MedSoc SAQ 1 + Tom's Mock Flashcards
1
Q
gold standard test to diagnose unstable angina
A
angiography
2
Q
extra articular manifestations of ankylosing spondylitis
A
5 A’s:
- anterior uveitis
- autoimmune bowel disease
- apical lung fibrosis
- aortic regurgitation
- amyloidosis
3
Q
what beside test to assess mobility of spine
A
schober’s test
4
Q
describe schobers test
A
- Have the patient stand, locate L5 vertebrae, mark a point 10cm above and 5cm below
- Ask patient to bend over forwards as far
as they can and measure the distance between the two points - distance of less than 20cm => reduced lumbar movement => support And. Spon. diagnosis
5
Q
X-ray finding of ankylosing spondylitis
A
- bamboo spine
- fusion of sacroiliac joint
- squaring of vertebral bodies
6
Q
ankylosing spondylitis treatment
A
- NSAIDS
- steroids (prednisolone) during flare ups
- anti TNF (infliximab)
7
Q
what PEFR is acute/severe asthma
A
33-50%
8
Q
what PEFR is moderate asthma
A
50-75%
9
Q
what is life threatening asthma
A
PEFR below 33%
oxygen sats less than 92%
10
Q
acute sever asthma attack management
A
- SABA (salbutamol)
- oxygen
- systemic corticosteroid (oral prednisolone, IV hydrocortisone)
11
Q
risk factors for migraine
A
- cheese
- OCP
- lack of sleep
- alcohol
- anxiety
- exercise
12
Q
migraine treatment
A
- NSAIDS (Ibuprofen)
- if severe: triptan (almotriptan)
- anti-emetic + hydration
- prophylaxis: Amitriptyline
13
Q
migraine prophylaxis
A
Amitriptyline
14
Q
what type of hypersensitivity reaction is anaphylaxis
A
- type 1 hypersensitivity reaction
- IgE mediated hypersensitivity
15
Q
anaphylaxis management
A
- ABCDE
- position supine + remove trigger
- IM adrenaline
- establish airways + high flow oxy
- IV fluids
16
Q
how does adrenaline work
A
beta adrenergic receptor agonist
17
Q
what antibiotic contraindicated in pregnancy
A
trimethoprim
18
Q
crohns risk factors
A
- white ancestry
- family history
- smoking
- NSAIDS
19
Q
gold standard investigation for IBD
A
- colonoscopy + biopsy
20
Q
in what would you see cobblestone mucosa (histology)
A
crohns disease
21
Q
describe goblet cells in crohns and UC
A
crohns: increase in goblet cells
UC: goblet cell depletion
22
Q
crohns treatment
A
- steroids (oral prednisolone) during flare up
- maintain remission: azathioprine or methotrexate
23
Q
non malignant causes of lymphadenopathy
A
- infection
- sarcoidosis
- SLE
24
Q
which cells are involved with CLL
A
B cells
25
what would CLL FBC look like
- lymphocytosis
- thrombocytopenia
- anaemia
26
what would CLL blood film look like
- smudge/smear cells present
27
CLL complications
- infection
| - transition to NHL
28
cushings syndrome vs cushings disease
Cushing disease (pituitary adenoma) is a specific type of Cushing syndrome
29
cushings presentation
- Mood change
- Acne
- Buffalo hump
- Osteoporosis
- Moon face
- Thinning of skin
- central obesity
- oligomenorrhoea
- abdo striae
30
Cushing's diagnostic test
- brain MRI
- dexamethasone suppression test: cortisol level not suppressed
- abdo CT: could be small cell lung cancer
31
complications of Cushing's
- Bone fractures
- depression and mood changes
- hypertension
- diabetes
32
non pharmacological management for OA
- physiotherapy
- weight loss
- activity/ exercise
- occupational therapy
33
OA pharmacological management
- topical NSAID (diplofenac)
| - oral paracetamol, NSAIDS, opiates
34
what does ABCD2 scoring stand for
```
A: Age >60 (1 point)
B: BP >140/90 (1 point)
C: Clinical features
- Speech disturbance without weakness (1 point)
- OR unilateral weakness (2 points)
D: Duration
- Symptoms 10-59 minutes = 1 point
- Symptoms >60 minutes = 2 points
D: Diabetes mellitus in patient history (1 point)
```
35
ischaemic stroke treatment
thrombolysis - altepase with 4.5 hrs
36
TB risk factors
- exposure to infection
- IVDU
- immunosuppressive drugs
- alcoholic
- HIV infection
37
TB CXR signs
fibronodular opacities in upper lobes
38
first line prophylaxis for migraine
amitriptyline
39
common cause of bacterial meningitis in kids
s. pneumonia
40
investigation used to confirm an allergy
patch test
41
polymyositis symtoms
