General mix Flashcards
1
Q
is myocardial infarction pain gradual or sudden in nature
A
gradual in nature
- example of sudden would be a pneumothorax
2
Q
how to determine if there is left bundle branch block
A
V1 negative - W
V6 positive- M
3
Q
how to determine if there is right bundle branch block
A
V1- M
V6- W
4
Q
right axis deviation
A
IIII largest
5
Q
left axis deviation
A
aVL largest
6
Q
example of Trifascicular block
A
Prolonged PR interval + RBBB + left axis deviation
7
Q
describe
A
saddle shaped
- most sensitive for pericarditis
8
Q
describe
A
PR depression
- most specific for pericarditis
9
Q
investigation for aortic stenosis
A
transthoracic echocardiogram
- may show left ventricular hypertrophy
10
Q
investigation for endocarditis
A
transosophogeal echocardiogram- better image of vegetation of valve
11
Q
signs of pulmonary oedema of x-ray
A
- Bat wing sign
- Kerley B lines
12
Q
infective endocarditis antibiotics: Initial blind therapy
A
Native valve
- amoxicillin, consider adding low-dose gentamicin
If penicillin allergic, MRSA or severe sepsis
- vancomycin + low-dose gentamicin
13
Q
Native valve endocarditis caused by staphylococci
A
Flucloxacillin
14
Q
Endocarditis caused by fully-sensitive streptococci (e.g. viridans)
A
Benzylpenicillin
15
Q
PCOS
A
- Multiple ovarian cysts
- Infertility
- Infrequent periods
- Hyperandrogenism
- Hirtuism
- Acne
- Insulin resistance
- OBESITY
16
Q
PCOS test finding
A
Hormonal blood tests typically show:
- Raised luteinising hormone
- Raised LH to FSH ratio (high LH compared with FSH)
- Raised testosterone
- Raised insulin
- Normal or raised oestrogen levels
TOM TIP: The key thing to remember for your exams is the raised LH, and the raised LH:FSH ratio.
17
Q
management of PCOS
A
- weight loss
- reduce risk of endometrial cancer
- mirena coil
- COCP
- treat other symptoms normally e.g. for acne
18
Q
chicken pox virus
A
varicella-zoster virus
19
Q
HIV is what sort of virus
A
retrograde ssRNA
20
Q
scabies manageemnt
A
- permethrin
- second line malathion
21
Q
croup symptoms
A
barking cough- viral
22
Q
epliglottis is
A
bacteria
- a severe sore throat.
- difficulty and pain when swallowing.
- leaning forwards.
- stridor
- drooling
23
Q
risks for GA: common
A
- sore throat
- PONV
24
Q
risks for GA: significant
A
- aspiration
- dental injury
- malignant hyperthermia
- accidental awareness
25
Osgood-Schlatter disease
is **caused by the constant pulling of the tendon in the knee**. It's seen in growing children and teens. This is an age where the bones are typically growing faster than the muscles and tendons. As a result, the muscles and tendons tend to become tight.
26
what is erythema infectiosum
fifth disease
27
fifth disease
slapped cheeked- parvovirus
* lace rash on face
* general illness
28
viral wheeze management in children
salbutamol and prednisolone
29
where are anal fissures most common
* **posterior midline** of the anal canal.
30
management of anal fissure
* soften stool
* high fibre
* laxative
* Topical glyceryl trinitrate (GTN) is first-line treatment for a chronic anal fissure
31
Sign of PE on ECG
* Sinus tachy
* RBBB
* Right axis deviation
32
where does the anaesthetic get injected for epidural
epidural space- outside the dura mater
* An epidural involves inserting a small tube (catheter) into the ***epidural space*** in the lower back. This is **outside** the ***dura mater***, separate from the ***spinal cord*** and ***CSF***. ***Local anaesthetic*** medications are infused through the catheter into the ***epidural space***, where they diffuse to the surrounding tissues and spinal nerve roots, where they have an analgesic effect. This offers good pain relief during labour. ***Levobupivacaine*** is often used, with or without ***fentanyl***.
