Random things from posters Flashcards
1
Q
When shouldnt you give beta blockers
A
asthma, heart block/failure, hypotension, bradyarrythmias
2
Q
What does hereditary spherocytosis cause
A
RBC membrane defects in haemolytic anaemia
3
Q
What does Glucose-6-phosphate dehydrogenase deficiency cause
A
Enzyme defects in haemolytic anaemia
4
Q
What do thalassaemias and sickle cell cause
A
Haemoglobinopathies in haemolytic anaemia
5
Q
What is poikilocytosis
A
Variation in RBC shape
6
Q
What is anisocytosis
A
Variation in RBC size
7
Q
What mutation is present in polycythaemia rubra vera
A
JAK 2
8
Q
What are the signs of Mobitz type 1 heart block and what is it
A
PR interval increasing with QRS dropped. It is second degree AV block AKA Wenckebach
9
Q
What is charcots triad and what does it suggest
A
worsening right upper quadrant pain, jaundice and fever. Cholangitis
10
Q
What do these symptoms suggest in children and how would you confirm a diagnosis: failure to thrive, recurrent respiratory tract infections, diarrhoea
A
Cystic fibrosis. Sweat test.
11
Q
Which murmurs are loudest on expiration
A
Mitral Regurgitation, Aortic Stenosis and Mitral Valve Prolapse
12
Q
What are the features of mitral regurg murmur
A
low pitched, pan-systolic murmur, loudest in expiration, radiates to the axilla
13
Q
Which type of anaemia is peripheral neuropathy associated with
A
B12 deficiency (macro)
14
Q
What do these features suggest Koilonychia (spoon-shaped nails – both fingers and toes)
Angular stomatitis and glossitis
Dysphagia, tongue atrophy
A
Iron deficiency anaemia (micro)
15
Q
Whats the MI sign where the patient has their hand over their chest called
A
Levines sign
16
Q
What is Beck’s triad
A
Signs of cardiac tamponade. Hypotension, muffled heart sounds and increased jugular venous distension (JVD)
17
Q
What does this suggest and what is the investigation: progressive dysphagia, regurgitation of undigested food debris, chronic cough, chronic aspiration, halitosis, a sensation of a lump in the throat, hoarseness, whistling and cervical borborygmi
A
Zenkers diverticulum. Outpouching of hypopharynx. Do a barium swallow.
18
Q
What are the signs and symptoms of pneumonia
A
productive cough, progressive shortness of breath and the clinical findings of left basal coarse crackles, tachypnoea and hypoxia.
19
Q
For what disease is Pirfenidone used
A
IPF, it is an antifibrotic which inhibits TGF-B
20
Q
What is the pulse like in aortic stenosis
A
Slow rising pulse
21
Q
Signs of aortic stenosis
A
A murmur typically loudest in the aortic region (2nd intercostal space right sternal edge)
Sitting forward and expiring accentuates the murmur
Slow-rising pulse
Narrow pulse pressure
Heaving apex beat
22
Q
What is the first investigation in PE
A
CT pulmonary angiogram
23
Q
Investigation if suspect angina
A
Exercise stress test
24
Q
What does this suggest: worsening fatigue, dizziness and dark stools (malaena)
A
Upper GI bleed
25
What is the pulse like in sepsis and hypercapnia
bounding
26
What is the pulse like in aortic regurgitation
collapsing
27
What is the pulse like in AF
Irregularly irregular
28
What is pulsus paradoxus
a large decrease in pulse pressure (>10mmHg drop) during inspiration: is a sign of various conditions, including: cardiac tamponade, constrictive pericarditis, pulmonary embolism and acute asthma
29
What is grey turners sign
The bruising on the flanks which occurs due to retroperitoneal haemorrhage in acute pancreatitis
30
What does brugada show on ECG
Coved ST in V1-V3 followed by inverted T
31
What channel is affected in brugada
Sodium
32
What features make a brugada diagnosis more likely
Young male, family early death, nocturnal agonal respiration
33
What causes superior vena cava syndrome
Small cell carcinoma
34
Most common presenting complaint in lung cancer
Cough
35
Name a tyrosine kinase inhibitor and what is it used for
Imatinib, used for CML
36
What are the signs of normal cardiac axis
Lead II has the most positive deflection compared to Leads I and III
37
What are the signs of left axis deviation
Lead I has the most positive deflection
Leads II and III are negative
Left axis deviation is seen in individuals with heart conduction defects
38
What are the signs of right axis deviation
Lead III has the most positive deflection and Lead I should be negative
This is commonly seen in individuals with right ventricular hypertrophy
39
What causes osteogenesis imperfecta
an autosomal dominant mutation that impairs the synthesis of type 1 collagen
40
When is the LH surge in the menstrual cycle
Day 12
41
What is vitiligo
localised loss of skin pigmentation due to the autoimmune destruction of melanocytes
