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Final year > Medicine 1 > Flashcards

Medicine 1 Flashcards

1
Q

What features do you see in bifascicular block?

A

RBBB+LAD

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2
Q

What features do you see in trifascicular block?

A

RBBB+LAFB+1st degree AV block

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3
Q

What is the difference seen on ECG with AVRT and AVNRT and explain how this occures?

A

AVRT-may see p wave
AVNRT-p wave buried in QRS

accessory pathway in AVRT can be located anywhere, whereas in AVNRT, it is located in the node (where atria and ventricles contract simultaneously)

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4
Q

What are the 4 treatments for AVRT/AVNRT?

A

radiocatheter ablation
vagal manouveres
medication
cardioversion

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5
Q

When is VT more likely compared to SVT with BBB?

A

Hx of MI

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6
Q

Name a cause of RVH.

A

cor pulmonale

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7
Q

Name 4 causes of LVH.

A

HTN
CoA
H(O)CM
AS

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8
Q

What are 2 features on ECG of brugada syndrome?

A

RBBB+ST elevation in V1-V3

genetic abnormality of heart conduction

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9
Q

What are the 3 signs of PE on ECG?

A

S1-deep s wave in lead 1
Q3-q wave in lead 3
T3-T wave inversion in lead 3

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10
Q

Name the 4 ECG changes in hyperkalaemia.

A

tall tented T waves
widened QRS
Flattened/absent P waves
sinusoidal

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11
Q

Name 4 features of hypokalaemia on ECG.

A

flatted T waves
ST depression
Prolonged QT
Prominent U wave

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12
Q

Name 5 causes of bradycardia.

A

DIVISIONS
D-drugs (antiarrhythmics, digoxin, B blocker, Ca2+ blocker)
Ischaemia/infarction
V-
Infection (IE, rheumatic fever, viral myocarditis)
Sick sinus syndrome
Infiltration (AI, sarcoid, haemochromatosis, muscular dystrophy)
O-hypOthyroid, hypOkalaemia (and hyper), hypOthermia
N-neuro (inc ICP)
Surgery/catheterisation

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13
Q

When do you NOT treat bradycardias? 2 things.

A

Asymptomatic

>40bpm

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14
Q

Name 4 indications of pacemakers.

A

AV block
Mobitz type 2
Sick sinus
AF

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15
Q

Name 3 mx steps of symptomatic bradycardia <40bpm.

A

1) rx underlying cause
2) atropine (500mcg up to 3mg) or isoprenaline
3) External pacing (e.g. transcutanous>transvenous)

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16
Q

When should you avoid using adenosine to revert AF and why?

What 2 things can be used instead?

A

If the patient has AF+WPW as they may go into VF

Amiodarone or fleicanide

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17
Q

What doses do you give adenosine in tachyarrhythmias after attempting vagal manouveres?

A

6mg, 12mg, 12mg

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18
Q

If there are no adverse signs in a tachyarrhythmia, what 4 options of drug treatment can be given?

A

Calcium channel blocker (verapimil)
B blocker (atenolol)
Digoxin
Amiodarone

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19
Q

If a patient with a tachyarrythmia has adverse signs/haemodynamically compromised, what should you do? Give doses etc.

A 
synchronised cardioversion (100j, 200j, 360)
Amiodarone (300mg over 1 hour then 900mg over 23hours)
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20
Q

Which patient group should you be careful with when giving adenosine?

A

asthmatics

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21
Q

Name 5 examples of narrow complex tachys.

A 
sinus tachy
AF
Atrial flutter
Atrial tachy
AVRT
AVNRT
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22
Q

Name 3 examples of broad complex tachys.

A

VT
SVT with BBB
Torsades de pointes

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23
Q

Which 2 antiarrythmic drugs should not be given together and why?

A

b blocker and Ca2+ channel blocker due to risk of bradycardia.

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24
Q

Name 4 causes of AF.

A

HTN
IHD
Rheumatic fever
thyrotoxicosis

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25
Q

What is rombergs test?

