Brainscape's Knowledge GenomeTM

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


See full index

Year 4 AFTs > October AFT > Flashcards

October AFT Flashcards

1
Q

Deficiency when knee reflexes are brisk and ankle absent. Reduced pinprick sensation up to mid calf.
Bloods:
- Low Hb
-Low WBC
-Low platelets
-High MCV

A

Vitamin B12 deficiency

Most common neurologic findings:
- Symettric paraesthesias or numbness and gait problems

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

55 Y/o man, lower back pain, fatigue foe 3 months.
Hb: low
WCC: Normal
Platelets: low
Corrected Ca: High
Albumin: low
Serum electrophoresis: monoclonal Ig Kappa peak
Bone marrow biopsy: foci of plasma cells, 18% of all haemopoietic cells

A

Multiple Myeloma

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

Women with reduced UO 24 hours post admission for CAP. Treated with IV amoxi and clarithro.
Creatine: normal on admission
High temp, HR: 106, BP: 102/50, Sats: 95% on O2.
Urinalysis: protein 1+
WCC: High
Platelets: Low
Urea: High
Creatinine: High

Cause of AKI?
A)Drug induced interstitial nephritis
B)HUS
C)Infection related glomerulonephritis
D) Renal hypoperfusion
E) Systematic vasculitis

A

D) RENAL HYPOPERFUSION

-Ptnt has ongoing sepsis with hypotension leading to pre-renal AKI
-This might lead to acute Tubular necrosis

-Not A: wouldn’t appear until 4-7 days of ABs
-Not B: Would present differently: marked anaemia, low platelet count
-Not C: Uncommon with pneumonia no evidence of haematuria
Not E: No evidence of non-visible haematuria

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

What type of ulcer:
-70 y/o woman
-Above left medial malleolus
-T2DM
-Smokes 10 PD
BMI: 34
Ulcer: 10 x 5cm and superficial
-Brown leg discolouration of both legs and thickened waxy feel.

A

Venous Ulcer

-Site and presence of hyperpigmentation are venous suggestive,
Plus not assoc with pain

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

What is the combination of hypoalbuminaemia, proteinuria, oedema, hypercholesteraemia characteristic of?

A

Nephrotic syndrome

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

Causes of nephrotic syndrome in 67 year old, non-diabetic, age group?

A

Membranous nephropathy
Minimal change
FSGS (Focal segmental glomerulosclerosis)

Myeloma can also be considered

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

What drugs are prescribed to reduce risk of future falls and fracture?

A

Calcium
Vitamin D
Alendronic acid

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

2nd line treatment of osteoporosis? And what is given if intolerant of oral bisphosphonate?

A

Denosumab (RANKL inhibitor)

Zoledronate IV

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

8 weeks of back pain, wakes at night, increasing tiredness, no history of problems/recent trauma.
Tenderness over L3/4

Hb: normal
ESR: High
Serum electrophoresis: no paraprotein

Investigation?
-CT scan+ abdomen
-DEXA
-HLA-B27
-Isotope bone
-X-ray lumbar spine

A

X-ray lumbar spine

-Spinal tenderness and elevated ESR = red flags espesh being woken from sleep

-If negative MRI would be next

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

17 y/o with florid 24hr skin rash, unwell for past week + intermittent abdo pain.

Rash: palpable, purpuric on lower limbs and buttocks
Temp: 37.2 PR: 70, BP:122/80
Urinalysis: Blood 3+, Protein 2+. nitrates -ve. leucocytes -ve
Bloods: normal Hb, WCC, platelets, Urea, Creatinine.

What is it?
A)IgA vasculitis
B) Meninococcal septicaemia
C) Microscopic polyangitis
D) Postinfectious glomerulonephritis
E) SLE

A

IgA Vascultis (Henoch-Schlonen Purpura)

-Classic presentation with vasculitic rash, and active urinary sediment
-Renal function usually normal

NOT:
B) Patient would be more unwell
C)Less common in this age, longer history
D) Follows clear infection, strep throat usually
E) Longer history, no vasculitic rash, othe features of SLE would be present

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

Other features of SLE?

A

Alopecia
Arthralgia
Skin rash
Cytopenias
Mouth ulcers

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

Glucose when a person is hypoglycaemic?

