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Phase 2a SAQ/MEQ > SAQ 2015 > Flashcards

SAQ 2015 Flashcards

1
Q

For suspected iron deficiency anaemia, on top of normal blood tests, what other blood tests should be performed to confirm the Dx?

A

Serum ferritin

Total iron binding capacity?

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2
Q

Why is serum ferritin investigation limited?

A

Ferritin is an acute phase protein (and increases with inflammation e.g. infection, malignancy)

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3
Q

Other tests for iron deficiency anaemia?

other than blood tests

A

c13 breath test for H.pylori
(as used for unexplained iron deficiency anaemia?)

endoscopy to look for GI bleed

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4
Q

potential cause of iron deficiency in pt that comes to GP tired and fatigued

A

Gi bleed e.g. colorectal cancer
Lack of iron in diet
Hookworm?

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5
Q

Drug Tx for iron deficiency anaemia

A

iron supplement
ferrous sulphate?
ferrous fumarate?

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6
Q

Pt presents with aortic regurgitation, what would make you think this was bacterial endocarditis?

A

fever + new murmur

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7
Q

what Ix would confirm bacterial endocardidits for pt with aortic regurgitation?

A

echocardiogram

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8
Q

what are 2 potentially fatal consequences of bacterial endocarditis?

A

embolism, sepsis, congestive heart failure

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9
Q

3 signs of bacterial endocarditis

A

Roth spots, splinter haemorrhages, osler nodes, janeway lesions

FORM JANE

  • fever
  • Osler’s node
  • Roth’s spots
  • Murmur
  • Janeway lesions
  • Anaemia
  • Nail/splinter haemorrhage
  • Emboli
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10
Q

Gram +ve organism, small pink colonies on MacConkey. No haemolysis. What’s the bacteria?

And what other infection does this organism cause?

A

Staph aureus,
Enterococci
Strep Viridans

cellulitis? TSS? osteomyelitis?

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11
Q

Purpose of NHS health checkup

A

secondary prevention - early screening to detect disease at early stage to control RF

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12
Q

For someone seemingly at risk of Cardiovascular disease, apart from BMI and BP, what blood tests should the nurse order?

A

triglycerides? cholesterol? HbA1c? random venous glucose? lipid profile?

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13
Q

name 1 risk calculator you would use to measure CV risk

A

Q-risk

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14
Q

3 modifiable and 3 non-modifiable risks of atherosclerosis

A

mod: sedentary lifestyle, smoking, weight

non-mod: gender, age, family history, familial hypercholesterolaemia

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15
Q

Central chest pain for 20 mins, turns out pt had STEMI, what process has happened in the coronary vessels?

A

rupture of an atherosclerotic plaque forming a thrombus occluding the vessel

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16
Q

name 4 cells found in an atheroma

A

smooth muscle cells, lymphocytes, foam cells, macrophages, endothelial cells? fibroblasts?

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17
Q

what treatment should someone with a STEMI have ASAP?

A

PCI

percutaneous coronary intervention

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18
Q

Sarcoidosis: bilateral hilar lymphadenopathy and nodules in lung.

List 4 other symptoms

A

pt complains of a rash (erythema nodusum)
joint pains
painful vision (due to uveitis + conjunctivitis)
weight loss, cough, nose bleeds

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19
Q

3 Ix to confirm/monitor sarcoidosis

A

Serum ACE
24hr unitary calcium
Serum vit D, lung biopsy?

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20
Q

2 Ix to rule out involvement of other organs in sarcoidosis

A

urine dipstick, LFTs? GFR

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21
Q

pt with sarcoidosis is having trouble with his breathing, what Tx should you consider?

A

inhaled corticosteroids? lung transplant? salbutamol?

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22
Q

Dr tries to lower steroid dose for someone with sarcoidosis, but couldnt due to symptoms, what Tx would be added?

A

methotrexate? lung transplant?

hydroxychloroquine? TNF alpha?

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23
Q

Pt with asthma presents with acute exacerbation, given neb with salbutamol and IV co-amoxiclav, immediate anaphylaxis reaction. What drug caused the reaction?

A

Co-amoxiclav

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24
Q

Immediate Mx for anaphylaxis reaction to co-amoxiclav

A

stop co-amoxiclav
ABC
secure airway and give 100% O2

25
Q

Drug Tx for anaphylaxis reaction, and mechanism of action

A

Adrenaline, sympathetic stimulation (vasoconstriction)

26
Q

2 other Tx (apart from adrenaline) to reduce severity of anaphylactic shock

A

ranitidine? anti-histamine (chlorophenamine)? steroids (hydrocortisone)?

oxygen and fluids?

