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Medicine finals > Medicine > Flashcards

Medicine Flashcards

1
Q

Which test is used to confirm Cushing’s disease over Cushing syndrome

A

High-dose dexamethasone suppression test

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2
Q

Which tests should be used to monitor treatment in haemochromatosis

A

Ferritin (measure of total iron stores) and transferrin (measures how much serum iron is bound to protein in blood)

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3
Q

First line test for acromegaly

A

Serum IGF-1 levels

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4
Q

Features of pernicious anaemia

A

Dyspnoea and fatigue
Lemon tinge to skin (haemolysis)
sensory loss
Glossitis

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5
Q

Atorvastatin dose for primary and secondary prevention

A

20 mg primary and 80 mg secondary

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6
Q

Asthmatic features that suggest steroid responsiveness in COPD

A
  • hx of asthma
  • high blood eosinophil count
    substantial variation in FEV1 over time (at least 400ml)
  • substantial diurnal variation in peak flow (at least 20%)
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7
Q

First line bronchodilator in COPD managment

A

Short acting beta-2 agonist or short acting muscarinic antagonist (e.g. ipatroprium)

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8
Q

According to NICE guidlines what treatment is recommended in step 3 of asthma management

A

SABA + low dose ICS + Leukotriene receptor antagonist (LTRA)

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9
Q

According to NICE guidelines what treatment is recommended in step 4 of asthma management

A

LABA

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10
Q

types of thyroid cancer in order of prevalence

A

Papillary
Follicular
Medullary (calcitonin)
Anakastic

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11
Q

In an asymptomatic patient what are the cut off levels of blood glucose for diabetes diagnosis

A

Fasting blood glucose 7.0 mmol/l and above

Random glucose than or equal to 11.1 mmol/l (on two occasions)

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12
Q

Management of stable angina

A
  • Aspirin and statin
  • Sublingual GTN for symptom relief
  • Either beta blocker or rate limiting CCB (nonDHP) such as Diltiazem or verapamil
  • Consider combination (using DHP CCB)
  • Consider long acting nitrate such as isosorbide mono-nitrate
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13
Q

Initial management of anaemia in CKD

A

correct iron deficiency before starting erythropoiesis

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14
Q

Third line intervention for poorely controlled hypertension

A

addition of thiazide like diuretic such as chlortalidone or indapamide

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15
Q

factors that indicate need for needle aspiration in pneumothorax

A

either shortness f breath or 2cm rim of air

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16
Q

Management of life threatening C. Diff infection

A

ORAL vancomycin and IV metronidazole

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17
Q

Visual field defect in temporal lobe lesion

A

Superior homonymous quadrantanopia

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18
Q

visual field defect in pituitary adenoma vs craniopharyngioma

A

pituitary –> upper quadrant (bitemporal)

craniopharyngioma –> inferior quadrant

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19
Q

Painful skin rash and dry cough

A

sarcoidosis

erythema nordosum

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20
Q

What are the 3 features of a Total anterior circulation stroke

A

Unilateral Weakness
Homonymous hemianopia
Higher cerebral dysfunction (dysphagia, visuospatial disorder)

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21
Q

What is the criteria for a Posterior circulation stroke

A

one of:

  • Cranial nerve palsy and contralateral motor/sensory deficit
  • bilateral motor sensory deficit
  • conjugate eye movement (e.g. gaze palsy)
  • cerebellar dysfunction (ataxia, nystagmus, vertigo)
  • isolated hemianopia or cortical blindness
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22
Q

Chest pain, relieved sitting forward and saddle-shaped ST elevation on ECG

A

pericarditis

23
Q

Causes of pericarditis

A
  • Viral
  • Autoimmune inc. RA
  • Malignancy
  • Post MI
  • Medication
24
Q

