MSRA Flashcards
Causes of ejection systolic murmur
Aortic stenosis
Pulmonary stenosis
Aortic sclerosis
Hypertrophic cardiomyopathy
CHA2DS2 VASc
Congestive heart failure
Hypertension
Age >75
Diabetes
Previous stroke, TIA, thromboembolism
Vascular disease
Age 65-74
Sex category - female
Causes of LBBB
Cardiomyopathy, idiopathic fibrosis, ischemic heart disease & hypertension.
Causes of diastolic murmur
Aortic regurgitation
Pulmonary regurgitation
Organisms responsible for HAP
Gram negative enterobacter or staph aureus
What scoring system is used for disease severity of Rheumatoid Arthritis?
DAS28 score
Criteria to help differentiate between exudate and transudate?
Light’s criteria
What is odynophagia?
Painful swallowing
When to offer FIT for suspected colorectal cancer?
> 40 with weight loss and abdominal pain
<50 with rectal bleeding plus abdominal pain +/- weight loss
50 with rectal bleeding OR abdominal pain OR wight loss
60 with anaemia
Signs of a niacin deficiency
Pellagra disease: dermatitis, diarrhoea & dementia.
When is urgent endoscopy indicated?
Dysphagia
OR
>55 with weight loss and abdominal pain / reflux / dyspepsia
When is non urgent endoscopy indicated?
Haematemesis
OR
>55 treatment resistant dyspepsia
OR
upper abdo pain with low Hb
OR
What is the Los Angeles classification of oesophagitis?
System for grading mucosal breakage in the distal oesophagus.
Grade A - mucosal breaks <5mm
Grade B - mucosal breaks >5mm
Grade C - breaks extending between the tops of two mucosal folds
Grade D - circumferential breaks >75%
Skin changes associated with dermatomyositis
- heliotrope rash on eyelids
- macular rash over back and shoulders “shawl rash”
- red papules over knuckles
Signs of hyperosmolar hyperglycaemic state
Hypovolemia, high osmolality & hyperglycaemia without ketonemia or acidosis.
Medication options for T2DM without cardiovascular risk factors
Metformin
DPP-4 inhibitor (-gliptins) OR Pioglitazone OR Sulfonylurea (e.g. gliclazide, tolbutamide
What is Nelson’s syndrome?
An enlargement of an ACH-producing tumour in the pituitary gland, following removal of both adrenal glands in a patient with Cushing’s disease.
Common ABX side effects
Flucloxacillin - diarrhoea
Metronidazole - altered taste
Erythromycin - hearing loss & tinnitus
Ceftriaxone - diarrhoea & skin reactions
Penicillin - thrombocytopenia (bruising/bleeding)
Neonatal life support algorithm
FIVE inflation breaths
Reassess for increased heart rate
Repeat FIVE inflation breaths if no chest wall movement
If HR absent/low THREE chest compressions to ONE ventilation 3:1
Reassess HR every 30s
What are the APGAR domains?
Appearance
Pulse
Grimace (reflex response)
Activity (tone)
Respiration
Paediatric life support algorithm
FIVE rescue breaths
15:2 compressions to ventilation
What are emergency contraception options?
Up to 72 hours - Levonorgestrel
Up to five days - copper coil & ulipristal acetate
Contraindications for progesterone only pill?
Acute porphyria and current breast cancer.
Caution with diabetes, history of breast ca, TIA/stroke, VTE.
What type of HRT will allow a monthly bleed?
Continuous oestrogen and cyclical progesterone tablet
