Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS > My common mistakes > Flashcards

My common mistakes Flashcards

1
Q

MDMA (ecstasy) poisoning is associated with…

A

Hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

N-Acetylcysteine commonly causes what type of reaction?

A

Anaphylactoid reaction (non-IgE mediated mast cell release)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

For DMT2 when is metformin contraindicated?

A

eGFR <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most highly negatively inotropic CCB? (weakens heart contractions- slows HR)

A

Verapamil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Key investigation for suspected CO poisoning?

A

ABG- carboxyhaemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Liver transplantation criteria in paracetamol overdose?

A

pH <7.3 more than 24hrs after ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Patient on amiodarone (eg for AF) develops hypothyroidism?

A

Continue amiodarone and add levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Double duct sign?

A

Pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Haemochromatosis iron study profile?

A

Raised transferrin and ferritin, low TIBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Upper GI bleed or lower GI bleed if high urea?

A

Upper- blood digested (contains protein) so increase in urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute hypophosphataemia management- severe or symptomatic

A

IV phosphate polyfusor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Visual hallucinations with dementia

A

Lewy body dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Blood tests that form part of the confusion screen

A

TSH, B12, Folate & Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Memantine drug class

A

NMDA receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of thyroid surgery

A
  • Recurrent laryngeal nerve damage
  • Bleeding- laryngeal oedema.
  • Damage to the parathyroid glands resulting in hypocalcaemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ways to remember causes of nystagmus?

A

Horizontal nystagmus = peripheral cause (goes in direction of ears)
Vertical nystagmus = central cause (goes in direction of brain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Difference between neuronitis and labrynthitis?

A

Neuronitis = No loss
Labrynthitis = Loss

Vestibular neuronitis = inflammation of the vestibular nerve, which deals with balance but not hearing

Labyrinthitis = inflammation of labyrinth, which deals with both balance AND hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

FLUID THERAPY IN CHILDREN

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

FLUID THERAPY IN ADULTS

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Atropine increase or decrease HR?

A

Increase, if fails then external pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Amiodarone increase or decrease HR?

A

Decreases HR (treats fast irregular HR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cause of infective endocarditis <2m post valve surgery

A

Staph epidermidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is a child is choking, why is the foreign object most likely found in right main bronchus?

A

Shorter, wider and more vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Severe anaemia is a cause of

A

high-output heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

RBBB +left anterior or posterior hemiblock + 1st-degree heart block

A

trifasicular block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Acute heart failure not responding to treatment

A

consider CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hypothermia is a cause of

A

Torsades de pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ACS: Nitrates are contraindicated in patients with

A

hypotension (< 90 mmHg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

‘Global’ T wave inversion (not fitting a coronary artery territory) - think

A

non-cardiac cause of abnormal ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Hypothermia causes what on ECG

A

J waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Mx if V tachy leads to haemodynamic instability?

A

synchronised electrical cardioversion; may be followed by an amiodarone infusion when more stable to enhance the probability of achieving sinus rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lichen planus vs scleorsus?

A

planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common

sclerosus: itchy white spots typically seen on the vulva of elderly women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Toxic epidermal necrolysis (TEN) vs Stevens-Johnson syndrome (SJS)?

A

Both severe skin reactions, TEN more severe end of spectrum.

SJS: Affects less than 10% of the body’s surface area
TEN: Affects more than 30% of the body’s surface area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

erythema nodosum vs erythema multiforme?

A

Erythema multiforme is typically target shaped and only slightly raised. It’s not typically painful but can be itchy. They can also be on various sites of the body

Erythema nodosum is more like a raised nodule that mainly presents on the shins. It looks a bit like a bruise and it is painful.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

most accurate way to asses the burns area

A

Lund and Browder chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Wallace’s Rule of Nine

A

Each of the following is 9% of the body when calculating surface area % if a burn:
Head + neck, each arm, each anterior part of leg, each posterior part of leg, anterior chest, posterior chest, anterior abdomen, posterior abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Psoriasis commonly exhibits what pgenomenon

A

Koebner phenomenon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What clotting factors and other components does the liver make?

A

1) Clotting factors= I (fibrinogen); II (prothrombin); V; VII; IX; XII; XIII (all for blood coag)

2) Albumin (transport and maintain BP)

3) Transport proteins= ceruloplasmin (transports copper) and transferrin (iron)

4) Bile salts (fat digestion)

5) Bilirubin (from RBC breakdown)

6) Glucose (through gluconeogenesis and glycogen storage/release)

7) Lipids (cholesterol, trigly and lipoproteins)

8) Detoxification products (ammonia to urea & drug metabolism)

9) Hormones= angiotensinogen and thrombopoietin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Role of angiotensinogen and thrombopoietin?

A

A= BP regulation

T= platelet production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What blood tests would you do to investigate the liver?

A

1) LFTs (enzymes & proteins):
- ALT & AST
- ALP
- GGT
- Bilirubin (total & direct)= direct is conjug and indirect is unconjug
- Albumin
- Total protein

2) Clotting screen= INR or PT

3) Viral serology= hep A, B, C, E

4) Autoantibodies= AMA, ANA, Anti-SMA

5) Ceruloplasmin

6) Ferritin and transferrin

7) Paracetamol levels

8) Alpha-1 antitrypsin

9) Tissue Transglutaminase antibody

10) Ammonia levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Overall tests to measure kidney function?

