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quesmed Flashcards

1
Q

severe diarrhoea and facial flushing cxr-opacification in right upper zone

A

carcinoid syndrome

tb is more persistent cough heamoptysis weight loss night sweats

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2
Q

urinary 5 hiaa excretion

A

carcinoid syndrome

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3
Q

cancer that skin goes darker

A

small cell due to cushing syndrome

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4
Q

anterior uvetitis is associated with

A

sarcoidosis

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5
Q

stab wound to chest liekly caueses

A

pneumothorax

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6
Q

pneumonia organism from being on. a ventillator

A

pseudomonas aruginosa

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7
Q

creon is given to

A

cf patients with pancreatic insuffiency

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8
Q

colestyramine us used for

A

pbC

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9
Q

drug for aspiration pneumonias

A

co-amoixiclav

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10
Q

new bilateral pulmonary infiltrates after penumonia

A

ARDS

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11
Q

swinging fever, cough , purulent fever, heamoptyssi, pleuritic chest pain

A

lung abscess

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12
Q

mycoplasma penumonia can present with round lesion with a

A

bullseye appearance

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13
Q

should be given after acute exacerbation of asthma to reduce relapse

A

prednisolone

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14
Q

hypothyroidism is what effusion

A

transudative

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15
Q

nasal congestant, adult onset asthma, red urine

A

chaurg strauss syndrome

MPo- anca/ p-anca positive

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16
Q

reduced DLCo in

A

pulmonary fibrosis

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17
Q

bilateral opacification of the lower lung lobes and hilar regions hints

A

pneumonia

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18
Q

silver stain

A

penumocystitis penumonia

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19
Q

homeless is a risk factor fo

A

tb

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20
Q

tb drug casing numbness and tingling in feet and fingers

A

isonaizaid

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21
Q

tb diagnosis

A

early morning sputum samples

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22
Q

drug used in the treatment of uti ‘s and can cause fibrosis

A

nitrofurantoin

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23
Q

curshmann spirals- shed epithelium become whorled mucous plugs

A

histology of asthma

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24
Q

klebsiella is a

A

gram negativve anaerobic rod

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25
Q

curb score of 2 means

A

hospital

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26
Q

carrdiac failure commoly presents with

A

bilateral pleural effusions, positive hepato jugular reflex

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27
Q

curb65 socre of 3 is what mortality risk

A

17%

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28
Q

copd patient shpuld be on a what% venturin face mask

A

28

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29
Q

known cause of bronchiectasis

A

rheuamtoid arthritis -inflammatory joint condition

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30
Q

painful red eye (angular uveitis ) associate with

A

sarcoidosis

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31
Q

in obstructive disease what is preserved

A

FVC

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32
Q

in asthma attack even if oxygen sats on air are normal if — raised then it is near fatal

A

paco2

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33
Q

cough for 10 days and crp raised and everything else normal

A

acute bronchitis

-treatment is rest/ adequate fluids, paracetemol

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34
Q

3 subdivisons of chest infections

A

acute bronchitis, infective exacerbation of asthma or copd or pneumonia

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35
Q

important treatmnt for hypercalaemia due to squamous cell carcinom. is

A

IV FLUIDS

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36
Q

meigs syndrome triad

meigs syndrome causes a transudative pleural effusion and woul deb stony dull to percuss

A

ovarian beningn tumour, ascites and pleural effusion

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37
Q

abdominal stiae and buffalo hump describe cushings syndrome which is associated with

A

small cell lung cancer

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38
Q

dry cough, myalgia and coryza and gram positive cocci in clusters is what pneumona