- struggle to get out of chair
| - affect proximal muscles first
42
polymyositis investigations
- electormyography
| - muscle biopsy
43
in what are heberden's nodes found
OA
44
reiter's triad (fancy terms)
arthritis, conjunctivitis, urethritis
45
in what are syndesmophytes found
ankylosing spondylitis
46
what antibodies found in SLE
anti-double stranded DNA antibodies
47
describe OA pain
- morning stiffness can be present
- wears off much quicker than inflammatory arthritis
- pain typically gets worse with activity
48
NO in relation to B12
causes B12 deficiency (depletes b12)
49
investigation to confirm diagnosis of CLL
Peripheral blood flow cytometry
50
APML associated with what
| AML
blood stuff
- prolonged prothrombin
- prolonged APTT
- low fibrinogen
51
what is Philadelphia chromosome translocation
t9-22
52
what are typical symptoms of sarcoidosis
pulmonary symptoms as predominate (cough, dyspnoea)
53
amyloidosis presentation
fatigue, weight loss, pre orbital purpura
54
amyloidosis investigation
Diagnosis would require tissue biopsy and apple-green birefringenece
55
PRV haemoglobin levels
increased
56
polycythemia vera mutation
JAK2
57
what affects APTT
intrinsic pathway compromised
| increased in haemophilia A and b
58
most common cause of SBO
adhesions
59
what antibodies most specific for coeliac disease
IgA anti-endomysial antibodies
60
what antibodies most sensitive for coeliac disease
IgA tissue-transglutaminase
61
investigation to confirm diverticulitis
Abdominal CT
62
Investigation for bowel cancer (check)
feacal occult blood test
63
what artery affected in posterior duodenal ulcer erosion
gastroduodenal artery
64
most common cause of reactive arthritis
Chlamydia
65
first line treatment for psoriatic arthritis
NSAIDS - Ibuprofen
66
-
-
67
most common cause of septic arthritis (pathogen)
s aureus
68
most common septic arthritis in young, sexual cite
Neisseria Gonorrhoeae
69
most common septic arthritis prosthetic joints
Staphylococcus epidermidis
70
primary hyperparathyroidism cause
| PTH + Calcium levels
cause: parathyroid tumour
PTH: high
Calcium: high
71
secondary hyperparathyroidism cause
| PTH + Calcium levels
cause: low vit D, or CKD
PTH: high
Calcium: low
72
tertiary hyperparathyroidism cause
| PTH + Calcium levels
cause: parathyroid hyperplasia
PTH: high
Calcium: high
phosphate: high
73
heberdens nodes are where and associated with what
- bony swellings at the proximal interphalangeal joints
| - OA
74
what drug to treat Raynauds
Nifedipine
75
how is legionnaire's disease most commonly diagnosed
antigens in urine
76
isoniazid (TB treatment) side effect
Isoniazid depletes B6 causing peripheral neuropathy
77
Which type of hypersensitivity reaction does atopic asthma generally fall into
type 1
78
what is goodpasture's
(also known as anti-glomerular basement membrane disease)
This is an autoimmune disease affecting BM => leading to pulmonary haemorrhage and glomerulonephritis
Think of Goodpasture’s when someone is peeing and coughing blood.
79
tension pneumothorax, where do you put the needle
- 2nd intercostal space MCL just above the rib (intercostal nerves and vessels lie just below each rib)
- left to right doesn't matter (check this!)
80
do BB cause bronchoconstriction or dilation ?
bronchoconstriciton
81
does COPD cause finger clubbing
NO
82
describe what to do with wells score results
>2: DVT likely => compression ultrasound scan
<2: D-dimer test done first
83
what inheritance is haemophilia A + B
x linked
84
normocytic MCV
80-100
85
in what condition is bench jones protein seen in urinary electrophoresis
multiple myeloma
86
when does idiopathic thrombocytopenic purpura usually present
in children following a viral infection
87
ITP treatment
- steroids (prednisolone)
| - if severe: IV immunoglobulin
88
in what are auer rods seen
AML
89
in what are rouleaux aggregations seen
myeloma
90
in what are smudge/smear cells seen
CLL
91
in what are bite cells seen
glucose-6-phosphate dehydrogenase deficiency
92
dormant malaria
Plasmodium vivax and Plasmodium ovale
93
how does B12 deficiency present
fatigue, palpitations, and headaches
| pins and needles
