Mock 1 Incorrect Flashcards
central vs branched retinal vein occlusion
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
central retinal artery occlusion
see a cherry red spot on the fundoscopy
btw look at these images as you go to remind yourself
what must always be excluded before progressing to water deprvation test in polyuric / dipsic pt?
hyperparathyroidism
i.e. check serum calcium not high first
what should be done with CKD patients before giving contrast?
volume expansion using sodium chloride 1ml/kg
long lie biggest cause of AKI
actually the hypovolaemia not the CK
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
supraventricular or ventricular ectopics
with COPD patient that has resp acidosis during exacerbation
give NIV
i.e. CPAP
treating nosebleeds in A+E
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
managing paralytic ileus initially
The initial treatment would involve making
patient nil by mouth and inserting a nasogastric tube. Morphine would make the condition
worse. T
remember this risk factor for pneumothorax and look at an x ray of it
COPD/asthma can trigger
look for the lack of lung markings!
common artery that bleeds with peptic ulcers
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.
with cachetic weak patients with tumours what is the preferred option to surgical treatment?
targetted radiotherapy for palliation
differentiate IgA nephropathy and GN
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).
classic inflammtory pain story
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
most likely area for degeneration first in brain in Alzhiemer’s?
temporal lobe
overdose of amitriptyline
Bicarbonate is the treatment of the choice in patients with prolonged QRS complexes
following a tricyclic antidepressant overdose.
why ACEx for diabetic nephropathy +HTN?
There is good evidence for renal function protection in diabetic nephropathy with ACE-1
in addition to its hypertensive properties.
amiodarone + SOB inv
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
classic delirium tremens
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.
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
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.
PKD with headache
examine
CT
then LP - consdiering subarac
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 =
polymyaglia rheumatica
PMR
give preds
