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FFP Medicine > Medicine > Flashcards

Medicine Flashcards

1
Q

What is May-Thurner’s syndrome?

A

a rare vascular disorder in which an artery compresses a vein in your pelvis. This compression can cause symptoms in your left or right leg and foot and may lead to blood clots.

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2
Q

what is an unprovoked DVT?

A

no major risk factor in history

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3
Q

what are the 3 questions to ask someone you suspect may have a PE?

A

SoB, chest pain signs of DVT

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4
Q

which heart valve is most commonly affected in IV drug users in infective endocarditis?

A

tricuspid

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5
Q

which valve is usually affected in infective endocarditis?

A

mitral

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6
Q

what is the most common abnormality in ECG in PE?

A

sinus tachycardia

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7
Q

define massive PE

A

Large or extensive
thrombus; saddle; bilateral
Acute PE with sustained hypotension

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8
Q

define sub-massive PE

A

Larger thrombus or embolus than low risk; right heart strained
Acute PE without hypotension, signs of RV dysfunction or myocardial necrosis- ECG changes, elevated troponin

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9
Q

define small risk emboli in PE

A
  • Acute PE without the clinical markers that define massive or sub-massive pulmonary embolism
    Mortality estimated at 15% at 90 days
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10
Q

what are the ECG changes found in sub-massive PE?

A

RV strain, ischemic changes, S1 Q3 T3 pattern,

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11
Q

define barretts oesophagus

A

pre-malignant, Metaplasia in the mucosal cells lining the lower portion of the oesophagus, from normal stratified squamous epithelium to simple columnar epithelium

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12
Q

define peptic ulcer

A

Peptic ulcers are defects in the gastric or duodenal mucosa that extend through the muscularis mucosa.

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13
Q

what is the pathophysiology of coeliac disease

A

Gluten triggers production of IgA antibodies and t-cell mediated inflammatory response that targets bowel. Small bowel most affected
-> chronic inflammation
-> villous atrophy (damage to lining of small intestine) -> decrease SA for absorption

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14
Q

what are the features of celiac disease on histology?

A

Increase in intraepithelial Lymphocytes(IELs)
Villous atrophy
Crypt hyperplasia
Chronic inflammatory cells (lymphocytes) in lamina propria

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15
Q

what are the human leukocyte antigens for celiac disease

A

HLA DQ2 (90%), remaining are HLA DQ8

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16
Q

what type of rash is ass with celiac disease?

A

dermatitis herpetiforms- Uncommon blistering subepidermal eruption of the skin, itchy

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17
Q

what are the investigations for someone with suspected celiac disease?

A

Blood tests: FBCs, LFTs, U&Es, bone profile, vitamin D, vitamin B12, haematinics and albumin- to check for nutritional deficiencies
Serological blood sample
1st line: total immunoglobulin A (IgA) and IgA tissue transglutaminase (tTG)
2nd line: IgA endomysial antibody (EMA) can be used if IgA tTGA is unavailable, or in cases where it is weakly positive
Definitive diagnosis is made via upper GI endoscopy and biopsy of small bowel tissue

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18
Q

when is bariatric surgery indicated?

A

BMI>40 or BMI>35 with complications (T2DM) after non surgical approaches tried ONLY if pt commits to long term and fit for surgery. otherwise BMI >50 option for choice

19
Q

define achalasia

A

Failure of oesophageal peristalsis and of relaxation of the lower oesophageal sphincter (LOS) due to degenerative loss of ganglia from Auerbach’s plexus (innervates smooth muscle) i.e. LOS contracted, oesophagus above dilated.

20
Q

is bloating a feature of GORD?

A

NO- need urgent referral if reflux and bloating

21
Q

which spinal tract decussates near level of entry?

A

spinothalamic tract (pain and temp)

22
Q

which muscles of the thumb are innervated by the median nerve?

A

thenar muscles (opponens, abductor brevis, flexor pollicis brevis)
lumbircals of digit 1 and 2 (flexor)

23
Q

what are the signs of LMN lesions

A

weakness
wasting
reduced tone
reflex loss
fasciculation

24
Q

define Bell’s Palsy

A

acute, unilateral, idiopathic facial nerve palsy

25
Q

what is the most important feature of Bell’s Palsy

A

LMN facial nerve palsy- forehead affected

26
Q

what is the most common ACUTE polyneuropathy?

A

Guillain-barre syndrome (viral infection triggers inflammatory response and autoimmune demyelination)

27
Q

what MUST be ruled out in new onset neuropathy?

A

diabetic neuropathy

28
Q

define Ramsay Hunt syndrome

A

VZV varicella zoster virus of geniculate ganglion of the facial nerve
- facial palsy AND painful vesicles of ear/ soft palate

29
Q

what are the signs of resp failure due to NM weakness?

A

Weak limbs, face, neck, swallow
Cannot count 1 – 20
Anxious, sweaty
Cannot lie flat and diaphragm paradox
VC < 1.5 liters
Saturation may be OK until late (not reassuring if normal)

30
Q

what are the two most common causes of acute NM failure?

A

myasthenia criss and GBS

31
Q

what is the best assessment of needing ICU in a pt with NM failure

A

VC <1.5L is serious concern (needs to be up 20ml/kg)

32
Q

what steps would you take at bedside on arrival of a pt with NM failure

A

Call for help: Critical care
Ensure airway is safe
Sit up, Oxygen mask monitoring HR and Saturations. (90-92%)
Suctioning if secretions++
Nil by mouth
Blood gases
IV access
Chest X-ray for ? Infection
Further management for critical care and neurology

33
Q

what organism commonly triggers Guillain barre syndrome?

A

campylobacter jejuni

34
Q

what is the treatment of migraines (acute and prophylactic?)

A

acute: triptan + NSAID or triptan + paracetamol
prophylaxis: topiramate or propranolol

35
Q

first line medication for black T2DM patients who are dx with hypertension?

A

A2RB (losartan, valsartan)

36
Q

how can serum osmolality be estimated?

A

2 * Na+ + glucose + urea

37
Q

what are the HbA1c targets in: T1DM, T2DM, T2DM on glicazide or insulin)

A

<48 T1 and T2
<53 T2 on glicazide or insulin

38
Q

Hashimoto’s thyroiditis increases the risk of which cancer?

A

MALT lymphoma (also ass with H pylori infection)

38
Q

how is MODY inherited?

A

autosomal dominant

38
Q

what is the most common endocrine disorder from lithium toxicity?

A

hypothyroidism

39
Q

what condition can cause a falsely raised HbA1c?

A

splenectomy

39
Q

what is the classical histology finding of TB?

A

caseating granulomas

40
Q
A

FFP Medicine (14 decks)

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