phase 2a sba Flashcards
what antiplatelet therapy do MI patients require
dual antiplatelet therapy consisting of aspirin and a PY12 inhibitor (e.g
clopidogrel, ticagrelor or prasugrel).
pharmacology of spironolactone?
Inhibition of aldosterone receptor in the distal tubules
whats the diagnosis for audible pan-systolic murmur at the apex
Mitral regurgitation
which ECG changes is most typically seen in a patient with a myocardial
infarction?
ST depression
Myocardial infarction ECG changes include: ST elevation, ST depression (C), T wave inversion,
abnormal Q wave
patient comes to A&E with slurred speech, left arm weakness and a severely ataxic gait. Which underlying condition
is most likely to have contributed to this presentation?
Atrial fibrillation
AF increases the risk of stroke due to blood collecting in the atria and forming clots
patient has hypertension and suspected Conns - What medication
is prescribed prior to her operation to stabilise her BP and K+ levels?
Spironolactone
3 key aspects of conns syndrome
- hypertension associated with
hypokalaemia - hypertension despite being on 3 or more antihypertensive
- hypertension before 40
years of age
Which of the following is not a cause of hypercalcaemia?
A. Down’s syndrome
B. Familial benign hypocalciuric hypercalcaemia
C. Malignancy
D. Sarcoidosis
E. Thyrotoxicosis
Down’s syndrome
causes of hypercalcaemia
CHIMPANZEES-
Calcium supplements,
Hydrochlorothiazide,
Iatrogenic/Immobilisation,
Multiple myeloma/Medication (lithium),
Parathyroidhyperplasia,
Alcohol,
Neoplasm,
Zollinger ellison syndrome,
Excessive Vit D,
Excess Vit A,
Sarcoidosis
side effects of tamsulosin
Postural Hypotension
what does tamsulosin do
is a selective alpha 1-adrenenergic receptor antagonist which relaxes the smooth muscle in the bladder neck and prostate, allowing an increase in urinary flow rate and an improvement in obstructive symptoms.
why does tamsulosin cause postural hypotension
alpha 1 adrenoceptors are also found in smooth muscle of blood
vessels and therefore alpha blockers cab also lower vascular resistance resulting in postural hypotension, dizziness and syncope.
Which of the following U&E components should we be most concerned about with an AKI patient
A. Chlorine
B. Creatinine
C. Potassium
D. Sodium
E. Urea
potassium
When a patient with an AKI’s kidney function start failing, they are unable to excrete potassium.
When this happens, it causes a build-up in the blood and leads to hyperkalaemia which is a medical
emergency as it can result in a cardiac arrest
pharmacology of furosemide
Loop diuretic acting on ascending limb of loop of Henle
how to diagnose CML
- WCC very high
- haemoglobin and platelets can be higher or lower.
- because there is an increase in
cell turnover of myeloblast cells which further differentiate into basophils, neutrophils and
eosinophils. - Leucocytosis is an increase in
WBCs in the blood stream which occurs due to the abnormal proliferation of WBCs in CML.
. Which of the following is not a risk factor for a deep vein thrombosis?
A. Dehydration
B. Malignancy
C. Nausea
D. Obesity
E. Varicose Veins
nausea
Which of the following findings would you least
expect to find in a patient with iron deficiency anaemia?
A. Brittle hair and nails
B. Koilonychia
C. Pale conjunctivae
D. Reduced reflexes
E. Systolic flow murmur
reduced reflexes - this is macrocytic anaemia
A patient recently started ceftriaxone for meningitis which has caused haemolysis, what
would you expect to see on assessment of the patient?
Presence of dark urine
side effects of amitryptiline
- blurred vision
- confusion
- dry mouth
- urinary retention
What are the three cardinal signs of heart failure?
Shortness of breath, fatigue, ankle oedema
ECG signs of right bundle branch block
R wave in V1 and Slurred S wave in V6
distinctive signs of infectve endocarditis
- splinter haemorrhages
- Osler’s nodes,
- janeway lesions
- Roth spots
- fever.
how to treat GORD
Omeprazole is a proton pump inhibitor commonly given as first line medication for GORD
first line investigation for bowel obstruction
Abdominal X-ray
complications of untreated GORD
- oesophagitis
- oesophageal ulcers and strictures
- oesophageal cancer
- barrrets oesophagus
presentation of coeliacs
- smelly floaty stools (Steatorrhea),
- diarrhoea
- weight loss.
- Dermatitis Herpetiformis,
gold standard investigation for bowel cancer
colonoscopy
Double contrast barium enema is 2nd line
causes of diverticulum
Low fibre diet
Obesity
NSAIDs
Smoking
A 38-year-old female presents to you with bouts of diarrhoea with urgency, fatigue,
abdominal pain and mouth ulcers. She smokes and complains of a stressful life. What
investigation result may you expect to see
she has crohns so
Anaemia due to Iron and Folate deficiency
describe chronic prostatitis
- characterised by pelvic or perineal pain lasting longer than 3 months as the key symptom.
- trauma causing nerve damage in the lower urinary tract is a risk factor for chronic prostatitis.
what drug can u not give a pregnant woman for uti
Trimethoprim - carries a teratogenic risk in the first trimester as it inhibits folate synthesis
complications of PKD
- Cardiovascular disease
- Kidney stones
- Polycystic liver disease
- Subarachnoid haemorrhage
describe ann arbor staging for lymphoma
I Confined to single lymph node region.
II Involvement of two or more nodal areas on the same side of the diaphragm.
III Involvement of nodes on both sides of the diaphragm.
IV Spread beyond the lymph nodes, e.g. liver or bone marrow.
Each stage is either ‘a’—no systemic symptoms other than pruritus; or ‘b’—presence of b symptoms
management of Venous ThromboEmbolsism in post-hip replacement patients states
Dalteparin acutely then maintenance treatment with apixaban
define hyperplasia
Increased size of a tissue due to increase in number of constituent cells
components of atherosclerotic plaques
- connective tissue
- foam cells- lipid-laden macrophages
- T lymphocytes
- smooth muscle cells
Others; cholesterol, lipid deposits, fragments of destroyed
internal elastic lamina
What cell type is the end result of the metaplastic change in Barrett’s oesophagus?
Barrett’s oesophagus occurs where the oesophageal stratified squamous cells undergo metaplasia to simple columnar cells
what is thee most indicative of prostate cancer?
A hard, craggy prostate on DRE
What is the 1st line pharmaceutical treatment for
paracetamol overdose?
- N-acetyl cystine
which disease has high AMA antibodies
Primary Biliary Cholangitis (PBC)
characteristics of upper GI bleeds
- Coffee ground vomit
- Hypotension
- Melaena
- Tachycardia
what is The main complication to be concerned about in alcohol withdrawal
seizures - The 1st line treatment of withdrawal seizures is chlordiazepoxide
side effect of alendronic acid
Alendronic acid is a bisphosphonate. Bisphosphonates can cause oesophagitis and so it is
recommended that patients take them first thing in the morning and remain upright for at least 30
minutes.
most appropriate in diagnosing Sjogren’s syndrome?
Schirmer’s test
- Which of the following X ray signs is mostly likely to be found a patient with psoriatic
arthritis?
Pencil in cup - in arthritis mutilans, a severe form of psoriatic
arthritis
Ankylosing Spondylitis first line management
ibuprofen
presentation of psuedogout
typically presents as an acute onset of monoarthritis, often in the knee.
A fever may also be present.
Risk factors include IV fluids and
parathyroidectomy (the benign tumour in his neck) as these can derange calcium levels.
Which of the following medications is the most appropriate to prescribe to prevent future gout
attacks occurring?
allopurinol
what T score suggests osteopenia
A T score of -1 to -2.5
what T score suggests osteoporosis
a score of under -2.5
suggests osteoporosis
what MSK disorder can chlamidya cause
Reactive arthritis
This can cause Reiter’s
triad of conjunctivitis, urethritis and arthritis (can’t see, can’t pee, can’t climb tree) as well as
keratoderma blennorrhagium (the rash on his feet) and mouth ulcers
what imaging is preferred for stroke
CT because it is fast
MRI is sensitive and specific but not readily available
describe amaurosis fugax
painless, unilateral vision loss secondary to emboli such as to lodge within the retinal artery
common features in patients with parkinsons
- Blank facial expressions except when told to smile
- Extremely small handwriting
- Rigid limbs and difficulty getting out of bed
- Slow walking
which features are likely in patients with brain tumours
Coma
Dysdiadochokinesis
Nausea and vomiting
Seizures
treatment of giant cell (temporal) arteritis
Oral prednisolone
risk factors for peripheral neuropathies
Diabetes Mellitus
immunocompromised status
Systemic lupus erythematosus
Thiamine (Vit B1) deficiency
Adult patients with acute ischaemic stroke should receive alteplase treatment within what
time after onset of their symptoms?
<4.5hrs
. IV alteplase – a clot busting drug or tissue
plasminogen activator
What is the commonest cause of an infective exacerbation of COPD?
Haemophilus influenzae
Which of the following is a sign of a life-threatening asthma attack?
A. Inability to complete sentences in one breath
B. SpO2 <92%
C. Pulse < 110
D. RR≥25
E. RR<25
SpO2 92%
Which
medication below is most commonly associated with a fine tremor?
Salbutamol Inhaler
Which type of lung cancer is most commonly seen in non-smokers
Adenocarcinoma
presentation of PE
pleuritic chest pain
(worse on deep breaths), shortness of breath and haemoptysis.
Pregnancy - RISK FACTOR
Which of the following is not a risk factor for a Pulmonary Embolism?
A. Antiphospholipid syndrome
B. Cancer
C. Early mobility post-surgery
D. Factor V Leiden mutation
E. Synthetic Oestrogen
Early mobility post-surGERY
presentation of TB
- productive cough for 4 months and sputum is sometimes tinged with blood.
- night sweats, fatigue, a decreased appetite
- cavitating lesion in the upper left lobe and hilar lymphadenopathy
- sputum sample is taken which comes back positive for
growing acid-fast bacilli
an excess of which foods
would decrease warfarin’s effect
spinach - because it is high in vitamin K
licensed treatment for heroin addiction
Methadone
what drug should you take before surgery for phaochromocytoma
Phenoxybenzamine
give a complication of Clostridium Difficile infection?
- Pseudomembranous colitis
symptoms of severe infective gastrienteritis
- Bloody diarrhoea
- Fever
- Headache
- Reduced skin turgor
causes of aytpical pneumonia
- Chlamydia psittaci
- Coxiella burnetii
- Legionella pneumophila
- Mycoplasma pneumoniae
Which antibiotic is not indicated in Staphylococcus Aureus infection?
Ampicillin
Which heart valve is most commonly affected in infective endocarditis?
tricuspid
give a Gram-negative diplococcus?
Neisseria spp
. Which of the following antibiotics does not inhibit cell wall synthesis?
A. Benzylpenicillin
B. Cefotaxime
C. Erythromycin
D. Teicoplanin
E. Vancomycin
- Erythromycin
Which is the most common cause of bacterial pneumonia?
Streptococcus pneumoniae`
A 58-year-old male presents with sudden painful inflammation of his big toe. What is the
treatment?
Colchicine - for gout
extra dural haemrrhoage characteristicd
A lemon shaped bleed and a lucid period following a head injury in the brain is characteristic of
an extradural haemorrhage which is caused by a rupture of the middle meningeal artery
first line treatment for migraine
ibuprofen
treatment for chorea
risperidone – dopamine receptor antagonist that helps to manage aggression and chorea.
Belongs to the antipsychotic drug class
What is the treatment for Guillian-Barre syndrome?
IV immunoglobulins
causes of tension headaches
Depression, lack of sleep, missed meals and stress
treatment for confirmed PE
DOAC
such as apixaban or rivaroxaban,
if this is unsuitable or contraindicated then you can start them on
LMWH such as dalteparin
how to treat classic primary spontaneous pneumothorax, which has developed into a tension pneumothorax
immediate decompression via large bore canula
What drug group cause bronchodilation by blocking acetylcholine receptors which
normally cause contraction of bronchial smooth muscle?
Long-acting muscarinic antagonists
describe the 6 in 1 vaccine
The 6-in-1 vaccine is given to babies three times when they are 8, 12 and 16 weeks old. Currently it
vaccinates against diphtheria, tetanus, pertussis, polio, Hib and Hepatitis B. T