A

staph aureus

treated with flucloxacillin

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39
Q

increased tactile vocal fremitus and dull percussion note

A

pneumonai

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40
Q

bronchiectasis with high fever and resp rate give

A

Iv antibiotics so it doesnt develop into sepsis

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41
Q

low soidum in seen in

A

legionella

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42
Q

rusty sputum

A

strep pmeumonia

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43
Q

tension pneumothorax breathing would be

A

absent breath sounds

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44
Q

once diagnosed with cancer then do – to see for metastasis

A

CT

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45
Q

if blood pressure is below — they are haemodynamically compromised

A

90/60

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46
Q

treatment for superior vena cava obstruction

A

dexamethasone

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47
Q

fine, bi-basal end inspiratory crackles, clubbing, reduced chest expansion

  • affects lung bases
A

idiopathic pulmonary fibrosis

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48
Q

primary ciliary dyskensia is can result in

A

bronchiectasis

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49
Q

strep pneumonia is associated with

A

blisters on lower lip

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50
Q

suspect pe and not haemodynamically stable then

A

thrombolysis such as alteplase

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51
Q

fevers follwing pneumonia is suggestive of

A

empyema

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52
Q

foul smelling sputum, recurrent fever and history of stroke sugegst

A

lung abscess- has finger clubbing

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53
Q

right ventricular heave may be present in— or pulmoanry fibrosis

A

copd

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54
Q

what is cor pulmoanle defined as

A

hypertrophy and subsequent failure of the right ventricle

-seen in severe copd

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55
Q

suspected lung cancer cases is how lung referral

A

2 weeks

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56
Q

pluural effusions due to rheumatois arthritis have

A

low glucose levels

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57
Q

most common cause for developin glung abscess

A

anaerobic bacteria

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58
Q

if suspect empyema it is good to know

A

pH

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59
Q

2 things that increase risk of pneumothorax

A

mechanical ventilaltion and copd

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60
Q

if hyperresonant to percuss should do what first

A

cxr to determine size of pneumothorax and confirm diagnosis

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61
Q

gram negative rod with a seagull shaped appearance

A

campylobacter

-treated with a macrolide eg azithroMYCIN

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62
Q

goblet cell depleteion and crypt abscess

A

UC

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63
Q

LUMP IN NECK, WEIGHT LOSS, DIFFICULTY SWALLOWING OLDER MAN

A

pharyngeal pouch

-investiagtion barium swallow

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64
Q

almost all duodenal ulcers are associated with

A

h.pylori

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65
Q

treatment for iron deficiency

A

ferrous sulphate

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66
Q

crusting round mouths and large tongue

A

iron deficiency

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67
Q

used for treatment of chemo of nausea and vomitting

A

5HT3 antagonist

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68
Q

having hypothyroidism and type 1 diabetes makes – likely

A

pernicious anaemia

69
Q

hep b cirrhosis patietns high ridk of hepatocellular cancer so

A

alpha fetoproteins should be checked regularly

70
Q

young person with painless jaundice after mild infection

A

gilberts syndrome- treatment is reassurance

71
Q

complication of TIPSS

A

hepatic encephalopathy

72
Q

IN TIPPS CHANNELS (stent ) is put between

A

portal vein and hepatic vein

73
Q

2nd line for h.pylori

A

replace clarithromycin with metronidazole

74
Q

alternating bowel habit, cramps

A

irritable bowel syndrome

75
Q

first line seriological investigations for coeliac disease

A

Total immunolglobulin A(IgA) and IgA tissue transglutimase (TTG)

76
Q

feeling of fullness after a few bites

A

gastroperesis

77
Q

domperidone used for

A

gastroperesis

78
Q

budd chairi syndrome triad

A

severe abdo pain, ascites, tender hepatomegaly

79
Q

symptoms of typhoid fever

A

malaised, fever, abdo pain , rash across chest - diarrhoea uncommon

80
Q

zollinger ellison syndrome is leads to peptic ulcers. due to excess

A

gastrin

81
Q

terlipressin reduces

A

portal venous pressure

82
Q

— is also recommednde in patients with variceal bleeding

A

antibiotics even if infection isnt confirmed

83
Q

co-amixclav causes sudden onset of

A

jaundice

84
Q

pale stools and dark urine are typically seen in

A

obstructive choleostasis

85
Q

treatment of thrush or oral candiasis

A

oral fluconazole

86
Q

dilated large bowel

A

toxic megacolon

87
Q

pellagra charctarised by

A

dermatitis, dementia, diarrhoea

88
Q

–can cause dilated cardiomyopathy.