A

1) Bloods= serum creatinine; blood urea nitrogen (BUN); eGFR; serum uric acid

2) Urine= eg. urinalysis; protein, albumin, glucose, blood, bacteria

3) Imaging= USS, CT or MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What does high serum creatinine indicate about kidney function?

A

impaired.

Creatinine= waste product from muscle metabolism in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What does elevated uric acid levels indicate about kidney function?

A

kidney disease or gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What does proteinuria indicate about kidney function?

A

damage or disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What does high urine albumin indicate about kidney function?

A

Damage eg. in diabetes or HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Budd-Chiari Ix- way to remember?

(pt presents with abdo pain, tender hepatomegaly and ascites- basically a painful swollen liver)

A

USS with doppler.

basically a ‘liver DVT’ , being a hepatic vein thrombosis.
The ‘painful, swollen calf’ is essentially just a painful swollen liver (abdo pain, tender hepatomegaly) + ascites due to venous obstruction.

They also have exactly the same gold standard investigation in Doppler Ultrasound!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Hepatocellular disease LFTs?

A

ALT= raised at least 2 fold
ALP= normal
ALT/ALP= 5+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Chlestatic disease LFTs?

A

ALT= normal
ALP= raised at least 2-fold
ALT/ALP= <2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

LFTs in mixed disease (hepatocellular + cholestatic)?

A

ALT= raised at least 2-fold
ALP= raised at least 2-fold
ALT/ALP= 2-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

ALP, AST and ALT produced by what?

A

AST & ALT produced by hepatocytes; in hepatocellular disease, hepatocytes release these enzymes into blood so get raised ALT.

ALP produced by cells lining bile duct so in obstructive disease ALP rises.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Summary of liver enzymes in LFTs?

A

ALT = correspond to hepatocytes
AST = correspond to hepatocytes, cardiac cells, and muscle cells
ALP = correspond to biliary system (bile ducts) & various tissues in the body eg. bones

GGT= more specific version of ALP in terms of biliary system; also indicates pt drinks alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

deranged LFTs combined with secondary amenorrhoea in a young female

A

autoimmune hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

C.diff Mx

A

1st: oral vancomycin
2nd: if doesn’t work then oral fidazomicin

OR IF SEVERE (eg. hypotension, shock) or doesn’t respond to above= oral vanc + IV metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Maintain remission in UC if have had a severe relapse or >=2 exacerbations in past yr?

A

oral azathioprine or oral mercaptopurine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Metoclopramide MOA?

A

antagonism of D2 dopamine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Electrolyte disturbances in refeeding syndrome?

A

hypophosphataemia, hypokalaemia and hypomagnesaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Receding bleeding gums

A

think scurvy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What electrolyte disturbance can PPIs cause?

A

hyponatraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Primary biliary cholangitis- M rule?

A

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

How long should pts not eat gluten for before they get endoscopic intestinal biopsy to diagnose coeliac?

A

6w

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Most common site affected in Crohn’s

A

ileum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

How to stop uncontrolled variceal haemorrhage?

A

Sengstaken-Blakemore tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

1st line Ix for acute mesenteric ischaemia?

A

Lactate= raised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Liver + neuro disease?

A

think Wilson’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Mneumonic to remember causes of erythema nodosum?

A

NO - idiopathic
D - drugs (penicillin sulphonamides)
O - oral contraceptive/pregnancy
S - sarcoidosis/TB
U - ulcerative colitis/Crohn’s disease/Behçet’s disease
M - microbiology (streptococcus, mycoplasma, EBV and more)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Reversible causes for cardiac arrest?

A

H.ypothermia
H.ypovolaemia
H.ypoxia
H.yperkalaemia

T.hrombus
T.oxins
T.ension pneumothorax
T.amponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

ALS for VF/pulseless VT?

A

single shock followed by CPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

ALS if cardiac arrest is witnessed in monitored pt eg. coronary care unit and is in VF/pulseless VT?

A

Up to 3 quick successive shocks rather than 1, then CPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is first like and should always be attempted in ALS?

A

IV access
if can’t achieve then give drugs IO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Role of adrenaline in ALS?

A

1mg given as soon as possible for non-shockable rhythms

shockable rhythms= 1mg once restart chest compressions after the third shock

repeat adrenaline 1mg every 3-5mins whilst ALS continues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Role of amiodarone in ALS?

A

300mg given to pt in VF/pulseless VT after 3 shocks have been given.

then further 150mg given after 5 shocks, then 7 ect.

lidocaine can be an alternative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

When should thrombolytic drugs be given in ALS and how long should CPR continue for?

A

is PE suspected.
continue CPR for extended period of 60-90mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

A to E vs DRABC?

A

DRABC for immediate, on-scene assessments, and A to E for systematic evaluation in a clinical setting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is a heart attack?

A
  • must have troponin RISE AND FALL
  • must also have typical CP, ECG changes or new scar (eg. ST depression or elevation; T wave inversion-new; CLINICAL CONTEXT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Standard bloods for chest pain?

A

FBC, U+E, LFT, Clotting screen, Troponin +/- D dimer, Cholesterol, Glucose/HbA1c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Ix for chest pain?

