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Year 3 Medicine > Make a Medic Mock 2021 > Flashcards

Make a Medic Mock 2021 Flashcards

1
Q

How is an NSTEMI and unstable angina differentiated?

A

NSTEMI will cause raised troponins, however both can cause ECG abnormalities

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2
Q

Which drugs have a positive prognostic indication on patients with heart failure with reduced ejection fraction?

A

Beta blockers and ACE inhibitors

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3
Q

What is the management of SVT?

A

Haemodynamically unstable:

  1. DC cardioversion

Haemodynamically stable:

  1. Vagal manoeuvres
  2. 6mg Adenosine
  3. 12mg Adenosine
  4. Verapamil (or beta blockers/ diltiazem)
  5. DC cardioversion
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4
Q

Which murmurs are loudest on inspiration?

A

Right sided murmurs

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5
Q

Which murmurs are loudest on expiration?

A

Left sided murmurs

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6
Q

What is the triad of characterising critical limb ischaemia?

A
  • Tissue loss
  • Gangrene
  • Pain at rest
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7
Q

What is the management of AF?

A
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8
Q

What is the management of ascending cholangitis?

A
  • IV fluids
  • Broad spectrum antibiotics
  • ERCP to remove obstruction
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9
Q

What are the manifestations of portal hypertension?

A
  • Caput medusae
  • Oesophageal varices
  • Haemorrhoids
  • Splenomegaly
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10
Q

What does SAAG <11 g/L indicate?

A

Exudate

  • Infection
  • Peritoneal mets
    *
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11
Q

What does SAAG >11 g/L indicate?

A

Transudate

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12
Q

What is the SAAG of nephrotic syndrome?

A

Nephrotic syndrome gives a SAAG of <11 g/L due to the decreased serum albumin

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13
Q

How is spontaneous bacterial peritonitis diagnosed?

A

Paracentesis of ascitic fluid with neutrophils >250 per mm3

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14
Q

Which organism most commonly causes SBP?

A

E.coli

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15
Q

What will histological analysis of a Crohn’s patient show?

A
  • Transmural inflammation
  • Non-caseating granulomas
  • Skip lesions
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16
Q

Which artery is occluded in chronic mesenteric ischaemia?

A

Superior mesenteric artery

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17
Q

What is the presentation of chronic mesenteric ischaemia?

A

Post-prandial colicky abdominal pain (pain on exertion of the gut)

18
Q

Occlusion of which artery leads to ischaemic colitis?

A

Inferior mesenteric artery

19
Q

What is the most common cause of small bowel obstruction?

A

Adhesions

20
Q

What is the class of carbocisteine?

A

A mucolytic

21
Q

What is the most useful biomarker of chronic CO2 retainers?

A

HCO3-, as chronic CO2 retainers will get increased bicarb as a compensatory mechanism

Rasied CO2 doesn’t equal CO2 retainer

22
Q

What are the three subgroups of beta-lactam antibiotics?

A
  • Amoxicillin
  • Cephalosporins
  • Carbapenems
23
Q

What is the management of provoked PE? (following surgery etc)

A

3 months of DOACs (some trusts use LMWH and Warfarin)

24
Q

What is the management of unprovoked PE? (not following surgery)

A

6 months of DOACs (LMWH and warfarin depending on trust) and screening for pro-thrombotic conditions

25
Q

What is the clinical difference between meningitis and encephalitis?

A

Meningitis rarely causes neurological symptoms, therefore focal neurology or seizures should raise suspicion for encephalitis

26
Q

What is the most common cause of encephalitis?

A

HSV1 (managed with acyclovir)

27
Q

Which arteries supply the primary motor cortex?

A

Anterior and middle cerebral arteries

28
Q

What is the pathophysiology of dementia with Lewy bodies?

A

Deposition of alpha synuclean proteins

29
Q

How can Parkinson’s and dementia with Lewy bodies be distinguished?

A

Parkinson’s will present with >= one year of motor symptoms before cognative, whereas cognative symptoms will preceed motor in DwLB

30
Q

What is the most common cranial bleed following head trauma?

A

Extradural haemorrhage, usually following damage to the middle meningeal artery after trauma to the pterion

31
Q

What is the presentation of an extra dural haemorrhage?

A
  1. Loss of consciousness
  2. Lucid period of feeling generally fine
  3. Rapid deterioration with focal neurology
32
Q

What feature of urea makes it a useful marker for dehydration?

A

Urea is reabsorbed in states of low circulating volume, to utilise its osmotic properites therefore high concentration of urea indicates dehydration

33
Q

What are the indications for haemodialysis in a patient with renal impairment?

A
  • Pulmonary oedema
  • Acidosis
  • Hyperkalaemia
  • Uraemic complications
    • Pericarditis
    • Encephalitis
34
Q

Which enzyme do the kidneys produce?

A

1-alpha hydroxylase

35
Q

What is the mechanism of post-streptococcal glomerulonephritis?

A

Molecular mimicry

36
Q

What is the function of the direct antiglobulin test?

A

Autoimmune haemolytic anaemia

37
Q

What is the best investigation for multiple myeloma?

A
  • Serum electrophoresis
  • Bone marrow biopsy
38
Q

What are the gold standard investigations for Conn’s syndrome?

A

Renan:aldosterone ratio

39
Q

What is the mechanism of action of calcium resonium?

A

K+, H+ exchange in the bowel leading to increased K+ excretion via the bowel

40
Q

What is the management of DKA?

A
  • A-E assessment
  • IV fluids and fixed rate insulin
  • 10% dextrose to avoid hypoglycaemia
41
Q

Which patients are nitrites contraindicated in?

A

Patients with risk of hypotension and patients with aortic stenosis

Year 3 Medicine (22 decks)

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