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Revision Questions Flashcards

1
Q

What drug is used to treat gout and what class of drug is it?

A

Allopurinol - Xanthine oxidase inhibitor

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2
Q

How does SLE present?

A

Discoid rash, oral ulcers, photosensitivity, arthritis, anti-dsDNA

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3
Q

How is rheumatoid arthritis diagnosed?

A

Anaemia, raised CRP/ESR, platelets
Rheumatoid factor
Anti-CCP +ve (anti-cyclic citrullinated peptide), ANA +ve (antinuclear antibodies)
X-ray: soft tissue swelling, reduced joint space, bony erosions
USS/MRI synovitis

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4
Q

What does rituximab inhibit?

A

CD 20 receptors on the surface of activated B cells

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5
Q

What does toclizumab inhibit?

A

IL-6

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6
Q

What does infliximab inhibit?

A

TNF-alpha

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7
Q

What organisms can cause UTIs?

A

E.coli, Klebsiella, S.aureus, Enterococcus

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8
Q

What drug is used to treat uncomplicated lower tract UTIs?

A

Trimethoprim

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9
Q

What drug is used to treat uncomplicated upper tract UTIs?

A

Co-amoxiclav (broad spectrum antibiotics)

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10
Q

What hormone is tested for in the diagnosis of testicular carcinoma?

A

betahCG (human chorionic gonadotrophin)

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11
Q

How are renal stones diagnosed and managed?

A

Urine dipstick: haematuria
KUBXR
NCCTKUB (non-contrast computerised tomography)
IV diclofenac for pain, cefuroxime, medical expulsion therapy, percutaneous nephrolithotomy

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12
Q

What are some differentials for renal colic?

A

Ruptured AAA, diverticulitis, appendicitis, testicular torsion

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13
Q

How can renal stones be prevented?

A

Drink 2-3L/day water, diet low in sodium, fat and protein, reduce oxalate rich food
Recurrent calcium stones/ hypercalciuria - thiazide diuretic

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14
Q

What are the 3 cardinal signs of nephritic syndrome?

A

Hypertension, haematuria, proteinuria

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15
Q

What are the 3 cardinal signs of nephrotic syndrome?

A

Proteinuria, oedema, hypoalbuminaemia

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16
Q

What 3 criteria are used to diagnose AKI?

A

Creatinine rise >26micromol/L in 48 hrs
Creatinine rise >50% in 7 days
Urine output <0.5ml/kg/hr for >6 hrs

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17
Q

What are the risk factors for AKI?

A

Sepsis, >75, diabetes, cardiac failure

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18
Q

What are the symptoms of AKI?

A

Oliguria, nausea, vomiting, confusion, increased heart rate

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19
Q

How does hyperkalaemia present on an ECG?

A

Tall T waves, small P waves, prolonged QRS

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20
Q

How is AKI diagnosed?

A

Bloods: serum creatinine
NCCT-KUB
Urinalysis: infective organisms

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21
Q

How is AKI managed?

A

Stop nephrotoxic drugs

IV fluid, abx for sepsis

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22
Q

How is non-urgent and acute hyperkalaemia (medical emergency) managed?

A

Non-urgent - polystyrene sulphonate resin = binds K+ in gut, decreasing uptake

Acute:
Calcium gluconate = decreases VFib risk in heart
Insulin + dextrose = drives K+ into cells
Salbutamol nebulised
Calcium resonium

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23
Q

How is CKD diagnosed?

A 
Low GFR (<90ml/min/1.73m2), Raised albumin:creatinine ratio, urine dipstick: haematuria/ proteinuria, USS
U+E's: raised urea and creatinine, low calcium, raised PTH, raised phosphate and potassium, raised renin
Renal biopsy
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24
Q

What causes CKD?

A

HTN, diabetic nephropathy, AKI, PKD, NSAIDs

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25
Q

What does GGT stand for and when is it raised?

A

Gamma-glutamyl transpeptidase

Raised in alcoholic liver disease

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26
Q

What does ALP stand for and when is it raised?

A

Alkaline phosphatase

Raised in biliary tree damage or in diseases that cause bone resorption e.g. metastases

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27
Q

What do AST/ALT stand for and when are they raised?

