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Finals random > May > Flashcards

May Flashcards

1
Q

Klebsiella penumoniae is what type of bacteria?

A

Gram negative rod

Normal gut flora

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2
Q

Features of klebsiella pneumonia

A 
Adults - alcoholics, diabetics
Red currant jelly sputum
Cavitating upper lobe pneumonia
Common after aspiration
Lung abscess and empyaema
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3
Q

Features of Kartagener’s syndrome

A

Quiet heart sounds
Dextrocardia
Recurring chest infections, sinusitis, bronchiectasis
Subfertility

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4
Q

Differentiate kartagener’s syndrome from Cystic fibrosis

A

Sweat test positive for CF

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5
Q

When does carcinoid syndrome commonly occur?

A

In liver metastases - release of serotonin

Or lung carcinoid

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6
Q

Features of carcinoid syndrome

A 
Flushing
Abdominal discomfort
diarrhoea
bronchospasm
hypotension
Right valvular stenosis
ACTH and GHRH giving Cushings syndrome
Pellagra
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7
Q

Investigations for carcinoid syndrome

A

Urinary 5-HIAA

Plasma chromogranin A y

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8
Q

Management of carcinoid syndrome

A

Octreotide - somatostatin analogue

Cyproheptadine to help diarrhoea

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9
Q

Features of steroid responsiveness

A

Any previous, secure diagnosis of asthma or of atopy
A higher blood eosinophil count
Substantial variation of FEV1 over time (at least 400ml)
Substantial diurnal variation in peak expiratory flow (at least 20%)

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10
Q

Iron study profile for haemochromatosis

A

Raised transferrin saturation
Raised ferritin
Low TIBC

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11
Q

Drugs causing pulmonary fibrosis

A

bleomycin, cyclophosphamide, nitrofurantoin, methotrexate and penicillamine
Amiodarone

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12
Q

Adverse effects of atorvastatin

A

Myopathy

Liver impairment

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13
Q

Adverse effects of trimethoprim

A

Myelosuppression

Neural tube defects

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14
Q

What conditions are treated by hydroxychloroquine?

A

SLE and rheumatoid arthritis

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15
Q

Adverse effects of hydroxychloroquine

A

Visual disturbances

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16
Q

Mechanism of ciclosporin

A

Inhibits calcineurin causing immunosuppression

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17
Q

Adverse effects of ciclosporin

A

Gum hypertrophy
Nephrotoxicity
Hepatotoxicity

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18
Q

Symptoms of pericarditis

A

chest pain: may be pleuritic. Is often relieved by sitting forwards
other symptoms include non-productive cough, dyspnoea and flu-like symptoms
pericardial rub
tachypnoea
tachycardia

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19
Q

Cause of pericarditis

A 
Viral  infection - Coxsackie
Tuberculosis
Uraemia
Trauma
Post MI, Dresslers
Connective tissue disease
Hypothyroid
Malignancy
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20
Q

Risk factor for pericarditis

A

Systemic Lupus erythematosus

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21
Q

Treatment for pericarditis

A

Treat underlying cause
NSAIDs
Colchicine

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22
Q

Diagnosis: cholestatic jaundice raised IgM and positive anti-mitochondrial antibodies

A

Primary Biliary cholangitis

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23
Q

Treatment for primary biliary cholangitis

A

Ursodeoxycholic acid

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24
Q

Adverse effects of thiazide diuretic - bendroflumethiazide

A

hypercalcaemia, as well as hyponatraemia, hypokalaemia and hypomagnesaemia.

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25
Q

Features of hypercalcaemia

A 
Stones
Bones
Groans
Thrones
Tones
Psychiatric Moans
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26
Q

Causes of Upper Zone Fibrosis

A

Coal workers’ pneumoconiosis
Histiocytosis
Ankylosing spondylitis/Allergic bronchopulmonary aspergillosis
Radiation
Tuberculosis
Silicosis (progressive massive fibrosis), sarcoidosis

CHARTS

27
Q

Which other structural abnormality is associated with coarctation of the aorta?

A

Bicuspid aortic valve

Systolic murmur - heard under left scapula

28
Q

First line treatment for Allergic Bronchopulmonary Aspergillosis in CF?

