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Incorrect qs Flashcards

1
Q

causes of hypothyroidism

A

HASHIMOTO’S THYROIDITIS
atrophic hypothyroidism
post-partum thyroiditis
iatrogenic- thyroidectomy, radioactive iodine tx
drug-induced
iodine deficiency

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2
Q

difference between Hashimoto’s thyroiditis and atrophic hypothyroidism

A

goitre or thyroid peroxidase antibodies (TPO-Ab) in Hashimoto’s

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3
Q

difference between UMN lesion and extrapyramidal lesion in Parkinsons

A

UMN: rigidity in limb mvt where resistance falls as mvt continues (clasp knife reflex)
Parkinsons: rigidity and resistance remains the same throughout the mvt

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4
Q

why is a decarboxylase inhibitor given with levodopa to treat Parkinson’s?

A

decarboxylase inhibitor prevents levodopa being converted to dopamine so there’s fewer peripheral side effects of levodopa AND/OR maximises the dose that crosses the bbb

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5
Q

what is seen on an AF ECG

A

no P wave
irregular + rapid QRS

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6
Q

acute AF management

A

cardioversion by DC shock w LMWH or IV amiodarone (anti-arrhythmic)
OR
ventricular rate control w either CCB, BB, digoxin or amiodarone

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7
Q

how does the body develop autoantibodies in SLE?

A

Reduced clearance by phagocytes of nuclear antigens following apoptosis so they’re transferred to lymphoid tissue where self-antigens are developed. The complexes deposit in tissue, activating complement causing inflammation and damage.

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8
Q

method of SLE dx

A

ESR raised but CRP normal
ANA +ve
MRI and CT for lesions on the brain
histological deposition of IgG and complement

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9
Q

mild SLE tx

A

prednisolone + hydroxychloroquine + NSAIDs

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10
Q

moderate + severe SLE tx

A

prednisolone + hydroxychloroquine + immunosuppressant

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11
Q

what happens in asbestosis?

A

interstitial lung disease where there’s fibrosis of the lungs from asbestos dust

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12
Q

what can develop from asbestosis and define this

A

mesothelioma- tumor of the mesothelial cells of the pleura
bronchial adenocarcinoma- tumour of the mucous-secreting glandular cells

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13
Q

asbestosis tx

A

corticosteroids

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14
Q

DIC pathophysiology

A

pro-coagulants eg cytokines/ tissue factor activate the coagulation cascade, forming blood clots which use up platelets and coagulation factors leading to microvascular thrombosis and organ failure or bleeding

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15
Q

DIC ix + dx

A

severe thrombocytopenia
hx of sepsis, trauma, malignancy
decreased fibrinogen
elevated PTT

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16
Q

conditions causing profuse bleeding

A

congenital thrombocytopenia
infiltration of bone marrow
low B12/ folate
liver disease
hypersplenism

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17
Q

UTI-causing microorganisms

A

KEEPS

Klebsiella pneumoniae
Enterococcus faecalis/ enterobacter cloacae
E coli
Pseudomonas aeruginosa/ proteus mirabilis
Staphylococcus saprophyticus/ serratia marcescens

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18
Q

pyelonephritis differentials

A

diverticulitis, aaa, kidney stones, cystitis, prostatitis

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19
Q

Define T1 + 2 DM

A

T1: insulin deficiency from autoimmune destruction of beta-cells in the pancreas (islets of Langerhans)

T2: combination of insulin resistance and deficiency

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20
Q

describe DKA

A

uncontrolled catabolism from insulin deficiency
causes peripheral lipolysis
so more free fatty acids broken down to acetyl coA in the liver
this is converted to ketones in the mitochondria
accumulation of ketones causes metabolic acidosis

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21
Q

diabetes dx from random plasma glucose and fasting plasma glucose

A

random: 11.1mmol/L
fasting: 7mmol/L

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22
Q

Age range offered mammogram and how often

A

50-69 every 3 years

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23
Q

type and species of organism that causes malaria

A

protozoa
plasmodium falciparum, p ovale, p vivax, p malariae

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24
Q

type of mosquito that carries plasmodium protozoa to humans

A

female anopheles mosquito

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25
Q

areas of the body malaria-causing protozoa inhabit

A

liver
RBCs
gut

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26
Q

complications of malaria

A

fever, haemolysis, myalgia, nausea/ vomiting, anaemia, jaundice, hepatosplenomegaly, coma, ARDS, hypoglycaemia, renal failure, hypovolaemia, shock, pulmonary oedema, DIC