A
  • vital signs
  • ECG
  • CXR
  • Bloods
  • ABG if hypoxic/PE suspected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Criteria for PPCI in STEMI?

A
  • ST elevation >2mm in 2 contiguous chest leads or >1mm in 2 contiguous limb leads (i.e. territorial not randomly distributed)

~Chest pain or other evidence of ischaemia

  • New or presumed new LBBB was an indication for thrombolysis and is often considered an indication for PPCI in the right clinical context
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

If morphine is given in acute Mx of STEMI, what needs to be given with it?

A

Metoclopramide as morphine can make pt feel sick (delays absorption of anti platelet drugs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What if pt is already on aspirin but you need to give 300mg stat for STEMI acute Mx?

A

in theory don’t need to give but best to just give anyway as shouldn’t do any harm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

When to measure troponin?

A
  • Depends on assay
    STH assay – hsTnT:
  • Measure ASAP
  • If raised, measure again in 3h – significant rise or fall suggests MI
  • If not raised, can r/o MI, unless pain was <6 hrs ago, in which case obtain further measurement at that point – significant rise suggests MI
  • Does NOT rule out ACS (could still be unstable angina)
  • MI is NOT always due to ACS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Follow up post MI?

A

Clinic 1 month – can consider device therapy if significant LVSD
Transthoracic echocardiogram if not had as inpatient
Cardiac rehabilitation programme
Smoking cessation
GP – uptitrate secondary prevention e.g. ramipril and bisoprolol towards 10 mg OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Advise for pt post MI?

A

Don’t drive for 1 week if PCI, 4 weeks if no PCI (we advise all pts 4 weeks)
Gradual return to usual activity levels
Typically 6 weeks off work
Stop smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

MI- what to write on the TTO?

A

Big 5

1) Aspirin 75 mg OD

2) Potent P2Y12 inhibitor – ticagrelor 90 mg BD or prasugrel 5-10 mg OD for >=1 year. Can consider a PPI alongside.

3) Cardioselective beta blocker (caution if asthmatic, bradycardic, conduction disease) e.g. bisoprolol 2.5 mg OD

4) ACE inhibitor (ARB if intolerant due to cough) (caution if hypotensive, severe CKD) e.g. ramipril 2.5 mg OD

5) High intensity statin e.g. Atorvastatin 80 mg OD

(PRN GTN)

Pretty much most pts will go home on these if tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What drugs to consider writing on the TTO for MI?

A
  • Consider if poor LV function
    MRA – eplerenone or spironolactone 12.5 – 25 mg OD
  • Consider if pericarditic pain
    Colchicine 500 mcg BD
  • Consider if clinical heart failure
    Loop diuretic e.g. Furosemide 40 mg OD
    SGLT2 inhibitor e.g. Dapagliflozin or Empagliflozin
  • Consider if non-revascularized significant coronary artery disease
    Anti-anginals - beta blocker, nitrates, amlodipine etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Cardiac Resynchronisation Therapy (CRT)

A

Patients with LVSD + LBBB or needing a PPM or very wide
RBBB

Dual chamber PPM
- RA lead
- RV lead

  • PLUS LV lead (in the CS)
  • Bi-ventricular PPM
  • Biventricular PPM = ‘CRT-P’
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Groups of patients with at significant risk of VT/VF

A

Severe LVSD
Previous VT/VF (but not if assoc with an acute infarct)
Inherited cardiac conditions
HCM, Brugada etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Implantable Cardioverter Defibrillator (ICD)

A

Adds a generator and shock coils to pacing function
If added to a single lead or dual chamber PPM = ‘ICD’
If added to a CRT device = ‘CRT-D’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is the tumour marker for pancreatic ca?

A

CA 19-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What lung ca has the strongest association with smoking?

A

squamous cell lung ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What drug is used to suppress N&V with intracranial tumours?

A

dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What chemo drug is associated with hypomagnesaemia?

A

cisplatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What chemo drug may cause pulmonary fibrosis?

A

bleomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What should be part of the diagnostic work up in a women found to have abdo malignancy of unknown primary?

A

CA 125

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What HPV subtypes are carcinogenic and increase risk of cervical ca?

A

16,18,33

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What HPV subtypes are NOT carcinogenic and are associated with genital warts?

A

6, 11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Tumour marker in colorectal ca and has a role in monitoring disease activity?

A

CEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Most common cause of SVCO?

A

small cell lung ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What chemo drug may cause peripheral neuropathy?

A

vincristine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Tumour marker for breast ca?

A

CA 15-3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Women with bone mets, likely to originate where?

A

breast ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Tumour marker in medullary thyroid ca?

A

calcitonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

PBC vs PSC?

A

PBC is middle-aged women, anti-mitochondrial antibodies, assoc with keratoconjunctivitis sicca.

PSC is young men, often with Ulcerative colitis, assoc with pruritus and fatigue, anti-mitochondrial antibodies negative.

Primary Sclerosing Cholangitis is associated with Ulcerative Colitis (i.e. both ‘itis’), which occurs in younger people.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Way to remember PBC?

