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phase 2 > Random things from posters > Flashcards

Random things from posters Flashcards

1
Q

When shouldnt you give beta blockers

A

asthma, heart block/failure, hypotension, bradyarrythmias

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2
Q

What does hereditary spherocytosis cause

A

RBC membrane defects in haemolytic anaemia

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3
Q

What does Glucose-6-phosphate dehydrogenase deficiency cause

A

Enzyme defects in haemolytic anaemia

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4
Q

What do thalassaemias and sickle cell cause

A

Haemoglobinopathies in haemolytic anaemia

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5
Q

What is poikilocytosis

A

Variation in RBC shape

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6
Q

What is anisocytosis

A

Variation in RBC size

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7
Q

What mutation is present in polycythaemia rubra vera

A

JAK 2

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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

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9
Q

What is charcots triad and what does it suggest

A

worsening right upper quadrant pain, jaundice and fever. Cholangitis

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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.

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11
Q

Which murmurs are loudest on expiration

A

Mitral Regurgitation, Aortic Stenosis and Mitral Valve Prolapse

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12
Q

What are the features of mitral regurg murmur

A

low pitched, pan-systolic murmur, loudest in expiration, radiates to the axilla

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13
Q

Which type of anaemia is peripheral neuropathy associated with

A

B12 deficiency (macro)

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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)

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15
Q

Whats the MI sign where the patient has their hand over their chest called

A

Levines sign

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16
Q

What is Beck’s triad

A

Signs of cardiac tamponade. Hypotension, muffled heart sounds and increased jugular venous distension (JVD)

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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.

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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.

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19
Q

For what disease is Pirfenidone used

A

IPF, it is an antifibrotic which inhibits TGF-B

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20
Q

What is the pulse like in aortic stenosis

A

Slow rising pulse

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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

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22
Q

What is the first investigation in PE

A

CT pulmonary angiogram

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23
Q

Investigation if suspect angina

A

Exercise stress test

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24
Q

What does this suggest: worsening fatigue, dizziness and dark stools (malaena)

A

Upper GI bleed

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25
Q

What is the pulse like in sepsis and hypercapnia

A

bounding

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26
Q

What is the pulse like in aortic regurgitation

A

collapsing

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27
Q

What is the pulse like in AF

A

Irregularly irregular

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28
Q

What is pulsus paradoxus

A

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

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29
Q

What is grey turners sign

A

The bruising on the flanks which occurs due to retroperitoneal haemorrhage in acute pancreatitis

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30
Q

What does brugada show on ECG

A

Coved ST in V1-V3 followed by inverted T

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31
Q

What channel is affected in brugada

A

Sodium

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32
Q

What features make a brugada diagnosis more likely

A

Young male, family early death, nocturnal agonal respiration

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33
Q

What causes superior vena cava syndrome

A

Small cell carcinoma

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34
Q

Most common presenting complaint in lung cancer

A

Cough

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35
Q

Name a tyrosine kinase inhibitor and what is it used for

A

Imatinib, used for CML

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36
Q

What are the signs of normal cardiac axis

A

Lead II has the most positive deflection compared to Leads I and III

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37
Q

What are the signs of left axis deviation

A

Lead I has the most positive deflection
Leads II and III are negative
Left axis deviation is seen in individuals with heart conduction defects

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38
Q

What are the signs of right axis deviation

A

Lead III has the most positive deflection and Lead I should be negative
This is commonly seen in individuals with right ventricular hypertrophy

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39
Q

What causes osteogenesis imperfecta

A

an autosomal dominant mutation that impairs the synthesis of type 1 collagen

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40
Q

When is the LH surge in the menstrual cycle

A

Day 12

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41
Q

What is vitiligo

A

localised loss of skin pigmentation due to the autoimmune destruction of melanocytes

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42
Q

Signs of IgA neuropathy

A

upper respiratory tract infection, gross haematuria, flank pain and red blood cells casts

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43
Q

Drugs which cause hyperkalaemia

A

ACE-I, NSAIDs, BB, Warfarin

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44
Q

Which drugs should you stop in AKI

A

ACE-I

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45
Q

What the signs of idiopathic premature ventricular contractions

A

extra-beats or palpitations, often exacerbated by caffeine or alcohol and are more evident during the nigh

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46
Q

First line african/ over 55

A

CCB; Amlodipine

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47
Q

Which leads provide a lateral view of the heart

A

I, aVL, V5 and V6

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48
Q

Describe vasovagal syncope

A

The event occurred after a postural change, was preceded by nausea and resolved rapidly with no intervention or residual neurological deficits

