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Finals passmed > Medical > Flashcards

Medical Flashcards

1
Q

What are the ECG findings in hypocalcaemia?

A

Prolonged QT interval

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2
Q

Removal of the parathyroid glands can lead to what electrolyte imbalance?

A

Hypocalcaemia

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3
Q

What are the features of hypercalcaemia on an ECG?

A

ST segment shortening

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4
Q

What is total iron binding capacity like in iron deficiency anaemia?

A

High

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5
Q

What is total iron binding capacity like in anaemia of chronic disease?

A

Low/normal

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6
Q

What levels are required to diagnose someone with diabetes?

A
  • 2 hour post-prandial glucose >= 11.1
  • Fasting glucose >= 7
  • HbA1c > 47
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7
Q

What are the levels of C-peptide in type 1 and type 2 diabetes?

A
  • Type 1 - low C-peptide
  • Type 2 - high C-peptide
    (C-peptide is made alongside insulin)
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8
Q

What are the key features of diabetic ketoacidosis?

A

abdominal pain, polyuria, polydipsia, kussmaul respiration (deep hyperventilation), acetone-smelling breath

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9
Q

What is the management of a myasthenic crisis?

A

IV IgG and plasmapheresis

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10
Q

What is the pathophysiology of myasthenia gravis?

A

Autoimmune - antibodies to acetylcholine receptors

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11
Q

What is the first line treatment of myasthenia gravis?

A

pyridostigmine

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12
Q

In type 1 diabetes when should blood sugar levels be checked?

A

before each meal and before bed

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13
Q

What are the blood glucose targets for type 1 diabetics?

A

5-7mmol/l on waking
4-7mmol/l before meals

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14
Q

In which patients with type 1 diabetes can you include metformin in their treatment?

A

Patients with a BMI > 25

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15
Q

What are the features of cellulitis?

A

unilateral, erythema usually with well-defined margins, swelling, systemic upset

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16
Q

What bacteria commonly causes cellulitis?

A

Strep pyogenes
(sometimes staph aureus)

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17
Q

What is the management of cellulitis?

A

oral abx if mild - flucloxacillin (clarithromycin or erythromycin (in pregnancy) if penicillin allergic)
if severe - IV co-amoxiclav/clindamycin/cef

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18
Q

What is the first line treatment for hypertension in diabetics?

A

ACE-I/ARBs e.g. Ramipril

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19
Q

What is the mechanism of action of SGLT-2 inhibitors?

A

Increase urinary glucose excretion

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20
Q

What is the mechanism of action of sulphonylureas (gliclazide)?

A

Increase insulin release from the pancreas

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21
Q

How do you diagnose type 2 diabetes in an asymptomatic patient?

A

two elevated fasting/random glucose tests on two separate occasions

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22
Q

what drug is used to treat thyrotoxicosis in pregnancy?

A

Propylthiouracil in first trimester
Carbimazole in second and third

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23
Q

Which diabetes medication increases risk of ulcers or infection?

A

SGLT-2 inhibitors (canagiflozin)

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24
Q

What conditions are associated with subclinical hyperthyroidism?

A

atrial fibrillation, osteoporosis, dementia

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25
Q

Which pain medications slow bone healing?

A

NSAIDs

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26
Q

How do you diagnose cellulitis?

A

On clinical observation

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27
Q

What is the management of hypocalcaemia?

A

IV calcium gluconate

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28
Q

Which drug is a calcimimetic?

A

Cinacalcet - it mimics the action of calcium on tissue by allosteric activation of the calcium-sensing receptor

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29
Q

Which tumours are most likely to metastasise to bone?

A

prostate, breast, lung

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30
Q

What are the signs of bone cancer/mets?

A

Pathological fractures, hypercalcaemia, raised ALP

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31
Q

What is subclinical hypothyroidism?

A

Raised TSH, but T3 and T4 normal, no symptoms

32
Q

What is a Mantoux test?

A

A skin-prick test for TB, if TB is present (active or latent) a skin reaction will occur - unless they are immunosuppressed

33
Q

What are the features of a phaeochromocytoma?

A

hypertension, headaches, palpitations, sweating, anxiety

34
Q

How do you test for a phaeochromocytoma?

A

24hr urinary collection of metanephrines

35
Q

What is the treatment of phaeochromocytoma?

A

Surgery
alpha-blockers (phenoxybenzamine) then beta-blockers (propranolol) in the meantime

36
Q

What are the sodium levels like in pre-renal uraemia?

A

High, because they hold onto sodium to preserve volume

37
Q

What is Kallmann syndrome?

A

Hypogonadotrophic hypogonadism

38
Q

What are the features of anti-phospholipid syndrome?