A

PBC - M Disease - Increased IgM, AMA associated, Middle Aged Women!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Melanosis coli is most commonly caused by

A

prolonged laxative use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

The oral contraceptive pill and co-amoxiclav is associated with

A

drug-induced cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Budd-Chiari syndrome presents with the triad of

A

sudden onset abdominal pain, ascites, and tender hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

High urea levels can indicate

A

upper GI bleed versus lower GI bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Bile-acid malabsorption may be treated with

A

cholestyramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Antinuclear antibodies, anti-smooth muscle antibodies and raised IgG levels are characteristic of

A

autoimmune hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Odynophagia is a concerning symptom that may be present in patients with

A

oesophageal ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

first line test for diagnosis of small bowel overgrowth syndrome

A

hydrogen breath testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

All patients with suspected upper GI bleed require

A

endoscopy within 24 hours of admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

key investigation for a suspected perforated peptic ulcer

A

erect CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

PPIs can increase the risk of

A

osteoporosis and fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

used in the management of severe alcoholic hepatitis

A

corticosteroids

116
Q

should be given before endoscopy in patients with suspected variceal haemorrhage

A

Both terlipressin and antibiotics

117
Q

Autoimmune hepatitis is more likely to show predominantly raised

A

raised ALT / AST on LFTs than ALP

118
Q

cause of hypogonadotrophic hypogonadism

A

haemochromatosis

119
Q

generally used to induce remission of Crohn’s disease

A

Glucocorticoids (corticosteroids) (oral, topical or intravenous)

120
Q

used to monitor treatment in haemochromatosis

A

Ferritin and transferrin saturation

121
Q

first-line in maintain remission in ulcerative colitis patients with proctitis and proctosigmoiditis

A

A topical (rectal) aminosalicylate +/- an oral aminosalicylate

122
Q

HBsAg negative, anti-HBs positive, IgG anti-HBc positive

A

previous infection, not a carrier

123
Q

Diarrhoea, fatigue, osteomalacia →

A

?coeliac

124
Q

diagnostic investigation of choice for pancreatic cancer

A

High-resolution CT scanning

125
Q

Always examine the what in a young man with RIF pain

A

testicles

126
Q

In an acute upper GI bleed, what can identify low risk patients who may be discharged

A

Blatchford score

127
Q

A transjugular intrahepatic portosystemic shunt (TIPS) procedure connects the

A

hepatic vein to portal vein

128
Q

may be useful for diagnosing and monitoring the severity of liver cirrhosis

A

Transient elastography

129
Q

characteristic iron study profile in haemochromatosis

A

Raised transferrin saturation and ferritin, with low TIBC

130
Q

Jaundice following abdominal pain and pruritus during pregnancy think

A

acute fatty liver of pregnancy

131
Q

somatostatin analogue used to treat the symptoms of carcinoid syndrome

A

Octreotide

132
Q

develops in around 10% of primary sclerosing cholangitis patients

A

Cholangiocarcinoma

133
Q

Obesity with abnormal LFTs

A

? non-alcoholic fatty liver disease

134
Q

Iron defiency anaemia vs. anaemia of chronic disease

A

TIBC is high in IDA, and low/normal in anaemia of chronic disease

135
Q

C. difficile antigen positivity only shows what?

A

exposure to the bacteria, rather than current infection

toxin=current

136
Q

If a patient with ulcerative colitis has had a severe relapse or >=2 exacerbations in the past year they should be given what to maintain remission?

A

oral azathioprine or oral mercaptopurine

137
Q

Small bowel obstruction (often due to intussusception) is a common presenting complaint in what syndrome?

A

Peutz-Jegher’s syndrome

138
Q

Ongoing diarrhoea in Crohn’s patient post-resection with normal CRP

A

cholestyramine

139
Q

Large-volume paracentesis for the treatment of ascites requires albumin ‘cover’. Evidence suggests this reduces

A

paracentesis-induced circulatory dysfunction and mortality

140
Q

best first line management for NAFLD

A

weight loss

141
Q

prophylaxis of oesophageal bleeding

A

non-cardioselective B-blocker (NSBB) eg. propanolol

142
Q

Acute mesenteric ischaemia first line Ix?

A

raised lactate (causes this and is the 1st line Ix)

143
Q

Acute hypoperfusion (e.g. low BP secondary to blood loss) may result in

A

ischaemic hepatitis

144
Q

Most likely area to be affected by ischaemic colitis

A

splenic flexure

145
Q

Increased goblet cells

A

Crohn’s

146
Q

Constipation - if symptoms don’t respond to a bulk-forming laxative such as isphagula husk, try what?

A

osmotic laxative such as a macrogol

147
Q

Bile-acid malabsorption may be treated with

A

cholestyramine

148
Q

The definition of an Upper GI Bleed is a haemorrhage with an origin proximal to the…

A

ligament of Treitz

149
Q

HBsAg negative, anti-HBs positive, IgG anti-HBc negative

A

previous immunisation

150
Q

In patients with severe colitis, colonoscopy should be avoided due to the risk of perforation, so what should be used?

A

flexible sigmoidoscopy

151
Q

Coeliac disease increases the risk of developing what ca?

A

enteropathy-associated T cell lymphoma

152
Q

Long term proton pump inhibitor therapy can cause what electrolyte disturbances?

A

hypomagnesaemia
hyponatraemia

153
Q

Dermatitis, diarrhoea, dementia/delusions, leading to death

A

Pellagra

154
Q

First-line pharmacological management of acute constipation

A

bulk-forming laxative such as isphagula husk

mobility, increasing fluid intake and high fibre diet also v important

155
Q

Induce remission in crohn’s

A

glucocorticoids (oral, topical or intravenous)

Budesonide is alternative in certain pts

metronidazole is often used for isolated peri-anal disease

156
Q

Maintaining remission in crohn’s?

