- lower oesophageal sphincter fails to open during swallowing causing a back-up of food into the oesophagus - peristalsis is reduced, which is needed to pass food down along the oesophagus, this often results in the food being brought back up

Mock PTS 2 Flashcards by Olivia Chrisp

what is in CHADS-VASc?

and what’s it for?

Congestive Heart Failure
Hypertension
Age (75+=2)
Diabetes
Stroke/ TIA/ Thromboembolism
Vascular disease
Age (65-74)
Sex category (female=1)

risk of stroke following AF

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what kind of pulse associated with atrial fibrillation

irregularly irregular

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what is pulses paradoxus

BP drops significantly during inspiration, seen in severe Asthma, COPD, blood loss and cardiac conditions.

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describe murmur

aortic stenosis

ejection systolic crescendo decrescendo murmur (and a slow rising, narrow pulse pressure), heard loudest on expiration

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describe murmur

Aortic regurgitation

early diastolic decrescendo murmur (and a collapsing pulse)

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describe murmur

Mitral regurgitation

apical pansystolic murmur.

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describe murmur

mitral stenosis

apical mid diastolic rumble

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describe murmur

Pulmonary stenosis

ejection systolic murmur heard loudest on inspiration

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3 cardinal signs of heart failure

sob, fatigue, ankle oedema

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other (not cardinal) signs of HF

cold peripheries, raised JVP, hypotension, cyanosis, oedema and increased weight

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explain MaRRoW on ECG

Right bundle branch block
- The first letter is M so lead 1 has a complex
resembling an M (R wave)
- 6th letter is W so lead 6 has a complex resembling a W (Slurred S wave).

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what BP reading is stage 1 Hypertension

> 140/90

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what BP reading is stage 2 Hypertension

> 160/100

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what coeliac poo like

pale smelly stools that are hard to flush away.

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crohns pain distribution

right side of abdo (usually)

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UC pain distribution

lower left quadrant of abdo

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what used to treat UC

Sulfasalazine (aminosalicylates)

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how does mucosal ischaemia cause peptic ulcers

stomach cells not supplied with enough oxygen => die + don’t produce mucin => gastric acid attack those cells => cells die and ulcer formation

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treatment for H. pylori infection

clarithromycin/metronidazole
amoxicillin
PPI (omeprazole/lansoprazole)

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first line investigation when expected bowel obstruction

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what is achalasia

lower oesophageal sphincter fails to open during swallowing causing a back-up of food into the oesophagus
peristalsis is reduced, which is needed to pass food down along the oesophagus, this often results in the food being brought back up

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describe duodenal ulcer pain with regards to eating

they cause pain several hours after eating and the pain gets better when eating

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male:female ratios of crohns and UC

UC: equal
crohns: female skewed

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which has a stronger genetic link. crohns or UC ?

crohns

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what is Dermatitis Herpetiformis

associated with coeliac itchy bumps immunological response to gluten which manifests in the skin

gold standard investigation for bowel cancer

colonoscopy

where are most colon cancers found

distal colon

diverticula risk factors

not alcohol ! - low fibre diet - obesity - NSAIDS - Smoking

most common cause of AKI

acute tubular necrosis

is hyper or hypovolaemia more likely to cause AKI

hypo

most common cause of pyelonephritis what pathogen

E. coli

first line Abx for pregnant woman with UTI

Nitrofurantoin (7 days)

what is reiters syndrome

can't pee, see or climb a tree => reactive arthritis

what pathogen can only cats pass on

Toxoplasma gondii

TTP treatment + don't to what

plasma exchange treat asap without without diagnostic confirmation - medical emergency ! don't give platelets !

treatment of polycythaemia rubra vera

- phlebotomy | - low dose aspirin

what is FRAX score

gives 10 year probability of fracture

what is HAS-BLED score

Estimates risk of major bleeding for patients on anticoagulation to assess risk-benefit in atrial fibrillation care

what is protein target of rituximab

CD20 (only found on B cells)

what cancers is rituximab used to treat

NHL, CLL

first line treatment for severe/complicated malaria

IV artesunate

what is Rhabdomyoma

Benign striated muscle neoplasm

what is Leiomyoma

Benign smooth muscle neoplasm

what is Leiomyosarcoma

Malignant smooth muscle neoplasm

what is Rhabdomyosarcoma

Malignant striated muscle neoplasm

describe barrets oesophagus metaplasia

oesophageal stratified squamous cells => SIMPLE columnar cells

what Budd-Chiari syndrome

condition involving an obstruction of the Hepatic vein via either a tumour or a thrombus => Hepatic ischaemia => liver failure

first line pharmaceutical treatment for paracetamol overdose

N-acetyl cysteine

what is very elevated amylase suggestive of

acute pancreatitis

wants chariots triad associated with

ascending cholangitis

describe BMI ranges

normal: 18.5 - 24.9 overweight: 25.0—29.9 obese: 30+

1st line treatment of withdrawal seizures

chlordiazepoxide

wernicke's encephalopathy is caused by deficiency in what vitamin

B1 (thiamine)

what is alendronic acid | + SE

- bisphosphonates | - oesophagitis

periarticular erosions seen on x ray. What condition is this?

gout

what seen on x ray in psoriatic arthritis

pencil in cup

first line management for ankylosing spondylitis if severe?

NSAID Infliximab, alongside other DMARDs and anti-TNF drugs

how does pseuodgout present

mono arthritis (usually knee), low grade fever

first thing to do with suspected stroke ?

CT imaging of head

adult patients with acute ischaemic stoke should revise alteplase treatment within what time after onset of their symptoms

<4.5 hours

most common cause of infective exacerbation of COPD

haemophilus influenza

what asthma treatment can cause fine tremor

salbutamol (short acting beta agonist)

what lung cancer most commonly seen in non-smokers

adenocarcinoma

which lung cancer associated with asbestos

mesothelioma

which lung cancer associated with asbestos

mesothelioma

normal HR

60-100 bpm

normal RR

12 - 20 (maybe a bit less)

temp over what is a fever

38 degrees Celsius

oxygen saturation below what is sever asthma

<92% | 92-97 % is moderate

what low BP

<90/60mmHg

what lung disease can alpha-1-antitrypsin disease cause

COPD

which gene mutated in CF

Transmembrane Conductance Regulator (CFTR)

what does CF gene mutation do

causing dysregulation of salt and fluid movement across cell membranes, this leads to really thickened secretions, affecting the respiratory, GI and reproductive systems

what is the most common type of lung cancer

adenocarcinoma

in bronchiectasis, what is common finding on CT

signet ring sign

common cause of HAP

Pseudomonas aeruginosa

describe typical person for spontaneous pneumothorax

Young males with a low BMI | marfans

what is site for needle thoracotomy to treat pneumothorax

A needle thoracostomy goes in the 2nd intercostal space, midclavicular line on the same side as the pneumothorax