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Year 3 > Other > Flashcards

Other Flashcards

1
Q

What is observer bias?

A

Information is collected differently from cases vs. Controls because the examiners know which is which

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2
Q

What is attrition bias?

A

Due to loss of participants during a study

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3
Q

What is selection bias?

A

Certain groups can be over or under represented in research

Can fix by randomising who is chosen

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4
Q

What is observation bias?

A

Participants are aware they are being studied so they may alter how they act or what they say

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5
Q

What is confirmation bias?

A

During interpretation of results, researchers may look for patterns to confirm beliefs they already have

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6
Q

What is sensitivity?

A

How well a test can detect a disease

= true positives / total diseased

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7
Q

What is specificity?

A

How well a test detects NOT having the disease

= no. Of true negatives / total non-diseased

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8
Q

What is a positive predictive value?

A

Percentage of truly diseased people out of those who tested positive
Affected by prevalence

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9
Q

What is a negative predicted value?

A

Percentage of truly non-diseased people who tested negative

Affected by prevalence

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10
Q

Cost effectiveness ratio

A

Costs / benefits

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11
Q

Incremental cost-effectiveness ratio (ICER)

A

Difference in cost between two things / difference in effect

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12
Q

Cost utility analysis

A

Like cost effectiveness but measured in QALYs

ICER - extra cost per QALY gained

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13
Q

What is a cohort study?

A

Like case-control but over time

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14
Q

What does double-blind study mean?

A

Neither participants nor the examiners know who is getting what treatment

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15
Q

Which ecg leads help determine the axis of the heart?

A

I and aVF

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16
Q

What on an ecg shows a normal axis?

A

I and aVF are both positive

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17
Q

What on an ecg shows left axis deviation?

A

I positive

aVF is negative

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18
Q

What on an ecg shows right axis deviation?

A

I negative

aVF positive

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19
Q

What on an ecg shows extreme right axis deviation?

A

I and aVF both negative

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20
Q

6 stages to analysing an ECG

A
  1. Verify name and DOB
  2. Check date and time it was taken
  3. Calibration of paper (25mm/sec, 10mm is 1mV aka. 10 small boxes
  4. Determine the axis (I and aVF)
  5. Rate and rhythm
    p waves present? Regular? HR? PR interval? QRS duration
  6. Any other changes? e.g. ST elevation
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21
Q

Which ecg leads are septal and which artery?

A

V1 and V2

LAD

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22
Q

Which ecg leads are anterior? Which artery do these correspond to?

A

V3 and V4

Distal LAD

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23
Q

Which ecg leads are lateral and what artery?

A

I, aVL, V5 and V6

Circumflex artery

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24
Q

Which ecg leads are inferior and which artery?

A

II, III and aVF

Right coronary artery

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25
Q

What areas does the right coronary artery supply?

A

Right atrium and ventricle

SA and AV nodes

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26
Q

What areas does the left anterior descending artery supply?

A

Right and left ventricles and the ventricular septum

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27
Q

What areas does the left circumflex artery supply?

A

Left atrium and ventricle

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28
Q

What areas do the right and left marginal arteries supply?

A

Right supplies the right ventricle and apex

Left supplies the left ventricle

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29
Q

Describe aortic stenosis

A

Ejection systolic murmur (crescendo-decrescendo)
Heard loudest over aortic valve but commonly radiates to carotid arteries
May help if patient is sitting forwards

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30
Q

Describe mitral regurgitation

A

Pansystolic murmur

Loudest over the mitral area and radiates to axilla

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31
Q

Describe aortic regurgitation

A

Early diastolic murmur
Loudest at left sternal edge
May have a collapsing pulse
Heard louder with them leaning forward and holding an out breath

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32
Q

Describe mitral stenosis

A

Mid-diastolic murmur that’s low pitched and rumbling
Heard loudest over the apex
Associated with A. Fib

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33
Q

PR interval

A

3-5 small boxes
0.12-0.2 sec
AV nodal delay

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34
Q

How to determine HR from ECG

A

If regular, 300/no.of large squares between beats

If irregular, number of QRS in 30 large squares and times by 10

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35
Q

What does ST depression on an ECG indicate?

A

Ischaemia

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36
Q

Treatment for C.Diff

A

Vancomycin

Metronidazole

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37
Q

What are the 4 C causes of C.Diff

A

Co-amoxiclav
Clindamycin
Cephalosporins
Ciprofloxacins

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38
Q

Treatment for H.Pylori

A

PPI twice a day plus penicillin plus metronidazole/clarithromycin
If penicillin allergic, PPI plus metronidazole plus clarithromycin

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39
Q

Which arteries make up Little’s area?

A

Anterior and posterior ethmoidal
Splenopalantine
Greater palantine
Superior labial

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40
Q

What is the Chorda Tympani

A

Branch of facial nerve that runs through middle ear and is needed for taste signals to get back to brain

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41
Q

Tensor Tympani

A

Muscle in middle ear connecting malleus to tube wall
Innervated by CNV3
Dampens noise from chewing and shouting etc.

