Quiz 1 Flashcards
Where do the irregular impulses of atrial fibrillation classically originate from?
Atrial fibrillation occurs due rapid impulse generation by an ectopic atrial focus, most commonly adjacent to or within the pulmonary vein orifices.
What term is used to describe a reduction in neutrophils?
Neutropaenia is a reduction in neutrophils.
what is neutrophilia
Neutrophilia is an increase in neutrophils.
Which of the following would result in dead space ventilation?
- pulmonary oedema
- pulmonary fibrosis
- acute respiratory distress syndrome
- emphysema
Emphysema causes airway obstruction and the formation of large bullae, resulting in dead space ventilation.
What is the pattern of ST elevation in ST elevation myocardial infarction?
The correct answer is ST elevation in contiguous leads.
ST elevation MI presents with ST elevation in contigous leads with reciprocal ST depression.
what is widespread ST elevation suggestive of
pericarditis
Which of the following does not directly indicate anaemia?
- reduced haemoglobin
- reduced red cell count
- reduced mean cell volume
- reduced haematocrit
Reduced haemoglobin, haematocrit and red cell count are all markers of anaemia.
Mean cell volume provides information about the type of anaemia, though in itself is not a marker of anaemia.
Which of the following is a cause of red blood cells in urine?
- haemolysis
- liver failure
- rhabdomyolysis
- glomerulonephritis
Glomerulonephritis is an important cause of red blood cells in urine. While haemolysis and rhabdomyolysis may cause a positive urine dipstick for blood, this is due to the presence of haemoglobin or myoglobin respectively, rather than red blood cells.
You are working in the emergency department, and a 22 year old normally healthy male presents with nausea and vomiting. You perform a urine dipstick which reveals the following:
acidic pH
glucose +++
Ketones++
what. is likely diagnosis: UTI Rhabdomyolysis alcoholic ketoacidosis diabetic ketoacidosis
The reduced pH, ketones and significant glucose suggest diabetic ketoacidosis. This is a common first presentation in type 1 diabetes.
What does the term glycosuria refer to? diabetes mellitus glucose in urine glycogen in urine ethylene glycol in urine
Glycosuria refers to the presence of glucose in urine.
Which of the following is NOT a cause of an obstructive pattern on spirometry?
- asthma
- bronchiectasis
- emphysema
- idiopathic pulmonary fibrosis
Asthma, chronic obstructive pulmonary disease (chronic bronchitis and emphysema) and bronchiectasis are common causes of an obstructive pattern.
Idiopathic pulmonary fibrosis is a type of interstitial lung disease which would produce a restrictive pattern
What is the significance of a prolonged PR interval?
prolonged atrioventricular conduction time.
Which of the following is NOT a cause of hypoventilation?
- morphine
- myasthenia gravis
- chest wall deformity
- high altitude
High altitude reduces the partial pressure of oxygen in inspired air, but does not have a significant effect on ventilation.
What does the P wave on an ECG represent?
- atrial repolarisation
- atrial depolarisation
- atrial contraction
- ventricular depolarisation
The P wave represents depolarisation of the atria.
what might hyperkaleamia produce on an ECG
tented T waves
Which of the following is most correct about a narrow QRS complex?
- A narrow QRS complex originates from the sinoatrial node
- A narrow QRS complex originates from the atria
- A narrow QRS complex may originate from anywhere above the ventricle
- A narrow QRS complex originates from the ventricles
A narrow complex rhythm may originate anywhere above the ventricle - from the sinoatrial node, the atria or the AV node.
Your next patient, a 25 year old male, presents with brown urine. He just started going back to the gym after a long hiatus and states that his muscles ache after a workout yesterday. You perform a urine dipstick which reveals the following: Haematuria
You are concerned about haematuria, and so you perform urine microscopy: comes back normal
what is the most likely diagnosis?
- renal calculus
- haemolysis
- rhabdomyolysis
- glomerulonephritis
The dipstick detects myoglobin and free haemoglobin as blood, and the microscopy confirms that there are no red cells in the urine. The recent gym visit and brown urine suggest rhabdomyolysis. Haemolysis is possible, however the normal urine urobilinogen goes against this.
What diabetic medication acts by causing excretion of glucose in urine?
- Metformin
- Glicazide
- Empagliflozin
- Pioglitazone
Empagliflozin is an sodium-glucose transporter 2 (SGLT2) inhibitor that causes urinary excretion of glucose.
Which of the following is a cause of an increased neutrophil count?
- bacterial infection
- B12 deficiency
- lymphoma
- alcohol abuse
Bacterial infection is a common and important cause of neutrophilia.
What is suggested by an elevated haemoglobin with a normal red cell count?
- Polycythaemia vera
- chronic hypoxia
- EPO-producing tumour
- dehydration
relative erythrocytosis is the presence of an elevated haemoglobin and haematocrit with a normal red cell count. This is suggestive of plasma volume contraction, commonly due to dehydration.
Which arrhythmia is associated with sawtooth waves?
- AF
- atrial flutter
- VF
- Torsade de pointes
atrial flutter
Which of the following typically produces a macrocytic, hyperchromic anaemia?
- iron deficiency
- B12 deficiency
- EPO deficiency (chronic kidney disease)
- Thalessemia
B12 and folate deficiency tend to cause a macrocytic, hypochromic anaemia.
What does erythrocytosis refer to?
- increased red blood cells
- reduced red blood cells
- increased white blood cells
- increased platelets
Erythrocytosis refers to an increase in red blood cells.
Which of the following would cause lactic acidosis? -hyperglycaemia -hypoglycaemia -seizure - Ethylene glycol toxicity
Seizures can cause anaerobic muscle hyperactivity, resulting in lactic acidosis.