Mock 1 Incorrect Flashcards

1
Q

central vs branched retinal vein occlusion

A

occurs at the optic disc area or behind as this is where the central retinal vein enters

differentiates from branched retinal vein occlusion easily

in branched most vessels appear normal but one branch is obliterated

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2
Q

central retinal artery occlusion

A

see a cherry red spot on the fundoscopy

btw look at these images as you go to remind yourself

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3
Q

what must always be excluded before progressing to water deprvation test in polyuric / dipsic pt?

A

hyperparathyroidism

i.e. check serum calcium not high first

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4
Q

what should be done with CKD patients before giving contrast?

A

volume expansion using sodium chloride 1ml/kg

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5
Q

long lie biggest cause of AKI

A

actually the hypovolaemia not the CK

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6
Q

She describes the episodes as feeling as if the heart stops for a
second followed by a pounding sensation. She reports episodes two to three
times per week lasting 5–10 minutes, most commonly when she is going to sleep

inv normal

A

supraventricular or ventricular ectopics

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7
Q

with COPD patient that has resp acidosis during exacerbation

A

give NIV

i.e. CPAP

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8
Q

treating nosebleeds in A+E

A

Minor bleeding from an accessible site can be treated with cautery using a silver nitrate
stick or electrocautery. Anterior pack is for profuse bleeding with site difficult to localise

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9
Q

managing paralytic ileus initially

A

The initial treatment would involve making
patient nil by mouth and inserting a nasogastric tube. Morphine would make the condition
worse. T

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10
Q

remember this risk factor for pneumothorax and look at an x ray of it

A

COPD/asthma can trigger

look for the lack of lung markings!

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11
Q

common artery that bleeds with peptic ulcers

A

The gastroduodenal artery runs posterior to the first and second parts of the duodenum
and may be a source of major haemorrhage in peptic ulcer disease.

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12
Q

with cachetic weak patients with tumours what is the preferred option to surgical treatment?

A

targetted radiotherapy for palliation

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13
Q

differentiate IgA nephropathy and GN

A

IgA characteristically causes visible haematuria a few days after URTI (post-infectious
GN has lag time of around 2 weeks before haematuria occurs and would be a less benign
presentation if associated with visible haematuria).

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14
Q

classic inflammtory pain story

A

Inflammatory back pain (IBP) is typically improved with activity and not relieved by rest,
as opposed to mechanical pain which is worse with activity and is relieved by rest.

morning stiffness >30mins

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15
Q

most likely area for degeneration first in brain in Alzhiemer’s?

A

temporal lobe

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16
Q

overdose of amitriptyline

A

Bicarbonate is the treatment of the choice in patients with prolonged QRS complexes
following a tricyclic antidepressant overdose.

17
Q

why ACEx for diabetic nephropathy +HTN?

A

There is good evidence for renal function protection in diabetic nephropathy with ACE-1
in addition to its hypertensive properties.

18
Q

amiodarone + SOB inv

A

This is because the patient has pulmonary fibrosis as a complication from amiodarone
therapy. This classically does not cause clubbing. Patients present with cough and
dyspnoea. Fever and reactive blood changes (raised WCC, ESR) are not uncommon. An
HRCT would confirm changes of interstitial lung disease

19
Q

classic delirium tremens

A

The patient has typical features of delerium tremens with confusion, visual hallucinations,
tachycardia and pyrexia on the background of heavy alcohol use. This normally occurs on
reduction or abstinence, which may not be clear from the history.

20
Q

what story is this fairly typical for?

A 61 year old woman is admitted with 2 days of confusion. She has a history
of hypertension and takes nifedipine. She smokes 20 cigarettes per day. She
is confused but has no focal neurological deficit. Her pulse rate is 75 bpm, BP
139/87 mmHg and JVP 2 cm above the sternal angle

A

SIADH
The picture is of syndrome of inappropriate ADH secretion with hyponatraemia and
inappropriately concentrated urine. ADH stimulates synthesis of aquaporin-2 in the apical
membrane of the collecting duct which promotes water absorption. This leads to a
dilutional hyponatraemia.

21
Q

PKD with headache

A

examine
CT
then LP - consdiering subarac

22
Q

this story
A 74 year old man has progressively worsening muscle aches that are now
causing him to struggle to get up from a chair or raise his arms above his
head. H

+ raised ESR =

A

polymyaglia rheumatica
PMR

give preds