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Y3 Medicine > Random 6 > Flashcards

Random 6 Flashcards

1
Q

What are some indications for a pleural tap?

A

Bilateral pulmonary oedema and if swelling is unequal.
Infection
If diuretics do not work

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2
Q

Which diabetic drug is contra-indicated in peripheral vascular disease?

A

Canagliflozfin

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3
Q

What type of heart sounds do you hear with atrial fibrillation?

A

Variable 1st heart sound. Short R-R interval is a loud heart sound, longer R-R is a quieter heart sound.

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4
Q

What antibiotics are given commonly for a foot infection?

A

Staph aureus (gram positive)
Glycopeptides like vancomycin and teicoplanin

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5
Q

What tool can you use to quickly assess cognitive function?

A

Abbreviated mental test (out of 10 points)

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6
Q

What are campbell de morgan spots?

A

Campbell de Morgan spots, also known as cherry angiomas, are common, benign skin lesions of middle to older age, formed by proliferating, dilated capillaries and postcapillary venules. They are named after an English surgeon, Campbell de Morgan (1811-76).

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7
Q

What is the right heart border made of?

A

Right atrium

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8
Q

What is the left heart border made of?

A

Left ventricle

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9
Q

What are causes of the left hemidiaphragm to be higher?

A

Phrenic nerve palsy or a lobe collapse

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10
Q

What are some causes of subcutaneous emphysema?

A
  • Infection
  • Respiratory compromise
  • Tension pneumothorax
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11
Q

What type of effusions do pulmonary embolisms cause?

A

Exudative and transudative

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12
Q

What is a group and save?

A

A “group and save” (also known as “group and screen”) is a laboratory test often ordered before a planned surgery or medical procedure that might require a blood transfusion. This test helps to determine the patient’s blood group (A, B, AB, or O) and Rh factor (positive or negative) and checks for the presence of irregular antibodies in the blood.

Blood grouping and screening for antibodies occurs.

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13
Q

What is the most common autoimmune connective tissue disease?

A

SLE

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14
Q

What do you prescribe with cyclophosphamide to ‘soften the blow’?

A

Mesna

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15
Q

What are some characteristic signs of SLE?

A
  • Malar rash
  • Discoid rash
  • Photosensitive rash
  • Oral ulcers
  • Arthritis
  • Serositis
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16
Q

What do Anti-dsDNA antibodies signify?

A

Nephritis

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17
Q

What is discoid cicatricial alopecia?

A

Inflammation of the hair follicles which results in scarring

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18
Q

What is Jaccoud arthropathy?

A

Systemic lupus
Jaccoud arthropathy is a deforming non-erosive arthropathy characterized by ulnar deviation of the 2nd to 5th fingers with metacarpophalangeal joint subluxation that is correctable with physical manipulation

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19
Q

What is LAD (left anterior descending) artery syndrome?

A

LAD (Left Anterior Descending) coronary artery syndrome refers to a condition in which there is a blockage or reduced blood flow in the LAD artery, a major blood vessel that supplies oxygen-rich blood to the front part of the heart. This condition is often associated with significant heart-related issues and can be diagnosed using an electrocardiogram (ECG or EKG).

On an ECG, certain patterns can indicate problems in the LAD coronary artery:

ST-Segment Elevation: If there is a sudden and sustained elevation of the ST-segment in the ECG, it can indicate acute myocardial infarction (heart attack) in the territory supplied by the LAD artery. This elevation occurs because the heart muscle isn’t receiving enough oxygen due to reduced blood flow in the LAD artery.

ST-Segment Depression: ST-segment depression can also be observed in conditions related to the LAD artery, indicating myocardial ischemia (reduced blood flow to the heart muscle). This can occur during exercise or stress tests, indicating insufficient oxygen supply to the heart muscle during periods of increased demand.

T-Wave Changes: T-wave inversion or flattening can be indicative of myocardial ischemia, which may result from LAD artery disease. T-wave changes can sometimes be seen on the ECG.

Pathological Q-Waves: After a heart attack, Q-waves can appear on the ECG. These Q-waves suggest a past myocardial infarction and can indicate damage to the heart muscle in the territory supplied by the affected artery, such as the LAD.

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20
Q

What scoring systems do you use to assess anticoagulation with patients with atrial fibrillation?

A

CHADS₂VASc and HAS-BLED

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21
Q

Explain CHADS₂VASc

A

C: Congestive heart failure (1 point)
H: Hypertension (1 point)
A₂: Age ≥75 years (2 points)
D: Diabetes mellitus (1 point)
S₂: Prior Stroke or Transient Ischemic Attack (2 points)
V: Vascular disease (history of myocardial infarction, peripheral artery disease, or aortic plaque) (1 point)
A: Age 65-74 years (1 point)
Sc: Female sex category (1 point)

22
Q

Explain HAS-BLED

A

H: Hypertension (1 point)
A: Abnormal renal or liver function (1 point each)
S: Stroke (1 point)
B: Bleeding history or predisposition (1 point)
L: Labile international normalized ratio (INR) (1 point)
E: Elderly (age >65 years, 1 point)
D: Drugs or alcohol usage (1 point)

23
Q

What are some ECG features of atrial fibrillation?

A
  • Absent p waves
  • Variable QRS heights
  • Fibrillatory activity
  • Irregular rhythm
24
Q

Describe pathophysiological features of asthma?

