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ICSM Year 6 + edits > Finals - SBAs > Flashcards

Finals - SBAs Flashcards

1
Q

Loop diuretic better oral availability than furosemide

A

Bumetanide

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2
Q

400 - 2000 BNP

A

refferal for echo specilaist review <6 weeks

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3
Q

Most common complication post MI

A

Ventricular fibrillation - arrhythmia

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4
Q

Dresslers syndrome on ECG

A

ST elevation with PR depression

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5
Q

What is Brugada syndrome

A

ST elevation + TWI in V1-V3

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6
Q

Left ventricular aneurysm

A

Hypoxic, pulmonary oedema, persistent ST elevation

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7
Q

Cold peripheries and poor urine output

A

Cardiogenic shock

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8
Q

Bradycardia and AV nodal block

A

Inferior MI

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9
Q

Essential test for nstemi

A

Grace score

> 3 % statin and PCI within 72 hrs

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10
Q

Renal artery duplex scan is indicated when

A

dramatic rise in creatinine on starting ACEi is seen in renal artery stenosis - diagnosed via renal artery duppler US

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11
Q

Causes of secondary HTN

A

RAS
Primary kidney disease
Sleep apnoea

Endo - conns, cushing, pheo

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12
Q

A-V nipping on fundoscopy

A

Hypertensive retinopathy

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13
Q

Malignant HTN Mx

A

IV GTN, IV nitroprusside, IV BB - get to 160/120

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14
Q

BP targets

A

> 80 - 150/90 or diabetes

diabetes less than 80 - 135/85 home, 140/90 clinic

ckd / t1dm and ACR > 70 - 130/80

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15
Q

Pneumothorax new guideline

A

Sympto - no - conservative - primary discharge and review, secondary - inpatient

high risk and sympt ct thorax if not safe and safe = chest drain

not high risk and not safe - conservative care

patient priority - avoid prodcuer - conservative

rapid symptom relief - ambulatory device, needle aspirate if not successful proceed to chest drain

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16
Q

§

high risk features of pneumothorax

A

haemo compromise

significant hypoxia

bilateral pneumothorax

underlying lung disease or smoking with Hx

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17
Q

P HTn Ix and MX

A

Echo + PA wedge pressure >20

CCB, Endothelin antagonists e.g. bosentan
Heart-lung transplant

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18
Q

Signs of cor pulmonale

A

peripheral oedema, raised venous pressure, loud pulmonary second heart sound and systolic parasternal heave (tricuspid regurg)

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19
Q

LTOT

A

need multiple ABGs regularly
hypoxia reducs RR and ventilation perfusion mismatch raising co2

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20
Q

SCLC - lambert improve muscles
breast cancer with muscle stiffness
sclc cerebellar symptoms and sensroy neuropathy

A

anti-voltage
anti-amphiphysin
anti-hu

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21
Q

Unprovoked pe

A

ct tap - consistent with malignancy

no - bloods - gbc, clotting etc - concern then do thrombophilia screen

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22
Q

skin necrosis after warfarin

A

protein c deficiency

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23
Q

Extra intestinal symptoms of coeliac

A

dermatitis herpetiformis
osteomalacia
iron, b12, folate
hyposplenism
t cell gi lymphoma

