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Year 3 > Pass med and general > Flashcards

Pass med and general Flashcards

1
Q

Fungal meningitis in immunosuppressed

A

Cryptococcal meningitis - yeast encapsulating - sex worker

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2
Q

Examination findings constitant with ankylosing spondylitis

A

Schober’s test <5cm

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3
Q

Investigation findings for SLE

A

Positive Anti-dsDNA and anti-smith antibodies, Low levels for C3 and C4

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4
Q

Genetic cause of Marfans syndrome and hw do you monitor

A

Marfan’s syndrome is an autosomal dominant connective tissue disorder. It is caused by a defect in the FBN1 gene on chromosome 15 that codes for the protein fibrillin-1. It affects around 1 in 3,000 people.

Monitor via regular echo

Give BBlocker and Losartan for ACE-I as it decreases TGF-B

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5
Q

What does chest pain with ECG changes in all leads and a small rise in troponin mean?

A

All coronary territories points away from ACS.

Small rise in troponin points to pericarditis

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6
Q

What type of pericarditis does ureamia cause?

A

fibrinous pericarditis

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7
Q

Specific ECG changes in pericarditis

A

widespread ‘saddle-shaped’ ST elevation

PR depression: most specific ECG marker for pericarditis

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8
Q

Imaging in non massive PE, with no renal failure

A

Computed tomographic pulmonary angiography (CTPA)

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9
Q

Periarticular erosions are seen in

A

rheumatoid arthritis

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10
Q

X-ray changes of osteoarthritis

A

decrease of joint space
subchondral sclerosis
subchondral cysts
osteophytes forming at joint margins

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11
Q

Electrolyte imbalance associated with sertraline

A

SSRIs are associated with hyponatraemia

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12
Q

What are the shockable rhythms in cardiac arrest?

A

VF and pulsless VT pVT - If VF/pVT persists, only after a third shock should adrenaline 1 mg IV and amiodarone 300 mg IV be administered.

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13
Q

How long before surgery should warfarin be stopped?

A

Five days in general - INR has to be bellow 1.5

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14
Q

Ankylosing spondylitis features

A 
Ankylosing spondylitis features - the 'A's 
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
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15
Q

TB drug that can induce lupus

A

Isoniazid

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16
Q

confusion and pink mucosae are typical features of

A

carbon monoxide poisoning

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17
Q

What drugs decrease lithium levels?

A

sodium bicarbonate and aminophylline

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18
Q

Common side effects of bisphosphonates

A

Eosophageal problems

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19
Q

… can be added as a second line treatment for rate control in atrial fibrillation

A

Digoxin

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20
Q

Diagnosis of Orthostatic hypotension

A

Orthostatic hypotension can be diagnosed when there is a drop in SBP of at least 20 mmHg and/or a drop in DBP of at least 10 mmHg within 3 minutes of standing

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21
Q

Patient taking antibiotics with new onsent of An ECG shows polymorphic ventricular tachycardia (torsades de pointes).

A

Clarithromycin can cause QT interval prolongation and therefore may trigger polymorphic ventricular tachycardia, particularly in patients with an underlying channelopathy.

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22
Q

Penicillamine can cause what in a patietn with wilsons disease

A

membranous glomerulonephropathy and therefore prominent bilateral leg swelling and periorbital oedema.

