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Year 3 > SBA DECK 30/05 > Flashcards

SBA DECK 30/05 Flashcards

1
Q

what is koilonychia?

A

a nail sign that arises due to iron deficiency anaemia

the nails look soft and scooped out

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2
Q

what might predispose someone to c diff infections?

A

being on broad spectrum antibiotics eg cifpro, penicillins, clindamycin

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3
Q

what is first line management for c diff?

A

oral vancomycin

make sure to isolate the patient

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4
Q

what joint does pseudogout most commonly affect?

A

the knee

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5
Q

what antiemetic should not be given to those with parkinsons and why?

A

metoclopramide

it is a dopamine antagonist and can make their symptoms way worse

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6
Q

what antibody is associated with psoriatic arthritis?

A

none, it is seronegative

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7
Q

what are the rules for using US to image the breast instead of mammogram?

A

use in under 35 if there is an actual lump

use in everyone under 40 if they are asymptomatic

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8
Q

what medication might cause proximal myopathy?

A

corticosteroids

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9
Q

what toxic product is produced in rhabdomyolysis?

A

myoglobin

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10
Q

where in the lung does fibrosis occur in coal workers pneumocosis and silicosis?

A

upper lung zones

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11
Q

what medication causes lower lung zone fibrosis?

A

amiodarone

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12
Q

how are gallstones in the CBD treated when found during cholecystectomy?

A

ERCP in the day

urgent exploration of the bile duct

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13
Q

what are the rules for someone taking the OCP when they need to have surgery?

A

stop it 4 weeks before, take an alternative form of contraception
start it 2 weeks after

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14
Q

if a breast lump invades the muscle what is the most likely diagnosis?

A

invasive breast cancer

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15
Q

what symptom will an empyema in a pneumonia classically cause?

A

swinging fever

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16
Q

how long do you have be admitted for a pneumonia to be a HAP?

A

48 hrs

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17
Q

describe ABPI results and their meanings

A 
>1.2= abnormal thickening of vascular walls (due to diabetes usually) 
0.9-1.2= normal
0.8-0.9= mild disease
0.5-0.8= moderate disease
<0.5= severe disease
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18
Q

what does an ABPI over 1.2 indicate?

A

abnormal artery thickening= stenosis

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19
Q

what is ABPI used to diagnose?

A

peripheral arterial disease

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20
Q

what granulomas do you see in sarcoidosis?

A

non caseating

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21
Q

what is the most common complication of multiple myeloma?

A

hypercalcaemia

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22
Q

what is 1st line treatment for hereditary haemochromatosis?

A

venesection

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23
Q

what is 1st line treatment for wilsons disease?

A

penicillamine

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24
Q

what should you think when you see villous atrophy, crypt hyperplasia and raised intra epithelial lymphocytes?

A

coeliacs disease

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25
Q

what is the most appropriate ix when you suspect a phaeo?

A

24h urinary metanephrines

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26
Q

how is a phaeo managed?

A

surgical resection

before this alpha blockade then beta blockade

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27
Q

when calculating GCS and 2 sides of the body have different responses, which side do u take as the score?

A

the better side

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28
Q

what are epidemiological rf for idiopathic inter cranial hypertension?

A

obese

young female

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29
Q

what is bradykinesia?

A

difficulty initiating movement

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30
Q

what is first line mx in someone with septic arthritis?

A

joint aspiration and culture

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31
Q

what is the first step in managing complete heart block if they are haemodynamically unstable?

A

IV atropine- for bradycardia

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32
Q

where does the qt interval start and end?

A

start of the q wave

end of the t wave

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33
Q

where does the pr interval start and end?

A

start of the p wave

start of the qrs complex

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34
Q

what is treatment for acute malaria?

A

IV artesunate

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35
Q

what is the most common causative organism for encephalitis?

A

herpes simplex virus

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36
Q

how is encephalitis diagnosed?

A

lumbar puncture will show HSV on PCR

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37
Q

what test is most helpful in diagnosing acute liver failure? what will the result be?

A

INR

1.5 or above

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38
Q

what cardiac medication should be avoided in those with myasthenia gravis?

A

beta blockers

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39
Q

if someone is on metformin what must their hba1c be in order for there to be an indication to add another drug?

A

if hba1c rises from the acceptable 48mmol/L to 50 mmol/L

40
Q

if someone is taking metformin in T2DM what should target hba1c be?

A

48 mmol/L

41
Q

what type of anaemia may prosthetic heart valves cause?

A

haemolytic

42
Q

what is the most common metabolic abnormality in sarcoidosis?

A

hypercalcaemia

43
Q

what is spared in motor neurone disease?

A

eye movements

44
Q

how do you differentiate gastric v duodenal ulcers?

A 
duodenal= better after eating 
gastric= worse when you eat
45
Q

how is h pylori negative peptic ulcer disease managed?

A

4-8 week dose of PPI until the ulcer has healed

46
Q

how is peptic ulcer disease managed if associated with NSAID use and h pylori positive?

A

2 month PPI

after this is over eradication therapy

47
Q

what is first line ix if you suspect testicular cancer?

A

ultrasound testes

48
Q

why can you not biopsy a testicular mass if you suspect cancer?

A

risk of seeding cancer cells into the rest of the testes

49
Q

what cancer is it important to remember you can’t biopsy and why?

A

testicular cancer

there is risk of seeding other cells into the rest of the testes

50
Q

how is hypoglycaemia managed if a patient is unconscious?

A

if there is no IV access IM glucagon 1mg

if there is IV access give 100ml 20% glucose IV over 10 mins

51
Q

when is IM glucagon not effective in hypoglycaemia?

A

when its due to alcohol

52
Q

how do you differentiate cluster headache from acute angle closure glaucoma?

A

cluster headache= will have a hx of occurring in clusters as well as a triad of periocular pain, rhinorrhoea/lacrimation/some form of secretion
acute angle closure glaucoma= will present with a headache, nausea/vomiting, visual changes, redness of the eye

53
Q

what is the presentation of acute angle closure glaucoma?

A 
visual disturbance
sudden onset headache
redness of the eye
nausea and vomiting
loss of vision worse at night (when pupil dilates and irido corneal angle closes more) 
floaters and flashes 
mild pupil dilation
54
Q

how is acute angle closure glaucoma initially managed?

A

IV acetazolamide
topical timolol
urgent referral to opthamology

55
Q

what is first line ix for someone with stable angina?

A

CT coronary angiography

56
Q

when is non invasive ventilation used in COPD?

A

when theres a respiratory acidosis

57
Q

what feature is specific to graves disease?

A

exopthalamos

58
Q

what site is most commonly affected in uc

A

rectum

59
Q

what is used to image the brain when someone has a suspected TIA?

A

MRI brain with diffusion weighted imaging

60
Q

what tumor marker is used for medullary thyroid cancer?

A

calcitonin

61
Q

what tumor marker is used for papillary and medullary cancer?

A

thyroglobulin

62
Q

how is menieres disease managed prophylactically and acutely?

A

acute attack= prochlorperazine Im or buccal

prophylaxis= betahistine

63
Q

how is thalassaemia managed?

A

regular blood transfusions

or stem cell transplant

64
Q

what chronic cardiac condition causes positive hepatojugular reflux?

A

heart failure

65
Q

what drug is used to treat CML?

A

imatinib

66
Q

how do co2 levels change as an acute asthma attack progresses. what does this tell you?

A 
initially= hypocapnic as they hyperventilate 
progressing= normocapnic and then hypercapnic as they tire

if co2 is normal or high they need to be intubated and ventilated as this is life thretening

67
Q

what is the programme for breast cancer screening in the UK?

A

offered to all women aged 50-70 every 3 years

68
Q

what artery is affected if there is an inferior stemi and what leads does this affect?

A

II, III, avF

right coronary artery affected

69
Q

why may a CKD patient not respond to EPO therapy?

A

if they have pre existing iron deficiency

70
Q

what organism most commonly causes infective exacerbations of COPD?

A

haemophilius influenzae

71
Q

how many doses of adrenaline can be given in anaphylaxis and how far apart do they have to be? what is done if this doesnt work

A

2 doses 5 mins apart

if refractory consider IV adrenaline

72
Q

what lobes are brocas v wernickes area found in?

A 
brocas= frontal lobe
wernickes= temporal lobe
73
Q

what speech problems would lesions in the frontal v temporal lobe cause?

A 
frontal= brocas area affected so issues with speech production
temporal= wernickes area affected so issues with speech comprehension
74
Q

how is PE managed?

A

stable= start on DOAC immediately, 3 months if the PE was provoked and 6 months if the PE was unprovoked
unstable (ie massive PE)= thrombolysis

75
Q

when is thrombolysis indicated in a PE?

A

when the PE is massive

when the patient is haemodynamically unstable

76
Q

what type of seizure are automatisms associated with?

A

temporal lobe

77
Q

when is flecanide v amiodarone used in AF for rhythmn control?

A 
flecanide= young person w no IHD or structural heart disease 
amiodarone= old person or has IHD/ structural heart disease
78
Q

whats first line imaging in prostate cancer

A

MRI prostate

79
Q

whats the best way to ix suspected gonorrhoea?

A

nucleic acid amplification test

80
Q

how can you identify portal hypertension on bloods? explain why

A

look at platelets

portal hypertension causes thrombocytopenia due to splenomegaly

81
Q

what organ is enlarged in portal hypertension?

A

spleen

82
Q

how is gout managed?

A

NSAID first line
if pmhx of CKD, GI issues or heart failure use colchicine
if current CKD use steroids

83
Q

how does ovarian cancer usually present?

A 
non specific symptoms 
bloating
early satiety
abdo distention
bowel obstruction
84
Q

what cancer is associated with tumor marker ca 19-9 and how will it present?

A

pancreatic
painless obstructive jaundice
FLAWS
palpable GB/ RUQ mass

85
Q

what cancer is associated with tumor marker ca 125 and how will it present?

A 
ovarian
non specific symptoms:
bloating
early satiety
abdo distention
bowel obstruction
86
Q

what cancer is associated with tumor marker CEA and how will it present?

A

colorectal cancer
FLAWS
lower GI bleed
bowel obstruction

87
Q

what cancer is associated with tumor marker AFP and how will it present?

A

hepatocellular carcinoma
FLAWS
jaundice

88
Q

what cancer is associated with tumor marker ca 15-3 and how will it present?

A

breast cancer
mass
FLAWS

89
Q

if there is loss in pain and temp where is the lesion in the spinal cord? (include name of tract and location in cord)

A

spinothalamic tract

located laterally

90
Q

if there is loss in fine touch, vibration and proprioception where is the lesion in the spinal cord? (include name of tract and location in cord)

A

dorsal column

posterior part of spinal cord

91
Q

if there is loss motor function where is the lesion in the spinal cord? (include name of tract and location in cord)

A

corticospinal tract

92
Q

if there is sphincter involvement eg urinary retention or constipation in a neuro injury what does this signify and explain why?

A

lesion in the spinal cord

it is essentially hypertonia of the sphincters which causes these symptoms (due to UMN lesion)

93
Q

how can you differentiate thoracic and cervical spinal cord lesions?

A 
thoracic= only arms affected
cervical= all 4 limbs affected
94
Q

what medication is contraindicated in hiatus hernia and why?

A

CCB

because it relaxes the sphincter and increases reflux

95
Q

what do howell jolly bodies indicate? what are they

A

they are the nuclear remnants of RBC breakdown

they are indicative of hyposplenism

96
Q

whats used for first line management in someone with symptomatic varicose veins?

A

NSAIDs

97
Q

in DKA what is first line insulin management?

A

infusion of 0.1 unit/kg/hr

Year 3 (104 decks)

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