A

azathioprine or mercaptopurine

and stop smoking

methotrexate is used second-line

157
Q

Useful in refractory disease and fistulating Crohn’s to induce remission?

A

infliximab
Patients typically continue on azathioprine or methotrexate.

158
Q

Induce remission in ulcerative colitis?

A

topical (rectal) aminosalicylate

if not achieved in 4w= add an oral aminosalicylate

still not achieved= add topical or oral corticosteroid

159
Q

Induce remission in ulcerative colitis in extensive disease?

A

topical (rectal) aminosalicylate and a high-dose oral aminosalicylate

if remission is not achieved within 4w= stop topical treatments and offer a high-dose oral aminosalicylate and an oral corticosteroid

160
Q

Induce remission in ulcerative colitis in severe colitis?

A

should be treated in hospital

IV steroids first-line
IV ciclosporin may be used if steroids are contraindicated

if after 72 hours there has been no improvement, consider adding IV ciclosporin to IV corticosteroids or consider surgery

161
Q

Maintaining remission in UC if mild or moderate eg. proctitis and proctosigmoiditis?

A

topical (rectal) aminosalicylate alone (daily or intermittent) or

an oral aminosalicylate plus a topical (rectal) aminosalicylate (daily or intermittent) or

an oral aminosalicylate by itself: this may not be effective as the other two options

162
Q

Maintaining remission in UC if left-sided and extensive ulcerative colitis?

A

low maintenance dose of an oral aminosalicylate

163
Q

Maintaining remission in UC following a severe relapse or >=2 exacerbations in the past year?

A

oral azathioprine or oral mercaptopurine

164
Q

UC flare severity?

A

Mild= <4 stools a day, with or without blood

Moderate= 4-6; minimal systemic distrubance eg. slight raise in CRP

Severe= >6 a day, containing blood; systemic disturbance eg. fever, anaemia, hypoalbuminaemia, tachy, abdo tenderness

165
Q

first line test for diagnosis of small bowel overgrowth syndrome

A

Hydrogen breath testing

166
Q

You cannot interpret TTG level in coeliac disease without looking at

A

IgA level (so test this when u test TTG)

167
Q

Patients must eat gluten for at least how long before they are tested for coeliac?

A

6w

168
Q

What is used for complex perianal fistulae in patients with Crohn’s disease?

A

A draining seton

169
Q

crypt abscesses

A

UC

170
Q

Dyspepsia: there is no need to check for H. pylori eradication with urea breath test if

A

symptoms have resolved following test and treat

171
Q

treatment for achalasia

A

1st= Pneumatic dilatation (less invasive)
2nd if failed= Heller cardiomyotomy (surgery)

172
Q

If a severe flare of UC has not responded to IV steroids after 72 hours, consider adding

A

IV ciclosporin or surgery

173
Q

In a mild-moderate flare of ulcerative colitis extending past the left-sided colon, how to Mx?

A

oral aminosalicylates should be added to rectal aminosalicylates, as enemas only reach so far

174
Q

Coeliac disease is associated with what deficiencys?

A

iron, folate and vitamin B12 deficiency

175
Q

What should be assessed before offering azathioprine or mercaptopurine therapy in Crohn’s disease?

A

TPMT activity

176
Q

Ascites: a high SAAG gradient (> 11g/L) indicates

A

portal hypertension

177
Q

A combination of liver and neurological disease points towards

A

Wilson’s

178
Q

During infection, ferritin is an unreliable indicator of iron stored in the body as it is an acute phase protein. What should be used instead?

A

Transferrin saturation

179
Q

Autosomal recessive vs dominant conditions typically….

A

Autosomal recessive conditions are ‘metabolic’ - exceptions: inherited ataxias

Autosomal dominant conditions are ‘structural’ - exceptions: Gilbert’s, hyperlipidaemia type II

180
Q

Cerebellar disease signs?

A

D - Dysdiadochokinesia, Dysmetria (past-pointing), patients may appear ‘Drunk’

A - Ataxia (limb, truncal)

N - Nystamus (horizontal = ipsilateral hemisphere)

I - Intention tremour

S - Slurred staccato speech, Scanning dysarthria

H - Hypotonia

181
Q

Unilateral cerebellar lesions cause…

A

ipsilateral cerebellar signs

182
Q

Ptosis + dilated pupil = ?

Ptosis + constricted pupil = ?

A

Ptosis + dilated pupil = third nerve palsy

Ptosis + constricted pupil = Horner’s

183
Q

Total anterior circulation infarcts - all 3 of the following:

A

unilateral hemiparesis and/or hemisensory loss of the face, arm & leg

homonymous hemianopia

higher cognitive dysfunction e.g. dysphasia

184
Q

left homonymous hemianopia means

A

visual field defect to the left, i.e. lesion of right optic tract

185
Q

homonymous quadrantanopias

A

PITS (Parietal-Inferior, Temporal-Superior)

186
Q

Lambert-Eaton Syndrome is a paraneoplastic myasthenic syndrome most commonly associated with

A

small cell lung cancer.

