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Year 4 part 2 > MSCAA questions revision > Flashcards

MSCAA questions revision Flashcards

1
Q

Acute Pancreatitis vs Acute Cholecystitis

A

Both have raised amylase levels.

ALP will be raised

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2
Q

Management of acute duration low back pain in fit person

A

Continue usual activity

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3
Q

What is the management of a PE in hospitals (major)

A

IV heparin not a DOAC

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4
Q

What is the CHADS2Vasc score

A

CHF - 1
H - Hypertension
A - Age (either 65+ is 1 or 75+ is 2)
D - Diabetes
S - Stroke (2)
Vasc - Vascular disease history

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5
Q

How do we calculate the lifetime risk of having a stroke from chadsvasc

A

score of risk x years from life expectancy (83)

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6
Q

Initial invetsigation of renal stones

A

Non enhanced CTKUB

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7
Q

When should drugs be stopped in suspected CKD

A

Only if there is >30% increase in serum creatinine

If not, repeat 2-4 weeks later

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8
Q

First line managemnet of hypoglycaemia

A

75ml of 20% glucose (IV)

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9
Q

What diabetic drug is approved for use in CKD (the only one)

A

Sitagliptin (DPP4 inhibtor)

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10
Q

In what condition is Pioglitazone contra-indicated for use

A

HF and bladder cancer

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11
Q

WHat is the diagnostic investigation for sensineural hearing loss

A

MRI imaging

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12
Q

What invetsigation must be done before suspectiing IBD

A

STool Cultures

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13
Q

Management of osteoarthritis on the pain ladder

A

First: Paracetamol/ibuprofen gel

Second Line: EITHER Co-Codamol or an NSAID (depending on contraidnications)

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14
Q

First line managemen of poisoning - is it gastric lavage or actiavted charcoal first

A

Activated charcoal

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15
Q

What condition gives way to adhesive capsulitis

A

Diabetes

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16
Q

What is an iatrogenic secondary pneumothorax cause

A

Chest drains themselves

Central lines

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17
Q

Management of hypertension

A

<55:

ACEi/ARB

ACEI/ARB + CCB or thiazide like diuretic

> 55:
CCB

CCB + ACEi/ARB or thiazide

Both:

Triple therapy of the three

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18
Q

What defines rapidly progressive glomerulonephritis

A

A drop in over 50% eGFR over 3 months

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19
Q

What are the indications for an ascites tap

A

To determine what’s causing ascites if unkown

To check for suspected sponatenous bacterial peritonitis

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20
Q

What diagnoses Spontaneous bacterial peritonitis

A

Neutrophil count >250 cells

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21
Q

What does an ascitic tap show for potential malignancy

A

RBC <1,000 cells/mm^3

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22
Q

What Serum albumin- Ascitic Albumin concentration indicates liekly cirrhosis and cardiac failure cause of ascites

A

> 11g/L

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23
Q

Management of a red eye

A

ALWAYS refer to Opthalmologist (could be corneal abrasions, endopthlamitis, acute glaucoma

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24
Q

What is the initial management of suspected bowel obstruction

A

NG tube striaght away for decompression

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25
Q

What type of fluid is 1.8% Sodium CHolride also known as

A

HYPERtonic saline

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26
Q

What are the role of goblet cells

A

Secrete mucin (provides a mucosal layer to the stomach)

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27
Q

In what condition is urseodeoxycholic acid a mainstay treatment for

A

Primary Biliary Cirrhosis

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28
Q

Where are adenocarcinomas of the lungs typically located

A

Peripherally

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29
Q

Where are squamous cell carcinomas typically located

A

Centrally

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30
Q

What do squamous cell carcinomas typically secrete

A

PTHrP

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31
Q

What do small cell carcinomas typically secrete

A

Cushing’s (ACTH)
ADH

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32
Q

Until blood gas can be measures, what oxygen therapy should be initially started

A

24 or 28%

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33
Q

What is the main indication for low concentration oxygen therapy

A

Hypercapnia

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34
Q

When should Oxygen therapy be considered in patients with COPD

A

PaO2 < 7.3 kPA when stable and do not smoke

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35
Q

What is a contraindictaion to using IV Adenosine for supreventiruclar tachycardia

A

Asthma- use verapamil

36
Q

Signs of supraventricular tacchycardia in an ECG

A

Absent p waves and sinus tacchycardia

37
Q

Management of a suspected tension pneumothorax

A

NO chest x ray needed

14G cannula needle decompression

38
Q

First line management of a primary pneumothorax with rim of air <2cm

A

Dishcarge + X-Ray

39
Q

Management of a primary pneumothorax with >2cm air rim

A

Aspiration

40
Q

If aspiration fials, what is second line treatment of a primary pneumothorax

A

Chest Drain

41
Q

First line management of a secondary pneumothorax if >50 and rim of air >2cm

A

Chest drain

42
Q

Management of a secondary pneumothorax if rim of air 1-2cm

A

Aspiration

43
Q

On an X-ray reading, what differentiates between a penumothorax and tension pneumothorax

