collagen depositing into organs causing failure:

  • breathing difficulty
  • swallowing difficulty
  • digestive dysfunction
  • raynauds phenomenon
  • arthritis & stiffening in joints of hand
44
Q

What is another word for limited systemic sclerosis and explain what each letter stands for. How is diffuse systemic sclerosis different?

A 
CREST syndrome
Calcinosis
Raynauds
Esophageal webs
Sclerodactyly
Telangiectasia

Diffuse-CREST+internal organ involvement

45
Q

Name an antibody measured in systemic sclerosis.

A

anti-centromere

46
Q

Which muscle in the thenar eminence is innervated by a different nerve that isn’t median nerve?

A

adductor pollicis

ulna nerve

47
Q

What is froment’s sign?

A

Flexion of thumb at IP joint on attempting pincer grip to compensate in ulna nerve palsy (when adductor pollicis is compromised)

48
Q

Name the ABCDE causes of peripheral neuropathy. Name the 3 extras that do not fit in this acronym.

A 
Alcohol
B12 deficiency
Chronic kidney disease
Diabetes and drugs
Every vasculitis

Cancer, Lyme disease and Charcot Marie Tooth

49
Q

Name the antibody detected in rheumatic fever

A

ASTO titre (anti streptolysin O titre)

50
Q

Name 5 major criteria in jones criteria.

A 
Sydenhams chorea
Inflammatory arthritis
Carditis
Nodules 
Erythema marginatum
51
Q

What is sydenhams chorea?

A

unco-ordinated voluntary movement of face, hands and feet after infection of group A beta haemolytic strep

52
Q

What does erythema marginatum look like and which condition is it seen in?

A

pale red macules or papules on trunk or proximal limbs

rheumatic fever

53
Q

Name a virus that causes erythema multiforme (target lesions). What else can cause this rash?

A

herpes simplex

drug reaction

54
Q

Which rash does lyme disease cause? How would you describe the rash?

A

erythema migrans

Bulls eye lesions

55
Q

What is charcot marie tooth disease?

A

hereditary sensorimotor neuropathy

56
Q

Name the cerebellar signs using DANISH.

A 
Dysdiadokokinesia
Ataxia
Nystagmus
Intention tremor
Scanning (staccato)/slurred speech
Hypotonia
57
Q

Rupture of which artery can cause an extradural/epidural haemorrhage?

A

middle meningeal artery

58
Q

Give 3 examples of when you shouldn’t thrombolyse a patient after an ischaemic stroke. Use High BROWS

A

High BP

Bleeding tendency
Recent surgery/head injury
Over 80 years old
Woke with symptoms
Stroke in last 3 months
59
Q

What scan must be done after thrombolysing a patient who has had an ischaemic stroke and why?

A

CT scan to exclude haemorrhagic transformation

60
Q

What should be given to a patient who has been on alteplase for ischaemic stroke?

A

aspirin daily thereafter

61
Q

What treatment method can be done up to 6 hours after ischaemic stroke occured?

A

mechanical thrombectomy

62
Q

Name some causes of carpel tunnel syndrome using acronym RAPID TTT.

A 
RA
Acromegaly
Pregnancy
Idiopathic
Diabetes

Trauma
Tendons
Thyroid

Final year (8 decks)

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