PassMedicine Flashcards
Diarrhoea can cause:
- metabolic alkalosis
- metabolic acidosis
- metabolic acidosis
Vomiting can cause:
- metabolic alkalosis
- metabolic acidosis
- metabolic alkalosis
What finding on a blood test would support a diagnosis of lung cancer?
- raised erythrocytes
- raised platelets
- raised lymphocytes
- raised platelets
What is the most appropriate action to take with regards to antidepressant medication prior to ECT treatment?
- increase the dose
- decrease the dose
- stop the medication
- switch it to a ‘safer’ class
- decrease the dose
Which of the following should be given to all patients with severe or life-threatening asthma?
- broad-spectrum antibiotic
- inhaled corticosteroid
- nebulised ipratropium bromide
- IV magnesium sulfate
- nebulised ipratropium bromide
Which of the following spirometry results is most likely in a patient with pulmonary fibrosis?
- FEV1 = 2.64, FVC = 3.41, TLCO = increased
- FEV1 = 2.64, FVC = 4.19, TLCO = decreased
- FEV1 = 2.79, FVC = 3.11, TLCO = increased
- FEV1 = 2.79, FVC = 3.34, TLCO = decreased
- FEV1 = 4.21, FVC = 5.10, TLCO = normal
- FEV1 = 2.79, FVC = 3.34, TLCO = decreased
(restrictive pattern FEV1: FVS > 70%), impaired gas exchange - reduced TLCO)
What is the strongest risk factor for anal cancer?
= HPV infection
Most common cause of bilateral hilar lymphadenopathy?
= tuberculosis (TB)
TB typically causes which of the following on CXR?
- diffuse fibrosis
- isolated lower zone consolidation
- upper zone fibrosis
- lower zone fibrosis
- upper zone fibrosis
What food should be avoided when taking monoamine oxidase inhibitors?
= cheese
(contains tyramine, could cause a hypertensive crisis)
Loperamide act to slow down bowel movements through the stimulation of which receptors?
= opioid receptors
Main ECG abnormality seen with hypercalcaemia
- long QT-interval
- short QT-interval
- large T-waves
- small T-waves
- short QT-interval
What is the mechanism of action of fondaparinux?
- Reversible direct thrombin inhibitor
- Glycoprotein IIb/IIIa receptor antagonist
- Inhibits antithrombin III
- Inhibits ADP binding to its platelet receptor
- Activates antithrombin III
- Activates antithrombin III
Stable angina: Verapamil + beta-blockers should not be taken together as this risks,
= complete heart block
What is atrial fibrillation?
= condition where the electrical activity in the atria becomes disorganised, leading to fibrillation (random muscle twitching) of the atria and an irregularly irregular pulse
Key finding in AF?
= irregularly irregular pulse
ECG findings in AF (3)
- no p-waves
- narrow QRS complex tachycardia
- irregularly irregular ventricular rhythm
What is paroxysmal AF?
= refers to episodes of AF that reoccur + spontaneously resolve back into sinus rhythm
These episodes can last between 30 seconds + 48 hours
In patients with a normal ECG + suspected paroxysmal AF, what is the next step of investigation?
= 24-hour ambulatory ECG (Holter monitor)
In patients who have a reversible cause for their AF, new onset AF (within the last 48 hours), or HF caused by AF. What is the best first-step?
- rate control
- rhythm control
- rhythm control
What is usually offered first-line for rate control in AF?
= beta-blocker (e.g., Atenolol or Bisoprolol)
Rhythm control options in AF (2)
- cardio version
- long-term rhythm control with drugs
How long after AF presents is immediate cardioversion not advised, and delayed cardioversion is best?
If AF presents > 48 hours + patient stable opt for delayed cardioversion
How long should anticoagulation be given to patient before delayed cardio version?
= at least 3 weeks before
What is used for long-time rhythm control in AF (first-line)?
= beta-blocker
AF: What is used for long-time rhythm control in patients who have had successful cardioversion, for maintenance?
- Amiodarone
- Adenosine
- Dronedarone
- Flecainide
= Dronedarone
AF: What is used for long-time rhythm control in patients with HF or left ventricular dysfunction?
- Amiodarone
- Adenosine
- Dronedarone
- Flecainide
- Amiodarone
What is used in patients with paroxysmal AF who quality for ‘pill-in-the-pocket’ approach. To terminate AF when they feel symptoms?
- Amiodarone
- Adenosine
- Dronedarone
- Flecainide
- Flecainide
What is used first-line for anticoagulation in patients with AF?
= DOACs
Apixaban, Edoxaban + Rivaroxaban MOA
- direct factor Xa inhibitor
- direct thrombin inhibitor
- direct factor IX inhibitor
- direct factor Xa inhibitor
Dabigatran MOA
- direct factor Xa inhibitor
- direct thrombin inhibitor
- direct factor IX inhibitor
- direct thrombin inhibitor
Warfarin MOA
= vitamin K antagonist
Target INR for patients with AF
2-3
What is CHA2DS2-VASc score?
= tool for assessing whether a patient with AF should start anticoagulation
What does CHA2DS2-VASc stand for?
C - congenital HF
H - hypertension
A2 - age > 75 (2 points)
D - diabetes
S2 - previous stroke or TIA (2 points)
V - vascular disease
A - age 65-74
S - sex (female)
What do CHA2DS2-VASc scores mean?
0 – no anticoagulation
1 – consider anticoagulation in men (women automatically score 2)
2 or more – offer anticoagulation
Arrangements are made to start PCI and you are asked to prepare the site of insertion.
What is the best site for insertion?
- brachial artery
- femoral artery
- femoral vein
- jugular vein
- radial artery
- radial artery
Fine end-inspiratory crepitations are suggestive of?
= idiopathic pulmonary fibrosis
Second most common cancer patients are at risk of developing if they have HNPCC?
= endometrial cancer
Which of the following are associated with heavy periods?
- hyperthyroidism
- hypothyroidism
- hypothyroidism
Which SSRI is the recommended choice for children + adolescents?
= Fluoxetine
After a change in dose, lithium levels should be checked how long after?
= 1 week after dose change
What type of therapy is helpful in managing personality disorders?
= dialectical behaviour therapy
When is breast cancer screening offered? And how often?
= from 50-70, every 3 years
Which of the following is most likely responsible for a metabolic ketoacidosis with normal or low glucose?
- diabetic ketoacidosis
- alcoholic ketoacidosis
- gastroenteritis
- hyperosmolar hyperglycaemic state
- alcoholic ketoacidosis
How long before surgery is Warfarin usually stopped?
= 5 days before
Which of the following investigations leads to a definitive diagnosis of TB?
- blood cultures
- CT of chest
- Mantoux test
- Sputum sample
- blood cultures
- CT of chest
- Mantoux test
- Sputum sample
Which valve is most commonly affected in infective endocarditis?
= mitral valve
Most common organism in bronchiectasis exacerbation?
= Haemophilius influenzae
For COPD patients, what are target oxygen saturations if CO2 is normal on ABG?
= 94-98%
