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3B > Past Paper Q's 2014 > Flashcards

Past Paper Q's 2014 Flashcards

1
Q

What are the RF for VTE?

A 
Active malignancy 
Recent immobility 
Obesity 
HRT/COCP 
Previous DVT/VTE 
Known thrombophilia
Pregnancy or given brith in <6weeks
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2
Q

How would you initially investigate a ?DVT

A

Venous doppler USS of proximal veins in leg

D Dimer

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3
Q

How does warfarin work?

A

It inhibits the VK dependant factors 2, 7, 9, 10

Reducing the intrinsic pathway in the coagulation cascade

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4
Q

What blood tests should you do before starting someone on warfarin?

A

U&E, FBC,

LFT and weight

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5
Q

How does heparin work?

A

Binds to enzyme inhibitor antithrombin III and activates it - this then deactivates factor Xa and thrombin

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6
Q

Give some of the features of downs syndrome (6)

A
  • Hyperreflexia, muscular hypotonia
  • Head: epicanthic folds, flat nasal bridge, low set ears, ring of iris speckles = brushfield’s spots
  • Mouth: protruding tongue and high arched palate
  • Neck: short
  • Hands: Single palmar crease, incurved little finger, short, broad hands
  • Feat: Gap between hallux and 2nd toe
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7
Q

Name 2 genetic mutations that can give rise to Down’s syndrome

A
  • Non-disjunciton 95%
    (failure of homologous chromosomes/sister chromosomes to separate properly during cell division)
  • Mosaicism
  • Robertsonium translocation
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8
Q

Give the CV defects associated with Downs

A

ASD
VSD
PDA
Tetralogy of fallot

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9
Q

Give the GI problems associated with downs syndrome

A

Oesophageal atresia
Pyloric stenosis
GOR
Hirschsprungs

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10
Q

What are the RF associated with vitamin D deficiency?

A 
Pigmented skin 
Lack of sun exposure - religion covering or institutionalised or suncream 
Malabsorption - short bowel 
Poor diet 
Cholestatic liver disease 
CKD
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11
Q

Explain VD metabolism

A

VD3 from the sun
VD2 from diet (fish, milk)
There are converted to 25(OH)D3 in the liver which is then convetered to 1,25(OH)2D3 in the kidneys which is called calcitriol

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12
Q

Give the function of the PTH

A

1) Increases renal reabsorption of Ca (while increased PO4 excretion)
2) Increased osteoclast activity (releasing ca from the bones)
3) Stimulates the production of 1,25(OH)2D3 (calcitriol) from the kidneys

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13
Q

What affect does PTH have on the bones?

A

It binds to osteoblasts and causes them to produce RANK-ligand
RANK ligand stimulates the osteoclasts to resorb bone

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14
Q

Why does vitamin D deficiency lead to under mineralisation of bone?

A

VD deficiency leads to lack of calcitriol (1,25(OH)2VD3) - therefore calcium in the blood. This leads to increased PTH which increases osteoclast activity causing bones to become under mineralised

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15
Q

What are the triggers of a gout attack?

A 
Dehydration 
Prolonged fasting 
Aspirin 
Starting allopurinol 
Alcohol 
Thiazide diuretics
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16
Q

How would cauda equina present in the lower limbs?

A

Paraplegia
Numbness
Weekness

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17
Q

How would cauda equina present peri-anally?

A

Saddle anaesthesia and loss of anal tone

18
Q

Which artery supplies the super vesicular artery?

A

The internal iliac artery

19
Q

Give the fat soluble vitamins and what you would get if you were deficient in them

A

A - night blindness
D - Osteomalacia
E - ataxia & muscle weakness
K - bleeding/bruising

20
Q

What is the skin disease that is associated with coeliacs?

A

Dermatitis herpetiformis

21
Q

What malignancy is associated with coeliacs?

A

Enteropathy-associated T-cell lymphoma of the small bowel

22
Q

What is economic evaluation?

A

It is the assessment of efficiency

It is a comparative study of the costs and benefits of healthcare interventions

23
Q

What makes a QALY?

A

Its the quality and quality of life lived

24
Q

What 2 things make an economic evaluation?

A

Cost and effectiveness

25
Q

Define efficiency

A

When resources are allocated between activities in such a way to maximise benefits for a give budget

26
Q

Define opportunity cost

A

The sacrifice in terms of benefits foregone from not allocating resources to the next best activity

27
Q

Give 3 types of economic evaluation

A

Cost-benefit analysis
Cost utility analysis
Cost-effectiveness

28
Q

What is equity in health economics?

A

It is fairness and justice in distribution of cost and benefits

29
Q

How can you prevent malaria?

A

C - long sleeve tops and trousers, use of DEET and insecticidal nets
M - doxycyline

30
Q

How do you dx malaria?

A

Thick and thin blood smears with giemsa stain

31
Q

What do you need to have to make a dx of bipolar?

A

At least 2 episodes where a persons mood is significantly disturbed - they need at leas t one episode of mania for it to be dx

32
Q

What tests should you do before starting someone on lithium?

A 
TFT 
ECG 
Pregnancy test 
U&amp;E 
FBC
33
Q

Give some signs of hypothyroidism

A 
Obesity 
Dry skin and hair 
Depressed 
Myxedema 
Malar flush
Cold peripheries 
Goiter 
Bradycardia 
Slow reflexes
34
Q

Give 3 neuro signs of lithium toxicity

A 
Coarse tremor 
Hyperreflexia 
Coma 
Ataxia 
Nystagmus
35
Q

What is an apical lung tumour called?

A

Pancoasts tumour

36
Q

Give the 3 symptoms of corners syndrome

A

Miosis, partial ptosis and anhidrosis

37
Q

Why would someone with a pancoasts tumour get pain in the shoulder and the scapula?

A

If they have involvement of the phrenic nerves C345 - referred pain

38
Q

Which nerve root causes wasting of the thenar eminence?

A

Median nerve - C8-T1

39
Q

Give 6 signs of MND

A 
Hyperreflexia 
Fasciculations
Muscle wasting 
Spasticity/hypotponia 
Hemiparesis 
Dysarthria/dysphagia
40
Q

Give 4 signs of bulbar palsy

A

Dysarthria
Dysphagia
Weak tongue
Fasciculations on tongue

41
Q

Name 4 MDT members for MND

A 
Consultant 
Physio 
OT 
Specialist nurse 
GP 
SALT
42
Q

What is an advanced directive?

A

It is a living will/a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity

3B (21 decks)

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