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Phase 2a Lauren > Peer teaching formatives > Flashcards

Peer teaching formatives Flashcards

1
Q

64yo male, chest pain on exertion, eases if sits down, stress ECG findings?

a) Saddle shaped ST with PR depression
b) Tall tented T waves and pathological Q waves
c) ST Elevation
d) ST Depression
e) Absent P waves

A

ST Depression

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2
Q

Acute pericarditis pain:

a) Fine in chair, comes on if stand up
b) If lean forward it hurts, when lie down it is fine
c) Hurts lead down, sit up and lean forwards better
d) Hurts during inhalation
e) Zumba = pain, rest is fine.

A

c) Hurts lead down, sit up and lean forwards better

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3
Q

Mitral regurgitation murmur:

a) Early-diastolic murmur
b) Early-systolic click murmmur
c) Ejection systolic ‘crescendo-decrescendo’ murmur
d) End-diastolic murmur
e) Pansystolic murmur

A

e) Pansystolic murmur

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4
Q

54yo caucasian, high BP, metformin and simvastatin. Appropriate anti-hypertensive?

a) Amlodipine
b) Bendroflumethiazide
c) Candesartan
d) Diltiazem
e) Isomorbide mononitrate

A

c) Candesartan

ACEi/ARB

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5
Q

Which of the following is the correct mechanism of drug action for Heparin?

a) Increases cGMP and reduces intracellular Ca2+ concentration
b) Inhibits cyclooxygenase (COX) reducing production of thromboxane A2
c) Inhibits production of vitamin-K dependent clotting factors
d) Inhibits thrombin and factor Xa
e) Induces Vagal Nerve stimulation

A

d) Inhibits thrombin and factor Xa

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6
Q

Fever and new heart murmur & hand symptoms. Infective endocarditis. Which is NOT Seen in infective endocarditis?

a) Roth Spots
b) Janeaway lesions
c) Oslar nodes
d) Splinter haemorrages
e) Clubbing

A

Roth Spots

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7
Q

Left calf swollen and red, Well’s score less than 4. Medium risk. Further test?

a) FBC
b) C-reactive protein
c) D-dimer
d) Tropomyosin I
e) Anti-phospholipid antibody

A

c) D-dimer

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8
Q

BP definition?

a) Cardiac output x Total vascular resistance
b) HR x Stroke volume
c) Diastolic pressure + pulse pressure
d) End diastolic volume - end systolic volume
e) Blood velocity x diameter of tube.

A

a) Cardiac output x Total vascular resistance

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9
Q

Which of the following blood tests is diagnostic of heart failure?

a) Troponin I
b) Atrial natriuretic peptide (ANP)
c) Brain natriuretic peptide (BNP)
d) CK-MB
e) FBC

A

c) Brain natriuretic peptide (BNP)

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10
Q 
43yo male, on ACEi for angina. Cough. Changes ACEi to ARB. What is responsible for the cough?
a) Acetylcholine.
B. Bradykinin
C. Histamine.
D. IgE
E. Prostaglandin
A

B. Bradykinin

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11
Q

34yo man, bloating, stinking floating stools. Coeliac. Which antibodies associated with coeliac disease?

a) Anti-DsDNA
b) Anti-phospholipid
c) ANCA
d) Alpha-gliadin
e) Rheumatoid factor

A

d) Alpha-gliadin

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12
Q

Diarrhoea. IBS, tried low FODMAP. Intervention?

a) Ferrous sulphate
b) Loperamide
c) Methotrexate
d) Metronidazole
e) Omeprazole

A

b) Loperamide

Immodium

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13
Q

34yo South African, left iliac abdominal pain, sudden onset. Unable to pass stool. No previous surgery, non-smoker and tTg results negative. Most likely diagnosis?

a) Coeliac disease
b) Colorectal cancer
c) Large bowel obstruction- volvulus
d) Small bowel obstruction- adhesion
e) Strangulation hernia

A

c) Large bowel obstruction- volvulus

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14
Q

Not a feature of chron’s?

