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4th Year Key Summaries > Random questions > Flashcards

Random questions Flashcards

1
Q

Heparin mechanism of action

A

Antithrombin III inhibitor

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2
Q

Warfarin mechanism of action

A

Factor II, VII, IX and X

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3
Q

Dabigatran mechanism of action

A

Direct thrombin inhibitor

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4
Q

Rivaroxiban, apixoban mechanism of action

A

Factor Xa inhibitors

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5
Q

Reed-sternberg cells

A

HL

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6
Q

Biochem in addisonian crisis

A

High potassium
Low sodium
Low glucose

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7
Q

Beta-blockers antidote

A

Glucagon

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8
Q

Benzodiazepines antidote

A

Flumezanil

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9
Q

Heparin antidote

A

Protamine

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10
Q

Iron antidote

A

Desferroxamine

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11
Q

Narcotics antidote

A

N-acetylcysteine

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12
Q

Causes of hyponatraemia

A 
Diuretics
Water excess
D&V
Intestinal fistulae
Renal failure
SIADH
Addison's
Nephrotic
Liver failure
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13
Q

Causes of hypernatraemia

A 
Fluid loss without water replacement
Saline excess
Diabetes insipidus
DKA
Conn's
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14
Q

Causes of hyperkalaemia

A 
Drugs - ACEIs, Spironolactone, suxamethonium
Digoxin toxicity
Excessive KCl
Massive transfusion
Burns
Rhabdomyolysis
Tumour lysis
Renal failure
Addison's
Metabolic acidosis
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15
Q

Causes of hypokalaemia

A 
Vomiting
Diarrhoea
Losses from intestinal fistulae
Diuretics
Cushing's, excess steroids/ACTH
Metabolic alkalosis
Conn's
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16
Q

Signs of hyponatraemia

A 
Confusion
Seizure
HTN
HF
Muscle weakness
Nausea
Anorexia
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17
Q

Signs of hypernatraemia

A 
Thirst
Dehydration
Confusion
Coma
Seizure
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18
Q

Signs of hyperkalaemia

A

Cardiac arrythmias - tall tented t waves, lengthened QRS, flatp waves, sloping up ST —> VT/VF
Sudden death

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19
Q

Signs of hypokalaemia

A 
Arrythmia
Weakness
Hypotonia
Cramps
Tetany
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20
Q

Immediate management of hyperkalaemia

A

Calcium gluconate - stabilise myocardium

Insulin and glucose - get potassium temporarily into the cells (doesn’t affect metabolism)

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21
Q

Metabolic acidosis

A

Usually follows an episode of severe tissue hypoxia - hypovolaemic shock, MI, sepsis etc. Inadequate oxygenation leads to lactic acid build-up. In surgical patients may be an indicator of serious intra-abdominal problems such as anastomotic leak. Also seen in renal failure and uncontrolled DKA. Treat underlying cause

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22
Q

Signs of metabolic acidosis

A

Rapid deep breathing - Kussmaul respiration
ABG - low or normal pH, low pCO2 if compensated, very low bicarbonate
Plasma K elevated due to shift to extracellular space

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23
Q

Respiratory acidosis

A

Results from CO2 retention due to iatrogenic of pathological respiratory depression. Treat underlying cause

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24
Q

ABG respiratory acidosis

A

Low or normal pH
High pCO2
High bicarb if compensated

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25
Q

Metabolic alkalosis

A

Usually due to severe and prolonged vomiting, or nasogastric aspiration due to obstruction.

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26
Q

CO2 acidis or alkaline

A

CO2 makes things acidic

Bicarb makes things alkaline

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27
Q

Classical acid-base picture of a patient with gastric outlet obstruction - including pyloric stenosis

A

Hypochloraemic metabolic alkalosis

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28
Q

ROME ABG nmnemonic

A

Respiratory
Odd
Metabolic
Equal

So if the C02 and HCO3 values are abnormal, if they are both low -“equal” it’s likely metabolic, and if they’re nt

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29
Q

Achalasia management

A

Medical - only if surgery contraindicated or while waiting for treatment - CCBs, nitrates
Pneumatic dilation
Surgical: laparoscopic or open Heller myotomy

