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YR3: MM FC Ed. > Past Paper Pop Quiz > Flashcards

Past Paper Pop Quiz Flashcards

1
Q

What would be the cause of meningitis where the LP showed lymphocytosis, high protein, low glucose and negative India ink staining?

A

Tuberculosis meningitis

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2
Q

Name a drug that can reduce proteinuria?

A

ACEi

reduce BP

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3
Q

List 4 drugs that can cause hyperkalaemia

A

ACEi
B Blockers
K+ sparing diuretics
NSAIDs

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4
Q

List 5 conditions that can cause hyperkalaemia

A 
Hyperglycaemia
Burns
Rhabdomyolysis 
Acute Renal failure
Chronic renal failure
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5
Q

Describe the hepatitis serology of someone who has been vaccinated

A

HBsAb

vaccine contains HBsAg

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6
Q

Describe the hepatitis serology seen in acute infection

A 
HBsAg
HBcAg
HBeAg (active + infectious)
HBcAb IgM
HBcAb IgG
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7
Q

Describe the hepatitis serology seen in chronic infection

A

HBsAg
HBcAg
HBeAg (active + infectious)
HBcAb IgG

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8
Q

Describe the hepatitis serology seen in someone who has been previously infected

A

HBsAb

HBcAb IgG

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9
Q

What is Beck’s triad?

A

Muffled heart sounds
Distension of jugular veins
Hypotension

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10
Q

What does Becks triad indicate?

A

Cardiac tamponade

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11
Q

What is Kussmaul breathing? What does this indicate? Give 2 causes

A

Deep sighing breaths (blowing off CO2)
Metabolic acidosis
DKA
Renal failure

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12
Q

What is Kussmauls sign? What does this indicate? Give 3 causes

A 
Rise in JVP on inspiration
Limitation of right ventricular filling
Constrictive pericarditis
Restrictive cardiomyopathy
Cardiac tamponade
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13
Q

How does Conn’s syndrome cause high blood pressure?

A

Aldosterone increases sodium reabsorption

This causes increased water reabsorption leading to high BP

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14
Q

Which organism can cause a bilateral pneumonia in middle to old aged patients?

A

Legionella spp

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15
Q

What occurs in ACTH dependent Cushing’s syndrome? Give 2 causes

A

Excess ACTH causes the excess cortisol production
Cushings disease: ACTH producing pituitary adenoma
Ectopic ACTH secretion

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16
Q

What occurs in a dexamethasone suppression test? What does this indicate?

A

Healthy: Presence of Dexamethasone provides negative feedback + suppresses ACTH release
Cushings: ACTH levels remain high

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17
Q

What occurs in ACTH independent Cushing’s syndrome?

A

Hyperactive adrenals/ adrenal tumour making excess cortisol

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18
Q

How can ACTH independent and dependent tumours be differentiated?

A

Dependent: HIGH plasma ACTH, HIGH CORTISOL
Independent: LOW plasma ACTH, HIGH CORTISOL

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19
Q

Describe the levels of cortisol seen in low and high dose dexamethasone suppression tests in Cushings syndrome caused by adrenal tumours, ectopic secretion and pituitary tumours

A 
Adrenal tumor
Low dose: no change
High dose: no change
Ectopic ACTH-producing tumor
Low dose: no change
High dose: no change
Pituitary tumor (Cushing's Disease)
Low dose: no change
High dose: normal suppression
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20
Q

Which skin condition causes formation of papule and pustules on the background of erythetamous skin?

A

Rosacea

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21
Q

What is the firstline anticonvulsant medication for a patient presenting with a seizure?

A

IV Lorazepam

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22
Q

What medication can be used for a patient in SVT?

A

Adenosine

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23
Q

What 2 vasovagal manoeuvres can be used for a patient in SVT?

A

Carotid sinus massage

Valsalva manœuvre

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24
Q

In which disease may you use penicillamine? What is an important possible side effect?

A

Wilson’s disease

Agranulocytosis + immunosuppression

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25
Q

In which MSK disorder do you see punched out periarticular erosions?

A

Gout

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26
Q

What is the most common cause of travellers diarrhoea?

