MCQ bank Flashcards
What staining is associated with amyloid?
Congo red staining will be positive (there will be bright green fluorescence staining)
How might PCKD present?
HTN, haematuria, flank pain, stroke, renal failure, palpable renal masses
Can renal amyloidosis present with masses?
Yes
What is pseudomembranous colitis caused by?
C.diff
What SEs of statins are there?
Myositis
Raised LFTs
Gallstones
Interstitial lung disease in rare cases
Ottawa rules (for XRAY) of knees?
Tenderness at head of fibula
Cannot flex to 90 degrees
Age =>55
Isolated tenderness of patella
What is peuts-jeghers syndrome?
Genetic syndrome associated with intestinal polyps
What conditions are associated with nasal polyps?
Asthma
Aspirin hypersensitivity
CF
Allergic rhinitis
Most common cause of CAP?
Strep pneumonia
Drugs used in Alzheimers?
Donepezil and memantine
Also use rivastigmine and galantamine
Management of COPD exacerbation?
Admit if severe.
Salbutamol nebs
Pred course
Abx if sputum positive or consolidation present
O2 to maintain sats >90
If unwell despite this - (acidotic) you would consider NIV (BiPAP)
If still unwell - ITU
How would diabetes insipidus present?
Excessive thirst and excretion of large volumes of diluted urine
High serum sodium and low urine osmolarity, high serum osmolarity
In severe cases may have seizures due to electrolyte disturbance
Causes of diabetes insipidus and results of fluid deprivation test and ADH?
Nephrogenic
- Insensitivity to ADH
- Fluid deprivation - will fix serum osmo (<300)
- ADH will not fix
- Can be caused by CKD/Lithium, congenital
Cranial
- Not producing ADH
- Fluid deprivation and ADH will fix osmo
Most common type of glomerulonephritis for adults?
IgA nephropathy (Bergers disease)
How does IgA glomerulonephritis present and how can you differentiate that from post strep GN?
Presents with nephritis syndrome (haematuria) 1-2 days after URTI
Post strep presents 1-3 weeks after
In what ways do GN disease present?
Nephritic syndrome (haematuria and low level protein, oliguria and HTN) Nephrotic syndrome (Proteinuria and oedema) Mixed picture
What GN’s causes a Nephritic picture? (most common and others in there)
Most commonly in adults: IgA nephropathy (typically men in 20s or 30s, 1-2 days afetr URTI)
Most commonly in children: Post strep GN (1-2 weeks after URTI)
Granulomatitis with polyangitis
- would have systemic features
Eosinophilic Granulomatitis with polyangitis
- associated with asthma and systemic features
Goodpasture
- pulmonary haemorrhage
Allport
- inherited
- sensorineural and eye disease
Thin basement membrane disease
- Inherited
What GNs cause a mixed picture?
Membranoproliferative
Diffuse proliferative
What GNs cause a nephrotic picture?
Most common in children: Minimal change,
- Idiopathic or caused by infection/drugs
Most common in adults: Focal segmental
- idiopathic or HIV
Diabetic nephropathy
Amyloidosis
On spirometry how can you differentiate asthma and COPD?
Asthma may have a normal or increased DLCO and a normal TLC
COPD would have a decreased DLCO and an increased TLC
XRAY changes for RA?
Soft tissue swelling
Juxta articular deminerlisation
Joint pace narrowing
Erosions
What virus is associated with nasopharnygeal carcinoma?
EBV
Common mechanism of injury of a calcaneal fracture?
jump or fall from high height
How to estimate plasma osolarity?
2x sodium plus glucose and urea
What vaccine is contraindicated to those with an egg allergy?
Flu (intramuscular)
What antihypertensive affects the metabolism of simvastatin?
Amlodipine
Can only give max 20mg of simva if on amlodipine
How is isolation different from dissociation?
Isolation is separating emotions from an event
Dissociation is actually changing oneself (character or identity) to avoid distress
How is somatisation different from hypochondirasis?
Somatisation is anything in which there is a symptom, hypochondriasis is just worry about something
How does milk-alkali syndrome present?
hypercalcaemia, renal failure and metabolic alkalosis
Associated with calcium antacids
How do non-haemolytic transfusion reactions present?
Fever malaise and chills during the 2nd half of the transfusion
How would bacterial contamination present in a blood transfusion?
Fever, shock, delayed, no focus of infection
How would transfusion relaetd lung injury present?
Dyspnoea and hypotension
Maybe has an infection/recent surgery
Painless rectal bleedign in older adults with normal PR and proctoscope?
Angiodysplasia
Can Haemorrhoids coat the stool?
Yes
Niacin deficiency (B3) is associated with what tumour?
Carcinoid
What causes syphillis?
Treponoma pallidum
What causes chancroid?
Haemophilus ducreyi
Most common cause of SIADH?
Idiopathic
Treatment of malignant hypertension?
IV nitroprusside is most common
Could also give Labetalol or nicardapine IV
Phentolamine if phaechromocytoma
Hydralazine if pregnant
How does diabetic amyotrophy present?
Severe pain
Unilateral (but can be bilateral) wasting
How does mononeuritis multiplex present?
Asymmetric loss of sensory/and or motor function
Rare
What would you give propylthiouracil for?
Thyroid storm
What is the test to diagnose cushings?
Overnight dexamethasone suppression test
Max dose of lidocaine?
3mg per kg or 7mg/kg if using adrenaline
If someone has a ?urethral injury/transection what should you do re: catheterisation?
refer to urology
Don’t try to catheterise - will likely need suprapubic catheter
how do you manage an extraperitoneal bladder injury (urine in pertoneum)
Catheter - if blood at meatus or suspicion of urethral injury then this should be suprapubic, if not then it should be urethral
Apart from pain in the anatomical snuffbox what other signs are there of a scaphoid fracture?
Pain on longitudinal compression of the thumb
Pain on gentle flexion and ulnar deviation of the wrist
Difference in PMR and fibromyalgia presentation?
Fibromyalgia with multiple points of pain all over their body, may have trouble with sleep (needs to be present for >3 months and have 11 tender areas)
PMR - shoulder pain and stiffness
Most common acute laeukaemia in children?
ALL
What is mortons neuroma, how does it present?
Pain inbetween 3rd and 4th metatarsal head usually related to tight footwear. Neuroma that forms related to tight footwear.
What is Freibergs disease? How does it present?
Osteochondritis of 2nd/3rd metatarsal heads. Vague pain limiting activity in 12-15F.
Dinner fork deformity fracture?
Colles
Elbow swollen after a child has fallen onto an outstetched hand?
Supracondylar fracture
Common organisms causign epididymo orchitis in men >35?
gram -ves: e.coli and pseudomonas
red flag Sx in GORD?
Dysphagia Evidence of Gi bleeding Weight loss persistent vomiting UGI mass
What is the most accurate non invasive H.pylori test?
Urea breath test
When should you test for H.pylori in someone who has GORD?
after PPI treatment for 1 month
Most common cause of UTI?
E.coli
Which joint does the z-deformity affect?
The thumb
How does a boutonniere deformity present? how is it different to swan neck?
Finger deformity, hyperextension of distal IP join, fixed flexion of proximal leaving the end pointing up
the boutonniere is pointing up and the swan neck points down at the distal finger
