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Sirpi's Phase 2A Medicine > Final Revision Content > Flashcards

Final Revision Content Flashcards

1
Q

fesWhat is labetalol used for?

A

Beta blocker which is a first-line antihypertensive for pregnant women.

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2
Q

X ray features of COPD

A

Hyperinflated lungs
Flattened diaphragm
Bullae formation

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3
Q

What is the management of HHS?

A

IV fluids (0.9% saline) + VTE prophylaxis with enoxaparin (LMWH) as there is hygher risk due to dehydration.

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4
Q

Non-diabetic causes of hypoglycaemia

A

EXPLAIN

Exogenous insulin administration
Pituitary insufficiency
Liver disease
Addison’s disease (adrenal insufficiency)
Insulinoma
Non-pancreatic cancers e.g fibrosarcoma

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5
Q

Acute management of SIADH <48 hours

A

IV hypertonic saline and fluid restriction/furosemide

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6
Q

Management of >48 hours SIADH

A

IV hypertonic saline
Fluid restriction - NOT IF SAH

Demeclocycline (tetracycline antibiotic)
Tolvaptan - V2 receptor antagonist

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7
Q

Causes of secondary hyperaldosteronism

A

Increased renin through:
Renal artery stenosis
Heart failure

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8
Q

Aetiology of prmary hyperaldosteronism

A

Bilateral adrenal hyperplasia - most common
Adrenal adenoma - Conn’s syndrome

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9
Q

Gold standard investigation for primary hyperaldosteronism

A

Adrenal vein sampling

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10
Q

Examples of potassium sparing diuretics

A

Amiloride, spironolactone

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11
Q

Investigation of Pituitary adenoma

A

Pituitary MRI

MEN1 gene testing

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12
Q

Dermatoligical signs/symptoms of Addison’s disease

A

Hyperpigmentation - esp palmar creases/buccal mucosa
Vitiligo - loss of skin pigment due to androgen loss
Loss of pubic hair

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13
Q

Prescription costs

A

9.65 pounds

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14
Q

Management of Addisonian/adrenal crisis

A

Iv fluids
Iv hydrocortisone 5oomg

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15
Q

Aetiology of hypercalcaemia

A

Calcium excess suplements
H
I
M
P
A
N
Z
E
E
Hyperparathyroidism
Milk-alkali syndrome
Sarcoidosis
Thyrotoxicosis
Thiazides, lithium
Squamous cell lung carcinoma

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16
Q

Clinical Presentation of Hypocalcaemia

A

CATS go numb

Convilsions
Arrythmias (palpitations)
Tetani (spasms)

Dermatitis, impetigo herpetiformis in pregnancy.

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17
Q

Causes of primary hypoparathyroidism

A

Surgical excision
Radiation exposure
DiGeorge syndrome
Polyglandular autoimmune syndrome T1
Haemochromatosis, Wilson’s Disease

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18
Q

Clinical presentation of carcinoid syndrome

A

FADD

Flushing
Abdominal pain/cramps
Diarrhoea
Dyspnoea

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19
Q

Management of carcinoid syndrome

A

Somatostatin analogues e.g ocreotide

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20
Q

Investigation of pheochromcytoma

A

FL - 24 hour urinary metanephrine testing
GS - CT adrenal

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21
Q

Management of pheochromocytoma

A

Alpha blockade before beta blockade to prevent hypertensive crisis

GS: Laporoscopic adrenalectomy

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22
Q

Drugs that cause hyperkalaemia

A

NASH

NSAIDs
ACEi
Spironolactone, amiloride
Heparin

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23
Q

How is ALP in parathyroid disorders?

A

All raised

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24
Q

Lab values for pseudohypoparathyroidism

A

High PTH, low Ca, high Ph, high ALP

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25
Q

Which genetic condition is associated with pseudohypoparathyroidism?

A

T1 Alrbright hereditary osteodystrophy

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26
Q

What alpha antagonist is usually prescribed to treat pheochromocytoma

A

Phenoxybenzamine

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27
Q

Macrovascular complications of diabetes

A

Stroke, ischaemic heart disease, peripheral vascular disease

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28
Q

Management of haemhorroids

A

Non-surgical

Band ligation
Injection sclerotherapy

Surgical: Haemorrhoidectomy

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29
Q

Aetiology of anal fistula

A

Anorectal abscess - mc
Crohn’s disease
TB

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30
Q

Which anal diseases have pruritus ani?

A

Haemhorroids, anal fistula

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31
Q

Which anal disease has pain during defecaetion?

A

Anal fissure

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32
Q

Which anal disease has pain during sitting?

A

Anal fistula

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33
Q

Which anal diseases can have smelly discharge?

A

Anal fistula or anal abscess.

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34
Q

Which epithelium is affected in an anal fissure?

A

Squamous keratinizing epithelium distal to dentate line.

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35
Q

Tx of anal fistula

A

Fistulotomy

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36
Q

Tx of anal fissure

A

FL = lidocaine
SL = botox

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37
Q

RF for diverticulitis

A

CONS

Constipation
Obesity
NSAIDs
Smoking

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38
Q

Tx of Crohn’s to induce remission

A

FL = glucocorticoids such as prednisolone, budesonide

SL = DMDs such as azathioprine (5-ASA), or methotrexate.

TL = biologics e.g infliximab

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39
Q

Tx of Crohn’s to maintain remission

A

FL = azathioprine (5-ASA) + methotrexate

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40
Q

Which MHC class is associated with Crohns and UC

A

Crohns is MHC 1
UC = MHC 2

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41
Q

What is the macroscopic appearance of UC & crohns bowel

A

Islandic pseudopolyps in UC, cobblestone in Crohn’s

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42
Q

Dermatological lesions associated with coeliac disease

A

Dermatitis herpetiformis rash and angular stomatitis (sores in corner of mouth)

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43
Q

Histological features of Coeliac disease

A

Villous atrophy
Crypt hyperplasia
Lymphocyte infiltration

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44
Q

RF for oesophageal adenocarcinoma

A

Barret’s oesophagus = MC
Obesity
GORD
Hiatus hernias

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45
Q

RF for oesophageal squamous cell carcinoma

A

Smoking - more so than oesphageal adenocarcinoma
Alcoholism
Plummer-vinson syndrome - web like membraneous growth on oesophagus.
Caustic ingestion e.g bleach

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46
Q

Extra-intestinal manifestations of IBD

A

A PIE SAC

Ankylosing spondylosis
Pyoderma gangrenosum
Iritis
Erythema nodosum
Sclerosing cholangitis
Apthous ulcers
Clubbing

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47
Q

Tx of mild ulcerative colitis

A

FL = 5-aminosalicylates e.g mesalazin
SL = steroids e.g prednisolone

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48
Q

Tx of moderate/severe ulcerative colitis

A

FL = IV hydrocortisone + biologics e.g infliximab.

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49
Q

Tx for maintaing UC remission

A

Azathioprine

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50
Q

Which scoring system is used for UC?

