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Mock PTS 1 Flashcards

1
Q

What is the Management for MI

A
  • use of GTN spray
  • administer O2 (only if hypoxaemic, pulmonary oedema or continuing myocardial ischaemia)
  • analgesia- (e.g morphine and a co-prescribed antiemetic),
  • dual antiplatelet therapy (aspirin and clopidogrel/ticagrelor)
  • restore patency to occluded artery (PCI or thrombolytic drug).
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2
Q

what drug class is this. name example.

Inhibition of aldosterone receptor in the distal tubules

A

potassium sparing diuretic

spironolactone

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3
Q

what drug class is this. name example.

inhibition of cyclooxyrgenase enzyme in the proximal tubule

A

aspirin

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4
Q

what drug class is this. name example.

inhibition of L-type voltage gated calcium channels in the nephron

A

CCB

amlodipine

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5
Q

what drug class is this. name example.

Inhibition of sodium chloride transporter in the distal convoluted tubule

A

thiazide like diuretic

bendroflumethiozide

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6
Q

what drug class is this. name example.

inhibition of sodium/potassium/chloride symporter in loop of Henle

A

loop diuretic

furosemide

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7
Q

what would aortic stenosis present with

and what would be hear on auscultation

A

Aortic stenosis would present with syncope and angina, and on auscultation an ejection systolic murmur would be heard

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8
Q

what would aortic regurgitation present with and what would be heard on auscultation

A

Aortic regurgitation would present with symptoms to similar symptoms as aortic stenosis (syncope and angina), with an early diastolic/Austin Flint murmur heard on auscultation

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9
Q

how would tricuspid regurgitation be heard

A

Tricuspid regurgitation may present with signs of right-sided heart failure, this pansystolic murmur is not heard at the apex but at the left lower sternal edge.

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10
Q

What are common MI ECG changes

A

Myocardial infarction ECG changes include:

  • ST elevation
  • ST depression
  • T wave inversion
  • abnormal Q wave
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11
Q

name conditions where absent T waves are commonly seen

A

Absent P waves are typically seen in SVT, atrial fibrillation, atrial flutter

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12
Q

what are tall tented T waves characteristic of

A

hyperkalaemia

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13
Q

When are wide QRS complexes commonly seen ?

A

patients with bundle branch blocks

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14
Q

a blood pressure over what requires pharmacological intervention

A

135/85

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15
Q

Caucasian under 55. what antihypertensive drug ?

contraindicated to it? then what?

A

ACEI - ramapril

if contraindicated, ARB: losartan

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16
Q

what does cor pulmonate present with

A

sob

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17
Q

what does LBBB present with

A

usually asymptomatic

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18
Q

what is used to determine stroke risk after a TIA

A

ABCD2

  • Age (>60)
  • BP (>140/90)
  • clinical features (speech disturbance, unilateral weakness)
  • Duration of TIA
  • Diabetes
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19
Q

What is used to calculate stroke risk in patients with AF

A

CHA2DS2-VASc

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20
Q

what is used to determine the risk of DVT or PE

A

wells score

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21
Q

what is conns disease

A

primary hyperaldosteroinism: adrenal adenoma => stimulate adrenal to secrete increased aldosterone

(low renin, high aldosterone)

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22
Q

does aldosterone increase or decrease potassium excretion

A

increase

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23
Q

what is Addisons disease

A

primary adrenal insufficiency: adrenal glands damaged => decreased aldosterone + decreased cortisol (usually autoimmune)

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24
Q

how does Addisons usually present

A

lean, tanned, tired, tearful, hypotension

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25
Q

what would be result of OGTT in suspected diabetic

A
  • fasting glucose levels to be above 7mmol/mol

- 2hr GTT levels to be more than 11mmol/mol

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26
Q

Hypercalcaemia presentation

A
  • stones, moans, groans, bones, thrones
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27
Q

3 symptoms of carcinoid syndrome

A

cardiac involvement, diarrhoea, flushing

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28
Q

what investigation is faecal calprotectin for

A

IBD

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29
Q

what investigation for coeliac

A

IgA tissue transglutaminase or endomysial antibody

IgA-tTGA or EMA are specific for Coeliac disease
duodenal biopsy

30
Q

4 signs of appendicitis

A

tachycardic with a raised temperature, guarding and with rebound tenderness

31
Q

what is rovsings sign and what is it a sign of ?

A

Pain in the right iliac fossa on palpation of the left is called Rovsing’s sign.

  • acute appendicitis
32
Q

would you see diarrhoea or constipation in coeliacs disease ?