Imaging modality for acoustic neuroma

A

MRI of cerebellopontine angle

25
Q

Preferred NOAC for patients renal impairment

A

Apixaban

26
Q

Potentially toxic dose of paracetamol

A

> 9500 mg (150 mg/kg * 60kg)

value above this start acetylcysteine immediately

27
Q

Laboratory test for SLE with high sensitivity

A

ANA

28
Q

Laboratory test for SLE with high specificity

A

anti-dsDNA and anti-Smith

29
Q

Management for idiopathic intracranial hypertension

A
  • Weight loss
  • Acetazolamide
  • Topiramate
  • Repeated LP
30
Q

Secondary prevention for stroke

A
  • Clopidogrel (aspirin = modified release dipyramidole if not tolerated)
  • High intensity statin
31
Q

Antibodies for pernicious anaemia

A

Intrinsic factor antibodies (higher specificity than gastric parietal cell antibodies)

32
Q

Inducing remission in acute Crohn’s

A

IV hydrocortisone

33
Q

Antithrombin treatment in MI

A

Fondaparinux should be offered to patients not at high risk of bleeding who are not having angiography immediately
if immediate angiography or creatinine >265, then unfractionated heparin

34
Q

suitable medication for use in palliative care for nausea and vomiting due to gastric dysmotility and stasis

A

Domperidone

metochlopramide

35
Q

Most common cause of viral meningitis

A

Enteroviruses most common being Coxsackie B

36
Q

Indicators of negative fluid balance

A

Hypotension
Tachycardia
Oliguria
Sunken eyes and reduced skin turgor

37
Q

Indicators of over-filled fluid balance

A

ascites, crackles, tachypnoea and elevated jvp

38
Q

Management of ischaemic stroke and secondary prevention

A 
Aspirin 300mg 2 weeks then convert to clopidogrel
Statin (after 48hrs)
Anticoagulation if AF (after 14 days)
Maintain blood glucose between 4-11
Permissive hypertension
39
Q

Most specific antibodies for limited cutaneous systemic sclerosis

A

anti-centromere antibodies

40
Q

Ankylosing spondylitis x-ray findings

A

subchondral erosions and sclerosis of sacroiliac joints
Squaring of lumbar vertebrae
‘bamboo spine’

41
Q

Why are allopurinol and azathioprine contraindicated together

A

causes bone marrow suppression

allopurinol = xanthine oxidase inhibitor therefore reducing the metabolism of active azathioprine

42
Q

cardiac effects of anticholinergics

A

muscarinic blockade of vagal tone leading to tachycardia

43
Q

Skin disorder associated with coeliac disease

A

Dermatitis Herpatiformis

44
Q

Skin disorders associated with IBD

A 
Eruthema nodosum 
Pyoderma gangrenosum (UC)
45
Q

Skin changes seen in lupus

A

Butterfly/malar rash
Livedo reticulatis
Discoid rash
Photosensitivity

46
Q

MOA for LMWH

A

Low molecular weight heparin (LMWH) is an anticoagulant injected subcutaneously or intravenously and acts via activation of antithrombin III which in turn inactivates thrombin and factor Xa to produce its effect

47
Q

Drugs that cause SIADH

A 
SSRIs and tricyclics 
PPIs
carbamazepine 
vincristine 
cyclophosphamide
48
Q

Drugs that alter colour vision

A

Digoxin

Ethambutol

49
Q

Clinical test used in neurology, patient is asker to close their eyes while standing

A

In the Romberg test, the standing patient is asked to close their eyes. An increased loss of balance is interpreted as a positive Romberg’s test. The Romberg test is a test of the body’s sense of positioning (proprioception), which requires healthy functioning of the dorsal columns of the spinal cord

50
Q

Clinical test ised to assess strength of hip abductor muscles

A

Trendelenburg

51
Q

Nehrotic syndrome features

A

Nephrotic syndrome is defined by a triad of clinical features: oedema, substantial proteinuria (> 3.5 g/24 hours) and hypoalbuminaemia (< 30 g/L). It is often associated with hyperlipidaemia, thromboembolism and an increased risk of infection

52
Q

Features of nephritic syndrome

A

Blood in the urine (urine appears dark, tea-colored, or cloudy)
Decreased urine output (little or no urine may be produced)
Swelling of the face, eye socket, legs, arms, hands, feet, abdomen, or other areas.
High blood pressure.

53
Q

First line managment of acute pericarditis

A

Combination of NSAIDs ans colchicine

Medicine finals (1 decks)

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