A

Truelove and Witts

<4 bowel movements = mild
4-6 = moderate
>6 = severe

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51
Q

What are the 2 types of stomach cancer?

A

T1 (intestinal) & T2 (diffuse)

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52
Q

Histological appearance of T1 vs T2 stomach cancer

A

T2 - signet ring cells
T1 - well formed tubules

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53
Q

What do you do if you suspect gastric cancer?

A

2 week endoscopy referral

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54
Q

Which side of the colon is affected by FAP?

A

Left + rectum

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55
Q

Which side of the colon is affected by HNCC/lynch syndrome?

A

Transverse and right

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56
Q

What is Psoas sign

A

Pain in appendicitis is worsened with hip extension

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57
Q

What is obturator sign

A

Pain in appendicitis worsens with flexion and internal rotation of hip

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58
Q

Tx for giardia lamblia diarrhoea

A

Metronidazole

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59
Q

Tx for pseudo-obstruction

A

Tx: Neostigmine + nasogastric decompression

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60
Q

Aetiology of LBO

A

Malignancy = most common
Sigmoid Volvulus
Diverticulitis

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61
Q

FL Ix for LBO/SBO

A

Abdominal X-ray

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62
Q

Bowel sounds in SBO vs LBO

A

Tinkling in SBO, absent in LBO

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63
Q

Clinical presentation of diverticulitis

A

BBL

Bloating
Bowel habit change
Lower left quadrant pain

+ fever, haematochezia

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64
Q

Examination of diverticulitis

A

Rebound tenderness
Guarding
Bowel sounds absent

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65
Q

Ix of mesenteric ischaemia

A

GS: CT abdominal angiography

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66
Q

Ix of ischaemic colitis

A

GS: Colonoscopy

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67
Q

Sx of mesenteric ischaemia/ischaemic colitis

A

Colicky pain (left sided for ischaemic colitis)
Abdominal bruit heard
Shock symptoms - pallor, palpitations, etc.

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68
Q

RF for mesenteric ischaemia/ischaemic colitis

A

AF
Atherosclerosis
Obesity
Shock

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69
Q

Tx of mesenteric ischaemia/ischaemic colitis

A

Abx - metronidazole + heparin + bowel resection surgery.

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70
Q

Aetiology of pseudomembraneous colitis

A

C.diff infection
CMV infection

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71
Q

Ix of pseudomembraneous colitis

A

Stool culture for c.diff
Colonoscopy + biopsy - owl eye inclusion bodies if CMV infection.

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72
Q

Felty syndrome Sx

A

NAS

Neutropaenia (recurrent/increased infections)
Arthritis (joint pain/swelling)
Splenomegaly

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73
Q

Which hormones other than glucagon can increase glucose levels?

A

Cortisol, GH, adrenaline (epinephrine)

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74
Q

What can group B strep (s.agalacticae) cause

A

Neonatal meningitis and sepsis

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75
Q

Examples of non-lactose fermenting gram negative bacilli

A

SSPP

Shigella salmonella proteus pseudomonas

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76
Q

Appearance of VZV rash

A

Can occur in areas of compression like belt line, bra line etc.
Mostly localized to the trunk.

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77
Q

Which test can be used for detecting viral antibody levels in the blood?

A

ELISA
enzyme linked immunosorbent assay

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78
Q

What are the antibodies in EBV infection serology?

A

EBV viral capsid antibody (EBVA) IgM and IgG

Latest production is of EBV nuclear antigen (EBNA) antibody so presence = longer infection.

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79
Q

Aetiology of infective mononucleosis

A

Group A strep
EBV

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80
Q

Tx for glandular fevere (infectious mononucleosis)

A

No contact sports for 6 months due to risk of bursting spleen since there would be splenomegaly.

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81
Q

What blood markers are looked for in HIV testing?

A

HIV antibodies, HIV p24 antigen, HIV RNA

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82
Q

What vaccine is involved in the 8 week baby check?

A

6 in 1 - diptheria, tetanus, h.influenzae B, hep B, polio, pertussis

Meningococcal
Rotavirus

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83
Q

What screening form is used for depression?

A

PHQ9 questionnaire

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84
Q

Abdominal imaging findings for bowel obstruction

A

Dilated bowel, absence of gas distal to dilation.

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85
Q

Management of Osteoarthritis

A

FL: Topical analgesia e.g diclofenac, capsaicin paracetamol
SL: Topical analgesia + paracetamol
TL: NSAIDs + topical analgesia + paracetamol

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86
Q

RF for Osteoarthritis

A

Female gender, increasing age, manual labour, obesity

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87
Q

4 DMARDs that can be used in RA treatment

A

Methotrexate
Sulfasalazine
Hydroxychloroquine
Leflonomide

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88
Q

Side Effects of Methotrexate

A

Nausea, mouth ulcers, anaemia

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89
Q

GS imaging for Ank Spond

A

MRI spine - perarticular bone marrow oedema.

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90
Q

X-ray changes in psoriatic arthritis

A

Pencil-in cup
Osteolysis of bone
DIPJ erosion

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91
Q

Dermatological presentation of reactive arthritis

A

Keratoderma blenhorragica

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92
Q

What is Enteric Arthritis

A

Arthritis secondary to IBD

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93
Q

Sx of polyarteritis nodosa

A

Livedo reticularis
Subcutaneous nodules
Abdominal pain

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94
Q

Sx of granulomatosis with polyangitis

A

Saddle-shaped nose
Haempoptysis
Haematuria
Hearing loss

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95
Q

Advice on taking bisphosphonates

A

Take it on an empty stomach
Take it with a glass of water
Remain upright for 30 mins after

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96
Q

Sx of fibromyalgia

A

WIDE

Widespread pain
Intense fatigue
Dfficulty sleeping,
Exaggerated pain response

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97
Q

Tx of fibromyalgia

A

Regular exercise, physiotherapy, CBT,

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98
Q

Tx of antiphospholipid syndrome

A

LMWH + Warfarin if non-pregnant
If pregnant, aspirin + heparin

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99
Q

Ix of dermato/polymyositis

A

Raised CK, LDH

GS = muscle biopsy

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100
Q

Tx of dermato/polymyositis

A

Oral corticosteroids e.g prednisolone.

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101
Q

Which conditions have livedo reticularis

A

Polymyalgia rheumatica
Antiphospholipid syndrome

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102
Q

Antibodies in diffuse cutaneous scleroderma

A

Anti-Scl-70, topoisomerase, RNA polymerase III antibodies

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103
Q

Tx of systemic sclerosis

A

Immunosuppression e.g cyclophosphamide

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104
Q

What condition is paget’s disease associated with

A

Osteosarcoma

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105
Q

Ix of osteosarcoma

A

X ray: Sunburst appearance

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106
Q

Where does ewing’s sarcoma arise from

A

Mesenchymal stem cells

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107
Q

Ix of primary bone tumours

A

FL = x-ray
GS = bone biopsy

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108
Q

RF for osteomalacia

A

CKD
Dietary vitamin D deficiency
Reduced sunlight exposure

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109
Q

Sx of osteomalacia

A

Bone pain, pain worsens on exercise, fatigue, pathological fractures.

