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General Medicine > Vol 4 > Flashcards

Vol 4 Flashcards

0
Q

What is type 1 respiratory failure?

A

Normal co2 - Q is wrong with V/Q. Macroscopically functional lungs.
E.g. PE, pneumonia, pulmonary oedema, VSD

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1
Q

What test is used to quantify lumbar flexion by measurement with rulers and marking?

A

Schober test

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2
Q

What are azathioprine, methotrexate and mecaptopurine all examples of?

A

Immunosuppressive drugs

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3
Q

What is Corrigans pulse?

A

The collapsing/dancing carotid pulse visible in aortic regurgitation

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4
Q

What is the Van Graefe sign?

A

Lid lag in hyperthyroidism (Graves)

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5
Q

What is Riddochs sign?

A

Hitler arm raise (rebound lift) in cerebellar dysfunction/UMNL

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6
Q

What is Traubes sign?

A

Gunshot femoral artery murmur associated with aortic regurgitation

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7
Q

What is the recommended treatment for pyelonephritis? What about in pregnant women?

A

Co-amoxyclav 14 days

Preg women cefalaxin

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8
Q

What is Murphy’s sign?

A

Pain on inspiration of the palpable gallbladder associated with acute cholecystitis

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9
Q

What is ciclosporin used for?

A

Immunosuppression - UC, graft vs host, uveitis

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10
Q

What is De Musset’s sign?

A

Head bobbing in time with heartbeat - aortic regurgitation

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11
Q

What is Reynolds pentad?

A

Indicates ascending cholangitis. Charcot’s triad (fever, jaundice and RUQ pain) + hypotension + altered mental state

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12
Q

What is the Bruit de Roger?

A

Pansystolic low pitched VSD murmur

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13
Q

Possible medications for epilepsy?

A

Sodium valproate
Lamotrigine, carbamazepine
Acute = phenytoin, phenobarbitol
Benzodiazepines

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14
Q

What is Quincke’s sign?

A

Light hold on nails, visible pulsatile blanching and redness

Indicates aortic regurgitation

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15
Q

6 things that can cause hypokalaemia?

A 
D+V
Diuretics
Insulin
Poor nutrition
Ileostomy
Bulemia nervosa
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16
Q

What changes do you get on ECG in response to hyperkalaemia?

A 
A wide QRS
Prolonged PR
Flattened P waves
T wave tenting
ST depression
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17
Q

4Hs and 4Ts of reversible cardiac arrest causes?

A 
Hypo/hyperkalaemia
Hypothermia
Hypoxia
Hypovolaemia
Toxins
Tamponade
Tension pneumothorax
Thrombosis
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18
Q

What is the characteristic sign of PE on ECG? What is actually the most common finding?

A

S1Q3T3

Sinus tachycardia

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19
Q

What is Fox’s sign?

A

Acute pancreatitis - ecchymosis down the inguinal ligaments

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20
Q

What is Mullers sign?

A

Pulsatile uvula visible in aortic regurgitation

21
Q

What is flecainide?

A

Can treat tachyarrythmias - paroxysmal AF, PSVT, VT

22
Q

What is the Brudzinski neck sign?

A

Meningism - flexing neck of couch causes reflex hip flexion

23
Q

Discuss primary sclerosing cholangitis PSC?

A

Has a male link, also strong link to ulcerative colitis
Presents with earlier RUQ pain and pruritis, TATT
Eventually liver cirrhosis

24
Q

Investigations for PSC?

A

ANCA

IgG

25
Q

4 causes of sacroiliitis?

A

Ankylosing spondylitis
Reiter’s syndrome
Crohns spondylitis
Psoriatic spondylitis

26
Q

What investigation is useful in indicating early sacroiliitis changes?

A

MRI

27
Q

4 radiological hallmarks of rheumatoid arthritis?

A

Symmetrical small joint involvement
Soft tissue swelling, synovial hyperplasia
Periarticular osteoporosis, bony erosion
Thinning of joint space

28
Q

What are the characteristic rheumatoid arthritis deformities?

A

Ulnar deviation
Z thumb
Boutonnière deformity
Swan neck deformity

29
Q

What is the progression of treatment for rheumatoid arthritis?

A

NSAIDs and physio -> DMARDs (methotrexate, ASAs) -> steroids -> biologics

30
Q

What disease may be indicated in a male with known rheumatoid arthritis, smoking history and chest symptoms?

A

Diffuse pulmonary fibrosis

31
Q

What defines an exudate found in pleural effusion?

A

Protein > 30g/L
Protein/blood protein > 0.6
LDH/blood LDH > 0.6

32
Q

What additional finding (other than protein/LDH) in pleural tap indicates empyema?

A

pH < 7.2

33
Q

What are the 3 further investigations that can be done with pleural tap analysis and what are they for?

A

Histology - cytology (cancer)
Biochemistry - proteins, LDH, glucose
Microbiology - culture and sensitivity

34
Q

What are 2 signs of chronic hypertensive retinopathy?

A

AV nicking -> branch retinal vein occlusion BRVO

Copper and silver wiring

35
Q

4 signs of acute hypertensive retinopathy?

A

Flame haemorrhages
Cotton wool spots
Hard exudates
Papilloedema

36
Q

3 causes of a microcytic anaemia?

A

IDA
SCD
Thalassaemia

37
Q

4 stages of diabetic retinopathy?

A

Mild non-proliferative
Moderate non-proliferative
Severe non-proliferative
Proliferative

38
Q

What characterises mild non-proliferative diabetic retinopathy?

A

Micro-aneurysms - dot and blot retinal haemorrhages

39
Q

What characterises moderate non-proliferative diabetic retinopathy?

A

Hard (yellow) exudates - chronic oedema

Cotton wool spots due to micro infarcts

40
Q

What characterises severe non-proliferative diabetic retinopathy?

A

Macular oedema visible on slit lamp

Venous dilatation

41
Q

What characterises proliferative diabetic retinopathy?

A

Neovasculature around medulla

Oedema and haemorrhage (-> sudden vision loss)

42
Q

What are the symptoms of a peptic ulcer?

A

Epigastric pain that may or may not be relieved by eating
Bloating, distension, oral flatulence
Coffee ground vomit, heartburn, melena

43
Q

What investigations are indicated in peptic ulcer?

A

Urea breath test
FBC
OGD and culture biopsies

44
Q

Management of peptic ulcers?

A

Lifestyle management, NSAID reduction
Abs for H pylori
PPI/H2RB
Endoscopic intervention?

45
Q

What is meant by a fluid challenge in fluid resus?

A

500ml of 0.9% saline stat

46
Q

What are the 2 components of resus fluid?

A

Volume replacement

Electrolyte balance

47
Q

What is usually designated as maintenance fluid?

A

Dexsaline - 5% dextrose, 0.9% saline

Often + 20mmol K+

48
Q

Sx of B12/folate deficiency?

A 
Fatigue
Paraesthesia, peripheral neuropathies
Sore red tongue
Weakness
Depression and cognitive deficits
49
Q

Drugs that can cause B12 folate deficiency?

A

PPIs

Anticonvulsants

General Medicine (5 decks)

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