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Medicine Phase 2a > Practice Questions additional points > Flashcards

Practice Questions additional points Flashcards

1
Q

What are 4 symptoms and 4 signs of hyperthyroid disease?

A

Sx: Weight loss, diarrhoea. fatigue, irritability, heat intolerance, sweating, increased appetite

Signs: Fine tremour, tachycardia, hair loss, ptosis, exophthalmos, pretibial myxoedema, acropachy, Hypertension

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2
Q

Risk factors for T2DM?

A

Hypercholesterolaemia
Obesity
Smoking
Male
Sedentary Lifestyle
Hypertension

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3
Q

2 Places where alpha adrenoceptors can be found and what they do?

A

Blood vessels - vasoconstrict
Sphincters - Contract

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4
Q

How do you avoid a hypertension crisis in phaeochromocytoma?

A

Phentolamine

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5
Q

4 short term side effects of chemotherapy treatment?

A

Sexual Dysfunction
Infection
Anaemia
Infection risk
Nausea and Vomiting
Alllopecia

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6
Q

What is the treatment for Febrile Neutropenia?

A

IV
Beta lactam
Piperacillin + Tazobactam (Tazocin)

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7
Q

What is a potential long term side effect of chemotherapy?

A

Tumour Lysis Syndrome

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8
Q

Why are iron studies a limited investigation when looking for iron deficiency anaemia?

A

Ferritin is an acute phase protein and therefore it will increase with inflammation

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9
Q

What is a key side effect of ferrous sulphate?

A

Turns stools black
Nausea and vomiting
Loss of appetite
constipation
diarrhoea

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10
Q

What are some treatments for haemophillia A?

A

Desmopressin
IV replacement of Factor VIII

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11
Q

List 3 signs you may see on an abdominal examination of a patient with a small bowel obstruction?

A

Abdominal Distension
Tinkling Bowel Sounds
Hyper resonant percussion

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12
Q

What is seen on an abdominal XRAY in a sigmoid Volvulus?

A

Coffee Bean Sign

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13
Q

What are some features seen systemically in a patient with Ulcerative colitis?

A

Uveitis/Episcleritis
Pyoderma Gangrenosum
Erythema Nodosum
Arthritis

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14
Q

What tests could you do other than biopsy and FBC/U&E to diagnose UC?

A

Faecal Calprotectin
P-ANCA

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15
Q

What are some investigations you would do to rule out other conditions in IBS?

A

tTg antibodies for coeliac
Faecal Calprotectin for IBD

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16
Q

What are some common exacerbating factors for IBS?

A

Stress
Fatty foods
Spicy Foods
Caffeine
Processed Foods

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17
Q

What are some complications of acute pancreatitis?

A

Acute Respiratory Distress Syndrome (ARDS)
Sepsis
Hypovolaemic Shock
DIC
Systemic Inflammatory Response Syndrome

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18
Q

What are some signs that may be found on examination of the hands in chronic liver disease?

A

Dupytrens Contracture
Palmer Erythema
Leukonychia
Finger Clubbing
Asterixis

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19
Q

What is the survival rate of pancreatic Cancer?

A

Very poor Prognosis
<3% 5 year Survival

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20
Q

What are the causes of Clubbing?

A

CLUBBING (L has ABCDEF)
C:cyanotic Heart Disease
L: Lung Disease
- Abscesses
- Bronchiectasis
- Cystic Fibrosis
- DONT SAY COPD
- Empyema
- Fibrosis
U: Ulcerative Colitis + IBD (Crohns)
B: Biliary Tract Disease
B: Birth Defects
I: Infective Endocarditis
N: Neoplasm (lung cancer or mesothelioma)
G: Gastrointestinal Malabsorption Syndrome (Coeliac Disease)

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21
Q

What are the causes of Clubbing?

A

CLUBBING (L has ABCDEF)
C:cyanotic Heart Disease
L: Lung Disease
- Abscesses
- Bronchiectasis
- Cystic Fibrosis
- DONT SAY COPD
- Empyema
- Fibrosis
U: Ulcerative Colitis + IBD (Crohn’s)
B: Biliary Tract Disease
B: Birth Defects
I: Infective Endocarditis
N: Neoplasm (lung cancer or mesothelioma)
G: Gastrointestinal Malabsorption Syndrome (Coeliac Disease)

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22
Q

where do diverticula most commonly occur?

