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first year med > wrong Qs 2.0 > Flashcards

wrong Qs 2.0 Flashcards

1
Q

what heart murmur is corrigans sign associated with?

A

aortic regurgitation - heard best upright leaning forward

corrigans sign = collapsing pulse, visible carotid pulsation

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2
Q

what cardiovascular problem can syphilis cause?

A

arterial aneurysm - ascending/arch of aorta common

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3
Q

complication of AAA surgery

A

trash foot

surgeries - laparotomy / endovascular repair (EVAR, less invasive)

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4
Q

prolong QT interval is a feature of what

A

hypocalcaemia

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5
Q

what can conns syndrome cause?

A

secondary hypertension

conns syndrome = hyperaldosteronism

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6
Q

IVC filter

A

for recurrent PEs

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7
Q

respiratory cause of AF

A

pneumonia

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8
Q

pathophysio of exercise in intermittent claudication

A

exercise encourages collateral artery development

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9
Q

critical limb ischaemia

A

rest pain for 2 weeks
ankle pressire <50 mmHG

amputation may be required to prevent gangrene spread

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10
Q

3rd heart sound characteristics

A

after S2 in early diastole

a sign of heart failure

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11
Q

what time of day is peripheral vascular rest pain worse?

A

@ night

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12
Q

what effect does constrictive pericarditis have on JVP?

A

raised JVP

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13
Q

murmur in ventricular septal defect

A

pan-systolic murmur

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14
Q

JVP in complete heart block

A

cannon waves

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15
Q

JVP paradoxically rising on inspiration

A

constrictive pericarditis

Kussmaul’s sign - impaired RV filling

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16
Q

risk factors of ischaemic HD

A

decreases HDL

hypothyroidism

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17
Q

major cause of cardiomyopathy

A

alcohol

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18
Q

a cause of high output heart failure

A

thyrotoxicosis

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19
Q

complications of MI

A 
LV aneurysm (late)
cardiogenic shock - rupture of heart septum or papillary muscles
oedema - heart failure
AF
pericarditis (dresslers)
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20
Q

hyper resonant percussion note + decreased expansion

A

pneumothorax

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21
Q

young patient, ST elevation in all leads (concave), radiates to neck + arm

A

acute pericarditis - angina/MI vibes but NOT !!

** relieved by sitting forward **

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22
Q

ECG of someone on digoxin

A

concave ST depression in ALL leads with T wave inversion

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23
Q

radio-femoral delay

A

coarctation of aorta

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24
Q

myxoma

A

tumour of primitive tissue in heart atrium

“plop” sound early diastole

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25
Q

haphazard electrical activity, no recognizable complexes + no coordination

A

ventricular fibrillation

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26
Q

drugs that can cause gynaecomastia

A

spironolactone
digoxin
cimetidine - H2 blocker (stomach acid)

liver cirrhosis

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27
Q

atrial septal defect on auscultation

A

wide fixed splitting of S2

normal = split on inspiration, single on expiration

FIXED splitting = when respiration makes no difference to the interval between aortic + pulmonary components of S2

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28
Q

difference between osler nodes + janeway lesions

A

both signs of infective endocarditis

osler - tips of fingers/toes + painful/tender

janeway - palms/soles + NON-tender

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29
Q

what are roth spots

A

retinal haemorrhages - sign of infective endocarditis

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30
Q

which cardiac drug can cause pulmonary fibrosis + liver cirrhosis as a side effect

A

amiodarone

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31
Q

most common cause of ejection systolic murmur + S4 in U30s

A

hypertrophic cardiomyopathy

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32
Q

cheyne-strokes

A

alternating hyper/hypoventilation

–> sign of severe heart failure

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33
Q

side effect of adenosine

A

hyper/hypothyroidism

–> weight loss, tremor, weakness, palpitations, heat intolerance

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34
Q

test for orthostatic syncope

A

tilt table testing

“fainting after standing behind fish counter for 2hrs” lol

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35
Q

diagnosis of paroxysmal SVT

A

holter monitoring - 24hr ECG

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36
Q

signs of HOCM

A

jerky pulse
double apical impulse
S3 + S4
late systolic murmur

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37
Q

drug that can cause gout

A

bendroflumethiazide > thiazide diuretic > hyperuricaemia

gout symptoms -
sudden severe pain in a joint – usually your big toe, but it can be in other joints in your feet, hands, wrists, elbows or knees
hot, swollen, red skin over the affected joint

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38
Q

angina investigation for patient who can’t exercise (non-invasive cardiac evaluation)

A

thallium scanning

stress echo - dobutamine used to stimulate heart + US used to look for wall motion abnormalities

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39
Q

non-metastatic extrapulmonary manifestation of bronchial carcinoma

A

cushings syndrome

–> due to ectopic adrenocorticotrophic hormone (ACTH) secretion

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40
Q

kartangeners syndrome

A

ciliary dysfunction (autosomal recessive)

causes bronchiectasis, situs inversus, chronic sinusitis,

41
Q

reduced chest wall movement + increased vocal resonance

A

lung consolidation

42
Q

ECG + respiratory failure type in PE

A

type 1 resp failure

ECG - RBBB

43
Q

meningioma

A

benign

44
Q

liver failure cause trans or exudative pleural effusion

A

transudative

–> hypoalbuminaemia - decrease in hydrostatic pressure

45
Q

a cause of hypertrophic pulmonary osteoarthropathy

A

bronchial carcinoma - NSCLC

46
Q

common causes of clubbing

A

bronchiectasis, empyema, bronchial carcinoma, mesothelioma, pulmonary fibrosis

if u say COPD ur a gimp

47
Q

goodpastures syndrome

A

vasculitic disorder featuring proliferative glomerulonephritis + pulmonary haemorrhage
–>autoimmune

causes haemoptysis
anti-GBM antibodies are characteristic

48
Q

pneumonia after influenza

A

staph aureus

49
Q

smoker, 6 month gradual SOB, CXR = hyperexpanded lung fields + no focal lesions

A

COPD

50
Q

rusty sputum

A

pneumococcal / strep pneumoniae

51
Q

terbutaline

A

SABA

52
Q

fluticasone

A

ICS - beclometasone

53
Q

impotent + buttock claudication

A

peripheral vascular disease

54
Q

23 y/o, SOB, just returned from africa, o2 sats 92%, CXR normal

A

PE from long haul - CTPA

55
Q

68 y/o, pancreatic cancer, 5hr history of haemoptysis + SOB, 92 o2 sats, high RR, CXR = small triangular area of increased density in right lung field

A

PE

wedged shaped lesion = infarct

56
Q

COPD patients, bone fractures/issues due to medication

A

steroids - prednisolone

57
Q

dry mouth caused by inhaler

A

ipratropium bromide - blocks parasympathetic bodily functions such as salivation (LAMA)

58
Q

bronchial carcinoma, swollen face, dilated veins over thorax

A

SVC obstruction - complication of lung cancer

59
Q

lethargy, constipation, abdo pain, nocturia, low mood, doesnt enjoy activities she once did, what type of cancer?

A

squamous - ectopic parathyroid hormone related peptide (PTHrP) causing hypercalcaemia

60
Q

bronchial carcinoma, drooping eyelids, after repeated attempts to open eyes fully, droopiness disappears

A

eaton-lambert syndrome - small cell

characteristically weakness improves with repeated activity

61
Q

suspected PE, CT pulmonary angiogram requested, what is the most important consideration before the test can go ahead?

A

normal renal function

62
Q

name of proteins which catalyse phosphorylation reactions

A

kinases

63
Q

gram positive rods

A

c diff

bacillus cereus

64
Q

glossitis

A

smooth red sore tongue

caused by iron, folate or b12 deficiency

65
Q

treatment of mallory-weiss tear

A

usually heals spontaneously

66
Q

symptoms of cholera gastroenteritis

A

watery diarrhoea - rice water

67
Q

what kind of diet can cause diverticular disease

A

low fibre

68
Q

small intestine valvulae conniventes on AXR

A

cross entire lumen

69
Q

risk factors for squamous cell carcinoma

A

achlasia
alcohol
coeliac disease

70
Q

painless jaundice, palpable mass in RUQ, weight loss, dark urine + pale stools

A

carcinoma of head of pancreas

71
Q

acute bloody diarrhoea in children

A

medical emergency

72
Q

A 43-year-old businessman presents to his general practitioner with fever, headache, and diarrhoea. He has not had any coughs, nausea, or vomiting. He is normally fit and well. The only history of note is that he returned from a business trip in India 3 weeks ago. He has been eating and drinking the same things as his family since his return, and they are all well. On examination, the man appears dehydrated and has right upper quadrant tenderness.

What is the most likely diagnosis?

A

hep A

Hepatitis A has an incubation period of 2-4 weeks, meaning that patients in the UK often present after returning home from travelling to at-risk countries

Traveller’s diarrhoea is when there are at least 3 episodes of diarrhoea in a 24 hour period, either during or shortly after foreign travel. 3 weeks after travel is too late.

73
Q

18 y/o, 1 week history of lethargy, headaches, painful sore throat, not travelled abroad

no rash until GP gave antibiotics

sore abdomen when examined over liver, spleen + lymphadenopathy, yellow eyes

most appropriate test to perform?