A

patient stands with eyes closed-test of proprioception to see if they can stay balanced

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26
Q

What is multiple endocrine neoplasia type 1?

A

Tumours of endocrine glands-pituitary (GH/prolactin), pancreas (insulinoma/gastrinoma), parathyroid

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27
Q

What is multiple endocrine neoplasia type 2?

A

Endocrine tumour:

  • thyroid
  • adrenal pheochromocytoma
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28
Q

What is zollinger ellison syndrome?

A

excessive levels of gastrin from tumours of duodenum or pancreas

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29
Q

What is the preferred rx for rate control of AF in patients with HF?

A

digoxin

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30
Q

What is the name of the pupil response seen in a relative afferent pupillary defect?

A

Marcus Gunn pupil

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31
Q

What is a hutchinsons pupil?

A

unilateral dilated pupil unresponsive to light-a result of compression of the occulomotor nerve

32
Q

What do you call bilaterally small pupils that accomodate but don’t react to bright light? Seen in diabetes

A

argyll robertson pupil
ARP, PRA
Accommodation reflex present BUT pupillary reflex absent

33
Q

Name a main feature of:

a) amyotrophic lateral sclerosis
b) primary lateral sclerosis
c) progressive muscular atrophy
d) progressive bulbar palsy

A

a) LMN signs in arms
UMN signs in legs
b) UMN signs only
c) LMN signs only, distal>proximal, BEST prognosis
d) palsy of tongue/muscles of chewing and swallowing-WORST prognosis

34
Q

What is:

a) peri umbilical bruising
b) flank bruising called?

A

a) cullens

b) grey-turner’s

35
Q

Which ulcer is painful and with painless in syphilis vs herpes?

A

Painless-syphilis

Painful-herpes

36
Q

What 2 diseases does the NAAT check?

A

chlamydia

gonorrhoea

37
Q

What is advised in a pregnant woman who has a primary attack of herpes at greater than 28 weeks gestation?

A

C-section

38
Q

What assessment tool is used to measure fracture risk? If there is a significant result, what test should be done next?
What is the equivalent measure of cardiovascular event risk?

A

FRAX- fracture risk assessment tool. Then do DEXA scan (bone mineral density scan)

QRISK score

39
Q

Name the 5 steps in newborn resuscitation.

A

1) DRY baby, maintain temp
2) Assess tone, breathing, heart rate
3) If not breathing, open airway and give 5 inflation breaths
4) If HR undetectable start CPR at rate of 3 compressions to 1 breath (3:1)
5) Reassess HR every 30 secs and if still undetectable, consider IV access

40
Q

Name the test used to detect a meniscal injury and 3 signs/symptoms seen.

A 
Mcmurrays test
Pain worse on straightening knee
May feel knee locking
Knee 'gives way'
Tenderness along joint line
41
Q

Which haematoma do patients experience a lucid interval?

A

extradural-patient appears to improve for a few days and then deteriorate suddenly

42
Q

Name 2 features of subdural haematoma.

A

occurs in older age, alcoholism, anticoagulation

fluctuating confusion/consciousness

43
Q

Which haematoma results in sudden worse headache, usually due to a ruptured aneurysm or following trauma?

A

SAH

44
Q

What is the most common symptom seen in PE?

A

tachypnoea!

45
Q

What must you test before giving someone amiodarone?

A

TFT

46
Q

What is the triad of symptoms seen in normal pressure hydrocephalus?

A

dementia
disturbed gait
incontinence

47
Q

What is the first line ix in hydrocephalus?

A

CT head

48
Q

What ix must NOT be done in obstructive hydrocephalus and why?

A

LP-difference in cranial and spinal pressures will cause brain herniation

49
Q

Name 3 features of lewy body dementia.

Name 3 drug treatments.

A

dementia+progressive cognitive impairment
visual hallucinations
parkinsonism

Donepazil, rivastigmine, memantine

50
Q

In what manner does vascular dementia progress?

