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Lectures final revision > Random > Flashcards

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1
Q

In the management of a patient with DKA, what is the most important factor:

A

give vigorous IV fluids

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2
Q

Patient with chest pain history and ECG finding ST elevation all leads

A

Pericarditis

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3
Q

Patient has upper abdominal pain, in which one of the following conditions will the pain not radiate to the back:

a. PUD
b. perforated appendicitis
c. acute pancreatitis
d. AAA (rupture?)
e. biliary colic

A

Which are retroperitoneal

S: suprarenal (adrenal) gland

A: aorta/IVC

D: duodenum (second and third part)

P: pancreas (except tail)

U: ureters

C: colon (ascending and descending)

K: kidneys

E: (o)esophagus

R: rectum

THerefore biliary colic

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4
Q

70 y/o male patient presents with weight loss, anorexia and constipation. Bloods show a microcytic anaemia. Which diagnosis is likely:

a. carcinoma of sigmoid colon
b. small bowel tumour
c. angiodysplasia of caecum
d. PUD
e. rectal polyp

A

A

Anorexia - cancer

Age - cancer

Constipation - obstruction

Microcytic anaemia - Iron deficient

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5
Q

Footballer injures shin during game, thereafter has painful toes, bandaging and analgesia do not relieve pain which is getting worser. What would you do next

A

Compartment syndrome

Decompress with fasciotomy

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6
Q

Patient has left homonymous hemi-anopia. Where is the lesion

A

Right Occipital Lobe

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7
Q

35 y/o female presents spitting blood 1 week post-tonsillectomy. What type of bleed is this

A

secondary

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8
Q

Patient presents with midline swelling that moves on tongue protrusion

A

thyroglossal cyst

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9
Q

Patient present with chronic suppurative chronic external otitis media. Which is most common symptom

A

conductive hearing loss

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10
Q

Middle-aged male eats fruit & nut chocolate bar. 15 minutes later he becomes short of breath and has stridor. How would you treat him

A

IM adrenaline

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11
Q

Patient is a slow eater, chest x-ray shows… , barium swallow shows tapering of the oesophagus distally. Diagnosis is

A

achalasia

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12
Q

DM fundoscopy. Proliferative retinopathy involves

A

neovascularization

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13
Q

50 y/o patient present s with headache, protruding L eye with a droop and dilated pupil. What is diagnosis

A

cavernous sinus aneurysm

?

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14
Q

20 y/o female, presents with painless irregular lump in L breast. Skin dimpling and tethering are present. No nodes on L are palpable. What is the diagnosis

A

GO OVER BREAST CANCER

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15
Q

Iron deficiency anaemia associated with MCV

A

Microcytic Anaemia

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16
Q

Anaemic patient with leg ulcers and priapism suffers from

A

Sickle Cell

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17
Q

Mid-diastolic murmur in a patient who has atrial fibrillation controlled by digoxin

A

Mitral Stenosis

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18
Q

Which ECG leads would suggest an inferior MI:

A

Ii III aVF

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19
Q

Male patient presents with history of shaft of femur fracture 1-2 weeks post-op. He has bilirubin of 80 and is jaundiced. There are no other symptoms and all other LFTs are normal. What is the likely cause

A

Gilberts

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20
Q

26 y/o builder, 3 hour history of R colic which radiates into genitalia and lasts ½ hour at a time. He also vomits and has microscopic haematuria:

a. UTI

b .ureteric colic

c. testicular torsion
d. bladder cancer
e. renal tuberculosis

A

Ureteric Colic

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21
Q

65 y/o female, 10 days post-THR, has chest pain, HR: 110 bpm, BP: 110/80, JVP: +15cm. The investigation of choice is

A

CTPA for PE

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22
Q

13 y/o female, has argument with grandmother and takes 12 tablets of 10mg diazepam. How will you treat her

A

flumazenil

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23
Q

80 y/o male with hypertension and atrial fibrillation. How would you reduce the risk of “embolic stroke”:

A

Warfarin

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24
Q

Male with alcoholic cirrhosis. On examination percussion dullness and fluid suggest ascites. USS shows fluid and diagnostic ascetic tap show sterile transudate with no malignant cells. He is not SOB. First line treatment

A

Sprio

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25
Q

70 y/o female with SOB on exertion has ejection systolic murmur, diagnosis

A

Aortic stenosis

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26
Q

26 y/o male homosexual footballer has fever, SOB and cough. He is admitted for 2 weeks and treated for pneumonia. He is very ill, however decides to self-discharge, what advice would you give him

A

IF TB then notifiable disease and keep in by force

Otherwise - to advise to stay

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27
Q

50 y/o male smoker has a cough, hoarseness and a “breathy” voice. There are no findings on examination. Nasoendoscopy reveals a vocal cord palsy. What investigation would you do next

A

Chest X ray for lung mets

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28
Q

Patient presents with hepatosplenomegaly, but no lymphadenopathy. Bloods show ↑ plt ,↑ wbc, ↓ hb. Blood film shows Philadelphia

A

CML

29
Q

Patient with increased BP has coarctation of aorta, which of the following sign

A

radio femoral

30
Q

Patient 5 days post-anterior resection operation. The fluid balance chart shows

-1370 ml/24 hr. What is the likely cause

A

third space losses

31
Q

Old male presents in A&E with 1 day history of acute L eye pain. The cornea was cloudy and the pupils mid-dilated. What is the diagnosis