A

If they are alert enough to swallow: Oral tablets
Confused, aggresive, but able to swallow: Gluco gel 2 tubes, if post 15 mins still not fixed, repeat 3 times
If still not fixed: IV Glucose 20%
Unconcious: IV glucose 20% 100ml or IV glucose 10% 200mls
If no IV access IM Glucagon

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

Hypo Guidelines?

A

https://abcd.care/sites/default/files/site_uploads/JBDS_Guidelines_Current/JBDS_01_Hypo_Guideline_with_QR_code_January_2023.pdf

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

Which of these drugs causes constipation?
-Amlodipine
-Doxazosin
-Gliclazide
-Metformin
-Oxybutynin

A

OXYBUTYNIN
Anticholinergic

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

65 y/o man sudden visual change, flashing lights, floaters, loss of vision in upper quadrant of right eye.
PMHx: HT

Options:
Acute glaucoma
CRAO
CRVO
Retinal detachment
Vitreous haemorrhage

A

RETINAL DETACHMENT

-Typically ptnts complains of increasing floaters in one eye, as detachment progresses the separating vitreous will tug on surface of retina and create mechanical depolarisation of axons running through the nerve and fibre layer of retina= flashing lights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

70 y/o pyrexia, recued OX sars 2 days post gastercomy.
Post op pain control: difficult, so no chest physio/mobilisation
Temp: 37.8, PR: 84. O2 sats: 92% on 02.
BMI: 36
Reduced breath sounds at both lung bases, soft abdo, wound tenderness
Serous output from drain

A

ATELECTASIS

-Development of fever in early post-op + reduced 02 sats: bibasal atelectasis particularly in abdominal surgeries

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

6 months intermittent weakness and numbness bilaterally in legs upon walking 100m which settles with rest, Leaning forwards helps, can bike ride without provoking symptoms.
Diet controlled T2DM, Ex-smoker, BP: 178/95, Bilateral hip flexion weakness.

A

Lumbar spinal stenosis

Typical history of neurogenic claudication

Comes on with walking and better leaning forwards (including bike riding)

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

If a mass is found on chest x-ray, what is next most appropriate investigation?

A

CT scan of chest

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

Single most important diagnostic factor of localised melanoma?

A

Breslow thickness

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

42 y/o with colicky Central abdo pain, vomitingm abdo distension, increased bowel sounds.
Ruptured appendix 20 years ago.

Diagnosis and management?

A

Bowel obstruction

Conservative:
-Fluid resus
-Nasogastric decompression of gut
-Aspirate stomach contents with syringe then bag placed on free drainage

Surgical is for patients who do not improve with this as dividing adhesions creates opportunity for more to grow

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

Thrombocytopenia?

A

Deficiency of platelets in blood

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

Patients with thrombocytopenia, prolonged PT and aPTT, low plasma fibrinogen and elevated plasma D dimer.
What is usual diagnosis?

A

Disseminated Intravascular Coagulation
(DIC)

This can be due to complicated urosepsis

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

22 y/o went to sleep after party, woken at 3 to urinate, felt faint+nauseous while bearing down, lost consciousness and fell.
Diagnosis?
-Alcohol related seizure
-Cardiac dysrhythmia
-Ecstasy Toxcity
-Hypoglycaemia
-Vasovagal syncope

A

VASOVAGAL SYNCOPE

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

Purpose of cricoid pressure?

A

Prevents passage of gastric contents into airway

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

25 y/o LHS chest pain, worse upon lying back, and deep breaths.
Recent RTI.
Troponin: 0.025 (<0.01)
ECG changes: widespread PR depression and ST elevation

A

Pericarditis

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

18 y/o female, 6 hrs of severe dizziness + nausea
-Room constantly spinning, several vomits, dizziness worse upon opening eyes

Nystagmus with fast phase to left, doesn’t fatigure

A

Vestibular neuronitis

-Single episode in 18 y/o girl,
-If recurrent: vestibular migraine, BPPV

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

One episode of visible haematuria, 75 y/o man, BP: 142/80, temp:36.2, Urinalysis: 2+, leucocytes -ve, protein -ve, nitrate -ve.

