Questions I got wrong Flashcards
What is the first line treatment for viral encephalitis?
IV aciclovir
How does an extradural haemorrhage present on a CT?
Biconvex image
What medication should never be prescribed with beta blockers, and why?
verapamil, it can cause heart failure
How does syringomyelia usually present?
With cape like loss of pain and temperature
When does a patient with Barrett oesophagus require an endoscopic intervention?
When there is evidence of dysplasia on a biopsy
What is dysplasia?
The abnormal development of cells within tissues or organs
If you patient has acute heart failure and is not responding to treatment what is your next line of treatment?
CPAP
What blood results will you see in a patient with Addisons disease?
Low sodium
High potassium
Low cortisol
What blood results would you see in a patient with Conn’s syndrome?
Increased aldosterone
Decreased potassium
What drugs should you NEVER prescribe with statins?
Erythromycin and clarithromycin
What is the nephritic triad?
Haematuria, oliguria and HTN
If a patient presents with neurological symptoms AND liver disease what should your main differential diagnosis be?
Wilson’s disease
What is Wilson’s disease?
It is a rare inherited disorder that that causes copper to accumulate in your liver, brain and other vital organs
If you have diagnosed Lyme’s then what drugs do you need to prescribe ASAP, give an example of the drug you would use
Antibiotics, doxycycline
What are the daily requirements for potassium?
1.0 mmol/kg/day
What are you looking for in blood results when you are testing for rheumatoid arthritis?
Anti-cyclic citrullinated peptide antibodies
If a patient presents with an AKI and their urea is significantly higher than their creatinine, what is the most likely cause of the AKI?
Dehydration
What intervention is used for patients in severe type 1 respiratory failure?
CPAP
What intervention is used for patients in severe type 2 respiratory failure?
BiPAP
What is your first line treatment for a UC flare up?
Aminosalicylates
How do you test for or monitor lupus?
Look at ANA levels
In a PCI are bare metal stents or drug eluting stents preferred?
Drug eluting stents
Can patients with AKIs remain on their ACEi?
NO, stop them ASAP
When looking at a coeliac screen what are the two results that you are looking at?
TTG and IgA
If you patient has liver cirrhosis and has developed heart failure or ascites, what drug should you be thinking of prescribing?
Spirinolactone
If your patient has AF and presents with sudden abdo pain with no abdo examination findings, what should be your differential diagnosis?
Acute mesenteric ischaemia
What will you hear from a tricuspid regurgitation murmur?
Pansystolic murmur
Heard loudest in the 4th intercostal space
Heard loudest on inspiration
If you see ring or tram like markings on an X-Ray what should you be thinking for a diagnosis?
Bronchiectasis
What scoring system is used to calculate the % risk of rebleeding and mortality after an endoscopy?
Rockall score system
What drug should never be prescribe to a patient with Parkinsons?
Metoclopramide
What can occur after an MI due to mitral valve regurgitation?
Flash pulmonary oedema
What type of murmur is heard with mitral valve regurgitation?
Pan systolic murmur
If you ALP > ALT (with great proportion) what is your differential diagnosis?
Cholestasis (the slowing or stalling of bile flow through your biliary system)
What LFT result will be significantly raised in alcoholic hepatitis?
Bilirubin (AST/ALT 2:1)
At what age do patients with haemoptysis need a 2ww referral?
If they are over 40 years old
If your patient has low Hb and high bilirubin what condition should you be thinking about?
Haemolytic anaemia
What is pneumoconiosis also known as?
Coal miners disease
Is pneumoconiosis obstructive or restrictive?
Restrictive
At what point do you need to add in an additional drug for patients with T2DM on max dose metformin?
When their HbA1c reaches 58 or above
How can alcohol binging affect ADH?
It can lead to ADH supression
What is a common complication of SAH?
SIADH
How long should your patients stop driving for after an MI?
4 weeks
What are the symptoms of polycythemia?
“Ruddy” complexion, gout and a history of peptic ulcer disease
What is a common side effect of lithium?
Polyuria
What drug can cause nephrogenic diabetes insipidus?
Lithium
Will patients with diabetes insipidus respond to vasopressin?
No
What will pts with diabetes insipidus respond to, to increase the sodium in their urine?
Thiazide diuretics
If the sodium in the urine increases what happens to the serum osmolarity of the urine?
Decreases
What does dehydration do to the plasma osmolarity?
Raises
What is more sensitive when testing B12 levels, intrinsic antibody testing, or parietal cell antibody testing?
Intrinsic antibody testing
When should you be cautious prescribing cyclizine, and why?
When the pt has HF, as it can reduce the cardiac output
Patients with diabetes insipidus will have what kind of plasma and serum osmolarity?
High plasma osmolarity and low urine osmolarity
How long should pts who have had a TIA refrain from driving and after that time do they need to inform the DVLA?
1 month, and they DONT have to inform the DVLA
If your patient has raised/normal total gas transfer and a raised transfer coefficient, what diagnosis are you thinking of?
Asthma
How do you calculate a patients osmolarity?
2(Na) + 2(K) + Urea + blood glucose
If your patient is male, a smoker, and is suffering from limb ischaemia, what disease should you think of?
