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2a Mocks > PTS Wrap Up SBAs > Flashcards

PTS Wrap Up SBAs Flashcards

1
Q

What is the diagnostic test for Addison’s disease?

A

SynACTHen test

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2
Q

Remember “…” for Addison’s

A

Lean, tanned, tired, tearful

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3
Q

Regular nebulised salbutamol is associated with…

A

hypokalaemia

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4
Q

Ramipril can cause…

A

hyperkalaemia

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5
Q

Cranial Diabetes Insipidus:

A

Hypothalamus doesn’t secrete enough ADH, but kidneys can still respond to ADH

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6
Q

Nephrogenic Diabetes Insipidus:

A

Kidneys are unable to respond to ADH, so can’t concentrate urine even when desmopressin is given

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7
Q

Acromegaly tests

A
  1. Serum IGF 1 1st line
  2. Oral glucose tolerance test is diagnostic
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8
Q

Symptoms of hyperaldosteronism

A
  1. Hypertension
  2. Excessive thirst
  3. Muscle cramps
  4. Fatigue
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9
Q

First line investigation for hyperaldosteronism?

A

Aldosterone Renin Ratio

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10
Q

Most likely cause of ACTH independent Cushing’s syndrome?

A

Iatrogenic - medication review and stop corticosteroids, eg. inhalers

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11
Q

What is a pheochromocytoma?

A

A tumour that secretes catecholamines derived from the chromaffin cells of the adrenal medulla

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12
Q

What is a phaeochromocytoma?

A

A tumour that secretes catecholamines derived from the chromaffin cells of the adrenal medulla

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13
Q

What is the pathophysiology of Graves’ hyperthyroidism?

A

TSH receptor autoantibodies activate TSH receptors - increased thyroxine and triiodothyronine

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14
Q

1st line treatment for diabetic ketoacidosis?

A

IV fluids then insulin therapy

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15
Q

What is the gold standard test for phaeochromocytoma?

A

Plasma free metanephrine (elevated)

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16
Q

What are some symptoms of Addison disease?

A
  1. Fatigue
  2. Weight loss
  3. Hyperpigmentation
  4. Salt craving
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17
Q

Signs/Symptoms of ketoacidosis?

A
  1. Excessive thirst
  2. Nausea and vomiting
  3. Fruity breath
  4. Weakness and fatigue
  5. Hypokalaemia due to excessive urination
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18
Q

Inferior leads:

A

II, III, aVF

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19
Q

Lateral leads:

A

I, aVL, V5, V6

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20
Q

Anterior/Septal leads:

A

V1-V4

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21
Q

What is the management for acute MI?

A

MONA - morphine, O2, nitrates, aspirin

O2 only indicated when SATS are below 94%

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22
Q

What drugs should be offered post-MI?

A
  1. Ace-i or ARB - Ramipril or Candesartan
  2. Beta blocker - Propanolol
  3. Statin - Atorvastatin
  4. Dual antiplatelet - Aspirin and Clopidogrel
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23
Q

ABCDE X ray findings in Heart Failure?

A

Alveolar oedema
Kerley B lines
Cardiomegaly
Dilation of UPPER lobe vessels
Effusions

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24
Q

ST elevation?

A

Prinzmetal angina
STEMI
Pericarditis

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25
Q

ST depression?

A

Unstable angina
NSTEMI

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26
Q

CHA2DS2VASc

A

Stroke risk for patients with AF

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27
Q

HAS-BLED

A

Risk of bleeding in patients on anticoagulation

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28
Q

QRISK3

A

Risk of a major CVA in next 10 years

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29
Q

Well’s Criteria

A

DVT risk

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30
Q

FRAX

A

Risk of fracture

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31
Q

What is the first line investigation, especially in primary care for heart failure?

A

BNP / NT-proBNP

Then ECG, Echo and CXR

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32
Q

ARD Fall

A

Aortic Regurgitation

Diastolic Decrescendo

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33
Q

ASS Bump

A

Aortic Stenosis

Systolic Crescendo / Decrescendo

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34
Q

MSD You

A

Mitral Stenosis

Diastolic Decrescendo / Presystolic Crescendo

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35
Q

MRS Through

A

Mitral Regurgitation

Pan systolic murmur

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36
Q

What is the best test for aortic stenosis diagnosis?

