Test Flashcards
What does stony dullness to percussion indicate?
Pleural Effusion
Stony dullness is a physical examination finding associated with fluid in the pleural space.
What is the most likely cause of right-sided pleuritic chest pain?
Pneumonia
Pleuritic chest pain is often associated with pneumonia, particularly when there is inflammation of the pleura.
What are the key radiological findings in pulmonary oedema? (4)
- Alveolar bat’s wings
- Kerley B lines
- Cardiomegaly
- Dilated prominent upper lobe vessels
These findings are indicative of pulmonary congestion and interstitial edema.
What does a ground-glass appearance on X-ray suggest?
- Pulmonary fibrosis
- Respiratory Distress Syndrome of the newborn
Ground-glass opacities can indicate various lung conditions, including fibrosis and acute respiratory distress.
What does a Ziehl-Neelsen stain positive for acid-fast bacilli indicate?
Tuberculosis (TB)
This staining method is used to identify mycobacteria, the bacteria responsible for TB.
What type of necrosis is associated with tuberculosis?
Caseous necrosis
Caseous necrosis is a distinctive form of tissue death seen in TB infections.
What is an Assmann focus?
Apical lesion in secondary tuberculosis
The Assmann focus is a characteristic finding in reactivation TB.
What is miliary tuberculosis?
Spread of organism into bloodstream
Miliary TB can lead to dissemination to multiple organs, resulting in a characteristic clinical picture.
What are the findings when the organism spreads via pulmonary artery in miliary tuberculosis?
Miliary dissemination into the lung
This leads to widespread pulmonary involvement seen in miliary TB.
What are the findings when the organism spreads via pulmonary vein in miliary tuberculosis?
Systemic dissemination to the liver, spleen, and kidneys
This results in organ involvement beyond the lungs.
What condition is indicated by positive anti-glomerular basement membrane antibodies?
Goodpasture’s syndrome
This autoimmune condition affects the kidneys and lungs.
What infection is associated with having a parrot or pigeon as a pet?
Chlamydophila psittaci infection
This zoonotic infection can lead to pneumonia.
What is the likely cause of dry cough and diarrhoea after a holiday abroad?
Legionella pneumophila
Testing urine for antigens is key for diagnosis.
What condition is suggested by the description ‘tall, thin young man who indulges in marijuana’?
Pneumothorax
This demographic is at higher risk for spontaneous pneumothorax, particularly Marfan syndrome.
What are the symptoms associated with sarcoidosis? (6)
- Bilateral hilar lymphadenopathy
- Erythema nodosum
- Granulomas
- Fatigue
- Uveitis
- Weight loss
Sarcoidosis is a systemic granulomatous disease.
What is the ‘signet ring sign’ on CT indicative of?
Bronchiectasis
This sign represents bronchi that are wider than adjacent blood vessels.
What does the ‘D sign’ on X-ray indicate?
Empyema
This sign is characterized by a crescent of fluid in the pleural space.
What does the ‘steeple sign’ on X-ray suggest?
Laryngotracheobronchitis/croup
This sign shows narrowing of the upper airway.
What condition is indicated by a child with a barking cough?
Croup
Croup is often viral in origin and presents with a characteristic cough.
What is the treatment for Pneumocystis pneumonia in HIV patients?
Co-trimoxazole (± prednisolone if severe)
This treatment is standard for PCP in immunocompromised individuals.
What triad is associated with asthma, nasal polyps, and salicylate sensitivity?
Samter’s Triad
This triad is significant in understanding aspirin exacerbated respiratory disease.
What is a risk factor for aspiration pneumonia?
Alcoholism
Alcoholics are at higher risk for aspiration due to impaired consciousness and reflexes.
What type of sputum is characteristic of Klebsiella pneumoniae?
Red jelly sputum
This appearance is due to the presence of necrotic tissue and blood.
What type of sputum is associated with Chlamydia psittaci infection?
Mucoid sputum
This sputum type is indicative of certain atypical pneumonia pathogens.
What does rusty sputum indicate?
Pneumococcal pneumonia
Rusty sputum is a classic sign of this bacterial infection.
What condition is indicated by cannonball metastases?
Classically from primary renal cell carcinoma
This pattern of metastasis is often seen in cases of renal cancer.
What does a morning headache suggest?
Hypercapnia or side effects of organic nitrates
Morning headaches can be a sign of sleep apnea or other respiratory issues.
What type of tumor secretes ACTH
Small cell carcinoma
This cancer is neuroendocrine and can lead to ectopic hormone syndromes.
What type of tumor secretes PTH?
Squamous cell carcinoma of the lung
This type of lung cancer can lead to hypercalcemia.
What are the characteristics of small-cell carcinoma? (3)
- Neuroendocrine
- Highly malignant
- May be associated with ectopic endocrine syndromes
This cancer type is aggressive and often diagnosed at an advanced stage.
What laboratory findings are increased in sarcoidosis?
- Serum ACE
- Calcium (Ca2+)
These markers are often checked in suspected cases of sarcoidosis.
What does eggshell calcification at the hilar region indicate?
Silicosis
This finding is characteristic of chronic silica exposure.
What are ‘heart-failure cells’?
Macrophages that have absorbed haemosiderin
These cells are seen in chronic pulmonary edema associated with heart failure.
What is a Ghon Focus?
An area of infection and caseous necrosis at the periphery of the lung
This is a classic finding in tuberculosis.
What occurs if a Ghon Focus ruptures into the pleural cavity?
Tuberculous pleurisy
This can lead to pleural effusion and pleuritic pain.
What is an Assmann Focus?
Apical lesion of secondary tuberculous infection
This is specific to reactivation TB.
What is a ‘coin lesion’ on chest radiographs?
A rounded solitary lesion
Common lesions include primary lung carcinoma, metastatic tumors, and granulomatous inflammation.
What is Horner’s Syndrome?
Signs include ptosis, enophthalmos, miosis, and lack of sweating
This syndrome can occur with local cancer spread or Pancoast tumors affecting sympathetic nerves.
What is the most common type of lung cancer in smokers?
Squamous cell carcinoma
Squamous cell carcinoma secretes parathyroid hormone and can cause hypercalcemia.
What are the common metastatic sites for squamous cell carcinoma?
- Lymph nodes
- Liver
- Bones
- Adrenal glands
- Brain
These sites are commonly affected by metastases from squamous cell carcinoma.
What symptoms can hypercalcemia cause?
Bones, stones, groans, and moans
This phrase summarizes the symptoms associated with hypercalcemia.
What characterizes large cell carcinoma?
Poorly differentiated and sex hormone releasing
Large cell carcinoma can cause gynecomastia due to its hormone-releasing properties.
What is the most common type of lung cancer in non-smokers?
Adenocarcinoma
Adenocarcinoma is derived from glandular cells and often leads to peripheral tumors.
What staining characteristic is associated with adenocarcinoma?
Mucus stains blue
This staining helps in identifying adenocarcinoma histologically.
What condition can adenocarcinoma lead to?
Hypertrophic pulmonary osteoarthropathy
This condition is characterized by finger clubbing and periosteal inflammation.
Which lung cancer type has the worst prognosis?
Small cell carcinoma
Small cell carcinoma is known for its aggressive nature and poor survival rates.
What is unique about small cell carcinoma in terms of treatment?
It is the only lung cancer that is chemo sensitive
This means small cell carcinoma responds to chemotherapy more effectively than other lung cancer types.
What condition is indicated by fever and pleuritic chest pain that is relieved by sitting up and leaning forward?
Pericarditis
What does an irregularly irregular pulse indicate?
Atrial Fibrillation
What ECG finding is characterized by a saw tooth baseline and a heart rate of 150 bpm?
Atrial Flutter
What are the signs of pulmonary oedema? (5)
Alveolar bat’s wings,
Kerley B lines,
cardiomegaly, dilated prominent upper lobe vessels, pleural effusion
What does raised JVP/hepatojugular indicate?
Right-sided heart failure
What symptom is described as a sense of impending doom?
MI
What type of ST elevation is saddle shaped?
Pericarditis
What does broad complex tachycardia indicate?
Ventricular problem
What is indicated by a mid-diastolic murmur with a tapping, undisplaced apex?
Mitral Stenosis
What is the significance of a PMHx of rheumatic fever?
Mitral stenosis
What does a broad QRS with a slurred upstroke on the R wave (delta wave) indicate?
Wolff-Parkinson-White syndrome
What ECG finding is characterized by tall, tented T waves?
Hyperkalaemia (and wide QRS complexes)
What is the condition when a patient gets pericarditis 4-6 weeks post MI?
Dressler’s syndrome
Relieved by sitting forward and characterized by diffuse saddle-shaped ST elevation.
What is a common symptom of Digoxin toxicity?
‘Blurred yellowing vision headache’
Indicates potential digoxin overdose or toxicity.
What lesions are associated with subacute bacterial infective endocarditis?
Janeway Lesions and Osler’s Nodes
These lesions are indicative of infective endocarditis.
What type of heart murmur is described as continuous and machine-like?
Patent Ductus Arteriosus
This murmur is characteristic of a patent ductus arteriosus.
What does rib notching on chest X-ray indicate?
Coarctation of the aorta
Rib notching occurs due to erosion from collateral circulation.
What type of murmur is associated with aortic stenosis?
Crescendo-decrescendo murmur
This is a characteristic sound in aortic stenosis.
What pulse characteristic is associated with aortic stenosis?
Slow rising pulse
This pulse pattern is indicative of aortic stenosis.
What is the relationship between alcohol and dilated cardiomyopathy?
Alcohol/dilated cardiomyopathy leads to pan-systolic murmur (mitral regurgitation)
Alcohol use can contribute to the development of dilated cardiomyopathy.
What type of murmur is indicative of aortic regurgitation?
Early diastolic murmur
This murmur occurs during the early phase of diastole.
What is indicated by diminished or absent lower limb pulses?
Coarctation of the aorta
This finding suggests reduced blood flow due to coarctation.
What does radio-femoral delay suggest?
Coarctation of the aorta
This delay is a classic sign of aortic coarctation.
What does radio-radial delay indicate?
Coarctation or aortic dissection
This finding requires further investigation for diagnosis.
What does MRS ASS stand for?
Mitral Regurgitation Systolic, Aortic Stenosis Systolic
These are types of systolic murmurs.
What type of murmur radiates to the neck?
Systolic murmur of aortic stenosis
This radiating pattern is characteristic of aortic stenosis.
What should be done if endocarditis is suspected with a positive blood culture for bovis?
Colonoscopy
This is necessary as colon cancer is the most likely cause of infective endocarditis in such cases.
What is a symptom of aortic dissection?
Sudden tearing/ripping chest pain, radiates to back
This type of pain is characteristic of an aortic dissection.
What does a soft S1 indicate?
Mitral regurgitation
This finding suggests a problem with mitral valve closure.
What does a soft S2 indicate?
Aortic stenosis
This finding may suggest a problem with aortic valve closure.
What are the symptoms of mitral stenosis?
Malar flush, atrial fibrillation
These symptoms are associated with mitral stenosis.
What are the Jones criteria for rheumatic heart disease?
Migratory polyarthritis, carditis, subcutaneous nodules, erythema marginatum
These criteria are used for diagnosis of rheumatic fever.
What do X and Y descents in JVP indicate?
Signs of heart failure; constrictive pericarditis
These descents are observed in the jugular venous pressure waveform.
What causes mitral stenosis?
CRAP: congenital, rheumatic, and prosthetic valve
These are common causes of mitral stenosis.
What type of murmur is associated with mitral stenosis?
Mid-diastolic rumbling murmur
This murmur occurs during diastole.
What does a large ‘y’ wave and raised JVP indicate?
Tricuspid regurgitation
This finding is indicative of tricuspid valve dysfunction.
What is the tetralogy of Fallot characterized by?
RVH, ventricular septal defect, pulmonary stenosis, overriding aorta
It is the commonest cause of congenital cyanotic heart disease.
What is a side effect of ACE inhibitors?
Dry cough
This is a common side effect that may necessitate discontinuation.
What is contraindicated in renal artery stenosis?
ACE inhibitors
Use of ACE inhibitors can worsen renal function in this condition.
What does a collapsing pulse indicate?
Aortic regurgitation
This pulse characteristic is often seen in aortic regurgitation.
What does a machine-like murmur indicate?
Patent ductus arteriosus
This murmur occurs when the ductus arteriosus fails to close.
What is another symptom of aortic stenosis?
Slow rising pulse
This is a repeated characteristic indicating severe aortic stenosis.
What are splinter hemorrhages associated with?
Infective endocarditis
These are small, linear streaks found under the nails.
What is the main cause of infective endocarditis in IV drug users?
Staphylococcus aureus
This organism is a common pathogen in infective endocarditis.
What organism is associated with infective endocarditis after dental surgery?
Streptococcus viridans
This organism is part of the normal flora of the mouth.
What is an atrial myxoma?
A noncancerous tumor in the heart
It most often grows on the wall that separates the two sides of the heart.
What is cardiac tamponade?
Collection of blood/fluid/pus/clots/gas around the heart
This condition prevents heart contractions and is a medical emergency.
What is the treatment for pericarditis?
Pain relief; NSAIDs
Nonsteroidal anti-inflammatory drugs are commonly used.
What is found on examination in cases of left-sided heart failure (6)
Mitral regurgitation
Displaced apex
Tachycardia
Bilateral and basal crackles
3rd heart sound
Tachypnoea
What conduction is associated with a triphasic systolic and diastolic murmur
acute pericarditis
What are the signs of cardiac tamponade (3)
Distended heart sounds
Distended JVP
Low blood pressure
Which side of murmurs are loud on expiration/inspiration
left sided - expiration
Right sided - inspiration
What condition is likely if there is a positive Murphy’s sign
Cholecystitis
What are pale stools, jaundice, and abdominal pain signs of
Biliary obstruction
What are the signs of portal hypertension and ascites (3)
abdominal distension
Capet medusae
Shifting dullness
What do tinkling bowel sounds indicate
Bowel obstruction
What are vesicular rashes and weight loss signs of
Coeliac disease
Rice water like stools are signs of what infection
vibrio cholera
What is present in cases of primary biliary cirrhosis
anti-mitochondrial antibodies
What is present in autoimmune hepatitis
anti smooth muscle antibodies
In what condition is cobblestone mucosa found in
Crohn’s disease (deep fissuring ulceration of mucosa)
What diuretic can be used to treat ascites
spironolactone
What does a corkscrew oesophagus on barium swallow suggest
diffuse oesophageal spasm
Conditions are Mallory’s hyaline bodies present in (2)
alcoholic liver disease
Chronic active hepatitis
What are crypt abscesses and cryptitis a sign of
Crohn’s
What are onion skinning fibrosis and beading of bile ducts signs of
primary sclerosing cholangitis
Thumb-printing on X ray suggests what
ischaemic colitis
What are the signs of acute cholangitis (3)
fever
Jaundice
Abdominal pain
What is Virchow’s node
a lymph node in the left supra-clavicular fossa
Suggests gastric malignancy
What is a side effect of spironolactone
gynaecomastia
What time of mouth disease to patients with Crohn’s have
Stomatitis gangrenosum
Which bacteria produce endotoxins/endotoxins
Negative - endotoxin
Positive - exotoxin
What receptors do IgE bind to in order to initiate a response
Fc
Where is the trachea palpated
Jugular notch
Which nerve supplies the rectum
Pudendal (s2,3, and 4)
Which antibiotic is used for gram positive cover
Vancomycin
What pattern of inheritance does the CF gene follow
Autosomal recessive
Which bone has no articulations in the body
hyoid bone
What is the role of 2,3-DPG
An acid that helps bind oxygen
Reduced amounts of this acid results in more dissociation
What are the cranial foraminae
Cribiform plate of the ethmoid bone
Optical canal
Superior orbital fissure
Foramen rotundum
Foramen ovale
Internal acoustic meatus
Jugular foramen
Hypoglossal foramen
What are the spirometry readings in asthma
FVC normal
FEV1 reduced
ratio reduced
What are the spirometry readings in COPD
FVC reduced
FEV1 reduced
Ratio normal
What are the spirometry readings in restrictive airway diseases
FVC reduced
FEV1 reduced
Ratio normal
What is type II respiratory failure
low oxygen levels with high carbon dioxide levels