a) Mouth Ulcers
b) Mucosal inflammation
c) Graulomatous skip lesions
d) Raised CRP levels
e) Smoking decreases the risk of disease

A

e) Smoking decreases the risk of disease

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15
Q

What indicates IBD instead of IBS?

a) Smelly stools
b) DXA scan revealing decreased bone mineral density
c) Nocturnal diarrhoea
d) Abdominal cramps
e) Feeling fatigued

A

c) Nocturnal diarrhoea

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16
Q

Which ascending cholangitis is false?

a) Caused by bacterial infection of biliary tree
b) Patients experience epigastric pain
c) Patients present with a temperature
d) Patients present with yellowing of the skin and sclera
e) Murphy’s sign is negative

A

b) Patients experience epigastric pain

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17
Q

Gallbladder is supplied blood by the systic artery. What is the cystic artery a branch of?

a) Coeliac trunk
b) Gastoduodenal artery
c) Left gastro-epiploic artery
d) Right hepatic artery
e) Splenic artery

A

d) Right hepatic artery

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18
Q

Which form of hepatitis is a DNA virus?

a) Hepatitis A
b) Hepatitis B
c) Hepatitis C
d) Hepatitis D
e) Hepatitis E

A

b) Hepatitis B

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19
Q

Haemochromatosis is a metabolic liver disease caused by uncontrolled intestinal absorption of which ion?

a) Ca2+
b) Cu2+
c) Fe2+
d) Li+
e) K+

A

Fe2+

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20
Q

42yo lawyer, 5/10 epigastric pain after eating. H. pylori breath test = peptic ulcer. Strategy: giving PPI eg. omeprazole, giving two antibiotics. Which two?

A

a) Amoxicillin and Clarithromycin

PAC man
PPI.
Amoxicillin
Clarithromycin

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21
Q 
Non-inflammatory cause of joint pain?
a) Rheumatoid arthritis
B Septic arthritis
C Spondyloarthritis
D Fibromyalgia
E  Gout
A

d) fibromyalgia

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22
Q

Which of these is not a feature of Rheumatoid Arthritis?
a) NSAIDs help
B Pain eases with use
C Effects the distal interphalangeal joints
D Pain lasts for an hour or so in the morning
E Ulnar deviation

A

c) affects the distal interphalangeal joints

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23
Q

Which of the following best describes the method of action of bisphosphonates?

a) Cause increased bone deposition
b) Cause reactivation of the metaphysis and epiphysis
c) Inhibit osteoclast activity and cause osteoclast apoptosis
d) Reduce the signally pathway between osteoblasts and clasts by increasing RANK ligand
e) Increase removal of calcium into the haversian canal within bone

A

c) Inhibit osteoclast activity and cause osteoclast apoptosis

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24
Q

Lavish lifestyle, wine and cheese. Painful big toe and gout. Joint aspiration, what confirms gout?
a) Tophi
B Needle shaped crystals which are +ve birefringent
C Needle shaped crystals which are -ve birefringent
D Rhomboid shaped/ brick like crystals which are +ve birefringent
ERhomboid shaped/ brick like crystals which are -ve birefringent

A

C Needle shaped crystals which are -ve birefringent

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25
Q 
21yo male, 3 week history or stiff painful knee. Painful urination and eye. Organism?
a) Staphylococcus aureus
B E.coli 0194
C Streptococcus Pneumonia
D Heamophilius influenza
E Chlamydia
A

E Chlamydia

Can’t pee, can’t see, can’t climb a tree

Could be salmonella/shigella

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26
Q

55yo painter. Aching hand and arm with pins and needles sensation in thumb, index and middle fingers. Shaking hand seeps to help. Most likely:

a) Cervical spine fracture
b) Compression of median nerve
c) Compression of radial nerve
d) C8-T1 nerve lesion
e) Compression of ulnar nerve

A

b) Compression of median nerve

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27
Q

21yo male, back pain 3 months, MRI = bamboo spine/ Ankylosing spondylitis. What tissue is associated with this condition?