A

Airway epithelial damage – shedding and subepithelial fibrosis,
basement membrane thickening
* An inflammatory reaction characterised by eosinophils, Tlymphocytes (Th2) and mast cells. Inflammatory mediators
released include histamine, leukotrienes, and prostaglandins
* Cytokines amplify inflammatory response
* Increased numbers of mucus secreting goblet cells and
smooth muscle hyperplasia and hypertrophy
* Mucus plugging in fatal and severe asthma
* Airways remodelling

25
Q

Who was the epidemiologist who ‘stopped smoking’?

A

Sir Richard Doll

26
Q

What imaging technique is commonly used for staging and diagnosing lung cancer?

A

Endobronchial ultrasound (EBUS) is a medical procedure that combines bronchoscopy with ultrasound imaging. It is commonly used for diagnosing and staging lung cancer, including cancers that involve the airways, lymph nodes, or nearby structures.

27
Q

What questions do you want to ask with occupational hazards leading to cancer?

A
  • What was the nature of the exposure?
  • When til when?
  • Who was your employer at the time?
  • What protective gear was provided?
28
Q

What is the WHO performance status?

A

0 Fully active, able to carry on all pre-disease performance without restriction
1 Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work
2 Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours
3 Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours
4 Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair
5 Dead

29
Q

What questions do you ask in a smoking history?

A
  • Do you smoke?
  • Have you ever smoked?
  • How much for how long?
  • Has that changed?
  • Do you smoke anything else?
30
Q

What are extra-pulmonary manifestations of lung cancer?

A
  • Hoarseness (left recurrent laryngeal nerve palsy)
  • Dysphagia
  • Palpitations
  • SVCO obstruction
  • Shoulder pain– tumor in the brachial plexus
  • Bone met in the shoulder
31
Q

What are the most common symptoms of lung cancer?

A
  • Cough
  • Weight loss
  • Dyspnoea
  • Chest pain
  • Haemoptysis
32
Q

Where does lung cancer metastasize to?

A
  • Bones
  • Liver
    -Spleen
  • Adrenals
  • Renal
  • Skin
  • Brain
33
Q

Why do lung cancers present late?

A

Because you are relatively asymptomatic

34
Q

What terms do you use to describe CT’s?

A

Shadowing is called attenuation

35
Q

What terms do you use to describe MRIs?

A

High signal (bright)
Low signal (dark)

36
Q

What liver function test result is raised in alcholics?

A

Gamma GT

37
Q

What check should you always do before prescribing Alendronic acid?

A

Checking dental health before starting alendronic acid is crucial to minimize the risk of osteonecrosis of the jaw, a rare but serious condition where jawbone healing is impaired after dental procedures, highlighting the importance of preventive dental care in patients taking this medication.

38
Q

What is the frax score?

A

The FRAX (Fracture Risk Assessment) score is a tool used by healthcare providers to estimate an individual’s 10-year risk of major osteoporotic fractures (including hip, spine, forearm, and shoulder fractures) and hip fractures specifically. It helps clinicians identify patients who are at higher risk of osteoporotic fractures and may benefit from interventions such as lifestyle modifications or medication to improve bone health.

39
Q

How can you distinguish between fat and accessory breast tissue?

A

Accessory breast tissue will get tender like the breasts when women menstruate.

40
Q

Why don’t you give someone ferritin while they are using antibiotics?

A

It decreases absorption of certain antibiotics like tetracyclines and quinolones and
Intravenous iron increases the levels of circulating non–transferrin-bound iron, which may be detrimental to the host by promoting pathogen growth13 and predisposes patients to infection.

41
Q

What is fucidin used for?

A

Fusidic acid is an oral antistaphylococcal antibiotic. Used for ulcer on man’s penis in elderly ward.

42
Q

What signs signify mitral regurgitation?

A
  • Wide pulse pressure (systolic blood pressure-diastolic blood pressure)
  • Thrusting apex (fluid overload)
  • Can radiate to the tricuspid area but more commonly radiates to the apex.
  • Pansystolic murmur
  • Louder rolling to the left
  • S1 maybe quiet or absent
43
Q

What signs signify atrial regurgitation?

A
  • Early decrescendo murmur
  • Wide pulse pressure
  • Accentuated when the patient holds their breath
  • Head bopping
  • Quincke’s sign (represents the visualization of capillary pulsations upon light compression applied to the tip of the fingernail bed)
  • Corrigan’s sign ( bounding carotid pulse, characterized by a rapid systolic rise and a rapid diastolic collapse)
44
Q

What signs signify mitral stenosis?

A
  • Mid diastolic murmur
  • Small pulse pressure
  • Soft first heart sound
  • Early opening snap
  • Long diastolic murmur
  • Diastolic thrill @ apex
  • PHT signs
45
Q

What signs signify aortic stenosis?

A
  • Crescendo-decrescendo murmur
  • Slow-rising carotid pulse
  • Narrow pulse pressure
  • Soft S2 sound
  • Ejection click
  • Tapping apex
46
Q

What is the difference between aortic stenosis and aortic sclerosis on physical examination?

A

Aortic stenosis radiates to the carotids and aortic stenosis does not

47
Q

What does a heaving heart signify?

A

Hypertrophy

48
Q

What is a CTAP?

A

CTAP (Computed Tomography Abdominal and Pelvic Scan): CTAP is a broader term that refers to a CT scan of the abdomen and pelvis. This type of CT scan is used to visualize the organs, blood vessels, and other structures in the abdomen and pelvis region.

49
Q

What measurement do we use to AKI apart from creatinine?

A

GFR

50
Q

How do we measure GFR?

A

Inulin clearance is the gold standard.

Y3 Medicine (17 decks)

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