A

thrombosis, recurrent miscarriage, livedo reticularis (lace-like appearance of skin), prolonged APTT

39
Q

What is the management of anti-phospholipid syndrome?

A

Primary thromboprophylaxis - low-dose aspirin
Secondary - lifelong warfarin

40
Q

What type of crystals are present in gout?

A

negatively bifringent needles, monosodium urate

41
Q

What are the features of an adrenal crisis?

A

hypotension, tachycardia, hyperkalaemia and hyponatraemia

42
Q

What is the management of an adrenal crisis?

A

IV hydrocortisone (no need for mineralocorticoids as hydro provides some mineralocorticoid activity)

43
Q

What are the features of hypomagnesaemia?

A

Parasthesia, tetany, seizures and arrhythmias

44
Q

How much adrenaline do you give to an adult in anaphylaxis?

A

500 micrograms (0.5ml of 1 in 1000)

45
Q

What is lupus pernio?

A

A raised purple rash over the nose, in patients with sarcoidosis

46
Q

What are the features of an acute haemolytic reaction?

A

Fever, abdo pain, hypotension

47
Q

What is the management of an acute haemolytic reaction?

A

stop transfusion, send crossmatch, fluid resuscitation

48
Q

What is the management of a cardiac arrest with a non-shockable rhythm?

A

Adrenaline 1mg immediately

49
Q

What is the management of an acute flare up of RA?

A

IM methylprednisolone

50
Q

In ALS if IV access cannot be gained how should drugs be given?

A

Intra-osseous

51
Q

What drug should be given in non-shockable rhythms?

A

adrenaline 1mg

52
Q

What drug should be give in VF/pulseless VT after shocks have been given?

A

Amiodarone

53
Q

What are the 8 reversible causes of cardiac arrest?

A

Hypoxia, Hypovolaemia, (Hyper/hypo kalaemia, hypoglycaemia, hypocalcaemia), hypothermia.
Thrombosis, tension pneumothorax, tamponade, toxins

54
Q

What is the triad of Behcet’s disease?

A

Oral ulcers, genital ulcers and anterior uveitis

55
Q

What is Behcet’s disease?

A

A multi-system vasculitis - most likely autoimmune. Causes oral ulcers, genital ulcers, anterior uveitis and DVT. Associated with BLA B51

56
Q

In patients with a CD4 count less than 200/mm3, what medication should be started?

A

Co-trimoxazole - antifungal as prophylaxis against pneuocystis jiroveci pneumonia

57
Q

What commonly causes a metabolic alkalosis with hypokalaemia?

A

Prolonged vomiting

58
Q

What commonly causes a metabolic acidosis with hyperkalaemia?

A

Prolonged diarrhoea

59
Q

Which vitamin deficiencies cause easy bruising?

A

Vitamin C or K

60
Q

What are the symptoms of psoriatic arthropathy?

A

symmetrical polyarthritis or asymmetrical oligoarthritis (hands and feet), psoriasias, soft tissue inflammation

61
Q

What are the X-Ray findings on psoriatic arthritis?

A

erosive changes and new bone formation, ‘pencil-in-cup’ appearance

62
Q

What is the management of psoriatic arthritis?

A

NSAIDs if mild
Methotrexate if moderate or severe - can add Monoclonal antibodies

63
Q

What is the maximum rate IV potassium can be given without cardiac monitoring?

A

10mmol/hour

64
Q

What are the common features of sarcoidosis?

A

FABLE. fevers, arthralgia, bilateral hilar lymphadenopathy, lupus pernio, erythema nodosum

65
Q

How much of the electrolytes are needed per day for maintenance?

A

1mmol/kg/day of sodium, potassium, chloride

66
Q

How much fluid should patients have per day for maintenance?

A

25-30ml/kg/day

67
Q

How much glucose should patients have per day to limit starvation ketosis?

A

50-100g/day

68
Q

What would you give in a heparin overdose?

A

Protamine sulphate

69
Q

What are the features of a salicylate overdose on ABG?

A

respiratory alkalosis (causes hyperventilation initially), then metabolic acidosis

70
Q

How do you administer TPN?

A

Through a central vein - subclavian line

71
Q

What is the sign when you inflate a BP cuff and the patient’s arm twitches?

A

Trousseau’s sign - hypocalcaemia

72
Q

What is the name of the sign when you tap on the facial nerve and it twitches?

A

Chvostek’s sign

73
Q

Which vitamin can be teratogenic in high quantities?

A

Vitamin A

74
Q

What is the most common cause of pseudomembranous colitis?

A

C.Diff

75
Q

What is the management of a hyperacute transplant rejection?

A

Remove graft

76
Q

What is Behcet’s syndrome?

A

auto-immune mediated inflammation of the vessels. Causes oral ulcers, genital ulcers and anterior uveitis

Finals passmed (23 decks)

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