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Questions from 2a SBA Practice > Mock 3 > Flashcards

Mock 3 Flashcards

1
Q

What is the diagnostic first line investigation for heart failure?

A

Raised NT-proBNP on blood work

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2
Q

What is the gold standard investigation in heart failure?

A

Echocardiogram

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3
Q

What is ejection systolic murmur indicative of?

A

Aortic stenosis

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4
Q

What is pan systolic murmur indicative of?

A

Mitral regurgitation

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5
Q

What are the 5 CXR signs of heart failure?

A 
ABCDE!
Alveolar oedema
Kerley B lines (interstitial oedema)
Cardiomegaly 
Dilated upper lobe vessels
Pleural effusion
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6
Q

What is sawtooth flutter waves seen in?

A

Atrial flutter

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7
Q

What ECG abnormality is characteristic of Wolf-Parkinson-White syndrome?

A

Delta waves

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8
Q

What ECG abnormality is seen in acute pericarditis?

A

Saddle shaped ST segment elevation

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9
Q

A 19-year-old male suddenly collapses whilst playing a football match for his local team. Paramedics arrive rapidly and find him in cardiac arrest and attempt to defibrillate him. His brother who was playing football with him tells you that he’s normally fit and well but for the past few months he had been experiencing some chest pain, palpitations and unexplained syncope. His brother also mentions that their dad died at a young age due to “some heart problems”. What is the most likely cause of this patient’s cardiac arrest?
A. Atrial fibrillation.
B. Aortic stenosis.
C. ST elevation myocardial infarction (STEMI).
D. Non-ST elevation myocardial infarction (NSTEMI).
E. Hypertrophic cardiomyopathy.

A

Hypertrophic cardiomyopathy

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10
Q

Give 3 types of cardiomyopathy

A
  1. Dilated
  2. Hypertrophic
  3. Restrictive
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11
Q

What are U waves seen in?

A

Hypokalaemia

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12
Q

What are 4 ECG abnormalities seen in hyperkalaemia?

A
  1. Absent P waves
  2. Long PR interval
  3. Wide QRS complex
  4. Tall tented T waves

(Go, go long, go wide, go tall = gonner)

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13
Q

What is the treatment goal in hypertension?

A

140/90

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14
Q

Are patients warm or cold in septic shock?

A

Warm

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15
Q

Describe heart rate in septic shock

A

Tachycardic

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16
Q

Describe heart rate in cardiogenic shock

A

Bradycardic

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17
Q

What kind of shock is a bounding pulse seen in?

A

Septic shock

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18
Q

What kind of pain is aortic dissection described as?

A

Tearing/shearing that goes to the back - also characteristic of AAA (MEDICAL EMERGENCY)

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19
Q

What kind of chest pain is seen in acute pericarditis?

A

Sharp, pleuritic chest pain that is worse on lying down and better when leaning forwards

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20
Q 
An 84-year old gentleman is rushed into A&E with sudden onset epigastric pain which radiates to the back. Vital signs: HR: 112, BP: 92/63, RR: 36, O2: 89%, Temperature: 37C. His hands are cold and clammy. What investigation is it important to do first?
A. Chest Xray
B. Coagulation screen
C. MRI
D. TroponinI
E. Ultrasound scan
A

Ultrasound scan

His vital signs suggest shock and an USS of an aorta would be used to exclude an AAA that would need immediate surgery

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21
Q

What are the typical symptoms of Graves’ ophthalmology?

A

Diplopia and eye pain

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22
Q

What is the gold standard test for acromegaly?

A

IGF-1 Test

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23
Q

What does IGF-1 do?

A

Stimulate skeletal and soft tissue growth

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24
Q

What is the number one cause of secondary hypoadrenalism?

A

Long term corticosteroid use

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25
Q

What test is diagnostic for Addison’s disease?

A

Synacthen Test - an infusion of ACTH

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26
Q

Describe the electrolyte imbalance seen in SIADH

A

Hyponatremia

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27
Q

What are carcinoid tumours?

A

Tumours of enterochromaffin cells

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28
Q

What is the immediate management for a patient with suspected carcinoid syndrome?

A

Somatostatin analogue

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29
Q

Give 3 symptoms of hypocalcaemia

A

Paraesthesia of extremities
Wrist flexion on BP cuff inflation
Facial twitching when tapping facial nerve

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30
Q

What is faecal calprotectin used to differentiate between?

A

IBS (normal) and IBD (raised)

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31
Q

What is angular stomatitis?

A

Soreness at corners of lips

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32
Q

Give 4 symptoms of coeliac disease

A

Weight loss
Steatorrhea
Mouth ulcers
Angular stomatitis

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33
Q

What is the most common cause of small bowel obstruction?

A

Surgical adhesions

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34
Q

What is the most common cause of large bowel obstruction?

A

Malignant tumours

35
Q

What would an enlarged Virchow’s (left supraclavicular) node suggest?

A

Gastric cancer

36
Q

Give an example of a drug used to treat Mild UC

A

Mesalazine

37
Q

What is used to treat severe UC?

A

IV Hydrocortisone

38
Q

What kind of anaemia does chronic disease cause?

A

Normocytic/microcytic

39
Q

What disease is auer rods seen in?

40
Q

Describe the WCC in AML/ALL

41
Q

What are bite cells characteristic of?

A

G6PD Deficiency

42
Q

What does MGUS predispose a pt to develop?

43
Q

Describe the WCC in Hodgkin’s

44
Q

What are bench jones proteins and rouleaux formation seen in?

