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5 Medicine > January > Flashcards

January Flashcards

1
Q

how can PPI cause muscle aches?

A

long term use of PPI can cause hypomagnesaemia which can cause muscle weakness and aches, begins after 3 months to 1 year of using

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2
Q

side effects of using PPIs

A

hyponatraemia, hypomagnasaemia

osteoporosis

increased Cdiff risk

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3
Q

what size changes can be seen on renal ultrasound in CKD?

A

bilateral smaller kidneys

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4
Q

what conditions are associated with enlarged kidneys on renal ultrasound

A

HIV associated nephropathy, PCKD, diabetic nephropathy and amyloidosis

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5
Q

if someone is found to be in AF with no symptoms, how to determine if going to anticoagulate or not?

A

chadvasc2 score

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6
Q

what diuretic to use in someone with ascites secondary to alcoholic liver disease?

A

spironolactone - aldosterone antagonist

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7
Q

what part of the colon is most likely to be affected by ischaemic colitis?

A

splenic flexure - watershed area

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8
Q

risk factors of bowel ischaemia?

A 
increasing age
AF
embolic conditions - cancer, endocarditis
cardiovascular disease risk factors 
cocaine
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9
Q

what is the pattern of pain for mesenteric ischaemia?

A

sudden and severe

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10
Q

features of bowel ischaemia?

A 
abdo pain
rectal bleeding
diarrhea
fever
leucocytosis + lactic acidosis
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11
Q

difference between mesenteric ischaemia and ischaemic colitis?

A

mesenteric ischaemia tends to be sudden and severe requiring urgent surgical treatment

ischaemic colitis can be transient and chronic, resulting in inflammation, ulceration and haemorrhage.

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12
Q

what murmur is associated with aortic dissection?

A

aortic regurgitation

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13
Q

if someone describes a tearing chest pain, what additional observations to be done?

A

right and left arm blood pressure

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14
Q

what ECG changes can be seen in aortic dissection?

A

inferior ST-elevation due to right coronary artery involvement of dissection

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15
Q

in addisons disease what can be seen in serum Sodium and potassium?

A

hyponatraemia and hyperkalaemia

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16
Q

What electrolyte imbalance is associated with sarcoidosis, why?

A

Hypercalcaemia due to inappropriate activation of vitamin D by macrophages within granulomas

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17
Q

What blood test can be used if sarcoidosis is suspected

A

Serum ACE

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18
Q

Dry cough, fever, dyspnea, 3 months after solid body organ transplant. What’s a likely diagnosis?

A

CMV pneumonitis

19
Q

What is a contraindication of Hartmanns solution?

A

Hyperkalaemia - contains potassium

20
Q

How to diagnose Cushing’s disease ?

A

High acth, not surprised by low dose dex test but surprised by high dose dex test

21
Q

cortisol not suppressed by low and high dose dex, what is the likely cause ?

A

Ectopic acth production

22
Q

WhT are the features of myeloma?

A

Crab

High calcium
Renal failure
Anaemia
Bone pain

23
Q

What is the biochemical picture for myeloma? Calcium phosphate alp

A

High calcium normal/high phos normal alp

24
Q

Definition of pathological Q waves?

A

> 1mm wide and >2mm deep

25
Q

What do ST segments do in prinzmental angina?

A

ST elevation

26
Q

Which T wave leads are usually inverted?

A

aVR and V1

27
Q

When are U waves seen

A

Hypokalaemia

28
Q

Describe 2nd degree type 2 heart block

A

Constant PR interval with occasional drops in QRS complexes

29
Q

Describe QRS complexes in 3rd degree heart block

A

Constant rate separate to P waves, may merge with P waves, abnormal shape

30
Q

In cor pulmonale with BBB, will it be left or right?

A

Right BBB

31
Q

Difference between atrial escape and junctional escape

A

Junctional escape beats will not have P waves but normal QRS-T waves

32
Q

How can mitral stenosis affect P waves on ECG?

A

Bifid P wave, broad P wave in lead II

33
Q

What do tall peaked p waves in lead II signify?

A

Cor pulmonale - right atrial enlargement

34
Q

Characteristic of wolf parkinson white syndrome on ECG?

A

Delta wave - slurred upstroke of R wave

35
Q

What does Coved ST elevation in V1 2 3 indicate

A

Brugada syndrome

36
Q

What is cushing’s reflex?

A

Increased ICP - bradycardia, hypertension, irregular breathing

37
Q

What must be done to patient before giving DC cardioversion

A

Sedation

38
Q

4T and 4H reversible causes of asystole

A

Tamponade
Toxin
Tension pneumothorax
Thrombus

Hypovolaemia
Hypothermia
Hyperkalaemia/hypokalaemia etc
Hypoxia

39
Q

Drugs of choice for rhythm control in acute AF

A

Flecainide or amiodarone

40
Q

When to use digoxin in AF?

A

If old and sedentary

41
Q

Significance of chadvasc2 score 1 2 male female

A

1 - anticoagulate for males

2 - anticooagulate for females

42
Q

Complications of MI

A

DARTH VADER

Death
Arrythmias
Rupture
Tamponade
Heart failure
Valve disease
Aneurysm
Dressler syndrome
Embolus
Recurrence
43
Q

Possible ECG changes in pulmonary embolism

A

S1Q3T3 - deep S wave in I, pathological Q in III, TWI in III

Right heart strain signs - right axis deviation, dominant R wave and TWI in V1-V3

44
Q

ECG changes In hyperkalaemia?

A 
Tall tented T waves
Widened QRS
Absent P wave
Sine wave appearance
Torsade de pointe

5 Medicine (5 decks)

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