Buergers Disease
What disease is commonly associated with SAH?
Polycystic kidney disease
If you patient has cancer and they suffer from a blood clot, what is the treatment and for how long?
DOAC for 6 months
How do the thyroid lobes present in Graves disase?
Enlargement of both of them in a uniform manner
How can you view demylinating lesions?
By requesting an MRI with contrast
What supplements must you ensure Parkinson’s patients are on?
Vitamin D
What TIBC and transferrin levels will you see in patients with iron deficiency anaemia?
Increased TIBC and transferrin levels
Name one of the main causes of autoimmune haemolytic anaemia
Systemic lupus erythemosis
If you have a pre-renal uraemia, what will happen to the sodium levels?
They will be low, as the kidneys are holding onto the sodium to try and maintain volume
What must you ensure you start when starting a patient on phenytoin?
Cardiac monitoring
What symptoms are seen if the patient has had a stroke that effected their middle cerebral artery?
Sensory loss in the upper extremeties, hemianopia, aphasia
How can you tell whether a patient has chronic or acute kidney injury?
Looking at the calcium, if its chronic the calcium will be low
What is the acronym that we use to remember myeloma signs and symtoms?
CRAB
C - Calcium high
R - Renal failure
A - Anaemia
B - Bone pain
What is sideroblastic anaemia?
When your body produces enough iron, but the body cant put it onto haemoglobin, and hence you become anaemic
What is the rate at which you should be replacing potassium?
10mmol/hour
What can frothy urine be a symptom of?
Focal segmental glomerulosclerosis
What disease puts you at higher risk of developing Focal segmental glomerulosclerosis?
HIV
If you patient is hypoglycaemic and has reduced conciousness, how should you give glucose, and what percentage?
IV 20% glucose
What is Hoffman’s sign?
Shaky hands
What is Kernig’s sign?
Its an UMN sign thats commonly seen in MS
What disease is associated with a mitral prolapse?
Polycystic kidney disease
If you have altered U&Es and a hx of NSAID use, what disease can it suggest?
Acute interstitial nephritis
What are some signs of Beta-thalassaemia trait?
Raised HBa2 levels and low Hb
What’s the first line treatment for C.diff?
Fluids and oral metronidazole
Female, fat and forty points to what?
Biliary colic or gallstones
Do patients with suspected GORD need to be started on high or low PPI doses?
High doses
What is Charcot’s triad?
Fever, jaundice and right upper quadrant pain
How can oesophageal strictures present?
Difficulty swallowing solid foods, but not liquids. Pts usually have a hx of GORD
If you patient has COPD but NOT asthma, and is still SOB and only on a SABA/SAMA what is the next treatment step?
LABA/LAMA
Ptosis and dilated pupils are associated with what CN problem?
CN3, oculomotor nerve
What drugs can cause hypercalcaemia?
Thiazides
What drugs should you use to treat ascites?
Spironolactone
What type of drug is spironolactone?
Aldosterone antagonist
How much should you increase a pts morphine if they are palliative and their pain is not controlled?
30-50%
What’s the treatment for SVT if the patient is haemodynamically stable?
Adenosine
Should you prescribe PPIs if you suspect an acute upper GI bleed?
NO
What is your first stage of treatment if you suspect an acute upper GI bleed?
Urgent endoscopy
What are the 3 main symptoms of mesenteric ischaemia?
Triad of CVD, high lactate and SNT abdomen
Painful rash and a cough are symptoms of what?
Sarcoidosis
What do you need to test if you suspect sarcoidosis?
Serum ACE levels
If your patient experiences significant renal impairment after starting an ACE inhibitor, what is the underlying pathology?
Bilateral underlying renal artery stenosis
What are some of the symptoms of primary hyperparathyroidism?
Depression, nausea, constipation and bone pain
What drugs can cause hypokalaemia?
Thiazide diuretics
What should you test to confirm T1DM?
C-peptide levels, they will be low
What disease can several perianal skin tags suggest?
Crohn’s disease
What pathology would lead to patients developing a high stepping gate?
Foot drop
What is the target BP measurement for a T2DM, that is under 80?
<135/85
Which regurgative murmur becomes louder on inspiration?
Tricuspid Regurgitation
Which regurgative murmur does not become louder on inspiration?
Mitral Valve regurgitation
Where is a mitral regurgitation murmur head at its loudest?
Left mid-clavicular 4th intercostal space
When should T2DM patients be started on an SGLT2- inhibitor?
When they present with signs of CVD
How can acute pancreatitis present when looking at calcium levels?
Hypocalcaemia
What’s the most common pathogen to cause acute pyelonephritis?
E.Coli
What’s the most common type of nephropathy?
IgA nephropathy
How does IgA nephropathy usually present?
With haematuria
What illness usually precedes IgA nephropathy?
Upper respiratory tract infections
If a male patient (especially younger males) presents with dysuria, what 3 things should you be thinking about?
Sexual health, prostatitis or cancer
What would you expect to see on a endoscopy if the patient has UC?
Pseudopolyps
If you see pseudopolyps on endoscopy what does this indicate?
UC
