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Phase 2 Quick > Things I got Wrong in Mocks > Flashcards

Things I got Wrong in Mocks Flashcards

1
Q

Mechanism of action of Neostigmine and Pyridostigmine

(BONUS : what are they used to treat?)

A

Blocks active site of acetylcholinesterase
∴ ↑ amount of Ach available to post-synaptic membrane

Myasthenia Gravis

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2
Q

Mechanism of action of Levodopa

A

Crosses the blood-brain barrier and is converted into dopamine which acts to reduce neurological symptoms

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3
Q

Mechanism of action of COX-i e.g. ibuprofen

A

Inhibits conversion of arachidonic acid to prostaglandins by inhibiting COX1 and COX2

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4
Q

Mechanism of action of Mannitol

A

↓ Intracranial pressure by setting up osmotic gradient between CSF and subarachnoid space

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5
Q

Define hyperplasia

A

Increased size of tissue due to increase of number of constituent cells

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6
Q

Things you see on blood film for IDA

A

Hypochromic
Microcytic
Poikilocystosis
Anisocytosis
Pencil cells
Thromobocytosis

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7
Q

Symptoms for the cause of IDA

A

Meleana
Heavy menstrual bleeding
Change in bowel habits
Nose/Gum bleeding
Haematuria
Pregnancy
Haematemesis

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8
Q

What protein carries iron around the body?

A

Transferritin

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9
Q

What blood test is used to confirm IDA?

A

Serum Ferritin
Low

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10
Q

1 Blood test to confirm Graves’ disease

A

TSH receptor antibodies

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11
Q

3 Accepted modalities for hyperthyroidism Tx

A

Thyroidectomy
Anti-thyroid drugs - Carbimazole
Radioactive iodine

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12
Q

3 Pathophysiological processes on Osteoporosis

A

Increased bone remodelling
↓ Osteoblast activity
↑ Osteoclast activity
↑ Bone resorption
Micro-architectural distortion

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13
Q

MOA Bisphosphonates

A

↓Osteoclast activity

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14
Q

Alongside bisphosphonates, what should be prescribed for Osteoporosis?

A

AdCal
(Vit D AND Calcium supplements)

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15
Q

Scoring tool to assess risk of developing osteoporosis

A

FRAX

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16
Q

Prev Medical history Qs after an epileptic fit!

A

Prev head injury?
Underlying brain disease?
Fever?
Born at full term?
Recently taken drugs or alcohol?

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17
Q

2 Ix that should always be taken after someone had an epileptic seizure

A

CT head
MRI Head
EEG

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18
Q

Histological features seen in UC

A

↑plasma cells in lamina propria
Ulceration
Crypt distortion

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19
Q

2 Major Elements in Pathophysiology of asthma

A

Airway hypersensitivity
Causes airway inflammation
and ∴ bronchoconstriction

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20
Q

Carcinoma definition

A

Malignant neoplasm of epithelium

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21
Q

Histological features of 1º carcinomas

A

Abundant mitotic figures
Areas of necrosis
Ulceration
Poorly circumscribed margin
Endophytic growth
Variable resemblance of normal tissue

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22
Q

How does the Chlamydia Screen Programme aim to control increase of STIs?

A

Control chlamydia through early detection and Tx of asymptomatic infection

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23
Q

1ºprevention =

A

Disease prevented from developing

e.g. Vaccinations, counselling, minimising risk factors

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24
Q

2º prevention =

A

Disease treated early, usually before symptoms present, to minimise consequences

e.g. screening programmes, contact tracing!

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25
Q

3º prevention =

A

Chronic disease managed to prevent further complications or further damage

e.g. control of DM, giving aspirin to someone who has already had a stroke to prevent a second

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26
Q

Sensitivity definition

A

Proportion with the disease that are correctly identified by the test

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27
Q

Specificity definition

A

Proportion of people without the disease that are correctly excluded by the test

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28
Q

False negative definition

A

Incorrectly reports a negative result

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29
Q

Population screening programmes in UK

A

Breast cancer
AAA
Cervical cancer
Diabetic eye
Infectious disease in pregnancy
Sickle cell disease
Thalassaemia

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30
Q

3 Diagnostic criteria for nephrotic syndrome

A

Proteinuria > 3g/L
Hypoalbuminaemia > 25 g/L
Oedema

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31
Q

5 Comps of Nephrotic syndrome and why they occur

A
  1. Hyperlipidaemia / Atherosclerosis
    ↑overproduction in liver
  2. Thrombosis
    bc renal loss of anti-thrombin III
  3. Infection
    Renal loss of Igs
  4. Renal impairment
    bc hypovolaemia
  5. Anemia
    Loss of iron
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32
Q

When is is suitable to send a urine sample for culture?

