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Phase 4 > Passmed (Feb) > Flashcards

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
Q

GTN - side effects?

A

Headache, hypotension, tachycardia

26
Q

Tall R waves on V1 and V2 on ECG - indicative of what?

A

Posterior MI

27
Q

Persistant diarrhoea - ABG?

A

Normal anion gap metabolic acidosis

28
Q

CML - 1st line treatment?

A

Imatinib

29
Q

Factor V Leiden - what is it?

A

Inherited thrombophilia
Activated protein C resistance

30
Q

Von Willebrands - clotting screen findings?

A

Prothrombin time - normal
Activated partial thromboplastin time - long
Factor VIII activity - decreased
Bleeding time - prolonged

31
Q

Lung function tests - obstructive picture?

A

FEV1:FVC ratio less than 0.75

32
Q

Lung function tests - restrictive picture?

A

FEV1:FVC ratio more than 0.75 (both equally reduced)

33
Q

TB - isoniazid side effects?

A

Peripheral neuropathy - pyridoxine is given as prophylaxis
Liver toxicity

34
Q

TB - rifampicin side effects?

A

Liver toxicity
Hepatic enzyme (p450) inducer
Bodily

35
Q

TB - ethambutol side effects?

A

Visual disturbance
Avoid in CKD

36
Q

TB - pyrazinamide side effects?

A

Liver toxicity

37
Q

PPI adverse effects?

A

Hyponatraemia, hypomagnesaemia
Osteoporosis -> increased fracture risk
Microscopic colitis
Increased risk C.diff infection

38
Q

Primary biliary cholangitis - what antibodies?

A

Anti mitochondrial antibodies

Note: M rule
- IgM
- anti Mitochondrial antibodies
- Middle age females

39
Q

Small bowel overgrowth syndrome - Ix?

A

Hydrogen breath test

40
Q

Blood result that indicates chronic rather than acute kidney disease?

A

Hypocalcaemia

41
Q

Cluster headaches - prophylaxis?

A

Verapamil

42
Q

1st line treatment for myasthenia gravis?

A

Reversible acetylcholinesterase inhibitors (usually pyridostigmine or neostigmine)

43
Q

Lidocaine - mechanism of action?

A

Blockage of sodium channels

44
Q

G6PD - what is it?

A

Most common RBC enzyme defect - increased susceptibility to oxidative stress
X-linked recessive
More common in Mediterranean and African people

45
Q

G6PD - features?

A

neonatal jaundice is often seen
intravascular haemolysis
gallstones are common
splenomegaly may be present

46
Q

G6PD - Ix and findings?

A

Dx - G6PD enzyme essay

Blood film - Heinz bodies, bite and blister cells

Phase 4 (3 decks)

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