MSRA Medicine Flashcards
Hashimotos thyroiditis is painful - true or false?
False
Does hashimotos cause hypo or hyperthyroidism?
Hypothyroidism
which extra intestinal features of crohns are related to disease activity?
Arthritis
erythema nodosum
episcleritis
Osteoporosis
which extra intestinal features of crohns are unrelated to disease activity?
arhtritis
pyoderma gangrenosum
uveitis
clubbing
PSC
diabetes may increase BNP level - true or false
True
COPD may decrase BNP level - true or false
False (increases)
Which drugs may decrease BNP level?
ACEi, ARB, Beta blockers, diuretics, aldosterone antagonists
Obesity may decrease BNP level - true or false?
True
which drug can be used to treat alcoholic hepatitis?
glucocorticoids eg prednisolone
serum ferritin can be increased in alcoholics - true or false?
True
sequestration causes organomegaly of what organ in sickle cell?
Splenomegaly
after TIA when should patients be seen in clinic?
24 hours
after TIA when should patients be seen if on anticoagulants?
immeadiately
HSP causes joint pain true or false
True
what antibiotics should be used for contacts of patients with meningococcal meningitis?
Ciprofloxacin
what drugs cause necrotising fasciitis of the genitalia or perineum
SGLT-2 inhibitors
what is the first line treatment for absence seizures?
Ethosuximide
what is the first line treatment for focal seizures?
Lamotrigine, Levetiracetam
vaginal discharge with pH >4.5 is associated with what organisms
Trichomonis vaginalis, bacterial vaginosis
what colour is the discharge in bacterial vaginosis?
thin white discharge
clue cells are associated with what organism
bacterial vaginosis
what is a treatment for galactorrhoea
bromocriptine
rose spots on the abdomen is consistent with infection with which organism?
Salmonella typhi
subacute (de quervians) thyroditis causes hyperthyroidism - true or false
true
splenectomy can give a falsely high HBa1c - true or false
true
erythema marginatum is associated with what illness
rheumatic fever
albumin increases in acute phase response - true or false
false
essential tremor is made worse by alcohol - t or f
false
essential tremor is inherited in what fashion
autosomal dominant
inhaled steroids reduce the frequency of exacerbations in COPD - true or false
true
erythema multiforme is seen with infection with what organism
mycoplasma pneumoniae
how many doses of tetanus compromise a full tetanus immunisation scheduele?
5
which chemotherapy can cause peripheral neuropathy?
vincristine
von willebrand disease causes increase in what blood marker?
APTT
what is the most common renal cause of AKI?
Acute tubular necrosis
Raised urinary sodium is consistent with a diagnosis of acute tubular necrosis - true or false
True
in T2DM with high risk of CVD/established CVD what drug should be added once metformin is established?
SGLT2 inhibitor
Electrical alternans is suggestive of what?
Cardiac tamponade
what criteria are used to diagnose AKI in adults?
- increase creating over 26umol in 48hr
- increase creating >50% in 7 days
- decrease urine output <0.5ml/kg/hr for >6 hours
in a TIA within 7 days what is the initial management?
Aspirin 300mg + specialist review within 24 hours
in suspected TIA when would specialist review within a 7 day window be appropriate?
If the episode occurred more than a week ago
hypocalcaemia is seen in rhabdomyolysis - true or false
True
LTOT is the most important intervention in patients with COPD for survival - true or false
FALSE
may increase survival in hypoxic patients but must important intervention is smoking cessation
what 3 drugs are recommended for migraine prophylaxis?
Topiramate
Propranolol
Amitryptyline
donepezil can increase risk of bradycardia - true or false
True
Should be avoided in patients with sick sinus syndrome
what vitamin deficiency is linked to wernicke korsakoff syndrome?
Thiamine (B1)
what disease is associated with B3 (niacin) deficiency?
Pellagra:
- dermatitis
- diarrhoea
- dementia
in aortic stenosis do you find a wide or narrow pulse pressure?
Narrow pulse pressure
in GBS are the legs or arms affected first?
Legs - ascending weakness
what blood test is used to diagnose coeliac disease?
Tissue transglutaminase (TTG) antibodies and IgA
what are the symptoms of left ventricular aneurysm after MI?
Tiredness, SOB, persistent ST elevation
what are the symptoms of dressers syndrome post MI?
Fever, pleuritic chest pain, worse lying supine
ST elevation >2 weeks after MI
what marker is raised in the acute phase after anaphylaxis?
serum tryptase
a combination of thrombolysis and thrombectomy is recommended for patients with acute ischaemic stroke presenting within 4.5 hours - true or false
True
what are considered eGFR variables?
CAGE:
C - Creatinine
A - Age
G - Gender
E - Ethnicity
minimal change disease causes what syndrome?
Nephrotic syndrome
if angina is not controlled on a beta blocker alone - what medication should be added?
long acting dehydropyridine CCB - eg. amlodipine, modified release nifedipine
what types of calcium channel blockers are contradindicated with beta blockers?
Rate limiting CCB eg. diltiazem, verapamil - cause bradycardia and heart failure
what type of feeding should be used in motor neurone disease
PEG
In AF lasting less than 48 hours DC cardio version is an appropriate treatment for rhythm control - true or false
True
Lhermitte’s sign describes what?
Tinging in hands when flexing neck
what is the name of this sign: ‘ in a patient with painless, enlarged gallbladder and mild jaundice - gallstones is unlikely to be the cause’
Courvoisier’s sign
- more likely to be malignancy of pancreas or biliary tree
transfer factor for carbon monoxide (TLCO) is increased or decreased in patients with pulmonary fibrosis?
Reduced - reflecting impaired gas exchange
what syndrome is associated with primary biliary chlolangitis?
Sjogrens syndrome - 80%
what is the first line drug treatment for primary biliary cholangitis?
Ursodeoxycholic acid
when investigating B12 deficiency which antibodies should be tested - gastric parietal or intrinsic factor?
Intrinsic factor antibodies
what is the triad seen in wernicke’s encephalopathy?
- encephalopathy
- ataxia
- oculomotor dysfunction (ophthalmoplegia)
untreated wernicke’s can lead to what syndrome
Korsakoff syndrome
amaurosis fugax affects what artery?
retinal/opthalmic
pyoderma gangrenosum - singular ulcerating shin lesions, associated with what condition?
IBD
hypertension, hypernatraemia and hypokalaemia are seen in what condition?
Primary hyperaldosteronism
what is the definitive treatment for wolf parkinson white ?
Accessory pathway ablation
shortened PR interval and wide QRS complexes with a slurred upstroke in lead II - describes what condition?
Wolff parkinson white
what electrolyte abnormality can cause prolonged QT interval?
Hypocalcaemia
Hypomagnesaemia
visual hallucinations are seen in what kind of dementia?
lewy body
which artery is affected in locked in syndrome?
Basilar artery
which part of the brain is affected in lacunar staple?
the basal ganglia, thalamus, internal capsule
in heart failure when should a beta blocker be started first over ACEi?
In patients with angina
in heart failure when should ACEi be started first over B blocker?
Signs of fluid overload, Diabetes
does bronchiectasis cause a restrictive or obstructive pattern on lung function tests?
Obstructive
ie. FEV1/FVC reduced
do neuromuscular disorders cause a restrictive or obstructive Pattern on lung function tests?
Restrictive
ie. FEV1/FVC normal or increased
patients with pneumothoraces should have a life long ban on deep sea diving - true or false
True
when can patients fly after pneumothorax?
1 week after having a chest x ray showing complete resolution of a pneumothorax
secondary or primary pneumothoraces have the lowest incidence of recurring?
Primary