42
Signs of IgA neuropathy
upper respiratory tract infection, gross haematuria, flank pain and red blood cells casts
43
Drugs which cause hyperkalaemia
ACE-I, NSAIDs, BB, Warfarin
44
Which drugs should you stop in AKI
ACE-I
45
What the signs of idiopathic premature ventricular contractions
extra-beats or palpitations, often exacerbated by caffeine or alcohol and are more evident during the nigh
46
First line african/ over 55
CCB; Amlodipine
47
Which leads provide a lateral view of the heart
I, aVL, V5 and V6
48
Describe vasovagal syncope
The event occurred after a postural change, was preceded by nausea and resolved rapidly with no intervention or residual neurological deficits
49
What is the distinctive sign of Myasthenia Gravis
Muscle fatigueability
50
What condition is associated with VSD
Foetal alcohol syndrome
51
What condition is associated with PDA
Congenital rubella
52
What condition is associated with ASD
Downs
53
What condition is associated with transposition of the great vessels
Maternal diabetes
54
Most common left axis deviation cause
Left anterior fasciculator block
55
Most common right axis deviation cause
Right ventricular hypertrophy
56
Where does pulmomary stenosis murmur radiate
Shoulder
57
Where does mitral regurg murmur radiate
Axilla
58
Loudest on inspiration murmurs
RHS; Pulmonary and tricuspid
59
Loudest on expiration murmurs
LHS; Aortic and mitral
60
Criteria for long term oxygen therapy
<55 when clinically stable or <60 and evidence of organ failure eg pulmonary HTN, RH Failure and polycythaemia
61
Which region of the heart is looked at with II, III and aVF
Inferior
62
Hypokalaemia ECG changes
tall/peaked P waves, T-wave flattening, supraventricular/ventricular ectopics and supraventricular tachyarrhythmias.
63
Hypercalcaemia ECG changes
typically features shortening of the QT interval and Osborn (J) waves on the ECG
64
Hyperkalaemia ECG changes
tall tented T waves, flattened P waves and broad QRS complexes
65
Hypocalcaemia ECG changes
Prolonged QT interval
66
Who gets SLE
Young girls
67
Osteopetrosis
Poor osteoclast function due to a carbonic anhydrase II mutation
68
Reactive arthritis skin sign
Keratoderma blennorrhagica on the feet
69
Which medications increase the change of gout
Loop and thiazide diuretics
70
What type of diuretic is Indapamide
Thiazide like diuretic
71
insidious onset of bleeding and bruising, in addition to the low platelet count and normal coagulation screen suggests
Immune thrombocytopenia, requires corticosteroids
72
Pulseless electrical activity management
Chest compressions and adrenaline
73
What condition is horners syndrome associated with
Coarctation of the aorta
74
What are the symptoms of horners syndrome
```
Short stature
Ovarian dysgenesis
Lymphatic defects
Cystic hygroma
Webbed neck
Lymphoedema
```
75
What is duloxetine
Antidepressant, serotonin and noradrenaline reuptake inhibitor
76
Factors which activate RAAS
Reduced renal Na, low blood pressure, hypovolaemia, sympathetic stimulation
77
In which days of the uterine cycle is the menstrual phase with bleeding
1-5
78
Polycythaemia rubra vera mutation
JAK2
79
Signs of cystic fibrosis in children
failure to thrive, recurrent respiratory tract infections, diarrhoea
80
Minimal change disease triad
oedema, hypoalbuminaemia and proteinuria
81
Which condition is suggested by normal O2 sats which fall very dramatically on walking
Pneumocystis pneumonia, HIV related condition
82
Which two conditions should you suspect HIV in
Reccurent shingles and candidiasis
83
Which coreceptor which HIV binds to is on the surface of Tcells, macrophages, monocytes and dendritic cells
CCR5
84
Which coreceptor is only present on the surface of Tcells and is often targetted during the chronic HIV stage
CXCR4
85
How does a hiatus hernia appear on CXR
retrocardiac air-fluid level.
86
What is used to assess the severity of pancreatitis
Abbreviated glasgow scoring system, PANCREAS
87
What does PANCREAS stand for for the assessment of pancreatitis
PaO2 (low), Age, Neutrophilia, Calcium, Renal function, Enzymes, Albumin, Sugar
88
Vommiting fresh bright red blood suggests
Mallory Weiss tear
89
Bruising on the flanks and abdominal region suggests
Acute pancreatitis
90
Most common cause of drug induced jaundice
Coamoxiclav and flucoxacillin
91
Which blood marker classically rises with upper GI bleeding
Urea due to blood breakdown
92
Primary sclerosing cholangitis investigations
Ultrasound at first, then MRCP to confirm. Magnetic resonance cholangiopancreatography
93
How does hyperventilation lead to perioral and peripheral paresthesia?