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110
Q

Which drugs can cause osteomalacia

A

Anticonvulsants, rifampicin

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111
Q

X-ray appearance of Paget’s diseaes

A

Cotton wool-skull

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112
Q

Tx for Paget’s disease

A

Bisphosphonates

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113
Q

Most common cardiac complication of Marfan’s

A

Mitral valve prolapse

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114
Q

Causes of Mechanical Lower Back Pain

A

Scoliosis
Lumbar spondylosis - loss of intervertebral disc compliance
Facet joint syndrome
Sciatica
Vertebral disc degeneration - can cause prolapse
Osteoarthritis

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115
Q

Pathophysiology of RA

A

Overproduction of TNF-a leads to synovitis.

Further cytokine release causes synovium to grow past joint margins to form a pannus.

The pannus destroyed articular cartilage and subchondral bone resulting in erosions.

Mutation in process of arginine to citrulline conversion causes presence of anti-CCP (citric citrullinated peptide) antibodies.

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116
Q

Sx of sarcoidosis

A

Fever, Fatigue
Dyspnoea
Dry cough
Anterior uveitis,
Lupus pernio - purple nodules on cheeks and nose.
Erythema nodosum
Lymphadenopathy

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117
Q

Diseases that can cause hilar lymphadenopathy

A

Sarcoidosis
TB
Silicosis
Hodgkin’s lymphoma

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118
Q

Infectious aetiology of bronchiectasis

A

H.influenzae
P.aeruginosa

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119
Q

Ix of bronchiectasis

A

HRCT

Tram track airway apperance - bronchial thickening.

Signet ring sign - bronchial dilation.

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120
Q

Non-pharmacological airway clearance techniques for CF and bronchiectasis

A

Active breathing cycle, autogenic drainage

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121
Q

Pharmacological airway clearance for CF

A

Nebulised saline + dornase alfa

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122
Q

Pharmacological airway clearance for bronchiectasis

A

Nebulised saline + carbocisteine

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123
Q

Anti-inflammatory treatment for CF and bronchiectasis

A

Azithromycin/ibuprofen

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124
Q

Lung diseases with normal DLCO

A

Asthma, chronic bronchitis

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125
Q

Lung disease with reduced DLCO

A

Non-neurological restrictive lung diseases e.g IFP, sarcoidosis,

Emphysema.

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126
Q

Aetiology of exudative pleural effusion.

A

P.E
Pneumonia
Small cell lung carcinoma
Dressler’s

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127
Q

GS Ix of pleural effusion

A

Thoracic ultrasound

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128
Q

X-ray signs of pleural effusion

A

Presence of meniscus
Costophrenic angle blunting

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129
Q

Thoracentesis results for pleural empyema

A

High LDH
Low pH <7.2
Positive culture
Turgid appearance

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130
Q

Specific signs of tension pneumothorax

A

Surgical emphysema
Distended neck veins - obstructive shock.
Pain worsening with inspiration

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131
Q

GOLD system for COPD grading

A

FEV1 percentage of predicted

1 = >80%
2 = 50-80%
3 = 30-50
4 = <30

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132
Q

Management of Acute COPD Exacerbation

A

O2 88-92

Nebulised SAMA + SABA

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133
Q

Contraindications of anti-muscarinics

A

BPH

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134
Q

Ix for hypersenstivity pneumonitis

A

Broncheoalveolar lavage + lung biopsy = lymphocytic infiltration

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135
Q

Ix for sarcoidosis

A

CXR - bilateral hilar lymphadenopathy + pulmonary infiltrates.

GS: Lung biopsy - non-caseating granulomas with schaumaunn and asteroid bodies.

Elevated serum ACE - marker for granulomatous inflammation.

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136
Q

Drug-induced causes of ILD

A

Nitrofurantoin
Methotrexate
Amiodarone
Bleomycin

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137
Q

Nature of cough for lung cancers

A

Ongoing for > 3 weeks

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138
Q

Paraneoplastic effect of large cell carcinoma

A

Produces hcG to result in gynaecomastia

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139
Q

Biopsy finding of squamous cell carcinoma

A

Keratin pearls

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140
Q

Sx of Horner’s syndrome

A

Ptosis
Meiosis
Anhydrosis
Hoarse voice - RLN compression.

Pemberton’s sign - raising arms causes facial flushing and redness.

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141
Q

Asthma Ix

A

Testing for Airway Obstruction:
Spirometry
Bronchial Challenge Test
Peak Flow Test

Testing For Airway Inflammation:
Total Serum IgE
Eosinophil Count
Skin Prick Testing
FeNO MeasurementDLCO

DLCO is NORMAL in ASTHMA

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142
Q

What biologics can be used in asthma treatment

A

Omalizumab - anti Ige

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143
Q

Viral aetiology of pharyngitis

A

Rhinovirus
Adenoviruses
EBV, hepatitis

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144
Q

Bacterial aetiology of pharyngitis

A

N.gonnorhoea - oral sex
S.pyogenes
C.diptheriae

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145
Q

Tx of diptheriae infection

A

Clarithromycin

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146
Q

What is the centor critera

A

Indicates likelihood of a sore throat being of bacterial origin.

Tonsilar exudate (pus)
Tender anterior cervical adenopathy
Fever over 38°C (100.5°F) by history
Absence of cough.

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147
Q

Otitis media Ix

A

Otoscopy - inflamed tympanic membrane

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148
Q

2 Phases of Whooping Cough

A

Catarrhal Phase: Fever, mucosal inflammation.

Paroxysmal Phase: Periods of coughing followed by a long inspiration

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149
Q

Tx of whooping cough

A

Clarithromycin

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150
Q

Tx of croup

A

Nebulised adrenaline

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151
Q

Bacterial aetiology of CAP

A

S.pneumoniae
H.influenzae
K.pneumoniae
Moraxella catarrhalis

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152
Q

Bacterial aetiology of atypical pneumoniae

A

Leigonella pneumophiliae
Mycoplasma pneumoniae - Reynaud’s
Chlamydophila pneumoniae
Chlamydophila psittaci - birds, parrots
Coxiella burnetti - sheep

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153
Q

Examination of pneumonia

A

Localised coarse crackles
Increased tactile fremitus (vibration)
Bronchial breath sounds

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154
Q

Empirical Abx for HAP

A

Co-amoxiclav

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155
Q

Extra-Pulmonary Manifestations of TB

A

Bone: Pott’s disease, joint swelling.

Abdominal: Ascites, malabsorption.