A

Trans thoracic doppler echocardiogram

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37
Q

Anaphylaxis Treatment?

A
  1. ABCDE
  2. Check diagnosis
  3. Call for help
  4. IM Adrenaline 500mg of 1:1000
  5. High flow O2
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38
Q

What is pericarditis?

A

Inflammation of the pericardium (the membrane that surrounds the heart)

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39
Q

What is Dressler syndrome?

A

Pericarditis occurring as a complication of MI, 2-3 weeks after the attack

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40
Q

What is endocarditis?

A

Inflammation of the heart valves

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41
Q

Which valve is usually affected in endocarditis?

A

Tricuspid as this is the first valve blood passes through after the systemic circulation

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42
Q

Signs/Symptoms of endocarditis?

A
  1. Fever
  2. Murmur
  3. Roth spots
  4. Janeway lesions
  5. Osler’s nodes
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43
Q

Causes of microcytic anaemia?

A
  1. Iron deficiency
  2. Thalassaemias
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44
Q

Causes of normocytic anaemia?

A
  1. Anaemia of chronic disease
  2. Renal disease
  3. Acute blood loss
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45
Q

Causes of macrocytic anaemia?

A
  1. B12 deficiency
  2. Folic acid deficiency
  3. Liver cirrhosis
  4. Bone marrow disorders
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46
Q

What is the MCV for microcytic anaemia?

A

<80 fL

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47
Q

What is the MCV for normocytic anaemia?

A

80-100 fL

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48
Q

What is the MCV for macrocytic anaemia?

A

> 100 fL

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49
Q

How is B12 absorbed?

A

B12 binds to intrinsic factor which is produced by the parietal cells of the stomach, it is then absorbed in the terminal ileum.

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50
Q

Pathophysiology of pernicious anaemia?

A

Parietal cells of stomach are attacked by immune system. This results in atrophic gastritis and the loss of intrinsic factor production

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51
Q

What is hereditary spherocytosis?

A

Defects in red cell membrane that cause the surface area to volume ratio to decrease and the cell to become more rigid and less deformable than normal RBCs

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52
Q

Symptoms of hereditary spherocytosis?

A
  1. Anaemia
  2. Jaundice
  3. Splenomegaly
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53
Q

What would the blood film look like in a patient with beta thalassaemia?

A

Large and small irregular hypochromic erythrocytes

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54
Q

What are the features of multiple myeloma?

A

Old CRAB

  1. Typically presents over 70 yrs of age
  2. Hyper calcaemia
  3. Renal impairment
  4. Anaemia
  5. Bone lesions - Back pain, pepper pot skull
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55
Q

What would show on a bone marrow biopsy to confirm a diagnosis of acute myeloid leukaemia?

A

Auer rods

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56
Q

What may show on a blood film of patients with multiple myeloma?

A

Rouleaux formation

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57
Q

What plasmodium causes the most severe form of malaria?

A

P. Falciparum

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58
Q

Symptoms of TB?

A
  1. Persistent cough
  2. Weight loss
  3. Night sweats
  4. Fever
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59
Q

What is a typical symptom of malaria?

A

Fever that causes sweats and chills

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60
Q

Stage 1 Lymphoma

A

Cancer is contained to a single lymph node group

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61
Q

Stage 2 Lymphoma

A

Cancer is on a single side of the diaphragm

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62
Q

Stage 3 Lymphoma

A

Cancer is on both sides of the diaphragm

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63
Q

Stage 4 Lymphoma

A

Cancer has spread beyond the lymph nodes

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64
Q

A or B at the end of the Ann Arbor staging system?

A

B if the patient has “B type” symptoms - fever, night sweats, weight loss

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65
Q

Which leukaemia is commonest in children?

A

Acute lymphoblastic leukaemia

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66
Q

What is the treatment for chronic myeloid leukaemia?

A

Chemotherapy and tyrosine kinase inhibitor (imatinib)

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67
Q

What is haemophilia A?

A

Clotting factor 8 deficiency

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68
Q

What is haemophilia B?

A

Clotting factor 9 deficiency

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69
Q

What are the two types of secondary polycythaemia?

A

Compensatory and abnormal

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70
Q

Example of compensatory polycythaemia?

