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A.REVISION > FORMATIVE 1 > Flashcards

FORMATIVE 1 Flashcards

1
Q

What causes a raised creatine kinase?

A

Rhabdomyolysis
Drugs - Statins, vibrates, anti gout meds, ARBs, BB, clozapine
Muscle trauma and overuse e.g. intensive exercise, crush syndromes, seizures, long lie
Myopathies
Compartment syndrome
Muscular dystrophies
Myocardial ischaemia
Endocrine - hypothyroidism, Cushing, hyperPTH, acromegaly
Pregnancy

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2
Q

How elevated should CK be to suspect rhabdomyolysis?

A

At least 5 times the upper limit of normal

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3
Q

Whats the most common presentation of amiodarone-induced pulmonary disease?

A

Interstitial pneumonitis

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4
Q

How does MDMA toxicity cause hyponatraemia?

A

SIADH
Some pts try to stop hyperthermia but risking large amounts of fluid

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5
Q

Tetrad of HSP?

A

Palpable purpura without thrombocytopenia and coagulates the
Arthritis
Abdominal pain
Renal involvement

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6
Q

Features of TTP?

A

Fever
Fluctuating neuro signs from micoemboli
Microangiopathic haemolytic anaemia = red cell fragments in blood film and raised bilirubin
Thrombocytopenia
Renal failure

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7
Q

MOA of chlorthalidone?

A

A thiazide diuretic - inhibition of the Na+/Cl- symporter in the cortical diluting segment of the ascending limb of the loop of Henle = reduction of sodium reabsorption = reduces ECF and plasma volume

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8
Q

Maximum dose of ramipril?

A

10mg OD

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9
Q

Maximum dose of amlodipine?

A

10mg OD

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10
Q

In a pt with aortic stenosis what test will pride the most information about the effect of the AS?

A

Exercise tolerance testing

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11
Q

What rate-control medication for AF has the quickest effect?

A

Beta blockers - metoprolol in particular

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12
Q

Best medication option for prophylaxis of meningococcal meningitis in a pregnant woman?

A

Still ciprofloxacin

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13
Q

Management of amphetamines overdoses?

A

Symptmatic support is best with IV fluids

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14
Q

First line management of painful peripheral neuropathy in DM?

A

amitriptyline, duloxetine, gabapentin or pregabalin as initial treatment for neuropathic pain (except for trigeminal neuralgia!!)

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15
Q

What imaging is best for an acute flare of IBD to assess for things like toxic megacolon?

A

AXR

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16
Q

How to manage chronic hyponatraemia?

A

If you suspect hypovolaemia then give normal fluid as a trial.
If euvolemic or hypervolemic then fluid restrict to <1000ml a day and consider loop diuretics or vaptans (these are vasopressin receptor antagonists!)

(Note it’s in acute hyponatraemia when you give hypertonic saline!!)

17
Q

Cancer levels greater than what may suggest a sinister cause?

A

3

18
Q

What are the indication s for acetylcysteine in a paracetamol OD?

A

Is paracetamol concentration is on or above the Tx line
If a staggered OD or doubt over time of ingestion regardless of concentration
Presenting 8-24 hours after ingestion of >150mg/kg
Presenting >24 hours and jaundiced OR hepatic tenderness OR ALT is above upper limit of normal

19
Q

What is considered “heavy proteinuria” as seen in nephrotic syndrome?

A

> 3.5g in 24 hours

20
Q

Most common ype of bladder cancer?

A

Transitional cell carcinoma accounts for >90% of cases

21
Q

Whats a common cause of squamous cell bladder carcinoma?

A

Chronic bladder inflammation arising from a schistosomiasis infection in countries where disease is endemic
Rare in the UK to see SCC!

22
Q

RF for transitional cell carcinoma of the bladder?

A

Smoking
Exposure to aniline dyes - for example working in the printing and textile industry e.g 2-naphthylamine and benzidine
Rubber manufacture
Cyclophosphamide

23
Q

Features of neuroleptic malignant syndrome?

A

Mental status change
Rigidity
Fever
Dysautonomia

24
Q

What are the key clinical signs suggesting inferior vena cava obstruction in a patient with advances renal cell carcinoma?

A

Bilateral pitting oedema of the legs, scrotum, and lower abdomen - progresses slowly
Ascites and obvious venous distension across lower abdominal wall

25
Q

What is the most likely cause of bilateral leg swelling, scrotal oedema, and abdominal venous distension in a patient with advanced renal cell carcinoma?

A

IVC obstruction due to invasion by RCC

26
Q

Adverse effects of statins?

A

Myopathy
Liver impairment

27
Q

Management of a TIA in a pt with AF?

A

Refer to TIA or stroke service within 24 hours or onset
CHA2DS2-VASc score to determine if anticoagulation is needed. If 1 in males or 2 in females give a DOAC. Start immediately after a TIA as soon as imaging has excluded haemorrhage!!

28
Q

What do gram negative diplococci look like on a gram stain?

A

Red/pink and cocci are in pairs

29
Q

What are examples of gram negative diplococci?

A

Neisseria meningitidis
Neisseria gonorrhoea

30
Q

What are examples of gram negative diplococci?

A

Neisseria meningitidis
Neisseria gonorrhoea

31
Q

What is the likely organism if a gram stain shows positive blood culture and gram positive cocci in clusters?

A

Staph aureus

A.REVISION (4 decks)

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