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49
Q

What is the distinctive sign of Myasthenia Gravis

A

Muscle fatigueability

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50
Q

What condition is associated with VSD

A

Foetal alcohol syndrome

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51
Q

What condition is associated with PDA

A

Congenital rubella

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52
Q

What condition is associated with ASD

A

Downs

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53
Q

What condition is associated with transposition of the great vessels

A

Maternal diabetes

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54
Q

Most common left axis deviation cause

A

Left anterior fasciculator block

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55
Q

Most common right axis deviation cause

A

Right ventricular hypertrophy

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56
Q

Where does pulmomary stenosis murmur radiate

A

Shoulder

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57
Q

Where does mitral regurg murmur radiate

A

Axilla

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58
Q

Loudest on inspiration murmurs

A

RHS; Pulmonary and tricuspid

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59
Q

Loudest on expiration murmurs

A

LHS; Aortic and mitral

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60
Q

Criteria for long term oxygen therapy

A

<55 when clinically stable or <60 and evidence of organ failure eg pulmonary HTN, RH Failure and polycythaemia

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61
Q

Which region of the heart is looked at with II, III and aVF

A

Inferior

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62
Q

Hypokalaemia ECG changes

A

tall/peaked P waves, T-wave flattening, supraventricular/ventricular ectopics and supraventricular tachyarrhythmias.

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63
Q

Hypercalcaemia ECG changes

A

typically features shortening of the QT interval and Osborn (J) waves on the ECG

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64
Q

Hyperkalaemia ECG changes

A

tall tented T waves, flattened P waves and broad QRS complexes

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65
Q

Hypocalcaemia ECG changes

A

Prolonged QT interval

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66
Q

Who gets SLE

A

Young girls

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67
Q

Osteopetrosis

A

Poor osteoclast function due to a carbonic anhydrase II mutation

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68
Q

Reactive arthritis skin sign

A

Keratoderma blennorrhagica on the feet

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69
Q

Which medications increase the change of gout

A

Loop and thiazide diuretics

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70
Q

What type of diuretic is Indapamide

A

Thiazide like diuretic

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71
Q

insidious onset of bleeding and bruising, in addition to the low platelet count and normal coagulation screen suggests

A

Immune thrombocytopenia, requires corticosteroids

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72
Q

Pulseless electrical activity management

A

Chest compressions and adrenaline

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73
Q

What condition is horners syndrome associated with

A

Coarctation of the aorta

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74
Q

What are the symptoms of horners syndrome

A 
Short stature
Ovarian dysgenesis
Lymphatic defects
Cystic hygroma
Webbed neck
Lymphoedema
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75
Q

What is duloxetine

A

Antidepressant, serotonin and noradrenaline reuptake inhibitor

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76
Q

Factors which activate RAAS

A

Reduced renal Na, low blood pressure, hypovolaemia, sympathetic stimulation

77
Q

In which days of the uterine cycle is the menstrual phase with bleeding

A

1-5

78
Q

Polycythaemia rubra vera mutation

A

JAK2

79
Q

Signs of cystic fibrosis in children

A

failure to thrive, recurrent respiratory tract infections, diarrhoea

80
Q

Minimal change disease triad

A

oedema, hypoalbuminaemia and proteinuria

81
Q

Which condition is suggested by normal O2 sats which fall very dramatically on walking

A

Pneumocystis pneumonia, HIV related condition

82
Q

Which two conditions should you suspect HIV in

A

Reccurent shingles and candidiasis

83
Q

Which coreceptor which HIV binds to is on the surface of Tcells, macrophages, monocytes and dendritic cells

A

CCR5

84
Q

Which coreceptor is only present on the surface of Tcells and is often targetted during the chronic HIV stage

A

CXCR4

85
Q

How does a hiatus hernia appear on CXR

A

retrocardiac air-fluid level.

86
Q

What is used to assess the severity of pancreatitis

A

Abbreviated glasgow scoring system, PANCREAS

87
Q

What does PANCREAS stand for for the assessment of pancreatitis

A

PaO2 (low), Age, Neutrophilia, Calcium, Renal function, Enzymes, Albumin, Sugar

88
Q

Vommiting fresh bright red blood suggests

A

Mallory Weiss tear

89
Q

Bruising on the flanks and abdominal region suggests

A

Acute pancreatitis

90
Q

Most common cause of drug induced jaundice

A

Coamoxiclav and flucoxacillin

91
Q

Which blood marker classically rises with upper GI bleeding

A

Urea due to blood breakdown

92
Q

Primary sclerosing cholangitis investigations

A

Ultrasound at first, then MRCP to confirm. Magnetic resonance cholangiopancreatography

93
Q

How does hyperventilation lead to perioral and peripheral paresthesia?

