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Phase2 > Peer Teaching Exam Questions > Flashcards

Peer Teaching Exam Questions Flashcards

1
Q

Triad of HF symptoms?

A
  • Oedema
  • Fatigue
  • Dyspnoea
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2
Q

Aortic dissection Symptoms?

A
  • tearing chest pain
  • Anuria
  • unequal arm pulses/ pressures
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3
Q

Secondary Hypertension Causes?

A
  • CKD, Polycystic Kidney Disease
  • Conn’s, Cushing’s
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4
Q

How do you exclude a PE?

A

Negative D-dimer test

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5
Q

Treatment of Legionella?

A

Ciprofloxacin
Clarithromycin

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6
Q

How does Pulmonary Hypertension show on CXR?

A

Dilated pulmonary arteries
Right hypertrophy

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7
Q

Treatment of Haemochromatosis?

A

Deferoxamine

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8
Q

Antibodies found in someone with Myasthenia Gravis?

A

AChR
MuSK

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9
Q

What is a common diagnosis for an old man with a NEW back pain?

A

Multiple myeloma

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10
Q

What is Neisseria?

A

Gram negative cocci

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11
Q

give examples of aerobic and anaerobic gram positive bacilli?

A

aerobic = bacillus, listeria monocytogenes
anaerobic = clostridium difficile

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12
Q

What are the 6 P’s of acute limb ischaemia?

A

Pain
Pallor
Paraesthesia
Perishing cold
paralysis
Pulseless

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13
Q

How do you distinguish between salmonella and shigella?

A

XLD agar
Shigella = Red
Salmonella = Red with black dots

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14
Q

Where is there ST elevation for someone who had a RCA MI? (inferior heart)

A

2,3, aVF

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15
Q

Where is there ST elevation for someone who had a LAD MI? (antro-septal)

A

V1,V2 and involvement of circum

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16
Q

Where is there ST elevation for someone who had a circumflex MI? (lateral)

A

1, aVL, V5, V6

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17
Q

Describe briefly the 4 hypersensitivity reactions

A

1= Allergic (IgE)
2= Cytotoxic (goodpasture’s, Haemolytic)
3 = Immune complex deposition ( SLE, pneumonitis)
3 = Delayed (t cell)

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18
Q

What may these precursors cause?

Asthma
Pulmonary Hypertension
Bronchiectasis
pleural Effusion

A

a- Pneumonia
P - RHF
B - Pneumothorax
PE - CCF

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19
Q

What are the signs of Infective Endocarditis

A

FROMJANE

Fever
Roth Spots
Osler’s Nodes
Murmur heart

Janeway’s lesions
Anaemia
Nail haemorrhage
Emboli

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20
Q

What are the severity crtierias for the following

Fontaine
new York heart association functional classification
Dukes
Ann Arbor
Killip

A

Fontaine = PAD

new York heart association functional classification = HF

Dukes = infective Endocarditis

Ann Arbor = lymphoma

Killip - MI

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21
Q

What cells are seen on blood film for:

Iron deficiency anaemia
Haemolytic anaemia
Thalassaemia
glucose-6-phosphate deficiency

A

IDA = Hypochromic

Thalassaemia = Target cells

Haemolytic = Schistocytes

G6PD = bite and blister cells

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22
Q

What is:

Chadsvacs
ABCD2
wells
FRAX
QRISK2

A

chadsvacs = stroke risk after AF

ABCD2 = stroke risk after TIA

Wells = DVT probability

FRAX = fracture risk in 10yrs

QRISK2 = CVS disease in 10 years

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23
Q

What do the crystals look like in gout and pseudo gout?

A

GOUT = NEGATIVELY BIREFRIGENT NEEDLE SHAPED

PSEUDO-GOUT = POSITIVELY BIREFRINGENT RHOMBOID SHAPED

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24
Q

Nephritic vs Nephrotic key features?

A

Nephritic = Oliguria, Haematuria, Oedema, HTN, decreased GFR

nephrotic = oedema, proteinuria, hypalbuminaemia, hyperlipidaemia

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25
Q

How does ACE-i work?

A

inhibit bradykinin breakdown

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26
Q

What stain do you use to show iron

A

Perl’s

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27
Q

What can cause meningitis in pregnant women?

A

Listeria

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28
Q

What can cause meningitis in kids?

A

Strep agalactiae

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29
Q

What antibodies are found in a coeliac?

A

IgA tissue transglutaminase
IgA anti-endomysial

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30
Q

Why are tympanic sounds of abdomen heard?

A

Air in bowel due to obstruction

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31
Q

Where does Appendicitis pain start?

A

Diffuse pain in abdo then localises

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32
Q

Side effects of Steroids?

A

Growth problems
increased risk to infection
osteoporosis
HTN
oedema
DM

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33
Q

What is a Reynolds pentad

A

symptoms suggesting the diagnosis obstructive ascending cholangitis, a serious infection of the biliary system.

It is a combination of
Charcot’s triad (RUQ pain, jaundice, and fever)
shock (low blood pressure, tachycardia)`
an altered mental status

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34
Q

questions before cancer surgery/

A

are they medically fit
is there mets
is it resectable

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35
Q

What are monoclonal bands in blood film found in?

A

MS

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36
Q

Why are methotrexate and trimethoprim related?

A

Folate antagonists so cant be used during pregnancy

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37
Q

what do you call trimethoprim and sulfamethoxazole?

A

co-trimoxazole

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38
Q

what antibiotic binds to RNA polymerase?

A

Rifampicin

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39
Q

name an aminoglycoside

A

Gentamycin

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40
Q

name a macrolide

A

Erythromycin / clarithromycin

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41
Q

name a cephalosporin

A

Cefuroxime
Cephalexin

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42
Q

name a glycopeptide

A

Vancomycin

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43
Q

Definition of anaemia

A

decrease in Hb conc due to plasma volume increase

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44
Q

Cause of Macroscopic anaemia?

A

B12/folate
alcohol
hypothyroid

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45
Q

Cause of CML

A

translocation of gene between 9,22 causing formation of Philadelphia chromosome

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46
Q

Ann Arbor staging?

A

1 - one node
2 - multiple lymph
3 - above or below diaphragm below = 3b and both sides of body
4 - organ mets

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47
Q

How can you tell its ALL on blood film?

A

increase conc of lymphoblast’s

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48
Q

How is febrile neutropenia found

A

Fever over 38c

Absolute neutrophil count <1

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49
Q

What is Rituximab?

A

monoclonal antibody which targets CD20 protein on surface of a b cell to treat lymphoma

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50
Q

What disease is it if someone has hyperkalaemia, hyperuricaemia, hyperphosphatemia, hypocalcaemia

A

Tumour lysis syndrome

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51
Q

How is tumour lysis syndrome treated and how does hyperkalaemia show on ECG

A

Fluids, allopurinol, electrolyte balance

tall T, absent p, broad QRS

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52
Q

How does hypercalcaemia show on ECG

A

short QT is hyper so hypo is long QT

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53
Q

What is the name of a pink diplococci organism

A

Neisseria Meningitidis

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54
Q

What are the real names of meningitis

A

Pneumococcal septicaemia
Meningococcal septicaemia

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55
Q

treatment of meningitis?

A

IV Cefotaxime

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56
Q

Headache red flags?

A

Seizure
Altered: consciousness, memory,confused
Papilloedema
Cluster Headache

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57
Q

What drug is given to decrease intracranial pressure?

A

IV Mannitol

58
Q

What has fasciculations and spasticity?

UMN or LMN

A

LMN has fasciculations
UMN has spasticity (increased tone and brisk reflexes)

59
Q

Give examples of primary and secondary adrenal insufficiency

A

Primary = Addisons, TB, Trauma

Secondary = Steroids, Congenital, Neoplasm

60
Q

How does hyperglycaemia lead to insulin secretion?

A

1) Increased uptake of glucose by cells
2) Increased ATP levels and K+ channels close
3) Depolarisation of membrane opens Ca2+ channels
4) Increased Ca2+ means exocytosis of insulin-containing vesicles
5) Insulin released by beta cells in Islets of Langerhans

61
Q

Thyroid autoantibodies?

A

anti-thyroid peroxidase antibodies (TPOAb)

thyrotropin receptor antibodies (TRAb)

thyroglobulin antibodies (TgAb)

62
Q

Treatment of Hyperthyrodism/ Graves

A

Beta blockers
Carbimazole
Radio iodine therapy
Thyroidectomy

63
Q

2 main symptoms of DI?

A

Polyuria and Polydipsia

64
Q

symptoms of pheochromocytoma

A

plapitations, sweating, headache

65
Q

blood tests for Pheochromocytoma

A

Plasma catecholamines

66
Q

what cells produce plasma catecholamines and where are they found

A

Chromaffin cells in the adrenal medulla

67
Q

What is Deontology?

A

the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of the action.

68
Q

Why does someone breath heavily during DKA?

A

Respiratory compensation to get rid of the CO2

69
Q

What shape are the different types of haemorrhage in the brain

A

sub-dural = crescent shaped
extra-dural = lens shape
sub-arachnoid = 5 point star

HYPERDENSE

70
Q

What does Pericarditis show on ECG?

A

Saddle shaped ST elevation and PR depression

71
Q

What heart murmur does:

Mitral Stenosis and Mitral Regurgitation show?

A

Mitral Stenosis: Early Diastolic

Mitral Regurg: Pan-systolic

72
Q

What heart murmur does:

Aortic Stenosis and Aortic Valve Replacement show?

A

Ejection systolic ‘crescendo-decrescendo’

Valve replacement = systolic click

73
Q

Which bacteria is most common in the community for Pnuemonia?

A

Strep. Pneumoniae

74
Q

What Hypersensitivity reaction is Goodpastures?

A

Type 2

75
Q

What Hypersensitivity reaction is SLE?

A

type 3

76
Q

What Hypersensitivity reaction is Graft rejection?

A

type 4

77
Q

Where does lung cancer commonly spread?

A

Bone, Brain, Liver, Lymph, Adrenal Glands

78
Q

what would you see if someone has a collapsed lung?

A

Sail Sign

79
Q

Which antibody is seen in SLE?

A

Anti-double stranded DNA (Anti-dsDNA) antibodies are a group of anti-nuclear antibodies (ANA)

80
Q

What is likely if someone has nocturnal diarrhoea?

A

IBD

81
Q

What sign is shown in acute Cholecystitis?

A

Murphy’s Sign

82
Q

What is negative in cholangitis?

A

Murphy’s Sign

83
Q

What is Common in the left iliac region of the bowel?

A

Volvulus

84
Q

Difference in pain with gastric and duodenal ulcers?

A

Gastric = pain when full/ after eating

Duodenal = pain when hungry

85
Q

Give Inflammatory and Non inflammatory reasons for joint pain

A

Inflammatory = Autoimmune/ AS/ Crystal Arthritis/ Infection

Non-inflammatory = OA/ Fibromyalgia

86
Q

3 differential diagnoses of HLA-B27 positive?

A

AS
Psoriatic Arthritis
Reactive Arthritis
Enteropathic Arthritis

87
Q

What classing system is used for fractures?

A

Salter- Harris Classification

88
Q

What is meant by a T/Z score?

A

T= bone density compared to 25 year old of same gender

Z = bone density compared to average of same age of same gender

89
Q

when might you prescribe allopurinol?

A

Long term gout
Kidney stones - reduce uric acid
Hyperuricaemia - tumour lysis syndrome

90
Q

Temporal Arthritis treatment?

A

Steroids (prednisolone)

91
Q

Triad of renal cancer symptoms?

A

Flank pain
Haematuria
Palpable Mass

92
Q

function of kidney?

A

Excretion of electolytes, water, urea

produces Epo

Ultrafiltration

93
Q

Causes of CKD

Pre renal, renal, post renal

A

Pre-renal- DM/ high cholesterol

Renal = NSAIDs, glomerulonephritis

Post renal = kidney stones

94
Q

Cause of Nephritic Syndrome

A

IgA nephropathy
post strep infection
SLE
ANCA positive vasculitis

95
Q

Definition of erectile dysfunction?

A

Inability to gain and maintain erection long enough to achieve sexual satisfaction

96
Q

Pharmacological and surgical treatment of Stress incontinence

A

Duloxetine

Artificial Sphincter

97
Q

Name the bacteria that cause chlamydia and gonorrhoea

A

Neisseria gonorrhoeae

Chlamydia Trachomatis

98
Q

What drug is used to treat syphilis

A

Azithromycin

99
Q

Describe the different types of Salter Harris Classification

A

Type 1 = Through growth plate

Type 2 = Through growth plate and metaphysis (most common)

Type 3 = Growth plate and epiphysis

Type 4 = all 3 elements

Type 5 = Crush injury of growth plates

100
Q

Cause of Polycythaemia?

A

JAK-2 mutation

101
Q

Signs and Symptoms of Polycythaemia?

A

Hepatosplenomegaly
Pruritis
Plethoric face
thrombus formation
Gout due to increased uric acid / DNA breakdown

102
Q

Diagnosis of polycythaemia?

A
  • JAK-2 mutation
  • FBC
  • Bone marrow aspirate
103
Q

Treatment of polycythaemia?

A

1) Venesection
2) Hydroxycarbamide
3) Interferon - alpha

104
Q

Symptoms of Polycystic kidney disease

A

Hypertension.
Bump.
Haematuria (blood in urine).
Proteinuria.
Back pain and flank pain. Back pain or flank pain is the most common symptom of ADPKD

105
Q

What may polycystic kidney disease cause?

A

Berry aneurysm- ruptures and becomes sub-arachnoid haemorrhage

106
Q

Acute Pyelonephritis (Upper UTI) symptoms?

A
  • Fever
  • Chills
  • Flank pain
  • Nausea and Vomiting
  • Increased WCC distinguishes upper from lower
107
Q

Complications of CKD

A
  • Hyperkalaemia
  • Hypocalcaemia (renal osteodystrophy)
  • Encephalopathy (flap)
  • Pericarditis
  • Increased renin so HTN
  • Anaemia (reduced EPO)
108
Q

Complications of DKA

A
  • Kussmaul breathing
  • Pear drop breath
  • Hyperkalaemia
  • Cerebral Oedema
109
Q

what may trigger DKA and what is the treatment? same as (HONK coma)

A

Infection, MI, wrong dose insulin

Treatment:

  • Fluids
  • Insulin
  • Electrolyte replacement
110
Q

Complications of Pancreatitis?

A
  • Pancreatic Pseudocyst / abscess (infection by e.coli)
  • Hypovolaemic shock
  • Acute Respiratory Distress Syndrome

Chronic = Diabetes

111
Q

Main visible diagnostic of cirrhosis?

A

Regenerative nodules

fibrotic tissue and collagen

112
Q

Complications of Cirrhosis

A
  • Gastro-oesophageal varices
  • Ascites
  • Splenomegaly
  • Hepatorenal failure
  • Jaundice
  • Palmar erythema due to oestrogen increase
113
Q

Symptoms of Cirrhosis

A
  • Pruritis
  • Easy bruising (low coagulation factors)
  • Hepatic Encephalopathy (liver flap)
  • Ascites
114
Q

Gold standard Dx of Cirrhosis?

A

Liver biopsy (nodules and fibrosis)

115
Q

Lab findings of Cirrhosis

A

Raised:

  • Bilirubin
  • AST>ALT ratio
  • ALP, GGT

Thrombocytopenia

116
Q

Diagnosis of Hypertension?

A

Ambulatory blood pressure monitor

117
Q

Causes of HTN?

A
  • Acromegaly
  • Conn’s
  • Hyperthyroidism
  • Glomerulonephritis
118
Q

Exclude secondary HTN?

A
  • renin/ aldosterone
  • Full blood count
  • U+E
119
Q

Signs of Asthma?

A
  • Low O2 sats
  • Use of Accessory muscles
  • Tachypnoea
  • Hyper-resonant percussion
120
Q

Bedside asthma tests?

A

Peak flow, ABG, ECG

121
Q

Asthma pathological changes

A
  • Increase mucous
  • bronchoconstriction
  • inflammation of mucosa
122
Q

Example of corticosteroid an method of action?

A

Prednisolone- upregulates anti-inflammatory genes
downregulates pro-inflammatory genes

123
Q

Ann Arbor staging, what is different betwee 3A and 3b ?

A

B- symptoms (fever, weight loss, night sweats)

124
Q

Extra-articular effect of Rheumatoid Arthritis?

A
  • Anaemia
  • Pericarditis
  • neuropathy
125
Q

Worldwide common cause of Hypothyroidism and the treatment?

A

Iodine deficiency and Levothyroxine (T4)

126
Q

Definition of a UTI

A

A UTI is a pure growth of more than 10^5 organisms per ml collected from a fresh clean catch urine sample

127
Q

Lifestyle advice to reduce UTI

A

Clean after sex, increase fluid intake and regular voiding

128
Q

Common complication of a UTI?

A

Pyelonephritis - Ascending bladder infection into the renal parenchyma

129
Q

4 areas of Wilson and Junger Criteria?

A

Condition - important, understood, detectable stage

treatment- accepted and early, facilities

Test - suitable, early, accepted

Benefits- cost effective, agreed on who to treat

130
Q

Mental Capacity requirements?

A

1) Ability to understand information
2) retain information
3) Evaluate information
4) Communicate decision

131
Q

Investigations of hernias?

A
  • Endoscopy
  • Barium swallow
132
Q

Name a different class of drug instead of PPI

A

H2 receptor antagonist

Ranitidine

133
Q

Risk factors to TB

A
  • Immunosuppressed
  • Close contact to infected/ crowded living conditions
  • Alcoholics
  • Homeless
134
Q

X-ray of TB?

A
  • Cavitation
  • upper lobe consolidation
  • pleural effusion
135
Q

What are the 4 quadrants of medical ethics?

A

medical indications,
patient preferences,
quality of life,
contextual features

136
Q

What are the signs of lung collapse and hypcalcaemia

A

Sail sign

Hypocalcaemia:

Chvosteks sign

Trousseau sign

137
Q

Site of action of loop diuretic

A

Block NKCC2 in ascending loop of henle

138
Q

Thiazide mode of action

A

Blocks Na+/Cl- co-transporter In DCT

139
Q

Aldosterone antagonist method

A

Blocks aldosterone at ENACs in collecting duct

140
Q

Breast cancer treatment and causes of lumps

A

Chemo and Trastuzumab

Causes:
lipoma
cancer
cysts
implant rupture
fibroadenoma

141
Q

Name a dopamine agonist and what would be seen on Parkinson brain

A

Lewy bodies, loss of dopaminergic neurones

Ropinirole

Phase2 (19 decks)

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