MSUS: RBCs and epithelial, no microbes

Investigation?
-US Scan of renal tract
-CT urography
-Serum prostate Specific ANtigen
-Urology opinion
-Repeat MSUS for culture and sensitivity

A

Urology Opinion

-Possibility of transitional cell carcinoma of bladder
-Thorough invgX of haematuria is required

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

73 y/o male, 3 months of increasing weakness in RH with reduced forearm sensation.

Wasting of all intrinsic muscles of RH, weakness of finger abduction & adduction and thumb adduction.
Finger flexion normal, mild light touch altered sensation along ulnar aspect of forearm,
Reflexes normal

Whats the most likely site of issue?

A

T1 nerve root
Normal reflexes and normal other arm: no cord lesion
Sensory loss on forearm: no median and ulnar nerve lesions

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

What does intrinsic hand muscle wasting suggest?

A

T1 root lesion

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

Mixed growth on urine specimen indicates what?

A

Contaminated Urine sample

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

What does this ptnt have? and what should treatment be?

70 y/o female, 6 weeks generalised shoulder and hip pain and stiffness, excessive tiredness

Temp: 37.5, reduced ROM at shoulders, no muscle tenderness
Synovial thickening and tenderness at wrist

ESR: High
CK: Normal

A

Polymyalgia rheumatica

Based on age, pattern of msucle weakness and raised ESR

-Prednisolone (corticosteroids)

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

Man, increasing abdo pain, 1-2 bottles of vodka per day.
Jaundice, spider naevi, prominent veins on abdo walls
Diffusely tender abdo
Temp: 37.6

INR: High
ALT: HIgh
Bilirubs: High

US: ascites with mild hepatosplenomegaly

What do you suspect and what invgX do you do?

A

Spontaneous bacterial peritonitis (SBP) should be sus in patients with ascites due to to cirrhosis who develop fever, abdo pain, tenderness adn confusion

Therefore an Ascitic tap should be done

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

65 y/o woman, painful watery left eye 3 days

Reduced visual acuity on left. Fundoscopy normal.

You’re in GP what do you do?

A

Refer to ophthalmology as emergency

PAINFUL EYE WITH ACUITY LOSS= EMERGENCY

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

Triple assessment of breast includes?

A

Clinical examination
Breast imaging
Core biopsy

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

1st line HT treatment in afro-carribean peoples?

A

CCB
-pines

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

What is a prospective cohort?

A

Longitudinal cohort study that follows a group over time of similar individuals who differ with respect to certain factors to determine how factors affect rates of certain outcomes

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

Classic features of lithium toxicity?

A

Confusion
Coarse tremor
Jerking leg movements

38
Q

Likely underlying pathology for 42 y/o female with 3 months of wt loss, insomnia, palpitations.
Fine resting tremor, bilateral proptosis.

A

GRAVES
-Autoantibodies to TSH receptors

39
Q

Clinical picture of Primary Biliary Cirrhosis?

A

Raised ALP
AMA +ve
No evidence of obstruction

40
Q

Treatment of PBC?

A

Ursodeoxycholic acid

41
Q

Commonest endocrine cause of HT?

A

Conn’s syndrome

42
Q

Classic presenting signs of conns?

A

HT
Hypokalaemia

aswell consider in
-Severe HT (150/100)
-HT with sleep apnoea
-HT with FHx of early inset HT

43
Q

Fat emboli classic presentation?

A

Multiple fractures
Early onset hypoxia, dyspnea, tachypnea
-Acute confusion, altered level of conciousness, seizures/focal deficits
Petechial rash (last component to appear,only in 1/3 of cases)
PE presents similarly minus the neurological beef

44
Q
A
44
Q

Cardiac arrest in ED following chest pain, ventricular fib after 3 DC shocks, treated with bolus of IV adrenaline.
What do next with drugs?
-Altepase
-Amiodarone hydrochloride
-Atropine sulfate
-Lidocaine
-Magnesium sulfate

A

Amiodarone hydrochloride

-After 3rd shock if condition persists, resume chest compressions then give adrenaline 1mg IV and amiodarone 300mg IV will performing firther 2 mins CPR.

45
Q

What is the likely cause and what investigation should he have?