33
germ cell tumours- most common
* **Seminomas**
* Remain localised- very good prognosis
* **Non-seminomatous GCTs** (metastasise early)
* Yolk sac tumours
* Choriocarcinoma
* teratoma
34
**Non germ cell tumours (NSGCT)**
A
* Usually benign
* Comprise
* Leydig cell tumour
* Sertoli cell tumours
35
criteria for inpatient admission- stones
* Post-obstructive acute kidney injury- renal impairment
* Uncontrollable pain from simple analgesics
* Evidence of an infected stone(s)
* Large stones (\>5mm)
36
definitive management of renal stones
* **Extracorporeal shock with** **lithotripsy**
* \<2mm
* **Percutaneous nephrolithotomy**
* for larger stones e.g. staghorn
37
adverse reaction to dialysis
* septicaemia
* endocarditis
* thrombosis
* AV fistula steal syndrome- causing ischaemic limb
38
risk factor for ectopic pregnancy
previous pelvic surgery
PID
intrauterine contraceptive device
39
FeverPAIN score
* Fever
* Pus on tonsils
* Attends rapidly
* Inflamed tonsils
* No cough
\>4 consider abx
40
fungi which causes skin rash
**Trichophyton rubrum**
* Terbinafine- topical
* itraconazole
41
CGA
comprehensive geriatric assessment
* problem list
* medication rveiew
* nutritional status
* functional capacity- ADR
* social
* home environemnt
* mental health
42
MUST
BMI
%weight loss
effective acute illness
43
UTI in pregnancy
Cephalexin safe throughout
* nitro- safe in first
* tri- safe in third
44
kawasaki
* aspirin
* do an echocardiogram
45
features of insulinoma
* Hypoglycaemia: typically early in morning or just before meal, e.g. diplopia, weakness etc
* rapid weight gain may be seen
* high insulin, raised proinsulin:insulin ratio
* high C-peptide
diagnosis: 72 hour fast
46
Blood test findings in acromegaly
* high IGF-1
* GH will not be suppressed after glucose
47
low cortisol can be split up into
* Primary cortisol insufficiency- Addisons → damage to the adrenal gland
* Secondary cortisol insufficiency - Damage directly to the pituitary (not enough ATCH)
48
Ottawa rules
49
where does lumbar puncture go through
L3/L4
## Footnote
inserted through the dura mater and arachnoid mater into a region called the subarachnoid space i.e. deeper than an epidural. This is done to take a sample of the cerebrospinal fluid (that fills that space) for disgnostic purposes, i.e. to test it to find out what is wrong with a patient.
50
Bronchiolitis- auscultation
fine inspiratory crackles
[***_respiratory syncytial virus_***](https://scholar.google.co.uk/scholar?q=respiratory+syncytial+virus&hl=en&as_sdt=0&as_vis=1&oi=scholart)
51
fine inspiratory crackles
pulmonary fibrosis
52
coarse inspiratory crackles
bronchiectasis
coarse crackles and green phlegm
* Moxella catarrhalis
* Haemophalis influenza
* Strep pneumonia
53
diff between pneumonia and bronchitis
will not show up on x-ray
54
management of bacterial bronchitis (although usually viral)
* first choice- doxycycline,
* second choice amoxicillin
*
55
***Chlamydia psittaci***
***atypical pneumonia- parrott***
56
lyme disease treatment
doxyxycline
* bulls eye rash- ticks
57
Contraindication to lumbar puncture
raised intracranial pressure e.g. reducing GCS
58
Suspected meningitis in the community- give
benzylpenicillin
59
Empyema classic symptom
swing fever, complication of pneumonia
60
heard failure on x-ray
Empyema – swing fever, complication of pneumonia
Heart failure on x-ray
* Cardiomegaly
* Alveolar oedema
* Kerley B
61
antibodies for hashimotos
ant-Thyroid peroxidase
62
antibodies in graves
anti TSH receptor
