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Passmed Content > Medicine > Flashcards

Medicine Flashcards

1
Q

What is thalassaemia

A

genetic defect in the protein chains that make up haemoglobin

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2
Q

What is the normal structure of haemoglobin?

A

2 alpha chains
2 beta chains

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3
Q

Why does beta thalassaemia have different severities?

A

gene can be abnormal or have deletion
ie. 1 abnormal 1 normal
2 abnormal or 1 abnormal 1 deletion
Most severe - 2 deletions

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4
Q

management of reactive arthritis?

A

ibuprofen
if contraindicated then steroids

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5
Q

what medication should be given to women with anti-phospholipid syndrome?

A

LMW heparin acutely
warfarin lifelong

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6
Q

when are nitrates contraindicated?

A

severe aortic stenosis - risk of profound hypotension

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7
Q

What disease causes erythema marginatum? Annular erythematous rash on trunk and inner arms/legs, non-pruritic

A

Rheumatic fever

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8
Q

Which valvular pathology is assoc with rheumatic fever?

A

Mitral stenosis - mid diastolic

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9
Q

Which bacteria causes typhoid?

A

Salmonella type - constipation not diarrhoea

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10
Q

what’s assoc with bence jones protein?

A

multiple myeloma

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11
Q

features of multiple myeloma

A

hypercalcaemia, renal damage, anaemia, thrombocytopenia, infection

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12
Q

on CXR, what does a widened mediastinum represent?

A

aortic dissection

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13
Q

what are the causes of dilated cardiomyopathy?

A

idiopathic
alcohol
coxsackie B virus
wet beri beri
doxorubicin

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14
Q

Features of tuberous sclerosis

A

ash leaf spots, fibromata underneath nails, cafe au lait spots, epilepsy, delay, learning difficulties, retinal hamartomas, polycystic kidneys

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15
Q

Features of dengue fever

A

retro-orbital headache, fever, facial flushing, rash, thrombocytopenia, recent travel
flavivirus spread by mosquitoes

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16
Q

typical feature of chagas disease

A

swelling of eyelids

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17
Q

features of malaria

A

prodrome = headache, myalgia, diarrhoea
cold stage
hot stage = fever, vomit, flushing
sweating stage

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18
Q

Pt had a PCI this afternoon, now experiencing severe chest pain again, management?

A

CABG

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19
Q

What is thoracic outlet syndrome?

A

compression of brachial plexus/subclavian artery/vein at thoracic outlet due to trauma or anatomical abnormality (cervical rib)

19
Q

What is thoracic outlet syndrome?

A

compression of brachial plexus/subclavian artery/vein at thoracic outlet due to trauma or anatomical abnormality (cervical rib)

20
Q

how is anion gap calculated?

A

(Na + K) - (bicarb+ Cl)

21
Q

what is indapamide?

A

a thiazide-like diuretic

22
Q

what are the fluid requirements for an adult?

A

25 ml/kg/day water
1mmol/kg/day K
50-100g/day glucose

23
Q

signs of R heart failure

A

raised JVP, hepatomegaly, peripheral oedema

24
Q

MEN type 1 features

A

3 Ps

Parathyroid (hyper)
Pituitary
Pancreas - insulinoma/gastrinoma (recurrent peptic ulceration)

25
Q

MEN IIa

A

Parathyroid
Phaeochromocytoma

+medullary thyroid cancer

26
Q

MEN IIb

A

Phaeochromocytoma

+ medullary thyroid cancer, marfanoid body, neuromas

27
Q

Zollinger Ellison syndrome

A

gastrin secreting tumour in pancreas/duodenal wall
leads to increased HCl acid production -> recurrent peptic/duodenal ulcers

28
Q

co-amoxiclav + deranged LFTs

A

cholestasis

29
Q

How does Gilbert’s syndrome affect LFTs?

A

solitary raised bilirubin

29
Q

How does Gilbert’s syndrome affect LFTs?

A

solitary raised bilirubin

30
Q

Lyme disease treatment?

A

oral doxycycline

31
Q

What causes Lyme disease?

A

borrelia burgdorferi - spirochaete spread by ticks

32
Q

which causes of nausea is cyclizine appropriate for?

A

intracranial/vestibular
GI obstruction
raised ICP

33
Q

Pneumonia after influenza, what’s the most likely organism?

A

Staph aureus

34
Q

migraine medical management?

A

acute = NSAID + Triptan + paracetamol
prevention = topiramate or propanolol

35
Q

which medication can be used for ER (oestrogen receptor) positive breast cancers?

A

if post menopausal -> anastrozole (reduces peripheral oestrogen synthesis)

36
Q

which medication is used in HER2 positive breast cancers?

A

trastuzumab (Herceptin)

37
Q

features of wernickes encephalopathy?

A

Confusion
Ataxia
Nystagmus

Opthalmoplegia
Peripheral Neuropathy

38
Q

patient presents with TIA, which medication should be given?

A

300mg aspirin + specialist review within 24 hours (don’t drive until this)

39
Q

which antibiotic can’t be prescribed with methotrexate?

A

Trimethoprim/co-trimoxazole - all folate antagonists -> myelosuppression means risk of life-threatening infection and severe bleeding

40
Q

which contraceptive is assoc with weight gain?

A

depo-provera

41
Q

how do you diagnose a miscarriage on USS?

A

Crown-rump length >7mm and no heart beat

42
Q

what test is diagnostic for acromegaly?

A

OGTT + measurement of GH, MRI pituitary showing adenoma

43
Q

back pain, weak hip abduction + foot drop = which dermatome?

A

L5

44
Q

Cluster headache - long term prevention?

A

verapamil

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