45
Q

Give 4 features/complications of Polycthaemia Vera Ruba

A

Dizziness
Itching
Haemorrhage
Thrombosis

46
Q

What is PCV?

A

A condition where the bone marrow overproduces blood cells - usually due to a JAK2 mutation

47
Q

Where is kussmaul breathing seen?

A

DKA

It is deep laboured breathing - a form of hyperventilation to get rid of CO2 in the blood

48
Q

What is asterixis?

A

A jerking movement of the hand that occurs when the arms are outstretched and wrists extended (cocked back towards the face), it is more commonly known as liver flap and can be seen in liver or type 2 respiratory failure.

49
Q

What is painless jaundice characteristic with stool and urine abnormality of?

A

Cancer of the pancreatic head

50
Q

What kind of cancer does benzene exposure have a risk of?

A

Renal cell carcinoma

51
Q

What is the mode of inheritance for alpha-1 antitrypsin deficiency?

A

Autosomal recessive

52
Q

What disease is associated with rice water stools?

53
Q

What is the best treatment for patients with profuse diarrhoea?

A

Rehydration with IV Fluids

54
Q

What does campylobacter jejune cause ?

A

Bloody diarrhoea

55
Q

What presents with jaundice, fatigue, joint pain, frequency and erectile dysfunction?

A

Haemochromatosis

56
Q

What is the gold standard investigation for Wilson’s disease?

A

Liver biopsy

57
Q

What is immediately given to patients with suspected meningococcal septicaemia?

A

Benzylpenicillin

58
Q

What is the classical triad of presentation of encephalitis?

A

Fever, altered mental state, headache

59
Q

What is given in hospital for encephalitis?

60
Q

Describe the 5 stages of the MRC dyspnoea scale

A

Grade 1: Breathless with strenuous exercise.
Grade 2: Short of breath when hurrying or when walking up hill.
Grade 3: Walks slower than people of the same age or stops for breath when walking at own pace on flat.
Grade 4: Stops for breath after walking 100m on flat.
Grade 5: Too breathless to leave the house/ Breathlessness on changing clothes.

61
Q

What is seen in Wegner’s granulomatosis?

62
Q

Describe COPD management pharmacologically

A

1) SABA / SAMA
2) *If steroid responsive/asthmatic = Add LABA + ICS
2) *If not steroid responsive / non-asthmatic= Add LABA + LAMA
3) Oral theophylline
4) Long term oxygen therapy

63
Q

What is diagnostic for sarcoidosis?

A

Tissue biopsy showing non-caseating granuloma

64
Q

What is a common cause of extradural haemorrhage?

A

Trauma to the temple causing a tear in the middle meningeal artery

65
Q

What is seen on CT in extradural haemorrhage?

A

Lens shaped/ lentiform / bi-convex haematoma

66
Q

What are the symptoms of a migraine?

A 
POUND
Pulsating 
Onset 4-72 hrs
Unilateral 
Neurological signs (photophobia)
Disabling
67
Q

Describe how a subarachnoid haemorrhage presents

A

THUNDERCLAP HEADACHE
Meningism
Severe
Occipital

68
Q

What is the most common cause of a subarachnoid haemorrhage?

A

Berry aneurysm rupture due to PKD

69
Q

How would you investigate for SAH?

A

CT head that would be normal, then lumbar puncture AFTER 12 HOURS looking for xanthochromia

70
Q

Who is at risk of a subdural haemorrhage?

A

Elderly
Alcoholics
Those on anti-coagulation or anti-platelets

71
Q

What would be seen on CT in subdural haemorrhage?

A

Sickle-shaped / crescent shaped haemotoma

72
Q

What is a jacksonian motor seizure/ Jacksonian march?

A

A feature of frontal lobe seizure with proximal spread of clonic jerking spreading from finger/toe/corner of mouth

73
Q

What kind of seizure does this symptom set describe?
Jacksonian march
Post-ictal Todd’s paralysis/weakness
Head/leg movements

A

Frontal lobe

74
Q

What kind of seizure does this symptom set describe?

Floaters/flashes in eyes

A

Occipital lobe

75
Q

What kind of seizure does this symptom set describe?

Paraesthesia and non specific sensory symptoms

A

Parietal lobe

76
Q

What kind of seizure does this symptom set describe?
Pre-seizure - aura (hallucinations, epigastric rising, emotional)
Seizure - automatisms e.g. chewing and picking at clothes
Post-ictal confusion

A

Temporal lobe

77
Q

Stroke of what artery caused “Locked in” syndrome?

A

Basilar artery

78
Q

In anterior circulation stroke, which side is affected?

A

THE OPPOSITE SIDE

79
Q

Describe the symptoms of left anterior cerebral artery stroke

A

Right sided hemiparesis/sensory loss

Usually lower limbs

80
Q

Describe the symptoms of a left MCA stroke

A 
Right sided weakness/sensory loss
Usually affects upper limbs 
Facial weakness with forehead sparing 
Right sided homonymous hemianopia 
Dysphasia due to dominant side affected
81
Q

Why is dysphasia not seen in right MCA stroke?

A

The left lobe is dominant

82
Q

What is Brown-Sequard syndrome?

A

Lateral hemisection of the spinal cord

83
Q

What are the features of Brown-Sequard syndrome?

A

Ipsilateral weakness and loss of proprioception and vibration

Contralateral loss of pain and temperature

Questions from 2a SBA Practice (3 decks)

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