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23
Q

Fever on alternating days

A

Malaria

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24
Q

Four myxoedemic coma signs

A

Hypothermia, hyporeflexia, bradycardia and seizures, think

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25
Renal disease caused by penicillin
acute interstitial nephritis
26
Eosinophilic casts in urine are a sign of ... usually caused by ....
tubulointerstitial nephritis, usually caused by drug reactions
27
Antibiotics that cause Rhabdomyolysis o
erythromycin
28
High anion gap means high which type of acid?
Organic acid
29
What type of acidosis is anion gap useful in?
Metabolic
30
What are the causes of high ion gap acidosis?
Lactic acidosis(Shock, salicylate), ketoacidosis, methanol poisoning, ethylene glycol poisoning
31
What are the causes of a normal ion gap acidosis?
Renal Tubular acidosis and diarrhoea
32
What can a normal ion gap acidosis be referred to?
Hyperchloraemic acidosis
33
Anti psychotic most linked to prolong QT
Halaperidol
34
Clozapine adverse effect
agranulocytosis
35
Acronym for mechanism of benzos and barbituates
Frequently Bend - during barbecues - Benzos increase frequency of chloride Barbiturates increase duration of chloride
36
Starting Fluoxetine from another SSRI
Stop SSRI and then start, if moving from fluoxetine wait seven days on nothing.
37
ECT side effects
``` headache nausea short term memory impairment memory loss of events prior to ECT cardiac arrhythmia ```
38
Side effects of lithium
nausea/vomiting, diarrhoea fine tremor nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus thyroid enlargement, may lead to hypothyroidism ECG: T wave flattening/inversion weight gain idiopathic intracranial hypertension
39
Lithium levels required
0.4-1.0 mmol/L
40
What two organs are effected by lithium
kidneys and thyroid - hypothyroid
41
Mirtazapine side effects and what patients you give it to
sedative and increased apatite. Good for elderly patients. a2 antagonist
42
Non-selective monoamine oxidase inhibitors side effect
Cheese reaction - avoid tyramine
43
Bromocriptine is a treatment for
galactorrhoea
44
According to current NICE guidelines on the management of DKA, the infusion of insulin should be
0.1 unit/kg/hr
45
Thiazolidinediones are absolutely contraindicated in
Heart failure`
46
prolactinoma first line medical treatment
Dopamine agonist such as bromocriptine
47
optimal treatment in HNF1A-MODY
Sulfonylureas
48
Atrial fibrillation cardioversion drugs
amiodarone + flecainide
49
Progressive multifocal leukoencephalopathy is caused by
the JC virus or BK virus
50
Factor V Leiden mutation results in
activated protein C resistance
51
Gait ataxia is caused by
cerebellar vermis lesions
52
Myelodysplasia may progress to
acute myeloid leukaemia
53
Antibiotics for acites with protein of 15 or less
oral ciprofloxacin
54
Large vessel arteritis in woman
Takayasu's arteritis
55
What respiratory drug increases lactate?
salbutamol
56
How to differential left and right heart failure?
You only get pulmonary oedema in Left sided heart failure, although chronic pulmonary oedema can then cause right sided heart failure think cor pulmonale
57
Where is BNP made?
Ventricles
58
Referral for BNP between 400-2000
six week cardiology
59
Referral for BNP over 2000
Two week wait cardiology
60
What can you use as a substitute for spironolactone
Eplerenone
61
Side effects of ACE- I
cough due to bradykinin, postural hypotension and angioedema which can look like anaphylaxis
62
Drug if patient in AF with HF
Digoxin
63
Blood cultures or antibiotics first if septic?
Blood cultures if you can still give antibiotics within an hour
64
What type of organisms normally cause UTIs and Pylionephritis
Gram negative rods e.g e. coli
65
How to protect kidneys if giving contrast
Give fluids
66
ALL triad
Bruised, tired and pale
67
Most common paediatric tumour
osteocytoma
68
Common SOL if someone had childhood radiotherapy
meningioma
69
Posterior rib fracture in kids
non accidental injury
70
Kid with lots of burns that look like NAI
Staph A blisters
71
most common cause of macropituitaryism
prolactinoma
72
mechanism of hyperpigmintation in addisons
ACTH binds to melanocortin 1 receptor
73
White sputum often means
COPD
74
Gout histological findings
negatively birefringent needle shaped crystals
75
Drug that causes gout
Bendroflumethiazide
76
Multiple Myeloma urinary protein
bence jones
77
Leads that change in a right sided MI
II, III, AVF
78
What artery normally supplies both the SA and AV node?
right coronary artery
79
Acute pancreatitis Blood test
amylase
80
Chronic pancreatitis test
stool elastase
81
Thyroid problem that causes a raised calcitonin?
Medullary thyroid cancer - can be part of MEN 2
82
Charcot's triad
RUQ pain, jaundice, fever
83
What does anti cardiolipin indicate?
Antiphospholipid
84
Most sensitive marker for lupus
ANA - 90%, double stranded DNA more spesific but only in 60%
85
Industrial cause of transitional cell carcinoma of the bladder
