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Yr 3 Medicine > PassMed Qs > Flashcards

PassMed Qs Flashcards

1
Q

What is the antibiotic prophylaxis of choice for COPD patients who continue to have exacerbations?

A

Azithromycin

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2
Q

How can a posterior MI present on a normal 12 lead ECG?

A

Tall R waves in V1-V2

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3
Q

What is the first line anti-anginal for stable angina with patients with HF?

A

Bisoprolol

(Aspirin + statins are appropriate but aren’t anti-anginals)

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4
Q

How do we diagnose Brugada Syndrome and how is it treated?

A

ECG: ST elevation followed by T wave inversion in V1-V3

Tx: Implantable cardioverter-defibrilator

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5
Q

When are nitrates contraindicated?

A

Hypotension (<90mmHg)

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6
Q

A patient presents to you with severe SOB + LOC, he suffered a MI recently.
What is the diagnosis and what murmur would you here?

A

Widespread systolic murmur

Mitral Regurgitation (secondary to papillary muscle rupture)

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7
Q

What drug is contraindicated in V Tachycardia and why?

A

Verapamil - cause hypotension, VFib, Cardiac arrest

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8
Q

How would a left ventricular aneurysm present?

A

ST Elevation 4 weeks after MI
Bibasal crackles
3rd and 4th heart sounds

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9
Q

What antibiotic should you avoid in long QT syndrome?

A

Erythromycin

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10
Q

What is the difference between mild and severe exacerbation of UC?

A

Mild - bloody diarrhoea

Severe - severe abdo pain, loss of appetite, fever, tachycardia, hypotensive, 6+ bloody stools daily

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11
Q

How do you treat vancomycin-resistant C diff?

A

Oral Fidaxomicin

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12
Q

What common drug can causes drug induced-cholestasis?

A

COCP

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13
Q

What is the ratio of AST:ALT in alcoholic hepatitis?

A

2:1

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14
Q

What microorganism can cause rose spots on the abdomen?

A

Salmonella typhi (typhoid fever)

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15
Q

How will conn’s syndrome present on ECG?

A

Hypokalaemia

U waves w/ shallow T waves + prolonged PR interval

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16
Q

What tests are helpful to distinguish between DM1 + DM2?

A

C-peptide levels
Anti-GAD Ab

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17
Q

How does acute interstitial nephritis appear on urine dip?

A

High WCC + eisonophills w/ reduced renal function

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18
Q

What drug would you use in penicillin allergic pregnant cellulitis?

A

Erythromycin

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19
Q

What is the first step in the management of cardiac tamponade?

A

Pericardial Needle Aspiration

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20
Q

What are the features of multiple myeloma?

A

CRAB

hyperCalcaemia
Renal failure
Anaemia
Bone fractures/lytic lesions

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21
Q

What is the treatment while awaiting for transfer to hospital with mengicoccoal sepsis?

A

IM benzylpenicillin

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22
Q

How does mesenteric ischaemia present?

A

Abdo Pain
Bloody diarrhoea
High WCC
Metabolic Acidosis

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23
Q

What is the best anti-emetic to prescribe in Parkinson’s?

A

Domperidone

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24
Q

What common cardiac drug can cause cold peripheries?

A

B blockers

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25
Q

How does ALD present on a FBC?

A

Macrocytic anaemia
Thrombocytopenia

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26
Q

What is the HbA1c target in DMII?

A

48 mmol/mol

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27
Q

What cancer are hashimotos patients more likely to suffer with?

A

MALT lymphoma

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28
Q

What treatment is first line for HFwRLVEF (LV)?

A

Bisoprolol + Ramipril

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29
Q

What antibiotic for MRSA?

A

Vancomycin

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30
Q

What microorganism can cause a cavitation lesion pneumonia?

A

Staph aureus

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31
Q

How does pulmonary stenosis sound?

A

Ejection systolic - louder on inspiration

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32
Q

What is the target BP for DMII?

A

Same as normal
<140/90mmHg

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33
Q

How does gastroparesis present? (paralysis of stomach)

A

Erratic blood glucose control
Bloating
Vomiting

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34
Q

What action should you undertake if an older woman is going to be on steroids for 3 months+?