A

Prednisolone

2nd line - antifungal

29
Q

Term given to multiple large, round, well-circumscribed masses in both lungs seen on Chest X-ray and condition

A

Cannonball metastases
Renal cell carcinoma

Can be choriocarcinoma or prostate but less common

30
Q

Diagnosis- painful rash on shins and cough

A

Sarcoidosis

31
Q

Features of sarcoidosis

A

acute: erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
insidious: dyspnoea, non-productive cough, malaise, weight loss
skin: lupus pernio
hypercalcaemia: macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)

32
Q

Which condition is most commonly associated with HOCM and can be demonstrated on ECG?

A

Wolff Parkinson White

33
Q

Features of autonomic neuropathy

A
  1. Postural hypotension
  2. Loss of respiratory arrhythmia
  3. Erectile dysfunction
34
Q

Condition associated with autonomic neuropathy

A

Type 2 diabetes

35
Q

Neuropathy associated with Vitamin B12 deficiency

A

Sensory neuropathy

36
Q

Neuropathy associated with botulism and lead poisoning

A

Motor

37
Q

Predisposing factors for sleep apnoea

A

Obesity
Macroglossia - acromegaly, hypothyroidism, amyloidosis
large tonsils
Marfan’s

38
Q

Symptoms and consequence of sleep apnoea

A

Daytime somnolence
Compensated respiratory acidosis
Hypertension

39
Q

Assessment of sleep apnoea

A

Epworth Sleepiness Scale - questionnaire completed by patient +/- partner
Multiple Sleep Latency Test (MSLT) - measures the time to fall asleep in a dark room (using EEG criteria)

40
Q

Diagnostic tests for sleep apnoea

A

Sleep studies - polysomnography

41
Q

What is measured in sleep studies?

A

EEG, respiratory airflow, thoraco-abdominal movement, snoring and pulse oximetry

42
Q

Management of sleep apnoea

A

Weight loss

Continuous Positive Airway Pressure

43
Q

Which antibiotics increase risk of tendonitis?

A

Fluoroquinolones - ciprofloxacin

44
Q

First line treatment for back pain?

A

NSAIDs - naproxen

45
Q

Features of carpal tunnel

A

pain/pins and needles in thumb, index, middle finger
unusually the symptoms may ‘ascend’ proximally
patient shakes his hand to obtain relief, classically at night

46
Q

What nerve is compressed in carpal tunnel?

A

Median

47
Q

Causes of carpal tunnel

A 
ARMPIT
Acromegaly
Rheumatoid Arthritis
Myxoedema (hypothyroidism)
Pregnancy
Idiopathic
Trauma
48
Q

Examination findings in carpal tunnel

A

Weakness of thumb abduction
Wasting of thenar eminence
Tinels sign
Phalens sign

49
Q

What is tinel’s test and how is it interpreted?

A

Tapping over the wrist causes paraesthesia - positive - carpal tunnel

50
Q

What is Phalen’s sign?

A

Full flexion of wrists - prayer sign - causes symptoms of carpal tunnel

51
Q

Management of carpal tunnel

A 
corticosteroid injection
wrist splints at night
surgical decompression (flexor retinaculum division)
52
Q

Which pathogen is associated with malaria and homozygous sickle cell disease?

A

Non typhi salmonella

53
Q

What event is an anterior shoulder dislocation most commonly associated iwth?

A

FOOSH

Fall onto Outstretched Hand

54
Q

Most common causative organism of osteomyelitis

A

Staph aureus

55
Q

Back pain relieved by sitting and leaning forward

A

Spinal stenosis

56
Q

what tests are required before starting a prescription of amiodarone?

A

TFT, LFT, U&Es, CXR

57
Q

Next step in adult with episodic wheezing and SOB, normal spirometry

A

Adults with suspected asthma should have both a FeNO test and spirometry with reversibility

58
Q

Aspiration pneumonia is more common on which sideR

A

Right

59
Q

Management of recurrent pleural effusion

A

recurrent aspiration
pleurodesis
indwelling pleural catheter
drug management to alleviate symptoms e.g. opioids to relieve dyspnoea

60
Q

Side effect of PPIs- omeprazole

A

hyponatraemia

61
Q

Most common presenting group with Primary Biliary Cholangitis

A

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

62
Q

Which medication should be avoided in VT?

A

Verapamil

63
Q

Tests required before commencing treatment with arithromycin

A

ECG

LFTs`

64
Q

Clear chest and acute onset shortness of breath - diagnosis

A

Pulmonary embolism

Finals random (5 decks)

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