Hypocalcaemia
94
Why does hypokalaemia happen with alkalosis
H+ dissociates from albumin so calcium binds and free calcium drops
95
Which antiviral is used for Herpes Zoster and encephalitis
Aciclovir
96
Neuro problem which is sudden
Vascular
97
Neuro problem which is episodic
Relaxing, remitting MS
98
Neuro problem with diurnal fatigueability
Myasthenia gravis
99
Focal neuro problem which progressively worsens
MND
100
What is the antibiotic for Group A B-haemolytic streptococci
Benzylpenicillin or clindamycin
101
What is Cryptorchidism
Cryptorchidism is the absence of one or both testes from the scrotum
102
What is the most common consequence of the macrophage stage, 4-7days after an MI
Myocardial rupture, and therefore. Cardiac tamponade / Shunt through the ventricular wall / Mitral insufficiency
103
RUQ mass
mass in the right upper quadrant is likely to represent a distended gallbladder secondary to bile flow obstruction from a malignant pancreatic mass
104
Minimial change disease is nephritic or nephrotic
Nephrotic
105
IgA nephropathy is nephritic or nephrotic
Nephritic
106
What is asterixis and what is it associated with
Flapping tremor, hypercapnia
107
Agar for bordatella pertussis
Bordet gengou
108
What is murphys sign and what does it mean
When you put hand on bile duct and they breathe in and it hurts. If positive it means acute cholecystitis
109
Radial nerve supplies muscles of flexion or extension
Extension (R-ex)
110
Ulnar nerve supplies muscles of flexion or extention
Flexion (U-Flex)
111
What is graves disease
An autoimmune disease of the thyroid
112
What does bloody diarrhoea + india suggest
Entamoeba histolytica
113
What is charcots foot
Loss of sensation
114
If there is a peptic ulcer in the pylorus of the stomach which artery will it perforate
Gastroduodenal
115
Paracetamol antedote
N-acetyl-cysteine
116
What is Kussmauls sign
Deep and laboured breaths, a sign of sever diabetic ketoacidosis
117
How does amoxicillin work
It inhibits peptidoglycan crosslinking in cell wall formation
118
If you suspect cirrhosis what would be the next step
CT abdo
119
If there is a glossopharyngeal nerve lesion which way does the tongue go
Towards the problem, lick the lesion
120
Which cancers metastasise to bone
Breast, bronchus, bridney, bryroid, brostate
121
3 signs of chronic liver disease
Bruising, clubbing, dupuytrens contracture
122
Signs of left ventricular failure
Pulmonary crackles, extra heart sounds, displaced apex beat, tachycardia
123
3 endocrine causes of HTN
Conns (hyperaldosteronism), Cushings (prolonged cortisol) and Phaeochromocytoma (Nad+Ad)
124
First line treatment for bradycardia with adverse features like syncope and shock
IV atropine
125
Superior vena cava syndrome, major cause and treatment
SSC of the lung. Elevate the head, corticosteroids and diuretics
126
Ventricular tachycardia and adverse effects
Synchronised DC shocks, further treatment would incluse IV amiodarone
127
Where are colostomies positioned
Left illiac fossa
128
Where are ileostomies positioned
Right illiac fossa
129
Cause of aortic regurg in young children
VSD
130
Sign of complete heart block on ECG
Complete dissociation between P waves and QRS complexes
131
Recent chemo and fever=
Neutropenic sepsis. Give broad spectrum antibiotics
132
What classically rises in upper GI bleeds
Urea
133
Describe the pericarditis pain
retrosternal, pleuritic (exacerbated on inspiration) and worse when lying flat
134
tall tented T waves, flattened P waves and broad QRS complexes
Hyperkalaemia
135
Skin abscess organism
Staph aureus
136
Pneumonia organsims
S.aureus, klebsiella pneumonia, anaerobic bacteria, mycobacterium tuberculosis
137
Liver abscess organisms
Gram negative (E.Coli), strep milleri, anaerobes (bacteriodes fragilis), entamoeba histolytica in tropics
138
Kidney abscess organisms
E coli, klebsiella
139
Bowel abscess organisms
Gram negative (Ecoli), strep milleri and anaerobes (bacteriodes fragilis)
140
Target BP in people under 80
140/90
141
Target BP in people over 80
150/90
142
Side effects of CCB
-ve chronotrope: bradycardia, AV block -ve ionotrope: worsening CF
143
What is doxazosin
Alpha one antagonist
144
Two major causes of regurgitiation
Rheumatic fever and infective endocarditis
145
Cause of mitral regurg
Myoxomatous degeneration, ischaemia, rheumatic heart disease and infective endocarditis
146
aortic stenosis triad of symptoms
Exertional syncope, exertional dyspnoea and angina
147
Aortic stenosis initial investigation
Echocardiography
148
Pulse in aortic stenosis
Slow rising carotid pulse, reduced pulse amplitude
149
What shape is the ejection murmur in aortic stenosis
Rhomboid
150
Indications for valve replacement in aortic stenosis
Symptomatic, LVEF decreasing
151
Signs of mitral regurg
Soft 1st HS, 3rd HS, pansystolic murmur
152
Investigations for suspected mitral regurg
Echo, ECG, Cxr
153
Treatment for mitral regurg
Rate control and anticoagulation for AF, diuretics for fluid, IE prophylaxis, surgery if symptomatic
154
When should you suspect Spondyloarthropathies
Inflammatory back pain, assymetrical large joint arthritis, skin psoriasis, IBD and inflammatory eye disease
155
What is enteropathic arthritis
Episodic peripheral synovitis which can occur with IBD, lower limb, assymetrical and usually gets worse and better as IBD does. Management similar to RA
156
Signs of Mobitz type 1, second degree heart block
PR increasing the QRS dropped.