A

Escherichia coli

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27
Q

How does bilateral lower limb pitting oedema differ from generalised pitting oedema?

A

Bilateral lower limb pitting edema suggests cardiac failure

Generalized peripheral pitting edema + swelling of eyelids indicates hypoalbuminemia

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28
Q

How do quinolones, macrolides and metronidazole interact with warfarin?

A

Cyp450 inhibitors

Increase action of Warfarin

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29
Q

How does Rifampicin interact with Warfarin?

A

Cyp450 inducer

Decreases action of Warfarin

30
Q

Name a class of antibiotics safe to use in patients taking Warfarin

A

Aminoglycosides e.g. Gentamicin

31
Q

List 7 side effects of sedative use

A 
Loss of coordination
Slurred speech
Decreased attention + memory
Disinhibition
Aggression
Hypotension
Respiratory depression.
32
Q

List 5 side effects of sedative withdrawal

A 
N+V
Autonomic hyperactivity
Insomnia
Delirium
Seizures
33
Q

What is the classic presentation of polymyalgia rheumatic?

A

Muscle stiffness + pain symmetrically affecting proximal muscles

34
Q

What constitutional symptoms may arise in polymyalgia rheumatica?

A

Weight loss
Fatigue
Night sweats

35
Q

How does IV adrenaline improve coronary perfusion pressure in cardiac arrest`?

A

Interacts with alpha + beta adrenergic receptors to cause peripheral + splanchnic vasoconstriction
This diverts blood away from the skin + GIT to the heart + brain

36
Q

What biochemistry causes alkalosis?

A

LOW CO2 = Respiratory alkalosis

High HCO3- = Metabolic alkalosis

37
Q

What biochemistry causes acidosis?

A

HIGH CO2 = Respiratory acidosis

LOW HCO3- = Metabolic acidosis

38
Q

What test is diagnostic of Sjorgens syndrome? What other features may be present?

A

Schirmer’s test: <10mm filter paper moist after placing under eyelid
Anti-Ro + Anti-La antibodies

39
Q

What non-metastatic extrapulmonary manifestations may arise in small cell carcinoma?

A

Inappropriate secretion of ADH: hyponatraemia

Ectopic secretion of ACTH: Hypercortisolism- Hypokalaemia or Cushings syndrome

40
Q

In which form of lung cancer may you see hypercalcaemia due to ectopic secretion?

A

Squamous cell carcinoma due to PTHrP

41
Q

Which cranial nerves are affected by a pathology in the cavernous sinus?

A 
III
IV
VI
Ophthalmic division of V 
Maxillary division of V
42
Q

What is the most common AIDS defining illness? List 4 symptoms

A 
Pneumocystis jirovecii pneumonia 
Dry cough
Dyspnoea 
Weight loss 
Fatigue
43
Q

What feature on dermoscopy would suggest a malignant melanoma rather than a benign naaevus or pigmented seborrhoeic keratosis?

A

Irregular pigment netword

44
Q

List 3 gastric primary causes of hypokalaemia

A

Vomiting
Diarrhea
Villous adenoma of the colon

45
Q

List 3 renal primary causes of hypokalaemia

A

Type 1 + 2 renal tubular acidosis
Cushings
Conn’s

46
Q

List 5 drugs that can cause hypokalaemia

A 
Thiazides
Loop diuretics
Osmotic diuretics
Beta 2-agonists
Insulin
47
Q

What A-E mneumonic can be used to remember drugs that can cause long QT syndrome?

A

A: AntiArrhythmics (Amiodarone, Flecainide)
B: AntiBiotics (Macrolides, Aminoglycosides)
C: AntiCychotics (Haloperidol, Quetiapine, Risperidone)
D: AntiDepressants (SSRIs, TCAs)
D: Diuretics
E: AntiEmetics (Ondansetron)

48
Q

In which condition should use of B-blockers be avoided if possible?

A

Asthma

B blockers can precipitate bronchospasm

49
Q

What is the triad seen in nephrotic syndrome?

A

Proteinuria >3.5g in 24hrs
Hypoalbuminaemia <30g/L
Oedema

50
Q

What mnemonic can be used for CYP inducers?

