EFA 8 Flashcards
Which of these symptoms would suggest advanced Alzheimer’s dementia?
A. Decline in activities of daily living & social skills
B. Reduced vocabulary
C. Difficulty learning new information
D. Disorientation in unfamiliar surroundings
E. Loss of bladder and bowel control
E. Loss of bladder and bowel control
Which of the following drugs blocks an ion channel?
A. Sodium valproate B. Citalopram C. Desipramine D. Methylphenidate E. Paroxetine
A. Sodium valproate
A 48 year old man reports a burning sensation in his chest. His electrocardiogram is shown below. Estimate his ventricular axis.
A. -30 to 0 degrees
B. 0 to 30 degrees
C. 30 to 60 degrees
D. 60 to 90 degrees
E. 90 to 120 degrees
C. 30 to 60 degrees
A 48 year old male presents to A&E with shortness of breath, coughing and a fever and is suspected of having a SARS-CoV-2 infection. As a result more invasive monitoring is carried out. Observations were O2 saturation of 90% on BiPAP, a heart rate of 80 bpm, a respiratory rate of 20/minute, blood pressure of 145/85 mmHg and a temperature of 38 degrees Celsius. A Schwanz ganz catheter indicates end diastolic volume of 256 mL and end systolic volume 111 mL. Which of the following describes his cardiac output, ejection fraction and mean arterial blood pressure?
A. CO: 11.6L EF: 64% MAP: 95 mm Hg
B. CO: 11.6L EF: 57% MAP: 105 mm Hg
C. CO: 10.5L EF: 57% MAP: 105 mm Hg
D. CO: 10.5L EF: 65% MAP: 95 mm Hg
E. CO: 10.5L EF: 63% MAP: 101 mm Hg
B. CO: 11.6L EF: 57% MAP: 105 mm Hg
Cardiac axis
What structural change of the heart is most commonly associated with aortic stenosis?
Left ventricular hypertrophy
The son of a 72-year-old woman sees a GP because he is concerned about his mother’s memory. She often forgets words, including the names of her family members. She goes shopping independently but sometimes gets lost. She has left the gas on sometimes while cooking. Her mood seems to change more, including sometimes getting angry with family members. What stage of Alzheimer’s dementia would these symptoms be most consistent with?
Progressive
You are the F1 covering a medical ward and are called to see a 51-year-old man who was admitted to hospital 2 days ago with a community-acquired pneumonia. On admission, he reported normally drinking over 70 units of alcohol a week. He is being treated with antibiotics and fluids. His observations are:
HR: 120
RR: 18
BP: 160/90
O2 saturations: 98% on room air
Temperature: 37.9
He is confused and does not know where he is. He seems to be responding to unseen stimuli. His hands are severely trembling. His chest is clear on auscultation. What condition are you most concerned could be causing the patient’s current symptoms?
Delerium tremens
The TNM8 lung cancer staging system uses primary tumour site, tumour size, regional lymph node metastases and which other characteristic to score lung cancer progression?
Extrathoracic metastases
Explanation: the final stage of staging lung cancer is to assess the presence of metastases outside the thoracic cavity
A 67 year old man with a history of COPD and lung cancer is admitted to hospital confused, breathless and with a fever. His O2 saturation is 95 %, he his blood pressure is 85/65 mmHg and his respiratory rate is 32 breaths per minute. Microbiological cultures reveal the presence of Mycoplasma pneumoniae. What types of antibiotics should be administered to this person?
Macrolides (eg clathiromycin) and a penicillin
Explanation: Mycoplasma pneumoniae is the most common cause of atypical community acquired pneumonia and responsive to macrolides rather than penicillins – however the high CRB-65 assessment indicates severe pneumonia which means rapid treatment with both classes of antibiotic is preferred.
Describe the patients’ acid-base status
uncompensated mixed alkalosis
It’s mixed as co2 and base exess are going in opposite directions
A 61 year-old male patient with presents with a cough and fatigue. The patient is a never smoker, and does not have occupational exposures, but has developed COPD. The patient has been able to continue their job in administration, but has increasingly found the twenty-minute walk to work challenging and struggles with stairs between floors at the office. Initial chest X-ray reveals an isolated peripheral tumour mass of ~2.5cm in diameter. There is no evidence of metastasis to the lymph nodes or elsewhere. Biopsy determines the presence of a mutation in ALK.
What WHO performance score would you assign the patient? (1 mark)
PS1
Based on the information above, what stage would you estimate the tumour to be? (1 mark)
T1cN0M0
What approach would you use to confirm the diagnosis histologically? (1 mark)
Peripheral tumour, so would use CT-guided lung biopsy
Identify two additional pieces of information that would be useful before proceeding with treatment (2 marks)
Any 2 of: comorbidities, medication history, lung function
