Mock 1 Flashcards

1
Q

What is the initial management of ACS?

A

300mg Aspirin

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2
Q

Describe the pharmacology of spironolactone

A

It inhibits the aldosterone receptor in the distal tubules

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3
Q

Describe the pharmacology of furosemide (loop diuretic)

A

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

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4
Q

Describe the pharmacology of benzoflumethiazide (thiazide diuretic)

A

Inhibition of the sodium chloride transporter in the distal convoluted tubule

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5
Q

Describe the pharmacology of CCBs on the nephron

A

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

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6
Q

What are absent P waves indicative of?

A

AF

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7
Q

What are wide QRS complexes indicative of?

A

Bundle branch blocks

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8
Q

What is used to determine stroke risk after a TIA?

A

ABCD2

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9
Q

What is conn’s syndrome?

A

Hyperaldosteronism

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10
Q

What electrolyte problem does conn’s syndrome cause?

A

Hypokalaemia

Hypernatraemia

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11
Q

What does a low renin and high aldosterone suggest?

A

Primary hyperaldosteronism

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12
Q

What does a high renin and high aldosterone suggest?

A

Secondary hyperaldosteronism

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13
Q

What happens to aldosterone levels in Addisons disease?

A

They decrease

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14
Q

Give 3 symptoms of Cushings

A

Abdominal striae
Moon face
Buffalo hump

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15
Q

Give 3 symptoms of Addisons

A

Hyperpigmentation
Central weight loss
Hypotension

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16
Q

How would you differentiate between central and nephrogenic diabetes insidipidus?

A

Water deprivation test with desmopressin

If urine osmolality changes it is cranial/central

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17
Q

What fasting plasma glucose is diagnostic for DM?

A

More than 7mmol/L

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18
Q

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

A

More than 11mmol/L

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19
Q

What HbA1c is diagnostic for DM?

A

48 +

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20
Q

What is carcinoid syndrome?

A

A paraneoplastic syndrome where neuroendocrine cells produce 5-HT

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21
Q

What are the symptoms of carcinoid syndrome?

A

Flushing
Diarrhoea
Dyspnoea

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22
Q

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

A

IgA TtG or IgA endomysial antibody

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23
Q

What is Rovsing’s sign?

A

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

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24
Q

How would you describe Barrett’s oesophagus?

A

The distal oesophageal epithelium undergoing metaplasia from squamous to columnar

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25
Q

What cells do PPIs act on?

A

Parietal cells - they block H+/K+ ATPase

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26
Q

What do mucous neck cells secrete?

A

Mucus and HCO3-

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27
Q

What do chief cells secrete?

A

Pepsinogen and gastric lipase

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28
Q

What do ECL cells secrete?

A

Histamine

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29
Q

What cells do H2 agonists work on?

A

ECL Cells

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30
Q

What is the gold standard for investigating for renal colic?

A

Non-contrast CT KUB

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31
Q

Give 3 storage symptoms

A

FUN
Frequency
Urgency
Nocturia

32
Q

Give 5 voiding symptoms

A
SHIPP
Straining 
Hestitancy
Incomplete emptying 
Poor stream
Post-micturition dribbling
33
Q

What is a side effect of tamsulosin?

A

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

34
Q

What are 5 causative organisms of UTIs

A
KEEPS
• Klebsiella
• E. Coli – most common
• Enterococcus
• Proteus/pseudomonas
• Staphylococcus saprophyticus
35
Q

What are the 4 cardinal symptoms of nephrotic syndrome?

A

Proteinuria
Hypoalbuminaemia
Peripheral oedema
Hyperlipidaemia/lipiduria

36
Q

What kind of syndrome is minimal change disease?

A

Nephrotic syndrome

37
Q

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

A

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

38
Q

Where on the loop of henle does furosemide act?

A

Ascending limb

39
Q

Describe the epidemiology of HL

A

Bimodal peak in 20s and 60s

40
Q

Describe the epidemiology of Multiple myeloma

A

Affects those aged 70+

41
Q

Describe the epidemiology of Non-HL

A

Tends to present in elderly

42
Q

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

A

CML

43
Q

What is the Ann Arbor Classification?

A

Used in HL and Non-HL

44
Q

What is the gold standard investigation for DVT?

A

Doppler USS

45
Q

What does dark urine suggest?

A

Haemolysis

46
Q

What is the definition of pharmacokinetics?

A

Action of body on drug

47
Q

What is the definition of pharmacodynamics?

A

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

48
Q

Give 3 symptoms of anti-cholinergic drugs

A
They decrease the PS NS so:
Blurred vision 
Confusion
Dry mouth 
Urinary retention
49
Q

What is the mechanism of action for penicillin antibiotics?

A

Bacterial cell wall synthesis inhibition

50
Q

What is the action of quinolone?

A

Interferes with bacterial DNA replication and transcription

51
Q

Before pheochromocytoma surgery what should be given?

A

Phenoxybenzamine

52
Q

What is pseudomembranous colitis a complication of?

A

C.diff infection

53
Q

What does coffee ground vomit indicate?

A

Bleeding in the upper GIT

54
Q

Why is coffee ground vomit NOT seen in gastroenteritis?

A

It causes irritation but not to the extent of GI bleed

55
Q

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

A

Legionnaires

56
Q

Which heart valve is most commonly affected in IE?

A

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

57
Q

How would you describe neisseria meningitidis?

A

Gram negative diplococcus

58
Q

Describe what would be seen microscopically in pseudo gout

A

Positively birefringent rhomboid crystals

59
Q

Describe what would be seen microscopically in gout

A

Negatively birefringent needle crystals

60
Q

What is the mechanism of action for bisphosphonates?

A

Inhibit bone resorption through inhibition of enzymes with reduce osteoclast activity

61
Q

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

A

Colchine

62
Q

What is the most specific investigation for RA?

A

Anti-CCP

63
Q

Describe the appearance of osteoarthritis on Xray

A
LOSS
Loss of joint space 
Osteophytes
Subchondrial sclerosis
Subchondral cysts
64
Q

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

A

They have septic arthritis- joint aspiration and blood cultures

65
Q

What is the first line treatment in ankylosing spondylitis?

A

Physiotherapy and NSAIDs

NOT bed rest - exercise makes it better

66
Q

What is the 1st line treatment for migraines?

A

Ibuprofen

67
Q

What kind of headache is aspirin used to treat?

A

Tension headaches

68
Q

Describe how Duchenne Muscular dystrophy presents and is inherited

A

In males only - X linked recessive

69
Q

What can make MS symptoms worse?

A

HEAT

70
Q

What is the treatment for Guillian-Barre syndrome?

A

IV Immunoglobulins- given to help prevent harmful antibodies damaging nerves

71
Q

Give 4 causes of tension headaches

A

Depression
Lack of sleep
Missed meals
Stress

72
Q

What is the most common cause of pneumonia?

A

Strep. pneumonia

73
Q

What is the immediate treatment for tension pneumothorax?

A

Immediate decompression via large bore cannula

74
Q

What electrolyte imbalance would be seen in sarcoidosis?

A

Hypercalcaemia

75
Q

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

A

Goodpastures syndome

Raised anti-GBM