GU: Dysuria, haematuria

CNS: Meningitis, CN palsy

Miliary: Widespread diffuse TB

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156
Q

S.E of pyrazinamide

A

Hepatitis, arthralgia, rash

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157
Q

RF for goodpastures

A

CASH

Cocaine
Alport syndrome
Smoking
HLA-DR15

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158
Q

Prophylactic drugs for contacts of those with meningitis

A

Ciprofloxacin

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159
Q

Genetic component of ALS

A

SOD1 mutation

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160
Q

Tx of PH

A

Sildenafil

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161
Q

Example of competitive inhibitor drug

A

Naloxone

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162
Q

Example of non-competitive inhibitor drug

A

Clopidogrel

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163
Q

What is morphine metabolised to and what are it’s complication.

A

Morphine 6 glucoronide, excess can cause respiratory depression.

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164
Q

Targets for drugs

A

TIRE

Transporters
Ion channels
Receptors
Enzymes

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165
Q

What to use if clopidogrel is contraindicated in TIA secondary prevention?

A

MA dipyradamole

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166
Q

DVLA rules for TIA

A

No driving cars for a month

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167
Q

Tx for SAH

A

IV nimodipine

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168
Q

Sick day rule for Addison’s

A

Double glucocorticoid dose for 48 hours, keep fludrocortisone levels the same.

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169
Q

S.E of metformin

A

Lactic acidosis, weight loss, B12 deficiency, gastric disturbance

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170
Q

3 regions and aetiology of acanthosis nigricans

A

Back of neck, under armpit, groin hypergpigmentation which can occur due to increased glucose

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171
Q

Tx of hypocalcaemia

A

IV calcium gluconate

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172
Q

Which types of seizures have automatism

A

Complex partial, absence seizures

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173
Q

Which organisms can cause meningitis in those who are immunocompromised?

A

TB, HIV, cryptococcus neoformans,

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174
Q

Definition of status epilepticus

A

Seizures that last longer than 5 mintues, or having >2 seizures with no regaining consciousness in between.

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175
Q

Tx of status epilepticus

A

Benzodiazepines e.g lorazepam, diazepam
SL = phenobarbital

176
Q

Diagnostic criteria for epilepsy

A

2 or more sizures > 24 hrs apart

177
Q

Tx of cauda equina syndrome

A

Decompression surgery

178
Q

DVLA rules for seizures

A

Isolated seizure = 6 months no driving
Epilepsy = 12 months no driving

179
Q

Is bell’s palsy an UMN or LMN lesion, and does it have forehead sparing?

A

Bell’s = LMN lesion so no forehead sparing.

180
Q

Sx of bell’s palsy

A

Ptosis, facial weakness, loss of taste, difficulty chewing

181
Q

Tx of trigeminal neuralgia

A

Carbamazepine

182
Q

Sx of occulomotor nerve palsy

A

Down and out eye appearance
Ptosis
Pupil dilation

183
Q

RF for myasthenia gravis

A

Other autoimmune conditions in women
Thymic hyperplasia in men

184
Q

Sx of myasthenia gravis

A

Myasthenic snarl
Diplopia, dysarthria, dysphagia

Muscle weakness that gets better with rest and worse with exercise.

185
Q

Antibodies in MG

A

Anti-muscle specific kinase (MusK) antibodies
Anti acetylcholine recepter antibodies

186
Q

Moa of isoniazid

A

Prevent mycolic acid formation in bacteria

187
Q

Moa of pyrazinamide

A

Inhibits fatty acid synthetase enzyme

188
Q

Complication of Myasthenia gravis with Tx

A

Myasthenia crisis where there is respiratory muscle dysfunction which can lead to respiratory failure and aspiration pneumonia.

Tx = Mechanical ventilation with IV immunoglobulins

189
Q

Tx of lambert eaton

A

Pyridostigmine + IV immunoglobulins + steroids

190
Q

Infectious aetiology of GBS

A

Campylobacter jejuni, Mycoplasma pneumoniae
CMV
EBV

191
Q

L5 radiculopathy vs CPN lesion

A

Can invert foot in CPN lesion, cannot in L5 radiculopathy.

192
Q

Tx of carpal tunnel syndrome

A

FL = wrist splint + steroid injections

GS = wrist decompression surgery

193
Q

Aetiology of syncope

A

Dehydration
Extended periods of standing
Vasovagal response to stimuli such as blood
Anaemia

194
Q

Ix of MS

A

GS: MRI brain and spinal cord - disseminated periventricular plaques.

Lumbar puncture - oligoclonal bands, raised IgG and myelin basic protein.

Evoked potentials - conduction delay.

195
Q

Tx of RR MS

A

Relapsing-remitting (2 or more relapses within 2 years)

DMD e.g IM/SC interferon beta 1A or 1B

Natalizumab - prevents T lymphocytes crossing BBB

196
Q

Management of Progressive MS

A

Ocrelizumab - anti CD20

197
Q

What hypersensitivity reaction is MS

A

T4 - t cell mediated.

198
Q

COMT inhibitors example

A

Entacapone

199
Q

How does metformin cause lactic acidosis

A

Inhibits pyruvate decarboxylase enzyme which causes increased lactic acid production through glycolysis.

200
Q

What 2 conditions can have trinucleotide repeat

A

Huntington - CAG trinucleotide repeat on HTT gene
Freidrichsen’s taxia - frataxin gene trinucleotide repeat on chromosome 9.

201
Q

Which MND is UMNL?

A

PLS

202
Q

Which MND is LMN?

A

PMA and PBP

203
Q

Pathophysiology of PLS

A

Loss of betz cells in motor cortex

204
Q

What enzyme is mutated in ALS?

A

Superoxide dismutase causing increased oxidative stress

205
Q

Tx of MND

A

Riluzole - Na channel blocker and glutamate antagonist.

206
Q

Sx of Alzheimer’s disease

A

Amnesia - episodic recent memory loss
Apraxia - cannot carry out skiled motor tasks
Agnosia - word finding difficulties
Aphasia - difficulty with speaking

207
Q

Sx of vascular dementia

A

Step-wise cognitive decline
Incontinence, apraxia

208
Q

Sx of lewy body dementia

A

Parkinsonism
Hallucinations
Sleep disturbances

209
Q

Which cranial nerves are affected by progressive bulbar palsy?

A

9-12

210
Q

What is given as prophylaxis for migraine

A

Propanolol, amyltriptiline

211
Q

Ix of post-streptoccal glomerulonephritis

A

Light microscopy - hypercellular and enlarged glomerulus

Immunofluoresence - starry sky appearance.

212
Q

What is a complication of lung adenocarcinoma and squamous cell carcinoma

A

Hypertrophic pulmonary osteoarthropathy

213
Q

Sx of hypertrophic pulmonary osteoarthropathy

A

Clubbing, arthritis, long bone swelling

214
Q

Where does small cell carcinoma come from?

