Mock PTS 3 Flashcards by Olivia Chrisp

STEMI management

within what time frame must PCI be done

within 2 hours of onset

- PCI is first line treatment for STEMI if it can be performed within 2 hours of onset

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STEMI management
if PCI no possible then what
+ time frame

fibrinolysis with IV Tenecteplase is done

- this should be within 12 hours

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first line diagnostic investigation for HF

NT-proBNP

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gold standard investigation for diagnosing HF

Echocardiogram

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chest x ray signs of HF

ABCDE
A: alveolar oedema
B: Kerley B lines
C: Cardiomegaly 
D: Dilated upper lobe vessels
E: pleural effusion

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QRisk3

what this for ?

10-year probability of CV event

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Modified Duke Criteria

what this for ?

Infective endocarditis criteria

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gold standard for diagnosing valvular disease

echocardiogram

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ECG
Sawtooth flutter waves
what is it

atrial flutter

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ECG changes associated with AF

Absent P waves
narrow QRS
irregularly irregular ventricular rhythm

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what is Kusmall breaths

what is it a sign of

deep, rapid breathing pattern

hyperventilation meant to get rid of carbon dioxide in the blood (seen in DKA)

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ECG changes of hyperkalaemia

Absent P, Long PR interval, Wide QRS, Tall Tented T waves (Go, Go long, Go wide, Go tall= Gonner)

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ECG changes of hypokalaemia

U waves

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name the Cardiomyopathy types

dilated
restrictive
hypertrophic

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postural hypertension diagnosis

systolic drop >20mmHg
OR
systolic BP drops to less than 90 (from any original starting point)

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pyrexia meaning

a rise in the temperature of the body; frequently a symptom of infection

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what kind of pain does pericarditis present with

sharp pleuritic chest pain

- worse on lying down and relieved by leaning forwards

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abdominal aortic aneurysm investigation

Urgent imaging

bedside aortic ultrasound
CT angiography (CTA) is required

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gold standard test for acromegaly

oral glucose tolerance test (OGTT)

increased glucose should suppress in GH in healthy individual

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most common cause of secondary hypoadrenalism

long term corticosteroid usage

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investigation for Addisons

short synacthen test (ACTH stimulation test)

administer synacthen (artificial ACTH) => if cortisol level fails to rise => primary insufficiency (Addisons)

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carcinoid syndrome presentation

flushing and diarrhoea, cardio involvement

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carcinoid syndrome treatment

somatostatin analogue (octreotide)

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gold standard investigation for crohns disease

colonoscopy + mucosal biopsy

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most common cause of SBO

surgical adhesions

what is Enlarged Virchow’s node commonly associated with

gastric cancer

first line treatment for mild UC

Mesalazine (aminosalicylate)

what is the most common leukaemia of adults

AML

in what condition are Roth spots found

infective endocarditis

HL WCC ?

can be high or low (counter intuitive but true)

major risk factors for DVT

- Trauma - immobility - surgery - malignancy

in what are Heinz bodies seen

G6PD deficiency

acute pancreatitis presentation

- sudden-onset mid-epigastric or left upper quadrant abdominal pain, which often radiates to the back (severe pain) - Nausea and vomiting

what is benzene exposure a risk factor for ?

renal cell carcinoma

gold standar investigaiton to diagnose Wilsons disease

Liver biopsy

a1-antitrypsin deficiency inheritance

autosomal recessive

what virus most likely to be young children

rotavirus

what virus most likely to be in care home resident

noravirus

what kind of diarrhoea does Campylobacter jejuni cause

bloody

Haemohromatosis inheritance

autosomal recessive

Haemohromatosis presentation

- fatigue - erectile dysfunction - arthralgia - bronze skin - diabetes mellitus - chronic liver disease signs - cardiac failure

dodgy air conditioner in Spain. what condition ?

