Laz and Oli SBA corrections Flashcards
what murmur does severe aortic regurg cause? explain why it arises and its specific name
severe regurg causes backflow of blood causing a physiological mitral stenosis
this causes a mid diastolic murmur known as an austin flint murmur
describe the motor scores in GCS?
1= no movement 2= abnormal extension 3= abnormal flexion 4= withdraws from pain 5= localises to pain 6= normal movement
what test is sued to measure chronic pancreatitis?
faecal elastase
what is the difference between transferrin, transferrin saturation and TIBC?
transferrin is a measure of the amount of free transferrin that can bind to and transport iron
TIBC is a measure of how easily iron can bind to transferrin
therefore, if one is low the other will also be low
transferrin saturation is how much transferrin has iron bound to it
it will therefore be inverse to transferrin and TIBC level
what are t scores for osteopenia and osteoporosis?
0 to -1.5= normal
-1.5 to -2.5= osteopenia
less than -2.5= osteoporosis
describe what is seen in background retinopathy, pre prolif, prolif and maculopathy in diabetes. explain what they mean
background= hard exudates (cheesy) due to leakage of lipids from damaged vessels, microaneurysms and blot haemorrhages
pre proliferative= all of the above plus soft exudates (sign of retinal ischaemia)
prolif= formation of new blood vessels
maculopathy= hard exudates near the macula
what is the most common cause of CKD?
diabetes mellitus
what cancer of the skin has occured if there is a raised lesion with everted edges and a keratinitic core?
squamous cell carcinoma
what cancer of the skin has occured if there is a lesion with raised pearly edges and fine telangiectasia on the surface?
basal cell carcinoma
what is the most common type of skin cancer?
basal cell carcinoma
how do you differentiate anterior and middle cerebral artery strokes
anterior= leg weakness greater than arm weakness middle= arm weakness greater than leg weakness
what is seen on LFTs in PBC?
ALP and GGT
what antibody is found in PBC?
anti mitochondrial antibodies
AMA M2 antibodies
what cells mediate inflammation in PBC?
T cells
what conditions is PBC associated with?
sjogrens syndrome
rheumatoid arthritis
coeliac disease
scleroderma
go through A-E CXR findings in heart failure
alveolar oedema kerley B lines cardiomegaly diversion of upper lobes pleural effusion
what are air bronchograms and when are they seen?
when alveoli are filled with something other than air
seen in pulmonary oedema- filled with fluid
seen in pneumonia- filled with pus/consolidation
seen in interstitial lung disease- filled with fibrosed tissue
what is it called on CXR when alveoli are filled with something other than air?
air bronchograms
what is first line imaging for pancreatitis?
ultrasound
out of amylase and lipase what is more specific for panreatitis?
lipase
if someone is speaking in sentences that dont make sense post stroke what area has been damaged?
wernickes- speech production is fine but speech comprehension is fucked
what might cause erroneously high K+? how can you identify this and how do you continue care
drawing blood quickly as it causes red cell lysis and releases lots of potassium
if K+ is really high but there are no ECG changes or symptoms you should suspect this and urgently redo the bloods before treating for hyperkalemia
what is the progress of pain in a duodenal ulcer?
pain relieved by eating
gets worse a few hrs after eating
what is the progress of pain in a gastric ulcer?
pain worse as you eat
gets better a few ours after you eat
out of duodenal and gastric ulcers whats more common?
duodenal
what will vocal resonance be in pleural effusion and why?
decreased, fluid doesnt conduct sound well
where are bronchial breathing sounds normal?
over the trachea
where are bronchial breathing sounds abnormal?
in the lungs
what causes bronchial breathing?
consolidation
what medication is contraindicated in GORD?
nitrates
in what deficiency will you see glossitis and angular stomatitis?
B12
iron
folate
what anticoag is given in acute limb ischaemia?
IV heparin
if someone has jaundice and a RUQ mass what should you think?
couvoisiers law- this is a palpable gallbladder and if accompanied by painless jaundice suggests pancreatic cancer
what is used to ix a suspected PE in a pregnant woman and why?
VQ scan
they cannot have a CTPA as the ionising radiation can harm the foetus
what is delormes procedure used to treat?
rectal prolapse
what drug is a common SABA?
ipatropium bromide
if someone has suspected lung cancer with a cavitating lesion what type of cancer are they likely to have?
squamous cell cancer
what acronym is used to remember causes of microcytic anaemia and what does it stand for?
TAILS: thalassaemia anaemia of chronic disease iron deficiency lead poisoning sideroblastic anaemia
whats the inheritance pattern of PCKD?
autosomal dominant
how can aspirin and paracetamol OD be differentiated?
aspirin OD= tinnitus
paracetamol OD= takes a while for symptoms to be displayed
how does carpal tunnel syndrome present?
pain in lateral half of the hand
pain wakes patients up at night
pain is relived by vigorously shaking the hand
what nerve is affected in carpal tunnel syndrome?
median
what is immediate management of suspected PE? whats done after
high flow oxygen and DOAC
then calculate the wells score and CTPA/d dimer
what ix is used to confirm a DVT in the lower limbs?
venous ultrasound of the lower limbs
what ratio is used to identify alcoholic hep?
AST:ALT> 2
out of AST and ALT which is raised more in alcoholic hep and by how much?
AST by more than 2
what are the 3 causes of raised JVP?
right HF (secondary to left HF or pulmonary hypertension) constrictive pericarditis tricuspid regurg
what ix is best to confirm hiaatus hernia?
barium swallow
how is SVT managed in asthmatics?
first line vagal manoeuvres
if this fails give a CCB like verapamil
in whom is adenosine contraindicated? whats given instead
asthmatics
give verapamil instead
what is primary amenorrhoea?
it is when someone never has a period (not an ovarian cause of amenorroea lol)
what does oligoclonal bands on electrophoresis of CSF suggest is the diagnosis?
MS
what eletrolyte abnormalities cause long QT syndrome?
hypomagnesemia
hypokalemia
if amyloidosis has caused nephrotic syndrome, what might the underlying diagnosis be?
multiple myeloma
what abx can be used to treat c diff?
vancomycin or metronidazole
when are shoerocytes v shistocytes produced?
spherocytes= hereditary spherocytosis or haemolytic anaemia shistocytes= fragment of RBC
out of FVC and FEV1 which is reduced in COPD?
FEV1
in young patients who have hypertension what should you consider as cuases?
phaeo
conns syndrome
coarctation of the aorta
renal artery stenosis
what is used first line to treat wernickes encephalopathy?
IV thiamine
what is pabrinex?
thiamine replacement
what is the medicatin/supplement name for whats given to replace thiamine?
pabrinex
what endocrine condition causes hyperprolactinaemia? explain why
hypothyroidism- it causes increased TRH which alongside increasing TSH increases prolactin too
what does TRH do?
stimulates production of TSH and prolactin