A

Sigmoid colon due to smallest luminal diameter and therefore the highest pressure to cause the mucosal herniation

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23
Q

What is the most common cause of portal hypertension that is not due to liver cirrhosis?

A

Schistosomiasis infection

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24
Q

What are the 2 forms of Fungi?

A

Yeast - single cells and use budding

Mould - Multicellular and use hyphae or spores

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25
Q

What are fungi cell walls made from?

A

Chitin
Glucan

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26
Q

What are the targets of antifungal drugs?

A

Target cell wall: Beta-glucan
Echinocandins

Target Cell membrane: Ergosterol
Polyenes - Amphotericin, Nystain
Ergosterol synthetic pathway inhibitors - Azoles

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27
Q

What is candida albicans?

A

A vaginal or oral yeast infection

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28
Q

What is aspergillus Fumigatus?

A

A lung Infection

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29
Q

What is the prepatent period?

A

Interval between infection of a helminth and the appearance of eggs in stools

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30
Q

What is the major helminth of concern? Where is it contracted?

A

Schistosomiasis
Contracted via freshwater swimming or drinking infected water in endemic africa

“Medical student comes back from elective, swimming in malawi”

31
Q

What 2 conditions are related to Schistosomiasis?

A

Can cause portal hypertension without causing Hepatocellular cirrhosis

Can lead to bladder Squamous Cell Carcinoma

32
Q

Classical presentation of renal stones?

A

Loin to groin
Patient cant lie still
Intermittent pain due to peristalsis

33
Q

What small cell vasculitis presents similarly to IgA nephropathy and post strep glomerulonephritis and will have IgA deposition in extra-nephritic tissue?

A

Henloch Schonlein Purpura

34
Q

Suggest some complications of CKD?

A

CVD
Arrhythmias
Anaemia
Osteodystrophy
Neuropathy/Encephalopathy

35
Q

Give some treatments to help the symptoms of CKD?

A

Fe Supplements for anaemia
Vitamin D supplements
Adcal D3
ACEi - blood pressure control
Statins

36
Q

What is the first line treatment for Ankylosing spondylitis?

A

NSAIDs

37
Q

How is rheumatoid arthritis disease progression monitored?

A

ESR and CRP levels

38
Q

What is a life-threatening complication of Rheumatoid arthritis?

A

Felty Syndrome:
RA
Neutropenia
Splenomegaly

39
Q

What are some extra-articular manifestations of RA?

A

Skin Nodules
Sjogren’s
Pleural Effusions
Pericarditis and MI
Glomerulonephritis
Deranged Blood results in haematology

40
Q

What is seen on electron microscopy in Diabetic Nephropathy?

A

Nephrotic Syndrome picture

Kimmelsteil Wilson Nodules

41
Q

What is the lifestyle management for nephrotic syndrome?

A

Low salt, protein and fat diet
Control CVD risk factors
Smoking cessation
Regular exercise
lose weight

42
Q

Describe the pathogenesis of a subdural haematoma?

A

Trauma/Deceleration injury causes shearing of Dural venous sinuses or bridging veins

43
Q

Why must patients with guillain barree syndrome be constantly monitored?

A

Monitor breathing rate as these patients are at a high risk of respiratory distress

44
Q

What part of the brain, what pathway and what is the result of Parkinsons diseaes?

A

Loss of dopaminergic neurones in substantia nigra pars compacta which results in an impaired nigrostriatal pathway and therefore problems initiating movement

45
Q

What is the spirometry results for an obstructive disease?

A

FEV1/FVC ratio < 0.7
FEV1<0.8
FVC normal or reduced

46
Q

What are the common organisms of an infective exacerbation of COPD?

A

Haemophilus Influenzae
Strep. pneumonia

47
Q

What might you want to ask about in a patients history when diagnosis asthma?

A

FHx
Atopic triad (do they have eczema, hayfever)
Drug Hx
Diurnal variation
Wake up at night coughing

48
Q

What are some signs of a poorly controlled asthma?

A

Inhaler > 3x per week
regular Exacerbations
Hyperinflated lungs
Wake up at night coughing

49
Q

What is the FVC and FEV1/FVC ratio for an asthma attack?

A

FVC = normal
FEV1/FVC = <0.7

50
Q

What are some risk factors for suicide?

A

Male gender
Alcohol/Drug misuse
Depression
anxiety
Low Socioeconomic status
Learning Difficulties
Trauma (physical/sexual abuse)
Recent Grief

51
Q

What are some questions to ask a depressed patient as a risk assessment for suicide or self harm?

A

Ever thought about killing/self harming yourself
Have you ever acted on this
was it planned or impulsive
written suicide notes

52
Q

Give 4 classes of drugs that can be used as antidepressants

A

SSRIs - Sertraline
SNRIs - Duloxetine
TCAs - Amitriptyline
MOAis - Selegiline

53
Q

What inherited condition can show high volumes of HDL and LDL in blood results?

A

Familial Hypercholesterolaemia

54
Q

What are some key complications of CF in adulthood?

A

Diabetes Mellitus
Infertility
Pancreatic Insufficiency

55
Q

What bacteria are the main causes of COPD exacerbations?

A

Haemophilus Influenzae
Strep. Pneumonia

56
Q

What bacteria are the main causes of recurrent Respiratory Tract infections in CF?

A

Staph. Aureus
Pseudomonas. Aeruginosa

57
Q

How does tension pneumothorax lead to cardiorespiratory distress?

A

Air cannot escape the pleural space and therefore a large tension PTX can lead to kinking of the mediastinal vessels and reduce air/blood flow.

58
Q

What is the classical triad for critical limb ischaemia?

A

Pain at rest
Arterial Insufficiency Ulcers
Gangrene

59
Q

What would the diurnal pattern of PEFR be for patients with asthma?

A

PEFR will be Lower in the morning and Higher in the Evening

60
Q

What may be seen on blood film in a Macrocytic megaloblastic anaemia?

A

Hyper segmented neutrophil Polymorphs

61
Q

What is the protocol for taking blood for IE?

A

3 cultures from 3 different sites on 3 different occasions

62
Q

What other blood tests may you do in a Mallory weiss tear?

A

FBC
U&E
Coagulation profile
LFTs
Erect CXR

63
Q

Name some features of the Glasgow Blatchford score?

A

Heart Rate
Systolic Blood Pressure
Hb
Urea
Gender
Melena
Hx of Syncope
Cardiac Failure Hx

64
Q

What is the First line management in an Upper GI bleed caused by a MWT if the bleeding is persistent?

A

Surgical Endoscopy and Clipping OR Thermal Coagulation
High Dose PPI

65
Q

How should bisphosphonates be taken?

A

First Thing in the morning
Empty Stomach
Stay upright or standing for 30 mins after
With a full glass of water

66
Q

Give 4 symptoms of a septic infection?

A

Fever
Rigors
Night sweats
Weight loss
Dizzy
Confusion
Nausea and vomiting

67
Q

What are some symptoms of delirium tremens?

A

Ataxia
Tremors
Confusion
Sweating
Irritability/agitation/aggression
N+V

68
Q

What are some signs of iron Deficiency anaemia?

A

Angular Cheilitis
Atrophic Glossitis
Koilonychia

69
Q

What kind of bacteria is Staphylococcus Aureus?

A

Gram Positive Cocci
Beta Haemolytic Staphylococcus

70
Q

What is a possible diet that can reduce the risk of gallstone development?

A

High grain Diet

71
Q

What are some factors that can increase the risk of gallstone development?

A

High fat diet
obesity
T2DM
Rapid weight loss

72
Q

What blood results are seen on primary hyperparathyroidism?

A

High PTH
High Ca
Low Phos

73
Q

What is the biggest cause of gout?

A

Underexcretion is the greatest cause so things such as thiazides

74
Q

What is the biggest risk factor for PSC?

A

Female Gender
(accounts for 90% of the cases)

Medicine Phase 2a (20 decks)

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