A

Arises from neuroendocrine Kulchitsky cells

215
Q

Autonomics Sx of cluster headache

A

Lacrimation
Meiosis
Ptosis
Rhinorrhoea

216
Q

Sx of Duchenne’s muscular dystrophy

A

Gower’s sign - have to use hands wehen getting up
Waddling gait
Pelvic girdle muscle weakness

217
Q

Sx of essential tremor

A

Responds to alcohol
Worse with movement
Symmetrical
Can be specific to an action

218
Q

Sx of functional tremor

A

Entrainability - can synchronise with movemnt of another body part

Distractibility - increases when attention is paid to it

Whack a mole sign where tremor moves throughout body depending on where attention is being paid.

219
Q

Sx of functional dystonia

A

Geste antagoniste - thinking about action can suppress the spasm.

220
Q

Aetiology of cauda equina syndrome

A

Lumbar disc herniation
Lumbar vertebral tumour

221
Q

Sx of wenicke’s encephalopathy

A

Ataxia, confusion, opthalmoplegia

222
Q

Sx of Korsakoff syndrome

A

Anterograde amnesia
Confabulation

223
Q

What is the BP criteria in CURB-65

A

systolic < 90, diastolic < 60

224
Q

FL drug for syphilis

A

Benzylpenicillin

225
Q

Sx of tonic-clonic seizures other than the jerking

A

Eyes open
Post-ictal confusion
Loss of recall of events

226
Q

Which hepatitis is most common in travelers?

A

Hep A

227
Q

What is the more common inguinal hernia type?

A

Indirect inguinal hernia - passes through deep inbuinal ring into the inguinal canal

228
Q

Which inguinal hernia can reduce easily and is not at risk for strangulation?

A

Direct inguinal hernia

229
Q

Sx of colorectal cancer

A

Change in bowel habits
Anaemia
Weight loss
Iron deficiency anaemia - pallor, koilonychia

230
Q

Triggerws for sickle cell crises

A

Parvovirus B19 vaccine
Grean beans
Anti-malarial medications

231
Q

Criteria for stage 1 CKD

A

eGFR <60 ml/min/1.73 m for > 3 months

232
Q

Tx of localised prostate cancer

A

Radical prostatectomy if <70yrs - excellent disease free survival

Radiotherapy = brachytherapy (implantation of radioactive material targeted at tumour)

Active surveillance if >70yrs and low risk

233
Q

Tx of metastatic prostate cancer

A

Surgical castration

GnRH antagonists - goserelin

Androgen receptor antagonists - abiraterone

234
Q

Tx of acute pulmonary oedema

A

High flow oxygen , IV furosemide, IV mprphine

235
Q

ECG appearance of WPW syndrome

A

Wide QRS
Shortened PR
Delta wave

236
Q

Achalasia vs Oesophageal cancer Sx

A

Achalasia = difficulty swallowing solids and liquids from the start

Oesophageal cancer - first difficulty with solids then liquids.

237
Q

Ix for testicular cancer

A

Same day testicular US - GS

Tumour markers - AFP, Beta HCG, lactate dehydrogenase

238
Q

Which testicular germ cell tumours are most associated with AFP as a tumour marker

A

Embryonal carcinoma
Yolk sac tumour
Teratoma

239
Q

Tx for testicular cancer

A

Radical inguinal orchidectomy

240
Q

What Sx can differentiate prostate cancer from BPH?

A

Constitutional symptoms + bone pain (e.g back pain) in prostate cancer.

241
Q

Tx of nephrolithiases

A

Symptomatic: IV diclofenac, fluids

If < 5mm, excrete as passing

If > 5mm,
Extracorporeal shock wave lithotripsy
Percutaenous nephrolithectomy

242
Q

RF for bladder cancer

A

Smoking
Age > 55
Male
Occupational exposure to chemicals e.g napthylamine
Drugs like cyclophosphamide
Schistosomiasis

243
Q

Imaging for bladder cancer

A

CT urogram

244
Q

3 most common sites for kidney stone formation

A

Vesicoureteric junction
Pelvic brim
Pelvi-ureteric junction

245
Q

Causes of secondary nephrotic syndrome

A

Diabetes, amyloidosis, pyelonphritis

246
Q

Contraindications of statins

A

Pregnancy, when taking macrolides due to risk of myopathy.

247
Q

Adverse effects of statins

A

Myopathy, myalgia,

248
Q

RF for focal segmental glomerulusclerosis

A

HIV, heroin, lithium

249
Q

Aetiology of membraenous nephropathy

A

SLE
NSAID use
Schistosomiasis

250
Q

RF for prostate cancer

A

BRCA2 gene
Smoking
Increasing age
High saturated fat diet

251
Q

Ix of prostate cancer

A

FL: DRE hard, lumpy prostate

GS: Trans-rectal ultrasound

252
Q

Tx of pyelonephritis

A

Co-amoxiclav + ciprofloxacin for min 7 days

if non responsive, co-amoxiclav + gentamicin

253
Q

Tx of PKD

A

Tolvaptan and ocreotide - reduce cAMP for cyst growth

Nephrectomy

254
Q

FL Tx for prostatitis

A

Oral ciprofloxacin

255
Q

Ix for STI

A

NAAT

256
Q

Ix for urethritis

A

Urine dip
MSUMC - GS
If STI suspected - NAAT

257
Q

Sx of testicular torsion

A

Severe unilateral testicular pain
Nausea/vomiting

Negative Prehn’s sign
Negative cremasteric reflex

258
Q

Epididymo-orchitis vs testicular torsion

A

Prehn’s sign and cremasteric reflex are negative in EO

259
Q

Murmur of mitral stenosis

A

Mid-diastolic murmur with loud S1 snap

260
Q

Murmur of mitral regurgitation

A

Pan-systolic murmur that radiates to the axilla

261
Q

How does warfarin cause an initially pro-coagulant state?

A

It inhibits protein C,S,Z which are involved in preventing clotting.

262
Q

Which herbal medicine can be used to treat depression and interacts with antidepressantsh?

A

St.John’s Wort

263
Q

X ray signs of TB

A

Dense homogenous opacities
Bilateral hilar lymphadenopathy
Ghon focus/complex
Pleural effusion

264
Q

RF for berriliosis

A

Aerospace work

265
Q

Methods to decrease carbon footprint of inhalers

A

Use dry powder/mist inhalers as they do not contain propellants
Return used inhalers to pharmacies
Use stronger inhalers with single doses rather than multiple doses.
Use non-pharmacological methods to reduce inhaler usage need.

266
Q

Methods to increase medicine concordance

A

Make sure to check in with the patient that they have understood everything.
Demonstrate how to use certain devices like inhalers etc.
Give information on how to minimise side effects.
Provision of meditation reminder sheets.

267
Q

Reasons for medicine non-concordance

A

Lack of understanding of the significance/process of taking the medication.
Not seeing an immediate improvement in symptoms.
Side effects
News/media influence.
Forgetting to take them.

268
Q

What is social prescribing?

A

Involves use of a link worker to connect patient to social organisations such as volunteering services, etc.