A

Aspartate transaminase/ Alanine aminotransferase

Raised in hepatocyte damage

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28
Q

What drug is used to treat chronic Hep B?

A

Pegylated interferon-alpha 2a (stimulates immune response)

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29
Q

What drug is used to treat chronic Hep C?

A

Antivirals - ribavirin

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30
Q

What drug helps remove excess iron in haemochromatosis and beta thalassaemia major?

A

Desferrioxamine

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31
Q

What is the pathophysiology behind portal hypertension?

A

Endothelin-1 production is increased in cirrhosis which increases vasoconstriction.
NO production decreases in cirrhosis which decreases vasodilation.
There is now a reduced radius, increasing the resistance and leading to a higher portal pressure in the portal system

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32
Q

What are the causes of portal hypertension?

A

Pre-hepatic: Portal vein thrombosis
Intra-hepatic: Sarcoidosis, primary biliary cirrhosis, Budd-Chiari syndrome, cirrhosis
Post-hepatic: constrictive pericarditis, IVC obstruction, RHF

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33
Q

What is the treatment for oesophageal varices?

A

Beta-blockers - reduce CO, reduce portal pressure
Nitrates reduce portal pressure
Terlipressin - reduce portal pressure
Surgical: Endoscopic banding

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34
Q

What are some causes of ascites due to transudate?

A

Cirrhosis, portal vein thrombosis, constrictive pericarditis, Budd-Chiari syndrome

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35
Q

What are some causes of ascites due to exudate?

A

Inflammation (increased vascular permeability), malignancy, infections, pancreatitis

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36
Q

What is the treatment of spontaneous bacterial peritonitis (complication of ascites with cirrhosis)?

A

Cefotaxime

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37
Q

What is the tumour marker?

A

Raised AFP - alpha-fetoprotein

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38
Q

What antibody is tested for primary biliary cirrhosis?

A

Anti-mitochondrial antibody

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39
Q

What antibody is tested for primary sclerosing cholangitis?

A

Anti-nuclear cytoplasmic antibodies

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40
Q

What are the features of Charcot’s Triad and Reynold’s pentad?

A

Charcot’s - fever, RUQ pain, jaundice
Reynold’s - hypotension, confusion
Presentation of Ascending cholangitis

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41
Q

What are the signs of late stage acute pancreatitis?

A

Grey-Turner’s sign - bruising flanks

Cullen’s sign - bruising around umbilicus

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42
Q

What score is used to measure the severity of LUTS?

A

International prostate scoring system

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43
Q

What are the macroscopic signs of Crohn’s disease?

A

Thickened and narrowed bowel, cobblestone appearance, deep ulcers in the mucosa, skip lesions, fistulae

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44
Q

How would a lumbar puncture CSF sample appear a.) 2 hours b.) 15 hours after a subdural haematoma?

A

a.) bloody b.) xanthochromic (yellow)

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45
Q

What chromosome is the causative mutation for Huntington’s found on and what is the trinucleotide repeat?

A

Chromosome 4

CAG

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46
Q

What is the term used to describe when an inherited disorder appears earlier in each generation?

A

Anticipation

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47
Q

What are the signs of a life-threatening asthma attack?

A

Exhaustion, bradycardia, peak flow <33%, silent chest, cyanosis, PaO2 <8kPa, severe SOB, low oxygen sats, audible wheeze, tachypnoea

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48
Q

What is the gold standard diagnostic test for DVT/ PE?

A

CT pulmonary angiography

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49
Q

Name one thing you’d see on an ECG of someone with a PE?

A

Sinus tachycardia

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50
Q

What are the causative organisms of reactive arthritis?

A

Campylobacter, shigella, salmonella

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51
Q

What drugs can cause hyperuricaemia?

A

Thiazide diuretics, NSAIDs (many more)

e.g. bendroflumethiazide, furosemide, aspirin

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52
Q

What is the diagnostic blood test for heart failure?

A

Brain natriuretic peptide

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53
Q

What are the radiographic signs of heart failure?

A

Alveolar oedema, Kerley B lines, Cardiomegaly, Dilated upper lobe vessels, pleural Effusion
(ABCDE)

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54
Q

What murmur would be heard in aortic stenosis and where would you hear it?