A

haemochromatosis

iron is deposited in the myocardium which can cause restrictive and dilated cardiomyopathy

89
Q

inflammation and redness on tongue

A

megoplastic anaemia

-affects terminal ileum

90
Q

pain relieved by defaecation investigation

A

tissue translutimase antibodies - test for coeliac sy

91
Q

symptom that would support a diagnosis of alcholic liver disease

A

nodules in the palms of the hands

92
Q

mucosal inflammation, diffuse erythema, loss of vascular markings

A

UC

93
Q

if you have had the vaccine

A

HbSAg will be negative as there is no active infection

(anti-HBs indicate previous vaccination)

HbSAb indicates previous vaccination

94
Q

should not have things with lots of vitamin c eg organge juice if

A

as vitamin c increases absorption of iron

and if patitent has hereditory haemochromatosis

95
Q

if ALP significant raised indicates a

A

cholestasis caused by drugs

96
Q

test for inflammatory bowel disease to indicate need for colonscopy

A

faecal calprotectin

97
Q

what test if suspect alpha 1 antitrpsin deficiency

A

spirometry

98
Q

UC with abnormal liver enzymes and weight loss

A

biliary tract carcinoma

99
Q

dysphagia, oesophageal webs and change in size/texture of tongue

A

plummer vinson syndrome

100
Q

in budd chairi syndrome patients presents with

A

liver failure or cirrhosis

101
Q

positive anti mitchondiral antibodies

A

primary biliary cholangitis

102
Q

used to reduced remssionin crohns flare up

A

azathioprine

103
Q

most common infection from guillian barres syndrome

A

campylobacter jejuni

104
Q

for uncomplicated sliding hiatial hernia treatment is

A

PPI

105
Q

prothrombin time over—- qualifies for urgent liver transplant

A

100secs

106
Q

water diarrhoea and unwell after course of antibiotics

  • yellow plaques with mucosal inflammation
A

c.difficle

107
Q

treatment for c.difficle

A

ORAL vancomycin

108
Q

first line treatment for peptic ulcer disease eg duodenal ulcares that are h.pylor inegative

A

full dose PPI for 4-8weeks

109
Q

medication for hepatic encephalopathy

A

lactulose

110
Q

lethary and pruritus

A

PBC anti mitochondial M2 positive in 98% of patietns

111
Q

inhibitio of tyrosine kinase

A

imatinib

112
Q

first line investiagtions for coeliac

A

anti-TTG antibodies

if negative then anti-TTG Ig should be measured

113
Q

what is recommended after the start of PPi therapy

A

endoscopy 6-8 weeks after start of ppi therapy

-check ulcer is healing and biopsies show benign disease as gastric ulcers are more likely to be malignant than duodenal ulcers

114
Q

if got severe uc and complaining of worsening abdo apin whato do next

A

x-ray to determine toxic megacolon

115
Q

treatment for ascending cholangitis

A

ERCP

116
Q

fever , ruq pain, jaundice - in keeping with

A

ascending cholangitis

117
Q

diarrhoea and fatty stools after bowel surgery

A

bile acid malabsorption

118
Q

pale stools that are difficult to flush and intermittent abdo discomfort, low IgA what test

A

endoscopic and biopsy to rule out coeliac

119
Q

first line and gold standard for coeliac

A

first line = IgA and TTG

gold standard for diagnosing = endoscopy with duodenal ulcer

120
Q

duodenal bopsy for coeliac shows

A

villous atrophy, crypt hyperplasia and intra-epithelial lymphocytes

121
Q

msot useful blood test for acute liver failure

A

International Normalized ratio

122
Q

what test if suspect colorectal cancer

A

colonscopy

123
Q

rash across elbows, knees and back -dermatitis herpetiformis associated with

A

coeliac disease

124
Q

high what is seen in hepatic encepaholpathy

A

ammonia

125
Q

2 signs of impired synthetic function of the liver

A

prolonged thrombin time and low serum albumin

126
Q

symmetrical inflammation

A

UC

127
Q

raised serum bilirub in excoriations which is

A

picking /itching of skin

128
Q

positive for tansglutimase antibodies

A

coeliac ??

