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MBChB Y1-3 > Year 1 > Flashcards

Year 1 Flashcards

1
Q

Define 3rd degree heart block

A

No relation between P wave and QRS complexes, but both are present

Abnormally shaped QRS

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2
Q

Describe the CT findings seen in idiopathic pulmonary fibrosis

A

Basal and sub-pleural reticulonodular shadowing

Ground glass appearance (early phase change)

Honeycombing (late phase change)

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3
Q

Name the coronary artery which supplies the left ventricle

A

Left marginal artery

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4
Q

Define 2nd degree heart block - Mobitz type II

A

Each P wave is associated with a QRS complex until there is one atrial conduction or P wave that is not followed by a QRS

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5
Q

Describe the sputum findings associated with pneumonia caused by Pseudomonas or Haemophilus

A

Green sputum

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6
Q

Which antibiotics would you use to treat community-acquired pneumonia with a CURB score of 0-2?

A

Amoxicillin IV/PO (if penicillin allergic: doxycycline day 1 then course of doxycycline or IV clarithromycin)

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7
Q

LFT interpretation:

Normal or ↑ ALT
↑↑ ALP
↑↑ GGT
↑↑ bilirubin

A

Cholestasis

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8
Q

What is a normal QRS complex duration?

A

<0.1 secs

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9
Q

Interpretation of ABG results: decreased pH, increased CO2, and normal HCO3

A

Uncompensated respiratory acidosis

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10
Q

Name the antibody which is. the second least abundant; its role is not fully known

A

IgD

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11
Q

Define sarcoidosis

A

Multisystem granulomatous (type IV) disorder to an unknown antigen

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12
Q

Which type of lung cancer is typically a peripheral tumour, and is the least common type (10%)?

A

Large cell carcinoma

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13
Q

What is the coronary sinus?

A

Short venous conduit located in the atrioventricular groove posteriorly which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

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14
Q

Name the coronary artery which supplies the right atrium and the right ventricle

A

Right coronary artery

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15
Q

Define pneumoconiosis

A

Lung disease caused by mineral dust exposure e.g. asbestosis

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16
Q

Describe the findings on CXR seen in hypersensitivity pneumonitis

A

Widespread pulmonary infiltrates

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17
Q

Interpretation of ABG results: normal pH, increased CO2, increased HCO3

A

Fully compensated metabolic acidosis

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18
Q

Name the first antibody to be made in an infection; it is involved in B cell activation, agglutination, and activates complement via the classical pathway

A

IgM

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19
Q

Name the antibody which is a monomer in serum but dimer in secretions

A

IgA

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20
Q

List the clinical features which make up the CURB65 score

A

Confusion
Urea ≳ 7 mmol
Resp. rate > 30
BP - systolic < 90, diastolic ≲ 60
≳65 years

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21
Q

Name the murmur: ejection systolic murmur best heard in the 2nd right intercostal space at the sternal edge, radiates to carotids

A

Aortic stenosis

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22
Q

Describe the mechanism of a type IV hypersensitivity reaction, and give an example

A

T cell-mediated, e.g. rheumatoid arthritis, sarcoidosis

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23
Q

Name the branches of the right coronary artery

A

Right marginal artery, posterior interventricular artery (in 80-85% of people - right dominant pattern)

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24
Q

Interpretation of ABG results: decreased pH, increased CO2, and increased HCO3

A

Partially compensated respiratory acidosis

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25
Q

Interpretation of ABG results: normal pH, increased CO2 and increased HCO3

A

Fully compensated respiratory acidosis

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26
Q

Name the coronary artery which supplies the SA node and AV node in the majority of patients

A

Right coronary artery

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27
Q

Name the coronary artery which supplies the right and left ventricles and the interventricular septum

A

Posterior interventricular artery

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28
Q

Name the antibody secreted in colostrum

A

IgA

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29
Q

ALT/AST __ ALP = hepatocellular

A

>

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30
Q

Which antibiotic would you use to treat atypical pneumonia apart from Legionella?

A

Doxycycline

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31
Q

Interpretation of ABG results: increased pH, increased CO2, increased HCO3

A

Partially compensated metabolic alkalosis

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32
Q

Which antibiotics would you use to treat non-severe hospital-acquired pneumonia?

A

PO amoxicillin (if penicillin allergic: PO doxycycline)

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33
Q

Which type of lung cancer is typically a central tumour, is the most common type in smokers, and can be associated with ectopic PTHrP release?

A

Squamous cell carcinoma

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34
Q

Name the heart rhythm (+ describe)

A

Torsade de pointes

Specific polymorphic VT associated with a long QT interval

QRS complexes appear to twist around the isoelectric line

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35
Q

Describe the sputum findings associated with pneumonia caused by Klebsiella

A

Red currant-jelly sputum

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36
Q

Which antibiotics would you use to treat severe hospital-acquired pneumonia?

