PTS SBA 4 Flashcards
What would hyper resonant sounds suggest?
Lungs hyper inflated with air
What would dullness to percussion suggest?
Accumulation of fluid
What is the treatment pathway for asthma?
- SABA - Salbutamol
- Low dose ICS - Beclomatasone
- LTRA - Monteleukast
- LABA - Salmeterol
- MART - Seretide
- Higher dose ICS
What is the most common type of lung cancer in non smokers?
Adenocarcinoma
What is the most common type of lung cancer in smokers?
Squamous cell carcinoma
What sites does lung cancer commonly metastasise too?
- Adrenals
- Bone
- Brain
- Liver
What is the gold standard diagnosis for PE?
CT Pulmonary Angiogram
What is the most common cause of community acquired pneumonia?
Streptococcus Pneumoniae
What is the most common cause of hospital acquired pneumonia?
Pseudomonas Aeruginosa
What is the most common cause of pneumonia in COPD patients?
Haemophilus Influenzae
What is another common cause of “typical” pneumonia?
Klebsiella pneumoniae
What chromosome is affected in cystic fibrosis?
Chromosome 7: CFTR protein
What is the primary treatment for syphilis?
Penicillin
What is the second line treatment for syphillis?
Azithromycin
What is the correct medication for meningitis prophylaxis?
Ciprofloxacin
What is the most common cause of work related ill health in the UK?
Stress, anxiety and depression
What is sensitivity?
The probability a test will be positive for a true positive
What is specificity?
The proportion of patients who test negative amongst all those who do not have the disease
What is the first step for people presenting with stroke symptoms?
Urgent CT
What is given to patient if they are found to have an ischaemic stroke?
Alteplase within 4.5 hrs of onset
Short term aspirin followed by clopidogrel
What are the cardinal symptoms for Parkinson’s?
- Bradykinesia
- Resting tremor
- Cogwheel rigidity
- Depression
What cancers commonly metastasise to brain?
- Lung
- Kidney
- Breast
- Skin
- Bowel
What nerve is affected in carpal tunnel?
Median nerve
What nerve roots are affected in carpal tunnel?
C5-T1
How long do patients need to be seizure free to have their driving license reinstated?
1 yr
What is the mechanism of action for NSAIDS?
Non selective inhibitor of COX 1 and COX 2 enzymes
What are some hand signs in Rheumatoid Arthritis?
- Swan neck deformity
- Boutonierre deformity
- Ulnar deviation
What are classic symptoms of reactive arthritis?
- Conjunctivitis
- Urethritis
- Arthritis
Can’t see, can’t pee, can’t climb a tree
What colour would E coli turn on MacConkey agar?
Pink because it is lactose fermenting
What colour would salmonella turn on MacConkey agar?
Pale because it is non lactose fermenting
What is the most common cause of hepatitis in travellers?
Hepatitis A
What is the process of dealing with a irreducible inguinal hernia?
Urgent referral to secondary care
What is the process of dealing with a reducible inguinal hernia?
Routine referral to secondary care
What are the 4 F’s of getting gallstones?
- Female
- Fat
- Forty
- Fertile
What is Dupuytren contracture?
A fibroproliferative disorder affecting the palmar fascia, mainly of the 4th and 5th fingers
What are risk factors for Dupuytren contracture?
Alcohol abuse and liver cirrhosis
What is the most common causative organism of spontaneous bacterial peritonitis?
Escherechia Coli
What are Reed Sternberg cells indicative of?
Hodgkin’s lymphoma
What is the Philadelphia chromosome indicative of?
Chronic myeloid leukaemia
What are Bence Jones proteins indicative of?
Myeloma
What are some symptoms of pernicious anaemia?
- Peripheral neuropathy
- Mouth ulcers
- Lemon tinged skin (jaundice and pallor)
What is the most common form of leukaemia in children?
Acute lymphoblastic leukaemia
What are causes of secondary polycythaemia?
Chronic hypoxia as a result of lung disease
What can cause a sickle cell crisis?
- Cold
- Infection (Parvovirus B19)
What are the treatments for myeloma?
- Chemotherapy
- Steroids
- Thalidomide
Bisphosphonates and radiotherapy can also be used
What is the diagnostic investigation for kidney stones?
Non contrast CT Kidney Ureter Bladder
What is used to define CKD?
eGFR < 60 mls/min/1.73m^2 for over 3 months
What are smudge cells indicative of?
Chronic lymphocytic leukaemia
What is the most common form of renal cancer?
Clear cell carcinoma
What are the two forms of renal cell carcinoma?
- Clear cell (75%)
- Papillary (15%)
Name an alpha blocker used as 1st line treatment of BPH
Tamsulosin
Name a 5-alpha reducatase inhibitor, used as 2nd line treatment of BPH
Finasteride
Name a GnRH agonist used in the treatment of prostate cancer?
Goserelin
Name an anticholinergic used as 1st line treatment for overactive bladder
Oxybutinin
What is the management of acute pulmonary oedema?
- High flow O2
- IV Furosemide
- IV Morphine / GTN
- Urgent CXR
What are some risk factors for erectile dysfunction?
- Smoking
- Cardiovascular disease
- Prostatectomy
- Poor relationship
- Diabetes
What are some complications of Autosomal Dominant Polycystic Kidney Disease
- Berry aneurysms
- Liver cysts
- Heart valve abnormalities
What are some symptoms of Graves’ disease
- Exophthalmos
- Weight loss
- Heat intolerance
- Lid lag
- Tachycardia
What is the immediate management for acute severe hypercalcaemia?
- IV fluids
- Bisphosphonates
- IV Calcitonin
- Prednisolone
What are some side effects of steroids?
- Diabetes
- Immunosuppression
- Osteoporosis
- Proximal muscle weakness
- Skin thinning
What are the ECG signs of Wolf Parkinson White?
- Delta wave
- Wide QRS
- Short PR
What is Wolf Parkinson White syndrome?
An atrioventricular re-entry tachycardia: where electrical signals re-enter the atria from the ventricles through an accessory pathway
What is the standard PR interval?
0.12-0.2s
What is the mechanism of action of Furosemide?
A loop diuretic that inhibits the Na+/K+/2Cl- cotransporter on the ascending limb of the loop of Henle
What is the mechanism of action of Bendroflumethiazide?
A thiazide diuretic that inhibits the Na+Cl- cotransporter channels in the distal convoluted tubule
What is the mechanism of action of Amiloride?
A potassium sparing diuretic that inhabits the ENaC channels in the distal convoluted tubule
What is the mechanism of action of Clopidogrel?
Prevents platelet aggregation by binding the P2Y12 receptor
What is angular stomatitis?
Red, swollen patches in the corners of your mouth.
A side effect of iron deficiency
What is the 1st line investigation for H. pylori?
Urea breath test
What is the most accurate test for H. pylori?
Endoscopy - but not 1st line as it’s invasive.
Urea breath test is 1st line
Stool antigen test also possible
What is a treatment for relieving diarrhoea in IBS?
Loperamide: Anti-motility agent