EMQ book key points Flashcards
slow rising pulse is in
aortic stenosis
collapsing pulse is in
aortic regurgitation
3 causes of bounding pulse
acute CO2 retention
hepatic failure
sepsis
radiofemoral delay is in
coarctation of aorta
jerky pulse is in
hypertrophic obstructive cardiomyopathy
mitral regurgitation
absent ‘a’ waves in JVP is in
atrial fibrillation
cannon ‘a’ waves in JVP is in
complete heart block
AV dissociation
ventricular arrhythmias
rumbling mid-diastolic murmur at apex is in
mitral stenosis
displaced apex beat and pansystolic murmur is in
mitral regurgitation
narrow pulse pressure, soft second heart sound and ejection systolic murmur is in
aortic stenosis
wide pulse pressure and early diastolic murmur is in
aortic regurgitation
pansystolic murmur is in
tricuspid regurgitation
harsh pansystolic murmur and left parasternal heaves are in
ventricular septal defect
pulsatile hepatomegaly is in
tricuspid regurgitation
bifid p wave is in
left atrial hypertrophy e.g. mitral stenosis
peaked p wave is in
right atrial hypertrophy e.g. pulmonary hypertension, tricuspid stenosis
2 causes of ST elevation
MI
left ventricular aneurysm
saddle shaped ST elevation is in
acute constrictive pericarditis
flattened t waves and prominent u waves are in
hypokalaemia
long QT interval, tetany, perioral paraesthesia are in
hypocalcaemia
impotence, SOB and cold peripheries are side effects of
beta blockers
gynaecomastia is side effect of
digoxin
spironolactone
hyper/hypothyroidism, corneal microdeposits and lung/liver fibrosis are side effects of
amiodarone
gout is side effect of
thiazide diuretic
radiofemoral delay is in
coarctation of aorta
jerky pulse is in
hypertrophic obstructive cardiomyopathy
mitral regurgitation
absent ‘a’ waves in JVP is in
atrial fibrillation
cannon ‘a’ waves in JVP is in
complete heart block
AV dissociation
ventricular arrhythmias
rumbling mid-diastolic murmur at apex is in
mitral stenosis
displaced apex beat and pansystolic murmur is in
mitral regurgitation
candidiasis mouth/pharynx can be side effect of
inhaled high-dose corticosteroid
saddle shaped ST elevation is in
acute constrictive pericarditis
flattened t waves and prominent u waves are in
hypokalaemia
long QT interval, tetany, perioral paraesthesia are in
hypocalcaemia
impotence, SOB and cold peripheries are side effects of
beta blockers
gynaecomastia is side effect of
digoxin
spironolactone
hyper/hypothyroidism, corneal microdeposits and lung/liver fibrosis are side effects of
amiodarone
side effect of methotrexate, bleomycin and busulphan
pulmonary fibrosis
gout is side effect of
thiazide diuretic
stony dull percussion is in
pleural effusion
fine crepitations are in
pulmonary oedema
pulmonary fibrosis
7 respiratory causes of clubbing
bronchial carcinoma bronchiectasis lung abscess empyema CF mesothelioma TB
2 respiratory things NOT causing clubbing
asthma
COPD
Kerley B lines and batwing shadowing are in
heart failure
tramline shadowing is in
bronchiectasis
wedge-shaped infarct is in
PE
ground glass appearance on CXR is in
pulmonary fibrosis
6 signs of UMN lesion
- weakness in upper limb extensors and lower limb flexors
- increased tone
- hyperreflexia, clonus
- pronator drift
- loss of abdominal reflexes
- extensor plantar response
early onset emphysema plus liver disease can be found in
alpha-1 antitrypsin deficiency
occupation involving water systems can result in
legionella infection
HIV +ve and bilateral hilar shadowing can be a sign of
pneumocystis carinii pneumonia
candidiasis mouth/pharynx can be side effect of
inhaled high-dose corticosteroid
reticulocytosis on blood film is found in
bleeding, haemolysis
target cells on blood film are found in
liver disease, iron deficiency anaemia
macrocytic anaemia + glossitis + peripheral neuropathy =
vitamin B12 deficiency
macrocytic anaemia + phenytoin/trimethoprim =
folate deficiency
2 signs of posterior circulation stroke
CN palsies/cerebellar signs e.g. vertigo, dysarthria, ataxia, choking
isolated homonymous hemianopia
microcytic anaemia + menorrhagia/chronic NSAIDs =
iron deficiency anaemia
microcytic anaemia + increased HbF =
beta-thalassaemia
when can anaemia NOT be called anaemia of chronic disease
if Hb <8 (because AOCD is normocytic - endocrine dysfunction can cause normocytic anaemia)
when to use colchicine for gout
alternative to NSAIDs in acute presentation if NSAIDs contraindicated (e.g. allergy or heart failure)
flushing, abdo pain, diarrhoea and heart failure are signs of
carcinoid syndrome
side effect of methotrexate, bleomycin and busulphan
pulmonary fibrosis
drop foot after hip replacement is caused by
sciatic nerve injury
what else can phenytoin cause
folate-deficiency macrocytic anaemia
most common cause of pancreatic pseudocyst
CHRONIC pancreatitis
2 side effects of lamotrigine