A

IV amoxicillin + gentamicin (if penicillin allergic: PO doxycycline + gentamicin)

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37
Q

Name the heart rhythm (+ describe)

A

Atrial flutter

Rate: atrial 300 bmp, ventricular usually 150 bmp

P wave: saw tooth ‘F’ wave

QRS: normal

Rhythm: regular, may be variable

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38
Q

Which channels do class II anti-arrhythmic drugs block?

A

β-adrenoceptors - decrease the rate of depolarization in the SA and AV nodes

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39
Q

Name the antibody that transfers across the placenta so is important in foetal immunity

A

IgG

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40
Q

Name the anti-arrhythmic drug class

A

Class III

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41
Q

What is a normal PR interval?

A

0.12-0.2 secs

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42
Q

Define hypersensitivity pneumonitis

A

Acute or chronic hypersensitivity type III reaction to an antigen e.g. thermophilic bacteria (farmer’s lung), avian proteins (bird fancier’s lung), and fungi (malt worker’s lung)

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43
Q

Which antibody has a pentameric shape?

A

IgM

44
Q

Hep B serology: HBsAG positive, anti-HBs negative, anti-HBc IgG positive

A

Chronic infection

45
Q

Hep B serology: HBsAG negative, anti-HBs positive, anti-HBc negative

A

Vaccinated

46
Q

Interpretation of ABG results: normal pH, decreased CO2, decreased HCO3

A

Fully compensated metabolic acidosis

47
Q

How do you determine cardiac axis?

A

Lead I positive and lead II positive = normal cardiac axis

Lead I positive and lead II negative = left axis deviation

Lead I negative and lead aVF positive = right axis deviation

48
Q

Name 3 common graft sites for coronary artery bypass grafting

A

Radial artery, internal thoracic artery, great saphenous vein

49
Q

Describe the mechanism of a type II hypersensitivity reaction, and give an example

A

IgM or IgG binds to antigens of particular tissue types, resulting in complement activation e.g. Goodpasture’s

50
Q

Interpretation of ABG results: increased pH, decreased CO2, decreased HCO3

A

Partially compensated respiratory alkalosis

51
Q

Describe the mechanism of a type III hypersensitivity reaction, and give an example

A

Antibody binds to excess soluble antigen resulting in immune complex formation e.g. SLE, hypersensitivity pneumonitis

52
Q

Name the coronary artery which supplies the left atrium and the left ventricle

A

Left circumflex artery

53
Q

Interpretation of ABG results: increased pH, normal CO2, increased HCO3

A

Uncompensated metabolic alkalosis

54
Q

Name the murmur: pan-systolic murmur best heard at the apex, radiates to the axilla

A

Mitral regurgitation

55
Q

Describe the sputum findings associated with pneumonia caused by S. pneumonia

A

Rust coloured sputum

56
Q

Name the anti-arrhythmic drug class

A

Class IV

57
Q

Which channels do class I anti-arrhythmic drugs block?

A

Na+ channels

58
Q

Interpretation of ABG results: decreased pH, decreased CO2, decreased HCO3

A

Partially compensated metabolic acidosis

59
Q

Name the arrhythmia (describe)

A

Wolff-Parkinson-White syndrome

Sloping QRS complex (delta wave) - pre-excitation

Short PR interval

60
Q

Hep B serology: HBsAG negative, anti-HBs negative, anti-HBc negative

A

Susceptible

61
Q

ECG interpretation: ST elevation in leads I, aVL, V3-6

A

Anterolateral MI - left coronary artery affected

62
Q

Interpretation of ABG results: increased pH, decreased CO2, normal HCO3

A

Uncompensated respiratory alkalosis

63
Q

Name the branches of the left coronary artery

A

Left anterior descending, left marginal artery, and the left circumflex artery

64
Q

LFT interpretation:

↑↑ ALT
Normal or ↑ ALP
Normal or ↑ GGT
↑ or ↑↑ bilirubin

A

Acute hepatocellular damage

65
Q

Describe the sputum findings associated with pneumonia caused by anaerobes

A

Foul smelling and bad-tasing sputum

66
Q

Hep B serology: HBsAG negative, anti-HBs positive, anti-HBc positive

A

Past infection

67
Q

Describe the CXR findings seen in sarcoidosis

A

Bilateral hilar or paratracheal lymphadenopathy

68
Q

Hep B serology: HBsAG positive, anti-HBs negative, anti-HBc IgM positive

A

Acute infection

69
Q

Name the heart rhythm (+ describe)

A

Atrial fibrillation

Atrial rate >300 bmp

Irregularly irregular rhythm

No P waves - irregular baseline

Narrow QRS

70
Q

Define primary sclerosing cholangitis

A

Chronic autoimmune condition that results in the fibrosis and destruction of intra-hepatic and extra-hepatic bile ducts

71
Q

80% of patients with primary sclerosing cholangitis have what associated disease?

A

IBD (more likely to be UC)

72
Q

Which antibiotics would you use to treat pneumonia caused by Legionella?