A

Hypocalcaemia

94
Q

Why does hypokalaemia happen with alkalosis

A

H+ dissociates from albumin so calcium binds and free calcium drops

95
Q

Which antiviral is used for Herpes Zoster and encephalitis

A

Aciclovir

96
Q

Neuro problem which is sudden

A

Vascular

97
Q

Neuro problem which is episodic

A

Relaxing, remitting MS

98
Q

Neuro problem with diurnal fatigueability

A

Myasthenia gravis

99
Q

Focal neuro problem which progressively worsens

A

MND

100
Q

What is the antibiotic for Group A B-haemolytic streptococci

A

Benzylpenicillin or clindamycin

101
Q

What is Cryptorchidism

A

Cryptorchidism is the absence of one or both testes from the scrotum

102
Q

What is the most common consequence of the macrophage stage, 4-7days after an MI

A

Myocardial rupture, and therefore. Cardiac tamponade / Shunt through the ventricular wall / Mitral insufficiency

103
Q

RUQ mass

A

mass in the right upper quadrant is likely to represent a distended gallbladder secondary to bile flow obstruction from a malignant pancreatic mass

104
Q

Minimial change disease is nephritic or nephrotic

A

Nephrotic

105
Q

IgA nephropathy is nephritic or nephrotic

A

Nephritic

106
Q

What is asterixis and what is it associated with

A

Flapping tremor, hypercapnia

107
Q

Agar for bordatella pertussis

A

Bordet gengou

108
Q

What is murphys sign and what does it mean

A

When you put hand on bile duct and they breathe in and it hurts. If positive it means acute cholecystitis

109
Q

Radial nerve supplies muscles of flexion or extension

A

Extension (R-ex)

110
Q

Ulnar nerve supplies muscles of flexion or extention

A

Flexion (U-Flex)

111
Q

What is graves disease

A

An autoimmune disease of the thyroid

112
Q

What does bloody diarrhoea + india suggest

A

Entamoeba histolytica

113
Q

What is charcots foot

A

Loss of sensation

114
Q

If there is a peptic ulcer in the pylorus of the stomach which artery will it perforate

A

Gastroduodenal

115
Q

Paracetamol antedote

A

N-acetyl-cysteine

116
Q

What is Kussmauls sign

A

Deep and laboured breaths, a sign of sever diabetic ketoacidosis

117
Q

How does amoxicillin work

A

It inhibits peptidoglycan crosslinking in cell wall formation

118
Q

If you suspect cirrhosis what would be the next step

A

CT abdo

119
Q

If there is a glossopharyngeal nerve lesion which way does the tongue go

A

Towards the problem, lick the lesion

120
Q

Which cancers metastasise to bone

A

Breast, bronchus, bridney, bryroid, brostate

121
Q

3 signs of chronic liver disease

A

Bruising, clubbing, dupuytrens contracture

122
Q

Signs of left ventricular failure

A

Pulmonary crackles, extra heart sounds, displaced apex beat, tachycardia

123
Q

3 endocrine causes of HTN

A

Conns (hyperaldosteronism), Cushings (prolonged cortisol) and Phaeochromocytoma (Nad+Ad)

124
Q

First line treatment for bradycardia with adverse features like syncope and shock

A

IV atropine

125
Q

Superior vena cava syndrome, major cause and treatment

A

SSC of the lung. Elevate the head, corticosteroids and diuretics

126
Q

Ventricular tachycardia and adverse effects

A

Synchronised DC shocks, further treatment would incluse IV amiodarone

127
Q

Where are colostomies positioned

A

Left illiac fossa

128
Q

Where are ileostomies positioned

A

Right illiac fossa

129
Q

Cause of aortic regurg in young children

A

VSD

130
Q

Sign of complete heart block on ECG

A

Complete dissociation between P waves and QRS complexes

131
Q

Recent chemo and fever=

A

Neutropenic sepsis. Give broad spectrum antibiotics

132
Q

What classically rises in upper GI bleeds

A

Urea

133
Q

Describe the pericarditis pain

A

retrosternal, pleuritic (exacerbated on inspiration) and worse when lying flat

134
Q

tall tented T waves, flattened P waves and broad QRS complexes

A

Hyperkalaemia

135
Q

Skin abscess organism

A

Staph aureus

136
Q

Pneumonia organsims

A

S.aureus, klebsiella pneumonia, anaerobic bacteria, mycobacterium tuberculosis

137
Q

Liver abscess organisms

A

Gram negative (E.Coli), strep milleri, anaerobes (bacteriodes fragilis), entamoeba histolytica in tropics

138
Q

Kidney abscess organisms

A

E coli, klebsiella

139
Q

Bowel abscess organisms

A

Gram negative (Ecoli), strep milleri and anaerobes (bacteriodes fragilis)