A

Ejection systolic murmur

Right sternal edge, 2nd intercostal space

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55
Q

What are the side effects of long term steroid use?

A

Weight gain, osteoporosis, immunosuppression, oedema, effects growth, hypokalaemia, hypertension

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56
Q

Name an example of a proton pump inhibitor

A

Omeprazole

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57
Q

What antibodies are tested for in coeliac’s disease?

A

IgA Tissue transglutaminase, IgA Anti-Endomysial

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58
Q

What is tumour lysis syndrome and how is it managed?

A

Complication of cancer treatment - large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream.
Replacement of electrolyte balance and IV fluids

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59
Q

What are the 2 diagnostic features of febrile neutropenia?

A

Temp >38C, absolute neutrophil count <1

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60
Q

What is Kernig’s sign and what condition is it a sign for?

A

Not being able to extend the knee when hip is flexed at 90degrees
Meningitis

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61
Q

What diagnostic tests would you do for a patient you suspect has meningitis?

A

Lumbar puncture, FBC, WBC count, GCS, Head CT, Throat swabs, Pneumococcal and Meningococcal PCR

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62
Q

How do you treat bacterial meningitis?

A

Urgent antibiotics, IV cefotaxime, consider amoxillicin if immunocompromised (listeria cover)

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63
Q

What are the features of Parkinson’s?

A

Shuffling gait, resting tremor, bradykinesia, increased tone, stooped posture, decreased arm swing

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64
Q

What specific part of the brain does Parkinson’s affect and which neurotransmitter?

A

Loss of dopamine in the substantia nigra of the pars compacta

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65
Q

What are the red flag symptoms for headaches?

A

New headache with Hx of cancer, cluster headache, seizure, altered consciousness/memory/ confusion, papilloedema

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66
Q

What drug decreases ICP?

A

MANNITOL

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67
Q

What are the complications of DM separated into microvascular/ macrovascular?

A

Micro - retinopathy, neuropathy

Macro - CVD, cerebrovascular disease, peripheral artery disease

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68
Q

What thyroid autoantibodies are tested for in hyperthyroidism?

A

Thyroglobulin and anti-thyroid peroxidase antibodies

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69
Q

How is hyperthyroidism treated?

A

Carbimazole, beta blockers e.g. propranolol, radioiodine therapy, thyroidectomy

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70
Q

What are the side effects fo ACEi?

A

Dry cough, headache, diarrhoea

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71
Q

How do STEMIs present on an ECG over a few hours then a few days?

A

Hours: Tall T waves, ST elevation
Days: T wave inversion, pathological Q waves

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72
Q

What are the 3 cardinal symptoms of heart failure?

A

SOB
Fatigue
Peripheral oedema

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73
Q

What condition is characterised with a concave-upwards (saddle-shaped) ST elevation?

A

Pericarditis

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74
Q

How does atrial fibrillation present on an ECG?

A

F waves, no P waves, QRS irregularly irregular

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75
Q

What are the clinical features of aortic dissection?

A 
Sudden tearing chest pain, may radiate to the back
Unequal arm pulses and BP
Acute limb ischaemia
Paraplegia
Anuria
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76
Q

What are the 4 stages of chronic limb ischaemia?

A
  1. Asymptomatic
  2. Intermittent claudication
  3. Rest pain/ nocturnal pain
  4. Necrosis/ gangrene
77
Q

What are the secondary causes of hypertension?

A

CKD, PKD, renal artery stenosis, Cushing’s, Conn’s, coarctation of the aorta, pregnancy, COCP

78
Q

What are the complications of aneurysms?

A

Rupture, thrombosis, embolism, excess pressure on other structures

79
Q

What are the radiographic signs of pulmonary hypertension?

A

Enlargement of the pulmonary arteries, lucent lung fields, enlarged right atrium, elevated cardiac apex due to right ventricular hypertrophy

80
Q

What are the side effects of chemo?

A

Alopecia, nausea and vomiting, peripheral neuropathy, constipation/diarrhoea, mucositis, rash, bone marrow suppression (anaemia, fatigue, anaphylaxis)

81
Q

What are the causes of pleural effusion consisting of exudate?

