Medics Hockey Phase 2a SBA Flashcards by Sameeha Amatal-Haqq

Jerry is a 76 year old man who has been brought to A&E by his husband after he noticed Jerry was unable to walk, had left-sided arm and leg weakness and slurred speech.
Jerry has a past medical history of type 2 diabetes mellitus and hypertension. He also drinks 3 cans of lager per day and has been a smoker for 25 years.

Following some investigations, the doctors diagnose Jerry with an ischaemic stroke. Which of the following vessels is the most likely to have been occluded?

right anterior cerebral artery
left anterior cerebral artery
right middle cerebral artery
left middle cerebral artery
posterior cerebral artery

right middle cerebral artery

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What is the way to remember the 6 steps taken for sepsis?

BUFALO
Blood cultures
Urine output monitoring
Fluids
Antibiotics
Lactate
Oxygen
(Give 3 things, take 3 things)

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What is the correct advise for a metered dose inhaler?

Shake your inhaler before use
Wait 30-60 seconds between puffs
Rinse your mouth after using your inhaler
Breath in slowly and steady for 3-5 seconds until your lungs feel full

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What screening tool would be appropriate to use to aid your diagnosis for major depressive disorder?

PHQ-9

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What is GAD-7 screening tool for?

Generalised anxiety disorder

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What is AUDIT screening tool for?

alcohol dependence

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What is CAGE screening tool for?

alcohol dependence

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What is PDSS screening tool for?

Panic disorder severity scale

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Which cancers commonly metastasise to lung?

Kidney cancer
Breast cancer
Bowel cancer
Prostate cancer

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The four quadrants approach (Jonsen et al 1982) identifies four distinct areas which can be applied to clinical scenarios in order to identify, assess and resolve ethical issues. What are they?

Medical indications
Patient preferences
Quality of life
Contextual features

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What are the TSH and T3, T4 levels for Hashimoto’s thyroiditis?

Primary hypothyroidism
High TSH
Low T3/4

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What are the TSH and T3, T4 levels for secondary hypothyroidism?

Low TSH
Low T3/T4

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What are the TSH and T3, T4 levels for Grave’s disease?

Primary hyperthyroidism
Low TSH
High T3/T4

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What are the TSH and T3, T4 levels for secondary hyperthyroidism?

(pituitary/hypothalamus):
high TSH
high T3/4

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Which pattern recognition receptors (PRRs) is able to detect the flagellin of certain bacteria?

TLR5

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Which pattern recognition receptors (PRRs) is able to detect gram positive bacteria?

TLR2

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Which pattern recognition receptors (PRRs) is able to detect dsRNA virus?

TLR3

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Which pattern recognition receptors (PRRs) is able to detect lipopolysaccharide gram negative bacteria?

TLR4

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Which pattern recognition receptors (PRRs) is able to detect ssRNA virus?

TLR7

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Which pattern recognition receptors (PRRs) is able to detect dsDNA virus?

TLR9

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Which pattern recognition receptors (PRRs) is able to detect C-reactive protein?

CRP

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What is the treatment for diffuse cutaneous systemic sclerosis?

Anti-topoisomerase-1 antibodies (anti-SCL 70)

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what is meant by ‘potentiation’ in regard to 2 drugs being used in conjunction?

the effect of one drug is greater than expected, but the other remains normal

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Which drug class works by inhibiting the 14a-sterol demethylase intermediate in the pathway of cholesterol and ergosterol production?

Azoles

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Which of the following is not a symptom usually associated with ankalosing spondylitis? Achilles and heel pain Red, sore eyes Lower back stiffness Swollen fingers Skin rash

Skin rash

What is the correct order for bloods?

aerobic cultures, anaerobic cultures, U&E, FBC

Which of the following is a cause of type 1 resp failure? Opioid overdose Guillain-Barre syndrome Traumatic spinal cord injury Hypothyroidism Pulmonary embolism

Pulmonary embolism Rest are type 2

What is the first line medication for depression?

selective serotonin reuptake inhibitor

What is the 3rd medication for COPD?