Legionella pneumophila

what given immediately to patients with suspected meningococcal septicaemia

IM benzylpenicillin

most common UTI causative organism

E. coli

what agar used to grow mycobacterium tuberculosis

Lowenstein- Jensen

test to distinguish between Staphylococcus and streptococcus

catalase test

describe MRC scale

- 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.

what will present with stony dull percussion

pleural effusions

which antibody is most commonly associated with GPA

C-ANCA

pattern or inheritance for Von-Willebrand's disease

autosomal dominant

what FEV1/FVC to indicate obstructive disorder

FEV1/FVC <0.7

what is Bronchiectasis

chronic infection leading to permanent dilatation of the airways

ongoing asthma treatment

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

most common CAP pathogen

streptococcus pneumoniae

most common HAP pathogen

pseudomonas aeruginosa

is testosterone or oestrogen a risk factor for PE

oestrogen (and HRT)

diagnostic investigation for sarcoidosis | shows what

- tissue biopsy - showing a non-caseating granuloma

streptococcus pneumoniae gram stain

gram positive diplococci

Neisseria meningitidis gram stain

gram negative diplococci

TIA management

- aspirin - atorvastatin - Then clopidogrel replaces aspirin for long-term secondary prevention.

first line investigation for suspected TB

CXR

what seen on X-Ray of person with TB

- hilar enlargement due to lymphadenopathy - pleural effusion - consolidation with cavitation

what type of lesion is usually present in TB

caceating granuloma

what type of staining for TB

Ziehl-Neelsen staining (acid fast bacteria)

gold standard diagnostic test for CF

sweat test (test for chloride conc)

what cancer is asbestos associated with

mesothelioma

what is Horner's syndrome

- ptosis - drooping of the eyelid - miosis - pupillary constriction - anhidrosis - lack of sweat on the affected side

pathophysiology of chronic asthma

narrowing of the airway due to: - smooth muscle contraction - thickening of the airway by cellular infiltration and inflammation - presence of secretions within airway lumen

investigation to confirm asthma

spirometry

example of asthma ICS

budesonide

example of asthma Leukotreine receptor antagonist

montelukast

example of asthma LABA

formoterol

what cancer to smokers usually get

squamous cell carcinoma

lung cancer most commonly diagnosed in non smokers

adenocarcinoma

what hormones can Paraneoplastic small cell lung cancer secrete

- ACTH (cushings) - ADH (SIADH) - GH (acromegaly)

similarity and difference between TB and sarcoidosis

- CXR shows bilateral hilarity lymphadenopathy - TB: caseating granuloma - Sarcoidosis: non-caseating granulomas

causes of bronchiectasis

- post infection - immunodeficiency - idiopathic - airway obstruction (inhaled foreign body)

what complication from repeated coughing

pneumothorax

COPD complications (3)

- recurrent pneumonia - cor pulmonale - lung cancer

Haemophilus influenza gram stain

gram negative coccobacillus

Abx for H. influenza

Co-amoxiclav, doxycycline

pneumothorax risk factors

- tall and slender build - cigarette smoking - previous pneumothorax - COPD - acute sever asthma

symptoms of pulmonary embolism

- shortness of breath - chest pain - sweating - dizziness - haemoptysis

pleural effusion vs pneumothorax on percussion

- Pleural effusion: dull on percussion | - Pneumothorax: hyper-resonant on percussion

name hidden places for psoriasis

- scalp - genitals - behind the ear - inside the ear - soles of feet

septic arthritis risk factors

- age (over 80) - prosthetic joint - penetrating trauma - immunosuppression - pre-existing joint disease (RA, OA) - systemic blood Bourne infection - IVDU

what primary cancers can spread to bone (5)

- breast - prostate - kidney - lung - thyroid

give instructions for how allendronic acid should be taken

- taken once a week - on an empty stomach - remain upright for at least half an hour after taking

name joint where Herbeden’s nodes occur

DIP

name joint where Bouchard’ nodes occur

PIP

describe RA hand deformities

- boutonnieres deformity - ulnar deviation - trigger finger - swan neck deformity

what condition is GCA associated with

polymyalgia rheumatica

What marker used to monitor SLE

ESR

woman has a lot of miscarriages. | what condition ?

anitphospholipid syndrome

osteomyelitis risk factors

- Decreased sun exposure: decreased sun exposure leads to less vit D activation - Diet: decreased dietary vit D leads to less vit D available for bone mineralisation