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My Year 3 Medicine > miscellaneous > Flashcards

miscellaneous Flashcards

1
Q

ECG signs of Hyperkalaemia

A
  • loss of P waves
  • widened QRS complexes
  • tented T waves
  • bradycardia
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2
Q

Normal PR interval on ECG?

A

120-200 ms

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3
Q

Normal QRS complex on ECG

A

<120ms

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4
Q

Causes of Chronic Pancreatitis

A
  • EtOH
  • autoimmune
  • Steroids
  • malnutrition
  • hereditary
  • Trauma or obstruction
  • Recurrent acute pancreatitis
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5
Q

History of Chronic Pancreatitis

A
  • severe pain radiating to the back
  • relieved by sitting forward
  • Weight loss
  • Loss of exocrine function –> steatorrhea
  • Loss of endocrine function –> diabetes
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6
Q

Investigations for Chronic Pancreatitis

A 
NOT amylase (= acute pancreatitis)
Check exocrine function: faecal elastase
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7
Q

Management of Chronic Pancreatitis

A
  1. Pain - analgesia (NSAIDs, opiates)
  2. Endocrine function - if diabetic give insulin
  3. Exocrine function - creon (enzymes)
  4. Give acid suppression: PPI: omeprazole to stop creon deactivation
  5. Coeliac nerve block
  6. Pregabalin
  7. Low fat diet for steatorrhoea (<20g fat a day)
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8
Q

Complications of Chronic Pancreatitis

A
  • pancreatic pseudocyst
  • splenic vein thrombosis
  • obstruction (may need ERCP)
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9
Q

Prognosis of Chronic Pancreatitis

A

High risk of pancreatic Ca

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10
Q

Causes of low phosphate

A
  • malabsorption: vit D
  • Increased PTH (1° hyperparathyroidism)
  • Insulin: drives phosphate into cells
  • Refeeding syndrome (due to insulin secretion when give food)
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11
Q

What is part of a Liver Screen?

A 
Alcohol
Autoimmune: (AMA, ANA, LK;M)
Drugs
Viruses: Hep B, C, A
a-fetoprotein if chronic liver disease
USS to look for obstruction or dilatation 
Metabolic: 
- haemochromatosis (increased ferritin)
- Wilson's: excess copper --> measure caeruloplasmin
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12
Q

Causes of pulmonary hypertension

A 
Chronic lung disease:
- COPD
- fibrosis
R heart:
- mitral stenosis 
Congenital heart disease:
- VSD etc. 
HIV --> causes idiopathic pulmonary hypertension
Sarcoid
Connective tissue disease: SLE
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13
Q

Henoch-Schönlein purpura

A

= small vessel vasculitis
Presents with purpura (non-blanching purple papules due to intradermal bleeding)
There may be glomerulonephritis, arthritis, and abdominal pain (+/- intussusception) which may mimic an acute abdomen.

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14
Q

Porphyrias

A

= heterogenous group of rare diseases caused by various errors of haem biosynthesis

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15
Q

Modifiable cardiovascular risk factors

A 
Alcohol
Blood pressure
Cholesterol (and lipids)
Diabetes/diet
Exercise
Smoking
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16
Q

Non-modifiable cardiovascular risk factors

A 
Age/gender/family history
Myocardial infarction
Rheumatic fever
Claudication
Stroke/TIA
17
Q

Respiratory causes of Clubbing

A 
Lung Ca
Mesothelioma
Fibrosing Alveolitis
Bronchiectasis
Cystic Fibrosis
Empyema
18
Q

Causes of COPD

A

Smoking
Environmental pollutants
Alpha-1-AT deficiency
Occupational exposure (coal minors etc.)

19
Q

X-ray findings of Heart failure

A 
A - alveolar shadowing (Bat wing)
B - Kerley B lines (interstitial oedema)
C - Cardiomegaly
D - upper lobe diversion
E - pleural effusion
20
Q

3 main drugs indicated in heart failure

A

Beta-blockers
ACE inhibitors
Spironolactone

21
Q

Risk factors for jaundice

A 
A - alcohol
B - blood (transfusions, taoos, IVDU, needle stick)
C - coitus 
D - drugs
E - expeditions (travel history)
F - family history
22
Q

What is Courvoisier’s Law?

A

A palpable non-tender gallbladder in the presence of jaundice is unlikely to be caused by gallstones.

23
Q

What are Kayser-Fleischer rings?

A

Caused by Wilson’s disease. Only visible with a slit light.

24
Q

GI systems review

A 
Mouth ulcers, dental problems
Difficulty swallowing (dysphagia)
Odynophagia
Nausea & vomiting
Haematemesis
Indigestion
Heartburn
Abdominal pain
CIBH
Change in colour of stools
25
Q

What is normal serum bilirubin?

A

17 microM

26
Q

What is the bilirubin level of visible jaundice?

A

approximately 35-40 microM

27
Q

Differentials for abdominal distension?

A 
Fat
Foetus
Fluid
Faeces
Flatus
28
Q

What does faecal calprotectin signify?

A

First line test for IBD. Neutrophil marker.

29
Q

In what condition does dermatitis herpetiformis occur?

A

Coeliac.

30
Q

Boas’ sign

A

Sign of pain radiating to back & right scapula. Can be associated with acute cholecystitis or gastric or duodenal disease.

31
Q

What is Murphy’s sign and what does it indicate?

A

Murphy’s sign –> place hand under right costal margin and ask Pt to take deep breath in; if Pt experiences pain and takes sharp breath in then positive.
It indicates acute cholecystitis.

32
Q

3 conditions that cause Rigors

A
  1. Malaria
  2. Ascending cholangitis
  3. Pyelonephritis
33
Q

What is a gallstone ileus?

A

An erosive gallstone causing small bowel obstruction; Inflammation of the gallbladder spreads to duodenum and results in fistula formation. Gallstone can pass through and may lodge in the ileocaecal valve in the terminal ileum & air can pass into the biliary tree.

34
Q

In what condition does pyoderma granulosum occur?

A

UC

35
Q

What are common infective causes of blood in the stool?

A 
C - campylobacter
H - haemorrhagic E. coli
E - entamoeba histolytica
S - salmonella
S - shigella 
Y - Yersinia
36
Q

What are the cardinal signs of bowel obstruction?

A
  1. Distension (5 F’s)
  2. Vomiting
  3. Pain, colicky
  4. Absolute constipation
37
Q

Causes of Intravascular haemolysis

A
  1. Congenital
    - G6PD deficiency
    - Sickle cell disease
    - Thalassaemia
  2. Acquired
    - Artificial heart valves
    - ABO group mismatch
    - DIC
    - Malaria
38
Q

Causes of Extravascular haemolysis

A
  1. Congenital
    - Hereditary spherocytosis
  2. Acquired
    - Autoimmune haemolysis

My Year 3 Medicine (4 decks)

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