A

Pregnant
Male with UTI symptoms
Persistent / Severe Sx
Failed Abx

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33
Q

What clinical features might make you think Aortic Stenosis is severe?

A

Slow rising carotid pulse
Pulsus parvus/Pulsus tardus
Split S2
Ejection-systolic murmur
↓Pulse amplitude
Systolic thrill

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34
Q

BEST absolute gold standard Tx for Aortic Stenosis?

A

Surgical Aortic Valve replacement

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35
Q

In elderly, frail patients, what is the best option to treat Aortic Stenosis?

A

Trans-Aortic Valve Insertion

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36
Q

Adrenaline MOA

A

Alpha and beta adrenergic receptor agonist

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37
Q

Other than Adrenaline, what drugs can be given to minimise the severity of Anaphylactic shock?

A

IV Chlorpheniramine
IV hydrocortisone

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38
Q

List 10 Symptoms of a severe anaphylactic reaction

A

Pruritus
Bronchospasm
Chest tightness
Cough
Faintness
↓ BP
Diarrhoea
Hypovolaemic shock!!!!
Chest pain
Abdo pain
Oedema of lips and tongue
Cyanosis
Periorbital oedema
Erythema

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39
Q

How does thrombocytopenia present?

A

Petechial rash
Easy bruising
Mucosal bleeding - nose bleeds

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40
Q

How does Factor 8 & 9 def (Haemophillias) present?

A

Joint & soft tissue bleeds

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41
Q

Tx for Cryptococcal Meningitis

A

Liposomal Amphotericin B

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42
Q

When should you suspect Oesophageal carcinoma?

A

Progressive dysphagia
Weight loss
IDA

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43
Q

When should a thrombophilia screen NOT be done?

A

if thrombosis suspected or Px on anti-coagulation

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44
Q

Severe acute Ischaemia presentation

A

Loss of sensation
Weakness
Cold

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45
Q

Meningococcal meningitis - which serogroup in the MC in UK?

A

Group B

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46
Q

Meningococcal meningitis - which serogroup in the MC worldwise?

A

Group A

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47
Q

What does a Pos Rhomberg sign indicate?

A

Neuro condition
Cervical myelopath

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48
Q

Extra sign’s of Cushings

A

Thin skin
Easy bruising

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49
Q

PCS signs / symptoms

i dont know if this is right idk where i got this from

A

Hirsutism
Acne

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50
Q

Haemoptysis + Haematuria = ?

A

GOODPASTURE’S

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51
Q

Over 55 + IDA,
What do you do?

A

Refer via 2 week wait pathway

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52
Q

PE
If Well’s score is above 4, what do you do?

A

CTPA

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53
Q

PE
If Well’s score is below or equal to 4, what do you do?

A

D-Dimer

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54
Q

ACh coordinates ___

A

Both sympathetic and parasympathetic

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55
Q

Where can you NOT find noradrenaline?

A

Skin

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56
Q

Known AIDS + Owl eye inclusion bodies =

A

CMV colitis

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57
Q

HSV can cause?

A

Encephalititis

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58
Q

What is the MC cause of LBO?

A

Malignancy

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59
Q

Describe some symptoms of optic neuritis

A

Blurry vision
Painful when looking sideways

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60
Q

Describe the cell type affected in Bladder cancer

A

Transitional (urothelial) = MC
UNLESS SCHISTOSOMIASIS, then Squamous Cell

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61
Q

Haemachromotosis Signs / Symptoms

A

Slate grey skin
Pituitary insufficiency
Testicular atrophy
Deranged LFTs

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62
Q

What would you find in a temporal artery biopsy in GCA?

A

Granulomatous w skip lesions

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63
Q

Tx GCA

A

Oral prednisolone if no vision change
IV prednisolone if vision change

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64
Q

Status Epilepticus Tx

A

IV Lorazepam 4mg
Then again after 5 mins if not working
Then IV phenytoin

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65
Q

What can sideroblastic anaemia be caused by?

A

Vitamin B6 def

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66
Q

H.Pylori increases the risk of which malignancy?

A

MALT Lymphoma

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67
Q

Peptic Ulcer common cause

68
Q

Describe the aspirate appearance of septic arthritis

A

Turbid, yellow

69
Q

Crest Antibodies

A

Anti-Scl-70

70
Q

PE Tx

A

Apixaban - DOAC
Warfarin
LMWH

71
Q

Pleural effusion XR finding

A

Bilateral costophrenic blunting

72
Q

DM makes UTI complicatde

73
Q

Goodpasture’s antibody?

74
Q

GS for Acromegaly

75
Q

Tx Syphilis

A

IM Benzylpenicillin

76
Q

Pathophys Osteoporosis

A

↓ Bone mass
Normal mineralisation

77
Q

Pathophys Paget’s

A

↑Osteoclastic bone resorption followed by formation of weaker bone

78
Q

Comps of ADPKD

A

SAH
Renal stones
Liver cysts
HTN

79
Q

Finding on ECG with Hyperparathyroidism

A

Short QT interval

80
Q

Causes of Hypercalcaemia

A

Hyperparathyroidism
↑ Diet
Sarcoidosis
CKD
Multiple Myeloma
Squamous cell cancer (PTHrP)
Dehydration
Bone mets

81
Q

Cell type targeted in MS

A

Oligodendrocytes

82
Q

MS Tx

A

ACUTE : IV methylprednisolone

CHRONIC : Beta interferon and glatiramer acetate
Infliximab

83
Q

Signs / Symptoms MS

A

NB LOSS YOU IDIOT
+ Charcot’s neuro triad
UMN signs
Uhthoff’s

84
Q

Staph Aureus Abx

A

Flucloxacillin

85
Q

S/E Vancomycin

A

Nephrotoxicity

86
Q

Pathophysiology Anaphylaxis

A

Allergen binds to IgE
Stimulates mast cell granulation
∴ Histamine released

Airway bronchoconstriction
Vessel vasodilation (and more permeable)

87
Q

MC cause of Lung Cancer in non-smokers?

A

Adenocarcinoma

88
Q

Asbestos CXR findings

A

Pleural plaques

89
Q

Atypical Pneumoniae Causes

A

Legions of Psitacci MCQ

Legionella Pneumophilia - AC
Chlamydia Psittaci - Birds
Mycoplasma Pneumoniae - Erythema Multiforme
Chlamydia Pneumoniae - School aged child
Q fever - farmers

90
Q

S/E SABA

A

Fine tremor

91
Q

What is Zollinger-Ellison?

A

Tumour - causes XS gastrin release
∴ lots of ulcers !
Presents with haemorrhage

92
Q

Late sign of pancreatic cancer?

93
Q

High SAAG causes

A

↑Portal HTN (i think)

Constrictive pericarditis
HF
Liver failure
Cirrhosis
Budd-Chiari syndrome

94
Q

Low SAAG causes

A

TB
Pancreatitis
Nephrotic syndrome
Peritoneal cancer

95
Q

What is gastroparesis?

A

Delayed gastric emptying

96
Q

Small/Non-Variceal bleeding Tx

A

Adrenaline injections
Thermal/Mechanical ligation
+ PPI for 72 hours

97
Q

Oesophageal varices bleeding Tx

A

Terlipressin - has bad S/E tho so be sure that it’s variceal before giving
Prophylactic ABx
Band ligation

98
Q

How to calculate units?

A

(ml x ABV%) / 1000

99
Q

Von-Hippel-Lindau assoc with?

A

Renal carcinoma

100
Q

Cell type in most renal carcinomas?

A

Clear cells

101
Q

Renal cancer assocs?

A

Von-Hippel Lindau
ADPKD
Tuberous sclerosis
Middle aged men
Smokers

102
Q

When to sus Phaeochromocytoma?

A

If BP hard to control, episodic or accelerating

103
Q

Diclofencac is a ?

104
Q

1st Line IxAppendicitis

105
Q

2nd Degree block
Mobitz type 1
ECG ?

A

Progressive PR elongation then dropped QRS

106
Q

2nd Degree block
Mobitz type 2
ECG ?

A

Randomly dropped QRS

107
Q

Causes of AF

A

Mrs SMITH

Sepsis
Mitral valve pathology
IHD
Thyrotoxicosis
HTN

108
Q

Abrupt Start and Stop of palpitations =?

109
Q

AVRT and AVNRT ECG?

A

Narrow QRS
AVRT : short PR
AVNRT : no P waves directly before/after QRS

110
Q

Pancreatitis Comps

A

Pancreatic abscess
Pancreatitis pseudocyst - can lead to intestinal obstruction
AKI
DIC
Acute resp distress syndrome!
DM
Sepsis
SIRS
Obstructive jaundice

111
Q

Pathophysiology behind MI

A

Atherosclerotic plaque RUPTURE

112
Q

Indications of atypical pneumonia

A

Time away from home
↓Na+
Confusion
Renal impairment
↑ Creatinine
↑ Urea

113
Q

Hypothyroidism Sx

A

BRADYCARDIC
Bradycardic
Reflexes relax slowly
Ataxia
Dry thin hair/skin
Yawning
Cold hands
Ascites
Round puffy face
Defeated demeanour
Immobile - ileus
Congestive HF

114
Q

DDx BPH

A

Age-related detrusor weakness

115
Q

What should you check once a Px has been diagnosed with HIV?

A

Hep B
Hep C
Syphilis

116
Q

Tx HIV

A

Aciclovir
Co-trimoxazole (septrin)

117
Q

When is risk of vertical transmission for HIV low?

A

With ART and undetectable viral load

118
Q

Clinical findings of HF

A

Peripheral oedema
↑ JVP
Bibasal crackles
Dull percussion at lung bases
Hepatomegaly
S3/S4
Tachycardia, Tachypnoea
Cyanosis
Cold, pale, confusion
Syncope
Narrow pulse pressure

119
Q

Classification system for HF Sx

A

New York Heart Association Classification

120
Q

Ix HF

A
  1. NT‑proBNP
  2. Echo
121
Q

COPD Scale

A

MRC Dyspnoea Scale

122
Q

CURB-65 ?

A

CURB-65

C onfusion
Uraemia > 7 mmol/L
RR > 30
BP systolic ≤ 90 mmHg or diastolic ≤ 60 mmHg
65 years or older

123
Q

MC CAP Cause?

A

Streptococcus Pneumoniae

124
Q

Stroke 1st line Ix

A

NON-CONTRAST CT head

125
Q

Other than aspirin, first line acute treatment for ischaemic stroke

A

Thrombolysis (IV alteplase) within 4.5 hours
OR
Thrombectomy

126
Q

Clopidogrel MOA

A

P2Y12 Inhibitor

127
Q

Findings on an ECG for AF

A

Irregularly irregular QRS complexes
No P waves

128
Q

Well’s Score ?
What treatment do you give ?

A

0 = lowe it
1 = consider oral anticoag or aspirin
2+ = oral anticoag (DOAC - apixaban)

BE AWARE OF CI

129
Q

What findings on a lumbar puncture indicate bacterial meningitis?

A

Raised neutrophils
Increased protein
Low glucose
Cloudy appearance

130
Q

Iatrogenic Comps of DKA Tx

A

Hypoglycaemia
Hypokalaemia
Cerebral oedema

131
Q

Blood tests used to monitor/diagnose diabetes

A

Random plasma glucose > 11.1 mmol/L
HbA1c > 48 mmol/L * check this unit
Fasting plasma glucose > 7 mmol/L

132
Q

RF Hodgkin’s

A

EBV infection
FHx
Male
20 - 40 years
Immunocomp
Smoker
Overweight

133
Q

Acute cholecystitis presentation

A

RUQ pain radiating to right shoulder
Fever
!!!!

Vomiting
No colour change

134
Q

4 Fs for Gallstones

A

Female
Fat
Forty
Fertile

135
Q

What is Murphy’s sign?

A

Pain upon palpation of right subcostal area while patient holds breath

136
Q

H. Pylori Tx

137
Q

Unmod RFs for BPH

A

Increasing Age
Black/Caucasian
FHx

138
Q

Reasons PSA may rise

A

Recent ejac
Biopsy
Exercise
UTI
Medication
BPH
Prostate cancer

139
Q

Screening programmes in the UK
What ages?

A

Breast cancer screening (50-71)
AAA (65 men)
Bowel cancer - FIT testing (60-74)
Cervical cancer (25-64)
Diabetic eye screening (12+)

140
Q

Tx Myasthenia Crisis

A

IV Ig
Plasmapharesis

141
Q

Antibodies for Myasthenia Gravis

A

Acetylcholine-receptor antibodies
Muscle specific kinase antibodies (MuSK)

142
Q

Define Uhthoff’s phenomenon

A

Neurological features are worsened due to ↑ body temp

143
Q

Findings on a lumbar puncture in a MS patient

A

Oligoclonal bands in the CSF
↑IgG
↑ WBC

144
Q

Summarise the process of atherosclerosis (6 marks)

A
  1. Endothelial injury - caused by smoking, high cholesterol
  2. LDL cholesterol accumulates in sub-endothelial space
  3. Macrophages enter and engulf LDL, forming foam cells
  4. Inflam response - smooth muscles proliferate and migrate
  5. Smooth muscles deposit collagen, form fibrous cap
  6. Pressure builds and fibrous cap weakens, leading to plaque rupture.
    Thrombus formation causes occlusion of artery
145
Q

Describe the LP findings of viral meningitis

A

Clear
Increased protein
Normal glucose
Increased lymphocytes

146
Q

Describe the LP findings of TB meningitis

A

Fibrin web
Increased lymphocytes
HIGH protein
Low glucose

147
Q

Describe the LP findings of Cryptococcal meningitis

A

Fibrin web
Increased lymphocytes
Increased protein
LOW glucose
HIGH OPENING PRESSURE

148
Q

Trimethoprim MOA

A

Folate inhibitor
(inhibits 5-dihydrofolate reductase)

149
Q

Shape of TB bacteria

A

Rod-shaped

150
Q

What would you see in a microscope with TB?

A

Caseating granuloma

151
Q

Patient presents with a rash that doesn’t go when pressed with a glass.
What is this and what is it a sign of?

A

Purpuric rash
Sign of DIC - bc of meningococcal septicaemia

152
Q

Tx Meningitis
Incl drug class

A

3rd generation cephalosporin
Cefotaxime or Ceftriaxone

153
Q

Neonate Meningitis bacteria

A

Group B step
aka S. agalactiae, S. pyogens

E.Coli, S. pneum, Listeria

154
Q

> 3 months Meningitis bacteria

A

Neisseria Meningitidis
Strep. pneumoniae

H. influenzae (type B)

155
Q

> 65 years Meningitis bacteria

A

S. pneumoniae

156
Q

What campaign is being used to reduce C.diff spread?

A

SIGHT campaign

157
Q

3 Meds for COPD

Have a precious history of Asthma

A

SABA
LABA
ICS

158
Q

Describe Duke’s criteria

A

Fever > 38
Vascular phenomenon - Roth spots
Immunological - Glomerulonephritis
jeidska

159
Q

What signs might you see on a patient’s hand that has IE?

A

Splinter haemorrhages
Osler nodes
Janeway lesions

160
Q

What might you see on a CXR for AS?

A

Calcification of aortic valve
Dilated ascending aorta
Cardiomegaly
Pulmonary oedema

161
Q

Septic infection Sx

A

Fever
Rigors
Night sweats
Weight loss
Anaemia
Clubbing
Splenomegaly

162
Q

XS alcohol abuse can lead to deficiency in what vitamine?
How does this present?

A

B1
Wernicke-Korsakoff’s Encephalopathy

163
Q

Tx delirium tremens

A

Chlordiazepoxide

164
Q

Delirium tremens presentation

A

Tachycardia
Confusion
Agitation
Tachypnoea

165
Q

What abx attack 30s?

A

Tetracyclines
Aminoglycosides

166
Q

VALPROATE S/E

A

Vomiting
Alopecia
Liver toxicity
Pancreatitis
Retention of fat i.e. weight gain
Oedema
Anorexia
Tremor
Enzyme inhibitor

167
Q

Cause of osteomyelitis

A

Staph Aureus
Staph epidermidis
Salmonella spp in Sickle cell patient

Phase 2 Quick (18 decks)

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