269
Q

Drugs that can interact with St.John’s wort

A

Oral contraceptive pill, warfarin, statins, digoxin

270
Q

S.E of antidepressants

A

Acid reflux - take with food
Vivid dreams - take in the morning
Constipation

271
Q

What should be done if a patient on metformin is having a procedure with contrast?

A

Check creatinine levels a month before
If intra-arterial/IV, stop taking 48 hours prior.

272
Q

What is the significance of water-soluble beta blockers

A

Less likely to cross BBB to cause vivid dreams.

273
Q

MOa of mesalazine

A

Prevent leukocyte recruitment into the bowel wall to prevent inflammation.

274
Q

How to monitor mesalazine

A

Is nephrotoxic so check urine dipstick, U + E, eGFR

275
Q

Which specific alpha 1 receptors does tamsulosin block?

A

Alpha 1A and 1D

276
Q

Why is tamsulosin contraindicated in cataract surgery?

A

Can cause intraoperative floppy iris syndrome (IFIS)

277
Q

How to moniter methotrexate

A

Check FBC, renal function tests, liver function tests.

278
Q

What diseases have shistiocytes?

A

TTP
HUS
DIC

279
Q

Triad for HUS

A

Microangiopathic haemolytic anaemia
Thrombocytopaenia
AKI

280
Q

What would be seen on BF for iron def anaemia?

A

Microcytic, hypochromic RBCs, pencil-shaped polikocytes, target cells.

281
Q

What type of contraception should be used in women with epilepsy and why?

A

Progesterone only or intra-uterine because COCP has reduced effectiveness with anticonvulsants.

282
Q

What 2 scoring systems are used for pancreatitis

A

Glasgow and Apache II

283
Q

3 cancers that can produce ADH

A

Prostate cancer
Lymphoma
Small cell lung carcinoma
Thymic cancer

284
Q

RF for pancreatic cancer

A

Smoking
Excessive aspirin usage
Alcohol
T2DM

285
Q

Tx of chronic pancreatitis

A

Pancreatic enzyme replacement + PPI

286
Q

Ix for chronic pancreatitis

A

FL Abdominal ultrasound

GS: Abdominal CT
- Pancreatic calcifications, pancreatic duct dilation, pancreatic atrophy

287
Q

Ix for alcoholic steatohepatitis

A

Liver biopsy: Mallory bodies
FBC: Macrocytic anaemia

LFT: AST > ALT

288
Q

Pathophysiology of NAFLD

A

Insulin resistance can cause decreased hepatic fatty acid oxidation leading to increased FA synthesis and steatosis. This eventually results in reactive oxygen species release which causes oxidative damage and inflammation = steatohepatitis.

289
Q

RF for NAFLD

A

T2DM
Hypertension
Obesity
High fat diet
Increasing age

290
Q

Pathophysiology of liver cirrhosis

A

Liver injury releases free radicals which promote stellate and kupffer cell activation, leading to further inflammation and fibrosis.

291
Q

Pre-hepatic causes of portal HTN

A

Portal vein thrombosis

292
Q

Intrahepatic cause of portal HTN

A

Cirrhosis
Schistosomiases

293
Q

Post-hepatic causes of portal HTN

A

RH failure
Budd-Chiari syndrome

294
Q

What are the phases of Hepatitis A infection

A

Incubation
Prodromal - rash, fever, RUQ pain
Icteric - Jaundice, SPUDS
Convalescent - recovery

295
Q

What would LFTs show in viral hepatitis?

A

ALT > AST

296
Q

What can be seen on serology for an acute hepatitis infection?

A

Anti-Hepatitis X Virus core IgM (e.g Anti-HBc IgM)

Hepatitis X Virus Surface Antigen (e.g HBsAg) - indicates ongoing infection

Hepatitis X e Antigen (e.g HBeAg) - indicates active viral replication and high transmissibility.

297
Q

What can be seen on serology for a chronic hepatitis infection?

A

Anti-Hepatitis X core IgG

Hepatitis B surface antigen

Hepatitis X e antigen

298
Q

What can be seen on serology for a patient who is vaccinated against hepatitis?

A

Anti-Hepatitis X surface antigen antibodies

299
Q

What can be seen on serology for a patient who has hepatitis immunity through a past infection?

A

Anti-hepatitis X surface antigen antibodies

Anti-hepatitis X core IgG

300
Q

Tx of Hep B

A

Pegylated IFN a + tenofovir/entecavir

301
Q

Tx of hep E

A

Rivabarin

302
Q

Tx of hep D

A

Pegylated IFN a

303
Q

Tx of hep C

A

Direct acting antiviral therapy - elbasvir + ribavarin

304
Q

Antibodies in T1 Autoimmune hepatitis

A

ANA, ASMA, Anti soluble liver antigen (ASLA)

305
Q

Antibodies in T2 Autoimmune hepatitis

A

Anti Liver Kidney Microsome (Anti LKM1) and anti liver cytosol (anti-LC)

306
Q

Ix of Autoimmune hepatitis

A

Serology - raised IgG
Liver biopsy - piecemeal necrosis

307
Q

Tx of autoimmune hepatitis

A

Prednisolone + azathioprine

308
Q

Moa of azathiprine

A

Inhibits purine synthesis

309
Q

Sx of haemochromatosis

A

Arthralgia
Greying/bronzing of skin
Loss of libido
Malaise

310
Q

Which gene is involved in Wilson’s

A

ATP7B gene, chromosome 13

311
Q

Pathophysiology of Wilson’s Disease

A

Mutation cause increased copper absorption and dysfunction in ceruloplasmin transport causes decreased copper excretion into bile

312
Q

Ix for wilson’s disease

A

Decreased ceruloplasmin
Increased free copper
Decreased total copper

GS = liver biopsy

313
Q

Sx of pancreatic adenocarcinoma

A

Courvoisier’s sign - painless jaundice with palpable GB

SPUDS
Weight loss
Epigastric pain that radiates to the back

314
Q

Ix of pancreatic adenocarcinoma

A

Raised serum Ca 19-9
FL imaging = abdo US
GS = abdominal CT with pancreatic protocol

315
Q

Tx of pancreatic adenocarcinoma

A

Whipples procedure pancreaticoduodenectomy for head of pancreas.

316
Q

GS Ix for PSC

A

MRCP - beaded appearance

NOT ERCP

317
Q

What antibiotics can be used in ascending cholangitis and appendicits?

A

Metronidazole and cefuroxime

318
Q

Tx of PBC

A

Ursodeoxycholic acid
Cholestyramine

319
Q

What score is used to asess severity of liver cirrhosis?

A

Child-Pugh

320
Q

Tx of hepatic encephalopathy

A

Lactulose - reduces colon pH to inhibit NH3 absorption.

Rifaximin - antibiotic that reduces NH3 producing gut bacteria.

321
Q

Tx of paracetamol overdose

A

Activated charcoal if presenting within an hr

IV N-acetylcysteine if presenting longer.

322
Q

What artery supplies AV node?

