weird questions

Question 1

What murmur is heard loudest in aortic regurgitation

Answer 1

Austin Flint murmur

Question 2

What murmur can be heard in pulmonary regurgitation loudest? ANd where?

Answer 2

graham steell murmur

at uppper left sternal edge

Question 3

What murmur can be heard in patent ductus arteriosus loudest?

Answer 3

Gibson

Question 4

What murmur can be heard with turbulent flow over a thickened mitral valve ? WHat is it associated with

Answer 4

carey coombs

rheumatic fever

Question 5

What murmur can be heard mitral valve prolapse? Where is it heard best?

Answer 5

Barlow murmur

Question 6

What is the most common cause of a nephrotic syndrome in children?

Answer 6

Minimal change glomerulo nephritis

Question 7

What is the most common cause of a nephrotic syndrome in adults?

Answer 7

Membranous glomerulonephritis

Question 8

What is the most common cause of a nephritic syndrome in adults?

Answer 8

Ig A nephropathy

Question 9

How does Ig A nephropathy present as?

Answer 9

few days after upper respiratory infection

Question 10

What is henoch schoenlein purpura?

Answer 10

older children

TRIAD of abdominal pain, arthritis and purpuretic rash

Question 11

Describe the typical history of complaint for reactive arthiris?

Answer 11

present days or weeks after GI infection or urogenital infection

Question 12

What is the triad of symptoms of reactive arthritis

Answer 12

uveitis, arthritis, urethritis

Question 13

What are the extra articular feature of a urogenital infection?

Answer 13

circinate balantis and keratoderma blenorrhagicum

Question 14

How would your investigation of chronic and acute pancreatitis differentiate?

Answer 14

chronic pancreatitis: normal serum amylase and low feacal elastase
acute pancreatitis: high serum amylase

Question 15

What drugs makes GORD worse?

Answer 15

exacerbate symptoms of reflux including drugs that damage the mucosa (e.g. NSAIDs, aspirin, steroids and bisphosphonates) and drugs that affect oesophageal motility (e.g. TCAs, nitrates and anticholinergics).

Question 16

What is The most common cause of fainting in young people

Answer 16

The most common cause of fainting in young people is vasovagal syncope

Question 17

What leads to left homonymous hemianopia?

Answer 17

right optic tract has been damaged.

Question 18

What leads to superior or inferior homonymous quadrantopia

Answer 18

Disruption of the upper and lower divisions of the optic radiations

Question 19

What is associated with Acute Myeloid Leukaemia (AML)

Answer 19

Auer rods

Sudan black stain

Question 20

What is associated with Acute Lymphoblastic Leukaemia (ALL)

Answer 20

Occurs in children

Question 21

What is associated with Chronic Myeloid Leukaemia (CML)

Answer 21

Philadelphia Chromosome (translocation between chromosomes 9 and 22)
Massive splenomegaly

Question 22

What is associated with Chronic Lymphocytic Leukaemia (CLL)

Answer 22

Smear/Smudge cells
Warm agglutinins (AIHA)

Question 23

What is associated with Hodgkin’s Lymphoma

Answer 23

Painful lymph nodes after alcohol ingestion
Reed-Sternberg cells
B symptoms (fever, weight loss, night sweats)

Question 24

What is associated with Non-Hodgkin’s Lymphoma

Answer 24

B symptoms (fever, weight loss, night sweats)
Painless enlarging cervical lymph nodes

Question 25

What is associated with Myelodysplasia

Answer 25

Ringed sideroblasts | NO splenomegaly

Question 26

What is associated with Myelofibrosis

Answer 26

MASSIVE splenomegaly Dry tap (failure of bone marrow aspirate) Dacrocytes (tear drop cells) Associated with polycythaemia rubra vera

Question 27

what is the treatment for TB

Answer 27

Rifampicin and Isoniazid – 6 months Pyrazinamide and Ethambutol – 2 months These drugs can be remembered using the mnemonic: RIPE

Question 28

symptoms of normal pressure hydrocephalus

Answer 28

confusion/dementia, gait disturbance and urinary incontinence

Question 29

what does the CREST syndrome involve?

Answer 29

CREST syndrome’ because the main features of it are: Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly and Telangiectasia.

Question 30

when is flecanide contraindicated?

Answer 30

Flecainide is | contraindicated in patients with a history of ischaemic heart disease.

Question 31

describe the management of AF?

Answer 31

The long-term management of AF involves rate control and anticoagulation. Verapamil and 1st bisoprolol are line for rate control. Digoxin may be used in some cases. Anticoagulation is achieved with warfarin, aiming for an INR of 2-3. Patients presenting for the first time with AF will be risk stratified using the CHA2DS2-Vasc score, to determine whether they need long-term anticoagulation. Patients with paroxysmal AF will also have a ‘pill in the pocket’ - sotalol or flecainide PRN.

Question 32

What are the symptoms of Acute lymphoblastic leukaemia (ALL)

Answer 32

bone marrow malignancy characterised by the proliferation of lymphoblasts. COMMON in children SYMPTOMS: anaemia, thrombocytopaenia and leukopaenia), which manifests as fatigue, dyspnoea, easy bruising and opportunistic infections, lymphadenopathy, hepatosplenomegaly, and, sometimes, testicular swelling. BLOOD FILM: high number of circulating lymphoblasts. Furthermore, a bone marrow aspirate or biopsy will reveal a hypercellular marrow with > 20% of the cells being lymphoblast

Question 33

What are the symptoms of AML

Answer 33

similar to ALL but less infiltration

Question 34

What are the symptoms of Chronic leukaemias

Answer 34

asymptomatic or have a chronic history spanning months or years

Question 35

What are the symptoms of Hodgkin’s lymphoma

Answer 35

Hodgkin’s lymphoma is a tumour of the lymphoid cells. It is diagnosed histopathologically by the presence of Reed-Sternberg cells (binucleate lymphocytes). The main features of Hodgkin’s lymphoma are a painless, enlarging neck/axilla/groin mass, lymphadenopathy that becomes painful after the ingestion of alcohol, pruritus and the B symptoms of lymphoma (fever, night sweats and weight loss).

Question 36

what does a SAAG higher than 11 indicate

Answer 36

most often due to portal hypertension. An increased hydrostatic pressure within the hepatic portal system, forces fluid out of the vasculature and into the peritoneal cavity, thereby concentrating the serum albumin. Causes of a high SAAG include cirrhosis, constrictive pericarditis, congestive cardiac failure, Budd-Chiari syndrome and hepatic venous obstruction.

Question 37

what does a SAAG lower than 11 indicate

Answer 37

Nephrotic syndrome is an important exception – the ascitic fluid does not have a high protein content but it does cause a low SAAG because albumin is freely filtered through damaged glomeruli, resulting in a reduced serum albumin. Other causes of a low SAAG include malignancy, pancreatitis, infection and bowel obstruction.