Laz Paper 3 Flashcards
Which condition is trigeminal neuraligia associated with?
Multiple sclerosis
Which virus is involved in shingles?
Varicella Zoster
What is Ramsay Hunt syndrome?
Reactivation of the varicella zoster virus in the geniculate ganglion of the facial nerve
How does Ramsay Hunt syndrome present?
- Unilateral facial palsy
- Vesicular rash on the ear
- Dry eyes/ mouth
What are the eye symptoms of cluster headache?
- Lacrimation
- Conjunctival injection
- Eyelid swelling
Why can coeliac disease cause steatorrhea?
Due to the malabsorption of fats
What are the antibodies in coeliac disease?
- Anti-ttg
- Anti-endomysial
- Anti-gliadin
What are air bronchograms?
Shaddowing of bronchi on x-ray due to filling of the alveoli with something other than air
What are the characteristics of heart failure on x-ray?
- Alveolar oedema
- Kerly B lines
- Cardiomegaly
- Upper lobe diversion
- Pleural effusion
What is found on blood film of multiple myeloma?
- Rouleaux proteins
Sticky IgG causing red blood cells to stack together
What is the diagnosis if a patient develops an annual cough for 3 months of the year?
Chronic bronchitis
What is the blood film appearance of myelodysplastic syndrome?
- Hyposegmented nuclei of granulocytes
- Granulocytes with no granulation
What is the blood film appearance of myelofibrosis?
- Dacrocytes (tear drop cells)
What is the best investigation for diagnosing TB?
An acid fast bacillus test on a sputum sample using the Ziel Neelson stain
What is the first line investigation for suspected pancreatitis?
Transabdominal ultrasound
What can abdominal ultrasound scan for pancreatitis show?
- Pancreatitic inflammation
- Free fluid
- Pancreatic calcification
Why can pancreatitis not be excluded on the grounds of normal amylase?
Because the half life of amylase is 10-12 hours therefore it may appear normal within 24 hours despite pancreatitis
What is Kussmaul’s sign?
Raised JVP on inspiration seen in pericardial effusion and cardiac tamponade
Which strain of malaria is responsible for causing the highest number of deaths?
Plasmodium falciparum
What is the presentation of Malaria?
Cylical flu like symptoms with joint and muscle aches
What is the difference in thick and thin blood films investigating Malaria?
Thick blood films
- More sensitive
- Used for detecting presence of malaria
Thin blood films
- Used for identifying causative organism
How do patients with COPD maintain their neural respiratory drive?
Through hypoxic drive as there is chronic CO2 retention
What is the SpO2 aim for patients with COPD?
88-92%
Which oxygen delivering system will give the tightest delivery control?
Venturi mask
How does hypercalcaemia affect urinary frequency?
There is increased Ca2+ excretion in the urine which increases H2O excreted therefore increases urinary frequency
Which electrolyte imbalance will cause ventricular tachycardia?
Mg2+
What are the BLS guidelines for pulseless ventricular tachycardia in the hospital setting?
- Defibrillate
- Commence CPR
- Defibrillate
- After 2nd defibrillation administer adrenaline
- Administer adrenaline every 3-5 minutes
- After 3rd defibrillation, administer amiodarone
What is the function of atropine in cardiology?
It’s administered in acute complete heart block
Why are the sigmoid and caecum more likely to under volvulus?
Because they’re loosly attached to the mesentry
What are the signs on x-ray produced by sigmoid and caecal volvulus?
- Sigmoid- coffee bean sign
- Caecum- embryo sign
How does damage to Wernicke’s vs Broca’s area manifest?
- Wernicke’s (what?) lack of understanding of speech but patients will be able to speak in fluent non-sensical sentences
- Receptive aphasia
- Broca’s (b-) lack of speech production but sound understanding
- Expressive aphasia
How will damage to the arcuate fasciculus manifest?
Patients will be able to understand and produce speech, but speech repetition is poor
What dosage of calcium gluconate should be given in hyperkalaemia?
10ml 10%
What is the most common cause of mitral stenosis?
Rheumatic fever
Which medications increase the risk of duodenal ulcers?
- NSAIDs
- Aspirin
- Bisphonsphonates
- Steroids
What pulmonary consequences can rheumatoid arthritis have?
Pulmonary fibrosis
What is the first step in the management of TIA?
300mg Aspirin
When would thrombolysis be considered for stroke?
If patients are presenting with an ischaemic stroke within 4.5 hours
Which patients is carotid endartectomy considered in?
If they have >70% stenosis of the carotid arteries
Which organism causes whooping cough?
Bordatella pertussis
What is an A wave (J waves)?
Backflow of blood up the superior vena cava due to atrial contraction
What is a C wave (J waves)?
Ventricular contraction causing the tricuspid valve to bulge causing a backflow of blood into the SVC
What is a V wave (J waves)?
Increased venous return to the right atrium occuring in late systole
What is an X descent (J waves)?
Atrial relaxation and filling
What is a Y descent (J waves)?
Blood flow from the right atrium to the right ventricle via an open valve
What is a cannon A wave (J waves)?
Backflow of blood into the SVC when the atria and ventricles contract at the same time, as the atria are contracting against a closed tricuspid valve
Most commonly seen in complete heart block
What is the presentation of ankylosing spondylitis?
Lower back pain that improves as the day progresses
What is Schober’s test?
- Patient standing straight
- A mark made 5cm below the iliac crest and 10cm above the iliac crest
- Patient leans forward and the distance between the two marks should expand to 21cm