A

diarrhoea. would expect to see any constipation

33
Q

how do you diagnose h pylori (2 ways)

A
  • Carbon-13 urea breath test

- stool antigen test

34
Q

what do g cells do

A

secrete gastrin which stimulates gastric acid secretion

35
Q

what do chief cells secrete

A

pepsinogen

36
Q

adverse effect of Contrast CT

A

anaphylactic reaction

37
Q

what is the most common composition of renal stones

A

calcium oxalate (75% of cases)

38
Q

man is a painter. what cancer he got?

A

bladder

39
Q

common causes of UTIs

A

KEEPS

  • Klebsiella pneumoniae
  • E. coli
  • Enterococcus
  • Proteus
  • Staphylococcus saprophyticus
40
Q

is minimal change disease nephritic or nephrotic

A

nephrotic

41
Q

AKI has what effect on K

A

can’t excrete potassium => hyperkalaemia => cardiac arrest

42
Q

where do potassium sparing diuretics usually act

A

collecting tubule

43
Q

which haematological disorder has pain when drinking alcohol

A

Hodgkins lymphoma

44
Q

in what are auer rods found

A

acute myeloid leukaemia

45
Q

gold standar investigation for DVT

A

doppler USS

46
Q

would urine be dark due to increased RBC haemolytic

A

yes. because liver can’t keep up => jaundice

47
Q

define pharmacodynamics

A

action of drug on body (Dynamic = Drug)

48
Q

define pharmacokinetics

A

action of body on the drug

49
Q

what is the mechanism of action for penicillin antibiotics

A

inhibits bacterial cell wall synthesis

50
Q

medication to treat heroin addiction

A

methadone

51
Q

management for phaechromocytoma

A

alpha blockers (phenoxybenzamine)

52
Q

what does c diff. cause

A

local inflammation of large intestine => significant diarrhoea

53
Q

what does coffee ground vomit indicate

A

upper GI bleed

not gastroenteritis

54
Q

TB treatment

plus side effects

A
  • Rifampicin: Red/orange discolouration of secretions (urine + tears)
  • Isoniazid: Peripheral neuropathy
  • Pyrazinamide: High uric acid levels→gout;
  • Ethambutol: Colour blindness + reduced visual acuity (EYE-thambutol)
55
Q

which heart valve is most commonly affected in infective endocarditis

A

tricuspid (blood returning from systemic circulation)

56
Q

most common cause of bacterial pneumonia

A

streptococcus pneumoniae

57
Q

what does CURB65 stand for

A
  • Confusion
  • Urea > 7mmol/L (HIGH)
  • Resp rate >30/min (HIGH)
  • BP (Sys <90mmHg, Dia <60mmHg) (LOW)
  • over 65
58
Q

in what disease are Bouchard nodules seen

A

osteoarthritis

59
Q

first line treatment for osteoporosis

A
  • Alendronic acid (oral bisphosphonate)

- AdCal (vit D and calcium supplement)

60
Q

second line treatment for osteoporosis

A
  • introduction of Denosumab (monoclonal antibody to RANK ligand). This inhibits osteoclast activity and bone resorption
61
Q

how do bisphosphonates work

A

enzyme inhibition which reduces osteoclast activity

62
Q

gout management. acute and ongoing

A

aCute= aColchincine. Long term= allopuri-long (alopurinol)

63
Q

which investigation is best for confirmed diagnosis of RA?

A

anti-CCP

64
Q

what is osteoarthritis appearance on X-ray

A

LOSS

  • Loss of joint space
  • Osteophytes
  • Subchondral sclerosis
  • Subchondral cysts
65
Q

first line treatment for migraine

A

NSAID

66
Q

treatment for Gillian barre syndrome

A

IV immunoglobulin – contains antibodies. Given to help prevent harmful antibodies damage your
nerves

67
Q

causes of tension head ache

A

not dehydration !

  • depression
  • lack of sleep
  • missed meals
  • stress
68
Q

what type of pathogen is chicken pox

A

Chickenpox is a highly contagious illness caused by the varicella-zoster virus (VZV), a type of herpes virus

69
Q

which pneumonia is most typically associated with AIDs

A

pneumocystis jirovecii

70
Q

treatment for PE

A
  • DOAC (apixaban)

Thrombolysis (streptokinase) is reserved for massive PE, with haemodynamic compromise

71
Q

what’s another term for Ach receptor

A

muscarinic

72
Q

what’s in the 6 in 1 vaccine

A

diphtheria, tetanus, pertussis, polio, Hib and Hepatitis B

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