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Sheff Phase 4 > Passmed TANGS > Flashcards

Passmed TANGS Flashcards

1
Q

Name 3 features of hereditary haemochromatosis?

Inheritance ?

A

early symptoms include fatigue, erectile dysfunction and

arthralgia (often of the hands)

‘bronze’ skin pigmentation

diabetes mellitus

liver: stigmata of chronic liver disease, hepatomegaly, cirrhosis, hepatocellular deposition)

cardiac failure (2nd to dilated cardiomyopathy)

hypogonadism (2nd to cirrhosis and pituitary dysfunction - hypogonadotrophic hypogonadism)

AR

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2
Q

ACS Mx ?

Post Mx?

A

Morphine
Oxygen
Nitrates
Aspirin

STEMI -> PCI

ABSeeD
ACEI
B blocker 
Statin 
Dual antiplatelet - clopi / aspririn
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3
Q

Nec Fash most common cause? Microbiology will report?

A

Streptococcus pyogenes
- Gram-positive in chains

Staphylococcus aureus is usually found in clusters.

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4
Q

Foreign travel and fever alternating days?

A

malaria

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5
Q

At what point do pregnancy-induced hypertension or pre-eclampsia occur?

A

After 20 weeks

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6
Q

Mx of gonno

A

single dose of:

oral azithromycin and intramuscular ceftriaxone

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7
Q

Features of cephalohaematoma

A

Several hours after birth, doesn’t cross suture lines, can take months to resolve

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8
Q

Normal pressure hydrocephalus pres ? mx?

A

Urinary incontinence + gait abnormality + dementia

ventriculoperitoneal shunting

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9
Q

What is charcot triad ? indicitive of?

Mx?

A

right upper quadrant pain, fever and jaundice

Ascending cholangitis

Management
intravenous antibiotics
ERCP after 24-48hrs to remove blockage

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10
Q

Which lobe if seizure has movement of arms/legs

A

frontal

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11
Q

Seen on bloods of:

Hyposplenism e.g. post-splenectomy

Iron-deficiency anaemia

Myelofibrosis

Intravascular haemolysis

Megaloblastic anaemia

A 
Hyposplenism e.g. post-splenectomy
target cells
Howell-Jolly bodies
Pappenheimer bodies
siderotic granules
acanthocytes

Iron-deficiency anaemia
target cells
‘pencil’ poikilocytes
if combined with B12/folate deficiency a ‘dimorphic’ film occurs with mixed microcytic and macrocytic cells

Myelofibrosis
‘tear-drop’ poikilocytes

Intravascular haemolysis
schistocytes

Megaloblastic anaemia
hypersegmented neutrophils

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12
Q

Sickle cell aplastic anaemia crisis ?

A

Parvovirus B19

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13
Q

Drug for smoking cessation

A

Varenicline

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14
Q

Brown sequard

A

ipsilateral weakness below lesion
ipsilateral loss of proprioception and vibration sensation

contralateral loss of pain and temperature sensation

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15
Q

PCOS hirtuism

A

COCP

Spirolactone

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16
Q

copd cxr

A

hyperinflation, bullae, flat hemidiaphragm

17
Q

What marker for severity of COPD

A

FEV1
(NOT ratio)

> 80 = mild
50-80 - mod
30-50 - severe

18
Q

4 sezure lobes and features

A 
Temporal lobe (HEAD)	
Hallucinations (auditory/gustatory/olfactory), Epigastric rising/Emotional, Automatisms (lip smacking/grabbing), Deja vu/Dysphasia post-ictal)
Frontal lobe (motor)	
Head/leg movements , posturing, post-ictal weakness
Parietal lobe (sensory)	
Paraesthesia
Occipital lobe (visual)	
Floaters/flashes
19
Q

Lung Ca paraneoplastic features

A

Squamous - PTH = HyperCa

Small cell - ACTH / LES

20
Q

3 causes of upper lobe fibrosis

A

SCART (upper lobe):

  • Sarcoidosis
  • Coal miners pneum.
  • Ank spon
  • Radiation
  • TB

RASIO (lower lober)

  • Rheumatoid
  • Asbestosis
  • Scleroderma
  • Idiopathic Pulmonary fibrosis (most common cause overall)
  • Othe
21
Q

Cor pulmonale mx

A

loop diuretic for oedema

consider long-term oxygen therapy

22
Q

Acute mesenteric ischaemia 1st Ix

A

serum lacate

23
Q

Med to avoid in obstruction

A

Metoclopramide

24
Q

prophylaxis of oesophageal bleeding from varicies

If bleeding?

A

propranolol

Terlipressin

25
Q

dyspnoea, fatigue and lethargy

lemon tinge to skin?

A

Pernicious

26
Q

Cushing’s disease - response to dexamethasone

A

pit adenoma - responds to high levels (secretes less)

SSLC - does not respond

27
Q

2 ECG changes pericarditis

Name 3 causes

A

widespread ‘saddle-shaped’ ST elevation

PR depression: most specific ECG marker for pericarditis

viral infections (Coxsackie)
tuberculosis
uraemia (causes 'fibrinous' pericarditis)
trauma
post-myocardial infarction, Dressler's syndrome
connective tissue disease
hypothyroidism
malignancy
28
Q

2 features ECG hypoK

A 
U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

[U have no Pot and no T, but a long PR and a long QT]

29
Q

Most common cause of pepperpot skull

A

primary HPT

30
Q

2 features of somatosation disorder

A

multiple physical SYMPTOMS present for at least 2 years

patient refuses to accept reassurance or negative test results

31
Q

What is conversion disorder

A

typically involves loss of motor or sensory function

the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)

32
Q

What is dissociative disorder

A

dissociation is a process of ‘separating off’ certain memories from normal consciousness

in contrast to conversion disorder involves psychiatric symptoms e.g. Amnesia, fugue, stupor

33
Q

What is facticious disorder

A

Munchausen’s syndrome

the intentional production of physical or psychological symptoms

34
Q

What is malingering disorder

A

fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

35
Q

MgSO4 antidote

A

calcium gluconate

36
Q

Compare Ruptured cyst and torsion Sx

A
  • Cyst - acute onset pain, maximal at onset, may have prior hx of others
  • Torsion - Gradually progressively worsening pain, associated with hx of sport
  • USS - Whirlpool sign
37
Q

Lynch syndrome? common ca?

A

HNPCC
Colo rectal cancer 30-70%
Endometrial cancer 30-70%
Gastric cancer 5-10%

Sheff Phase 4 (26 decks)

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