It may precede the cancer diagnosis by a number of years

187
Q

Lateral medullary syndrome - PICA lesion?

A

cerebellar signs, contralateral sensory loss & ipsilateral Horner’s

188
Q

Fever, headache, psychiatric symptoms, seizures, focal features e.g. aphasia

A

?herpes simplex encephalitis

189
Q

The radial nerve is at risk in a shaft fracture of the

A

humerus

190
Q

Raised ICP can cause what nerve palsy?

A

third nerve palsy due to herniation

191
Q

Contralateral hemiparesis and sensory loss with the upper extremity being more affected than the lower, contralateral homonymous hemianopia and aphasia

A

middle cerebral artery

192
Q

Patients who present 4.5-9 hours after symptom onset, or with ‘wake-up stroke’ should still be considered for thrombolysis if

A

they have imaging evidence of potential to salvage brain tissue

193
Q

Progressively worsening headache with higher cognitive function impaired

A

urgent imaging

194
Q

Contraindication to triptan use

A

Cardiovascular disease

195
Q

Hoover’s sign

A

differentiates between organic and non-organic lower leg weakness

196
Q

Headache linked to Valsalva manoeuvres =

A

raised ICP until proven otherwise so LP is contraindicated

197
Q

Partial anterior circulation infarcts - 2 of the following:

A

unilateral hemiparesis and/or hemisensory loss of the face, arm & leg

homonymous hemianopia

higher cognitive dysfunction e.g. dysphasia

198
Q

rapid onset dementia and myoclonus

A

Creutzfeldt-Jakob disease

199
Q

Intubate if the GCS is less than

A

8

200
Q

Common peroneal nerve lesion can cause

A

weakness of foot dorsiflexion and foot eversion

201
Q

Pt presents with a fall following a recent diagnosis of Parkinson’s, think what?

A

may be Parkinson’s Plus syndrome eg. Progressive supranuclear palsy- so test CN III, IV and VI (common CP of PSP is vertical supranuclear gaze palsy

anyone with a fall test CN III, IV and VI

202
Q

Progressive supranuclear palsy

A

postural instability, impairment of vertical gaze, parkinsonism, frontal lobe dysfunction

203
Q

Progressive supranuclear palsy vs multiple system atrophy?

A

PSP= vertical gaze impairment

MSA= autonomic dysfunction is a more significant feature such as tachycardia, fainting, erectile dysfunction

both may present like Parkinsons

204
Q

Pulmonary function test results for obstructive lung disease eg. asthma, COPD, Bronchiectasis,
Bronchiolitis obliterans?

A

FEV1 - significantly reduced
FVC - reduced or normal
FEV1% (FEV1/FVC) - reduced

transfer factor reduced or normal

205
Q

Pulmonary function test results for restrictive lung disease eg:

Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity

A

FEV1 - reduced
FVC - significantly reduced
FEV1% (FEV1/FVC) - normal or increased

transfer factor reduced or normal

206
Q

Normal FEV1, FVC and FEV1/FVC ratio?

A

FEV1= >80% predicted
FVC= >80% predicted
FEV1/FVC= >70% predicted

207
Q

Clubbing may be seen in what?

A

bronchiectasis

208
Q

What is helpful in ventilated pts with ARDS?

A

prone positioning

209
Q

Pneumothorax Mx- what are the high-risk characteristics that determine the need for a chest drain?

A
  • Haemodynamic compromise (suggesting a tension pneumothorax)
  • Significant hypoxia
  • Bilateral pneumothorax
  • Underlying lung disease
  • ≥ 50 years of age with significant smoking history
  • Haemothorax
210
Q

Over rapid aspiration/drainage of pnuemothorax can result in what?

A

re-expansion pulmonary oedema

211
Q

When should oral Abx only be given in acute exacerbation of COPD?

A

presence of purulent sputum or clinical signs of pneumonia

212
Q

Neuromuscular disorders result in what pattern on pulmonary function tests?

A

restrictive pattern

213
Q

patient get admitted and you don’t know their full PMH. If someone is put on 15L of high flow O2 and suddenly go into respiratory acidosis and T2RF

A

think COPD

214
Q

Causes of upper lobe pulmonary fibrosis?

A

C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis

215
Q

Examples of SABA, SAMA, LABA, LAMA, ICS

A

SABA - Salbutamol or Terbutaline
SAMA - Ipratropium Bromide
LABA - Salmeterol or Formoterol
LAMA - Tiotropium
ICS - Budesonide or Fluticasone

216
Q

Characterising fractures: way to remember the Salter-Harris criteria (type of fracture)?

A

SALTEr
1 S-Straight
2 A-Above
3 L-Lower
4 T-Through (above and below)
5 Er-Everything (Crush)

217
Q

General Abx for pregnant pt allergic to penicillin?

A

erythromycin

218
Q

CO2 in asthma exacerbation?

A

pt hyperventilates so should be high O2 and low CO2

in severe= CO2 normal

near-fatal= CO2 >6 (should be low as breathing fast in exacerbations but as it is raised this is really bad)

219
Q

Pregnant women, severe asthma attack and improve with medical Tx?

A

still need hospital admission if pregnant

220
Q

What causes lower zone pulmonary fibrosis?

A

A - asbestos.
C - connective tissue diseases.
I - idiopathic pulmonary fibrosis.
D - drugs e.g. methotrexate, nitrofurantoin.

221
Q

Acute asthma Mx?

A
  1. Oxygen
  2. Salbutamol nebulisers
  3. Ipratropium bromide nebulisers
  4. Hydrocortisone IV OR Oral Prednisolone
  5. Magnesium Sulfate IV
  6. Aminophylline/ IV salbutamol
  7. ITU (intubation)

Oh
Shit,
I
Hate
My
Asthma

initially salbutamol + ipra together if severe or life-threatening

222
Q

COPD exacerbation, what to do when medical Mx fails?

A

BiPAP

if this fails then intubation and ventillation

223
Q

Target O2 sats in COPD?

A

if a known type 2 resp failure i.e hypercapnic on blood gas= 88-92%

Normal CO2 (not hypercapnic)= 94-98%

224
Q

COPD symptoms in a young person/non-smoker?

A

think alpha-1 antitrypsin (A1AT) deficiency

225
Q

Painful shin rash + cough

A

?sarcoidosis

226
Q

Persistent productive cough +/- haemoptysis in a young person with a history of respiratory problems →

A

?bronchiectasis

227
Q

Bronchiectasis vs pulmonary fibrosis

A

Bronchiectasis:

Primary Problem= Airway damage and dilation
Cough= Productive (mucus) Onset= Chronic but not necessarily progressive
Main Tx Focus= Infection control, airway clearance

Pulmonary Fibrosis:

Primary Problem= Lung tissue scarring
Cough= Dry
Onset= Progressive and worsening
Main Tx Focus= Slowing fibrosis, symptom management

228
Q

Sudden deterioration with ventilation suggests

A

tension pneumothorax

229
Q

Patients diagnosed with pneumonia who have COPD should be given what even if no evidence of the COPD being exacerbated

A

corticosteroids

230
Q

Although diagnosis is often confirmed on CT imaging, WHAT is raised in approximately 60% of sarcoid patients at diagnosis and is the most specific autoantibody used in diagnosis.

A

serum ACE raised in sarcoidosis (also hypercalcaemia)

231
Q

Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes

A

silicosis

232
Q

Hypercalcaemia + bilateral hilar lymphadenopathy

A

?sarcoidosis

233
Q

Light’s criteria state that a pleural effusion is an exudate if:

A
  • Effusion lactate dehydrogenase (LDH) level greater than 2/3 the upper limit of serum LDH
  • Pleural fluid LDH divided by serum LDH >0.6
  • Pleural fluid protein divided by serum protein >0.5
234
Q

If a pleural effusion is drained too quickly, a rare but important complication that can develop is

A

re-expansion pulmonary oedema

235
Q

Gynaecomastia - associated with what lung ca

A

adenocarcinoma

236
Q

most commonly causes a cavitating pneumonia in the upper lobes, mainly in diabetics and alcoholics

A

Klebsiella

237
Q

A chest infection failing to improve with antibiotics followed by a deterioration in symptoms with a cough productive of foul, purulent sputum, and rigours suggests

A

an empyema or abscess

CT findings of a smooth-walled fluid collection with air-fluid levels and pleural enhancement, alongside pleural fluid analysis showing a low pH, high LDH, and low glucose, confirm this diagnosis

chest tube drainage combined with antibiotics

238
Q

Indications for corticosteroid treatment for sarcoidosis are:

A

parenchymal lung disease, uveitis, hypercalcaemia and neurological or cardiac involvement

239
Q

treatment of choice for allergic bronchopulmonary aspergillosis

A

oral glucocorticoids eg. pred

240
Q

Which of the following options confirms that the chest drain is located in the pleural cavity?

A

The water seal rises on inspiration and falls on expiration

241
Q

COPD - still breathless despite using SABA/SAMA and no asthma/steroid responsive features →

A

add a LABA + LAMA

242
Q

COPD - still breathless despite using SABA/SAMA and asthma/steroid responsive features →

A

add a LABA + ICS

243
Q

contraindication for chest drain insertion

A

INR >1.3

244
Q

The treatment of extrinsic allergic alveolitis is

A

mainly avoidance of triggers

245
Q

Acute respiratory distress syndrome can only be diagnosed in the absence of

A

a cardiac cause for pulmonary oedema (i.e. the pulmonary capillary wedge pressure must not be raised)

246
Q

Decrease in pO2/FiO2 in poorly patient with non-cardiorespiratory presentation eg. acute pancreatitis →

A

?ARDS

247
Q

Obstructive sleep apnoea can cause

A

HTN

248
Q

first-line for acute bronchitis (unless pregnant/child)

A

oral doxycycline

249
Q

Fine end-inspiratory crepitations are seen in

A

idiopathic pulmonary fibrosis

250
Q

Coal workers’ pneumoconiosis typically causes

A

upper zone fibrosis

251
Q

What is recommended in COPD pts who have frequent exacerbations?

