Peer Teaching Exam Questions Flashcards
1
Q
Triad of HF symptoms?
A
- Oedema
- Fatigue
- Dyspnoea
2
Q
Aortic dissection Symptoms?
A
- tearing chest pain
- Anuria
- unequal arm pulses/ pressures
3
Q
Secondary Hypertension Causes?
A
- CKD, Polycystic Kidney Disease
- Conn’s, Cushing’s
4
Q
How do you exclude a PE?
A
Negative D-dimer test
5
Q
Treatment of Legionella?
A
Ciprofloxacin
Clarithromycin
6
Q
How does Pulmonary Hypertension show on CXR?
A
Dilated pulmonary arteries
Right hypertrophy
7
Q
Treatment of Haemochromatosis?
A
Deferoxamine
8
Q
Antibodies found in someone with Myasthenia Gravis?
A
AChR
MuSK
9
Q
What is a common diagnosis for an old man with a NEW back pain?
A
Multiple myeloma
10
Q
What is Neisseria?
A
Gram negative cocci
11
Q
give examples of aerobic and anaerobic gram positive bacilli?
A
aerobic = bacillus, listeria monocytogenes anaerobic = clostridium difficile
12
Q
What are the 6 P’s of acute limb ischaemia?
A
Pain Pallor Paraesthesia Perishing cold paralysis Pulseless
13
Q
How do you distinguish between salmonella and shigella?
A
XLD agar
Shigella = Red
Salmonella = Red with black dots
14
Q
Where is there ST elevation for someone who had a RCA MI? (inferior heart)
A
2,3, aVF
15
Q
Where is there ST elevation for someone who had a LAD MI? (antro-septal)
A
V1,V2 and involvement of circum
16
Q
Where is there ST elevation for someone who had a circumflex MI? (lateral)
A
1, aVL, V5, V6
17
Q
Describe briefly the 4 hypersensitivity reactions
A
1= Allergic (IgE) 2= Cytotoxic (goodpasture's, Haemolytic) 3 = Immune complex deposition ( SLE, pneumonitis) 3 = Delayed (t cell)
18
Q
What may these precursors cause?
Asthma
Pulmonary Hypertension
Bronchiectasis
pleural Effusion
A
a- Pneumonia
P - RHF
B - Pneumothorax
PE - CCF
19
Q
What are the signs of Infective Endocarditis
A
FROMJANE
Fever
Roth Spots
Osler’s Nodes
Murmur heart
Janeway’s lesions
Anaemia
Nail haemorrhage
Emboli
20
Q
What are the severity crtierias for the following
Fontaine new York heart association functional classification Dukes Ann Arbor Killip
A
Fontaine = PAD
new York heart association functional classification = HF
Dukes = infective Endocarditis
Ann Arbor = lymphoma
Killip - MI
21
Q
What cells are seen on blood film for:
Iron deficiency anaemia
Haemolytic anaemia
Thalassaemia
glucose-6-phosphate deficiency
A
IDA = Hypochromic
Thalassaemia = Target cells
Haemolytic = Schistocytes
G6PD = bite and blister cells
22
Q
What is:
Chadsvacs ABCD2 wells FRAX QRISK2
A
chadsvacs = stroke risk after AF
ABCD2 = stroke risk after TIA
Wells = DVT probability
FRAX = fracture risk in 10yrs
QRISK2 = CVS disease in 10 years
23
Q
What do the crystals look like in gout and pseudo gout?
A
GOUT = NEGATIVELY BIREFRIGENT NEEDLE SHAPED
PSEUDO-GOUT = POSITIVELY BIREFRINGENT RHOMBOID SHAPED
24
Q
Nephritic vs Nephrotic key features?
A
Nephritic = Oliguria, Haematuria, Oedema, HTN, decreased GFR
nephrotic = oedema, proteinuria, hypalbuminaemia, hyperlipidaemia
25
How does ACE-i work?
inhibit bradykinin breakdown
26
What stain do you use to show iron
Perl's
27
What can cause meningitis in pregnant women?
Listeria
28
What can cause meningitis in kids?
Strep agalactiae
29
What antibodies are found in a coeliac?
IgA tissue transglutaminase
| IgA anti-endomysial
30
Why are tympanic sounds of abdomen heard?
Air in bowel due to obstruction
31
Where does Appendicitis pain start?
