Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 3A > Passmed general > Flashcards

Passmed general Flashcards

1
Q

What are the signs of cardiac tamponade?

A

Raised JVP, pulsus paradoxus, diminished heart sounds

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

What is the immediate management for anaphylaxis?

A

IM adrenaline (500mg in adults)

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

What are the guidelines for treatment of an acute anaphylactic response?

A

IM adrenaline, once then 5 mins later if no change. Then seek expert help for consideration of an IV adrenaline infusuon.

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

What is the common cause of subacute combined degeneration of the cord?

A

B12 deficiency

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

What other levels must be checked before giving folate?

A

B12 (these should be replaced before giving folate)

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

What are the symptoms of subacute combined degeneration of the spinal cord?

A

Distal tingling and sensory loss, brisk knee reflexes, absent ankle reflexes, gait abnormalities and positive romberg’s sign

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

What is the first line treatment for hypertension in an over 55 year old or person with African-Caribbean descent?

A

Calcium Channel Blocker

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

What is the first line treatment for hypertension in an under 55 year old or type 2 diabetic person?

A

ACE inhibitor

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

What is the second line treatment for hypertension?

A

If on CCB: add ARB, ACE-I or Thiazide diuretic (ARB in preference to ACE-I in African-Caribbean’s)
If on ACE-I: add CCB or Thiazide diuretic

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

What is the typical presentation for lyme disease?

A

Erythema migrans - Bulls eye rash that can develop 1-4 weeks after bite
Systemic upset

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

What is the treatment for lyme disease?

A

Doxycycline if early disease (can give if bulls-eye rash is seen, no need for testing)
Ceftriaxone if disseminated disease

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

How do you interpret blood gases?

A

ROME
Respiratory = Opposite
low pH + high PaCO2 i.e. acidosis, or
high pH + low PaCO2 i.e. alkalosis

Metabolic = Equal
low pH + low bicarbonate i.e. acidosis, or
high pH + high bicarbonate i.e. alkalosis

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

Which diabetes drug increases insulin sensitivity?

A

Pioglitazone

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

What is the typical presentation of an acoustic neuroma/vestibular schwannoma?

A

Vertigo, hearing loss, tinnitus and absent corneal reflex

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

Which antibody levels are raised in an autoimmune reaction?

A

IgG

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

Which vitamin should be administered with isoniazid to reduce the risk of peripheral neuropathy?

A

Vitamin B6 - Pyridoxine

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

Which conditions typically reduce FVC?

A

Restrictive lung diseases - scarring in the lungs - pulmonary fibrosis, asbestosis, neuromuscular disorders

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

Which conditions typically reduce FEV-1?

A

Obstructive lung diseases - COPD, asthma, bronchiectasis

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

What is lynch syndrome?

A

Hereditary non-polyposis colorectal cancer

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

Which cancer is most associated with hereditary non-polyposis colorectal cancer?

A

Endometrial cancer

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

What is the management of someone with fever who is undergoing chemotherapy?

A

Worried about neutropenic sepsis - immediately prescribe IV piperacillin/tazobactam

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

In addison’s disease when should the hydrocortisone dose be given?

A

Majority in the morning, remainder in the evening

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

What are the most common causes of meningitis?

A

0-3months - group B strep
3months-60years - neisseria meningititis
>60years - strep pneumoniae
Immunosuppressed - listeria monocytogenes

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

Which general investigations should be done in patients with metastatic disease of unknown origin?