A

Immediate co-prescription of alendronate

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35
Q

A middle aged man presents with sudden onset headache and jaw claudication. You suspect GCA and prescribe steroids and take a biopsy. The biopsy comes back normal, what is your next step of management?

A

Continue prednisolone
(GCA has skip lesions so may show a normal biopsy)

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36
Q

What drug class can reduce hypoglycaemiac awareness and make hypos less obvious?

A

Beta-blockers

Suppress adrenaline/fight or flight response

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37
Q

How does wernicke’s encephalophaty appear and what is the management?

A

Confusion
Ataxia
Yellow sclera
Involuntary rhythmic motion of the eyes (nystagmus)

Pabrinex (IV Vitamin B/C)

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38
Q

What effect does metronidazole have on warfarin?

A

Increases the anticoagulant effect of warfarin
(increases INR)

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39
Q

How does Anti-glomerular basement membrane disease present?

A

Haemoptysis
AKI
Proteinuria
Haematuria

(a pulmonary-renal syndrome)

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40
Q

How does typhoid fever present? (salmonella typhi)

A

Fever
Abdo pain
Constipation
Small rose spots over abdomen

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41
Q

What are heparins (enoxaparin) effect on potassium levels?

A

Hyperkalaemia

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42
Q

How do you manage a RA flare in GP?

A

IM methylprednisolone and refer to rheum

43
Q

How does yellow fever present and what is it’s incubation period?

A

Incubation period: 2-14 days

Diffuse pain in legs
Lethargy

Jaundice
High fever
Vomiting

44
Q

What vaccine should people with coeliac disease receive and why?

A

Pneumocococcal due to hyposlenism

45
Q

How does a patient present with ANCA associated vasculitis?

A

Weight loss
Fatigue
Joint pain

Blood in urine

SOB

CXR - bilateral perihilar cavitating nodules
cANCA +ve

46
Q

What is the risk of over treating hypothyroidism?

A

osteopersosis

47
Q

What is the first line treatment for Immune Thrombocytopenic Purpura (ITP)?

A

PO Prednisolone

48
Q

What type of dementia is associated with motor neurone disease?

A

Frontotemporal Dementia

49
Q

What is the most common microorganism to cause peritonitis secondary to peritoneal dialysis?

A

Stphylococcus epidermidis

50
Q

How does sarcoidosis present?

A

Young Female
SOB
Fatigue on exertion
Facial rash (lupus pernio)
Lymphadenopathy

Elevated serum Caclcium

51
Q

On histology what does UC show?

A

Crypt Abscesses

52
Q

What should you do if triple therapy (metformin, flozin, glitazone) doesn’t control DM II?

A

Switch one of the meds to liraglutide

53
Q

What should you advise a patient that is due to have anti-transglutimase test?

A

Ensure they eat gluten 6 weeks prior

(no inflammation otherwise)

54
Q

What is the M rule for PBC?
(primary biliary cholangitis)

A

igM
anti-Mitochondrial antibodies
Middle aged woman

55
Q

What is the main complication with correction of hypernatraemia with fluids?

A

Cerebral Oedema (especially in young patients

56
Q

What can be the first sign of myocardial ischaemia on an ECG?

A

Large/hyperacute T waves

57
Q

What is the first line anti-hypertensive for a black DMII patient?

A

Losartan (ARB)

58
Q

How does a patient with a posterior MI present appear on ECG?

A

Tall R waves in V1-V2

59
Q

What is the management for a suspected PE?

A

DOAC for 3 months

60
Q

What is the triad for Budd-chiari syndrome?

A

Sudden onset abdo pain
Ascites
Tender Hepatomegaly

61
Q

Which cardiac drug is contraindicated in VT and why?

A

Verapamil as can precipitate MI

62
Q

How does sarcoidosis present?

A

Bilateral hilar lymphadenopathy (CXR)
Cough
Low grade fever
Erythema Nodosum

More common in afro-caribbeans

63
Q

How does dengue fever present?

A

Retro-orbital headache
Fever
Facail flushing
Eash
Theombocytopenia

64
Q

What disturbance to a blood gas can prolonged vomiting cause?

A

Metabolic alkalosis
Hypokalaemia

65
Q

How does dilated cardiomyopathy present?

A

Increasing SOB on exertion
3rd heart sound

66
Q

How would an MI affecting the AV node present?