157
Mutation in Polycythaemic rubra vera
JAK2
158
Which part of the HIV virus binds to receptors
GP160
159
Which enzyme converts viral RNA into DNA
Reverse transcriptase
160
Which enzyme encorporates Viral DNA into the Cellular DNA
Integrase
161
Complication of having a pacemaker fitted
Pneumothorax
162
Organism causing croup
Parainfluenza Virus 1
163
Most common cause of right sided heart failure
Left sided heart failure
164
What is quinckes sign
Pulsations visible in the nail bed with each heartbeat upon light compression of the nail bed
165
Collapsing pulse
a sudden, abrupt drop in the pressure on the arterial wall after systole
166
Corrigan's sign
visible distention and collapse of the carotid arteries in the neck
167
De Musset’s sign:
Head bobbing with each heartbeat
168
Most common mitral regurg cause
Rheumatic fever
169
Cullens sign
periumbilical oedema and bruising suggestive of retroperitoneal bleeding
170
Grey-turners sign
bruising on the flanks bilaterally suggestive of retroperitoneal bleeding.
171
Mcburneys sign
deep tenderness over McBurney's point (1/3 between the anterior superior iliac spine to the umbilicus) suggestive of acute appendicitis
172
Rovsings sign
palpation of the left lower quadrant causes pain in the right lower quadrant, suggestive of acute appendicitis
173
Sudden death of young athletes, heart cause
Hereditary hypertrophic cardiomyopathy is due to autosomal dominant mutations in the beta-myosin heavy chain. It causes massive hypertrophy of the left ventricle which results in diastolic dysfunction and subaortic stenosis
174
How does hypertension lead to paraesthesia
Alkalosis leads to hypocalcaemia
175
Charcots triad for cholangitis
worsening right upper quadrant pain, jaundice and fever
176
Paraneoplastic syndrome from lung SCC
Parathyroid hormone related peptide is high and phosphorus is low
177
Rockall risk scoring system
attempts to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding
178
Minimal change syndrome
oedema, hypoalbuminaemia and proteinuria
179
What does a short PR interval suggest
Wolff-parkinson-white syndrome. An abnormal pathway between the atria and ventricles
180
CHA2DS2–VASc Score
is used to predict the probability of a stroke or thromboembolic event with atrial fibrillation
181
ABCD² Score
Estimates the chance of a stroke following a suspected TIA
182
Wells score
Predicts the probability of a patient suffering a DVT or PE
183
TIMI
Estimates the probability of mortality in a patient with unstable angina or an NSTEM
184
QRISK2 score
Predicts the chance of having a cardiovascular event (myocardial infarction or stroke). Used for primary prevention of cardiovascular disease to identify patients at high risk, and patients who would benefit from primary prevention treatments
185
The ECG shows a slurred upstroke of the QRS complex (known as a Delta wave).
Wolff parkinson white syndrome
186
Turner's syndrome
sex chromosome disorder of female sexual development commonly associated with preductal coarctation of the aorta which causes hypertension in the upper extremities and weak pulses in the lower extremities
187
PR interval is fixed but there are dropped beats
MOBITZ TYPE 2 SECOND DEGREE HEART BLOCK
188
Bradycardia and adverse effects treatment
IV Atropine
189
Takotsubu cardiomyopathy
Stress cardiomyopathy
