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Clinical stuff > SAQ book QS idk > Flashcards

SAQ book QS idk Flashcards

1
Q

CX of hypoglycaemia in non diabetics

A

L iver failure, A ddison’s, insulin-secreting tum ours, alcohol
binging, pituitary insufficiency.

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2
Q

SOAP RAIN MD mneumonic?

A 
Serositis – Pleurisy, pericarditis
Oral ulcers
Arthritis
Photosensitivity
Blood disorders
Renal involvement
Antinuclear antibodies
Immunologic phenomena
Neurologic disorder
Malar rash
Discoid rash
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3
Q

As of Ank spond?

A

Aortic regurg, Ant uveitis, Amyloid, apical fibrosis, achilles tendonopathy,

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4
Q

OE acromegaly signs

A

T h ic k spade-like hands, frontal bossing, m acroglossia, bitem poral
hem ianopia, headache, sweats, w ide-spaced teeth, prognathism ,
voice changes, sleep disturbance due to obstructive sleep apnoea,
carpal tunnel syndrom e, increased blood pressure.

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5
Q

complications of DM2?

A

M acrovascular: cerebrovascular disease/stroke, m yocardial
infarction/ischaem ic h eart disease, peripheral vascular disease.
M icrovascular: nephropathy, neuropathy, retinopathy.

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6
Q

IX for hypercalcaemia

A

PTH, ALP, albumin, vit D, urine PO4, PO4,
images: DEXA scan, isotope scan, ultrasound, abdominal X-ray, CT/MRI
neck.

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7
Q

SX of hypercalcaemia

A

Polydipsia, polyuria, signs of dehydration, weakness, depression,
constipation, signs of renal stones, signs of pancreatitis, bone pain.
reduced QT interval, arrhtythmias

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8
Q

DM2: what would u find on feet?

A

Charcot’s joint/neuropathic arthropathy/joint deformity; painless
ulcer; high arched foot with clawing of the toes; diminished
reflexes
sensation: vibration lost first, glove and stocking

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9
Q

other types of diabetic neuropathy

vomiting CX?

A

peripheral
Autonomic neuropathy; diabetic amyotrophy; mononeuropathy/
mononeuritis multiplex; acute painful neuropathy.
Autonomic gastroparesis

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10
Q

Causes of splenomegaly?

A

Malaria, myelofibrosis, lymphoma, liver cirrhosis with portal
hypertension, haemolytic anaemia, mononucleosis, amyloidosis
leukaemia

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11
Q

WCC in chronic leukaemia?

A

high

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12
Q

Bone marrow failrue features on FBC?

A

Leucopenia/neutropenia, thrombocytopenia, anaemia.

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13
Q

WHat is the definition of a massive transfusion?

A
  1. T ransfusion o f th e entire p atien t’s blood v o lu m e/10 units o f blood
    (1) w ithin 24 hours.
    risks :hypocalcaemia, hypothermia, hyperkalaem a and a dilutional effect on the other com ponents
    o f blood, causing a throm bocytopenia
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14
Q

O/E signs of B major?

A

Hepatosplenomegaly, frontal bossing, jaw enlargement, dental
malocclusion, flow murmur, generalised pallor, conjunctival pallor,
tachycardia

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15
Q

what is chelation therapy?

A

desferrioxamine

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16
Q

Extr-GI features of crohns?

A

erythema nodosum, polyarthritis, anterior uveitis and pyoderma
gangrenosum., fistulas, gallstones

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17
Q

Endoscopy of crohns?

histology?

A

endoscopy: skip lesions and
histology:Presence o f granulom a form ation, transm ural inflam m ation,
lym phocytic infiltration.

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18
Q

DD for chronic diarrhea in 25 YO?

A

Inflam m atory bow el disease, irritable bow el disease, infective
diarrhoea (protozoa/parasites m o re likely at 3 m onths), coeliac
disease, colorectal carcinom a, m edications, chronic pancreatitis,
thyrotoxicosis.

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19
Q

investigations for chronic diarrhea/ crohsn?

A 
• full blood co u n t m ay reveal anaem ia and a raised w hite cell
count
• C R P m ay be raised
• album in m ay be decreased
• vitam in B 12 deficiency
• stool M C & S
• coeliac screen
• amylase
• T F T
Invasive tests:
• sigm oidoscopy + rectal biopsy
• colonoscopy
• barium enem a (m ay show cobblestoning, strictures and ulcers,
b u t unable to biopsy)
• capsule endoscopy (for small bow el disease)
20
Q

Small bowel enema - crohns?

A

strictures: kantor’s string sign, proximal bowel dialtion, fistulae,

21
Q

risks of crohns disease?

A

Perianal abscess and fistulae, enteric fistulae, perforated bowel,
small-bowel obstruction, colonic carcinoma, malnutrition.

22
Q

PBC or PSC? - associated with sojrens, RA, hypothyroid, systemic sclerosis?

A

PBC

23
Q

which PBC/PSC is associated with raised AMA, ANA, ESR and IGM?

A

PBC

24
Q

RF for carpal tunnel?