a) HLA DQ2
b) HLA B27
c) HLA DR3
d) HLA DR2
e) HLA AD6

A

b) HLA B27

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28
Q 
Most common cause of osteomyelitis?
a) Strep Pneumonia 
B Staph Aureus 
C Strep Pyogenes 
D Mycobaterium tuberculosis 
E. H. Influenzae
A

B Staph Aureus

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29
Q

29yo female, fatigued, mouth ulcers, butterfly shaped rash on face. She has lupus. Her blood tests reveal which of the following?

a) Anti-DsRNA positive
b) Raised ESR and CRP
c) Raised ESR but normal CRP
d) ANCA+
e) ANA negative

A

c) Raised ESR but normal CRP

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30
Q

92yp fall and fractured hip. DXA scan = T-score of -1.6. What does this mean?

a) Normal
b) Osteopenia
c) Osteoperosis
d) Severe osteoperosis
e) Padget’s disease

A

b) Osteopenia

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31
Q

Patient presents with chest pain on exertion. Diagnosis?

A

Stable angina

32
Q

ECG shows saddle-shapped ST.. diagnosis?

A

Pericarditis

33
Q

Name a condition in which beta blockers are contraindicated?

A

Asthma

34
Q

MRI reveals CNS lesions disseminated in space and time.. diagnosis?

A

Multiple sclerosis

35
Q

Common side effect of ACEi?

A

Cough

36
Q

Commonest cause of hospital acquired pnseumonia?

A

Staph aureus

37
Q

Bowel biopsy reveals transmural lesion.. diagnosis?

A

Chron’s

38
Q

Pain in big toe, diet of excessive red win and cheese.. diagnosis?

A

Gout

39
Q

Antibiotics for treating TB?

A

Rifampicin, isoniazid, pyrazinamide, ethambutol

40
Q

Painless haematuria - works in a dye factory.. diagnosis?

A

Bladder cancer

41
Q

Routine blood glucose measurement comes back a little high. What is NOT a physiological response to increased blood glucose?

a) Decreased breakdown of mucle
b) Glycogenesis
c) Increased lipolysis
d) Increased uptake of glucose cells
e) Production of insulin from pancreas

A

c) Increased lipolysis

42
Q

Who doesn’t have DM T2?

a) Fasting plasma glucose - 10mmol/L
b) Fasting plasma glucose 8 mmol/L
c) Oral glucose tolerance test 25 mmol/mol
d) HbA1c 47
e) Random plasma glucose of 13 mmol/L with symptoms

A

d) HbA1c 47

43
Q

3 risk factors for developing T2DM?

A

Non mod- ethnicity, FHx, Hx gestational diabetes

Mod - diet, exercise, obesity, medications (thiazide diuretic with beta blockers)

44
Q

2 symptoms of DMT2?

A

Blurred vision, polydipsia, polyuria, fatigue

45
Q

Hot and bothered, mood changes, weight loss. What other symptoms would align with diagnosis?

a) Dry skin
b) Hair loss
c) Consitipation
d) Lethargy
e) Clubbing

A

e) Clubbing

Everything ramps up. 
Head - anxiety, heat intolerance
Eyes - bulging 
Mouth - increased appetite 
Neck - goitre
Chest - tachy
Hands - tremor, clubbing, sweating
Abdomen - weight loss, diarrhoea
Menstrual - oligomenorrhoea (infrequent)
46
Q

What are common symptoms of hypothyroidism?

A

Dry skin, cold intolerance, slow brain, Hair loss, hearing loss, decreased libido,
Apathy/blank expression
Mouth - decreased appetite
Chest - brady
Hands - brittle nails
Abdomen - weight gain, Consitipation, Lethargy
Menstrual - amenorrhoea/menorrhagia

47
Q

What is the treatment of hyperthyroidism?

A

Carbimazole, radioiodine, surgery

48
Q

What is the treatment of hypothyroidism?