A

High altitude - in hypoxic conditions, kidneys produce more erythropoetin

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71
Q

Example of abnormal polycythaemia vera?

A

Tumour secreting erythropoetin

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72
Q

What is the first line investigation for acute pancreatitis?

A

Serum amylase

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73
Q

What is the first line treatment for autoimmune hepatits?

A

Prednisolone (Steroids)

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74
Q

What tests would you order for a diagnosis of autoimmune hepatits?

A

Investigative bloods - FBC and:
1. IgG
2. Anti smooth muscle antibodies - high level is indicative of autoimmune hepatits

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75
Q

What is primary sclerosing cholangitis?

A

Fibrosis destroying the intrahepatic and extrahepatic bile ducts

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76
Q

What is primary biliary cholangitis?

A

Inherited abnormality of immunoregulation leads to a T lymphocyte mediated attack on intrahepatic bile ducts

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77
Q

What is a diagnostic feature of primary biliary cholangitis?

A

Anti-mitochondrial antibodies (AMA)

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78
Q

What is a diagnostic feature of primary sclerosing cholangitis?

A

Beaded appearance of bile ducts on MRI / Endoscopic retrograde cholangiopancreatography

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79
Q

What diseases is primary biliary cholangitis associated with?

A

Other autoimmune disorders, eg. RA, Sjogrens

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80
Q

What disease is primary sclerosing cholangitis associated with?

A
  1. Ulcerative colitis
  2. Cholangiocarcinoma
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81
Q

What are some symptoms of primary biliary cholangitis?

A
  1. Jaundice
  2. Pruritus (Itching)
  3. Fatigue
  4. Irritable bowel
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82
Q

What colour urine / stools would you see in someone with pre-hepatic jaundice?

A

Normal urine, dark stools

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83
Q

What colour urine / stools would you see in someone with intra-hepatic jaundice?

A

Dark urine, normal -/ slightly lighter coloured stools

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84
Q

What colour urine / stools would you see in someone with post-hepatic jaundice?

A

Dark urine, pale stools

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85
Q

What is the first line treatment for alcohol withdrawal?

A

Chlordiazepoxide

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86
Q

What is the most common cause of liver cirrhosis?

A

Alcohol abuse

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87
Q

What is Charcot’s triad of ascending cholangitis?

A

Jaundice, fever, RUQ pain

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88
Q

What is the difference between the presentation of acute cholecystitis and ascending cholangitis?

A

Patients with acute cholecystitis will NOT HAVE JAUNDICE

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89
Q

What is Gilbert’s syndrome?

A

A disorder causing impaired conjugation of bilirubin due to decreased levels of the UDPGT enzyme

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90
Q

What is alpha-1-trypsin deficiency?

A

A condition where deficiency in alpha-1-trypsin causes elastase to break down elastin in the lungs and liver causing damage

91
Q

What are some presentations of alpha-1-trypsin deficiency?

A

1.Dyspnoea
2. Hepatomegaly

92
Q

What is median arcuate ligament syndrome?

A

A condition where the median arcuate ligament presses on the coeliac artery compressing it and causing pain

93
Q

What does recent travel with chronic diarrhoea following an episode of diarrhoea abroad suggest?

A

Parasitic infection or tropical malabsorption

94
Q

What is small intestine aspirate culture used for?

A

If bacterial overgrowth is suspected in the small intestine. This is more likely post intestinal surgery, or in motility disorders.

95
Q

What can a small intestine biopsy be used for?

A

Diagnosis of parasite or villous atrophy suggesting tropical malabsorption

96
Q

What are some red flag symptoms for gastro-intestinal cancer?

A
  1. Weight loss
  2. Anaemia
  3. Melaena
  4. Haematemesis
97
Q

What is a common cause of dyspepsia and epigastric pain in adults?

A

H. pylori gastritis

98
Q

What are symptoms of haemorrhoids?

A
  1. Fresh red blood and mucous in stool
  2. Itchy anus
  3. Soreness around the anus
99
Q

What are symptoms of diverticulitis?

A
  1. Fresh red blood
  2. Vomiting
  3. Pyrexia
  4. Abdominal pain
100
Q

What are the main differences between haemorrhoids and anal fissures?

A
  1. Haemorrhoids can present with mucus
  2. With haemorrhoids you may feel an external lump
101
Q

What are some differences between small intestine obstruction and large bowel obstruction?

A

Small bowel obstruction usually occurs with vomiting before constipation because it is more proximal in the tract

102
Q

What are 5 red flags for GI Cancer?

A
  1. Unexplained weight loss
  2. Family history
  3. Rectal bleeding / melaena
  4. Anaemia
  5. Rectal or abdominal mass
103
Q

What is haemochromatosis?

A

An inherited disorder of iron metabolism

104
Q

What are the most common antibiotics that cause C.diff?

A
  1. Clindamycin
  2. Co-amoxiclav
  3. Cephalosporins
  4. Penicillins
  5. Quinolones
105
Q

What is the treatment for C. diff?

A

Vancomycin

106
Q

What is the first line investigation for coeliac?

A

tTg - IgA antibodies

107
Q

What is the gold standard investigation for diagnosis of coeliac?

A

Endoscopy with duodenal biopsy

108
Q

What are some biopsy signs of coeliac disease?

A
  1. Villous atrophy
  2. Crypt hyperplasia
  3. Intraepithelial lymphocytosis
109
Q

What is a Mallory-Weiss tear?

A

A mucosal tear at at the gastro-oesophageal junction, occuring due to a sudden increase in intra-abdominal pressure

110
Q

Name 4 causes of gastric ulcers

A
  1. NSAIDS
  2. Haemodynamic shock
  3. H. pylori infection
  4. Stress
111
Q

What are some symptoms of diverticulitis?

A

Similar to appendicitis but on the other side
1. Fever
2. Lower left quadrant pain
3. Nausea
4. Abdominal distension

112
Q

What is the gold standard diagnostic investigation for acute diverticulitis?

A

Contrast CT colonography

113
Q

What are some red flags symptoms of oesophageal cancer?

A
  1. Weight loss
  2. Bleeding
  3. Anorexia
  4. Vomiting
  5. Lymphadenopathy
  6. PROGRESSIVE dysphagia
114
Q

Would a sudden onset dysphagia of solids and liquids indicate oesophageal cancer?

A

NO - in oesophageal cancer the dysphagia would start with initial difficulty swallowing solids then progress. Rapid onset dysphagia indicates a benign disease

115
Q

What is the issue with oesophageal cancer diagnosis?

A

By the time it is found it is often extremely advanced because most patients have no symptoms or signs for a while

116
Q

What are some signs of chronic liver disease?

A
  1. Clubbing
  2. Palmar erythema
  3. Spider naevi
  4. Dupuytren contracture
  5. Pruritus
117
Q

What is the most common cause of oesophageal varices in the UK?

A

Liver cirrhosis

118
Q

What tumour marker is raised in testicular cancer?

A

Alpha feto protein and B-hCG

119
Q

Name 5 thing that can cause a raised PSA (Prostate specific antigen)

A
  1. Prostate cancer
  2. Benign prostatic hyperplasia
  3. Prostatitis
  4. UTIs
  5. Older age
120
Q

What is the diagnostic investigation for bladder cancer?

A

Cystoscopy

121
Q

What staging system is used for colorectal cancer?

A

Dukes

122
Q

What staging system is used for prostate cancer?

A

Gleason

123
Q

What staging system is used in liver cirrhosis?

A

Child-Pugh

124
Q

What staging system is used in gynaecological cancers?

A

FIGO

125
Q

What staging system is used in lymphoma?

A

Ann Arbor

126
Q

What staging system is used for most cancers?

A

TNM

127
Q

What are some complications of polycystic kidney disease?

A
  1. Increased risk of brain aneurysm
  2. Liver cysts
  3. Chronic pain
  4. Mitral valve prolapse
  5. DIverticula in the colon
128
Q

What is Goodpasture’s syndrome?

A

A type 2 hypersensitivity reaction where antiglomerular basement membrane antibodies attack type 4 collagen in the lung alveoli and glomerulus

129
Q

What are some signs of nephrotic syndrome?

A
  1. High levels of anticoagulants
  2. Hypoalbuminaemia
  3. Proteinuria
  4. High serum triglycerides
130
Q

What are some signs of nephritic syndrome?