A

RCA

323
Q

Tx of hereditry spherocytosis

A

Phototherapy/exchange blood transfusion

324
Q

Diagnostic Ix for Sickle cell anaemia and thalassaemia

A

Haemoglobin electrophoresis

325
Q

Blood film for Sickle Cell Disease

A

Sickle cells, howell-Jolly bodies due to splenic damage.

326
Q

Sx of B12 deficiency anaemia

A

Lemon-yellow skin
Angular stomatitis
Glossitis
Confusion, parasthesia, muscle weakness/cramps
Pallor

327
Q

Diagnostic investigation for leukaemias

A

Bone marrow trephine biopsy

328
Q

Aetiology of non-megaloblastic anaemia

A

Hypothyroidism
Liver disease
Alcoholism
Drugs e.g azathiprine

329
Q

Which translocation is associated with acute pro-myelocytic leukaemia?

A

t(15,17)

330
Q

What translocation is associated with ALL

A

t(12,21)

331
Q

Tx for acute promyelocytic leukaemia

A

All trans retinoic acid

332
Q

WHat class of drug can be used for chemo treatment of AML?

A

Anthracyclines e.g daunorubicin whcih destroy mailgnant cell DNA through preventing DNA intercalation.

333
Q

Sx specific to AML

A

Normal leukaemia signs + gum hypertrophy

334
Q

What is a complication of CLL?

A

Richter’s transformation where there is accumulation of B cells in lymph nodes causing lymphadenopathy and transformation into NHL>

335
Q

Ann Arbor Staging for Lymphomas

A

1 - single lymph node spread
2 - multiple lymph nodes, same side of diaphragm
3 - spread to lymph nodes on both sides of diaphragm
4 - extra-nodal spread

336
Q

Tx of HL

A

ABVD
Adriamicin
Bleomycin
Vinblastine
Dacarbazine

337
Q

Tx for NHL

A

R-CHVP
Rituximab
Cyclophosphamide
Hydroxydaunorubicin
Vincristine
Prednisolone

338
Q

Tx for ALL

A

PCVD
Prednisolone
Cyclophosphamide
Vincristine
Daunorubicin

339
Q

General presentation os Leukaemia

A

Anaemia - dyspnoea, pallor, fatigue
Neutropaenia - infection, mouth ulcers
Thrombopaenia - easy bleeding,
High WCC - visual problems
Hepatosplenomegaly
Lymphadenopathy

340
Q

Tx of multiple myeloma

A

Bortezomib (proteosome inhibitor) + dexamethasone

341
Q

X-ray finding of multiple myeloma

A

Raindrop-skull

342
Q

Urine electrophoresis findings of Multiple Myeloma

A

Bence-Jones proteins

343
Q

What are the 2 phases of Malaria Life cycle

A

Erythrocytic and exo-erythrocytic

344
Q

Describe exo-erythrocytic phase of malaria life cycle

A

Sporozoites present in mosquito saliva.

Get injected into blood after feeding and infect hepatocytes where they become merozoites.

Some merozoites in p.vivale and ovaxe infections become hypnozoites and remain latent in the hepatocyte.

345
Q

Describe erythrocytic phase of malaria life cycle

A

With p.falciparum infection the merozoites get released into the blood and infect RBCs - become trophozoites.

Trophozoites mature into a schizont and then are released into the blood as merozoites.

Some merozoites infect other blood cells, others begin to mature as gametocytes which are taken up by mosquitoes.

346
Q

What drug do you supply with isoniazid to prevent peripheral neuropathy

A

Pyridoxine - B6 supplement.

346
Q

S.E of pyrazinamide

A

Arthralgia, rash, gout, hepatitis

347
Q

What agar is used to culture TB

A

Lowenstein Jensen

348
Q

What is used to culture neisseria

A

Thayer-Martin

349
Q

Sx of malaria

A

Fever
Anaemia symptoms

350
Q

RF for testicular torsion

A

Belt-clapper deformity
Trauma to the testicle
Anal intercourse

351
Q

Why does p.falciparum cause the worst malaria disease?

A

Infected RBCs are coated by an adhesive protein that prevents splenic destruction and causes cytoadhesion.

352
Q

Ix for malaria

A

Thick blood film to detect disease and thin blood film to detect specific species

Needs to be done 3x

353
Q

Tx of uncomplicated malaria

A

Hydroxychloroquine

354
Q

Tx of complicated malaria

A

IV artesunate + quinine

355
Q

Tx of complicated malaria

A

IV artesunate + quinine

356
Q

Examples of complications of malaria

A

Cerebral malaria - seizures
DIC
Bilious malaria - jaundice

357
Q

Sx of polycythaemia vera

A

Post-bathing itching
Erythromelagia
Splenomegaly

358
Q

Tx of polycythaemia vera

A

FL: venesection
SL: Low does aspirin, ruxolitinib

359
Q

Tx of haemophilia

A

IV clotting factor infusion
Desmopressin to stimulate vWf release

360
Q

Genetic aetiology of VWD

A

Autosomal dominant mutation on VW gene on chromosome 12

361
Q

What clotting factor is VWD a carrier for?

A

VIII

362
Q

Cushing’s triad for raised ICP

A

Widened pulse pressure - increased systolic to maintain cerebral perfusion

Bradycardia,

irregular respiration

363
Q

Which valve pathology causes narrow pulse pressure?

A

Aortic stenosis

364
Q

Tx of VWD

A

Administer desmopressin

365
Q

Aetiology of DIC

A

Trauma, acute pancreatitis, meningococcal septicaemia

366
Q

Complication of MG and GBS

A

Respiratory depression and ARDS

367
Q

What gene is mutated in TTP?

A

ADAMTS13

368
Q

Pathphysiology of TTP

A

Gene inactivates vWF, mutation = vWf multimer formation & overactivity = increased clot formation = thrombocytopaenia.

369
Q

Tx of TTP

A

Plasma exchange

370
Q

Causes of secondary hypertension

A

Hyperaldosteronism
Pheochromocytoma
Renal artery stenosis - increased RAAS activation

371
Q

Tx of ITP

A

IV immunoglobulins, prednisolone

372
Q

What does alpha thalassaemia/sickle cell anaemia protect against?

A

Malaria

373
Q

Tx of thalassaemia

A

Regular blood transfusions

Iron chelating agents - desferroxamine

374
Q

Which antibiotics are nephortioxic

A

Vancomycin
Gentamicin

375
Q

Which chromosomes are alpha and beta thalassaemia associated with?

A

Alpha = chromosome 16

Beta = chromosome 11

376
Q

Complications of multiple myeloma

A

AKI
Spinal cord compression

377
Q

Sx of left heart failure

A

Bi-basal crackles on auscultation
Paroxysmal nocturnal dyspnoea
Orthopnoea
Frothy sputum when coughing
Dyspnoea

378
Q

Is aspirin a reviersible or irreversible COX enzyme inhibitor?