140
Q

Target BP in people under 80

A

140/90

141
Q

Target BP in people over 80

A

150/90

142
Q

Side effects of CCB

A

-ve chronotrope: bradycardia, AV block -ve ionotrope: worsening CF

143
Q

What is doxazosin

A

Alpha one antagonist

144
Q

Two major causes of regurgitiation

A

Rheumatic fever and infective endocarditis

145
Q

Cause of mitral regurg

A

Myoxomatous degeneration, ischaemia, rheumatic heart disease and infective endocarditis

146
Q

aortic stenosis triad of symptoms

A

Exertional syncope, exertional dyspnoea and angina

147
Q

Aortic stenosis initial investigation

A

Echocardiography

148
Q

Pulse in aortic stenosis

A

Slow rising carotid pulse, reduced pulse amplitude

149
Q

What shape is the ejection murmur in aortic stenosis

A

Rhomboid

150
Q

Indications for valve replacement in aortic stenosis

A

Symptomatic, LVEF decreasing

151
Q

Signs of mitral regurg

A

Soft 1st HS, 3rd HS, pansystolic murmur

152
Q

Investigations for suspected mitral regurg

A

Echo, ECG, Cxr

153
Q

Treatment for mitral regurg

A

Rate control and anticoagulation for AF, diuretics for fluid, IE prophylaxis, surgery if symptomatic

154
Q

When should you suspect Spondyloarthropathies

A

Inflammatory back pain, assymetrical large joint arthritis, skin psoriasis, IBD and inflammatory eye disease

155
Q

What is enteropathic arthritis

A

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
Q

Signs of Mobitz type 1, second degree heart block

A

PR increasing the QRS dropped.

157
Q

Mutation in Polycythaemic rubra vera

A

JAK2

158
Q

Which part of the HIV virus binds to receptors

A

GP160

159
Q

Which enzyme converts viral RNA into DNA

A

Reverse transcriptase

160
Q

Which enzyme encorporates Viral DNA into the Cellular DNA

A

Integrase

161
Q

Complication of having a pacemaker fitted

A

Pneumothorax

162
Q

Organism causing croup

A

Parainfluenza Virus 1

163
Q

Most common cause of right sided heart failure

A

Left sided heart failure

164
Q

What is quinckes sign

A

Pulsations visible in the nail bed with each heartbeat upon light compression of the nail bed

165
Q

Collapsing pulse

A

a sudden, abrupt drop in the pressure on the arterial wall after systole

166
Q

Corrigan’s sign

A

visible distention and collapse of the carotid arteries in the neck

167
Q

De Musset’s sign:

A

Head bobbing with each heartbeat

168
Q

Most common mitral regurg cause

A

Rheumatic fever

169
Q

Cullens sign

A

periumbilical oedema and bruising suggestive of retroperitoneal bleeding

170
Q

Grey-turners sign

A

bruising on the flanks bilaterally suggestive of retroperitoneal bleeding.

171
Q

Mcburneys sign

A

deep tenderness over McBurney’s point (1/3 between the anterior superior iliac spine to the umbilicus) suggestive of acute appendicitis

172
Q

Rovsings sign

A

palpation of the left lower quadrant causes pain in the right lower quadrant, suggestive of acute appendicitis

173
Q

Sudden death of young athletes, heart cause

A

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
Q

How does hypertension lead to paraesthesia

A

Alkalosis leads to hypocalcaemia

175
Q

Charcots triad for cholangitis

A

worsening right upper quadrant pain, jaundice and fever

176
Q

Paraneoplastic syndrome from lung SCC

A

Parathyroid hormone related peptide is high and phosphorus is low

177
Q

Rockall risk scoring system

A

attempts to identify patients at risk of adverse outcome following acute upper gastrointestinal bleeding

178
Q

Minimal change syndrome

A

oedema, hypoalbuminaemia and proteinuria

179
Q

What does a short PR interval suggest

A

Wolff-parkinson-white syndrome. An abnormal pathway between the atria and ventricles

180
Q

CHA2DS2–VASc Score

A

is used to predict the probability of a stroke or thromboembolic event with atrial fibrillation

181
Q

ABCD² Score

A

Estimates the chance of a stroke following a suspected TIA

182
Q

Wells score

A

Predicts the probability of a patient suffering a DVT or PE

183
Q

TIMI

A

Estimates the probability of mortality in a patient with unstable angina or an NSTEM

184
Q

QRISK2 score

A

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
Q

The ECG shows a slurred upstroke of the QRS complex (known as a Delta wave).

A

Wolff parkinson white syndrome

186
Q

Turner’s syndrome

A

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
Q

PR interval is fixed but there are dropped beats

A

MOBITZ TYPE 2 SECOND DEGREE HEART BLOCK

188
Q

Bradycardia and adverse effects treatment

A

IV Atropine

189
Q

Takotsubu cardiomyopathy

A

Stress cardiomyopathy

phase 2 (17 decks)

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