A

RCA involved
STEMI on II,III,aVF
1st degree heart block
Bradycardia

67
Q

What abx is used to treat MRSA?

A

Vancomycin

68
Q

What drug is used to treat PBC?

A

Cholestyramine

69
Q

What could a high Total Iron Binding Capacity indicate on bloods?

A

INFLAMMATION

70
Q

What would a high urinary sodium indicate?

A

Acute tubular necrosis

71
Q

How does gastroperesis present?

A

Erratic blood glucose
Bloating
Vomiting

72
Q

What is the initial management for Bell’s palsy?

A

PO Prednisolone

73
Q

A patient presents with fatigue, osteomalacia and diarrhoea. What could be the cause?

A

Undiagnosed Coeliac Disease

74
Q

What diet changes should be made in patients with ascites?

A

Restrict sodium/salt intake

75
Q

What condition is medullary thyroid cancer associated with?

A

Phaeochromocytoma

76
Q

What drug reduces mortality in HF?

A

B blockers

77
Q

What drug can be used in the management of severe alcoholic hepatitis?

A

Predinsolone

78
Q

Why would a patient on long term PPI present with muscle aches?

A

Low magnesium

79
Q

What drug is given to diarrhoea predominant IBS?

A

Loperamide

(sertraline/amitryptiline 2nd line)

80
Q

What bacterial pneumonia would cause:
dry cough
erythema multiforme
CXR - reticular nodular shadowing

A

Mycoplasma pneumoniae

81
Q

What anti-hypertensives are contraindicated in renovascular disease?

A

ACE-i

82
Q

Which diuretic causes hypercalcaemia?

A

Thiazide like1

83
Q

What is the treatment for an unstable patient in VT?

A

DC Cardioversion
(I.v amiodarone in stable)

84
Q

Where are inhaled foreign objects most like to sit?

A

Right main bronchus

85
Q

What common condition can cause postural hypotension?

A

Diabetes

86
Q

How does coarctation of the aorta present?

A

Weak femoral pulses
systolic murmur heard loudest at the left sternal edge

87
Q

How quickly should fibrinolysis be administered after semi?

A

No longer then 12 hours post symptoms

88
Q

What is the relevance to the length of symptoms of ACUTE AF with regards to treatment?

A

< 48 hours: rate or rhythm control

≥ 48 hours or uncertain: rate control
(delay cardioversion until they have been maintained on therapeutic anticoagulation for a minimum of 3 weeks)

Unstable: cardioversion

89
Q

What is the most specific ECG finding for acute pericarditis?

A

PR DEPRESSION

90
Q

What is an ADR of Nicorandil?

A

Ulceration (Gi tract or oral cavity)

91
Q

What ECG change do you see with hypercalcaemia?

A

shortening of the QT interval

92
Q

What cardiac drug should be temporarily stopped when on co-amoxiclav, erythromycin or clarithromycin?

A

statins

93
Q

What do you do in asystole?

A

Give adrenaline every 3-5 mins
CPR and check rhythm every 2 mins

Atropine no longer used

94
Q

Which valve are IVDU most likely to get endocartitis?

A

Tricuspid valve

94
Q

What is the angina management cascade?

A
  1. B blocker/Ca channel blocker
  2. amlodipine/modified-release nifedipine
  3. ivabradine
    nicorandil
    ranolazine
95
Q

How does a ventricular septal defect sound?

A

Pansystolic murmur

96
Q

How does pulmonary fibrosis from asbestos and coal differ?

A

Asbestos - CXR lower zone changes
Coal - CXR upper zone changes

97
Q

How would a lung abscess present?

A

Night Sweats
Foul smelling sputum
Productive Cough
Previous pneumonia

98
Q

How does Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis) present?

A

asthma
blood eosinophilia (e.g. > 10%)
paranasal sinusitis/nasal polyps
mononeuritis multiplex
pANCA positive in 60%

99
Q

What should you give if you are draining a large ascites?

A

Human albumin solution (reduced mortality)

100
Q

How does vomiting appear on ABG/VBG?

A

Metabolic alkalosis

101
Q

What cancers are Lynch syndrome (HNPCC) sufferers likely to get?

A

Colorectal
endometrial

102
Q
A

Yr 3 Medicine (11 decks)

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