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2A > Things I get wrong a lot > Flashcards

Things I get wrong a lot Flashcards

1
Q

How to treat IHD?

A

Immediate = 300mg aspirin and GTN
Hospital = Morphine, Oxygen, Nitrates, Aspirin/Clopidogrel
Long term = Beta-blockers, ACEis, Clopidogrel, Aspirin, Statins

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2
Q

Causes of left sided HF?

A

IHD, MI, Cardiomyopathy, Ventricular hypertrophy, Constrictive pericarditis, Cardiac tamponade

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3
Q

S&S of left sided HF?

A

Dysponea, poor exercise tolerance, fatigue, orthoponea, nocturnal dysponea/cough, wheeze, nocturia and cold peripheries

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4
Q

Causes of right sided HF?

A

LV HF, pulmonary stenosis, lung disease e.g. cor pulmonale

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5
Q

S&S of right sided HF?

A

peripheral oedema, ascites, nausea, anorexia and epistaxis

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6
Q

What causes Marfans and Ehlers-Danlos Syndromes?

A

Inherited Autosomal Dominant conditions

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7
Q

What is Ehlers-Danlos syndrome?

A

A defective type 1 and type 2 collagen production

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8
Q

What may trigger gout onset?

A

Red meat/alcohol binge, trauma/surgery to the joint, starvation, infection and diuretics

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9
Q

What may trigger pseudo-gout onset?

A

Ilness, direct joint trauma or surgery

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10
Q

Name some risk factors for pseudo-gout?

A

Old age, being female, hyperparathyroidism, hypophospataemia and haemochromatosis

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11
Q

Name some common extra-articular manifestations of RA?

A

Rheumatoid nodules, vasculitis, pulmonary fibrosis and pericarditis

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12
Q

What is scleroderma?

A

An autoimmune disease of the connective tissue leading to scarring and thickening of tissues

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13
Q

How may scleroderma present?

A

Weight loss, fatigue, Reynauds phenomenom, Sclerodactyly and thickened skin on the face

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14
Q

Red flag signs in diarrhoea?

A

Severe dehydration, electrolyte imbalance, renal decline/failure, severe abominal pain and immunocompromised patients

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15
Q

What is the main cause of travellers diarrhoea? How does it present?

A

Enterotoxigenic E.coli.

Watery diarrhoea precceded by cramps and nausea

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16
Q

Which antibiotics most commonly cause C.difficile infection?

A

clindamycin, cephalosporins, carbapenems, co‑amoxiclav and quinolones

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17
Q

How is C.difficile treated?

A

Metronidazole, Vancomycin (main) and foecal transplant

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18
Q

How do you treat cholera?

A

Oral rehydration salts/IV fluids and doxycycline/tetracycline

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19
Q

Name 3 parasites commonly affecting the GI tract

A

Cryptosporidium, Entomeba histolytica and Giardia

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20
Q

Non GI symptoms of Coeliac’s disease?

A

Osteomalacia, weight loss, fatigue, iron deficiency anaemia and weakness

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21
Q

GI symptoms of Coeliac’s disease?

A

Steatorrhoea, diarrhoea, abdominal pain/cramps, abdominal bloating, nausea/vomiting

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22
Q

Diseases associtated with Coeliac’s disease?

A

Dermatitis herpetiformis, Sjorgen’s sydrome, T1DM etc. (autoimmune diseases)

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23
Q

What is gastritis?

A

Inflammation of the stomach mucosa following damage

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24
Q

Treating gastritis?

A

Antacids, H2-receptor antagonists e.g. cimetidine, PPIs and treat H.pylorio infection (lansoprazole, clarithromycin and amoxicillin)

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25
Q

What are some consequences of hypoglycaemia?

A 
Autonomic = sweating, anxiety, hunger, tremour, palpatations and dizziness
Neuroglycopenic = confusion, drowsiness, visual disturbances, seizures and coma
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26
Q

How does metformin work and what are its side effects?

A

Inscreases sensitivity to insulin, increases glucose absorption by the skeletal muscles, decreases liver glucose secretion and decreases glucose uptake at the intestines.
S/Es = GI disturbances e.g. diarrhoea, nausea and vomiting

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27
Q

How can you treat PVD?

A

Angioplasty/stenting, encourage patient to walk through pain (to assist new vessel formation) and smoking cessation

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28
Q

What causes psuedohypoparathyroidism?