A

Pregnancy, menopause, oral contraceptive pill, obesity, trauma,
diabetes mellitus, hypothyroidism, rheumatoid arthritis,
acromegaly, amyloidosis, dialysis, repetitive activities, local
compression (e.g. lipoma, ganglion).

25
Q

medication that much be started with levodopa?

A

Peripheral dopa-decarboxylase inhibitor, as it reduces peripheral
breakdown, leading to a decreased dose of levodopa required for
symptom control and therefore a reduced risk of side effects. (

26
Q

SE of levodopa?

A

On-off fluctuations, dyskinesias, weaning off phenomenon

27
Q

CX of Space occupying lesion?

A

Neoplasm, haematoma, abscess, granuloma, aneurysm

28
Q

Eczema child distribution?

A

scalp, neck, flexor and extensor

surfaces

29
Q

eczema tX apart from emollients and CS?

A

Sedating antihistam ines, paste bandaging, phototherapy, oral
steroids, azathioprine, ciclosporin

30
Q

O/E eczema?

A

Sym m etrical flexural. (1)
2. A llergic rhinitis, asthm a, food allergy. (1 mark for each, max
2 marks)
3. E rythem atous, scaly, excoriations, lichenification, crust and
w eeping if infected.

31
Q

What is Nikolskey ssign

A

Separation o f skin layers (extension o f blisters) w hen skin is
rubbed

32
Q

DM eye problems?

pre-proliferative problems? O/E

A

C ataract, glaucom a, vitreous haem orrhage, retinal detachm ent,
ocular m o to r nerve palsies, infection.
maculpathy: central vision loss

pre-proliferative: cotton
wool spots and flame-shaped haemorrhages, which mark the presence
of ischaemia at the retina

proliferative:new vessels at or around the optic disc.

33
Q

findings on the retina that are characteristic of severe

hypertensive retinopathy

A

Arteriolar constriction (silver/copper wiring), arteries nipping
veins where they cross (AV nipping), cotton wool spots or
exudates, flame-shaped haemorrhages, papillloedema.

34
Q

blood pressure of
238/122 mmHg, but is complaining of blurred vision and palpitations.
On fundoscopy, you notice an absence of venous pulsation, blurring of
the disc margins and also a slight elevation of the disc bilaterally

  • what is this?
A

Papilloedema

endo cause: phaechromocytoma

35
Q

DD for appendicitis?

A

ectopic
pregnancy, to rsio n /ru p tu re o f ovarian cyst, salpingitis, U T I,
renal stone, testicular torsion, G I obstruction, constipation,
strangulated hernia, C ro h n ’s disease, gastroenteritis, m esenteric
adenitis, M eckel’s diverticulum and intussusception.

36
Q

complications of appendicitis

A

P erforation, appendix mass (om entum and small bow el adhere to
appendix), abscess, sepsis, paralytic ileus, intestinal obstruction.

37
Q

acute diverticular disease IX?

A

FBC, CRP, blood cultures, CXR, AXR, C T scan, USS. (2)
(NB: barium enemas/endoscopy should be avoided in the acute phase
due to the risk of perforation.)

38
Q

complications of diverticular disease?

A

Perforation, bleeding, abscess, strictures, fistulas

39
Q

complications of hernia removals?

A

R ecurrence, w ound site infection, m esh infection, hydrocoele,
intestinal dam age, bladder dam age, sperm atic cord dam age,
testicular infarction secondary to blood vessel dam age.

40
Q

complications of hemorrhoids

and SX?

A

U lceration, stricture, throm bosis, infection, anaem ia, skin tags

sx:Anal itching, m ucous, rectal fullness, pain, soiling, PR bleed

41
Q

findings on IX in mesenteric ischaemia?

A

M etabolic acidosis. (1)
3. Raised W C C , raised lactate, raised H b (due to
haem oconcentration), raised amylase.
supply:
F o reg u t - celiac trunk; m id g u t - superior m esenteric artery;
h in d g u t - inferior m esenteric artery

42
Q

pancreatitis early complications:

and late:

A

earlu: Shock, A R D S, sepsis, D IC , renal failure.
late:Pancreatic pseudocyst, pancreatic necrosis, abscess, throm bosis o f
splenic/duodenal arteries, chronic pancreatitis.

43
Q

CX of parkinsons?

A

Drug-induced Parkinsonism (e.g. antipsychotics), Lewy body
dementia, Shy-Drager syndrome, multiple system atrophy,
vascular disease

44
Q

Action of carbidopa?

A

They are peripheral decarboxylase inhibitors, preventing L-dopa
from being broken down outside the CNS

45
Q

LFT in prostate cancer?

A

ALP raised

46
Q

describe The Liverpool Care Pathway (LCP)?

A

pathway addresses the most distressing symptoms patients may develop in the last stages of life,
and offers guidance on how they should be managed
Pain (morphine), agitation (midazolam), nausea (cyclizine),
respiratory tract secretions (hyoscine butylbromide/
hydrobromide), dyspnoea (morphine)

Clinical stuff (11 decks)

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