A

Trachea not deviated vs devaited trachea

44
Q

What medication improves motor symptoms in Parkinson’

A

Levodopa

45
Q

What type of nutrition is given to patients with motor neurone disease

A

Percutaneous gastrostomy tube

46
Q

First line management of asystole

A

Chest compression and ventilation

47
Q

Once chest compressions and ventilation are started, what should be done in asystole

A

IV Adrenaline/epinerphine

48
Q

Investigations of an unprovoked DVT

A

CT of the abdomen and pelvis

49
Q

Log term anticoagulation for people with mechanical valves

A

Aspirin + Warfarin

50
Q

What anaesthetic airway device protects the lungs from stomach contents

A

Tracheal tube

51
Q

What is the first investigation for someone with a suspected PE

A

First do a chest X-Ray to rule out other things, then do the well’s score

52
Q

INvestigation of choice for a thyroid neck swelling

A

USS of the neck

53
Q

What are the maintenance fluid requirmenets for someone with underlying cardiac disease

A

20-25ml/kg not 25-30

54
Q

What needs to be monitored in someone with MG exacerbation

A

FVC

55
Q

Most common cause of cellulitis

A

Strep pyogenes

56
Q

Drainage of the ovary

A

Para-aortic nodes

57
Q

How to calculate GCS

A

Eye:

None
Opens to pain
Open to commands or speech
Open spontaneously

Motor:
No motor response
Extensors response
Abnormal flexion
Withdraws from pain
Moves purposefully to painful stimulus
Obeys commands

58
Q

WHat is diagnostic for nephrotic syndrome

A

Renal biopsy

59
Q

What is the initial screening tool for Syphillis

A

EIA

60
Q

What is used to monitor syphillis

A

RPR (decreasing means succerssful treatment)

61
Q

Management of asymptomatic aortic stenosis

A

If LV function is impaired (less than 55%) - they need to be referred for aortic valve replacement

Signs of Heart Failure with AS

62
Q

At what mean gradient across the aortic valve, should someone be referred for aortic valve replacement

A

> 40 mmHg

63
Q

Complication of aortic stenosis

A

Herat Failure

64
Q

What is the most likely outcome of HZV opthalmicus

A

Usually complete resolution with no sequelae

65
Q

What is the normal urine output

A

800 to 2,000 mls a day

66
Q

PTH levels in primary hyperparathyroidism

A

NORMAL

67
Q

Species that causes Infective endocarditis in IVDU users

A

Staph aureus

Strep viridian’s - dental care

68
Q

What fibre deficiencies can cause colon cancer

A

Fibre
Folate
Calcium

69
Q

What chronic condition can cause colic cancer

A

UC and Crohn’s
DM

70
Q

Clinical features of right colon cancers

A

Weight loss
Anaemia
Masses

71
Q

Clinical features of left colon cancers

A

Increased frequency of stools (change in bowel habits)
Bowel obstruction
Rectal bleeding

72
Q

First line investigation for colon cancers

A

Proctoscopy with or without sigmoidoscopy

73
Q

Sounds heart in a ventricular septal rupture

A

Sudden harsh pan systolic murmur at the apex

74
Q

Clinical features of a ventricular septal rupture

A

Sudden angina/hypotension and pulmonary oedema

75
Q

Clinical features of a free wall rupture (MI)

A

Cardiac tamponade

76
Q

How do we diagnose a pseudo aneurysm

A

ECHO

77
Q

Management of a papillary muscle rupture

A

Mitral valve replacement - cause mitral regurgitation (pan systolic murmur)

78
Q

Most common type of arrhythmia seen post MI

A

Ventricular fibrillation

79
Q

Management of obesity (25-29.9)

A

General advice on lifestyle;e

80
Q

management of obese people with 27 BMI + Diabetes, HTN or dysplipidaemia

A

Consider Orlostat (definitive management at 30+)

81
Q

Management of Obesity in T2DM with BMI 30-35+

A

Refer to bariatric surgery

82
Q

Management of BMI >40 with no other health issues

A

Consider bariatric surgery

Definitive first line if BMI is over 50

83
Q

Management of asymptomatic AF

A

As long as rate is controlled - no further treatment is needed

84
Q

Management of cord compression in palliative care

A

Radiotherapy and then bisphosphonates

85
Q

What lobe of the brain does Alzheimer’s effect

A

Temporal lobe

86
Q

Management of pain postoperatively in people with respiratory distress risk

A

Epidural anaesthesia

Year 4 part 2 (10 decks)

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