A

Genetic abnormalities - there will be PTH resistance.

Short stature, short fingers, round face and a short neck are also seen

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29
Q

Describe 1st line hypertension treatment?

A

55 + and any age in black patients = CCBs

<55 and white = ACEis

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30
Q

Which condition is most likely to cause thoracic aortic aneurysm?

A

Marfans syndrome - defective fibrillin 1 production

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31
Q

1st line treatment for PE

A

LMW Heparin

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32
Q

What is the staging for lymphoma?

A

Ann Arbor Staging
I = one area of lymph node involvment
II = 2+ lymph nodes involved but on the SAME side of the diaphragm
III = 2+ lymph nodes involved but on DIFFERENT sides of the diaphragm
IV = Extranodal involvment

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33
Q

What drug is used in disollution therapy and for which gall stones?

A

Ursodeoxycholic acid for cholesterol gall stones

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34
Q

Which disease matches these 3 classic symptoms:

Urethritis, Conjunctivitis and arthritis

A

Reactive arthritis

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35
Q

Which disease causes bony growths (may lead to hearing loss, enlarged head etc.)

A

Pagets disease of bone - causes bones to become fragile and misshapen, usually affects pelvis, skull, spine and legs

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36
Q

First line BPH treatment?

A

Alpha-blockers e.g. tamulosin

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37
Q

Which cancer gives painless heamaturia?

A

Bladder (transitional cell bladder cancer)

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38
Q

Signs of meningitis?

A

neck stiffness, photophobia, Kernig’s sign, non-blanching petechial rash, seizures and decreased GCS score

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39
Q

What are the two signs seen in hypocalcaemia?

A

Chvostek’s (twitch in response to tapping of the facial nerve) and Trousseau’s (spasm of hand when tightening blood pressure cuff) signs

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40
Q

Patient has UMN signs plus muscle wasting and fasiculation, what do they have?

A

Motor neruone disease

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41
Q

What is the syndrome of innapropriate aldosterone secretion called?

A

Conn’s syndrome

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42
Q

What are the antibodies found in Graves and Hashimotos?

A

Thyroid Stimulating Receptor hormone antibodies in graves, anti-TPO in hashimotos

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43
Q

What may cause increased testosterone in a woman?

A

Polycystic ovary disease

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44
Q

What condition may present with periodic sweating, headaches, snoring and insomnia?

A

acromegaly

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45
Q

A fault with which protein is associated with eczema?

A

Filaggrin

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46
Q

How do you treat an arterial thrombus?

A

LMW heparin, aspirin and thrombolytic therapy

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47
Q

What imaging methods assess PE?

A

CT angiography and V/Q scan

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48
Q

How do you treat a PE?

A

LMW heparin, then thrombolysis (if haemodynamically unstable).
Long term = DOAC or warfarin (3 months if provoked and up to 6 months if unprovoked)

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49
Q

Define Myeloma?

A

Early malignant proliferation of bone marrow cells

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50
Q

What increases the risk of both types of lymphoma?

A

EBV, being male and immunosuppression

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51
Q

Treatments for non-hodgkin’s lymphoma?

A

Low grade = Radiotherapy in local disease or palliative care

High grade = R-CHOP chemotherapy

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52
Q

Clinical features of platelet dysfunction?

A

Epistaxis, Gum bleeding, Easy bruising, Petechiae/purpura, Traumatic haematoma

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53
Q

Tests for thalassaemia?

A

FBC, MCV, blood film, iron/Hb levels

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54
Q

Treatment for thalassaemia?

A

Life long transfusions, splenectomy, bone marrow transplant/stem cell transplant

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55
Q

What are the most commonly used antibiotics in UTIs?

A

Nitrofurantoin and Trimethoprin

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56
Q

What is Fanconi syndrome?

A

Damage to the PCT causing changes in the urinary content

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57
Q

How does membranoproliferative glomerulonephritis present?

A

Nephrotic and nephritic syndrome

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58
Q

What two organs does Goodpasture’s syndrome affect and how?

A

Kidneys - oedema and hypertension

Lungs - dysponea, chest pain and haemoptysis

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59
Q

Risk factors for urinary stones?

A

Obesity, diuretics, IBD, PKD, structural abnormalities of the urinary tract and past occurance

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60
Q

How does renal colic present?

A

Unilateral flank pain which radiates to the groin associated with nausea/vomiting

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61
Q

How do uriany stones present?

A

Dysuria, Urinary urgency, Urinary frequency and Haematuria

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62
Q

Complications of urianry stones?

A

Chronic renal damage, Recurrent stones, Renal abscess and Renal fistula

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63
Q

Medical treatment for CKD?

A

EPO/Iron supplementation, Frusemide, Losartan/Ramipril and Atorvastatin/simvastatin

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64
Q

What is Beck’s triad?

A

Hypotension, jugular venous distention (raised JVP) and muffled heart sounds
This is a sign of cardiac tamponade

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65
Q

What is pheochromocytoma?

A

An endocrine tumour, this in an important differential in hyperthyroidism

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66
Q

What is Charcot’s triad?

A

Jaundice, fever and right upper quadrant pain indicating ascending cholangitis

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67
Q

How do loop diuretics work?

A

Inhibition of the sodium/potassium/chloride symporter in the loop of Henle

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68
Q

How do thiazide diuretics work?

A

Inhibition of the sodium chloride transporter in the distal convoluted tubule

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69
Q

How do potassium sparring diuretics work?

A

Inhibition of aldosterone receptor in the distal tubules

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70
Q

What is the ABCD2 score used to calculate?

A

Risk of stroke after TIA
Age 60+ - 1 point
BP >/= 140/90 - 1 point
Clinical features: unilateral weakness - 2 points, slurred speach no weakness - 1 point
Duration: >/= 1 hour - 2 points, 10-59mins - 1 point
Diabetes - 1 point

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71
Q

What is the QRISK2 score used to calculate?

A

Risk of heart attack

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72
Q

How does sarcoidosis affect 1,25-dihydroxyvitamin D production?

A

It becomes uncontrolled so will eventually lead to hypercalcaemia

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73
Q

How does hyperthyroidism affect calcium levels?

A

It causes hypercalcaemia

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74
Q

How do you identify suspected coeliac’s diseases cases which should be sent for biopsy?

A

IgA tissue transglutaminase (tTg) and IgA endomysial (EMA) antibodies present in the blood

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75
Q

How can you tell between IBS and IBD?

A

Faecal Calprotectin is raised in IBD but not in IBS

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76
Q

What is the most common composition of renal stones?

A

Calcium oxalate

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77
Q

What are the stages in CKD grading?

A

Stage 1 > 90 ml/min with evidence of renal damage
Stage 2 60-89 ml/min with evidence of renal damage
Stage 3a 45-59 ml/min with or without renal damage
Stage 3b 30-44 ml/min with or without renal damage
Stage 4 15-29 ml/min with or without renal damage
Stage 5 <15 ml/min, established renal failure
ml/min is in refference to eGFR

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78
Q

A patient in their twenties presents with b syptoms and an asymmetrical painless lymphadenopathy worse on drinking alcohol what is the likely diagnosis?

A

Hodgkin’s lymphoma

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79
Q

Where are auer rods found?

A

AML

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80
Q

How does multiple myeloma present?

A

C - calcium increse
R - renal impairment
A - anaemia (and pancytopenia)
B - bone lesions/pain/fractures

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81
Q

What is leukocytosis?

A

An increased number of WBCs e.g. in CML

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82
Q

Name some side effects of amitriptyline?

A

It is anticholinergic so causes blurred vision, confusion, dry mouth and urinary retention

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83
Q

What are the TB drugs? Give SEs of each?

A

Rifampicin - Red/orange discolouration of urine/tears
Isoniazid - Peripheral neuropathy
Pyrazinamide - High uric acid levels → gout
Ethambutol - Colour blindness/reduced visual acuity

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84
Q

What are the known casues of tension headaches?

A

Depression, lack of sleep, missed meals and stress

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85
Q

What is the initial treatment for PE/DVT?

A

LMW Heparin, you perform thrombolysis in haemodynamically unstable patients

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86
Q

Patient (25-40) presents with long term dry cough, SOB and erythma nodosum. X-ray shows bilateral hilar lymphadenopathy and biopsy shows non-caseating granulomas with epithelioid cells. What is the likely diagnosis?

A

Sarcoidosis

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87
Q

What are the cardinal signs of carcinoid syndrome?

A

Cardiac involvment, bronchoconstriction, diarrhoea and flushing

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88
Q

What are the common causative orgnaisms of UTIs?

A

Klebsiella, E. Coli, Enterococcus, Proteus/pseudomonas and Staphylococcus saprophyticus

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89
Q

What are the causes of megaloblastic anaemia? How do you tell betweeen them?

A

B-12/folate defficiency
B-12 is found in fish, meat and pultory products so is often deficient in vegans. It is absorbed at the terminal ileum and deffiency also leads to neurological signs

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90
Q

What are teh beta-lactams?

A

Penicillins, Cephalosporins (e.g. ceftriaxone and cefotaxime) and Carbapenems (e.g. Ertapenem and Biapenem)

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91
Q

What are the red flags in bone pain and what do they signify?

A

Pain at rest/night - cancer, infection or fracture

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92
Q

Name some clinical features seen in spondlyarthropathies?

A

Sausage fingers, Psoriasis, Inflammatory back pain, NSAIDs response, Enthesitis, Arthritis, CRP elevation, HLAB27, Eye issues

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93
Q

What is fibromyalgia?

A

Widespread pain > 3 months in >11 of the 18 tender spots when no other cause can be identified

94
Q

Give some extra-articular manifestations of RA?

A

Nodule formation, lymphadenopathy, vasculitis, interstital fibrosis, IHDs, pericarditis, pericardial effusion, carple tunnel syndrome

95
Q

What makes up the crystals in gout and pseudogout?

A

Urate in gout, calcium phosphate in pseudo gout

96
Q

Pink puffers vs blue bloaters?

A

PP - Exhilation issues due to emphysema, perfusion is maintained - weight loss and breathlessness
BB - reduced perfusion causing cyanosis and chest expansion (take large breaths) - due to chronic bronchitis so there will be a productive cough and respiratory failure may occur

97
Q

S&S of acute asthma attack?

A

Dysponea, coughing, chest pain/tightness, tachyponea, tachycardia, cyanosis, drowsiness/confusion

98
Q

What are the two steroids you can use in acute asthma attack and how do you deliver them?

A

Hydrocortiosne - IV

Prednisolone - PO

99
Q

How does pneumonia occur?

A

Bacterial infection of the alveolar space leads to neutrophils and fluid moving into the lungs

100
Q

How much fluid is neded to diagnose pleural effusion?

A

Clinically - 500ml

CXR - 350ml

101
Q

Transudate vs exudate?

A

Transudate <25g/L of proteins due to CHF/liver cirrhosis/nephrotic syndrome
Exudate >35g/L protein due to infection e.g. TB or pneumonia/inflammation/malignancy

102
Q

What are the tests used to diagnose TB?

A

Latent disease = mantoux skin test

Active disease = ziehl-neelson stain/acid fast bascilli

103
Q

What is miliary TB and how do you test for it?

A

TB infection which has spread to the CNS - test using lumbar puncture

104
Q

What is polycythemia?

A

Relative polycythaemia = decreased plasma volume but normal RBC mass
Absolute polycythaemia = increase in RBC mass

105
Q

Name a thrombolysis drug?

A

Streptokinase and Alteplase

106
Q

What causes huntington’s disease?

A

CAG repetes on chromosome 4

107
Q

What is a Jacksonian March?

A

Where a seizure spreads from the distal part of the limb towards the ipsilateral face - seen in frontal lobe seizures

108
Q

What is the defining freature of a trigeminal neuraliga?

A

Sudden severe shooting facial pain lasting only for a few seconds

109
Q

What are the triggers of migraine?

A

Chocolate, Hangovers, Orgasms, Cheese/Caffine, Oral-contraceptives, Lie-ins, Alcohol, Travel, Exercise, Stress

110
Q

Where in the nervous system does demyelination NOT occur in MS

A

Cerebellum

111
Q

Name the causes of macrocytic anaemia?

A

B-12 deficiency, alcohol excess/liver damage, hypothyroidism, haemolysis, BM failure and pernicious anaemia

112
Q

Name the causes of iron deficieny anaemia?

A

Blood loss, poor diet, malabsorption and hook worm

113
Q

What medications prevent an angina attack and what medications reduce complications?

A

Angina attack prevention =Beta-blockers and CCBs

Complications prevention = Aspirin, statins and ACEis

114
Q

How does acute pericarditis appear on ECG?

A

Saddle shaped ST elevation and PR depression

115
Q

What criteria is used to diagnose IE?

A

Duke criteria

116
Q

What are common SEs of CCBs?

A

Oedema, flushing and palpatations

117
Q

What are common SEs of amioderone?

A

Sun sensitivity, Hyperthyroidism, Corneal deposits, Interstitial pneumonitis, Hepatic disorders and Nausea

118
Q

How do you manage acute AF?

A

Rate control = Bisoprolol or Diltiazem

Anticoagulation = LMW Heparin (until emboli risk is assed) then if high risk DOAC (e.g. apixaban) or warfarin

119
Q

What are the steps in chronic asthma management?

A

Step 1 = Short acting Beta-2 agonists (if >1 daily/night time symptoms go to step 2)
Step 2 = Add standard dose inhaled steroids
Step 3 = Add long acting Beta-2 agonists

120
Q

What is Virchow’s triad?

A

Factors which contribute to thrombosis:
Hypercoagulability
Haemodynamic Changes (stasis/turbulence)
Endothelial injury/dysfunction

121
Q

Define chronic bronchitits?

A

A cough with sputum production for >3 months for over 2 years

122
Q

Type 1 vs 2 respiratory failure?

A

Type 1 = Low PaO2, Normal/low PaCO2

Type 2 = High PaCO2, Normal/low PaO2

123
Q

What is the most common microorganism to cause osteomyelitis?

A

Staph. aureus

124
Q

What is the mode of action of gliclazide?

A

Stimulates beta cells to secrete insulin

125
Q

What visual disturbance occurs in acromegaly?

A

Bitemporal hemianopia

126
Q

What is the first treatment in DKA?

A

Replace volume with fluids - then give insulin

127
Q

What is the most common cause of primary hyperthyroidism?

A

Graves disease

128
Q

What is the first line treatment for thyroid storm?

A

Propanolol (consider diltiazem if contraindicated) - to slow heart
Then give carbimazole

129
Q

What can gram -ve bacteria release?

A

Endotoxins

130
Q

How do viruses cause diesease?

A

Direct destruction of host cells, Cell proliferation and cell immortalisation, Inducing immune system mediated damage and Modification of host cell structure or function

131
Q

What is a protazoa?

A

A single celled eukaryotic organism, causes malaria

132
Q

Where do viruses replicate?

A

DNA viruses = nucleus, RNA viruses = cytoplasm

133
Q

What is the best way to identify gall stones?

A

Abdominal US

134
Q

What are adenomas?

A

Benign tumours - may become cancerous

135
Q

What is Reynold’s pentad?

A

Charcot’s triad (Jaundice, RUQ pain and fever in ascending cholangitis) PLUS hypotension and decreased consiousness - this indicates sepsis onset

136
Q

What causes severe abdominal pain radiating to the back, nausea and vomiting?

A

Acute pancreatitis

137
Q

What is cobalamin deficiency?

A

B-12 deficiency - caused by disorders of the stomach, small bowel, pancreas and seen in strict vegitarians

138
Q

What is Choledocholithiasis?

A

Bile duct stones/gall stones, will cause intermittent pain which is worse after eating

139
Q

What is a lentivirus?

A

A genus of retroviruses which casue severe diseases with long incubation periods e.g. HIV

140
Q

What dies innate immunity depend on?

A

Leukocytes e.g. natural killer cells, mast cells, eosinophills and basophils

141
Q

What is a malignant neoplasm of glandular epithelium called?

A

Adenocarcinoma

142
Q

What does Emax describe?

A

The potency of a drug

143
Q

Describe the types of hypersensitivity reactions?

A 
T1 = IgE mediated in allergic response/anaphylaxis
T2 = IgG and IgM mediated in autoimmune disease e.g. Rheumatic fever/Grave's/Good Pastures
T3 = immune complex mediated in IgA nephropathy and SLE
T4 = pre-sensitized T lymphocytes coming into contact with antigens in contact dermatitis and Gullain-Barre syndrome
144
Q

How does Botox work?

A

Inhibits the release of acetylcholine from the pre-synaptic neurones at the neuromuscular junction leading to muscle paralysis

145
Q

What antibiotics are used in diverticulitis?

A

Ciprofloxacin and metronidazole

146
Q

Where are NSAIDs most likely to cause ulceration?

A

The duodenum

147
Q

What is the first line investigation in appendicitis?

A

Abdo US

148
Q

What does bloody diarrhoea and a recent trip to hospital suggest is the causative organism?

A 
Bloody = bacerial
Hoptial = C. difficile
149
Q

What is C.difficile?

A

A gram positive, spore forming, obligate anaerobe

150
Q

What is deontology?

A

Acts are right or wrong and people have a duty to act accordingly

151
Q

Where are tamulosin and finasteride used?

A

Symptomatic BPH

152
Q

What are the treatments for prostate cancer?

A

Radical prostectomy, orchidectomy, antigonadotrophins e.g. goserelin/buserelin, androgen receptor blockers e.g. bicalutamide/futamide

153
Q

What stimulates the external urethral sphincter to contract?

A

The pudendal nerve

154
Q

Where are calcium levels monitored?

A

The parathyroid gland

155
Q

What causes syphyllis?

A

Treponema pallidum

156
Q

What causes a rise in PSA?

A

Benign prostate enlargement, Urinary tract infection, Prostatitis and Prostate cancer

157
Q

What is teh Rome III criteria for IBS?

A

Abdo pain for at least 3 days a month for the last 3 months + two or more of:
Change in frequency
Change in form of stools
Pain improves upon defecation

158
Q

What drugs can treat IBS?

A

Anti-spasmodics e.g. dicyclomine for cramps
Loperamide for diarrhoea
Laxatives for constipation
Tricyclic antidepressants

159
Q

What are the initial treatments for UC and Chron’s?

A 
UC = 5 ASAs e.g. mesalazine
Chron's = prednisolone
160
Q

What can be seen on ECG in hyperkalaemia?

A

Absent P waves, long PR interval, wide QRS and tall tented T waves

161
Q

What can be seen on ECG in hypokalaemia?

A

U waves

162
Q

S&S of sepsis?

A

Shiver/fever/cold, Extreme pain, Pale/discoloured skin, Sleepy/difficult to wake, Impending doom, Shortness of breath
Septic shock = warm peripheries and bounding pulse

163
Q

Main symptom of pericarditits?

A

Sharp pleuritic chest pain worse when lying flat

164
Q

What is the most common cause of secondary hypoadrenalism?

A

Long term corticosteroid use

165
Q

What is seen in Barret’s oesophagus?

A

change from stratified squamous to simple colunmar

166
Q

What is angular stomatitis?

A

Sores in the corner of the lips, seen in coeliac’s disease alongside apthous ulcers

167
Q

What is Trosier’s sign?

A

Englarged Virchow’s nodes seen in gastric cancer

168
Q

What are the most common leukaemias?

A 
Adults = AML 
Children = ALL
169
Q

Symptoms of Polycythaemia Vera?

A

Headaches, dizziness, tinnitus, visual disturbances, itching after a hot bath and erythromelagia. It can also cause haemorrhage and thrombosis.
It this is the primary cause for polycythemia

170
Q

How will RBCs appear in iron defficiency anaemia?

A

Abnormally shaped (polikilocytosis), pale (hypochromic), vary in size (anisocytosis) and small (microcytosis)

171
Q

When does asterixis occur?

A

Type 2 respiratory failure or liver failure

172
Q

How does liver failure affect oestrogen levels and what does this lead to?

A

Increased oestrogen (as the liver can no longer break it down), this causes spider navaei and gynaecomastia

173
Q

What is Kussmaul breathing?

A

A deep breathing done in DKA (it is a form of hyperventilation to remove excess CO2)

174
Q

What are the definitions of liver failure?

A

INR > 1.5, onset duration of <26 weeks, mental alteration without cirrhosis, no previous liver disease

175
Q

What is painless jaundice a red flag for in teh UK?

A

Cancer of the pancreatic head (could also be cholangiocarcinoma howevere this is rare in the Western World)

176
Q

S&S and test for addisons?

A

Hyperpigmentation, fatigue, tearfulness, weakness and anorexia
ACTH stimulation test/Synacthen test

177
Q

Test for Wilson’s disease?

A

24hr urinary copper secretion

Liver biopsy - DIAGNOSTIC

178
Q

S&S of haemachromatosis?

A

Skin bronzing/goes slate grey, joints pain, erectile dysfunctions/amenorrhoea, liver failure and kidney issues

179
Q

Which antibiotics inhibit nucleic acid synthesis?

A

Ciprofloxacin, Metronidazole, Rifampicicin and Trimethoprim

180
Q

What is a common cause of neonate meningitis?

A

Strep. agalactiae

181
Q

How do you differentiate between teh non-lactose fermenting (pale on MacConkey) aerobic bacilli?

A

Oxidase test
Positive = pseudomonas
Negative = proteus, salmonella and shigella

182
Q

What are the two types of alpha-haemolytic strep?

A

Optochin resisitant e.g. strep. viridans

Optochin sensitive e.g. strep pneumoniae

183
Q

What are the two types of beta-haemolytic strep?

A

Lancefield A = strep. pyogenes

Lancefield B = strep. agalactiae

184
Q

What is teh first line test for lung cancer?

A

CXR

185
Q

What is seen in pleural effusions?

A

Stony dull percussion

186
Q

What is the immediate management for a TIA?

A

300mg aspirin

187
Q

What is the duke’s staging of colonc cancer?

A 
A = The cancer is in the inner lining of the bowel or it is slightly growing into the muscle layer. 
B = The cancer has grown through the muscle layer of the bowel.
C = The cancer has spread to at least 1 lymph node close to the bowel.
D = The cancer has spread to another part of the body
188
Q

S&S of Conn’s syndrome?

A

Weakness, cramps, polyuria, polydypsia, parasthesia and increased BP

189
Q

How do you serologically differentiate between UC and Chron’s?

A 
UC = pANCA positive
Chrons = ASCA positive
190
Q

What are owls eyes inclusions?

A

A radiological/histological pattern that is highly specific to cytomegalovirus

191
Q

What is the most common cause of foot drop?

A

Compression of the peroneal nerve

192
Q

Which types of leukaemia have blast cells?

A

AML and ALL

193
Q

What are candersartan and amlodipine?

A 
Candasartan = ARB
Amlodipie = CCB
194
Q

Risk factors for GORD?

A

Lower oesophageal hypotension, hiatus hernia, oesophageal dysmotility, obesity, gastric acid hypersecretion, delayed gastric emptying, smoking, alcohol, pregnancy and drugs e.g. tricyclics

195
Q

What is the first line test for a bowel obstruction?

A

X-ray

196
Q

Describe duodenal ulcers?

A

Worse several hours after eating and relieved by eating

197
Q

What is the dignostic test for bowel cancer?

A

Colonoscopy

198
Q

Where do the majority of colon cancers occur?

A

Distal colon

199
Q

Name the complications of PKD?

A

Liver cyst formation, Increased blood pressure => CVD, berry aneurysm and kidney stones

200
Q

How do you treat malaira?

A 
Uncomplicated = oral chloroquine
Complicated/severe = IV artesunate
201
Q

What is seen in acute inflammation?

A

Rubour (redness), Dolor (pain), Calor (heat), Tumour (swelling) and loss of function
There will be neutrophil polymorph infiltration

202
Q

What is amaurosis fugax?

A

Unilateral painless progressive vison loss ‘like a curtain descending’ typically seen in TIA due to retinal artery occlusion

203
Q

Risk factors for peripheral neruopathies?

A

Diabetes, alcohol abuse, vitamin B deficiencies, autoimmune diseases e.g. sjorgens and SLE, immunocompromised patients (due to increased risk of infection e.g. lyme disease, shingles, EBV, HBV/HCV and HIV)

204
Q

What are the most common bacterial and viral causes for COPD exacerbation? Which is the most common?

A

Bacterial - H.influenzae
Viral - rhinovirus
Bacterial exacerbations are more common

205
Q

What is seen in RBBB and LBBB?

A

WILLIAM MARROW
LBBB = slurred S wave in V1, R wave in V6
RBBB = R wave in V1, slurred S wave in V6

206
Q

S&S of IE?

A

Fever, Roth spots, Osler nodes, Murmur, Janeway lesions, Anaemia, Nail bed (splinter) haemorrhages, Emboli (FROM JANE)

207
Q

What is xanthelasma?

A

Build up of yellow plaques on the eyelid seen in hyperlipidaemia

208
Q

RFs for oesophageal cancer?

A

poor diet, alcohol, smoking, oesophagitis, barretts oesophagus, obesity, hot drinks and reflux

209
Q

Causes of diverticular disease?

A

Low fibre diet, Obesity, NSAIDs and Smoking

210
Q

What is Thrombotic Thrombocytopenic Purpura and how do you treat it?

A

Blood condition presenting with low platelets, RBC fragmentation, renal failure, neurological deficit and fever as blood clots occur in the small vessels throught the body
Treat first line with urgent plasma exchange

211
Q

What is hydroxycarabimide?

A

A bone marrow suppressive drug used to treat polycythaemia rubra vera and sickle cell disease

212
Q

What is cytopenia?

A

Whe one or more of your blood cell types are low

213
Q

What is leukonychia?

A

White discolouration of the nails due to injury of the nail base

214
Q

PBC vs PSC?

A 
PBC = autoimmune (affects small interlobular ducts), more common in women and associated with AMA
PSC = associated with UC (affects intra/extra-hepatic ducts), more common in men and associated with ANCA and ANA
215
Q

How do you treat myasthenia gravis?

A

Neostigmine/pyridostigmine - block the action of actelycholinesterase so increase the amount of ACh in the synapse

216
Q

Define the thresholds for life-threatening asthma attack?

A

PEF <33%, silent ches/cyanosis, arrythmia/hypotension, exhaustion/confusion/coma, PaCO2 >4.6kPa, SaO2 <92%/PaO2 <8kPa

217
Q

Define the thresholds for a severe asthma attack?

A

Inability to complete scentences in one breath, RR >/= 25, pulse >/= 110, PEF 33-50%

218
Q

S/Es of salbutamol?

A

Headaches, restlessness, fine tremour, palpatations and sore throat

219
Q

S&S of aortic vs mitral stenosis?

A 
Aortic = ejection systolic murumr, non-displaced apex beat, slow rising narrow pressure pulse
Mitral = mid-diastolic murmur, non-displaced apex beat, low volume pulse, malar flush
220
Q

S&S of aortic vs mitral regurgitation?

A 
Aortic = early diastolic murumr, displaced hyperdynamic apex beat, colapsing wide pressure pulse
Mitral = pansystolic murmur, displaced hyperdynamic apex beat, AF
221
Q

How does HF appear on CXR?

A

Alveoar oedema, kerley B lines, Cardiomegaly, Dilated promient upper lobe veins, pleural Effusions (ABCDE)

222
Q

S&S/test of Addison’s ?

A

Lean, tanned, tired, tearful, dizziness, postural hypotension, generally feeling unwell
Short ACTH stimulation test (Synacthen test)

223
Q

Causes of SIADH?

A

Malignacy, CNS issues, Chest disease, Drugs e.g. opiates, trauma, alcohol withdrawal and major abdo/chest surgery

224
Q

Treatment of carcinoid syndome?

A

Somatostatin anologue e.g. octerotide

225
Q

What are the two types of buising seen in pancreatitis?

A

Cullen’s sign = periumbillical bruising

Grey Turner’s sign = flank bruising

226
Q

Bacteria vs viral on a lumbar puncture?

A 
Bacterial = raised nutrophils, turbid, high protein, low glucose
Viral = raised lymphocytes, clear, normal glucose/protein
227
Q

Main causative organisms of bronchiectasis?

A

H. influenzae, Strep. pneumoniae, Staph. aureus and Psuedomonas aeruginosa

228
Q

Treatment of COPD?

A

1) SAMA/SABA
2) LAMA/LABA
3) Inhaled corticosteroids

229
Q

How can you localise focal seizures (frontal vs parietal)?

A 
Frontal = Motor features (retained awarness), Jacksonian march, dysphasia and post-ictal weakness
Parietal = sensory disturbances and parasthesia
230
Q

How can you localise focal seizures (temporal vs occipital)?

A 
Temporal = Motor features e.g. lip smacking/grabbing (impaired awareness), dysphasia, deja vu, emotional disturbances/hallucinations
Occipital = visual phenomona
231
Q

S&S of a PCA stroke?

A

Contralateral homonomous hemianopia/cortical blindness, visual agnosia/prospagnosia, dyslexia and unilateral headache

232
Q

S&S of an ACA stroke?

A

Les weakness/sensory disturbances, gait apraxia/truncal ataxia, akinetic mutism and incontinence

2A (12 decks)

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