ICS

Which is not a symptom of hyperparathyroidisim? loin to groin severe pain nausea and vomiting constipation muscle weakness parasthesia

parasthesia (hypo)

What is the way to remember risk factors for atrial fibrillation?

SMITH (sepsis, mitral valve pathology, ischaemic heart disease, thyrotoxicosis, hypertension)

What is an appropriate test for a 6 month old baby with low weight, cough, wheeze, cough and prolonged jaundice

CF most likely so sweat test if heel prick test not done then sweat test

Which of the following is not a type of complementary and alternative medicine? Acupuncture Osteopathy Homeopathy Aromatherapy Flexopathy

Flexopathy

What is the treatment for rate control for atrial fibrillation?

Beta-blocker / CCB / digoxin

What is the treatment for rhythm control for atrial fibrillation?

Amiodarone / flecainide

Which area of the heart and coronary artery do leads II, III and avF correspond to?

Inferior and right coronary artery

What fracture is it where the leg is characteristically shortened and externally rotated?

Neck of femur fracture

Describe the pathophysiology behind front-temporal dementia

degeneration of the frontal and temporal lobes due to intracellular collections of tau protein (Pick bodies) and TDP 43

Which HLA genes are associated with coeliac disease?

HLA-DQ2

What scoring systems assesses the severity of the pancreatitis?

Glasgow Severity Assessment Score

What cells are seen in Chronic Lymphoblastic Leukaemia?

Smudge cells

What is a side effect commonly associated with the use of Nifedipine?

Ankle swelling

Which growth medium is most appropriate for culturing a fungal organism?

Sabouraud agar

What is naproxen?

An NSAID

What condition is likely? 56 year old Bill is admitted to EMU with haematemesis and melaena. He previously worked in construction and takes regular medication for back pain. He smokes (1 pack per week) but does not drink alcohol. Blood tests show anaemia (Hb 64)

Upper GI bleed (possibly due to overuse of NSAIDS)

What is the mechanism of pernicious anaemia?

Autoimmune destruction of gastric parietal cells stops the production of intrinsic factor needed for B12 absorption

What is the mnemonic to remember risk factors for acute pancreatitis?

IGETSMASHED Idiopathic Gallstones Ethanol Trauma Steroids use Mumps Autoimmune Scorpion stings Hyperglycaemia ERCP Drugs

What is seen on Xray for ankylosing spondylitis?

squaring of the vertebral bodies subchondral sclerosis syndesmophytes joint fusion

Rhinorrhoea, miosis, ptosis and lacrimation are most associated with what type of headache?

Cluster headache

Which of the following is not a type of primary brain tumour? Astrocytoma Oligodendroglioma Ependymoma Meningioma Ewing sarcoma

Ewing sarcoma

Which drug works by interfering with the synthesis of folic acid?

trimethoprim

What is 1st line treatment for DVT?

DOAC such as rivaroxiban or apixaban

Palpation of the right upper quadrant on inspiration causes severe pain is what sign and positive in what condition?

Murphy's sign Acute cholecystitis

What is the MRC Dyspnoea scale?

0 - breathless with strenuous exercise 1 - short of breath hurrying on level ground or walking up a slight hill 2 - on level ground walking slower than others the same age or having to stop for breath 3 - having to stop after 100 yard or a few minutes for breath 4 - too breathless to leave the house or breathless when dressing/undressing

Which plasmodium parasites causes the most severe type of malaria?

Plasmodium falciparum

Which of the following conditions is not a common cause of diarrhoea? Inflammatory bowel disease Coeliac disease Irritable bowel syndrome Pseudomembranous colitis Diverticulosis

Diverticulosis Usually constipation

What is the treatment for uncomplicated lower urinary tract infection (NO fever, medical history, flank pain etc.)?

Treatment is usually a 3 day prescription of Nitrofurantoin or trimethoprim

Describe the order of asthma treatment

SABA (reliever) eg. salbutamol ICS (preventer) eg. beclometasone +- LTRA eg. montelukast +- LABA (but if using in children then stop LTRA) eg. salmeterol

Patient flexes his wrists his hands begin to move up and down. What is this a sign of?

