Mock 1 Flashcards by Katherine Wostenholme

What is the initial management of ACS?

300mg Aspirin

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Describe the pharmacology of spironolactone

It inhibits the aldosterone receptor in the distal tubules

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Describe the pharmacology of furosemide (loop diuretic)

Inhibition of the sodium/potassium/chloride symporter in the loop of Henle

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Describe the pharmacology of benzoflumethiazide (thiazide diuretic)

Inhibition of the sodium chloride transporter in the distal convoluted tubule

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Describe the pharmacology of CCBs on the nephron

Inhibition of L-type voltage gated calcium channel in the nephron

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What are absent P waves indicative of?

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What are wide QRS complexes indicative of?

Bundle branch blocks

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What is used to determine stroke risk after a TIA?

ABCD2

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What is conn’s syndrome?

Hyperaldosteronism

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What electrolyte problem does conn’s syndrome cause?

Hypokalaemia

Hypernatraemia

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What does a low renin and high aldosterone suggest?

Primary hyperaldosteronism

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What does a high renin and high aldosterone suggest?

Secondary hyperaldosteronism

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What happens to aldosterone levels in Addisons disease?

They decrease

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Give 3 symptoms of Cushings

Abdominal striae
Moon face
Buffalo hump

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Give 3 symptoms of Addisons

Hyperpigmentation
Central weight loss
Hypotension

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How would you differentiate between central and nephrogenic diabetes insidipidus?

Water deprivation test with desmopressin

If urine osmolality changes it is cranial/central

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What fasting plasma glucose is diagnostic for DM?

More than 7mmol/L

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What GTT/random plasma glucose w symptoms is diagnostic for DM?

More than 11mmol/L

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What HbA1c is diagnostic for DM?

48 +

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What is carcinoid syndrome?

A paraneoplastic syndrome where neuroendocrine cells produce 5-HT

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What are the symptoms of carcinoid syndrome?

Flushing
Diarrhoea
Dyspnoea

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What initial test would you order if coeliac disease is suspected?

IgA TtG or IgA endomysial antibody

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What is Rovsing’s sign?

Pain in the right iliac fossa on palpation of the LIF (appendicitis)

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How would you describe Barrett’s oesophagus?

The distal oesophageal epithelium undergoing metaplasia from squamous to columnar

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What cells do PPIs act on?

Parietal cells - they block H+/K+ ATPase

What do mucous neck cells secrete?

Mucus and HCO3-

What do chief cells secrete?

Pepsinogen and gastric lipase

What do ECL cells secrete?

Histamine

What cells do H2 agonists work on?

ECL Cells

What is the gold standard for investigating for renal colic?

Non-contrast CT KUB

Give 3 storage symptoms

FUN Frequency Urgency Nocturia

Give 5 voiding symptoms

``` SHIPP Straining Hestitancy Incomplete emptying Poor stream Post-micturition dribbling ```

What is a side effect of tamsulosin?

It is an alpha 1-adrenergic receptor egoist so can cause postural hypotension

What are 5 causative organisms of UTIs

``` KEEPS • Klebsiella • E. Coli – most common • Enterococcus • Proteus/pseudomonas • Staphylococcus saprophyticus ```

What are the 4 cardinal symptoms of nephrotic syndrome?

Proteinuria Hypoalbuminaemia Peripheral oedema Hyperlipidaemia/lipiduria

What kind of syndrome is minimal change disease?

Nephrotic syndrome

What value are you most concerned about in an AKI patient's U&Es?

Potassium.- AKI can cause hyperkalaemia, which can lead to cardiac arrest

Where on the loop of henle does furosemide act?

Ascending limb

Describe the epidemiology of HL

Bimodal peak in 20s and 60s

Describe the epidemiology of Multiple myeloma

Affects those aged 70+

Describe the epidemiology of Non-HL

Tends to present in elderly

What does the Philadelphia chromosome put you at increased risk of?

CML

What is the Ann Arbor Classification?

Used in HL and Non-HL

What is the gold standard investigation for DVT?

Doppler USS

What does dark urine suggest?

Haemolysis

What is the definition of pharmacokinetics?

Action of body on drug

What is the definition of pharmacodynamics?

Action of drug on body (‘D’ynamics= ‘D’rug)

Give 3 symptoms of anti-cholinergic drugs

``` They decrease the PS NS so: Blurred vision Confusion Dry mouth Urinary retention ```

What is the mechanism of action for penicillin antibiotics?

Bacterial cell wall synthesis inhibition

What is the action of quinolone?

Interferes with bacterial DNA replication and transcription

Before pheochromocytoma surgery what should be given?

Phenoxybenzamine

What is pseudomembranous colitis a complication of?

C.diff infection

What does coffee ground vomit indicate?

Bleeding in the upper GIT

Why is coffee ground vomit NOT seen in gastroenteritis?

It causes irritation but not to the extent of GI bleed

Patient presents w pneumonia symptoms after staying in hotel with bad AC or standing water reservoir - diagnosis?

Legionnaires

Which heart valve is most commonly affected in IE?

Tricuspid - this is the 1st valve encountered after systemic circulation

How would you describe neisseria meningitidis?

Gram negative diplococcus

Describe what would be seen microscopically in pseudo gout

Positively birefringent rhomboid crystals

Describe what would be seen microscopically in gout

Negatively birefringent needle crystals

What is the mechanism of action for bisphosphonates?

Inhibit bone resorption through inhibition of enzymes with reduce osteoclast activity

What could you give a patient having a gout flare up?

Colchine

What is the most specific investigation for RA?

Anti-CCP

Describe the appearance of osteoarthritis on Xray

``` LOSS Loss of joint space Osteophytes Subchondrial sclerosis Subchondral cysts ```

Pt presents with red swollen joint and fever - what is the appropriate management?

They have septic arthritis- joint aspiration and blood cultures

What is the first line treatment in ankylosing spondylitis?

Physiotherapy and NSAIDs NOT bed rest - exercise makes it better

What is the 1st line treatment for migraines?

Ibuprofen

What kind of headache is aspirin used to treat?

Tension headaches

Describe how Duchenne Muscular dystrophy presents and is inherited

In males only - X linked recessive

What can make MS symptoms worse?

HEAT

What is the treatment for Guillian-Barre syndrome?

IV Immunoglobulins- given to help prevent harmful antibodies damaging nerves

Give 4 causes of tension headaches

Depression Lack of sleep Missed meals Stress

What is the most common cause of pneumonia?

Strep. pneumonia

What is the immediate treatment for tension pneumothorax?

Immediate decompression via large bore cannula

What electrolyte imbalance would be seen in sarcoidosis?

Hypercalcaemia

Pt presents with AKI and haemopytsis - diagnosis? What would be seen on bloods?

Goodpastures syndome | Raised anti-GBM

Mock 1 Flashcards

(75 cards)