rash and blisters in mouth
flu symptoms
what is increased if lamotrigine and sodium valproate are used together
risk of TEN/SJS
drug to treat AACG
acetazolamide
treatment of GCA
high dose oral prednisolone
drug to treat trigeminal neuralgia
carbamazepine
what can a headache worsening on coughing/sneezing indicate
mass lesion
6 signs of UMN lesion
- weakness in upper limb extensors and lower limb flexors
- increased tone
- hyperreflexia, clonus
- pronator drift
3 signs of LMN lesion (lesion at level of anterior horn cells or distal to it)
fasciculation and wasting
loss of reflexes
hypotonia
type of tremor in PD
pill-rolling
what is Shy-Drager syndrome
combination of parkinsonism plus primary autonomic failure e.g. postural hypotension
triad in Wernicke’s encephalopathy (caused by thiamine deficiency)
nystagmus
ophthalmoplegia
ataxia
type of gait in peripheral neuropathy
high stepping/stamping (sensory ataxia)
type of gait in cerebellar lesion
wide-based
ptosis, eye deviated laterally and downwards is
CN III lesion (defective elevation, depression, adduction)
3 signs of anterior circulation stroke
unilateral weakness/sensory deficit
homonymous hemianopia
higher cerebral dysfunction e.g. dysphasia, neglect
2 signs of posterior circulation stroke
CN palsies/cerebellar signs e.g. vertigo, dysarthria, ataxia, choking
isolated homonymous hemianopia
2 signs of SLE
- symmetrical joint inflammation (no bony erosion)
- lung involvement (50%) e.g. pleuritic chest pain, pleural effusion, pneumonitis
radiological bone erosions in psoriatic arthritis vs RA
psoriatic = central erosions
what does Schirmer’s test do
identify insufficient production of tears in Sjogren’s
when to use colchicine for gout
alternative to NSAIDs in acute presentation if NSAIDs contraindicated (e.g. allergy or heart failure)
why do renal and liver tests for methotrexate
cumulative toxicity
side effect of sulphonamides
exfoliative dermatitis (emergency)
drop foot after hip replacement is caused by
sciatic nerve injury
bile stained vomit shows an obstruction in the
small bowel
most common cause of pancreatic pseudocyst
CHRONIC pancreatitis
gynaecomastia, testicular atrophy and Dupuytren’s contracture can be a sign of
chronic liver disease 2
where do direct hernias push through
directly through the posterior wall of the inguinal canal
where does diverticular disease mostly occur
sigmoid colon
symptoms of duodenal vs gastric ulcer
duodenal = relieved by eating and drinking milk gastric = aggravated by easting
main treatment of Mallory-Weiss tear
antiemetic therapy
what is pseudomembranous colitis
inflammation of colon due to C. diff
test for coeliac disease with greater sensitivity and specificity than anti-gliadin antibodies
anti-endomysial antibodies (serum IgA)
5 symptoms of hypercalcaemia
thirst tiredness depression bone pain constipation
most common cause of upper GI bleed when patient has known cirrhosis
varices (otherwise usually PUD) - do upper GI endoscopy
treatment of severe UC
IV hydrocortisone
anti-spasmodic agent used in IBD
mebeverine
buccal pigmentation is found in
Addison’s disease
aphthous ulceration is found in
IBD
coeliac disease
10 signs of chronic liver disease
clubbing flapping tremor Dupuytren's contracture palmar erythema gynaecomastia spider naevi splenomegaly testicular atrophy ascites encephalopathy
barium enema result in CD vs UC
CD = cobble stoning and rose-thorn ulcers UC = loss of haustra
do ACEis cause hyperkalaemia or hypokalaemia
hyperkalaemia (opposite of diuretics)
2 things raised in tertiary hyperparathyroidism
calcium
phosphate
unlike secondary hyperparathyroidism - calcium low or normal
what is necrobiosis lipoidica
shiny areas on shins + yellow colour and overlying telangiectasia (often in diabetes)
reduced QT interval is found in
hypercalcaemia
can nitrofurantoin be used in pregnancy
not if at term or breastfeeding (can earlier on)
what to avoid when taking tetracyclines
milk products - decrease absorption
antibiotic to use in severe CAP
IV combo of co-amoxiclav/cephalosporin + macrolide (e.g. clarithromycin + erythromycin)
antibiotic for meningococcal meningitis
IV benzylpenicillin
what do TCAs e.g. amitriptyline do to pupils
dilate them
side effect of amiodarone
photosensitive rash
type of diuretic precipitating gout
thiazide
when is metformin contraindicated
in patients who are at risk of lactic acidosis (e.g. significant renal impairment)
proximal myopathy can be a side effect of
corticosteroids (iatrogenic Cushing’s syndrome)
spironolactone and digoxin can both cause
gynaecomastia
flushing and ankle swelling can be caused by
nifedipine (CCB)
acute dystonic reactions are a side effect of
metoclopramide
acute pancreatitis is an adverse effect of
sodium valproate
dyspepsia is a common side effect of
NSAIDs