A

Clarithromycin/erythromycin or levofloxin

73
Q

Name the heart rhythm (+ describe)

A

Ventricular fibrillation

Bizarre irregular waveform

No recognizable QRS complexes

Random frequency and amplitude

Uncoordinated electrical activity

74
Q

Which channels do class IV anti-arrhythmic drugs block?

A

Ca2+ channels - slow conduction in SA and AV nodes, decrease force of cardiac contraction

75
Q

Name the most abundant antibody in plasma; it is dominant during the secondary response

A

IgG

76
Q

Which channels do class III anti-arrhythmic drugs block?

A

K+ channels - prolong AP duration, increasing refractory period

77
Q

LFT interpretation:

Normal or ↑ ALT
Normal or ↑ ALP
Normal or ↑ GGT
Normal or ↑ bilirubin

A

Chronic hepatocellular damage

78
Q

Interpretation of ABG results: decreased pH, normal CO2, decreased HCO3

A

Uncompensated metabolic acidosis

79
Q

Which antibiotics would you use to treat community-acquired pneumonia with a CURB score of 3-5?

A

Co-amoxiclav IV + doxycycline IV (if penicillin allergic: levofloxin)

80
Q

ECG interpretation: ST elevation in V1-V4

A

Left anterior descending artery affected

V1 and V2 - anterior

V3 and V4 - septal

81
Q

ALP __ ALT/AST = cholestasis

A

>

82
Q

Interpretation of ABG results: normal pH, decreased CO2, decreased HCO3

A

Fully compensated respiratory alkalosis

83
Q

Define 2nd degree heart block - Mobitz type I

A

Progressive lengthening of the PR interval, eventually resulting in a dropped beat (P wave with no QRS)

84
Q

Name the anti-arrhythmic drug class

A

Class II

85
Q

Name the heart rhythm (+ describe)

A

Polymorphic VT

QRS complex varies in amplitude

86
Q

Which antibiotics would you use to treat severe aspiration pneumonia?

A

IV amoxicillin + gentamicin + metronidazole (if penicillin allergic: PO doxycycline + IV gentamicin + metronidazole)

87
Q

Which type of lung cancer is typically a peripheral tumour and is the type most closely associated with asbestos exposure (most likely in non-smokers)?

A

Adenocarcinoma

88
Q

Name the coronary artery which supplies the right ventricle, left ventricle, and interventricular septum

A

Left anterior descending artery

89
Q

Which antibiotics would you use to treat community-acquired pneumonia where the patient is in ICU?

A

Co-amoxiclav IV + clarithromycin IV (if penicillin allergic: levofloxin)

90
Q

Name the murmur: ejection systolic murmur best heard at the left sternal edge, made louder if you ask the patient to sit forward, breathe out and hold, collapsing pulse

A

Aortic regurgitation

91
Q

Describe the mechanism of a type I hypersensitivity reaction, and give an example

A

IgE-mediated response to external antigen e.g. asthma, anaphylaxis

92
Q

Define 1st degree heart block

A

PR interval greater than 0.2 seconds (5 small squares)

93
Q

Name the murmur: mid-diastolic murmur best heard at the apex, malar flush, tapping apex beat

A

Mitral stenosis

94
Q

Which antibiotics would you use to treat non-severe aspiration pneumonia?

A

PO amoxicillin + metronidazole (if penicillin allergic: doxycycline + metronidazole)

95
Q

ECG interpretation: ST elevation in I, aVL, V5, V6

A

Lateral MI - left circumflex artery affected

96
Q

ECG interpretation: ST elevation in II, III and aVF

A

Inferior MI - right coronary artery affected

97
Q

Name the coronary artery which supplies the right ventricle and the apex

A

Right marginal artery

98
Q

Name the second most abundant antibody

A

IgA

99
Q

Describe the findings on imaging (CXR and CT) seen in chronic hypersensitivity pneumonitis

A

CXR - pulmonary fibrosis, most commonly in upper zones

CT - ground-glass attenuation and patchy micronodules of fibrosis in the upper lobes

100
Q

Name the anti-arrhythmic drug class

A

Class I

101
Q

Which type of lung cancer is typically a central tumour, and can be associated with ectopic ACTH secretion and SIADH?

A

Small cell lung cancer

102
Q

Define primary biliary cholangitis

A

Autoimmune disease of the liver which causes the destruction of the small bile ducts - liver only

103
Q

Name the antibody which is the least abundant in plasma; it mediates type I hypersensitivity

A

IgE

104
Q

Name the heart rhythm (+ describe)

A

Monomorphic VT

Constant QRS morphology

Board complex rhythm

Rapid rate

105
Q

Describe the CXR findings seen in pneumoconiosis

A

Simple pneumoconiosis - non-calcified multiple round opacities in the upper zone

Complicated pneumoconiosis - bilateral, upper-mid zone fibrotic masses, develops from periphery to hilum

MBChB Y1-3 (3 decks)

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