A

Malignancy, infection, inflammation - SLE, PE, traumatic, drug reaction

82
Q

What stain is used for Mycobacterium tuberculosis and what is it grown on?

A

Ziehl-Neelsen stain

Lowenstein-Jensen culture

83
Q

What is the action of salbutamol?

A

Binds to beta-2 adrenoreceptors present In the lungs leading to smooth muscle relaxation and therefore bronchodilation

84
Q

What tests are done to diagnose cystic fibrosis?

A

Sweat test, genetics, faecal elastase

85
Q

What drug would you use to treat a UTI on a pregnant patient?

A

Nitrofurantoin

86
Q

How does the catalase test work?

A

A small amount of the bacteria is added to hydrogen peroxide, if bubbles of oxygen are observed = catalase positive

87
Q

What drug would you give to a patient with a morphine overdose?

88
Q

Where are venous ulcers most likely to occur?

A

Medial gaiter region

89
Q

What is the result of a random plasma glucose test for a type 2 diabetic?

A

> 11mmol/L

90
Q

How does metformin work?

A

It increases the cell sensitivity to insulin

91
Q

What drug is used to treat eczema?

A

Tacrolimus

Emollient creams to hydrate

92
Q

Name some ‘risk score’ calculating theories and what they are for

A 
Kilip - acute MI
Fontaine - Peripheral vascular disease
Wells score - DVT
Qrisk2 - CV event in next 10 years
CHADS2VASc - stroke with AF
93
Q

When is methotrexate contraindicated and why?

A

Pregnancy - folate antagonist - can cause macrocytic anaemia

94
Q

How would psuedogout appear under polarised light microscopy?

A

Weakly positive birefringent rhomboid crystals

Gout = -ve needle crystals

95
Q

What is Lhermitte’s sign and what is it a sign of?

A

A sudden, brief, buzzing sensation like an electric shock that moves down your neck into your spine
MS

96
Q

What are the 3 physiological changes that occur in asthma?

A

Inflammation of the mucosa
Bronchoconstriction
Increased mucous secretion

97
Q

What is the mechanism of action of prednisolone?

A

Up-regulate anti-inflammatory genes and down regulate pro-inflammatory genes

98
Q

What are the contraindications for thrombolysis?

A

Haemorrhage, intracranial bleeds, onset of symptoms over 4.5 Hours ago, time of onset unknown, heparin, BP >185/110, peptic ulcer, low platelets, recent stroke, recent trauma, aneurysms, clotting disorders

99
Q

What are the signs in the hand for RA?

A

Hot, swollen joints

Swan neck deformity, Z thumbs, ulnar deviation, muscle weakness, Boutonniere deformity

100
Q

What are the extra-articular effects of RA?

A

Vasculitis, pulmonary fibrosis, pericarditis, pericardial effusion, lymphadenopathy, neuropathy, anemia

101
Q

Name some differentials for fatigue

A

Cancer, hypothyroid, diabetes, depression, coeliac disease, chronic fatigue syndrome, anaemia, anxiety, restless leg syndrome, infection, pregnancy

102
Q

Give 2 examples of drugs and their classes that can be used to treat GORD

A

PPI - omeprazole

Histamine 2 receptor antagonist - Ranitidine

103
Q

What would be seen on an X-ray of someone with TB?

A

Consolidation of upper lobe, pleural effusion, cavitation, hilarity lymphadenopathy

104
Q

What test is used to detect latent TB?

A

Mantoux (t4 HS reaction) / Quantiferon test

105
Q

What are the side effects of the TB drugs?

A

Rifampicin - red urine
Isoniazid - Peripheral neuropathy
Pyrazinamide - arthralgia
Ethambutol - optic neuritis

106
Q

What are the side effects of sodium valproate?

A

Cognitive disturbance, heart disease

107
Q

What are the differences between epileptic and non-epileptic seizures?

A

Epileptic - eyes open, incontinence, tongue biting

Non-epileptic - hip thrusting, last longer

108
Q

What drugs are used to treat breast cancer?

A

Pre-menopause: Tamoxifen

Post-menopause: Anastrozole

109
Q

What is a monoclonal paraprotein?

