Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YEAR 6: PACES > Medicine 10 > Flashcards

Medicine 10 Flashcards

1
Q

List some causes of a fixed dilated pupil.

A

3rd nerve palsy
Mydriatics (e.g. tropicamide)
Iris trauma
Acute glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List some causes of optic atrophy.

A

MS
Glaucoma
Congenital (LHON, CMT, Friedreich ataxia)
Toxins (ethambutol, B12 deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can acute glaucoma be distinguished from anterior uveitis?

A

Cloudy cornea
Large pupil
Increased IOP

NOTE: both are painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can episcleritis and scleritis be distinguished?

A

Scleritis: vasculitis of the sclera, PAINFUL, worse on eye movement
Episcleritis: painless, acuity preserved, redness can be moved over sclera

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which imaging tool is used to give a 3D representation of the retina?

A

Optical coherence tomography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Outline the management options for wet ARMD.

A

Photodynamic therapy
Intravitreal VEGF injections (bevacizumab)
Anti-oxidants and zinc may help early ARMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List some classes of medications that are used to reduced IOP in open angle glaucoma.

A

Beta-blockers (reduce production) - timolol
Prostaglandin analogue (increase uveoscleral outflow) - latanoprost
Alpha-agonists (reduce product and increase outflow) - brimonidine
Carbonic anhydrase inhibitors - acetazolamide
Miotics - pilocarpine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List some causes of cataracts.

A

Age
DM
Steroids
Congenital (Rubella, Wilson’s, myotonic dystrophy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the normal duration of the following parts of an ECG?
PR interval
QRS complex
QTc

A

PR interval: 120-200 ms (3-5 small squares)
QRS complex: < 120 ms (3 small squares)
QTc: 380-420 ms (~2 big squares)

NOTE: normal ECG calibration is 25 mm/s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the difference between bifascicular and trifascicular block?

A

Bifascicular: RBBB + left anterior or posterior fascicular block
Trifascicular: RBBB + left anterior or posterior fascicular block + prolonged PR (1st degree)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are escape rhythms?

A

Appear after an anticipated beat
Atrial Escape: SAN fails to depolarise leading to failed sinus beat, followed by atrial escape (narrow complex)
Ventricular Escape: atrial wave fails to conduct due to AV block, followed by ventricular escape (broad complex - weird and wide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some differentials for broad complex tachycardia.

A

VT
VF
Torsades de pointes
SVT with BBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List some causes of VT.

A 
Infarction
Myocarditis 
Long QT syndrome 
Cardiomyopathy 
Iatrogenic (antiarrhythmics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List some contraindications for thrombolysis.

A

GI bleeding
Recent haemorrhagic stroke
Severe hypertension
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List some differentials for chest pain.

A 
ACS 
Angina
Aortic dissection 
Aortic aneurysm 
GORD 
Oesophageal spasm 
Musculoskeletal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List some causes of heart failure.

A

SYSTOLIC: ischaemia, DCM, hypertension, myocarditis
DIASTOLIC: pericardial effusion, restrictive cardiomyopathy
ARRHYTHMIA: brady/tachy
Valve disease
HIGH OUTPUT: anaemia, thyrotoxicosis, pregnancy, Paget’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List the main CXR features of heart failure.

A 
Alveolar shaddowing 
Kerley B lines 
Cardiomegaly 
Upper lobe diversion 
Effusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the main indications for pharmacological management of hypertension?

A

< 80 yrs, stage 1 hypertension (140/90-160/100) and one of:
- target organ damage (retinopathy, LVH)
- 10 yr CVD > 10% (QRISK)
- established CVD
- diabetes mellitus
- renal disease
Anyone with stage 2 hypertension and above

NOTE: statin should also be offered if QRISK > 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

List some echocardiography features of severe mitral stenosis.

A

Valve orifice < 1 cm^2
Pressure gradient > 10 mm Hg
Pulmonary artery systolic pressure > 50 mm Hg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which investigations should be requested insuspected infective endocarditis?

A

Bloods: ESR, blood cultures (3 x 12 hours apart), serology for unusual organisms
Urine: microscopic haematuria
ECG: AV block
Echo: vegetations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which investigations should you request in a patient with suspected rheumatic fever?

A

Bloods: ASO titre, streptococcal antigen, FBC, ESR
Throat swab (if strep throat)
ECG
Echocardiogram (MR/AR)

22
Q

List some causes of restrictive cardiomyopathy.

A

Amyloidosis
Haemochromatosis
Sarcoidosis
Primary endomyocardial fibrosis

23
Q

List some causes of dilated cardiomyopathy.

A 
Muscular dystrophy 
Myocarditis 
Alcoholism
SLE 
Drugs (doxorubicin)
Thyrotoxicosis
24
Q

List some complications of congenital heart disease.

A

Infective endocarditis
Pulmonary hypertension
Paradoxical emboli
Eisenmenger syndrome

25
Q

List some features of Marfan syndrome.

A 
Cardiac: aortic aneurysm, aortic dissection, aortic regurgitation, mitral valve prolapse 
Lens dislocation 
High-arched palate 
Arm span > height 
Pectus excavatum 
Scoliosis 
Hypermobility
26
Q

List some features of Ehlers-Danlos syndrome.

A

Hyperelastic skin
Hypermobility (Beighton)
Cardiac (mitral prolapse, MR, AR, aneurysms)
Easy bruising (fragile blood vessels)

NOTE: cutis laxa is loose skin and hypermobile joints

27
Q

List some complications of pneumonia.

A 
Respiratory failure 
Sepsis 
AF 
Pleural effusion 
Empyema
28
Q

List the different diseases that can be caused by aspergillosis.