Alanine dyes
86
Risk factors for squarmous cell carcinoma of the bladder
smoking and schistosomiasis
87
TB staining
Acid Fast
88
pneumonia urinary tests
pneumococcal and legionella
89
serum ceoliac test
Anti TTG
90
what happens to lipids in nephrotic syndrome
Hyperlipidaemia
91
Coffee bean sign
Sigmoid Volvulus
92
Meningitis and rash
meningicoccal septicaemia
93
Hyperkalaemia ECG changes
Tall T, Broad QRS, flat P
94
what part of brain circulation are the legs supplied from?
anterior circulation
95
Treatment for status epilepticus
lorazapam
96
TB treatment algorithm
2 weeks of RIPE, four weeks of RI
97
Middle aged woman who wears a head scarf and breaks her hip
Vit D deficiency
98
Pin point pupils overdose
opioids
99
Young girl, wide QRS, long QT overdose
Tricyclics, give bicarbonates
100
Benzo overdose signs and treatment
Flumazenil, but only if very bad as lover the siuzuire threshold
101
Heparin overdose treatment
Protamine sulphate
102
Beta blocker overdose treatment
Atropine if brady, glucagon if resistant
103
Wrist drop after a bender
radial nerve palsy
104
Treatment for oesophageal candida
fluconazole
105
AIDs diarrhoea
cryptosporidium
106
HIV penumonia
P Jiroveci, give co trimoxazole
107
HIV and rash
Kaposi's sarcoma
108
HIV focal neurological lesions
Toxoplasmosis
109
Meningitis in HIV
Cryptococcus
110
HIV eye disease
CMP retinitis
111
GORD associated cancer
adenocarcinoma of the oesophagus
112
Smoking and oesophagus cancer
squamous cell carcinoma
113
treatment for PE but anticoagulation contraindicated
IVC filter
114
gold standard investigation for achalasia
Manometry
115
Two muscles that a pharangeal pouch is made in
between thyopharyngeus and cricopharangeus
116
Systemic sclerosis symptoms and treatment
Raynaud's and scleroderma, in CREST Calcinosis, Raynaud's phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia. Associated with anti centromere antibodies
117
diffuse cutaneous systemic sclerosis test
scl-70 antibodies
118
GI cause of high urea
Upper GI bleed
119
Peptic ulcer sign and treatment
Pain on eating, H pylori, triple therapy for PPI two months, amox and clarithro
120
Multiple gastric ulcers and no H Pylori
Zollinger Elison syndrome
121
Calcified pancreas
Chronic pancreatitis
122
IBD with granuloma
Always crohns
123
Albumin in IBD
Low as chronic inflamation
124
Crohns treatment
Azathioprin
125
Side effect of TNF-alpha inhibitors
reactivation of TB. Example: infliximab
126
Gold standard investiagtion of ceoliac
Jejunal biopsy - can get dermatitis hepetiformis and deranged LFTs
127
HNPCC inheritance
autosomal dominant
128
What can you give for IBS pain
mebeverine
129
Complication of compylobacter jejuni
Guillan barrie
130
If Salmonella, diiarrhoea and rose rash
typhoid fever
131
Acute liver injury and blood
in acute liver injury clotting will be off
132
If AST:ALT is greater than 2
Alcohol
133
NASH and LFTs
ALT higher than AST
134
Paget's and LFTs
rise in ALP
135
Thyroid cancer that secretes calcitonin
Medullary tumour, cancer of parafolicular C cells, secretes calcitonin as part of MEN 2
136
Thyroid cancer associated with hashimotos
lymphoma
137
Most common thyroid cancer
papilliary
138
commonest type of ovarian cyst
follicular cyst - gets smaller after several mestrual cycles
139
Yoke sac tumours secrete
AFP
140
High AFP in pregnancy
nural tube defect
141
Low AFP in pregnancy
Trisomy 21
142
Ovarian tumour that secretes hCG
choriocarcinoma - often malignant
143
Time window for stroke thrombolysis
4.5 hours, if over 300mg aspirin
144
Valoprate and enzymes
Enzyme inhibitor - think of trading inhibitions
145
Migraine treatment and migraine prophylaxis
Treatment Triptan (T), Prophylaxis Propanolol or topiramate
146
Suspected or known lung cancer from CXR
contrast enhanced CT before biposy
147
Hyperaldosteronism blood gas
metabolic alkalosis
148
When is pioglitazone contraindicated?
Bladder cancer and high weight
149
What drugs to avoid in CKD
antibiotics: tetracycline, nitrofurantoin NSAIDs lithium metformin
150
When should warfarin be stopped before surgery?
5 days before, INR below 1.5
151
Inferior MI and aortic regurg
Proximal aortic dissection
152
Downsloping ST depression
digoxin toxicity
153
Deep T wave inversion or biphasic T waves in V2-V3
ritical stenosis of the left anterior descending artery
154
Prophylaxis of cluster headaches
Verapamil
155
Prophylaxis of migranes
propanolol
156
Condition associated with temporal arteritis
polymyalgia rheumatica,
157
Side effects of bisphosphonates
oesophagus problems
158
NOAC that can be used to prevent ischemic stroke in AF
Dabigatran
159
unprovoked DVT wafarin treatment time
6 months
160
Hypercalcaemia, renal failure, high total protein =
myeloma
161
Hereditary spherocytosis aplastic cause
precipitated by parvovirus infection
162
What is Cryoprecipitate
Factor VIII, fibrinogen, vWF and factor XIII
163
Myloma CRAB:
high Calcium, Renal impairment, Anaemia and Bone pain

Year 3 (26 decks)

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