18 y/o male, 3 weeks malaise, fever, headaches, 1 week sore throat
Large tonsils with exudate, petechial rash on palate, axillary/inguinal lymphadenopathy

Temp: 37.6, PR:84, BP: 120/82, RR: 12

WCC: High
Lymphocytes: High
AST: High
ALT: High
Alkaline phosphatase: normal
Bilirubin: Normal

A

Glandular Fever

EBV serology

This is a common presentation of EBV induced mononucleosis

-YA sore throat, fever, malaise, lymphadenopathy, pharyngitis
Palatal petechiae
Lymphocytosis

46
Q

Most appropriate first step management for man in ED after fall, history of Afib and takes apixaban. No pain, signif bruising o to LHS face and arm.
PR: 80, Irregular
BP: 150/95
O2 sats: 96%
GCS 14

A

Cervical Spine Immobilisation

47
Q

Repeated episodes of racing sensation in abdomen, followed by loss of awareness.
Vacant stare, waves left arm around in writhing manner.
What do we think it is? What is the most likely site of origin?

A

Focal onset impaired awareness seizures

-The aura implicates it is one of the temporal lobes
-The waving of his left arm implicates a spread to the R frontal lobe however this is not the origin

48
Q

Risk with clozapine?

A

AGRANULOCYTOSIS

49
Q

34 y/o man, 3 day fever, sweat, productive cough, brown sputum.
Temp: 38.8, bronchial breathing over right mid-zone.
Likely pathogen?

A

Strep pneumoniae

50
Q

38 y/o man, blood stained sputum 3 months.
+ve for mycobacterium tuberculosis
Treated with quadruple therapy, 2 weeks later passing orange urine.

Whats going on?

A

Rifampicin

This typically casues orange discolouration

(Rifam-pissing: orange urine)

51
Q

46 y/o
Fevere, headache, confusion over several hours
Impossible to life head and resists attempts to feel neck
Temp: 38.1, PR: 105, BP: 110/60, GCS:14

Whats happening, what investigation do you want, and what result will it have?

A

Bacterial meningitis
Lumbar puncture

High pressure, raised protein, XS neutrophils

52
Q

Treatment of chlamydia trachomatis infection?

A

Doxycycline orally

53
Q

Difference between croup and bronchiolitis?

A

Croup: URT illness, inflammation of larynx resulting in inspiratory stridor and harsh barky cough

Bronchiolitis: LRT ilness with inflammation of bronchioles resulting in expiratory wheezing and wet cough

Ronchi: weird low noise when breathing indicative of secretions

54
Q

What do you give a pregnant woman who is seizing?

A

Magnesium sulfate

55
Q

5 y/o girl
Smooth indistinct philtrum, thin upper lip, small eyes with epicanthal folds, flat midface, short nose
What is likely diagnosis?

A

Fetal alcohol syndrome

56
Q

Presentation of turners syndrome?

A

Neck webbing
Low set ears
HIgh palate
Retro or micrognathia
Posterior low hairline

57
Q

Physical presentation of DS?

A

Microcephaly
Low set ears
Protruding tongue
Small nose with flattened nasal bridge

58
Q

Old person in home with bloody diarrhoea. No urine output in past 24 hours. Other patients had similar episodes?

A

Ecoli
HUS: Reason for low UO

59
Q

Prominent hilar lymphadenopathy + scattered non-caeseating granuloma?

A

Sarcoidosis

60
Q

57 y/o woman, intermittent fresh vaginal bleeding for 3 weeks.
LMP: 6 yers ago
Left mastectomy for breast carcinoma, currently on tamoxifen?

Likely diagnosis:
A) Cervical carcinoma
B) Cervical ectropion
C) Endometrial carcinoma
D) Endometrial hyperplasia
E) Uterine leiomyoma

A

D ENDOMETRIAL HYPERPLASIA

A) Typical presentation: post-coital bleed
B) Typically doesn’t cause symptoms
C) This is possible due to tamoxifen, however benign hyperplasia is more likely
D) This is CORRECT as more likely given her use of tamoxifen
E) These tend to regress after menopause

61
Q

14 day old baby vomiting. Born at 28 weeks, still on resp support.
Lethargic and abdominally distended.

Whats going on?

