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Passmed (Feb) Flashcards

1
Q

Recent sore throat + arthritis + rash + pansystolic murmur = ?

A

? Rheumatic fever

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2
Q

Hypercalcaemia ECG findings?

A

Shortened QT

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3
Q

Cardiac abnormality associated with polycystic kidney disease?

A

Mitral valve prolapse

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4
Q

Hypokalaemia - ECG changes?

A

U waves
Small or absent (occasionally inverted) T waves
Prolonged PR
Long QT
ST depression

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5
Q

Cardiac tamponade - Beck’s triad?

A

Falling BP
Raised JVP
Muffled heart sounds

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6
Q

What is Torsades de pointes and what to Rx?

A

Polymorphic ventricular tachycardia associated with prolonged QT
Treat with IV magnesium sulphate

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7
Q

Stable angina - treatment?

A

Acute - GTN
Prevention - 1st line = CCB or BB

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8
Q

Cardiac tamponade - ECG findings?

A

Electrical alternans

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9
Q

Verapamil + BB =?

A

Big no no

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10
Q

Hypothermia - ECG changes?

A

Bradycardia, J waves

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11
Q

PE and renal impairment - what Ix?

A

V/Q scan

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12
Q

What is haemochromatosis and it’s treatment?

A

Excessive total body iron and deposition in tissues.
Hereditary - HFE, chromo 6, auto recessive

Treat with venesection.

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13
Q

First step in treatment for hepatic encephalopathy?

A

Lactulose - excretion of ammonia

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14
Q

Features of myeloma?

A

CRABBI

Calcium raised
Renal failure - light chain deposition
Anaemia
Bleeding
Bone pain / lesions
Infection

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15
Q

Investigations for myeloma?

A

Bloods - FBC (anaemia), U&Es (renal failure), hypercalcaemia, peripheral film (rouleux formations)

Protein electrophoresis (monoclonal IgA / IgG)

Whole body MRI

Bone marrow aspirate (sig raised plasma cells)

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16
Q

Hodgkins lymphoma - diagnostic histology?

A

Reed-Sternberg cells = mirror imagine nuclei

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17
Q

Polycythaemia vera - association with mutation of which gene?

A

JAK2

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18
Q

Immune thrombocytopenic purpura - management?

A

If platelets <30
or are >30 WITH high risk of bleeding
oral prednisolone

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19
Q

Acute pericarditis - ECG changes?

A

Widespread changes
Saddle ST elevation
PR depression

20
Q

Acute pericarditis - treatment?

A

Combination of NSAIDs and colchicine (for viral and idiopathic causes - most)

21
Q

Stable angina not controlled with GTN - next step?

A

Calcium channel blocker THEN
Beta-blocker

(note if BB CI’d then long acting nitrate eg ivabradine, nicorandil or ranolazine)

22
Q

Long QT syndrome - pathophysiology?

A

Usually due to loss-of-function/blockage of K+ channels

23
Q

Ventricular tachycardia + verapamil = ?

A

Contraindicated

24
Q

What will be shown on a clotting screen of a patient on long term warfarin?

A

Prolonged PT
Normal APTT

25
GTN - side effects?
Headache, hypotension, tachycardia
26
Tall R waves on V1 and V2 on ECG - indicative of what?
Posterior MI
27
Persistant diarrhoea - ABG?
Normal anion gap metabolic acidosis
28
CML - 1st line treatment?
Imatinib
29
Factor V Leiden - what is it?
Inherited thrombophilia Activated protein C resistance
30
Von Willebrands - clotting screen findings?
Prothrombin time - normal Activated partial thromboplastin time - long Factor VIII activity - decreased Bleeding time - prolonged
31
Lung function tests - obstructive picture?
FEV1:FVC ratio less than 0.75
32
Lung function tests - restrictive picture?
FEV1:FVC ratio more than 0.75 (both equally reduced)
33
TB - isoniazid side effects?
Peripheral neuropathy - pyridoxine is given as prophylaxis Liver toxicity
34
TB - rifampicin side effects?
Liver toxicity Hepatic enzyme (p450) inducer Bodily
35
TB - ethambutol side effects?
Visual disturbance Avoid in CKD
36
TB - pyrazinamide side effects?
Liver toxicity
37
PPI adverse effects?
Hyponatraemia, hypomagnesaemia Osteoporosis -> increased fracture risk Microscopic colitis Increased risk C.diff infection
38
Primary biliary cholangitis - what antibodies?
Anti mitochondrial antibodies Note: M rule - IgM - anti Mitochondrial antibodies - Middle age females
39
Small bowel overgrowth syndrome - Ix?
Hydrogen breath test
40
Blood result that indicates chronic rather than acute kidney disease?
Hypocalcaemia
41
Cluster headaches - prophylaxis?
Verapamil
42
1st line treatment for myasthenia gravis?
Reversible acetylcholinesterase inhibitors (usually pyridostigmine or neostigmine)
43
Lidocaine - mechanism of action?
Blockage of sodium channels
44
G6PD - what is it?
Most common RBC enzyme defect - increased susceptibility to oxidative stress X-linked recessive More common in Mediterranean and African people
45
G6PD - features?
neonatal jaundice is often seen intravascular haemolysis gallstones are common splenomegaly may be present
46
G6PD - Ix and findings?
Dx - G6PD enzyme essay Blood film - Heinz bodies, bite and blister cells

Phase 4 (3 decks)

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