A

Azithromycin prophylaxis

252
Q

Large bullae in COPD can mimic a

A

pneumothorax

253
Q

Squamous cell carcinoma is associated with

A

hypertrophic pulmonary osteoarthropathy (HPOA)

254
Q

Asthmatic features/features suggesting steroid responsiveness in COPD:

A

previous diagnosis of asthma or atopy

a higher blood eosinophil count

substantial variation in FEV1 over time (at least 400 ml)

substantial diurnal variation in peak expiratory flow (at least 20%)

255
Q

Causes of hypoglycaemia

A

EXPLAIN

Exogenous drugs (typically sulfonylureas or insulin)
Pituitary insufficiency
Liver failure
Addison’s disease
Islet cell tumours (insulinomas)
Non-pancreatic neoplasms

256
Q

DKA resolution is defined as:

A

pH >7.3 and
blood ketones < 0.6 mmol/L and
bicarbonate > 15.0mmol/L

257
Q

What should happen to patients regular insulin if DMT1 in DKA?

A

continue long acting insulin and stop short acting

258
Q

Hyponatraemia, hyperkalaemia and weight loss

A

?Addison’s disease. Presentation of adrenal insufficiency can be very non-specific.

259
Q

Cushing’s syndrome electrolyte abnormality

A

hypokalaemic metabolic alkalosis

260
Q

Primary hyperaldosteronism can present with

A

hypertension, hypernatraemia, and hypokalemia

261
Q

High-dose dexamethasone suppression test with an ectopic source of ACTH

A

Cortisol: not suppressed
ACTH: not suppressed

262
Q

High-dose dexamethasone suppression test with Cushing’s syndrome due to other causes (e.g. adrenal adenomas)

A

Cortisol: not suppressed
ACTH: suppressed

263
Q

High-dose dexamethasone suppression test with Cushing’s disease (i.e. pituitary adenoma → ACTH secretion)

A

Cortisol: suppressed
ACTH: suppressed

264
Q

‘unrecordable’ blood sugar measurement with confusion and abdominal pain

A

DKA

‘unrecordable’ means it is too high

265
Q

High insulin, High C-peptide = Endogenous insulin production →

A

Insulinoma or sulfonylurea use/abuse

265
Q

Congenital adrenal hyperplasia has the following biochemical abnormalities

A

Increased plasma 17-hydroxyprogesterone levels
Increased plasma 21-deoxycortisol levels
Increased urinary adrenocorticosteroid metabolites

266
Q

PHaeochromocytoma - give what to manage HTN prior to surgical removal

A

PHenoxybenzamine (non-selective alpha-blocker) before beta-blockers

267
Q

Water deprivation test: primary polydipsia

A

urine osmolality after fluid deprivation: high
urine osmolality after desmopressin: high

268
Q

Endocrine parameters reduced in stress response: eg. following major surgery

A

Insulin
Testosterone
Oestrogen

269
Q

SGLT-2 inhibitors examples

A

canagliflozin, dapagliflozin and empagliflozin.

270
Q

TFTs in critically ill pt eg. ITU with pneumonia?

A

TSH normal, T3 & T4 low (Sick euthyroid syndrome)

271
Q

How to distinguish between DMT1 and DMT2?

A

C-peptide levels and diabetes-specific autoantibodies (anti-GAD)

normally in type 1= c-peptide low and antibodies present

272
Q

normal stroke - Mx

normal TIA - Mx

AF causing stroke - Mx

AF causing TIA - Mx

A

normal stroke - aspirin first, then lifelong clopi
normal TIA - aspirin first, then lifelong clopi
AF causing stroke - aspirin first, then DOAC
AF causing TIA - immediate DOAC

273
Q

1st line Mx for HTN?

A

Do they have diabetes? Yes = ACEi or ARB if Afro-Carribean
Are they Afro-Carribean or over 55? Yes = CCB
Are they non-Afro-Carribean and under 55? Yes = ACEi

274
Q

Patients with bradycardia and signs of shock require what

A

500micrograms of atropine (repeated up to max 3mg)

275
Q

New onset AF is considered for electrical cardioversion if it presents within

A

48 hours of presentation

276
Q

A patient develops acute heart failure 5 days after a myocardial infarction. A new pan-systolic murmur is noted on examination -

A

ventricular septal defect

277
Q

Mx of aortic dissection?

A

type A - ascending aorta - control BP (IV labetalol) + surgery
type B - descending aorta - control BP(IV labetalol)

278
Q

ACE inhibitor or ARB in pt who is afro-caribbean (after CCB or 1st line if diabetic)?

A

ARB preferred

279
Q

A right coronary infarct supplies the AV node so can cause what after MI (infarction)?

A

arrhythmias

280
Q

Poorly controlled hypertension, already taking an ACE inhibitor, calcium channel blocker and a standard-dose thiazide diuretic. K+ > 4.5mmol/l - what should you add?

A

specialist review

add an alpha- eg. carvedilol
58% or beta-blocker

281
Q

Tx if pharmacological cardioversion of AF agreed on?

A

amiodarone

282
Q

A posterior MI causes what on a 12-lead ECG

A

ST depression not elevation

283
Q

What drug class is contraindicated in V Tach?

A

CCB eg. verapamil

284
Q

PR interval over 200ms with an otherwise normal ECG (regular sinus rhythm, no missing QRS complexes) is consistent with

A

1st-degree atrioventricular block.

Isolated 1st degree atrioventricular block is common rarely problematic and a normal variant in athletes

285
Q

Mx of alcohol withdrawl if pt has liver cirrhosis?

A

long acting benzodiazepines eg. lorazepam

chlordiazepoxide C/I in cirrhosis

286
Q
A

FINALS (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions