SBA 3 Mock Flashcards
COPD spirometry results
FEV <80% predicted
FEV1/FVC <0.7
COPD = Obstructive
Pharmacological management of adult diagnosed with asthma
- SABA - Salbutamol
- Low ICS - beclomethasone
- LTRA - Montelukast
- LABA - Salmeterol
- MART = ICS + fast-LABA
6 Mod ICS
7. High ICS
What would indicate that a pt should add ICS to their asthma management?
If they:
- use SABA > 2/week +/- asthma symptoms
- use SABA >2/week +/- woken at night by asthma weekly
Which lung cancer is strongly associated with cigarette smoking?
Small Cell Carcinoma
Which lung cancer is most common in NON-SMOKERS? Any risk-factors?
Adenocarcinoma
RF: Asbestos exposure
Common sites for lung cancers to metastasise to?
Adrenal glands Bone Brain Liver Lymph nodes
Common site for breast cancer to metastasise to?
Lungs
but lung cancer does not usually metastasise to breast
Pt is a 55yr old pilot. He is a smoker. He has noticed pain and swelling in his right calf for weeks but has ignored it. He now has pain in his chest.
Gold standard investigation for likely diagnosis? What RF does he have?
CT Pulmonary Angiogram
Likely diagnosis: Pulmonary Embolism
His RF:
- Likely DVT
- Long flights
- smoking
Most common causes of typical pneumoniae in both the community and hospital
TYPICAL CAP
1. Strep pneumonia
TYPICAL HAP
1. Staph aureus
COPD
1. Haemophilus influenza B
Causes of atypical bacterial pneumoniae
Are they detectable on gram stain?
Mycoplasma pneumonia
Chlamydophila pneumonia
Legionella pneumonia
- Not detectable on gram stain
Most common cause of pneumonia in COPD patients
Haemophilus influenza B
CURB-65 parameters and use
CAP Severity
Confusion
Urea >7
RR >30
BP s<90 or d<60
> 65
TB Management and side effects
4 for 2, 2 for 4 RIPE
Rifampicin - Red/orange
Isoniazid - peripheral neuropathy (give pyridoxine)
Pyrazinamide - uric acid: arthralgia, gout, rash
Ethambutol - Eyes; Optic neuritis
Chromosome 7 mutation
Cystic Fibrosis
c/s 7 codes CFTR protein > defective Cl- secretion/ Na+ absorption
Chromosome 6 mutation
Hereditary Haemochromatosis
Chromosome 13 mutation
Wilson’s disease
Chromosome 14 mutation
Alpha-1 Antitrypsin deficiency
Chromosome 21 mutation
Trisomy - Down’s syndrome
29-F presents with painless genital ulcer. She had unprotected sex with a new partner in the last 6 months.
EIA IgM is positive for syphilis. She has no allergies; she is not pregnant.
Management?
Primary Syphilis
1L: Benzathine penicillin
2L: Azithromycin/ Doxycycline (if penicillin-allergic)
Below are the underlying causes of Raynaud’s syndrome. What features differentiate them?
- Carpal Tunnel
- Dupuytren’s contracture
- SLE
- Hand arm vibration syndrome
- Carpal Tunnel - median nerve distribution weakness, tingling
- Dupuytren’s contracture - permanently flexed digits
- SLE - young, autoimmune, rash
- Hand-arm vibration - power tools
Pt presents with tingling, weakness and aching of his hands. He works an office job.
Likely diagnosis?
Repetitive Strain Injury
Meningitis management
- primary care
- hospital care
- prophylaxis
Primary care: Benzylpenicillin (if non-blanching rash)
Hospital:
1. IV Ceftriaxone
2. a) Amoxicillin - Neisseria
b) Ampicillin - Listeria (young, old, immunosuppressed)
c) Vancomycin - Strep pneumonia
d) Acyclovir - Viral
<3months - IV Cefotaxime + ampicillin/amoxicillin
Prophylaxis
- Ciprofloxacin
- Rifampicin
Bacterial causes of meningitis
Strep pneumonia
Neisseria meningitides
Haemophilus influenza
Listeria monocytogenes
SHiLN
Viral causes of meningitis
Enterovirus - Echo/Coxsackie
HSV
Measles, Rubella