42
Q

Stapedius

A

Smallest muscle in the body connecting the temporal bone to the neck of stapes
Innervated by CN VII
Protects the ear from loud sounds

43
Q

What level is the hyoid?

A

C3

44
Q

What level is the laryngeal prominence of the thyroid cartilage at?

A

C4

45
Q

At what level does the cricoid cartilage end?

A

C6

46
Q

At what level is the thyroid?

A

C5 to T1

47
Q

Symptoms of hypercalcaemia

A

Bones, stones, groans and moans
Polyuria and polydipsia
Decreased QT interval on ECG
Constipation and vomiting

If urea is also high it could just be dehydration

48
Q

Causes, Signs and treatment of hypokalaemia

A

Causes: diarrhoea, duiretics, insulin
Signs: Weakness, cramping, twitches
ECG: T wave depression, ST sagging, Prolonged P wave interval
Treat with K supplements

49
Q

Causes, signs and treatment of hyperkalaemia

A

Causes: ACE inhibitors, B-blockers, NSAIDS, addisons, rhabdomyolysis, burns
Signs: Tall tented T waves, small P waves, wide QRS, V. Fibb
Treatment is URGENT is any ECG changes: Calcium gluconate (stabilises heart), Insulin and glucose (drives K+ into cells), salbutamol

50
Q

Type of kidney stones if rhomboid shaped crystals

A

Uric Acid

Cant be seen on CT or x-ray

51
Q

Type of kidney stones if envelope-shaped crystals

A

Calcium oxalate

Most common

52
Q

Type of kidney stone with hexagonal shaped crystals

A

Cysteine

53
Q

Type of kidney stone with wedge-shaped prism crystals

A

Calcium phosphate

2nd most common after oxalate

54
Q

Describe thyroid hormone synthesis

A

Iodide taken up by follicle cells and oxidised to iodine
Iodine attaches to tyrosine residues on thyroglobulin to form MIT and DIT (mono- and di- iodotyrosine unit)
MIT+DIT = T3
DIT+DIT = T4
Hormones are stored in colloid until required

55
Q

ENT sinuses and innervation

A

Frontal, Ethmoidal and Sphenoidal all CNV1

Maxillary CNV2

56
Q

What is consequentialism

A

And action can either be right or wrong, it depends on the consequences

57
Q

What is Utilitarianism

A

Acting to maximise the greatest happiness to the most people

E.g. triage

58
Q

What is communitarianiam

A

Acting for everyone not just individuals

E.g. notifiable diseases and vaccination programmes

59
Q

What does SMART goals stand for?

A 
Specific
Measureable
Achievable
Realistic
Time-limited
60
Q

What does contraction of the posterior cricoarytenoid do?

A

Widens the rima glottidis

E.g. gives more air for forced respiration

61
Q

What does contraction of the arytenoids and lateral cricoarytenoids do?

A

Closes the rima glottidis

Adducts for protection

62
Q

What does contraction of the thyroarytenoids do?

A

Relaxes the vocal ligaments decreasing pitch

63
Q

Contraction of which muscle decreases the pitch of voice?

A

Thyroarytenoid

64
Q

Contraction of which muscle increases pitch of voice?

A

Cricothyroid

65
Q

What does contraction of the cricothyroid do?

A

Tenses the vocal ligament increasing pitch

66
Q

What does contraction of just the lateral cricoarytenoid do?

A

Whispers

67
Q

What are the three big branches of the aorta?

A

Brachii cephalic artery which splits into right subclavian and right common carotid
Left common carotid
Left subclavian

68
Q

At what level is the coeliac trunk?

A

T12

69
Q

At what level is the superior mesenteric artery?

A

L1

70
Q

At what vertebral level is the inferior mesenteric artery?

A

L3

71
Q

Bullous pemphigus (vulgaris) and bullous pemphigoid differences

A

Pemphigus = younger, desmogelin 3, intraepidermal, rupture easily, nikolskys sign positive, mucosal involvement, net-like IgG on immunofluorescence

Pemphigoid = older, hemidesmosomes, subepidermal, tense and firm, nikolskys sign negative, linear IgG on immunofluorescence

72
Q

Difference between UVA and UVB

A

UVA causes longterm skin damage as it penetrates deeper into collagen, causes wrinkles
UVB doesn’t penetrate as deeply, responsible for sunburn

73
Q

Breslow’s Thickness

A

Deepest part of the tumour from the granular cell layer in mm
<1mm, 5yr survival of >95%
>4mm, 5 yr survival of 50%

74
Q

Which skin cancers are related to what type of sun exposure

A

Basal Cell and Malignant Melanoma is due to peak sun exposure, where youve been burned
Squamous Cell is due to cumulative sun exposure

75
Q

Type of excisions for what type of skin cancer

A 
MM = primary excision with clear margins
BCC = wide excision with histology to ensure clear margins
SCC = Complete surgical excision with a minimal margin of 5mm
76
Q

