Medicine

Question 1

Hyperkalemia ECG changes

Answer 1

• peaked T waves
• shortened QT
  -absent p waves
  -lengthened PR
  -widened QRS
  -sinusoidal

Question 2

treatment for 6.5< or ecg changes

Answer 2

calcium gluconate
it stabilizes myocardial excitability
inc threshold potential
- normalize

Question 3

insulin

Answer 3

causes intracellular movement of potassium
given with glucose

Question 4

multiple sclerosis

Answer 4

chronic demyelinating disease
affecting central nervous system
tissue hardening -> sclerosis

Question 6

multiple sclerosis

Answer 6

immune mediated destruction of oligodendrocytes
partial remyelination
scar tissue forms -> plaques
mostly on white matter
after infections -> BBB can become injured, and permeable -> allow immune cells through it

Question 7

symptoms of MS

Answer 7

motor deficits -> weakness, spasticity , tremors
sensory disturbance -> paraesthesia, hypoethesia
bulbar dysfunction -> dysphagia, dysarthria
vision disturbance -> central monocular loss, diplopia, pain
also - depression, anxiety, urinary symptoms, cog impairment (optic neurtitis)

uhthoff phenomenon -> detritaton of symptoms
lhermitte’s sign - electric shock sensation in neck flexion

Question 8

epidemiology of MS

Answer 8

3:1 f to m
ages 20-40s
infection exposure
EBV risk
smoking and adolescent obesity
europe/america

Question 9

management

Answer 9

corticosteroids iv
long term - disease modifying
interferon beta -> modify t and b cells (inflam response)

Question 10

Nephrotic syndrome

Answer 10

high protein loss (more than 3.5 g)
leads to hypoalbuminemia (<30)

Question 11

nephritic syndrome

Answer 11

moderate proteinuria
and evidence of hematuria
rbc/wbc casts in urine
hypertensions and oliguria

Question 12

types of nephrotic syndrome

Answer 12

minimal change disease
focal segmental glomeruloscloerosis
membranous nephropathy
diabetic nephropathy
amyloidosis

Question 13

types of GN

Answer 13

RPGN or crescentic
a. anti glomerular membrane (goodpastures)
b. immune complex mediated
iga
post strep
diffuse prolif
pauci immune
anca vasculitis

Question 14

iga vasculitis (henoch schloein purpura)

Question 15

PSGN

Answer 15

2-3 weeks following infection
positive ASO
lumpy bumpy - granular deposits

Question 16

diffuse proliferative

Answer 16

most common in lupus
anti dsDNA immune complexes
and ANA
thickening of wall (wire loop)

Question 17

pauci immune

Answer 17

no anti gbm or immue complexes
anca vasculitis
inflam-> fibrosis
ANCA positive
wegeners, churg strauss, microscopic

Question 18

Alport syndrome

Answer 18

defects in type 4 collagen
x linked
triad - hematuria, sensorineural hearing loss, cataracts
lamelation of GBM

Question 19

courvoiser’s law

Answer 19

painless ruq lesion = malignancy until proven otherwise

Question 20

symptoms of afib

Answer 20

fatigue, dizziness, palpitations, chest pain and dyspnea

Question 21

virchow’s triad

Answer 21

blood stasis, hypercoagulabilty and endothelial injury

Question 22

uc

Answer 22

psc

Question 23

MEN (multiple endocrine tumor)

Answer 23

MEN1 -> menin gene
pituatary, parathyroid, pancreas
MEN 2A -> RET
MEN2B -> RET

Question 24

cushings triad

Answer 24

hypertension, bradycardia and irregular respirations

Question 25

monro kelly principle

Question 26

abx for chole

Answer 26

co amoxiclav, pipercillin tazobactam, meropenem, cipro

Question 27

us/ct signs of inflammation

Answer 27

fat stranding, wall thickening, fluid collections

Question 28

DIverticulitis dx

Answer 28

no colonscopy - perforation risk , do ct with contrast