129
Q

pruritic papulovesicular lesions on bum, arms, legs , trunk

A

coeliac

130
Q

reduced bone mineral density is associated with

A

coeliac disease

131
Q

epigastric pain radiating to back, exxacerbated by fatty food, relieved by sitting forward, pale foul smelling stools

A

chronic pancreatitis

132
Q

chronic pancreatitis will haev what on abdo x ray or ct

A

pancreatic calcification

133
Q

patient had h.pyloir that was diagnosed by stool and had treatment but is uneffective what investigation should be done to re test for h.pylori

A

carbon 13 urea breath test

134
Q

a drug that can contribute to dyspepsia

A

risedronate

it is a biphosphonate-associated with dyspepsia and acid reflux

135
Q

symptoms of cholestasis(jaundice, pruritis)in a patient with UC should raise suspicion for

A

PSC

136
Q

what is diagnostic of wilsons disease

A

low caeruloplasmin

137
Q

bacilus cereus is common after eating

A

rice! so sushi!

138
Q

cholera

A

profuse watery diarrhoea

139
Q

travellers diarrhoea

A

e.coli

140
Q

used to treat remission of uc

A

aminosalicycylate agents eg sulphasalazine or mesalazine

141
Q

continous inflammation from rectum to mid transverse colon, goblet cell depletion and crypt abscess

A

UC

142
Q

gamma glutamyltransferase in normal range

A

gilberts syndrome

-as no abnormality in liver enzymes

143
Q

what is hepatic encephalopathy

A

complication of liver disease that can cause change in behaviour or personality

144
Q

what are avoided in heppatic disease

A

opiates eg morphine

145
Q

what class of antibiotic is associated with dyspepsia

A

macrolide eg clarithromycin

146
Q

common side effect of opiates like codeine

A

constipation

147
Q

patients with coeliac are at increased risk of

A

small bowel lymphoma and adenocarcinoma

148
Q

diarrhoe and rash in young person

A

coeliac

-duodenal biopsy confirms diagnosis

149
Q

biopsy shows PAS

A

tropheryma whipplei

150
Q

patients with SBP are at increased risk of developing

A

renal impairment

151
Q

treatment for SBP

A

Tazocin and HAS( whcih has albumin)

152
Q

treatment for inflamed rectum and recent complicated childbirth

A

c.difficile colitis- treat w vancomycin

153
Q

patient with severe ocd with bleeding gums and feeling tired all the time. she has severely restricted diet

A

Vitamin C deficiency

vitamin c deficiency - bleeding gums

154
Q

vitamin – more likely to present with fractures and deranged calcium

A

d

155
Q

what should be given if got alcoholic liver disease prior to OGD

A

TERLIPRESSLIN

156
Q

tumour marker for hepatocellular carcinoma and and germ cell tumours such as testicular cancer

A

alpha fetoprotein

157
Q

what has recurrent peptic ulcer disease that is not treated with maximum medical management

A

zollinger-elison syndrome

158
Q

abdo discomfort, nausea, belching and nothing else

A

functional dyspepsia

159
Q

treatment of low grade MALToma

A

h.pylori eradication therapy

160
Q

investiation if suspected flare of an inflammatory bowel vs investigation if not currently having a flare

A

flare- flexible unprepared sigmoidoscopy

not having flare-colonscopy

161
Q

if taking metronidazole what should you not have with it

A

alcohol

162
Q

treatment of asthma that can cause epigastric pain and vomitting

A

oral prednisolone- corticosteriod - known to cause ulceration adn dyspepsia

163
Q

treatment for mild UC

A

mesalazine

164
Q

treatment for hepatic encephaopathy is oral or iv lactulose

A

oral

165
Q

treatment for salmonella

A

ceftriaxone

166
Q

barretts oesophagus is associated with

A

oesophageal adenocarcinoma

167
Q

treatment for rash in coeliac

A

dapsone

168
Q

itch , tired , got irritable bowel syndrome, tissue transglutimase normal

A

Coeliac disease

-should have IgA levels tested

question med (2 decks)

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