A

One immunoglobulin which is excessively produced

110
Q

What makes LABAs longer acting in the tissues than SABAs?

A

They are lipophilic

111
Q

How does an epidural haemorrhage appear on a CT scan?

A

Midline shift, adjacent to skull, hyper dense (white) haematoma, biconvex (lemon-shaped)

112
Q

What can happen if beta-2-agonists are used at high conc in badly controlled asthma?

A

B2-receptor desensitisation

113
Q

What are the characteristic heart sounds of mitral stenosis?

A

Diastolic murmur, loud opening S1 snap

114
Q

Why is acne more common during puberty?

A

Androgen and progesterone production is increased so sebum production is increased

115
Q

What is the 1st line treatment for acne?

A

Keratolytics - benzyl perozide

Topical erythromycin

116
Q

What is the first line treatment for cellulitis?

A

Flucloxacillin

117
Q

What is the treatment for psoriasis?

A

1st line - Emollient creams

2nd line - Topical calcipotriol

118
Q

What is necrotising fasciitis?

A

Rapid deep fascia infection = necrosis of subcutaneous tissue
Pain, erythema, systemic toxicity

119
Q

What is the first line treatment for necrotising fasciitis?

A

Benzylpenicillin and surgical debridement

120
Q

What CD4 cell count is diagnostic of AIDS?

121
Q

What is a common AIDS defining illness and why is it not normally found in other people?

A

Pneumocystis pneumonia

Opportunistic pathogen - can only can cause disease in those that are immunocompromised

122
Q

What are the treatments for hyper/hypoparathyroidism?

A

Hyper - Treat cause, bisphosphonates (alendronic acid)

Hypo - Calcium supplements, calcitriol, synthetic PTH

123
Q

What is the first line treatment for type 2 diabetes?

A

Lifestyle advice

124
Q

What is the first medication you would prescribe to a T2DM patient, what is its action and side effects?

A

Metformin - increases insulin sensitivity

SE: nausea, weight loss, diarrhoea

125
Q

What is the dual therapy for T2DM and what HbA1c would you start it on?

A

HbA1c >53mmol/mol
Metformin + DDP4 inhibitor e.g. Sitagliptin
OR
Metformin + sulphonylurea e.g. Gliclazide

126
Q

What is the action of DDP4 inhibitors?

A

Stimulate insulin secretion

127
Q

What is the action of sulfonylurea?

A

Stimulates B cells to secrete insulin

128
Q

What is the triple therapy for T2DM and what HbA1c would you start it on?

A

HbA1c >58mmol/mol
Metformin + DDP4 inhibitor e.g. Sitagliptan + sulfonylurea e.g. Gliclazide
Insulin based therapy is last resort

129
Q

What are 3 diabetic emergencies and how would each present?

A

DKA - insufficient insulin - fruity breath, dehydration, Kussmaul breathing
Hypo - too much insulin - aggression, sweating, seizures
HHS - hyperglycaemia - signs of dehydration

130
Q

What is the diagnostic test for adrenal insufficiency?

A

Short ACTH stimulation test: give ACTH, measure cortisol - levels should remain low if AI

131
Q

What is Eisenmenger’s complex?

A

ASD - shunt reversed due to development of pulmonary hypertension = cyanosis and organ damage

132
Q

What abnormal heart sounds would you hear in a ventricular septal defect or coarctation of the aorta?

A

VSD: pan-systolic murmur. Smaller the hole = louder the murmur
CoA: Systolic murmur over left scapula (scapular bruit)

133
Q

What is the gold standard diagnostic test for angina?

A

CT angiography - shows luminal narrowing

134
Q

What are the SIGNS of an MI?

A

Clammy and pale, 4th heart sound, pan systolic murmur, may later develop pulmonary oedema

135
Q

Give some differentials of Chest pain

A

ACS, pericarditis, pneumonia, PE, rib fracture, chest trauma, GORD, anxiety/panic attack

136
Q

What is the EF for diastolic and systolic heart failure and what can cause each?

A

Diastolic - EF >50%, constrictive pericarditis, hypertension, cardiac tamponade
Systolic - EF <40%, IHD, MI, CM

137
Q

What are the compensatory changes that occur in heart failure?