A

step wise manner

51
Q

What is the triad of things seen in plummer vinson syndrome?

A

dysphagia
oesophageal webs
iron deficiency anaemia

52
Q

What is the first line diagnostic test of oesophageal ca?

A

upper GI endoscopy

53
Q

What is the most preferred rx of oesophageal ca and what is a major complication of this?

A

Ivor Lewis

Mediastinitis due to anastamosis being in thorax

54
Q

Name 4 examples of extra pyramidal side effects. Which drug is used to manage this?

A

Parkinsonism
acute dystonia (torticollis/oculogyric crisis)
Tardive dyskinesia
Akathisia (severe restlessness)

procyclidine

55
Q

Which antipsychotics cause extra pyramidal side effects? Atypical or typical

A

typical

56
Q

What 2 things are the elderly at risk of when taking antipsychotics?

A

stroke

VTE

57
Q

Which typical antipsychotic most commonly causes prolonged QT interval?

A

haloperidol

58
Q

Unilateral deafness, vertigo and tinnitus in 64y/o pt over past 4 weeks. What is the diagnosis?

A

acoustic neuroma HOWEVER depending on the CN affected, my get facial palsy (CN7) or absent corneal reflex (CN5)

59
Q

Bilateral deafness occurs in presbyacusis and otosclerosis-how do you differentiate?

A

presbyacusis-sensorineural

otosclerosis-conductive

60
Q

What is the ix of choice to diagnose acoustic neuroma/vestibular schwannoma?

A

MRI cerebellopontine angle

61
Q

What rare autosomal dominant genetic disorder leads to abnormal vessel formation in skin and mucous membranes, causing nosebleeds and GI bleeding?

A

hereditary haemorrhagic telangiectasia

62
Q

What abx is used to treat animal bites?

A

co-amoxiclav

63
Q

What is another name for lateral epicondylitis? When is pain the worst?

What are 3 rx options?

A

tennis elbow

Wrist extension against resistance whilst elbow is extended

physiotherapy
steroid injection
simple analgesia

64
Q

What does CREST syndrome stand for?

A 
Calcinosis
Raynauds
Esophageal dysnfunction
Sclerodactyly (tightening of skin around fingers and hands)
Telangiectasia
65
Q

What is achalasia?

A

causes oesophageal dysfunction and LOS does not allow food into stomach

66
Q

Which patient group should not receive cyclizine as an anti emetic and why?

A

HF-cyclizine causes reduced cardiac output and inc HR

67
Q

Which anti emetic should be avoided in intestinal obstruction?

A

metoclopramide as pro kinetic

68
Q

What happens to a thyroid swelling when you swallow?

A

moves upwards

69
Q

What movement makes a thyroglossal cyst move? Which age group is it most common in?

A

protrude tongue

most common in <20years old

70
Q

Name 3 symptoms experienced with a pharyngeal pouch (oesophageal herniation between 2 muscles).

A

dysphagia
regurgitation
aspiration

71
Q

What is the name of the neck lump that is fluid filled and present at birth, found in post triangle and transilluminates.?

A

cystic hygroma

72
Q

What cyst is found between SCM and pharynx and usually presents in early adulthood?

A

branchial cyst

73
Q

What is the name of the pulsating neck mass that doesn’t move on swallowing?

A

carotid aneurysm

74
Q

which condition has bi-basal fine end-inspiratory creps on auscultation, as well as exertional dyspnea, dry cough and clubbing?

A

idiopathic pulm fibrosis

75
Q

What are the 3 rx of idio pulm fibrosis?

A

lung rehab
oxygen
lung transplant

76
Q

If a patient progresses from having decorticate to decerebrate herniation, what may have caused this?

A

tonsillar/uncal herniation (coning)

77
Q

What is the first line management of mastitis?

A

continue breastfeeding with non infected side and express to empty breast (prevent abscess formation) and give antibiotics

Final year (8 decks)

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