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30
Q

Follow up for varices

A

Follow up every 3-6 months, banding or sclerotherapy of any recurrent varices

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31
Q

4 types of benign colonic polyp

A

Adenomatous
Inflammatory
Metaplastic
Harmatomous

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32
Q

Bowel ischaemia ABG picture

A

metabolic acidosis

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33
Q

M rule in PBC

A

IgM
Middle aged women
Anti-Mitochondial antibodies

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34
Q

First line medical management in IBS

A

Loperamide

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35
Q

MEN 1

A

Pituitary
Parathyroid
Pancreas

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36
Q

Artery at risk with duodenal ulcers on the posterior wall

A

Gastroduodenal

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37
Q

Tongue and uvula deviation in hypoglassal nerve injury

A

Tongue goes t’same side

Uvula goes utha way

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38
Q

Treatments for hyperkalaemia

A

Calcium gluconate
Insulin and dextrose infusion
Salbutamol nebs
Calcium resonium

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39
Q

Pre-renal causes of ARF

A

Hypovolaemia
Multiple organ failure
Rhabdomyolysis

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40
Q

Renal causes of ARF

A

Vasculitis
Crescentic GN
Acute tubular necrosis

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41
Q

Post-renal causes of ARF

A

Blocked catheter
Prostatic hypertrophy
Extra-ureteric tumour
Retroperitoneal fibrosis

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42
Q

Common blood finding in interstitial nephritis

A

Eosinophil count elevated

43
Q

Good marker in DM patients for assessing risk of future nephropathy

A

Microalbuminuria

44
Q

Do you stop aspirin in AKI?

A

In low-dose for cardioprotection, no. Otherwise, yes

45
Q

Most common renal AKI cause

A

Acute tubular necrosis

46
Q

Diuretic for ascites

A

Spironolactone

47
Q

Most common and important viral infection in solid organ transplant

A

CMV

48
Q

Alternative to spironolactione if the patient develops gynaecomastia

A

Eplenerone

49
Q

Diabetes Insipidus plasma and urine osmolality

A

high plasma osmolality and a low urine osmolality

50
Q

Why is nephrotic syndrome associated with hypercoagulability?

A

Loss of antithrombin III

51
Q

High or low urinary sodium in pre-renal vs ATN

A

Low in pre-renal as the kidney works to reabsorb because of the volume depletion and hold onto fluid
High in ATN
NB that a big difference in osmolality suggests pre-renal
In ATN the osmolality ratio is close to equal

52
Q

Muddy brown casts suggestive of

A

ATN

53
Q

4 eGFR variabilites

A 
CAGE
Creatinine
Age
Gender
Ethnicity
54
Q

Screening test for APKD

A

USS

55
Q

1st line therapy in hyperparathyroidism requiring treatment

A

Vitamin D supplementation

56
Q

Most common renal stones

A

Calcium oxalate

57
Q

Gold standard for kidney stone

A

CT KUB - non-contrast

58
Q

Staghorn composition

A

Struvium (magnesium ammonium phosphate)

59
Q

6 functions of skin

A 
Environmental barrier
Vitamin D synthesis
Cosmesis
Immunosurveillance
Sensation
Temperature regulation
60
Q

Mnemonic for describing a lesion

A 
SCAM
Size - widest diameter, Shape
Colour
Associated secondary change
Morphology, Margin
61
Q

Melanoma screen mnemonic

A 
ABCD
Asymmetry
Border
Colour
Diameter - >6mm
62
Q

4 cell types of the epithelium

A

Keratinocytes
Langerhans’ cells
Melanocytes
Merkel cells

63
Q

Chondromalacia patellae vs osteochondritis dissecans

A

Chondromalacia patellae:

Softening of the cartilage of the patella
Common in teenage girls
Characteristically anterior knee pain on walking up and down stairs and rising from prolonged sitting
Usually responds to physiotherapy

Osteochondritis dissecans:

Pain after exercise
Intermittent swelling and locking

64
Q

Electrolyte abnormality which predisposes to digoxin toxicity

A

Hypokalaemia

65
Q

Most common side effect of isotretinoin

A

Dry skin

66
Q

Severe side effect of hydroxychloroquine

A

Retinopathy

67
Q

Metabolic acidosis with normal anion gap

A

Addisons

68
Q

How long to wait after prostatitis to do PSA

A

1 month

69
Q

Possible side effect of intubation and ventilation in a flail chest patient

A

Tension pneumothorax

70
Q

First line treatment for severe C diff

A

Vancomycin

71
Q

First and second line choices for MRSA treatment

A

Vancomycin

Linezolid

72
Q

Causes of raised prolactin

A 
pregnancy
prolactinoma
physiological
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines, metoclopramide, domperidone
73
Q