A

Sympathetic stimulation: Peripheral vasoconstriction causing increased after load
RAAS: salt and water retention. Increased afterload and preload
Ventricular dilatation, myocyte hypertrophy

138
Q

What is the treatment for acute heart failure?

A

100% O2, nitrates - GTN spray, IV opiates - diamorphine, IV furosemide (loop diuretics), consider inotropic drug

139
Q

What is the treatment for chronic heart failure?

A 
ABCD
ACEi e.g. ramipril / ARB e.g candesartan
Beta blockers e.g. atenolol
CCB e.g. amlodipine
Diuretics and digoxin
140
Q

What would an ECG of atrial fibrillation look like?

A

Irregularly irregular (pulse), no clear P waves, F waves, rapid and irregular QRS

141
Q

What murmur would be heard in aortic stenosis?

A

Ejection-systolic, crescendo-decrescendo character

142
Q

What are the 4 types of shock and their causes?

A

Septic - infection with any organism - acute vasodilation from inflammatory cytokines
Anaphylactic - Type-1 IgE mediated hypersensitivity, release of histamine
Neurogenic - spinal cord injury, epidural, spinal anaesthesia
Hypovolaemic - bleeding, trauma, ruptured aortic aneurysm, GI bleed

143
Q

What are the signs of septic shock?

A

Temp >38C/ <36C
Tachycardia
Resp rate >20per min
WBC > 12x10^9/L

144
Q

What would be heard through a stethoscope on a patient with acute pericarditis?

A

Pericardial friction rub (scratching sound)

145
Q

What would spirometry of a COPD patient show?

A

FEV1/FVC <70, normal FVC, FEV1 < 80

146
Q

What is screened for in a cystic fibrosis screening?

A

Immunoreactive trypsinogen

147
Q

What are the complications of lung cancer?

A

SVC obstruction, Addison’s disease, bone pain, recurrent laryngeal nerve palsy

148
Q

What would pleural effusion sound like when percussed?

A

Stony dull percussion

149
Q

Where would you do a needle aspiration or a chest drain tube?

A

Needle aspiration - 2nd intercostal space, midclav line

Chest drain tube - 4-6th intercostal space midaxil line

150
Q

What is an example of a mucolytic?

A

Dornase alfa

151
Q

How is a life threatening asthma attack managed?

A 
OSHIT
Oxygen to 94-98%
Salbutamol (neb 5mg)
Hydrocortisone IV
Ipratropium 0.5mg/6h to nebulisers
Theophylline IV
152
Q

What drug is used to treat diarrhoea?

A

Loperamide

153
Q

How is Crohn’s managed?

A

Oral corticosteroids, IV hydrocortisone in severe flare ups
Add anti-TNF antibodies if no improvement (infliximab)
If frequent exacerbations - methotrexate to stay in remission

154
Q

What antibody is tested for in ulcerative colitis?

A

pANCA - perinuclear anti-neutrophil cytoplasmic antibodies

155
Q

What drugs can be used for the symptoms of IBS?

A

Pain/bloating - buscopan
Constipation - laxative e.g. Senna
Diarrhoea - loperamide

156
Q

What causes peritonitis?

A

AEIOU

Appendicitis, ectopic pregnancy, infection with TB, Obstruction, Ulcer

157
Q

How is pancreatitis diagnosed?

A

High amylase, high lipase, CT chest/abdo

AXR shows no psoas shadow

158
Q

What chromosomes are BRCA1 and BRCA2 found on?

A

1 - Chromosome 17
2- Chromosome 13
Tumour suppressor genes

159
Q

How does breast cancer present?

A

Axillary lump, breast lump with/without pain, nipple changes of concern e.g. discharge and retraction, skin changes e.g. tethering

Mets - bone pain, jaundice, SOB, headache

160
Q

What dose of paracetamol can be fatal for the average adult and the malnourished?

A

Adult - 150mg/kg

Malnourished - 75mg/kg

161
Q

What is the treatment for paracetamol overdose?

A

IV N-acetylcysteine

162
Q

What is the characteristic feature of amyloidosis and how is it treated?