A

FBC, U&E, LFT, calcium, urinalysis, CXR, CT chest, abdo, pelvis, AFP, hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the medical management of neuropathic pain?
OTC analgesia, then drugs like amitriptyline, pregabalin as monotherapy. Tramadol is not used as regular medication
26
Which two angina medications should not be taken together?
Verapamil (CCB) and beta blockers
27
What is the first line test for suspected legionella?
Urinary Antigen Test
28
What is the treatment for legionella?
Erythromycin/clarithromycin
29
What are the ECG changes seen in an acute MI?
- hyperacute t waves (few mins) - ST elevation - T wave inversion (within 24hrs) - Pathological Q waves (several days after)
30
What test results are seen in type 1 autoimmune hepatitis?
Antinuclear antibodies, anti-smooth muscle antibodies, raised IgG levels
31
What is goodpastures syndrome?
Anti-glomerular basement membrane disease - small vessel vasculitis causing haemoptysis and haematuria/proteinuria
32
In a suspected DVT if the D-dimer or doppler scan cannot be done within 4 hours what do you do?
Start DOAC - direct oral anti-coagulant (rivaroxaban/apixaban)
33
Which score is used for a DVT?
Wells
34
What is the first line treatment for C Diff?
Oral Vancomycin for 10 days
35
What type of medicine is metformin?
Biguanide - decreases gluconeogenesis in liver and increases glucose sensitivity
36
What type of medicine is glicazide?
Sulfonylureas - increase insulin release from beta-cells in pancreas
37
What are the feature of a myeloma?
CRABBI - hypercalcaemia - renal - dehydration and thirst - anaemia - bleeding - bones - lytic lesions (fractures and pain) - infection (increased risk)
38
What are the first line investigations in a confused/forgetful older patient in primary care?
Blood screen - FBC, U&E, LFTs, calcium, glucose, ESR/CRP, TFTs. B12, folate
39
What are the management guidelines for type 2 diabetes?
- 1st line - lifestyle - 2nd line - metformin - 3rd line - SGLT-2 inhibitors (added in increased CVD risk)
40
Should you use an ARB with an ACE-I?
No
41
Beta blockers are contraindicated in which condition?
Asthma
42
What type of medication is diltiazem?
CCB
43
What are the guidelines for treatment of stable angina?
- Aspirin, statin (unless contraindicated) - plus beta blockers or CCB - beta blocker and CCB/ or nitrate
44
What is renal tubular acidosis?
Inability to generate acid urine (cant secrete H+ or reabsorb HCO3-) in DCT, causes hypokalaemia
45
At what QRISK score should patients be given statins?
=>10%
46
What is the first line treatment for hypercholesteraemia?
Atorvastatin 20mg daily for prevention, 80mg for secondary prevention
47
What are 'B' symptoms of hodgkin's lymphoma?
Imply a poor prognosis - fever > 38, weight loss > 10% in last month, night sweats
48
What is the first line treatment for COPD?
SABA or SAMA
49
What is the second line treatment for COPD?
Add a LABA and LAMA, if already taking a SAMA, discontinue and switch to SABA
50
What are the clinical features of aortic regurgitation?
Early diastolic murmur, collapsing pulse, wide pulse pressure, quincke's sign (nailbed pulsation), De Musset's sign (head bobbing)
51
What is the first line investigation for patients with a suspected PE?
CTPA If this is negative then proximal leg vein ultrasound V/Q scan in those who cannot have CTPA
52
What is the Well's score for?
Suspected DVT and PE
53
What are the first line investigations with someone with suspected IBS and no red flags?
FBC, ESR, CRP, tissue transglutaminases or endomysial antibodies to test for coeliac disease
54
Which diabetes medication increases likelihood of hypoglycaemia?
Sulfonylureas - Chlorpropamide (increase pancreatic insulin secretion)
55
What are the features of duchenne muscular dystrophy?
Inherited myopathy. Progressive degeneration and weakness of muscle groups. Cannot walk by age 12 and ventilated by age 25.
56
What are the features of charcot-Marie-Tooth disease?
hereditary sensory and motor peripheral neuropathy. Usually LMN signs in all limbs with reduced sensation - more pronounced distally
57
What are the features of sarcoidosis?
Erythema nodosum, lymphadenopathy, dyspnoea, lupus pernio, fatigue, weight loss, hypercalcaemia (due to increased vitamin D conversion)
58
What is the most common ECG change in patients with a PE?
Sinus tachycardia (sometimes S1Q3T3 but this is more rare)
59
What is barrett's oesophagus?
Metaplasia of the oesophageal mucosa from squamous to columnar
60
What is the management of barrett's oesophagus?
high dose PPI, endoscopic surveillance with biopsies every 3-5 years. Endoscopic intervention if dysplasia is seen
61
What should be tested for to confirm anaphylaxis?
Tryptase
62
What does HbA1c measure?
The average blood glucose level over about 3 months - corresponds to the life span of a normal RBC
63
Which conditions cause lower than expected HbA1c levels?
Sickle-cell anaemia, GP6D deficiencym hereditary spherocytosis, haemodialysis
64
Which conditions cause higher than expected HbA1c levels?
B12/folate deficiency, iron-deficiency anaemia, splenectomy
65
What are the SIGN guidelines for pain prescribing?
- breakthrough dose of morphine is 1/6th of daily dose - patients on opioids should be prescribed a laxative - opioids should be used with caution in patients with CKD
66
What blood results are seen with DIC?
Prolonged prothrombin time, prolonged APTT, prolonged bleeding time and a low platelet count
67
What is the first line test for small bowel bacterial overgrowth?
hydrogen breath testing
68
What is the typical presentation of botulism?
Descending flaccid paralysis - starts with difficulty swallowing, speech issues, ptosis