Diffuse pain in abdo then localises
32
Side effects of Steroids?
```
Growth problems
increased risk to infection
osteoporosis
HTN
oedema
DM
```
33
What is a Reynolds pentad
symptoms suggesting the diagnosis obstructive ascending cholangitis, a serious infection of the biliary system.
It is a combination of
Charcot's triad (RUQ pain, jaundice, and fever)
shock (low blood pressure, tachycardia)`
an altered mental status
34
questions before cancer surgery/
are they medically fit
is there mets
is it resectable
35
What are monoclonal bands in blood film found in?
MS
36
Why are methotrexate and trimethoprim related?
Folate antagonists so cant be used during pregnancy
37
what do you call trimethoprim and sulfamethoxazole?
co-trimoxazole
38
what antibiotic binds to RNA polymerase?
Rifampicin
39
name an aminoglycoside
Gentamycin
40
name a macrolide
Erythromycin / clarithromycin
41
name a cephalosporin
Cefuroxime
| Cephalexin
42
name a glycopeptide
Vancomycin
43
Definition of anaemia
decrease in Hb conc due to plasma volume increase
44
Cause of Macroscopic anaemia?
B12/folate
alcohol
hypothyroid
45
Cause of CML
translocation of gene between 9,22 causing formation of Philadelphia chromosome
46
Ann Arbor staging?
1 - one node
2 - multiple lymph
3 - above or below diaphragm below = 3b and both sides of body
4 - organ mets
47
How can you tell its ALL on blood film?
increase conc of lymphoblast's
48
How is febrile neutropenia found
Fever over 38c
Absolute neutrophil count <1
49
What is Rituximab?
monoclonal antibody which targets CD20 protein on surface of a b cell to treat lymphoma
50
What disease is it if someone has hyperkalaemia, hyperuricaemia, hyperphosphatemia, hypocalcaemia
Tumour lysis syndrome
51
How is tumour lysis syndrome treated and how does hyperkalaemia show on ECG
Fluids, allopurinol, electrolyte balance
tall T, absent p, broad QRS
52
How does hypercalcaemia show on ECG
short QT is hyper so hypo is long QT
53
What is the name of a pink diplococci organism
Neisseria Meningitidis
54
What are the real names of meningitis
Pneumococcal septicaemia
| Meningococcal septicaemia
55
treatment of meningitis?
IV Cefotaxime
56
Headache red flags?
Seizure
Altered: consciousness, memory,confused
Papilloedema
Cluster Headache
57
What drug is given to decrease intracranial pressure?
IV Mannitol
58
What has fasciculations and spasticity?
UMN or LMN
LMN has fasciculations
| UMN has spasticity (increased tone and brisk reflexes)
59
Give examples of primary and secondary adrenal insufficiency
Primary = Addisons, TB, Trauma
Secondary = Steroids, Congenital, Neoplasm
60
How does hyperglycaemia lead to insulin secretion?
1) Increased uptake of glucose by cells
2) Increased ATP levels and K+ channels close
3) Depolarisation of membrane opens Ca2+ channels
4) Increased Ca2+ means exocytosis of insulin-containing vesicles
5) Insulin released by beta cells in Islets of Langerhans
61
Thyroid autoantibodies?
anti-thyroid peroxidase antibodies (TPOAb)
thyrotropin receptor antibodies (TRAb)
thyroglobulin antibodies (TgAb)
62
Treatment of Hyperthyrodism/ Graves
Beta blockers
Carbimazole
Radio iodine therapy
Thyroidectomy
63
2 main symptoms of DI?
Polyuria and Polydipsia
64
symptoms of pheochromocytoma
plapitations, sweating, headache
65
blood tests for Pheochromocytoma
Plasma catecholamines
66
what cells produce plasma catecholamines and where are they found
Chromaffin cells in the adrenal medulla
67
What is Deontology?
the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of the action.
68
Why does someone breath heavily during DKA?
Respiratory compensation to get rid of the CO2
69
What shape are the different types of haemorrhage in the brain
```
sub-dural = crescent shaped
extra-dural = lens shape
sub-arachnoid = 5 point star
```
HYPERDENSE
70
What does Pericarditis show on ECG?
Saddle shaped ST elevation and PR depression
71
What heart murmur does:
Mitral Stenosis and Mitral Regurgitation show?