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24
Q

scleroderma with diarrhoea

A

small bowel bacterial overgrowth

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25
bile acid malabsorption
sehcat test
26
barley wheat and rye
coeliac patients should avoid
27
if Uc patient does not improve with iv hydro on severe admission
iv ciclosporin and input - biologic such as infliximab
28
suspected ibd
faecal calprotectin
29
before using infliximab what needs to be done
interferon gamma test and cxr
30
signs of decompensated liver disease
worsening jaundice ascites encephalopathy coagulopathy hypoglycaemia
31
dld discrimination scores
discrimination function - prothrombin and bilirubin - alcohol hepatitis only child pugh - cirrhosis meld - end stage liver and transplant planning lille score assess response to steroids
32
DLD breakdown
discriminatory function >32 no infection no ugi bleeding give steroids
33
hep b treatment
interferon alpha tenofovir if assessed at 24 weeks and still 20,000 units high if negative consider stopping at 12 months
34
LFt
AST/ALT 2:1 - alcohol if not other causes of hepatitis e.g. nafld, viral, ischaemic, drugs e.g. tb, methotrexate, paracetamol bilirubin alp raised - gallstone pathology with RUQ Pain if not - pancreatic, cholangio, pbc, psc, drugs: penicillins, sulfonyureas, cocp
35
hep b and HIV
tenofovir
36
needle stick with hep b
accelerated hep b vaccination
37
Gallstones
fat, forty, foetues, female and fair cholesterol and calcium bilirubinate
38
RUQ pain gallstones
USS - no stones -> deranged liver -> MRCP - stones -> CBD stones -> ERCP - deranged -> MRCP if not choleystecotmy
39
Colorectal cancer
colonoscopy than stagin ct thorax etc or MRI if rectal 1 stool sample FIT test if abnormal get colonoscopy t3 rectal - neoadjuvant than colonic resection than adjuvant chemo
40
Resections
right hemi - ileostomy left hemi - colostomy , involves splenic flexure as well sigmoid colectomy - hartmanns, stoma, colostomy anterior - rectacl tumour, rectum spar sphincters, colostomy abdomino perineal resection - rectal tumour less thaan 5cm from anal verge, includes sphincters, stoma and colostomy
41
Colonic polyps and APC
FAP
42
Colon cancers do not need neoadujvant therapy because
need more operating space
43
SBO workup
suspected - unstable - emergency laparotomy - ct abdo pelvis with contrast (low egfr <30 without) - ischaemia shown or closed loop - emergency - adehsional if not - conservative - ng, nbm, iv fluids drip and suck
44
indications of ischaemia
peritonism high lactate irreducible & discoloured hernia
45
Mechanisms of SBo
extrinsic - external compressions - hernia, adhesions, volvulus intrinsic - disease of small bowel, internal blockages e.g. strictures and tumours intrinsic process - normal bowel wall but forgein body e.g intussectopin
46
unexplained acute large bowel obstruction
ogivies syndrome
47
ischaemic bwoel what category
1 within 1 hr surgery
48
saccular vs fusiform
one sided vs dilatation around whole vessel treat endovascular anerusym repair and open repair
49
IVC collapse or Halo sign on Ct
hypovolaemic shock
50
aneurysmal sac enlargement post evar
endoleak
51
chest pain and connective tissue disorder
aortic dissection
52
IDA guidance
40-49 wiht unexplained weight loss, pain and bleeding - 2ww 50-59 - rectal bleeding - 2ww colonoscopy - no bleeding - faecal occult blood test - if positive - 2ww 60 - 2 ww
53
upper gi concerning features
ALARMS anaemia loss of weight anorexia recent onset melaena swollowing
54
microcytic disproportionally low mcv
thalassaemia
55
normocytic reduced renal function
ckd related anaemia
56
asthma eosinophilia panca
churg strauss
57
obesity t2rf osa
obesity hypoventilatory syndrome
58
asthma diagnosis
symptoms - 3 times a week notrunal once saba 3 + 2 diagnotic tests
59
features of hhs
hypovolaemia hyperglycaemia >30 keotnaemia below 3 ph above 7.3 osmolality above 320
60
mx of HHS
within 60 mins fluids iv insulin if - ketonaemia with ph above 7.3 etc 0.05 units ketonaemia above 0.6 - 0.01 and ph below 7.3
61
ankle swelling, erythema, loss of foot sensation and t2dm
charcot arthropathy
62
Sus of melanoma
nodal involvement mets - excision biopsy + SLNB + met screening - if IV - resect, chemo, metastatectomy, palliative not sus of nodal mets - excision biopsy - if more than 2mm - slnb - staging - if 3 - lymh node dissection and chemo stage 2 follow up advice if less than 2mm and non cancerous discharge | najor = size, colour and shape
63
Mnemonic for suspicious lesions
Asymmetry Borders Colour Diameter Exposed area superficial spreading most common
64
skin scc and bcc
SCC - male bowens, lips, forearms and legs, scaly crusted that bleed bcc - previous scc, head and neck, pearly nodule rolled and erythamtous edge
65
multiple flat and light brown plaques, waxy surface aong scalp
sebhorreic keratosis
66
scaly and thick plaques on sun exposed areas
actinic keratosis
67
hard rasied growth with ulcerated centre boil
keratocanthomas
68
visual hallincations + macular degeneration
charles bonnet syndrome
69
bisphosphonate use jaw pain and swelling
osteonecrosis of jaw
70
Best long term anitthrombotic post stroke
Anti-platelet - clopidogrel 75mg Af = apixiban
71
Causes of atherosclerosis
stenosis athermoa small vessel disease carotid and vertebral stenosis - if symptomatic carotid endarterectomy
72
Cardio emobolic sources of stroke
Af and cardiac thrombus
73
Other causes of stroke
aterial dissection giant cell arteritis vasculitis haem disorders - antiphospholipid and sickle cell disease genetic - MELAS
74
Cerebellum innervation
signs on the same side of the lesion
75
Vertigo and ataxia - blood infarct location
vertebral supplies posterior circulation - carotid supplies anterior ipsilateral horners
76
Causes of lateral medullary syndrome
vertebral artery or posterior inferior cerebellar artery
77
Horners
sympathetic chain affected ptosis, meiosis, anhidrosis, enophthalmos
78
SAh if normal on Ct
LP - raised bilirubin - 12 hrs from symtpom onset then ct angiogram of intracerebral blood vessels if either positive
79
GCS scoring
M: obey, local, flexed withdraw, abnormal flexion, abnormal extension orient, confused, inappropwo words, incomprehensible, none eyes - comman, voice, pain, none
80
Predom lymphocytes LP
CSF viral PCR - HSV - encephalitis
81

ICSM Year 6 + edits (28 decks)

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