A

Necrotising enterocolitis

Presentation: Vomiting, lethargy, bloody diarrhoea on deterioration

62
Q

Who is most commonly going to get NEC?

A

Sick preterm babas
Particularly with progression on enteral nutrition

63
Q

When would jaundice due to haemolysis present in a baby?

A

24 hours of birth

64
Q

Breast feeding jaundice occurs when?

A

Between 1-2 weeks of life

65
Q

Physiological jaundice when?

A

Within first week of life

66
Q

What type of epilepsy do tonic-clonic seizures suggest?

A

Generalised epilepsy

67
Q

First line generalised epilepsy treatment for non-child bearing age people?

A

Sodium valproate
Then
Lamotrigine

68
Q

Examples of Enzyme inducing AEDs?

A

Carbamazepine
Phenytoin
Topiramate

69
Q

What is an important POI with Enzyme inducing AEDs?

A

CANNOT BE USED WITH HORMONAL CONTRACEPTION

70
Q

Kernigs sign?

A

MENINGITIS

71
Q

Unilateral tremor of gradual onset?

A

PARKINSONIAN TREMOR

-Unilateral rules out essential + alcohol dependence
-Cerebellar lesion would cause coordination problems not tremor

72
Q

What is seen in meconium aspiration syndrome?

A

Meconium stained liquor

73
Q

Prolonged ROM increases likelihood of what?

A

Infection

74
Q

16 y/o painful, irregular periods: contraception?

A

COCP

-Irregularity + pain= COCP

Mirena: won’t help with pain
POP: Won’t provide hormonal balance
Intra-uterine device and depo-povera: breakthrough bleeding

75
Q

Diagnostic procedure for primary infertility where 36 y/o female has PID and normal ovulatory cycle, partner is fit and healthy?

A

Diagnostic laparoscopy

76
Q

4 y/o with fever for 7 days, erythematous rash 4 days across body.
Fully immunised, temp: 38.1, lips crackedm numerous palpable lympmhnodes
Bilateral conjunctivitis

A

Kawasaki disease

Fever duration: diagnostic

77
Q

What to do when a child vomits green?

A

THIS IS BILLIOUS VOMITING = EMERGENCY

Suggestive of obstruction

78
Q

37 y/o planning pregnancy soon, essential HT severe.
Treatment?

A

Labetalol, nifidepine, Methyldopa

79
Q

Progressive confusion over 2 weeks, slight slurring of speech, history of alcoholism and fall 2 weeks previously.
Diagnosis?

A

Chronic subdural bleed

80
Q

Overweight, 13 y/o male, limp for 3 weeks, antalgic gait, pain on passive and active movement of Left hip. Temp 37.1.
Diagnosis?

A

Slipped Upper Femoral Epiphysis

DDH: normally picked up in infancy
Perthes: Between 4-12 years old

81
Q

13 y/o girl, short for ages, mild LD, no signs of puberty?

A

Turners syndrome

82
Q

Allodynia?

A

Pain due to stimulus that wouldn’t normally provoke pain

83
Q

19 y/o male, post sore throat haematuria, feels well.
2 weeks later hands in urine sample, blood pressure 160/96, blood 3+, protein 2+.
Diagnosis?

A

IgA Nephropathy

84
Q

External rotation and groin pain in 72 y/o lady?

A

Intracapsular hip fracture (? dodgy explanation so maybe don’t take this at it’s word)

85
Q

1st line preventative treatment of migraines?

A

Topiramate

or
Propanolol (Just be careful of asthma)

86
Q

Little boy, sudden onset dyspnoea, fatigure, pink urine. Began shortly after eating lunch.

Biological father has genetic blood condition

Visibly pale, HR: 130

Hb: Low border of normal
MCV: Normal
Haptoglobin: low

A

G6PD deficiency

87
Q

Treatment for OCD?

A

SSRIs

88
Q

Medication for PTSD?

A

SSRIs (Sertraline)

89
Q

Change in memory, urinary incontinenece, unsteady gait.
DIganose?

A

Normal pressure hydrocephalus

90
Q

What is given in hard to control bleeding, when patient is on anti-platelet meds?

A

Platelets

91
Q
A

Year 4 AFTs (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions