PTS SBA 3 corrections/notes Flashcards
when is a PCI used for a STEMI?
first line but must be done within two hours of onset
when is fibrinolysis with IV Tenecteplase used
within 12 hours of the onset of STEMI if PCI was not done
what test does NICE recommend for diagnosing heart failure
NT-proBNP levels
naturietic peptides
what does ABCDE stand for in heart failure XRAY
aleveolar oedema
kerley B lines
cardiomegaly
dilated upper lobe vessels
pleural Effusion
who can hypertrophic cardiomyopathy cause sudden death in
children, young adults, and competitive athletes
what does a patient in diabetic ketoacidosis present with?
deep fast breaths (Kusmall breaths)
hyperkalaemia (tall tented T waves on ECG)
pear drop breath
what are the types of cardiomyopathy
dilated, restrictive, hypertrophic
dr H (heart)
when is a bounding pulse found?
in septic shock
would a PE be a cause of hypovolaemic shock?
no
what type of pain does pericarditis present with?
pleuritic sharp pain, worse when lying down and relieved by leaning forward
What is the first line investigation for AAA?
USS of aorta- quick
is polyuria a symptom of thyroid disease?
no it is a symptom of diabetes
what is the most common cause of hyperthyroidism?
GRAVES disease
explain graves disease
autoimmune condition- body produces TSH receptor stimulating antibodies.
presents with: Graves ophthalmopathy, eye pain, diplopia and other hyperthyroid symptoms.
how is Addison’s disease tested for?
synacthen test
what does dexamethasone test for?
cushings
what is carcinoid syndrome?
result of tumour of enterochromaffin cells with secrete 5-HT.
excess secretion of substance P, insulin, serotonin, ACTH and bradykinin.
classical triad is: palpitations, diarrhoea, flushing.
what treats carcinoid syndrome?
somatostatin analogue.
what is trousseaus sign.
wrist felxion on the inflation of a BP cuff
what causes trousseaus sign.
hypocalcaemia.
what are the two signs of hypocalcaemia
trousseaus and chvosteks
describe chvosteks sign.
tapping the facial nerve in the parotid gland causes ipsilateral facial muscle twitching.
what is the lining of the oesophagus
stratified squamous
what is the metaplastic change seen in barrets oesophagus
STRATIFIED SQUAMOUS –> Simple columnar
what is angular stomatitis
soreness at the corners of lips, seen in severe coeliac disease
what are aphthous ulcers?
mouth ulcers commonly seen in severe coeliac disease.
what is the management for H. pylori infections
PPI + Metronizadole + clarithromycin
what is the treatment for TB
RIPE
Rifampicin: Red/orange discolouration of secretions e.g. urine + tears; Isoniazid: Peripheral
neuropathy; Pyrazinamide: High uric acid levels → gout; Ethambutol: Colour blindness + reduced
visual acuity (EYE-thambutol)
what is the most common cause of small bowel obstruction
surgical adhesions.
scar like tissue between organs can compress the small bowel.
is chronic disease associated with normocytic or microcytic anaemia?
BOTH
is white cell count raised in hodgkins lymphoma?
NO!
what is polycythaemia vera
bone marrow overproduces blood cells
95% of cases are caused by mutation in JAK2.
what are symptoms of polycythaemia vera?
dizziness, itching, haemorrhage
when are Heinz bodies seen?
G6PD deficiency
what is the presentation of liver failure
asterixis (jerking movement of the hand when arms are extended)
spider naevi
gynaecomastia
Jaundice
is low albumin included in the definition of acute liver failure
NO
INR greater than 1.5, onset of less than 26 weeks duration, mental alteration without pre-existing cirrhosis, no previous liver disease
what does jaundice indicate?
problem in hepatobilliary system
what type of jaundice is indicated if both the stool and urine colour is affected (light and dark respectively)
OBSTRUCTIVE
how can a cancer of the head of the pancrease cause obstructive jaundice?
blocks the common bile duct
is benzene exposure a risk factor for renal cell carcinoma
YES
how is a diagnosis of wilsons obtained?
liver biopsy
what is the treatment for cholera (rice water stools)
rehydrate with IV fluids
what are the investigations for haemochromatosis
raised transferrin saturation, high ferritin low TIBC
what is the community treatment for meningococcal septicaemia
BENPEN
benzylpenicillin
what is the hospital treatment for meningococcal septicaemia
cefotaxime IV (3rd gen cephalosporin)
what is lowenstein jensen agar used for?
culture mycobacterium tuberculosis
what is blood agar used for
Haemophilus influenzae, Streptococcus pneumoniae and Neisseria species. It is also required to detect and differentiate haemolytic bacteria, especially Streptococcus species.culture anaerobes such as fusobacteria
what is charcoal agar used for
campylobacter jejuni
what is chocolate agar used for
grow aerobes such as strep. pneumonia
alsogood for H. influenzae as there is both nicotinamide adenine dinucleotide and haemin
what is macconkey agar used for
grow gram negative bacilli
what type of bacteria is Psuedomonas
non-lactose fermenting aerobic bacilli with positive oxidase test
what type of bacteria are proteus, salmonella, shigella
non lactose fermenting aerobic bacilli with negative oxidase test.
what is the most common cause of infective endocarditis in adluts?
strep viridans
what type of bacteria is strep viridans
optochin resistant alpha haemolytic strep.
which bacteria is optochin sensitive
strep. pneumonia
an example of lancefield A bacteria
strep. pyogenes
lancefield b bacteria?
strep agalactiae
which strep are non haemolytic?
s. mutans, s. milleri
what does a catalase test show
+ve= staph, -ve= strep
is Rheumatoid factor or anti CCP more specific for rheumatoid arthritis.
ANTI CCP
what is C-ANCA associated with?
granulomatosis with polyangitis
what is anti dsDNA associated with
SLE
what indicates type 2 resp failure?
oxygen is low, cO2 is high.
what indicates type 1 resp failure
normal CO2, low oxygen.
what inheritance is von willebrand disease?
autosomal dominant
what is the key finding of sarcoidosis
bilateral hilar lymphadenopathy
name the main steroid treatment for asthma
beclometasone
what is the indicator in a history of TB?
cough >3weeks
recent travel
what is the most common casue of community acquired pneumonia
strep pneumoniae
what is a type 3 hypersensitivity reaction?
deposition of immune complexes and cellular immunity.
IgG/IgM
what is type 2 hypersensitivity reaction
cytotoxic
antibody mediated
what is a type 1 hypersensitivity reaction
allergic
IgE mediated, quick onset
what is a type 4 hypersensitivity reaction
delayed
cell mediated
if TIA is SUSPECTED what is the treatment
Aspirin 300mg
if TIA is confirmed what is the long term treatment?
clopidogrel monotherapy
what are the symptoms of cauda equina syndrome?
LMN signs
lower back pain, LMN weakness, sphincter disturbance (urinary and faecal), impotence, saddle paraesthesia, decreased anal tone.
where does cauda equina start
L1/2- level where the spinal cord terminates
what is indicative of MG rather than MND?
MG = progressive weakness on repetitive movements eg blinking.