A

monospot test

diagnosis = infectious mononucleosis (glandular fever, epstein-barr virus)

74
Q

12 y/o, decreased pigmentation of skin + eyes, history of severe bacterial + viral infections + bleeding abnormalities

A

Chediak-Higashi (auto recessive)

–> decreased phagocytosis resulting in pyogenic infection, partial albinism + peripheral neuropathy

75
Q

1 y/o, well until 6 months - developed recurrent otitis media

severe pneumonia @ 8 months

now presents with seizure, reduced GCS, high fever, globally reduced tone

A

Bruton’s agammaglobulinemia

X-linked primary immunodeficiency disease with absence of IgG

condition presents in young children with sino/pulmonary infections

76
Q

drug that HIV patient with pneumocystis pneumonia responds to

A

co-trimoxazole

77
Q

22 y/o backpacker, travelled trough southern russia for months. presents with iron deficiency anaemia

most appropriate test?

A

distal duodenal biopsy

differentials = Giarda or coeliac

distal duodenal = gold standard for both

** (not sure about that luv but its what the q says) **

78
Q

most common malignant tumour in colon? where does it metastases first?

A

adenocarcinoma

metastases in liver first

79
Q

what stage of lung maturation does branching of the terminal bronchioles occure?

A

pseudoglandular

80
Q

reducing agent in conversion of pyruvate to lactate

A

NADH

81
Q

very low infectious dose, effects mediated by toxin, most common cause of renal failure in under 5s

A

E coli 0157

82
Q

units of alcohol in litre of 40% proof spirits

A

40 units

83
Q

30 y/o, RIF pain, previous gynae surgery

investigations?

A

laparoscopy

differentials = appendix or ovarian pathology

would exclude both

84
Q

what does increased pulmonary arterial vasoconstriction result in?

A

increased pulmonary vascular resistance - associated pulmonary hypertension

–> this in turn leads to increased RV afterload + initially RV hypertrophy, eventually followed by RV dilation + failure (Cor pulmonale)

85
Q

medication used for rapid relief of thyrotoxic symptoms including atrial fibrillation

A

bisoprolol - selective beta blocker

86
Q

20 y/o, lethargy, headaches, fever, nausea, abdo pain for 4 days. no rash. returned from backpacking india 28 days ago, yellow eyes

A

hep A

dengue fever typically has rash

87
Q

pathology seen in person not attending barretts review sessions with worsening symptoms

A

uncontrolled proliferation of MUCOUS GLAND cells in lover 1/3 of oesophagus

–> adenocarcinoma = GLAND cells

88
Q

62 y/o man w alcohol related cirrhosis + alcoholic hepatitis who is anuric + CVP = 12

most appropriate initial management?

A

terlipressin

–> has developed hepato-renal syndrome = has been adequately fluid resuscitated - terlipressin will improve renal flow

(anuria = failure of kidneys to produce urine)

89
Q

55 y/o with know PBC, bilirubin rose to 110 over 6 months, abdominal US show normal bile ducts

most appropriate initial management?

A

liver transplant

–> raised bilirubin in absence of biliary disease shows deteriorating liver function + liver failure requiring transplantation

90
Q

artery located inferior to retroinguinal space

A

femoral

–> retroinguinal space lies deep to inguinal ligament through which structures pass between abdominopelvic cavity + lower limb

(external iliac artery becomes femoral as it passes under inguinal ligament)

91
Q

healthy start vitamins are provided to low-income pregnant woman

this is most likely to reduce the prevalence of which deficiency disease?

A

rickets/osteomalacia (vit D)

–> the vitamins contain folic acid + vitamins C+D

92
Q

what acts on membrane bound beta2 adrenoceptor on airway smooth muscle to mediate relaxation?

A

adrenaline

93
Q

confidentiality

A

confidentiality is about the importance of keeping medical info private + secure

94
Q

50 y/o alcoholic with history of recurrent abdominal pain + central abdominal calcification on AXR

Ix to confirm diagnosis?

A

faecal elastase

–> recurrent abdo pain makes chronic pancreatitis likely, this is supported by calcification on AXR, also alcohol is big cause

> best test of pancreatic function = faecal elastase

95
Q

severe aspiration pneumonia treatment

A

IV amoxicillin, gentamicin + metronidazole

96
Q

most appropriate treatment for grade C oesophagitis

A

PPI

97
Q

tight benign peptic stricture seen on endoscopy - most appropriate management?

A

balloon oesophageal dilatation

–> rapid relief of symptoms, safer that bougie

98
Q

choosing between hellers cardiomyotomy + balloon oesophageal dilatation for achlasia

A

myotomy - young, fit, has advantage of not requiring repeat procedures

99
Q

causes of of Beri-Beri + Pellagra

A

Beri-Beri - thiamine deficiency (vit B1)

Pellagra - niacin deficiency (vit B3)

first year med (15 decks)

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