Mitral Stenosis: Early Diastolic
Mitral Regurg: Pan-systolic
72
What heart murmur does:
Aortic Stenosis and Aortic Valve Replacement show?
Ejection systolic 'crescendo-decrescendo'
Valve replacement = systolic click
73
Which bacteria is most common in the community for Pnuemonia?
Strep. Pneumoniae
74
What Hypersensitivity reaction is Goodpastures?
Type 2
75
What Hypersensitivity reaction is SLE?
type 3
76
What Hypersensitivity reaction is Graft rejection?
type 4
77
Where does lung cancer commonly spread?
Bone, Brain, Liver, Lymph, Adrenal Glands
78
what would you see if someone has a collapsed lung?
Sail Sign
79
Which antibody is seen in SLE?
Anti-double stranded DNA (Anti-dsDNA) antibodies are a group of anti-nuclear antibodies (ANA)
80
What is likely if someone has nocturnal diarrhoea?
IBD
81
What sign is shown in acute Cholecystitis?
Murphy's Sign
82
What is negative in cholangitis?
Murphy's Sign
83
What is Common in the left iliac region of the bowel?
Volvulus
84
Difference in pain with gastric and duodenal ulcers?
Gastric = pain when full/ after eating
Duodenal = pain when hungry
85
Give Inflammatory and Non inflammatory reasons for joint pain
Inflammatory = Autoimmune/ AS/ Crystal Arthritis/ Infection
Non-inflammatory = OA/ Fibromyalgia
86
3 differential diagnoses of HLA-B27 positive?
AS
Psoriatic Arthritis
Reactive Arthritis
Enteropathic Arthritis
87
What classing system is used for fractures?
Salter- Harris Classification
88
What is meant by a T/Z score?
T= bone density compared to 25 year old of same gender
Z = bone density compared to average of same age of same gender
89
when might you prescribe allopurinol?
Long term gout
Kidney stones - reduce uric acid
Hyperuricaemia - tumour lysis syndrome
90
Temporal Arthritis treatment?
Steroids (prednisolone)
91
Triad of renal cancer symptoms?
Flank pain
Haematuria
Palpable Mass
92
function of kidney?
Excretion of electolytes, water, urea
produces Epo
Ultrafiltration
93
Causes of CKD
Pre renal, renal, post renal
Pre-renal- DM/ high cholesterol
Renal = NSAIDs, glomerulonephritis
Post renal = kidney stones
94
Cause of Nephritic Syndrome
IgA nephropathy
post strep infection
SLE
ANCA positive vasculitis
95
Definition of erectile dysfunction?
Inability to gain and maintain erection long enough to achieve sexual satisfaction
96
Pharmacological and surgical treatment of Stress incontinence
Duloxetine
Artificial Sphincter
97
Name the bacteria that cause chlamydia and gonorrhoea
Neisseria gonorrhoeae
Chlamydia Trachomatis
98
What drug is used to treat syphilis
Azithromycin
99
Describe the different types of Salter Harris Classification
Type 1 = Through growth plate
Type 2 = Through growth plate and metaphysis (most common)
Type 3 = Growth plate and epiphysis
Type 4 = all 3 elements
Type 5 = Crush injury of growth plates
100
Cause of Polycythaemia?
JAK-2 mutation
101
Signs and Symptoms of Polycythaemia?
```
Hepatosplenomegaly
Pruritis
Plethoric face
thrombus formation
Gout due to increased uric acid / DNA breakdown
```
102
Diagnosis of polycythaemia?
- JAK-2 mutation
- FBC
- Bone marrow aspirate
103
Treatment of polycythaemia?
1) Venesection
2) Hydroxycarbamide
3) Interferon - alpha
104
Symptoms of Polycystic kidney disease
```
Hypertension.
Bump.
Haematuria (blood in urine).
Proteinuria.
Back pain and flank pain. Back pain or flank pain is the most common symptom of ADPKD
```
105
What may polycystic kidney disease cause?
Berry aneurysm- ruptures and becomes sub-arachnoid haemorrhage
106
Acute Pyelonephritis (Upper UTI) symptoms?
