Gastro, Cardio + Diabetes

Question 1

blood results in alcoholic hep? Tx?

Answer 1

AST x2 of ALT

steroids

Question 2

in ascites, who gets PO cipro?

Answer 2

ascitic protein of 15 g/litre or less

Question 3

what ascites is low protein and which is high?

Answer 3

low - cancer, low albumin
high - cirrhosis, cardiac

Question 4

grading for c diff?

Answer 4

mod - high WCC, 3-5 stools

severe - moderate + pyrexial or colitis

life threatning - low BP, ileus, toxic megacolon

Question 5

Tx for c diff?

Answer 5

PO vanc
fidamixin if reccurrent

life threatening - PO van + oral met

Question 6

features of mesenteric ischaemic vs ischaemic colitis?

Answer 6

mes - sudden, small bowel, emboli

colitis - bloody diarrhoea, gradual, large bowel

Question 7

antibodies in autoimmune hepatitis?

Answer 7

ANA + SMA

LKM1 in kids

Question 8

what abg do alcoholic have?

Answer 8

metabolic acidosis
ketotic
normal glucose

Question 9

Ix for bile acid malabsorption? Tx?

Answer 9

SeHCAT

cholestyramine

Question 10

inheritance for haemachromatosis?

Answer 10

aut rec

Question 11

common bug causing SBP?

Answer 11

E coli

Question 12

cell type of oesophageal cancer?

Answer 12

lower 1/3rd adeno
upper 2/3 squamous

Question 13

antibodies in hep B and meaning?

Answer 13

HBsAg - infection
anti HBc - caught
anti HBs - immunised

Question 14

antibodies in PBC?

Answer 14

AMA
high IgM

Question 15

biopsy results in crohns?

Answer 15

inflam all layers
granulomas
goblet cells

Question 16

biopsy results in UC?

Answer 16

not beyond submucoa
crypt abscess
pseudopolyps

Question 17

Tx for crohns?

Answer 17

acute - steroids, mesal, AZA

AZA for remission

Question 18

Tx for UC?

Answer 18

rectal aminosalicate + steroid
PO amino sal if L side of colon affected

AZA for remission

Question 19

Ix for H pylori?

Answer 19

13c urea breath test
urease if post tx

Question 20

melanosis coli meaning?

Answer 20

laxative abuse

Question 21

what is wilsons? Tx?

Answer 21

increased copper

penicillamine

Question 22

results of anaemic of chronic disease?

Answer 22

low TIBC (high in iron def anaemia)

Question 23

leads in anterior MI? Blood supply?

Answer 23

V1-4
LAD

Question 24

leads in lateral MI? Blood supply?

Answer 24

I, v5-6,
L circumflex

Question 25

leads in inferior MI? Blood supply?

Answer 25

II, III, AvF right coronary RISK OF HEART BLOCK

Question 26

leads in posterior MI?

Answer 26

V1-3

Question 27

time frame for PCI and fibrinolysis?

Answer 27

PCI 120mins fibrin - 12hrs

Question 28

types of heart block?

Answer 28

1 - PR >0.2secs (5ss) II Mobits 1 - progressively longer PR then drop Mobits 2 - P waves constant III - no assoc

Question 29

when do drugs get given in arrest?

Answer 29

adrenaline asap 3-5 mins amiodarone if shockable 3rd and 5th shock

Question 30

Tx for angina?

Answer 30

Bb + ccb (verap/dilt) + nitrate GTN, aspirin and statin also

Question 31

what valves cause S1 and S2?

Answer 31

S1 - M T S2 - A P

Question 32

HF Tx?

Answer 32

ACE + Bb aldosterone agonist SGLT2 (gliflozin)

Question 33

HT diagnostic criteria?

Answer 33

clinic >140/90 HBPM >135/85 and QRISK >10%

Question 34

where do loop diuretics work?

Answer 34

thick ascending loop of henle

Question 35

aortic regurg features?

Answer 35

early diastolic collapsing pulse

Question 36

aortic stenosis features?

Answer 36

ESM syncope 4th HS

Question 37

MR features?

Answer 37

post MI/endocarditis pansystolic

Question 38

MS features?

Answer 38

mid to late diastolic loud S1 Malar flush associated with AF

Question 39

where do thiazide diuretics work?

Answer 39

inhibit Na reabsorption at DCT

Question 40

Tx for bradycardia?

Answer 40

atropine

Question 41

Tx for tachycardia?

Answer 41

vagal manouvres adenosine (6, 12, 18mg) if VT - amiodarone

Question 42

Tx for hypertension in diabetics?

Answer 42

ACE/ARB

Question 43

what IE do IVDU get?

Answer 43

tricuspid

Question 44

AF and stroke - when to start DOAC?

Answer 44

2 weeks post

Question 45

Tx post stroke?

Answer 45

75mg aspirin and 75mg clop (lifelong)

Question 46

diagnosis for T1DM?

Answer 46

symptomatic fasting ≥7 random ≥11.1 if asymptomatic, need 2 readings

Question 47

diagnosis for T2DM?

Answer 47

HBA1c ≥48 fasting ≥7

Question 48

Tx for T2DM?

Answer 48

metformin + SGLT2 if CVD/HF if no CVD/HF/risk + DPP4 / PIO/ SU

Question 49

SGLT2 examples and side effects?

Answer 49

dapagliflozin UTI normyglycaemic DKA HF

Question 50

Pioglitazone side effects?

Answer 50

weight gain fluid retention (avoid in HF) fractures bladder cancer

Question 51

SU examples and side effects?

Answer 51

gliclazide low BM weight gain low Na peripheral neuropathy