A 
CRAPS out drugs
Carbamezapine
Rifampicin
barbiturates
Phenytoin
St Johns Wort
51
Q

What mnemonic can be used for CYP inhibitors?

A 
Some Certain Silly Compounds Annoyingly Inhibit Enzymes Grrrr
Sodium valproate
Ciprofloxacin
Suphonamide
Cimetidine/ Omeprazole
Antifungals, Amiodarone
Isoniazid
Erythromycin
Grapefruit juice
52
Q

Which drugs interact with enzyme inducers/ inhibitors?

A 
Warfarin
cOCP
Theophylline
Corticosteroids
Tricyclics
Pethidine
Statins
53
Q

What is the most common cause of glomerulonephritis?

A

IgA nephropathy

54
Q

Name a cause of nephrotic syndrome in adults and kids?

A

Kids: Minimal change glomerulonephritis
Adults: Membranous glomerulonephritis

55
Q

What ECG change is seen in a posterior MI?

A

Posterior descending artery

ST depression in V1-4

56
Q

Which joints are usually spared in RA?

A

DIP joints

57
Q

What measurement is often used to identify chronic pancreatitis?

A

Faecal elastase (LOW) due to exocrine insufficiency

58
Q

Describe the typical results of iron studies in hereditary haemochromatosis

A

High Serum Iron: deficiency of hepcidin leads to increased iron transport into the blood via ferroportin
High Ferritin: increased serum iron leads to an increase in ferritin in a compensatory attempt to increase intracellular iron storage
Low Transferrin: increased serum iron leads to decreased transferrin levels to prevent more iron from becoming plasma protein bound in the blood
High Transferrin Saturation: due to high serum iron + low transferrin
Low Total Iron Binding Capacity (TIBC): a measure of the blood’s capacity to bind iron to transferrin. As transferrin is low, it is more difficult for iron to bind to transferrin.

59
Q

What are the 3 stages of diabetic retinopathy?

A

Background: Hard exudates, microaneurysms + blot haemorrhages
Pre-proliferative: Soft exudates (retinal ischaemia)
Proliferative: New vessel formation in response to ischaemia. Prone to bleeding

60
Q

What parameter should be closely monitored in patients with GBS?

A

FVC

GBS can cause respiratory muscle weakness, respiratory failure + death

61
Q

What is the most common cause of CKD?

A

Diabetes mellitus

62
Q

Give 2 signs of appendicitis

A

Rovsing’s sign: Palpation of LIF illicits pain in RIF

Psoas sign: LHS, straight right leg + passively extending right hip

63
Q

In which cases are abdominal aortic aneurysms surgically intervened with?

A

If diameter >5.5cm

If rapidly expanding >1cm per year

64
Q

How frequently are smaller asymptomatic AAAs checked?

A

3-4.5cm: every year

4.5-5.5cm: every 3 months

65
Q

What does HUS commonly follow?

A

E. coli O157 infection in children

66
Q

What is the triad in HUS?

A

Microangiopathic haemolytic anaemia
Acute renal failure (Uraemia)
Thrombocytopenia

67
Q

What is the pentad in TTP?

A 
Microangiopathic haemolytic anaemia
Acute renal failure (Uraemia)
Thrombocytopenia 
Fever
Neuro problems: headaches, confusion, seizures
68
Q

What distinguishes Legionella pneumophila from the other atypical pneumonias?

A

Found in bodies of water kept <60°C
e.g. as air conditioning units
Causes confusion.
Urinary antigens

69
Q

What is the GRACE scoring system used for?

A

Risk stratifying patients who have suffered an NSTE-ACS

70
Q

Name 2 firstline antibiotics used in uncomplicated UTIs

A

Nitrofurantoin

Trimethoprim

71
Q

How do grade 3 haemorrhoids and type 2 rectal prolapse differ?

A

Rectal prolase: circular, muscular folds (intussusception of whole circumference of the rectal wall)
Hemorrhoids: radial folds (submucosal, fibrovascular, arterio-venous sinusoids)

72
Q

What is Dressler’s syndrome?

A

Pericarditis arising 2-10 weeks post MI

YR3: MM FC Ed. (46 decks)

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