A
  1. Haematuria
  2. Hypertension
  3. Temporary oliguria
  4. Uraemia
131
Q

What is GFR category G1?

A

> = 90

132
Q

What is GFR category G2?

A

60-89

133
Q

What is GFR category G3a?

A

45-59

134
Q

What is GFR category G3b?

A

30-44

135
Q

What is GFR category G4?

A

15-29

136
Q

What is GFR category G5?

A

<15

137
Q

What is AKI stage 1?

A

Increased serum creatinine 150-200%
Urine production <0.5ml/kg/hr for 6-12 hours

138
Q

What is AKI stage 2?

A

Increased serum creatinine 200-300%
Urine production <0.5ml/kg/hr for 12-24 hours

139
Q

What is AKI stage 3?

A

Increased serum creatinine 300%+
Urine production <0.5ml/kg/hr for 24+ hours or anuria in 12 hours

140
Q

What is minimal change disease?

A

Damage to the glomeruli - the most common cause of nephrotic syndrome in children

141
Q

What 6 factors make a UTI “complicated”

A
  1. Males
  2. Pregnant people
  3. Children
  4. Recurrent
  5. Elderly
  6. Patient’s with abnormal urinary tract or systemic disease that involve the kidney
142
Q

What is the treatment for Chlamydia Trachomatis?

A

Azithromycin or doxycycline

143
Q

What is the treatment for Neisseria Gonorrhoea?

A

Azithromycin and ceftriaxone

144
Q

What are some symptoms of pyelonephritis?

A
  1. Loin pain
  2. Severe headache
  3. Fever
  4. Pyuria
145
Q

What is the first line treatment for benign prostatic hyperplasia?

A

Alpha blockers

146
Q

What do alpha blockers do in the treatment of BPH?

A

Decrease smooth muscle tone of the prostate and bladder

147
Q

What can be added to alpha blockers in the treatment of BPH?

A

5 - alpha- reductase inhibitors

148
Q

What is the mechanism of 5a reductase inhibitors in the treatment of BPH?

A

Decrease the conversion of testosterone to dihydrotestosterone in the prostate gland - reduces side of prostate

149
Q

What test can be used to assess the mobility of the spine (for example, with someone in ankylosing spondylitis)?

A

Schober’s test

150
Q

What is the most common cause of osteomyelitis?

A

S. Aureus

151
Q

What is the most common cause of osteomyelitis in patients with sickle cell anaemia?

A

Salmonella species

152
Q

What is an X ray sign of Ewing’s sarcoma?

A

Onion skin appearance of periosteum

153
Q

What is an X ray sign of osteosarcoma?

A

Sunray spiculation

154
Q

What is an X ray sign of chondrosarcoma?

A

Popcorn calcifications

155
Q

In SLE, what levels would CRP and ESR be?

A

CRP normal ESR raised

156
Q

What are gout crystals made of?

A

Monosodium urate

157
Q

What shape are gout crystals?

A

Long needle shape and are negatively bifringent under plane polarised light

158
Q

What are pseudogout crystals made of?

A

Calcium pyrophosphate crystals

159
Q

What shape are pseudogout crystals?

A

Rhomboid shaped and are positively bifringent under plane polarised light

160
Q

What is sign on the X ray in Rheumatoid Arthritis?

A

L-oss of joint space
E-rosions
S-oft tissue swelling
S-oft bones (osteopenia)

161
Q

Risk factors for osteoporosis?

A

S-teroids
H-yperthyroid/parathyroid
A-lcohol and smoking
T-hin - low BMI
T-estosterone decrease
E-arly menopause
R-enal or liver failure
E-rosive / inflammatory bone disease
D-ietary calcium decrease

162
Q

What is Paget’s disease of bone?

A

A disease of increased uncontrolled bone turnover

163
Q

What is a typical presentation for Paget’s?

A

Older male, with bone pain and raised ALP. Can also cause deafness, skull thickening, fractures and osteosarcoma

164
Q

What would blood tests show in Paget’s?

A

Raise ALP
Normal calcium and phosphate

165
Q

What disease is most associated with cANCA?

A

Wegener’s granulomatosis

166
Q

What is Wegener’s granulomatosis?