Treatment for A. Fibb

A

Rate control: Digoxin, beta blockers, verapamil/diltiazem

Cardioversion with amiodarone

77
Q

Treatment for sinus bradycardia

A

Atropine

78
Q

Treatment for acute supraventricular tachycardia

A

Manouvres
IV Adenosine
IV verapamil

79
Q

Phases of ventricular muscle action potential

A

Phase 0: big upstroke caused by fast Na+ influx
Phase 1: slight downstroke caused by closure of Na+ channels and transient K+ efflux
Phase 2: Plateau caused by Ca++ influx
Phase 3: Sharp downstroke caused by closure of Ca++ channels and K+efflux
Phase 4: Resting membrane potential

80
Q

Symptoms specific to Crohns Disease and treatment

A 
No blood of mucus
Entire GI tract
“Skip lesions”
Terminal ileum most effected
Transmural inflammation
Smoking is a risk factor

Also weight loss, strictures and fistulas

Treatment: prednisolone and immunosuppressants e.g. azathioprine

81
Q

Symptoms specific to ulcerative colitis

A 
Continuous inflammation
Limited to colon and rectum
Only superficial mucosa is effected
Smoking is protective
Excrete blood and mucus
Use aminosalicylates (mesalazine)
Primary Sclerosing Cholangitis
82
Q

Describe Torsades de Pointes.

How it happens and symptoms

A

Long QT syndrome (usually inherited) and shows no symptoms but if theres too much sympathetic stimulation like from adrenaline then Torsades de Pointes can happen
Looks like scribble zig zag just up and down on ECG
Torsades de Pointes can cause fainting, seizures and sudden death
A problem with early after depolarisation

83
Q

Brugada Syndrome

A

Symptoms: sudden death, syncope, chest pain, SOB
Most likely at rest or after a meal, when feverish, or after alcohol
Predisposes to V. Tach or V. Fibb
ECG: ST elevation (though no plateau part) and with T wave inversion

84
Q

Wolff-Parkinson-White Syndrome

A 
Accessory Pathway (Bundle of Kent) that doesn’t have as much atrial delay
ECG: Short PR interval, Slanted/wide QRS, T wave inversion
Predisposes to atrial tachyarrhythmias
85
Q

Strange Situation: Child is distressed when mother leaves, scared of stranger when alone but will play with mum there, happy when mum returns and uses mum as a safe base to explore.
What type of attachment style is this?

A

Secure Attachment

86
Q

Strange Situation: Child is sad when mum leaves, avoids stranger always, in a huff when mum returns, cries a lot and doesnt explore.
What type of attachment is this?

A

Ambivalent attachment

87
Q

Strange situation: Child is fine when mum leaves, plays with stranger, doesnt care when mum comes back, is equally happy with both mum and stranger.
What type of attachment is this?

A

Avoidant attachment

88
Q

Teenager: self-reliant, doesn’t form relationships, has a negative view of other people.
What type of attachment?

A

Insecure-avoidant attached - Type A

89
Q

Teenager: anti-social behaviour, unpredictable, complains.

What type of attachment?

A

Insecure-ambivalent attached - Type C

90
Q

6 week milestones

A

Head control
Follows torch
Responsive to voice
Social smile

91
Q

6 month milestones

A

Rolls over, push up and weight bear on legs
Palmar grasp, puts things in mouth
Babbles and screams
Friendly with strangers, plays with feet

92
Q

12 month milestones

A

Crawls, may take first steps
Fine grip, bangs toys together
Responds to name, jargon words
Drinks from cup and waves goodbye

93
Q

18 month milestones

A

Runs and climbs
Tower of 3-4 bricks, picture books
5-20 words, points to body parts
Feeds with spoon, imitates adult behaviour

94
Q

2 year milestones

A

Stairs 2 feet a step
Tower of 6-7 bricks
50+ words, understands simple instructions
Puts on hat and shoes

95
Q

3 year milestones

A

Stairs with alternating feet
Copies circle, cuts with scissors
Simple conversation, asks lots of questions
Imaginative play, shares and plays with others

96
Q

4 year milestones

A

Runs stairs, kick, throw and catch
Copies cross, draws stick man
Tells stories, counts to 20
Dresses self, can take turns

97
Q

Developmental Red Flags

A 
Asymmetry of movement
Not reaching for object by 6 months
Not sitting unsupported by 12 months
Not walking by 18 months
No speech by 18 months
Regression
98
Q

Endocarditis in a ‘normal’ person or someone who’s recently been to dentist.
Most likely organism and empirical treatment

A

Strep. Viridans

Amoxicillin and Gentamicin (IV)

99
Q

Endocarditis in someone with a prosthetic heart valve

Most likely organism and empirical treatment

A

If <2months then staph. Epidermis. If >2 months then staph. Aureus
Vancomycin and gentamicin (IV) then on day 3/5 add oral rifampicin

100
Q

Endocarditis in an IVDU.

Most likely organism and empirical treatment

A

Staph. Aureus or epidermis

Flucloxacillin IV

Year 3 (10 decks)

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