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Progress Test > Toms Top Tips > Flashcards

Toms Top Tips Flashcards

1
Q

eating worsens the pain of which ulcers

gastric or duodenal

A

gastric

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2
Q

eating improves the pain of which ulcers

gastric or duodenal

A

duodenal

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3
Q

why does urea rise in upper GI bleed

A

blood in the GI tract gets broken and one of the breakdown products is urea

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4
Q

what is group and save

A

where the lab simply checks the patients blood group and keeps a sample of their blood saved in case they need to match blood to it

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5
Q

what is crossmatch

A

the lab actually finds the blood, tests that it is compatible and keeps it ready in the fridge to be use if needed

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6
Q

we test all type 1 diabetics for which disease, even if they don’t have symptoms as the conditions are often linked

A

coeliac disease

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7
Q

anti-TTG and anti-EMA antibodies are which kind of immunoglobulin (IgA-E?)

A

IgA

remember to test for total IgA levels to exclude IgA deficiency

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8
Q

What can the causes of renal impairment be split into

A

pre renal
renal
post renal

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9
Q

if you come across a patient in the exam with a combination of acute renal failure and haemoptysis, what two conditions are you thinking of

A

good pasture syndrome

granulomatosis with polyangitis (aka wagerers granulomatosis

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10
Q

what is the difference between Goodpasture syndrome and granulomatosis with polyangiitis (AKA Wegener’s granulomatosis)

A

good pastures is associated with anti-GBM antibodies

Wegeners is associated with ANCA

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11
Q

most common cause of nephrotic syndrome in
children
adults

A

minimal change in children

focal segmental glomerulosclerosis in adults

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12
Q

what is the most common cause of primary glomerulonephritis

A

IgA nephropathy aka burgers disease

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13
Q

muddy brown casts found on urinalysis is a pathognomonic finding specific to which kind of kidney disease

A

acute tubular necrosis

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14
Q

type 4 renal tubular acidosis
- most common caused by reduced aldosterone
name some reasons that this can be due to

A 
adrenal insufficiency 
medications such as ACE inhibitors and sprionolactone 
SLE
diabetes 
HIV
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15
Q

what is the management of type 4 tubular acidosis

A

fludrocortisone

sodium bicarbonate and treatment of the hyperkalaemia may also be required

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16
Q

what is the most common cause of haemolytic uraemia syndrome

A

toxin produced by the bacteria e coli called the shiva toxin
shigella also produces this toxin
the use of antibiotics and anti motility agents such as loperamide to treat gsatronteritits increases the risk of developing HUS too

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17
Q

you should suspect rhabdomyolysis in patients with

A

crush injury
trauma
prolonged immobilisation
excessive sweating

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18
Q

name the main medications that cause hyperkalaemia

A 
Aldosterone antagonists (spironolactone and eplerenone)
ACE inhibitors
Angiotensin II receptor blockers
NSAIDs
Potassium supplements
19
Q

name the main conditions that cause hyperkalaemia

A 
Acute kidney injury
Chronic kidney disease
Rhabdomyolysis
Adrenal insufficiency
Tumour lysis syndrome
20
Q

name the main treatments for hyperkalaemia

A

insulin and dextrose to drive potassium into the cells
calcium gluconate to stabilise the cardiac muscle cells
nebulised salbutamol

21
Q

what is the most common cause of secondary hypertension

A

hyperaldosteronism (may also have low potassium but not always the case)

22
Q

what is the most common cause of paraneoplastic Cushing’s.

A

Small Cell Lung Cancer

23
Q

what are the 3 most dangerous aspects of DKA

A

dehydration
potassium imbalance
acidosis

24
Q

what is the mnemonic for treating DKA

A

FIG-PICK

F – Fluids – IV fluid resuscitation with normal saline (e.g. 1 litre stat, then 4 litres with added potassium over the next 12 hours)
I – Insulin – Add an insulin infusion (e.g. Actrapid at 0.1 Unit/kg/hour)
G – Glucose – Closely monitor blood glucose and add a dextrose infusion if below a certain level (e.g. 14 mmol/l)
P – Potassium – Closely monitor serum potassium (e.g. 4 hourly) and correct as required
I – Infection – Treat underlying triggers such as infection
C – Chart fluid balance
K – Ketones – Monitor blood ketones (or bicarbonate if ketone monitoring is unavailable)

25
Q

what are the main side effects of metformin

A

lactic acidosis

26
Q

what are the main side effects of pioglitazone (thiazolidinedione)

A

weight gain
fluid retention
anaemia
heart failure

27
Q

what is the most common side effect of Sulfonylureas

A

it is a gliclazide

weight gain
hypoglycaemia
increased risk of CVD and MI if used as montherapy

28
Q

mnemonic for symptoms of hypercalcaemia

A

renal stones, painful bones, abdominal groans and psychiatric moans

29
Q

what are the 2 main causes of secondary hyperparathyroidism

A

low vitamin D or CKD

30
Q

what is used to diagnose pheochromocytoma

A

plasma free metanephrines as they are less prone to fluctuations compared to catecholamines

31
Q

name the 2 most common causes of pneumonia

A 
Streptococcus pneumoniae (50%)
Haemophilus influenzae (20%)
32
Q

which antibiotic can you not treat atypical pneumonia with

A

penicillins

33
Q

name the 5 causes of atypical pneumonia “legions of psittacosis MCQs”

A 
Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
34
Q

which of the following atypical pneumonia does the exam patient stay in cheap hotel holiday and presents with hyponatramia

Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
A

legionella

35
Q

which of the following atypical pneumonia does the exam patient present with erythema multiform “target lesions”

Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
A

Mycoplasma pneumoniae

36
Q

which of the following atypical pneumonia does the exam patient is a school aged child with a mild to moderate chronic pneumonia and wheeze

Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
A

chlamoydophila pneumoniae

37
Q

which of the following atypical pneumonia does the exam patient a farmer with flu like illness

Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
A

Q fever aka Coxiella burnetii

38
Q

which of the following atypical pneumonia does the exam patient a parrot owner

Legionella pneumophila 
Psittaci 
M – mycoplasma pneumoniae
C – chlamydydophila pneumoniae
Qs – Q fever (coxiella burnetii)
A

Chlamydia Psittaci

39
Q

an exam patient who is a 20-40 year old black women presenting with a dry cough and SOB. they may have nodules on their shins suggesting erythema nodosum

what condition are you thinking about

A

sarcoidosis

40
Q

what is the management for left ventricular failure

A

mnemonic ‘pour SOD’

Pour away (stop) their IV fluids
Sit up
Oxygen
Diuretics

41
Q

what is the management of heart failure

A

ABAL
ACE inhibitor (e.g. ramipril titrated as tolerated up to 10mg once daily)
Beta Blocker (e.g. bisoprolol titrated as tolerated up to 10mg once daily)
Aldosterone antagonist when symptoms not controlled with A and B (spironolactone or eplerenone)
Loop diuretics improves symptoms (e.g. furosemide 40mg once daily)

42
Q

what are the main secondary causes of HTN

A

ROPE

R – Renal disease. This is the most common cause of secondary hypertension. If the blood pressure is very high or does not respond to treatment consider renal artery stenosis.
O – Obesity
P – Pregnancy induced hypertension / pre-eclampsia
E – Endocrine. Most endocrine conditions can cause hypertension but primarily consider hyperaldosteronism (“Conns syndrome”) as this may represent 2.5% of new hypertension. A simple test for this is a renin:aldosterone ratio blood test.

43
Q

what are the main causes of AF

A

SMITH

Sepsis 
Mitral valve pathology 
IHD
Thyrotoxicosis 
Hypertension

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