A

A disorder that causes inflammation of the blood vessels in the nose, sinuses, throat, lungs and kidney

167
Q

What are some symptoms of Wegener’s granulomatosis?

A
  1. Renal, respiratory and nasopharyngeal symptoms
  2. Systemic symptoms
  3. Saddle nose deformity
168
Q

What is the most specific antibody for SLE?

A

Anti ds DNA

169
Q

What is a sensitive antibody test for SLE?

A

Anti nuclear antibodies

170
Q

What are some important histories to take when considering antiphospholipid syndrome?

A

Pregnancy issues
Livido reticularis

171
Q

What is the first line drug treatment for neuropathic pain?

A

Amitryptyline

172
Q

What are the symptoms of common peroneal nerve palsy?

A
  1. Foot drop
  2. Weakness of toe extensors
  3. Ankle eversion affected
173
Q

What are the symptoms of L5 radiculopathy?

A
  1. Foot drop
  2. Weakness of toe extensors
  3. Ankle inversion affected
174
Q

What is the first line treatment for trigeminal neuralgia?

A

Carbamazepine

175
Q

What is the treatment for migraines?

A

NSAIDS / Aspirin for acute relief
Triptans
Prophylaxis: Propanolol, Amitryptyline, Topiramate, BoTox type A

176
Q

What investigations are used in a diagnosis of dementia?

A

Confusion screen first to rule out any other causes then:

  1. Mini mental state assessment
  2. MRI head (Wider sulci and ventricles, less gyri)
  3. CSF analysis (amyloid and tau proteins)
177
Q

What is the pathophysiology of vascular dementia?

A

Reduced blood flow to the brain damages and kills cells resulting in cognitive impairment

178
Q

What is a hallmark of vascular dementia?

A

Stepwise deterioration

179
Q

What is the pathophysiology of Alzheimer’s dementia?

A

Extracellular beta-amyloid plaques deposit cause signalling obstruction and inflammation around vessels

Intracellular tau protein neurofibrillary tangles obstruct neuron signalling by reducing microtubule stability, causing induced apoptosis

180
Q

What is Lewy Body dementia?

A

Abnormal protein deposits (Lewy bodies) affect chemical signalling in the brain

181
Q

What are hallmarks of Lewy Body dementia?

A

Parkinsonism’s
Sleep disturbance
Visual hallucinations

182
Q

What is Huntingdon’s disease?

A

An autosomal dominant neurodegenerative condition that causes loss of neurones in the caudate nucleus and putamen of the basal ganglia, resulting in a loss of GABA and ACh

183
Q

What are some symptoms of Huntingdon’s?

A
  1. Hyperkinesia
  2. Chorea
  3. Depression
  4. Dementia
184
Q

What is myasthenia gravis?

A

An autoimmune condition where AChR antibodies attack the post synaptic part of the neuromuscular junction, impacting muscle movement and contraction

185
Q

What are the symptoms of myasthenia gravis?

A

1.Weakness
2. Fatigability of ocular (ptosis), bulbar (dysphagia, dysarthria) and proximal limbs
3. Improves after rest

186
Q

What is the treatment for myasthenia gravis?

A
  1. Pyridostigmine - to reduce the muscle weakness
  2. Prednisolone - to inhibit immune system
  3. Thymectomy - because of high increased risk in thymus cancers
187
Q

What is Guillain-Barre syndrome?

A

An autoimmune acute inflammatory demyelinating attack of the PNS which can cause acute onset motor paralysis

188
Q

When does Guillain-Barre syndrome tend to occur?

A

A few weeks after a previous infection, especially respiratory or GI

189
Q

What are the symptoms of Guillain-Barre?

A

Similar to myasthenia gravis but acute
Also can be associated with difficulty breathing, paraesthesia and cramping pain

190
Q

What is the treatment for Guillain-Barre?

A

Intravenous Immunoglobulin

191
Q

What is the difference between a complex partial seizure and a simple partial seizure?

A

A simple partial seizure would not affect awareness or have post-ictal symptoms

192
Q

What are the signs of upper motor neurone lesion?

A
  1. Increased muscle tone
  2. No muscle atrophy
  3. Hyperreflexia
  4. Spasticity
193
Q

What are the signs of lower motor neurone lesion?

