Past paper pop quiz 3 Flashcards
How do myasthenia gravis and Lambert eaton syndrome differ?
MG: Fatigue WORSENS with activity
LE: Fatigue IMPROVES with activity
Name a risk factor for bladder cancer
Exposure to dye-stuffs
List 3 drugs that damage the mucosa, thus worsening symptoms of reflux
NSAIDs
Aspirin
Steroids
Bisphosophonates
List 3 drugs that reduce lower oesophageal sphincter contraction, thus worsening symptoms of reflux
TCAs
Nitrates
Anticholinergic
What characterises Wolf Parkinson White syndrome?
Slurred upstroke + short PR interval on ECG
Due to bundle of Kent accessory pathway
In which COPD patients should long term oxygen therapy be considered in?
PaO2 < 7.3 kPa despite maximal tx
PaO2 7.3-8.0 kPa + 1 of: pulmonary HTN,
polycythaemia, peripheral oedema or nocturnal hypoxia
Terminally ill patients
What triad of features characterises acute mesenteric ischaemia?
Severe abdominal pain
Normal abdominal examination
Shock
What are the causes of acute mesenteric ischaemia?
Thrombosis (Atherosclerosis)
Embolism (emboli from AF)
Venous thrombosis (in hypercoaguable states)
Hypotension
What are the causes of chronic mesenteric ischaemia?
Low flow states e.g. HF + Atherosclerotic disease
How does chronic mesenteric ischaemia present?
Gut claudication (diffuse abdo pain, colicky, post prandial)
PR bleeding
Weight loss
Name 2 signs of perforation seen on AXR
Rigler’s sign: air on both sides of bowel wall
Pneumoperitoneum: air under diaphragm
What may be seen on AXR in advanced mesenteric ischaemia?
Gassless abdomen
Thickening of bowel wall
Pneumatosis (air in bowel wall due to necrosis)
What can cause acute limb ischaemia?
Thrombus in situ
Embolus from AF
What should be given to patients with suspected acute limb ischaemia? What are the definitive treatment options?
IV Heparin
Embelectomy
Thrombolysis
What triad characterises granulomatosis with polyangitis?
URT involvement (Nosebleeds) LRT involvement (Haemoptysis) Glomerulonephritis (haematuria + proteinuria)
Name a clinical feature of granulomatosis with polyangitis
Saddle nose
What antibody is strongly associated with granulomatosis polyangitis?
cANCA
What is Cor pulmonale?
right heart failure resulting from chronic pulmonary hypertension
List 3 causes of Cor pulmonale
Chronic lung diseases (e.g. COPD)
Pulmonary vascular disease (e.g. PE)
Neuromuscular disease (e.g. myasthenia gravis)
What condition causes telescoping of the digits?
Arthritis mutilans
What is the inheritance pattern of PCOS?
Autosomal dominant
What is the inheritance pattern of HOCM?
Autosomal dominant
List the 3 main visual field defects and location of the causative lesion
Mononoculear vision loss: optic nerve
Bitemporal hemianopia: optic chiasm
Homonomous hemianopia: post optic chiasm= optic tract
How do bacterial and viral conjunctivitis differ?
Bacterial: purulent discharge (‘yellow crust’)
Viral: only makes eyes water.
What scrotal lump transilluminates ?
Hydrocele
List 4 causes of dilated cardiomyopathy
Inherited
Alcohol abuse
Post-viral myocarditis
Thyrotoxicosis.
What occurs in restrictive cardiomyopathy? List 3 causes
stiff ventricles unable to relax + adequately fill with blood. Amyloidosis
Sarcoidosis
Haemochromatosis.
What 3 signs are indicative of HOCM?
Jerky pulse
Ejection systolic murmur
Double apex beat
What medication reduces the effects of alcohol withdrawal?
Chlordiazepoxide (a benzodiazepine)
Which TB antibiotic can cause peripheral neuropathy? How can this be prevented?
Isoniazid as causes Vitamin B6 deficiency
Give Pyridoxine
What is the inheritance pattern of hereditary haemorrhagic telangiectasia? What can the formation of abnormal blood vessels lead to?
Autosomal dominant
Bleeding, can manifest as haeatemesis or rectal bleeding
What triad of symptoms characterises normal pressure hydrocephalus?
Confusion/ dementia
Gait disturbance
Urinary incontinence
Which TB antibiotic causes visual impairment?
Ethambutol
Which TB antibiotic causes joint pain?
Pyrazinamide