27
Q

cell which mediates allergic reaction

A

mast cells

28
Q

antibody associated with anaphylacix reaction

A

IgE

29
Q

mediator of decreased BP in anaphylactic shock?

A

histamine

30
Q

Teacher with 3 week history of diarrhoea, 4 things in history to help discern the cause?

A 
travel history
volume of blood in stools
recent meds/change in meds
similar Sx in past?
associated adb pain
pale stools?

weight loss, menstruation

31
Q

2 blood tests to determine cause of diarrhoea

A

tissue trans-glutaminases, blood culture

anaemia- terminal ileum involvement of chrons

32
Q

2 stool tests to determine cause of diarrhoea

A

faecal calprotectin & lactoferrin

33
Q

Ix suggest inflammatory bowel disease, 2 histological features of UC?

A

crypt accesses, neutrophil infiltrate, goblet cell depletion

34
Q

layers of bowel affected in UC

A

mucosa and submucosa

35
Q

4 causes of CKD

A 
SLE
diabetic nephropathy
glomerulonephritis i.e. IgA neuropathy
ADPKD
vasculitis
hypertension
goodpastures
TB
DM type 1 pyelonephritis (chronic reflux)
36
Q

2 mechanisms by which proteinuria induces kidney damage?

A

activation of RAA system

destroys the filtration slit membrane further —> more damage to tubular interstitium (increases tubular oncotic pressure?)

37
Q

glomerular hypertension, 2 drugs to treat?

A

ACEI, ARB

38
Q

which 2 bone diseases are further complications of CKD?

A

osteoporosis, osteomalacia, Paget’s disease of bone?

39
Q

Cell that produces myelin in peripheral/central nervous system.
Function of myelin?

A

Peripheral: Schwan
central: oligodendrocyte

Function: saltatory conduction

40
Q

define absolute and relative refractory period in relation to the action potential

A

Absolute: no AP can happen

Relative: more stimulus needed for AP to happen

41
Q

How does the change in conduction in MS lead to symptoms?

A

(no answer given)

Think its this:
acute relapses are caused by focal inflammatory demyelination causes conduction block, signals can’t travel –> optic neuropathy, brainstem demyelination and spinal cord lesions

42
Q

Why are MS symptoms so varied?

A

can affect any nerve in CNS

43
Q

what channel opens initially when the AP propagates + what does this do to the value of the membrane potential?

A

voltage gated sodium channel and membrane depolarises to +40 mv

44
Q

2 examples of socials stratification

A

Rich people best jobs - highest in society

Poor people worst jobs bottom of society

45
Q

4 examples of inequality that were mentioned in some reports marmots report, black report

A

women live longer so more likely to contract disease

men do dangerous jobs so more likely to die

46
Q

how does materialism have an effect on poor health? (two ways)

A

poor access to green space?

crowded living conditions ?

47
Q

2 strategies that focus on behavioural change

A

junk food taxation?
ban of smoking in public spaces?
change 4 life campaign trying to promote exercise?
minimum alcohol pricing

48
Q

describe appearance of meningococcus

A 
diplococci, red?
turbid appearance (csf)
49
Q

contacts of suspected meningism are given chemoprophylaxis, why?

A

to reduce spread to susceptible people/contain the disease

50
Q

who should be notified when someone has meningitis?

A

public health england

communicable disease centre

51
Q

when would you notify organisations of a case of meningitis?

A

ASAP/within 24hrs?

52
Q

other than breast cancer, 4 other causes that may present as lumps in the breast

A 
fibroadenoma
breast cysts
breast abscesses
fat necrosis
ductal infection
lipoma
53
Q

Pt has over-expression of HER2 gene, which specific drug would you use to treat?

A

Trastuzumab + (herceptin)

  • its used for HER2 +ve tumors, in combination with chemotherapy
54
Q

Pt undergoes necessary Tx for breast cancer and is symptom free, 5 years later presents with vertebral column problems. what has happened?

A

bone metastases

55
Q

2 characteristics used to stage breast cancer

A

lymph involvement

mets

56
Q

2 hormones that regulate the menstrual cycle

A

FSH, LH

57
Q

What does oestrogen do to the uterus

A

no answer given

think its: thickens smooth muscle of uterus
softening of cervic and pelvic ligaments

58
Q

which 2 cells of the ovary secrete oestrogen

A

granulosa cells, corpus leuteum?

follicular cells

59
Q

causes of infertility

A

problem ovulation: turner’s syndrome
problem of tubes: cystic fibrosis

drugs: chemo e.g. cisplat
the pill

Environmental: radiation exposure, malnutrition, anorexia, stress?

Phase 2a SAQ/MEQ (2 decks)

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