69
What ECG changes are seen in patients with hyperkalaemia?
Tall tented T waves, absent P waves, broad QRS complexes, sinusoidal wave pattern
70
What is the treatment for hyperkalaemia?
- IV calcium gluconate to stabilise the myocardium - Insulin/dextrose IV or salbutamol to remove potassium from ECF - diuretics and treat cause
71
What are the investigations for acromegaly?
- 1st line - serum IGF-1 - confirmed diagnosis by oral glucose tolerance test and serial growth hormone measurements
72
What is the main causative organism of bronchiectasis?
Haemophilus influenzae
73
What are the typical features of bronchiectasis?
productive cough with crackles that clear on coughing, X-ray: thickened walls in the lower zones (tram-track sign)
74
What are the typical features of staphylococcus aureus gastroenteritis?
Short incubation period - severe vomiting after 30mins-8hours, symptoms usually resolve within 2 days.
75
What are the typical features of E.coli gastroenteritis?
Incubation period of 3-4 days, diarrhoea that becomes bloody, lasting up to a week
76
What are the typical features of salmonella gastroenteritis?
Diarrhoea and fever, symptoms usually occur between 6hrs and 6 days after infection
77
What type of medicine is rampril?
ACE-Inhibitor
78
What are some pre-renal causes of AKI?
Ischaemia, hypovolaemia secondary to diarrhoea, vomiting, renal artery stenosis
79
What are some intrinsic causes of AKI?
glomerulonephritis, acute tubular necrosis, rhabdomyolysis, tumour lysis syndrome
80
What are some post-renal causes of AKI?
Kidney stone in ureter or bladder, BPH, external compression of the ureter
81
Which drugs can cause AKI?
NSAIDS, aminoglycosides, ACE-I, angiotensin 2 receptor antagonists, diuretics, contrast agents
82
What is the diagnostic criteria for AKI?
Any of the following: - a rise in serum creatinine of >26um/L in 48 hrs - a 50% rise in serum creatinine in 7 days - a fall in urine output to less than 0.5ml/kg/hr for more than 6 hours
83
What is the initial management for acute coronary syndrome? (STEMI, NSTEMI)
aspirin 300mg oxygen if sats <94% morphine for patients in severe pain nitrates - IV or sublingually
84
What is the acute management of patients with NSTEMI?
Aspirin 300mg, fondaparinux if no immediate angiography or PCI planned (angiography for patients who are clinically unstable - hypotensive)
85
What is the main pathology that the US between 16 and 24 weeks detects in twins?
Twin-to-twin transfusion syndrome
86
What is the classical presentation of Henoch-Schonlein purpura?
Purpuric rash with localised oedema over buttocks and extensor surfaces, abdo pain, polyarthritis, features of IgA nephropathy
87
What is the treatment for aortic dissection?
Ascending aorta - IV labetalol and surgery Descending aorta - IV labetalol
88
What is the most common cause of neutropenic sepsis?
Coagulase negative, gram +ve bacteria - staphylococcus epidermidis
89
What is the first line treatment for diabetics with hypertension?
ACE inhibitors/ARBs
90
What is achalasia?
Failure of oesophageal peristalsis and of relaxation of the lower oesophageal sphincter
91
What are the typical features of achalasia?
Dysphagia of both liquids and solids heartburn regurgitation of food - aspiration pneumonia bird's beak appearance on barium swallow
92
What are the features of necrotising fasciitis?
- acute onset - pain, swelling and erythema, often presents with worsening cellulitis with pain out of keeping with physical features - very tender to touch
93
What is the management of necrotising fasciitis?
Urgent surgical debridement, IV antibiotics
94
What are the typical features of Addison's disease?
Primary adrenal insufficiency - hyponatraemia - confusion - high ACTH - hyperpigmentation - Low aldosterone - low BP - High potassium
95
What is the criteria for a diagnosis of CKD stage 1 and 2?
There must be signs of kidney damage for a diagnosis to be made 1 = eGFR < 90ml/min 2 = eGFR 60-90ml/min
96
What are the CKD stages?
1 Greater than 90 ml/min, 2 60-90 ml/min 3a 45-59 ml/min, 3b 30-44 ml/min, 4 15-29 ml/min, 5 Less than 15 ml/min,
97
What is the Ann-Arbor staging of Hodgkin's lymphoma? (name the stages)
I: single lymph node II: 2 or more lymph nodes/regions on the same side of the diaphragm III: nodes on both sides of the diaphragm IV: spread beyond lymph nodes A = no systemic symptoms other than pruritus B = weight loss > 10% in last 6 months, fever > 38c, night sweats (poor prognosis)
98
What are the clinical features of aortic dissection?
Widened mediastinum on CXR Acute fall in BP Widespread ST depression, normal troponin BP differences between limbs
99
What investigations should be done for potential aortic dissection?
CXR CT angiography is best Transoesophageal echocardiography for unstable patients
100
What are the features of Hodgkin's lymphoma?
- Reed-Sternberg cells - mirror image nuclei - large, non-tender, rubbery lymph nodes - alcohol induced pain - weight loss, pruiritus, night sweats, fever
101
What are the clinical features of acute epiglottitis?
Rapid onset, high temperature, stridor, drooling of saliva, tripod position (leaning forward, neck extended in seated position)
102
How do you calculate the units of alcohol per week?
Ml of alcohol x strength (ABV) / 1000
103
Which organism causes epiglottitis?
Haemophilus influenzae type B
104
How does hyperventilation help raised intracranial pressure?
Reduced CO2 - vasoconstriction of the cerebral arteries - reduce ICP
105
How do you calculate units of alcohol?
Ml x percentage / 1000
106
What is the treatment for angina?
aspirin + statin + GTN
107

Phase 3A (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions