101-113 Flashcards by Kate O'Leary

Antimotility drug in diarrhoea?

Loperamide

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If systemically unwell with diarrhoea, caused by campylobacter, what antibiotics?

Macrolides

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If systemically unwell with diarrhoea, caused by salmonella or shigella, what antibiotics?

Ciprofloxacin

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If systemically unwell with diarrhoea, caused by typhoid, what antibiotics?

Ceftriaxone- cephalosporin

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If systemically unwell with diarrhoea, caused by C. Diff, what antibiotics?

Metronidazole

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If a child is unwell with diarrhoea, recently started play school, what is infectious agent?

Rotavirus

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If an elderly person has recently been treated with antibiotics and get’s diarrhoea what is likely causative agent?

C. difficile

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If someone has got traveller’s diarrhoea, (Europe, Latin America) what is likely causative agent?

ETEC

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If diarrhoea looks like rice water, what is it caused by?

Cholera

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If diarrhoea is fatty stools, what is causative agent?

Giardia lamblia

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If someone gets diarrhoea haven eaten rice, what is the likely causative agent?

Bacillus cereus

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If someone gets diarrhoea after eating chicken what is likely causative agent?

Campylobacter (2-5 days) or salmonella (2 days)

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What immunoglobulin is secreted early in the immune response?

Ig M

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What is an example of hypersensitivity type 1?

Allergies

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What is an example of hypersensitivity type 2?

Cytotoxic - Myasthenia gravis

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What is an example of hypersensitivity type 3?

Immune complex- RA

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What is an example of hypersensitivity type 4?

Delayed response- contact dermatitis

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What WBCs appears in largest numbers at infection onset?

Neutrophils

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What WBCs release histamine?

Basophil

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What WBCs produce antibodies?

B lymphocytes

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Which interleukin acts as a pyrogen?

Interleukin 1

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Take a breath in and out normally. What is this called?

Tidal volume- 500ml

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Take a normal breath in. Breath in more, what is the extra bit called?

Inspiratory reserve volume

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Take a normal breath out. Breath out more. What is this extra bit called?

Expiratory reserve volume

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Take deepest breath in and then breath out as much as possible. What is this total called?

Vital capacity (IRV+tidal volume+ERV)

When you breath out fully what volume do you reach?

Residual capacity

How to measure the anatomical dead space?

Nitrogen washout/Fowler's method

How to measure the physiological dead space?

Bohr equation

How to measure the functional residual capacity?

Helium dilution

How to treat COPD?

SABA then LABA then inhaled corticosteroids

Name a short acting bronchodilator?

SABA (beta 2 agonist)- salbutamol, SAMA (muscarinic antagonist)- Iprtropium

Name a long acting bronchodilator?

LABA - Salmeterol | LAMA - Tiotropium

Name an inhaled corticosteroid?

Beclomethasone. Used in exacerbations

Patient presents with miosis (constricted pupils) and a low respiratory rate. What is likely overdose agent?

Heroin - codeine constricts pupils and lowers RR

What antidote for opiod overdose?

Naloxone

Overdose, with vomiting, tinnitus, and hyperventilation. Likely overdose agent?

Aspirin - causes metabolic acidosis

Overdose, hypotonia, hyporeflexia, hypotension. Likely overdose agent?

Lorazepam

Mydriasis (pupil dilated), delirium, melting (hyperthermia_, agitation. What overdose agent?

MDMA

Antidote for paracetamol overdose?

N acetyl cysteine

Antidote for benzodiazepine overdose?

Flumazenil

Antidote for beta blockers overdose?

Glucagon

Antidote for iron overdose?

Desferrioxamine

Antidote for digoxin overdose?

Digoxin specific antibodies

Patients presents with jaundice, abdominal pain and nausea/vomiting, taken on overdose. What agent?

Paracetamol

What is the treatment for a simple pneumothorax?

Aspirate with a 16-18G cannula

What is the treatment for a tension pneumothorax?

Chest drain (needle thoracotomy)

Causes of transudate pleural effusion?

Heart, liver, renal failure

Causes of exudate pleural effusion?

Infection, malignancy

Groin to loin pain, lateral pain can radiate to back, colicky pain, can't get comfortable?

Renal colic

What investigations in renal colic?

Urine microscopy to rule out infections. Test urine for microscopic haematuria (90+ in renal colic). Spiral non contract CT -imagining of choice

How to treat renal colic?

1. Analgesia. If stone's smaller than 5mm will pass spontaneously. More than 5mm might need medical expulsive therapy - 2. calcium channel blocker or alpha blocker- nifedipine or tamsulosin. If that doesn't work 3. shockwave therapy- EWSL

What urine dipstick findings in UTIs?