3 key characteristics of HHS

A
  1. ) Severe hyperglycaemia
  2. ) Dehydration and renal failure
  3. ) Mild/absent ketonuria
74
Q

Impetigo treatment

A

topical fusidic acid → oral flucloxacillin / topical retapamulin

75
Q

3 key characteristics of HHS

A
  1. ) Severe hyperglycaemia
  2. ) Dehydration and renal failure
  3. ) Mild/absent ketonuria
76
Q

Impetigo treatment

A

topical fusidic acid → oral flucloxacillin / topical retapamulin

77
Q

ECG changes in hyperkalaemia

A 
Tall tented t waves
Loss of p waves
Broad QRS complexes
Sine wave
VF
78
Q

If a post menopausal woman has a fracture do you medicate, and if so with what

A

Yes, bisphosphonate and calcium

You don’t need to do a DEXA scan

79
Q

Papillary and medullary thyroid cancer tumour markers

A

Medullary - Calcitonin - the MC

Papillary - Thyroglobulin - the PT

80
Q

Things which falsely reduce HbA1c

A

SCD, G6PDD, HS

81
Q

Things which falsely increase HbA1c

A

Splenectomy, iron-deficiency anaemia, B12 deficiency, alcoholism

82
Q

Does Grave’s disease cause a tender goitre? What does?

A

No, De Quervain’s (subacute) does

83
Q

Medication used in vestibular neuronitis and when

A

Prochlorperazine, only in the acute phase

84
Q

Most common organism in acute bacterial tonsillitis

A

Strep pyogenes

85
Q

Differential for tinnitus

A 
Meniere's
Acoustic neuroma
Drugs - quinine, aspirin, loop diuretics
Otosclerosis
Hearing loss
86
Q

Management of unilateral nasal polyp

A

Urgent ENT referral - usually bilateral so need to rule out malignancy

87
Q

Otitis media abx, and in diabetics

A

Amoxicillin, DM - ciprofloxacin

88
Q

How long to wait before ENT referral for tympanic membrane perforation

A

6 weeks

89
Q

Causes of gingival hyperplasia

A

phenytoin, ciclosporin, calcium channel blockers, AML

90
Q

Addison’s antibodies

A

21-hydroxylase

91
Q

Reason for hyperpigmentation in Addison’s

A

Increased ACTH production

92
Q

U&Es in Addison’s

A

Low sodium

High potassium

93
Q

Test for addison’s other than antibody

A

Morning cortisol - low

94
Q

Differentials for addison’s

A

Secondary hypoaldosteronism - Cushing’s or hypo-pit axis disease
Hyperthyroidism
Hameochromatosis

95
Q

What are the three things a patient is short of in an Addisonian crisis

A

Steroid
Salt
Glucose

96
Q

Management of an addisonian crisis

A

IV dexamethasone
IV 0.9 NaCl
IV glucose if hypoglycaemic
Regular monitoring and supportive Rx

97
Q

2 key meds in stable Addison’s

A

Hydrocortisone and fludrocortisone

98
Q

Hormone which reduces in response to surgery

A

Insulin

99
Q

Test to differentiate between T1DM and T2

A

C-peptide

100
Q

Causes of SIADH - mnemonic

A 
SIADH
S     Surgery (24-48 hours post-op)
I	Idiopathic/Intracranial/Infection
A	Acute and chronic lung disease
D	Deficiency of cortisol/Drugs - opiates, cytotoxics, anti-     psychotics, anti-epileptics
H	Hypothyroidism/Hyponatraemia
101
Q

Myeloma screen

A

Total Protein
Albumin
Calculated Globulins
Serum Protein Electrophoresis (SPE) and free light chain measurement

102
Q

Diagnostic criteria in myeloma

A
  1. Monoclonal plasma cells >10% on bone aspirate
  2. Monoclonal antibodies in blood or urine
  3. At least one of CRAB
103
Q

Causes of increased INR (drugs)

A

Allopurinol Influenza Vaccine Tramadol Oxandrolone
H-2 Blockers
Macrolide Antibiotics Metronidazole
Protease Inhibitors Quinolone Antibiotics SSRI Antidepressants Statins and Fibrates Tricyclic Antidepressants
Ethanol

4th Year Key Summaries (5 decks)

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