Decompensated alcohol-related liver disease

Which of the following is not found in an atherosclerotic plaque? Lipids Smooth muscle cells foam cells macrophages plasma cells

Plasma cells

What is the diagnosis for young, chest pain, crunching snow sound on auscultation?

Pericarditis

What is the 1st line treatment for pericarditis?

The treatment for pericarditis is high dose NSAIDs/Aspirin + colchicine

Which of the following is not a symptom of Parkinson's disease? hypomimia resting tremor asymmetrical reduced arm swing cog wheel rigidity chorea

chorea huntington's

Which of the following antibodies is associated with coeliac disease? ADAMTS13 Anti-cyclic citrullinated peptide antibody Anti-nuclear antibody Anti-liver kidney microsomal-1 antibody Tissue Transglutaminase antibody

Tissue Transglutaminase antibody

Which of the following clotting factors is part of the extrinsic pathway in the coagulation cascade? Factor XII Factor IX Factor VIII Factor XI Factor VII

factor 7

Which of the following is not a factor which influences a patient's perception of risk? lack of personal experience with the problem belief that is is preventable by personal action belief that if it has not happened by now it is not likely to belief that the problem is infrequent belief that the problem doesn't affect the patient because they partake in positive health behaviours

belief that the problem doesn't affect the patient because they partake in positive health behaviours

Which of the following hepatitis' is a patient likely at risk from with IV drug use?

Hep A, B and C

Which of the following conditions is not an AIDS-defining illness? Pneumocystis jirovecii pneumonia Cryptococcal meningitis Non-hodgkin lymphoma Cervical cancer Pertussis

Pertussis

What is the diagnosis for severe untreated Addison's disease presents to hospital with palpitations, vomiting and fatigue. An ECG is done which shows hyper acute tented T waves and a wide QRS complex?

Hyperkalemia severe

What is the treatment for severe hyperkalaemia?

insulin (cells take in K+), dextrose, calcium gluconate (protect heart) and salbutamol (shift K+ to intracellular)

What is the diagnosis for the following? 54 year old Jane has come to the diabetic foot clinic as she has noticed some redness and shape change in her left foot. Upon examination, Jane has a 10mm necrotic ulcer on her 3rd distal phalanx, with approximately 5mm redness surrounding it. The doctor decides to x-ray her foot which shows an ill-defined periosteum of the 3rd distal phalanx, significantly different to her x-ray 3 months ago which was normal

Osteomyelitis

What is the most common cause for osteomyelitis?

Staphylococcus Aureus

Which enzyme is responsible for the conversion of purines to uric acid?

xanthane oxidase

What is the diagnosis? drowsy, have a reduced respiratory rate and although conscious are responding very slowly. Their pupils are small and do not change when you shine a pen torch in their eyes. The patient is known to be homeless, and you can see track marks on their forearms

Opioid overdose

What is the treatment for opioid overdose?

Naloxone (opioid antagonist)

What is seen on ECG for DKA

Hyperkalaemia Loss of P waves, wide QRS, tall tented T waves, prolonged PR interval

What are the shapes of Subarachnoid haemorrhage, Subdural haemorrhage and Extradural haemorrhage on CT?

Star Crescent Lentiform

What is the mnemonic to remember congestive heart failure symptoms?

SOB AS FAT SOB ankle swelling fatigue

What is the treatment for congestive HF?

ABAL 1. ACE inhibitor 2. Beta Blocker 3. Aldosterone antagonist 4. Loop diuretic +- hydralazine & isorbide denigrate, digoxin, ivabradine

What is the ABCD2 score for strokes?

Age 60+ 1 BP >140/90 1 Clinical - speech only 1, speech with muscular weakness 2 Diabetes 2, Duration >60mins 2, <60mins 1

How to calculate units of alcohol?

ABV (%) x volume (ml)) / 1000

What is the mnemonic to remember risk factors for osteoporosis?

SHATTERED FAMILY Steroids Hyperparathyroidism/Hyperthyroidism Alcohol The family history Testosterone (low) Early menopause Renal/liver failure Erosive/inflammatory bone disease (RA) Diabetes/vitamin D/dietary calcium BMI (low) Older age No movement Eating disorder Smoking/female Sex Family history