SBA DECK 16/05 Flashcards
out of PT and APTT which measures the intrinsic vs extrinsic pathway?
APTT= intrinsic PT= extrinsic
how can you differentiate VWB disease and haemophilia?
VWB disease= superficial bleeding ie bleeding gums, petechiae, purpura
haemophilia= deep bleeding ie haemarthrosis, haematoma etc
what is the major class of side effects when taking bisphosphonates? how are patients taught to avoid this?
oesophageal problems eg oesophageal ulcers, oesophagitis etc
patients are taught to take the medication half an hour before breakfast, swallow the pill whole with water and sit upright for half an hr
what are signs and symptoms of hereditary haemochromatosis?
bronze skin T2DM fatigue joint pain liver cirrhosis
what is the first line treatment for severe hyperclacaemia?
IV fluid therapy
describe birefringence and needle shape in joint fluid aspirate in gout v pseudogout? how do you remember birifringence?
gout= negatively birifringent needle shaped pseudogout= positively shaped rhomboid
gout= neg birifringence because its worse than pseudogout therefore its more negative
what is another word for anti dsDNA antibodies?
anti nuclear antibody
when does transudate v exudate collect?
transudate= increased intravascular pressure or reduced oncotic pressure exudate= due to infection, inflammation and neoplasm
out of transudate and exudate what is due to infection, inflammation and malignancy?
exudate
out of transudate and exudate what has high protein? how do you remember this?
exudate
think about the cause of each one- if its due to infection, inflammation or malignancy
how is thoracocentesis in tension pneumothorax done specifically?
IV cannula in the 2nd ICS mcl
when can you not interpret IgA ttg?
when IgA levels are low
how long after possible HIV exposure do you have to wait to be tested?
4 weeks if asymptomatic
what what arrhythmias is atropine vs adenosine used?
atropine= sinus bradycardia adenosine= SVT
what is first line management for haemodynamically unstable bradycardia?
IV atropine
where do you find emphysema in COPD v alpha 1 antitrypsin deficiency?
COPD= upper lobes
A1AT deficiency= lower zones
what is deformity is radio femoral delay associated with?
coarctation of the aorta
what is the max dose of atropine you can give someone who is bradycardic?
3mg
what is used to differentiate endogenous v exogenous causes of hypoglycaemia? explain why
endogenous= c peptide is raised exogenous= c peptide is normal
c peptide is a by product of insulin production so if lots of insulin is produced endogenously it will be raised whereas if insulin is administered exogenously it will be normal
whats the biggest side effect of adenosine administration?
flushing
when would you shock a patient 3 times (stacked shocks) instead of once?
if they are being monitored in a coronary care unit
what rhythms are shockable v non shockable?
shockable= VF and pulseless VT
non shockable= asystole and pulseless electrical activity
what pulseless rhythm is shockable?
pulseless VT
when and how is adrenaline given in cardiac arrest?
when= as soon as possible in non shockable rhythms, after 3 shocks in shockable rhythms how= 1 mg, give every 3-5 mins as ALS continues
what test is used to check for h pylori post eradication therapy?
urea breath test
if you see haemoptysis/cough with haematuria what should you think immediately in terms of diagnosis?
goodpastures syndrome
what supplement can reduce the absorption of levothyroxine?
iron
what is first line ix in primary hyperaldosteronism?
renin: aldosterone ratio
what electrolyte imbalance will occur in hyperaldosteronism?
hypernatraemia and hypokalemia
what antibody is very specific for rheumatoid arthritis?
anti CCP
what antibodies are checked for SLE? which is more specific
ANA
anti double stranded DNA (more specific)
what cancer are those with haemochromoatosis more at risk of?
hepatocellular carcinoma
what is urine:plasma urea in pre renal aki?
urine urea is way higher
what quadrant is more affected in bitemporal hemianopia due to pituitary tumor? why?
upper quadrant
because the compression is inferior
what is given first line for itching due to jaundice?
chlorphenamine
what medication is first line for lower back pain?
NSAIDs
what investigation is diagnostic for pancreatic cancer?
high res abdominal CT
after fibrinolysis is given in ACS when should you do an ECG?
60-90 mins after
what is the most common cause of large bowel obstruction?
colon cancer
what valve problem is associated with polycystic kidney disease?
mitral valve prolapse
what happens to goblet cells in crohns?
increase
what are crypt abscess and decreased mucin associated with?
ulcerative colitis
what is seen on intestinal biopsy in crohns vs uc?
crohns= increased goblet cells
ulcerative colitis= crypt abscess and decreased mucin
what specific referral and in what time frame needs to be done urgently when leukaemia is suspected in children?
FBC within 48 hrs
what is the most common type of thyroid cancer?
papillary carcinoma
what antibiotic used to treat UTIs can cause pulmonary fibrosis?
nitrofuratonin
what should you do when someone is on warfarin and has a major bleed?
stop warfarin
give vitamin K 5mg IV and prothrombin complex
how is acute relapse of MS treated?
steroids
what are jacksonian movements and what are they associated with?
jerking clonic movements that move from distal to proximal
they are characteristic of frontal lobe seizures
how long after an URTI does PSGN v IgA nephropathy develop?
PSGN= 1-2 weeks IgA= 1-2 days