+ve for nitrites, WBC. Clinical definition is 1000 organisms per ml of freshly voided urine

What antibiotics in UTIs?

Trimethoprim (not in 1st trimester), Nitrofurantoin

What is the normal QRS duration?

120ms

What is normal PR interval?

120-200ms

What is 1st degree heart block?

Regular, but PR interval is greater than 200ms

What is 2nd degree heart block, Mobitz type 1?

PR interval gets progressively longer then you get a non-conducted P wave

What is 2nd degree heart block, Mobitz type 2?

2 P waves for every 1 QRS complex

What is 3rd degree heart block?

Complete heart block. No association between P waves and QRS complex

What is mean arterial pressure dependent on?

Systemic vascular resistance (aka total peripheral resistance)

What does the ectoderm end up forming?

External structures- epidermis, retina and nervous system

What does the mesoderm end up forming?

Muscle, CV system, skeleton, reproductive organs

What does the endoderm end up forming?

GI system and respiratory epithelium

What should a child be able to do by 12 months?

Walk

Penetrance of BRCA gene?

60-80%

Penetrance of FAP colon cancer?

100% if polyps not detected

What is adrenarche?

Pubic and axillary hair

What is gonardarche?

Testicle and ovary development

What is thelarche?

Breast development

What investigations would you do in GORD?

Endoscopy to look for epithelial change. 24 hour pH study. Barium swallow for hiatus hernia

What type of ulcer gets worse during and after a meal?

Gastric

What type of ulcer gets better during and after a meal?

Duodenal

How to test for H. pylori infection?

breath test- (CLO test, urease test, carbon 13 test)

What is treatment for H. pylori infection?

Triple therapy- Omeprazole, Amoxicillin and Clarithromycin. Use metronidazole in cases of penicillin allergy

What nerve has been compressed with wrist drop (commonly called Saturday night palsy)?

Radial nerve

What nerve has been trapped with carpal tunnel syndrome?

Median nerve (loss of wrist flexion, thenar wasting, loss of sensation)

What nerve has been compressed with loss of sensation of medial fingers, with hypothenar wasting?

Ulnar nerve

What nerve has been compressed in loss of sensation over lateral thigh to knee?

Lateral cutaneous nerve of the thigh- tight trousers syndrome

What nerve has been compressed with a foot drop?

Common perineal nerve (around head of fibula)

Patient presents with rapid onset muscle weakness, previous infection, ascend polyneuropathy, what Is likely cause?

Guillain Barre Syndrome - important to do spirometry to check lung function. Treat with IV immunoglobulins

Patient presents with fatiguability, drooping of eyelids, dysphagia, quiet voice, what is likely cause?

Myasthenia gravis - treat with Pyridostigmine (inhibits acetylcholinesterase)

Patient presents with gait disturbance before drooping eyes. Reflexes get better with increased testing. What is the cause?

Lambert Eaton syndrome. Antibodies against calcium channels

Patient presents with hereditary motor and sensory neuropathy. Foot drop, hammer toes (always curled) inverted champagne bottle sign, and PMP22 marker. What is the cause?

Charcot Marie Tooth

What is distribution of diabetic neuropathy?

Glove and stocking

What is the effect of high leptin levels?

Lower appetite

What is the effect of high ghrelin levels?

Increased appetite

What does the foregut cover?

Mouth to duodenum

What does the midgut cover?

Small intestine, caecum, ascending colon, 2/3 transverse colon

What does the hindgut cover?

1/3 transverse colon, rectum, descending colon, sigmoid colon

What is blood supply to the foregut?

Coeliac trunk

What is blood supply to the midgut?

Superior mesenteric artery

What is the supply to the hindgut?

Inferior mesenteric artery

What muscle fibres would suit a marathon runner?

Slow twitch, type 1.

Red muscle fibres with high levels of glycogen are what type?

Type 2a - high myoglobin so are red, lots of glycogen so are fast

What muscles are supplied by the median nerve?

LOAF - lateral lumbricals, Opponens pollicis, Abductor pollicis brevis, Flexor pollicis brevis

What artery supplies the superficial palmar arch?

Primarily ulnar artery

Which artery supplies the deep palmar arch?

Primarily the radial artery

What are the interossei muscles supplied by?

Ulnar artery (superficial palmar arch, palmar metacarpal artery, dorsal metacarpal artery)

What is the primary pathological process in early primary OA?

Disorganisation of collagen matrix in cartilage

What are features of OA on X-ray?

Loss of joint space, osteophytes, subchondral cysts, subchondral sclerosis

101-113 Flashcards

(100 cards)