A

acute closed angle glaucoma

32
Q

Hypernatraemia is associated with:

a. Cirrhosis of the liver

b heart failure

c. SIADH
d. diabetic coma

A

diabetic coma

others cause hypo

33
Q

A patient and his family present with history of itching. Likely diagnosis

A

scabies

34
Q

An old male with diabetes present complaining of hand pain at night relieved by shaking etc. What is the likely cause

A

CTS

35
Q

An old lady with rheumatoid arthritis presents with gradual reduction in visual acuity. What is the likely cause

A

Steroid induced glaucoma

36
Q

A patients blood film shows rouleaux formation and his bloods show

↓ hb, ↓ plt, ↓ wcc, ↑Ca2+. What is the likely diagnosis

A

Myeloma

37
Q

A patient presents with haematuria 1 week post-URTI. What is the likely cause:

A

IgA nephropathy (Berger’s Disease)

38
Q

An alcoholic patient vomits blood. He has surgical emphysema etc. etc. What is the likely cause

A

lower oesophageal rupture

39
Q

Patient has cellulitis of leg. You need to prescribe an antibiotic. Which organism would you ensure you covered

A

Haemolytic streptoccoi

40
Q

treat trichomonas

A

Metronidazole

41
Q

AMitriptaline overdose

A

IV bicarb

42
Q

How do you treat HIV encecphalitis

(toxoplasma gondii)

A

pyrimethamine plus sulfadiazine or clindamycin

43
Q

Pneumovax indications

A

all over 65

defunctioning spleen

chronic resp conditions

chronic heart, kideny, liver conditions

immunosupressed

cochlear implants

CSF leak

occupational hazard

44
Q

TB meningitis treatment

A

rifampicin + isonoazid + pyrazinamide + ethambutol

45
Q

An old male presents with a unilateral swelling of the parotid gland. On
examination cranial nerve VII function has not been affected

A

Pleopmorphic adenoma

  • 80% of tumours in the parotid are benign pleopmorphic adenomas
  • Typically: middle age, slow growth
  • Removed by superficial parotidectomy or enucleation. Radiotherapy has a role eg in residual disease or recurrence (recurrence rate of 1-2% at 12 years)

VII nerve paresis suggests malignancy

  • Rapid growth, hard fixed mass, pain and VII nerve palsy
46
Q

Non-necrotising granulomas found in

A
  • Chron’s: non-necrostising granulomas are found within the inflammation in the gut wall.
  • Sarcoidosis: get graulomas in multiple organs. Most do not contain necrosis and are surrounded by concentric scar tissue (fibrosis).
47
Q

caseating granulomas found in

A
  • TB: Said to be caseating – grossly visible cheese like appearance
    • Wegeners granulomatosis
48
Q

A lady presents with constipation, abdominal pain and vomiting. She has
other symptoms suggestive of malignancy. most important/first line investigation

A

Calcium

49
Q

ABCDEFGHI

of vomiting

A
  • Acute renal failure/Addisons, brain (eg raised ICP), cardiac (MI), DKA, ears (labyrinthitis, Menieres), foreign substances (alcohol, drugs), gravidy (eh hyperemesis gravidarum), hypercalcamia/hyponatraemia, infection (eg UTI, meningitis)
50
Q

Isosorbide mononitrate

A
  1. postural hypotension, fast/fluttering heart beat, flushing
51
Q

Frusemide

A

postural hypotension, ringing in the ears, increased sensitivity to sunlight

52
Q

Phenytoin

A

increased hair growth, acne, numbness/tingling, sore/swollen gums

53
Q

Simvastatin

A

muscle/joint pain, numb/pins+needles, nightmares, mood change, sexual probs

54
Q

Bisoprolol

A

postural hypotension, coldness of the extremities, disturbed sleep, nightmares

55
Q

Enalapril

A

dry cough, low mood, taste disturbance

56
Q

Verapamil/diltiazem

A

postural hypotension, flushing, muscle/joint pain, , swollen ankles, rash

57
Q

B2-agonist (maybe salbutamol)

A

tremor, palpitations

58
Q

achondroplasia is what type of inheritance

A

85% sporadic mutation

auto dominant

59
Q

when to suspect ampyema

A

if resolving pneumonia but swinging fevers and lower lobe effusion

60
Q

lung cancer histological finding of increased keratinisation

A

SCC

61
Q
  1. 20 y/o male who is otherwise fit and healthy develops typical community acquired pneumonia:
A

Streptococcus pneumoniae

62
Q

75 y/o male with COPD has an acute exacerbation

A
  1. viral- influenza/ rhinovirus/ adenovirus streptococcus or haemophilus
63
Q

20 y/o male with cystic fibrosis

A

pseudomonas

64
Q

male with SOB. worse on week days, better on weekends. works in zoo

A

psittaci

65
Q

40 y/o male develops life-threatening community acquired pneumonia
after returning from sprain/brazil

A

legionella

66
Q

young male presents with 19 day history of gradual SOB and low fever. His
chest x-ray reveals “diffuse perihilar shadowing

A

PCP

67
Q

if a patient has random bits of palpitations what the best ivx

A

Holter monitor

68
Q

in A.fib how do you manage?

A

Rate vs rhythm

Rhythm first in young - amioderone

Rate in old or ICH - bb or digoxin

69
Q
A

Lectures final revision (10 decks)

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