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Question 1

First line for anaphylaxis?

Answer 1

IM adrenaline
Fluids

Note: why not IV adrenline? would send patient into arrhythmias

Question 2

When do you give IV adrenaline?

Answer 2

Cardiac arrest

Question 3

Fine crepitaiotn

Answer 3

Fibrosis

Pulmonary oedema

Question 4

Coarse crepitations suggests

Answer 4

PNEUMONIA

Question 5

Amoxicillin would cover which pneumonias?

Answer 5

Streptococcus

Question 6

Name a macrolide

Answer 6

Clarithromycin

Question 7

Which organisms are covered by clari for CAP?

Answer 7

Atypical organisms
Legionella
Mycoplasma
Chlamydia

Question 8

What would make you think of deranged

Answer 8

Low sodium
Deranged LFTs
Recent travel

Question 9

Coarse crepitations and bronchial breathing suggests

Answer 9

Pneumonia

Question 10

What would you order if someone has microcytic anaemia?

Answer 10

Haematinics
Coeliac screen (tissue transglutaminase antibody)

OGD / colonoscopy (top and tail)

Question 11

What would be seen in biopsy of coeliac disease?

Answer 11

Villous atrophy

Question 12

Red flags in microcytic anamiea

Answer 12

Weight loss
anaemia
dyspepsia

Question 13

Adenosine is used to treat

Answer 13

SVT

Question 14

Treatment of AF less than 48 hours

Answer 14

DC cardioversion

Question 15

Treatment of AF MORE than 48 hours

Answer 15

Rate control (e.g. digoxin, metoprolol) and anticoagulate

Question 16

Amiodarone is used to treat

Answer 16

VT

Question 17

Trousseu’s sign suggests

Answer 17

Pancreatic cancer

Question 18

What causes Grey Turner’s/Cullens?

Answer 18

Haemmorhage due to acute pancreatitis

Question 19

Causes of portal

Answer 19

Encephalopathy
Ascites
SBP
Variceal bleed

Question 20

Diarrhoea plus schistocytes - what does it suggest?

Answer 20

Haemolysis

Maybe DIC or HUS

Question 21

What happens in DIC?

Answer 21

Low platelets
Low fibrinogen
High PT/APTT
High D-dimer

due to lots of clots being formed around the body

Question 22

What are the classifications of haemolytic anaemia?

Answer 22

Hereditary

Acquired

Question 23

Red cell membrane problem

Answer 23

Hereditary spherocytosis

Question 24

Red cell enzyme deficiency

Answer 24

G6PD deficiency

Question 25

Haemoglobinopathy

Answer 25

Sickle cell disease | Thalassemia

Question 26

Four acquired causes of haemolytic anaaemia

Answer 26

Autoimmune MAHA Drugs Infection

Question 27

Microangiopathic haemolytic anaemia

Answer 27

Clots form in small vessels, so as the

Question 28

Circular folds are called?

Answer 28

Valvulaecoliventi

Question 29

Circular folds are called?

Answer 29

Valvulae conniventes

Question 30

Where are haustra found and what do they suggest?

Answer 30

Large bowel obstruction

Question 31

What is the short SynACTHen test done for?

Answer 31

Adrenaline function

Question 32

Normal range for sodium?

Answer 32

135-145

Question 33

Normal range for potassium

Answer 33

3.5-5

Question 34

If you have someone with hyponatremia, what else are you looking at?

Answer 34

Whether they have hypovolemia, euvolemia or hypervolemia

Question 35

Hypovolemia can be due to

Answer 35

Diarrhoea Vomiting Diuretcs

Question 36

What's the sodium like in hypovolemia?

Answer 36

Low urine sodium

Question 37

What could be the problem if you have euvolemia and hyponatremia?

Answer 37

Hypothyroidism Adrenal insufficiency SIADH

Question 38

What investigations would you do if someone has euvolmia and hyponatremia?

Answer 38

TFTs Short Synacthen Test Plasma and urine osmolality

Question 39

What could it be if you have hypervolemia and hyponatremia? e.g. with oedema

Answer 39

Cardiac failure Cirrhosis Nephrotic syndrome

Question 40

What is the most common cause of hyponatremia?

Answer 40

Too much ADH

Question 41

Rarer causes of hyponatremia?

Answer 41

Excess water intake | Sodium-free irrigation solutions such as those used in transurethral prostate resection (TURP)

Question 42

Causes of SIADH

Answer 42

CNS pathology (hence do brain MRI) Lung pathology (DO CXR) Drugs Tumours

Question 43

Causes of oncholysis

Answer 43

Trauma Thyrotoxicosis Fungal infection Psoriasis

Question 44

Abdo pain and vomiting in someone with T1DM

Answer 44

CBG | Capillary ketone

Question 45

Loin pain with blood, what investigations do you do?

Answer 45

CT KUB

Question 46

CATCH UP ON SLIDES 29-30

Answer 46

??????????

Question 47

Alkaline phospohatase goes up in what?

Answer 47

High in obstructive liver disease | Bone diseases e.g. malignancy, fracture, Paget's disease

Question 48

If someone has hypercalcemia with low pth and normal alp (in bone cancer it's normally high), what kind of cancer is it?

Answer 48

Multiple myeloma

Question 49

Features of multiple myeloma

Answer 49

Calcium (high) Renal impairment Anaemia Bone (CRAB)

Question 50

Common cause of small mobile lump in breast in young person

Answer 50

Fibroadenoma

Question 51

Causes of cavitating lung lesions (solid/fluid bits)

Answer 51

Infection: TB, staph, klebsiella Inflammation: RA Infarction: PE Malignancy

Question 52

Oedema plus hypoalbuminaemia - what do you do next?

Answer 52

Urinalysis | nephrotic syndrome

Question 53

Facial telangiectasia suggests?

Answer 53

Hereditary haemorrhagic telangiectasia | if not then maybe cirrhosis

Question 54

Hereditary haemorrhagic telangiectasia is autosomal dominant or recessive? What's the problem?

Answer 54

autosomal dominant Abnormal blood vessels in skin, mucous membranes, lungs, liver, brain

Question 55

Low sodium and potassium suggests

Answer 55

Low aldosterone

Question 56

Low aldosterone plus low cortisol suggests

Answer 56

adrenal insufficiency

Question 57

Why might you get high prolactin in hypothyroidism?

Answer 57

TRH stimulates prolactin as well

Question 58

Differentiate between thyroiditis and multinodular goitre

Answer 58

TFTs normal in multinodular goitre | Hyperthyroid picture in goitre