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27
Q

malaria tx

A

quinine, doxycycline, chloroquine

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28
Q

malaria differential in children

A

meningitis

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29
Q

adrenal hyperplasia pharmacological tx

A

aldosterone agonists: spironolactone, amiloride

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30
Q

hyperaldosteronism sx

A

HTN, weakness, cramps, polyuria, polydipsia

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31
Q

Why do 95% of abdominal aneurysms occur below the renal arteries but above the aortic bifurcation?

A

naturally less elastin in the arterial walls

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32
Q

What area of Virchow’s triangle does an abdominal aortic aneurysm affect?

A

stasis, abnormal blood flow

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33
Q

size of aneurysm to be operable

A

> 5.5cm2

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34
Q

State Laplace’s Law

A

R = 1/r4

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35
Q

Describe the lifecycle of a malarial plasmodium within the human body, naming each stage of plasmodium development

A

Sporozoites in mosquito saliva -> goes into blood, mature into hypnozoite in liver, released as schizont into blood stream, schizont explodes releasing merezoites, which enter RBCs and become trophozoites, eventually become gametocytes, taken up by mosquito.

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36
Q

malaria gold standard ix

A

thick and think blood smears stained w Giemsa stain

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37
Q

target bp for DM pt

A

> 130/80

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38
Q

complications of htn

A

retinopathy, heart failure, IHD, renal failure, headache, nausea

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39
Q

how to test for organ damage from htn

A

echo for left ventricular hypertrophy or past MI
urine analysis for proteinuria from renal damage

40
Q

signs of anaphylaxis

A

low bp, dyspnoea from bronchoconstriction, rash, swelling, vomiting

41
Q

mechanism of re-exposure in anaphylaxis

A

allergen binds to IgE
receptor cross linking causes a cascade
mast cell degranulation of histamine

42
Q

pathophysiology of BPH

A

benign nodular or diffuse proliferation
of musculofibrous and glandular layers of prostate
inner/ transitional zone enlarges

43
Q

meningitis triad presentation

A

neck stiffness
fever
headache

44
Q

bacterial causes of meningitis in children

A

streptococcus pneumoniae
neisseria meningitidis
haemophilus influenzae

45
Q

meningitis CSF sample

A

cloudy colour
neutrophils
high protein
low glucose

46
Q

how to differentiate meningitis and SAH

A

SAH headache is sudden onset and more severe

47
Q

meningococcal septicaemia management

A

IV cefotaxime
no lumbar puncture due to risk of coning cerebellar tonsils/ raised intracranial pressure
confirm dx w blood culture

48
Q

DEXA results

A

> -1.0 normal
-1.0 to -2.5 osteopenia
<-2.5 osteoporosis
<-2.5 plus fracture severe osteoporosis

49
Q

what does DEXA stand for

A

dual energy x-ray absorptiometry

50
Q

example of bisphosphonates

A

oral alendronate/ oral risedronate

51
Q

UC histology

A

increased plasma cells in lamina propria
crypt distortion/ branching/ abscess
ulceration

52
Q

appearance of meningococcal bacteria on microscopic examination

A

gram negative diplococci

53
Q

who should be notified and when following meningitis dx

A

PHE immediately

54
Q

damage to which nerve causes foot drop

A

common peroneal nerve

55
Q

“owl eyes” on histology is indicative of what

A

cytomegalovirus

56
Q

Wernicke’s encephalopathy triad of sx

A

ataxia, confusion, ophthalmoplegia

57
Q

how does menopause cause osteoporosis?

A

post-menopause there’s lower oestrogen levels so increased number of osteoclasts and premature arrest of osteoblastic synthetic activity so high bone turnover

58
Q

tests and results to differentiate osteoporosis and osteomalacia

A

bloods:
Ca/ phosphate/ alkaline phosphatase is normal in osteoporosis
low Ca/ low phosphate/ high alkaline phosphatase in osteomalacia

59
Q

triad of ketoacidosis

A

hyperglycaemia, ketonaemia, acidaemia

60
Q

bloods to diagnose ketoacidosis

A

pH <7.3
bicarbonate <15mmol/L
glucose >11mmol/L
ketones >3mmol/L

61
Q

how does ketoacidosis occur?