A
  1. Decreased muscle tone
  2. Muscle atrophy
  3. Hyporeflexia
  4. Fasciculations
194
Q

What are the symptoms of cerebellar pathology?

A

DASHING
Dysdiadochokinesis (inability to perform rapid alternating muscle movements)
Ataxia
Slurred speech
Hypotonia
Intention tremor
Nystagmus
Gait abnormality

195
Q

Why is lumbar puncture contraindicated with raised ICP?

A

With raised ICP, initially brain removes CSF from ventricles into spinal cord in order to offset pressure

Once the tumour becomes large enough there comes a point where no more CSF can be removed leading to a rapid rise in ICP

A lumbar puncture has the potential to cause rapid coning (brain herniation) and brainstem death

196
Q

What does damage to the radial nerve cause?

A
  1. Inability to open the fist
  2. Inability to extend the wrist (wrist drop)
197
Q

What does damage to the median nerve cause?

A
  1. Affects precision grip muscles (“Can’t open jam jar”)
  2. Wasting of thenar eminence
198
Q

What does damage to the ulnar nerve cause?

A
  1. Ulnar claw
  2. Inability to cross fingers in a good luck sign
199
Q

What does damage to the axillary nerve cause?

A
  1. Weakness in shoulder abduction
200
Q

Which gene is mutated in cystic fibrosis?

A

CFTR gene
Transmembrane Conductance Regulator Gene

201
Q

What is the pathophysiology of cystic fibrosis?

A

Mutated CFTR gene causes dysregulation of salt and fluid movement across membranes

This leads to significantly thickened secretions affecting respiratory, GI and reproductive symptoms

202
Q

What is rifampicin used for?

A

Tuberculosis

203
Q

What are some potential side effects of rifampicin?

A

Red secretions

204
Q

If a patient’s asthma was not improving / getting worse, what would your first action be?

A

Check inhaler adherence and technique before increasing dose or adding drug

205
Q

What would be the next drug added to salbutamol?

A

Increase the dose of inhaled corticosteroid (eg. Budesonide)

206
Q

What is the most common form of lung cancer?

A

Adenocarcinoma

207
Q

What is the most common lung cancer in non smokers?

A

Adenocarcinoma

208
Q

What is a sign of bronchiectasis on CT?

A

Signet ring sign

209
Q

What is FEV1?

A

Forced expiratory volume in 1 second - The maximum amount of air that a patient can forcibly expel during the first second following maximal inhalation

210
Q

What is FVC?

A

Forced vital capacity - the amount of air that can be forcibly exhaled from your lungs after taking the deepest breath possible

211
Q

What is an obstructive lung disease?

A

Difficulty expiring air
One where FEV1/FVC < 0.7

212
Q

Name 4 obstructive lung diseases

A
  1. Asthma
  2. COPD
  3. Bronchiectasis
  4. Bronchiolitis
213
Q

What is a restrictive lung disease?

A

Lungs unable to fully expand and fill
Reduced FVC

214
Q

Name restrictive lung diseases

A
  1. Pulmonary fibrosis
  2. Sarcoidosis
  3. Tuberculosis
215
Q

What is CURB-65?

A

A score to calculate the severity of community acquired pneumonia

216
Q

What 5 things are in CURB-65 score?

A

Confusion
Urea > 7mmol/L
Resp rate > 30/min
BP <90 systolic or <60 diastolic
Age over 65

217
Q

What is hyper expansion a sign of?

A

Obstructive lung disease

218
Q

What is a common cause of communityacquired pneumonia?

A

Streptococcus pneumoniae

219
Q

What is a common cause of hospital acquired pneumonia?

A

Pseudomonas aeruginosa

220
Q

What group is at risk for pneumothorax?

A

Young males with low BMI (tall, lanky men)
Marfan’s syndrome also increases risk

221
Q

In dealing with a tension pneumothorax, where does a needle thoracostomy go?

A

2nd intercostal space mid clavicular line large bore cannula

222
Q

In a pneumothorax, which way does the trachea deviate?

A

Away from the affected lung

223
Q

What signs support a diagnosis of tension pneumothorax?

A
  1. Tracheal deviation away from the affected lung
  2. Hypotension
  3. Hypoxia

2a Mocks (5 decks)

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