A 
Asthma 
ABPA
Aspergilloma
Invasive aspergillosis 
Extrinsic allergic alveolitis
29
Q

List some causes of ARDS.

A

Pulmonary: pneumonia, aspiration, inhalational, contusion
Systemic: sepsis, pancreatitis, DIC, acute liver failure

30
Q

List some causes of pulmonary oedema.

A 
Heart failure 
Renal failure 
Liver failure 
Iatrogenic fluid overload 
Nephrotic syndrome 
Lymphatic obstruction 
ARDS (exudative)
31
Q

What concentration of oxygen should be used in acutely unwell COPD patients?

A

80-90% 15 L/min through non-rebreathe mask initially and perform ABG
If PCO2 < 6 kPa: aim for target SaO2 94-98%
If PCO2 > 6 kPa: maintain target SaO2 88-92%

32
Q

Outline the management of primary and secondary pneumothorax.

A

PRIMARY

  • < 2 cm rim and not SOB - consider discharge
  • otherwise: aspiration –> chest drain

SECONDARY

  • > 2 cm rim OR SOB OR > 55 years –> chest drain
  • otherwise: aspiration –> chest drain
  • ALL patents should be admitted for at least 24 hours
33
Q

List some features of sarcoidosis.

A 
Constitutional upset 
Respiratory (fibrosis, bilateral hilar lymphadenopathy) 
Arthralgia
Peripheral/cranial neuropathy (e.g. Bell's palsy) 
Uveitis/keratoconjunctivitis 
Restrictive cardiomyopathy 
Hepatosplenomegaly
Lupus pernio 
Erythema nodosum
34
Q

What pulmonary artery pressure counts as pulmonary hypertension?

A

> 25 mm Hg

NOTE: normal is 8-20 mm Hg

35
Q

Outline the management of pulmonary hypertension.

A 
Treat underlying condition
LTOT
CCB
Sildenafil 
Prostacyclin analogues 
Heart failure treatment 
Heart-lung transplant
36
Q

List some secondary causes of diabetes mellitus.

A

Drugs (steroids, tacrolimus, ciclosporin)
Pancreatic (chronic pancreatitis, cystic fibrosis, hereditary haemochromatosis)
Endocrinology (phaeo, Cushing’s, phaeo)

37
Q

What is usually checked at a routine diabetes check up?

A

Control (glycaemic) - HbA1c, BP, lipids, capillary blood glucose
Complications - BP, cardiac auscultation, fundoscopy, ACR, sensory testing
Competency - with treatment regime
Coping - psychosocial

38
Q

What are the two main types of insulin regime in diabetes?

A

Biphasic - 30 mins before breakfast and dinner, good for patients with regular lifestyle (e.g. children, elderly)
Basal-Bolus - bedtime long-acting insulin + short-acting insulin before meals, good for patients with flexible lifestyle

NOTE: once-daily long-acting before bed is initially used in patients switching from tablets in T2DM

39
Q

List some side-effects of insulin therapy.

A

Hypoglycamia (careful with alcohol and beta-blockers)
Lipohypertrophy
Weight gain

40
Q

What should patients with diabetes be informed about regarding diabetes management when they are ill?

A

Insulin requirements usually increase
Check BMs more frequently than every 4 hours (and check urine for ketonuria)
Increase insulin dose if glucose is rising
Maintain calories as much as possible

41
Q

Which investigation is used to check for proliferative diabetic nephropathy and wet ARMD?

A

Fluorescein angiography

42
Q

List some complications of DKA.

A

Cerebral oedema (excess fluid administration)
Aspiration
Hypokalaemia
Hypophosphataemia (resp and skeletal muscle weakness)
VTE

43
Q

List some causes of hypoglycaemia.

A 
Inappropriate insulin 
Drugs (sulphonylureas) 
Pituitary insufficiency 
Addison's disease 
Liver failure 
Insulinoma
44
Q

List some causes of hypothyroidism.

A 
Atrophic hypothyroidism 
Hashimoto's hypothyroidism 
Iodine deficiency 
De Quervain's thyroiditis
Drugs (thionamides, lithium)
Thyroidectomy
45
Q

What are the main features of multiple endocrine neoplasia (MEN)?

A

MEN1: pituitary adenoma (prolactin, GH) + parathyroid adenoma/hyperplasia + pancreatic islet cell (gastrinoma, insulinoma)
MEN2: medullary thyroid cancer + phaeochromocytoma + parathyroid hyperplasia (2B - marfanoid body habitus)

46
Q

Which diseases fall under the autoimmune polyendocrine syndromes?

A 
Type 1 (recessive): Addison's, candidiasis, hypoparathyroidism 
Type 2 (polygenic): Addison's, thyroid disease, T1DM
47
Q

List some clinical features of acromegaly.

A 
Prominent supraorbital ridges 
Coarse facial features 
Prognathism 
Macroglossia
Wide-spaced teeth 
Thenar wasting (and CTS symptoms) 
Sweaty spade-like hands
48
Q

What are the initial steps in the management of a patient with suspected coeliac disease and a high TTG?

A

Refer for gastroscopy and duodenal biopsies
Referral for bone density scan
Screening of first-degree relatives
Referral to dieticians for gluten-free diet advice

49
Q

Which extra-GI manifestations of UC are related to the activity of colitis?

A 
Erythema nodosum
Aphthous ulcers
Episcleritis
Acute arthropathy
Pyoderma gangrenosum
Anterior uveitis
50
Q

List some medical treaments used for multiple sclerosis.

A

Steroids (IV methylprednisolone for optic neuritis)
1st line: Beta-interferon, glatiramer acetate
2nd line: natalizumab
Symptomatic: baclofen (spasticity)

YEAR 6: PACES (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions