Phase 3B 2004/2005 Flashcards
What test would you do to confirm Legionnaires disease
Urinary antigen test
Treatment of Legionnaires
Azithromycin
Eryhtromycin
Doxycycline
Clairthromycin
Signs of sepsis
increased HR Increased cap refill Increased RR Rash Temperature Drowsy
Mechanism of action of SSRIs
Selectively inhibit the reuptake of 5HT at the prefrontal cortex
Features of TGA overdose
Tachycardia Dilated pupils Hypotension Arrthymias Seizures Absent bowel sounds Urinary retention
Examples of infectious diseases that causes splenomegaly
Salmonella typhi Malaria Leishmanias Viral hepatitis Typhoid fever Trypanosomiasis
Define empirical
Basis of a clinically educated guess in the absences of a complete information
What cells are affected in EBV
B lymphocytes
Epithelial cells
Signs of anaphylaxis
Flushed Swelling of the tongue Swelling of the lips SOB Stomach pain Fainting Sweating
Outline the mechanism in which hypotension occurs in anaphylaxis
An allergen reacts with specific IgE antibodies on mast cells and basophils (type 1 hypersensitivity reaction), triggering the rapid release of stored histamine and the rapid synthesis of newly formed mediators. These cause capillary leakage, mucosal oedema and ultimately shock and asphyxia.
What drugs are given in anaphylaxis
Corticosteriods
IM adrenaline
Chloramphenamine
Beware of a biphasic reaction a couple of hours later
ECG changes defining an MI
ST elevation of 1mm in at least 2 contiguous limb leads
Hyperacute T waves
New onset BBB
ECG changes of ST elevation in 2mm in at least 2 contiguous chest leads
Contra indications to thrombolysis
Previous intracranial bleed Aortic dissection GI bleed Neuro Severe HTN
Mechanism of action of statins
Competitively inhibits HMG-CoA reductase
Decrease the production of cholesterol
Drug to treat postural hypotension
Fludrocortisone
ECG signs of hyperkalaemia
Tall tented T waves
Absent P waves
Widened QRS complex
Increased PR interval
Modality of imaging in Intussusception and what will be seen
Ultrasound
Doughnut or target sign
Complications of CF seen in neonates
Meconium illeus
Pancreatic obstruction
Common disease causing organism in CF
Staph aureus
Haemophilus influenza
Pseudomonas aerginuosa
What organism requires isolation treatment in CF patients
Burkhoderi cepacia
Chromosomal abnormality in Down
Non disjunction of chromosomes
Transloaction
Mosacism
Examples of trisomys and which chromosomes are affected
Pateaus (13)
Edwards (18)
Down’s (21)
Non infective causes of splenomegaly
Leukaemia
Hepatitis
Sickle cell
Examples of gram - ve bacillus
Klebsiella E.coli Enterobacter Salmonella Shigella
Give an example of a DNA gyros inhibitor
Ciprofloxacin
Define incidence
Measure of probability of occurrence of a disease
Define absolute risk
Actual numbers involved
Define relative risk
Risk of those in the exposed group compared to risk of those in the unexposed
Name the three types of cells found in the ovary and what tumours can arise from them
Granulosa cells
- Granulosa cell tumours
Germ cells
- Teratomas
Theca cells
- Thecoma
Management of ovarian cancer
Bilateral salingo-oophrectomy with hysterectomy and lymph node clearance
What investigations would you do in a case of suspected SIADH
U&Es: sodium and potassium Osmolality - Serum osmolality (expect it to be low) - Urine osmolality (expect it to be high) - Urine sodium (expect it to be high TFTs Adrenal function (ensure not in a salt losing crisis) Imaging (may be an ectopic)
Three ECG features of WPW
Delta wave
Widened QRS
Shorten PR interval
Causes of a palpitations
AF Atrial flutter Palpatations AVNRT Frequent ectopics Hyperthyroid Alcohol Anxiety
Types of AF
Paroxysmal Af ( ~7 days) Persistent AF Chronic AF (>12mnths)
Causes of AF
Hyperthyroid Mitral stenosis Alcohol Infraction Iscahemia Inflammation Metabolic
List the components of CHADsVASc
Congestive heart failure Hypertension Age > 75 Diabetes Vascular disease Age >60 Sex
What options do you have for rate controlling AF
Calcium channel blocker Beta blockers (must be cardioselective) Digoxin Pill in pocket (flecanide)
What is the danger with WPW
If you go into AF you have a risk of slipping into VF
Sides of a previous MI on an ECG
T wave inversion
Pathological Q waves
Name the cardiac enzymes that may be measured in MI
Troponin T or I Creatine Kinase Myocyctes Creatine kinase skeletal muscle AST Lactate dehydrogenase
Name some causes other than MI for a raised trop
Myocardiits Endocarditis Pericarditis Trauma to the heart CKD Sepsis
Reversible cause of MI
4 Ts
- Toxins
- Tamponade
- Tension pneumothorax
- Thrombosis
4H’s
- Hyperkalaemia
- Hypothermia
- Haemoorhage
- Hypoglycaemia
Investigations in case of microcytic hypochromic anaemia
Blood film HB electrophoresis Iron studies - Fe - Ferritin (is an acute phase reactant can be skewed) - TIBC
Foetal complications in a mother with DM
Macrosomia Sudden uterine death Structural congenital defects Hypoglyaemia Shoulder dystocia
Sings of Down syndrome
Epicanthic folds Brush field spots Wide saddle gap Single palmer crease Falt occiput Low set ears
What is the biochemical picture typically seen in bulmia nervosa
Hypocholoraemia hypokalaemia hypophosphataemia hypomagnesium metabolic alkalosis
if laxatives are being used it is a metabolic acidosis
Signs of hypokalaemia
Hypotonia Cramps Tetany Palpatations Muscle weakness Reduce reflexes Arrythymias
List the side effects associated with the TB drugs
Rifampacin: orange sercretion
Isoniazid: peripheral neuropathy
Pryzidamide: hepatitis
Ethamabutol: Colour blindness, loss of peripheral vision
Treatment for MS
- flares
- maintenance
Flares
- IV methlypred
Maintenance
- IFN-beta
- Natilizumab
- Alemtuzumab
6 causes of rectal bleeding
Haemorroids Constipation Inflammatory bowel disease Malignancy ischaemic colitis infective colitis
Management of HONK
IV fluids (0.9% NaCl)
- Rehydrate slowly
Replace any lost K+
If glucose doesn’t fall by 5mmol/L by the hour with rehydration think about starting an insulin sliding scale
What is the bradford hill criteria
Strength of association Consistency Temporality Biological gradient Specificity Biological plausible Coherence Anaology