A

Levothyroxine

49
Q

16yo, abdo pain for 24hrs, weight loss and lots of water. Tachycardic, tachypnoeic, clammy, confused. Diagnosis?

a) Cushing’s
b) Diabetes insipidus
c) Diabetic ketoacidosis (DKA)
d) Hyperaldosteronism
e) Syndrome of inappropriate anti-diuretic hormone secretion (SIADH)

A

c) Diabetic ketoacidosis (DKA)

50
Q

Treatment of DKA?

A

IV fluids and insulin

51
Q

Action of aldosterone?

A

Increases sodium retention –> water retention –> hypertension
Increases exretion of potassium —> hypokalaemis

52
Q

Thyroid function tests (TFTs) come back with TSH high, T4 low. Diagnosis?

a) Sub-clinical hypothyroidism
b) Primary hypothyroidism
c) Sub-clinical hyperthyroidism
d) Primary hyperthyroidism
e) TSH secreting tumour

A

Primary hypothyroisism

53
Q

High TSR, high T4. Diagnosis?

A

Pituitary problem, eg. TSH secreting tumour

54
Q

TSH low, high T4. Diagnosis?

A

Thyroid problem - primary hyperthyroisism

55
Q

TSH low, T4 low. Diagnosis?

A

Pituitary problem

56
Q

What secretes TRH and what is TRH?

A

The Hypothalamus secretes TRH (Thyrotropin-releasing hormone)

57
Q

What does TRH do?

A

This stimulates the anterior pituitary to produce Thyroid Stimulating Hormone (TSH).

58
Q

What does TSH do?

A

This stimulates the production of T4 (thyroxine) and T3 (triiodothyronine).

59
Q

Looks like they have a tan, 68yo woman. Tired and tearful. U&E show low sodium, high potassium. Most likely diagnosis?

a) Addison’s
b) Conn’s
c) Cushing’s
d) Depression
e) T1DM

A

Addison’s

60
Q

No sex drive, skin thinning, easy bruising, mood swings. BP 160/105. What investigation do you perform?

a) Arterial blood gas
b) 24hr urine cortisol collection
c) CT head
d) Thyroid function test
e) Liver function tests

A

b) 24hr urine cortisol collection

Cushing’s?

61
Q

Conditions caused by long term steroids?

a) Adrenal insufficiency
b) Conn’s
c) Hypothyroidism
d) Hyperparathyroisism
e) Phaeochromocytoma

A

a) Adrenal insufficiency

62
Q

What causes adrenal insufficiency?

A

Addison’s disease, steroids

63
Q

What causes Conn’s?

A

Adrenal adenoma (80%)

64
Q

What causes hypothyroidism?

A

AI (Hashimoto’s thyroiditis), iatrogeneic, iodine deficiency, drugs eg. lithium

65
Q

What causes hyperparathyroidism?

A

Parathyroid gland ademona

66
Q

What causes phaechromocytoma?

A

Tumur of chromaffin cells of adrenal medulla

67
Q

High calcium doesn’t cause..?

a) Bone pain
b) Constipation
c) Depression
d) Hypertension
e) Kidney stones

A

d) Hypertension

Hypercalaemia = BONES, STONES, GROANS AND PSYCHIC MOANS

68
Q

Fasting plasma glucose threshold for diagnosing DMT2?

A

> 7mmol/L

69
Q

Oral glucose tolerance test threshold for diagnosing DMT2?

A

> 11.1mmol/mol

70
Q

Random plasma glucose threshold for diagnosing DMT2?

A

> 11mmol/L + Sx

71
Q

Symptoms of Cushing’s?

A

Weight gain, no drinking oproblems, no acute crisis

72
Q

Symptoms of diabetes insipidus instead of DKA?

A

No polydipsia, no weight loss, less likely to cause dehydration & shock

73
Q

Symptoms of hyperaldosteronism?

A

Polydipsia, polyuria

74
Q

Symptoms of hyperthyroidism?

A

Weight loss but no thirst or polydipsia

75
Q

Blood test result for Cushing’s?

A

High cortisol

76
Q

Blood test result for Conn’s?

A

High aldesterone = low potassium and high sodium

77
Q

Blood test result for Addison’s?

A

High potassium, low sodium

Phase 2a Lauren (15 decks)

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