- Fever
- Chills
- Flank pain
- Nausea and Vomiting
- Increased WCC distinguishes upper from lower
107
Complications of CKD
- Hyperkalaemia
- Hypocalcaemia (renal osteodystrophy)
- Encephalopathy (flap)
- Pericarditis
- Increased renin so HTN
- Anaemia (reduced EPO)
108
Complications of DKA
- Kussmaul breathing
- Pear drop breath
- Hyperkalaemia
- Cerebral Oedema
109
what may trigger DKA and what is the treatment? same as (HONK coma)
Infection, MI, wrong dose insulin
Treatment:
- Fluids
- Insulin
- Electrolyte replacement
110
Complications of Pancreatitis?
- Pancreatic Pseudocyst / abscess (infection by e.coli)
- Hypovolaemic shock
- Acute Respiratory Distress Syndrome
Chronic = Diabetes
111
Main visible diagnostic of cirrhosis?
Regenerative nodules
fibrotic tissue and collagen
112
Complications of Cirrhosis
- Gastro-oesophageal varices
- Ascites
- Splenomegaly
- Hepatorenal failure
- Jaundice
- Palmar erythema due to oestrogen increase
113
Symptoms of Cirrhosis
- Pruritis
- Easy bruising (low coagulation factors)
- Hepatic Encephalopathy (liver flap)
- Ascites
114
Gold standard Dx of Cirrhosis?
Liver biopsy (nodules and fibrosis)
115
Lab findings of Cirrhosis
Raised:
- Bilirubin
- AST>ALT ratio
- ALP, GGT
Thrombocytopenia
116
Diagnosis of Hypertension?
Ambulatory blood pressure monitor
117
Causes of HTN?
- Acromegaly
- Conn's
- Hyperthyroidism
- Glomerulonephritis
118
Exclude secondary HTN?
- renin/ aldosterone
- Full blood count
- U+E
119
Signs of Asthma?
- Low O2 sats
- Use of Accessory muscles
- Tachypnoea
- Hyper-resonant percussion
120
Bedside asthma tests?
Peak flow, ABG, ECG
121
Asthma pathological changes
- Increase mucous
- bronchoconstriction
- inflammation of mucosa
122
Example of corticosteroid an method of action?
Prednisolone- upregulates anti-inflammatory genes
| downregulates pro-inflammatory genes
123
Ann Arbor staging, what is different betwee 3A and 3b ?
B- symptoms (fever, weight loss, night sweats)
124
Extra-articular effect of Rheumatoid Arthritis?
- Anaemia
- Pericarditis
- neuropathy
125
Worldwide common cause of Hypothyroidism and the treatment?
Iodine deficiency and Levothyroxine (T4)
126
Definition of a UTI
A UTI is a pure growth of more than 10^5 organisms per ml collected from a fresh clean catch urine sample
127
Lifestyle advice to reduce UTI
Clean after sex, increase fluid intake and regular voiding
128
Common complication of a UTI?
Pyelonephritis - Ascending bladder infection into the renal parenchyma
129
4 areas of Wilson and Junger Criteria?
Condition - important, understood, detectable stage
treatment- accepted and early, facilities
Test - suitable, early, accepted
Benefits- cost effective, agreed on who to treat
130
Mental Capacity requirements?
1) Ability to understand information
2) retain information
3) Evaluate information
4) Communicate decision
131
Investigations of hernias?
- Endoscopy
| - Barium swallow
132
Name a different class of drug instead of PPI
H2 receptor antagonist
Ranitidine
133
Risk factors to TB
- Immunosuppressed
- Close contact to infected/ crowded living conditions
- Alcoholics
- Homeless
134
X-ray of TB?
- Cavitation
- upper lobe consolidation
- pleural effusion
135
What are the 4 quadrants of medical ethics?
medical indications,
patient preferences,
quality of life,
contextual features
136
What are the signs of lung collapse and hypcalcaemia
Sail sign
Hypocalcaemia:
Chvosteks sign
Trousseau sign
137
Site of action of loop diuretic
Block NKCC2 in ascending loop of henle
138
Thiazide mode of action
Blocks Na+/Cl- co-transporter In DCT
139
Aldosterone antagonist method
Blocks aldosterone at ENACs in collecting duct
140
Breast cancer treatment and causes of lumps
Chemo and Trastuzumab
```
Causes:
lipoma
cancer
cysts
implant rupture
fibroadenoma
```
141
Name a dopamine agonist and what would be seen on Parkinson brain
Lewy bodies, loss of dopaminergic neurones
Ropinirole
