Past paper 2011 Flashcards
What is the most common cause of mitral stenosis?
Rheumatic fever
Give 2 methods to stop smoking
Nicotine replacement therapy (varenilcine + bupropion)
Preparing for a stop date
Behavioural support - nicotine anonymous
What are some of the RF for acute pancreatitis?
Gallstones Alcohol Trauma Steroids Mumps + other viruses AI Scorpions Hyperlipidaemeia, hypercalcaemia ERCP Drugs - thiazides and valproate
Whats the benefit of doing an Allens test
Some people lack the dual supply – doing an ABG can occasionally cause disruption of the artery which could put the hand at risk of ischaemia
How would you test to see if someone had addison’s? Explain it
Short synactin test
Give cortisol level and give synactin - repeat cortisol level after 30m
If cortisol >500 then addison’s can be excluded
+ve: Failure of cortisol rise due to ACTH
Give the presenting features of Addisonian Crisis
Dehydration Hypotension Hypovolaemic shock N + V Muscle cramps Confusion
What is the pathophysiology behind splenomegaly in CML
CML there is a raised number of abnormal haematopoietic cells. This causes an increased work load of the spleen to clear these cells - which suggests it could be a response to hyperfunction of the spleen causing it to become enlarged
What is the chromosomal abnormality associated with CML
Philadelphia chromosom (9,22)
Is there a family link with this chromosome?
No, this translocation is acquired through a persons lifetime
Where are bone marrow biopsies usually taken?
Posterior, superior iliac crest
Give 2 STI - full name
Nisseria Gonorrhoeae
Chlamydia Trachomatis
Give local signs of STIs on male
D/c
Sore, ulcers or rash around the penis
Lymphadenopathy
A person with an STI develops knee pain and sore eyes. Dx?
Reiters syndrome
Name 4 sexual behaviours that increase the risk of HIV
Not using barrier protection
Anal sex
Multiple partners
Penetrative vaginal sex
Give signs of inhalation injury
Facial burns, singed nasal hairs, hoarse voice, respiratory distress, harsh cough, stridor, soot in saliva or sputum
Describe a superficial epidermal burn (1st degree)
Red, painful,
No blisters
Increased CRP
Describe partial thickness superficial dermal (second degree)
Painful, pink, pale, blistered, swelling, extremely hypersensitive
Heals with minimal scarring
Describe partial thickness deep dermal (second degree)
Typically white, may have patches of non-blanching erythema
Reduced/absent sensation, blisters
Describe a full thickness burn
Dry,
Brown/white/black
No blisters
Give a viral and bacterial cause of diarrhoea
Norovirus
Campylobacter
Person in hospital develops diarrhoea
Give 3 sources of infection
Fecal oral, Respiratory droplet/airborne Contaminated equipment Catheters Direct from invasive procedures
Person in hospital develops diarrhoea
How should they be managed?
Barrier nursing Side room Hand washing Infection control nurses PPE (personal protection equipment)
Why do you get splenomegaly in EVB?
Spleen is a sieve - removed abnormal cells and will not let abnormal cells through. If there are more atypical cells to be removed it slows down the system causing more cells being stored in the spleen while they wait to be filtered back into the system - this causes the spleen to swell and become hypertrophic
Why do you get raised LFTs in EBV
EBV are associated with hepatocellular hepatitis
Mild, can be clinically undetected - but raised liver enzymes, serum transaminases
How do you dx EBV
Postive heterophile ab tets
Why would you prescribe an SSRI for depression?
They increase the amount of serotonin in the synaptic cleft - serotonin thought to increase happiness
SSRIs are the 1st line treatment options for clinical depression
?Fluoxetine less side effects
What are the SE for the SSRIs?
Sexual dysfunction D + N Haedache Sleep problems - insomnia Weight loss and anorexia
Give 2 features other than erythema you would expect to find in a patients mouth/pharynx if they have tonsillitis
Tonsilar enlargement
Uvula oedema
Lymphadenopathy
How would you treat severe symptoms associated with EBV?
Steroids + aciclovir