A

in absence of insulin
unrestrained increase in hepatic gluconeogenesis/ peripheral uptake by tissues is reduced
ketones produced as bodies require glucose in cells

62
Q

HbA1c for suspected diabetes

A

> 48mmol/mol
6.5%

63
Q

complicated malaria organism

A

plasmodium falciparum

64
Q

complicated malaria sx

A

shock
cerebral malaria
renal failure
ARDS

65
Q

3 stages of malaria infection

A

exoerythrocytic stage
endoerythrocytic stage
hypnozoite stage/ dormant

66
Q

uncomplicated malaria tx

A

quinine and doxycycline

67
Q

Wernicke’s encephalopathy triad

A

confusion
ataxia
ophthalmoplegia

68
Q

how does COPD lead to peripheral oedema?

A

hypoxic kidney not perfused
no excreted sodium and water

69
Q

side effects of insulin therapy

A

hypoglycaemia, weight gain, hypokalaemia

70
Q

angina gold ix

A

CT angiography

71
Q

Hodgkin’s RFs

A

HIV
EBV
SLE
FHx

72
Q

most common subtype of Hodgkin’s

A

Nodular sclerosing

73
Q

Hodgkin’s subtype w worst prognosis

A

Lymphocyte depleted

74
Q

which drugs are in ABVD chemo?

A

doxorubicin
bleomycin
vinblastine
dacarbazine

75
Q

4 types of seronegative spondyloarthropathies

A

ankylosing spondylitis
psoriatic arthritis
enteropathic arthritis
reactive arthritis

76
Q

what are vertebral syndesmophytes?

A

bony proliferations due to enthesitis between ligaments and vertebrae

77
Q

indications of worse prognosis in ank spond

A

ESR >30
onset <16yrs
early hip involvement
poor response to NSAIDs

78
Q

ank spond tx

A

NSAIDs
steroids
anti-TNFs

79
Q

most common cause of an AKI

A

sepsis

80
Q

hyperkalaemia first line tx 2 drugs

A

insulin
dextrose

81
Q

most common type of MND

A

amyotrophic lateral sclerosis

82
Q

which sub-types of MND affect which type of MN

A

amyotrophic lateral sclerosis: UMN + LMN
progressive bulbar palsy: UMN + LMN
primary lateral sclerosis: UMN
progressive muscular atrophy: LMN

83
Q

how can MND be distinguished from MS and polyneuropathies?

A

no sensory loss or sphincter disturbance in MND

84
Q

how can MND be distinguished from Myasthenia Gravis?

A

MND never affects eye movements

85
Q

MND tx + mechanism

A

riluzole
inhibitor of glutamate release and NMDA receptor antagonist

86
Q

HIV tx

A

2 NRTI + NNRTI

nucleoside reverse transcriptase inhibitor:
abacavir
zidovudine

non-nucleoside reverse transcriptase inhibitor:
nevirapine

87
Q

define carcinoma

A

malignant tumour of epithelial cells

88
Q

most common type of carcinoma in CRC

A

adenocarcinoma

89
Q

bowel cancer screening programme

A

faecal occult blood test in men + women age 60-69

90
Q

2 methods to stage CRC

A
91
Q

aortic stenosis murmur

A

ejection systolic at the 2nd intercostal space, right sternal border, radiates to carotid arteries

92
Q

mitral stenosis murmur

A

loud first heart sound
early diastolic opening snap
low-pitched decrescendo-crescendo rumbling diastolic murmur
louder after Valsalva manoeuvre + exercise

93
Q

mitral regurgitation murmur

A

pansystolic murmur heard best at the apex

94
Q

aortic regurgitation murmur

A

blowing, high-pitched, diastolic, decrescendo
begins soon after aortic component of S2 (A2)
loudest at 3rd or 4th left parasternal intercostal space

95
Q

tricuspid regurgitation

A

pansystolic heard best at left middle or lower sternal border

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