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Year 3 Exams > General mix (3) > Flashcards

General mix (3) Flashcards

1
Q

management of ventricular tachycardia and fibrillation

A

unsynchronised cardioversion

10ml 1:10,000 adrenaline

then amiodarone

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2
Q

torsades de pointes management

A

synchronised DC cardioversion

IV MgSO4

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3
Q

management of AV node blo0ck

A

1st line: atropine

2nd : transcutaneous pacing

3rd: pacemaker

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4
Q

bifascicular block

A

RBBB and LAD

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5
Q

trifasicular block

A

RBBB, LAD and 1st degree AV block

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6
Q
A

RBBB

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7
Q
A

LBBB

william marrow

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8
Q

initial management of someone with aortic stenosis who has collapsed

A

stope ACEi

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9
Q

cause of aortic stenosis and presentation

A
  • aortic stenosis
    • calcification- age
    • bicuspid- Turners
    • exertional chest pain and syncope if very severe
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10
Q

aortic stenosis dinitive management

A

if large valve gradient / poor LVEF : valvuloplasty

  • open if well
  • TAVI if old
    • transcather aortic valve implantation
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10
Q

aortic stenosis dinitive management

A

if large valve gradient / poor LVEF : valvuloplasty

  • open if well
  • TAVI if old
    • transcather aortic valve implantation
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11
Q

mitral regurg causes

A
  • calcification
  • MI (<1 week)- papillary rupture→ flash pulmonary oedema
  • Infective endocarditis
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12
Q

Ankolysing spondylitis- As

A
  • Anterior uveitis
  • AV block
  • Apical fibrosis
  • Aortitis
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13
Q

what medication are all T1DM on

A

insulin

statin

q

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14
Q

Q75.) You are called to see an 83-year old patient on the ward as the nurses are concerned she has not opened her bowels in the past 5 days. The patient has a pmhx of Alzheimer’s dementia and is on the ward recovering from a recent pneumonia infection, but appears well. On abdominal examination you feel a palpable mass in the Lower left quadrant. You decide to perform a PR examination on the patient with a chaperone and you notice a relaxed anal spinter tone with some hard stool in the rectum. How would you manage this patient?

  1. Stimulant laxative
  2. Oral macrogol
  3. Glycerol suppository
  4. Enema
  5. Oral lactulose
A

macrogol

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15
Q

HHS

A

Immediate vigorous IV rehydration (0.9 saline)

HHS patients’ main problem is dehydration. It is not recommended to start insulin therapy until after the patient’s fluid balance is positive. Oftentimes, insulin isn’t even needed once the patient’s fluids are corrected.

Generally, even in DKA (where insulin is needed), potassium replacement is only started a little while into fluid therapy.

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16
Q

neuropathic ulcers ulcers found

A

likely to be toes- rubbing for shoes

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17
Q

in asthma if CO2 raised

A

life-threatening

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18
Q

mitral stenosis causes

A

Mitral stenosis

  • Rheumatic and scarlet fever
  • Malar flush
19
Q

Pericarditis cause

A
  • Post viral
  • Post Mi
    *
20
Q

investigation for H.pylroi

A
  • urea breath test- Carbon 13 ura
  • stool antigen test
  • rapid ureas test during endoscopy

all must be done 2 weeks without PPI

21
Q

management of H.pylori

A

PPI+

Amoxicillin + metronidazole

if pen allergic: clarithromycin and metronidazole

22
Q

barrets

A

metaplasia : squamous → columnar

management

  • PPI
  • endoscopic surveillance

if dysplasia identified during endoscopy: endoscopic mucosal resection

23
Q

endoscopic findings in coeliac

A

villous atrophy and crypt hypertrophy in small intestine

24
Q

presentation of coeliac

A

fatigue, ulcers, weigthlsos, bloating, farting

  • dermatitis herpiteformis
25
Q

investigation for coeliac

A

6 week gluten diet

  • IgA leveles - anti TTG
  • jejunum biopsy
26
Q

haematochromotosis symptoms

A
  • bronzed skin
  • joint pain
  • fall in cog and memory

can cause:

liver cirrhosis and cancer

27
Q

haemochromotosis

A

autosomal recessive

excess iron- free radicals- damage

e.g. women after menopause (period removes iron)

28
Q

investigations for haematochromatosis

A

serum ferritin

serum transferrin

derranged LFTs

29
Q

wilsons presentation

A

autosomal recessive: excess copper absorptiona and decreased hepatic excretion

  • Copper
  • Confusion
  • Kayser-fleischer
  • Young
30
Q

investigations for wilsons

A
  • reduced caeruloplasmin
  • reduced serum copper
  • increased urinary copper excretion

can cause liver hepatitis and cirrhosis

31
Q

management of wilsons

A

pencillamine (chelates copper) can cause PF

32
Q

primary biliary cholangitis

A

M rule

Middle age women

anti-Mitochondrial antibodies

IgM

  • associated with sjogrens, RA and system
33
Q

primary sclerosing cholangitis

A

UK, pANCA and cholangiocarcinoma, beaded bile duct

34
Q

which pathogens can cause hepatitis

A

Types A, B, C, D, E, cytomegalovirus, adenovirus

35
Q

LFT for hepatitis

A

ALT>AST

36
Q

acute Hep

A

A (vaccine) and E (no vaccine) (RNA)

foecal oral

37
Q

Hep D can only infect people if they have

A

HEP B

38
Q

alcoholic liver LFTS

A

AST x2>2

39
Q

management of alcoholic liver disease

A

for hepatitis - prednisolone

40
Q

management of varcies

A

terlipress

propanolol

band ligation

Abx

41
Q

hepatic encephalopathy

A

patient with infection and constipation

  • excess absorption of ammonia and glutamine from bacterial breakdown of protein in the gut→ confusion
  • management
    • laxative e.g. lactulose- wash out bacteria
42
Q

ascites can look at

A

SAAG

  • serum-ascites albumin gradient
43
Q

SAAG <11g/l

not much of a difference between albumin in the blood and ascitic fluid

A

cancer

TB

  • lots of albumin
44
Q

SAAG >11g/l

A

HF

liver failure

  • not much albumin

Year 3 Exams (25 decks)

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