Medsoc SAQ 2

Question 1

What does the modified Duke criteria require for a diagnosis of infective endocarditis

Answer 1

One of the following:
- 2 major criteria met
- 1 major, 3 minor criteria met
- 5 minor criteria met

Question 2

Give 3 factors of the major criteria in Duke’s criteria

Answer 2

• 2 +ve blood cultures
  Endocardial involvement:
• Endocardial vegetations
• New valvular regurgitations

Question 3

Give 4 factors of the minor criteria for Duke’s

Answer 3

• Predisposing heart condition or IVDU
• Fever >38
• Immunological phenomena - peripheral stigmata, glomerulonephritis or RF
• Vascular abnormalities - arterial/ septic emboli

Question 4

What is the Glasgow Blatchford score

Answer 4

Used to risk stratify patients with an upper GI bleed

Question 5

Give 4 factors that are taken into account in the Glasgow Blatchford score

Answer 5

• Urea
• Hb
• Gender
• Tachycardia

Question 6

Treatment for an oesophageal tear with persistent bleeding

Answer 6

• Upper GI endoscopy with one of the following:
  Mechanical - clipping +/- adrenaline
  Thermal coagulation + adrenaline
• High dose IV PPi (omeprazole) post-op

Question 7

4 substances that urinary tract stones can be formed by

Answer 7

Cholesterol
Calcium
Uric acid
Bilirubin

Question 8

Name 3 anatomical areas where urolithiases are likely to become stuck within the urinary tract

Answer 8

• Ureteropelvic junction
• ureteral crossing of iliac vessels
• ureterovesical junction

Question 9

3 SEs of bisphosphonates

Answer 9

Oesophagitis
Osteonecrosis of jaw
Oesophageal ulcers

Question 10

RFs of osteoporosis

Answer 10

Steroids
Hyperthyroidism/ HyperPTH
Alcohol and tobacco
Thin (BMI <18.5)
Testosterone low
Early menopause
Renal/ liver failure
Erosive/ inflammatory bone disease - RA, myeloma
Dietary - T1DM, malabsorption

Question 11

3 signs seen on CXR in aortic stenosis

Answer 11

Cardiomegaly
Dilated ascending aorta
Calcification of aortic valve

Question 12

Give 4 symptoms of septic infection

Answer 12

Fever
Night sweats
Weight loss
Anaemia

Question 13

3 ways legionella pneumophila can be caught

Answer 13

Air conditioning systems
Humidifiers
Spa pools and hot tubs

Question 14

Cause of brown-sequard syndrome

Answer 14

Lateral hemisection of the spinal cord usually caused by trauma

Question 15

Features of brown-sequard syndrome

Answer 15

Ipsilateral weakness below lesion
Ipsilateral loss of proprioception and vibration sensation
Contralateral loss of pain and temperature sensation

Question 16

Spinal cord responsible for pain and temperature and location of decussations

Answer 16

Lateral spinothalamic tract
Ascending tract that decussates in the spinal cord

Question 17

Spinal cord responsible for fine touch, vibration and proprioception

Answer 17

Dorsal column-medial lemniscus
Decussates in medulla oblongata

Question 18

Cushing’s triad

Answer 18

widened pulse pressure (increasing systolic, decreasing diastolic)
bradycardia
irregular respirations

Question 19

SEs of glucocorticoids (eg prednisolone)

Answer 19

Impaired glucose regulation
Cushing’s
Osteoporosis
Weight gain

Question 20

SE of mineralcorticoids

Answer 20

Fluid retention
HTN