A

Irreversible

379
Q

Blood electrolyte values for tumour lysis syndrome

A

Hyperkalaemia, hyperuricaemia, hyperphosphataemia, hypocalcaemia

380
Q

Tx of tumour lysis syndrome

A

Allopurinol

381
Q

What are the classes of T2DM treatment drugs you can use

A

Sulfonylureas - gliclazide
Thazodeneliones - pioglitazone, rosiglitazone
DPP4 inhibitors - sitagliptin,
GLP 1 agonists - semaglutide
SGLT2 inhibitors - dapagliflozin, canagliflozin

382
Q

S.E of thazodeneliones

A

Increased risk of heart failure, fractures, weight gain

383
Q

S.E of GLP-1 agonsits

A

Respiratory and urinary infections

384
Q

What is the Sepsis Six

A

Give IV fluids, BS antibiotics, oxygen

Take blood cultures, measure serum lactate, and urine output

385
Q

What is the diagnostic critera for HHS?

A

Severe hyperglycaemia >30mmol
Serum Osm <320 mOsm
No acidosis
No ketosis

386
Q

Translocation for multiple myelome

A

t(11,14)

387
Q

Tropical sprue vs coeliac diseaese

A

Can occur after returning from an exotic location, and presents like coeliac diseaes symptomatically and histoligically but no Hx of eating gluten.

388
Q

Complications of chemotherapy

A

Myelosuppression
Alopecia
Infertility
Neutropaenic sepsis

389
Q

Sx & Tx of toxic megacolon

A

Severe, frequent diarrhea with abdominal distension and widened colon

Treat with colectomy.

390
Q

Meaning of S1Q3T3

A

Large S wave in lead I, Large Q wave in lead III, T wave inversion in lead III

391
Q

Complications of Cushing’s disease

A

Osteoporiss
T2DM
Hypogonadism
Increased risk of osteoporosis

392
Q

Complications of Acromegaly

A

Obstructive sleep apnoea
Stroke
Colorectal cancer
Carpal tunnel syndrome
Arthritis
T2DM
Cardiomyopathy

393
Q

Moa of Ribavarin

A

Nucleotide analogue so prevents RNA nucleotide binding.

394
Q

Sx of hepatic encephalopathy

A

Asterixis, delirium, ataxia

395
Q

Presentation of IgA nephropathy vs Post-Strep Nephropathy

A

Iga presents a couple of days after infection
Post strep presents a couple of weeks after infection.

396
Q

Which organism most commonly costs meningitis infants and why?

A

GBS e.g strep agalacticae because it can colonize the birth canal.

397
Q

Tx for meningococcal septicaemia

A

Dexamethasone + ceftriaxone if on a hospital setting

IM benzylpenicillin in the community setting

398
Q

What artery is affected of a patient with quadripelegia

A

Basilar - locked in syndrome

399
Q

Respiratory complications of stroke

A

Aspiration pneumonia - stroke can cause bulbar paralysis which can lead to unsafe swallowing and aspiration

400
Q

When can lumbar puncture be done after suspected cerebral haemhorrage?

A

Post-12 hours because that is how long it takes RBCs to break down aand appear in CSF as bilirubin (xanthochromia).

401
Q

Surgical management of haemhorragic stroke

A

Endovascular coiling

402
Q

Sx of subdural haematoma

A

Slow onset symptoms, FLUCTUATING LEVEL OF CONSCIOUSNESS

403
Q

What are parkinson’s plus syndromes

A

Lewy body dementia

Multi-system atrophy - autonomic sx such as sweating, incontinence, constipation, can also have postural HTN.

Progressive supranuclear palsy - vertical gaze

404
Q

Tx of Parkinson’s disease

A

Levodopa - given in combo with a decarboxylase inhibitor as co-benyldopa.

405
Q

Moa of decarboxylase inhibitors

A

Prevent conversion of L-dopa into dopamine.

406
Q

GS Ix for aortic dissection

A

CT coronary angiogram

407
Q

Types of obstructive shock

A

Hypovolemic, cardiogenic

408
Q

Types of distributive shock

A

Neurogenic, anaphylactic, septic

409
Q

Sx of obstructive shock

A

Hypovolemic - clammy, cold skin, pallor, tachycardia

Cardiogenic: Raised JVP, pulmonary oedema

410
Q

Murmur of ASD

A

Ejection systolic with split S2

411
Q

Murmur of VSD

A

Pan-systolic murmur

412
Q

Aetiology of dilated cardiomyopathy

A

Alcoholism

413
Q

Aetiology of RHD

A

Group A strep infection

414
Q

Pathophysiology of RHD

A

T2 hypersensitivity reaction due to molecular mimicry of M protein in bacteria.

415
Q

Sx of RHD

A

Joint pain
Organ inflammtion
Noduluse subcutaenously
Erythema marginatum rash
Sydenham’s chorea

416
Q

Tx of essential tremor

A

Primidone and propanalol (BB)

417
Q

What region does pseudogout mainly present in ?

A

The knee vs gout which is the first metatarsal (big toe)

418
Q

How is the diurnal variation of peak flow in asthma?

A

Lower in morning, higher in the night.

419
Q

Tx of neutropaenic sepsis

A

IV piperacillin/tazobactam

420
Q

X-ray sign for sigmoid volvulus

A

Coffee bean sign,

421
Q

SIgns of ascites

A

Abdominal distension
Fluid thrill
Shifting dullness to percusission

422
Q

What would EMG show for MNDs

A

Fibrillation potentials

423
Q

4 Organisms that can cause Epidimo-Orchitis

A

Mumps
E.coli
Chlamydia trachomatis
N.gonnorhoea

424
Q

What is the GRACE score used for

A

Calculates the 6 month mortality rate for patients with ACS.

425
Q

Examples of drugs that potentiate each other -

A

Amoxicillin + clavulanate
Alcohol + sedatives

426
Q

Causes of clubbing

A

Cyanotic heart disease, Cystic fibrosis
Lung abscess, lung cancer
Ulcerative Colitis
Bronchiectasis
Biliary cirrhosis (PBC)
IPF, infective endocarditis
Neurogenic tumours
Gastroenteritis

427
Q

Factors that can exacerbate angina

A

Exercise, emotion, temperature

428
Q

WHat is Alport syndrome?

A

X-linked dominant
CKD + hearing loss

429
Q

Antibodies in dermatomyositis

A

Anti-MI2 and ANA

430
Q

GS Ix for Portal hypertension

A

Hepatic venous pressure gradient.

431
Q

Ix for prostate cancer

A

FL: DRE, multiparametric MRI

GS: Prostate biopsy.

432
Q

Blood markers for sarcoidosis

A

Raised ACE
Hypercalcaemia
Raised ESR/CRP

433
Q

Which receptors does HIV target when binding to T cells?

A

CXC4, CCR5

434
Q

What are features of the latent phase of HIV?

A

Persistent lymphadenopathy
Fevers
Infections by opportunitist organisms.

Sirpi's Phase 2A Medicine (13 decks)

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