A 
Periorbital purpura (really bad black eyes)
IV melphalan
163
Q

How do you treat reactive arthritis?

A

No cure. Splint joints
NSAIDs, local steroid injections
Methotrexate if >6months

164
Q

Give 2 examples of drugs and their classes that can be used to treat BPH?

A

Alpha blocker - tamsulosin

5-alpha-reductase inhibitor - finasteride

165
Q

Give 3 side effects of NSAIDs

A

Diarrhoea, dizziness, nausea

166
Q

Give 3 side effects of bisphosphonates

A

Alopecia, anaemia, constipation, headache

167
Q

Give 3 side effects of methotrexate

A

Fever, anaemia, fatigue, diarrhoea

168
Q

Give 3 side effects of hydroxychloroquine

A

Abdo pain, diarrhoea, headache

169
Q

What are the complications of bronchiectasis?

A

Amyloidosis, pneumothorax, pulmonary hypertension and RVF

170
Q

What are the differentials for a wheeze?

A

Asthma, COPD, Bronchiectasis, Cystic fibrosis

171
Q

What are the differentials for haemopytsis?

A

Bronchiectasis, lung cancer, pneumonia, Goodpasture’s syndrome, Wegener’s granulomatosis

172
Q

What are the differentials for a cough?

A

COPD, asthma, bronchiectasis, cystic fibrosis, lung cancer, TB, pneumonia, pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, Wegener’s granulomatosis

173
Q

What is Post-ictal Todd’s Palsy?

A

Paralysis of the limbs involved in a seizure for several hours

174
Q

What is the treatment for Parkinson’s?

A

1st line - Dopamine receptor agonists - ropinirole
2nd line - monoamine oxidase-B inhibitor - Selegiline
Co-careldopa (L-dopa) late - causes dyskinesias
Amantadine - anticholinergic drug to manage tremors

175
Q

How is Huntington’s treated?

A

Chorea and aggression - antipsychotics - risperidone

Depression - selective serotonin reuptake inhibitors (SSRI) - sertraline

176
Q

What are the causes of tension headaches?

A

MC SCOLD - missed meals, conflict, stress, clenched jaw, overexertion, lack of sleep, depression

177
Q

What is the 1st line treatment for MS?

A

Beta interferon and glatiramer acetate

Acute attacks: IV methylprednisolone

178
Q

What is the treatment for myasthenia graves?

A

Acetylcholinesterase inhibitor - Pyridostigmine

179
Q

What is sciatica?

A

L5/S1 nerve lesion - S1 nerve root compression

Sensory loss/pain down back of leg

180
Q

How does clopidogrel work (anti-platelet)?

A

Inhibits P2Y12 ADP receptor on platelets

181
Q

How do statins work (e.g. simvastatin)?

A

Inhibit HMG CoA, reducing cholesterol synthesis

182
Q

How is peripheral artery disease diagnosed?

A

CT angiography - stenosis, Ankle-brachial pressure index, colour duplex USS - shows vessels and blood flow

183
Q

What makes up conventional chemotherapy?

A

TI-CE

Topoisomerase, ifosamide, Etoposide, cisplatin

184
Q

Give the treatment for different types of anaemia

A 
Iron def - ferrous sulfate
Chronic dis - erythropoietin to raise Hb
Sidero- pyroxidine, repeat transfusions 
Folate def - folic acid
Pernicious - hydroxocobalamin (vit B12)
Aplastic - bone marrow transplant
185
Q

How is polycythaemia treated?

A

Keep haematocrit <0.45 to decrease risk of thrombosis
Young - venesection
>60 - hydroxycarbamide
Low dose aspirin

186
Q

What monoclonal antibody can be found in urine of a myelomas patient?

A

Bence Jones protein

187
Q

How is malaria treated?

A

Quinine + doxycycline

188
Q

What are the signs of iron deficiency anaemia?

A

Brittle hair and nails, atrophic glossitis, kolionychia, angular stomatitis

189
Q

What is the main side effect of ferrous sulphate?

A 
Black stools
(Also: constipation/ diarrhoea, nausea, upset, epigastric abdo pain)

Phase 2a (16 decks)

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