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check yoself Flashcards

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1
Q

causes of secondary hypertension

A

R - renal disease, renal artery stenosis
O - obesity
P - pregnancy / pre-eclampsia
E - endocrine, hyperaldosteronism (conns)

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2
Q

stage 2 + 3 hypertension

A

2
clinic = >160/100
AB = >150/95

3
clinic = >180/120

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3
Q

long term angina treatment

A

beta blocker - bisoprolol
CCB - amlodipine

others (not 1st line)
long acting nitrates (isosorbide mononitrate)
ivabradine
nicorandil
ranolazine
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4
Q

secondary prevention angina

A

aspirin
atorvastatin
acei
already on beta blocker

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5
Q

MI complications

A 
D - death
R - rupture of heart septum or papillary muscles
E - edema (heart failure)
A - aneurysm / arrhythmia
D - Dresslers
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6
Q

AAA screening

A

men age 65-74

<3 normal
>3 monitored

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7
Q

homans sign

A

pain in calf on dorsiflexion of foot

DVT

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8
Q

common causes of AF

A

SMIRTH

S- sepsis / infection
M - mitral / mechanical valve [athology
I - intoxication (alcohol)
R - rheumatic heart disease
T- thyrotoxicosis
H - Hypertension
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9
Q

AF rate control (first line)

A

BB (atenolol)
CCB (dil / vera)

** never together verapaKILLLLL !!!!

digoxin if fails - take a while to kick in, dangerous if hypokalaemic, slows AV conduction (more time to fill ventricle)

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10
Q

what anticoag if mitral stenosis associated AF

A

warfarin

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11
Q

when would you DC cardiovert in AF

A

if symptoms <48hrs or anticoagulated prior

do echo first to look for emboli

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12
Q

AF HR

A

300 - 600 bpm

irregularly irregular

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13
Q

atrial flutter HR

A

220-240bpm

regularly irregular

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14
Q

symptoms / causes of VT

A

dizziness / syncope
hypotension

usually triggered - hypoxia, electrolyte abnormalities

common in CHD or previous MI

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15
Q

mode of inheritance of brugada syndrome

A

autosomal dominant
ST elevation in RBBB in leads V1-3

cjanges may be seen after flecainide

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16
Q

2nd + 3rd heart block treatment

A

atropine IV
no improve - other inotropes = noradrenalin
defibrillate

long term = pacemaker

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17
Q

acute HF / oedema / cardiogenic shock

A

morphine
NIV / CPAP
inotropes - noradenalin infusion

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18
Q

dresslers pathophysio

A

AUTOIMMUNE response to cardiac damage - damaged heart muscle release previously encountered material that stimulates an immune response

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19
Q

HOCM management

A

high risj = ICD
low = amiodarone

genetic analysis

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20
Q

mode of inheritance of familial dilated cardiomyopathy

DCM

A

autosomal dominant

DCM can be sporadic - toxins, autoimmune
echo, CXR (cardiac enlargement)

same Mx as HF

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21
Q

drugs to close/open ductus arteriosus

A

open - prostaglandin E2

close - indomethacin

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22
Q

hereditary condition associated with coarctation of aorta

A

turner syndrome - monosomy X

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23
Q

corctation of aorta symptoms

A

headaches / nosebleeds - due to hypertension
claudication
delayed pulses

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24
Q

clinical features of tetralogoy of fallot

A

spasms of sub pulmonary muscles
episodes of severe cyanosis

cyanosis develops due to increased right sided pressure - right-to-left shunt

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25
tetralogy of fallot conditions
VSD overriding aorta pulmonary stenosis RV hypertrophy
26
tetralogoy of fallot treatment
treat each spasms relieved by increasing systemic resitance using postural manoeuvres -- squatting
27
marfans mode of inheritance
autosomal dominant - FBN1 mutation 50/50 - each child of one affected parent
28
marfans clinical features
heart - aortic aneurysm + dissection, mitral valve prolapse eye - dislocated lenses, retinal detachment tall, long arms, scoliosis high arched palate
29
marfans management
BB (atenolol) - slows rate of dilation of aortic root ARB lifestyle - avoid long exercise, sedentary job monitoring genetic screening, counselling
30
normal ejection fraction
>50%
31
ADH + angiotensin II - vasodilators/constrictors?
vasoconstrictors
32
chemical vasoconstrictors
serotonin thromboxane A2 leukotrienes
33
what is pacemaker potential due to?
decrease K+ efflux
34
neurotransmitter + receptor in negative chronotropic effect
acetylcholine via muscarinic M2 receptors
35
erbs point
3rd ICS left sternal edge
36
role of aldosterone
(steroid hormone) acts on kidneys to increase sodium + water retention -> increasing PV + BP
37
natriuretic peptides
made by heart - also brain + others released in response to cardiac distension decrease renin secretion - decreasing BP (vasodilators - decrease SVR + BP)
38
antidiuretic hormone
(vasopressin) increases reabsorption of water (conserves it) - concentrates urine --> increases extracellular + PV - increase CO+BP = vasoconstriction
39
where oesophagus begins
C6
40
barretts is premalignant condition to what
adenocarcinoma **ablation only if dysplastic
41
what must happen prior to H pylori testing
2 weeks PPI free
42
how would bacillus cereus appear on a gram stain
purple rod - gram positive bacillus (so would listeria monocytogenes) has heat resistant spores
43
what can campylobacter be precursors of
guillan barre = 1-2 weeks post infection travellers diarrhoea
44
biggest risk factor for E coli 0157 progressing to HUS
antibiotics - AVOID
45
upper GI bleeds scorng
glasgow blatchford - risk of having upper GI bleed rockall score - post endoscopy for risk of rebleed / overall mortality
46
management of bowel obstruction
``` ABC analgesia IV fluids - usually hypokalaemic + alkalotic NG tube - drain stomach nil by mouth catheterise ``` IV fluids to hydrate the patient and correct electrolyte imbalances
47
commonest site of diverticular disease
sigmoid related to low fibre diet
48
treatment of diverticulitis
mild = ciprofloxacin + metronidazole severe = IV fluids, IV antibiotics + bowel rest
49
mallorys hyaline antibodies
alcoholic liver disease (acute hepatitis) chronic active hepatitis
50
hep b incubation
1-6months
51
mrker of viral replication in hep b
HBeAg **Ag NOT Ab**
52
hep c treatment
protease inhibitors for 8-12 weeks daclarasvir + sofosbuvir or sofosbuvir + simeprevir always 2+ drugs - reduces resistance no vaccine available
53
IBD screening
faecal calprotectin - | released due to inflammation of intestines
54
genetic predisposition to crohns
NOD2/CARD15 - involved in mucosal defences
55
prior to coeliac testing
must be on gluten diet for 6 weeks prior
56
why do coeliac get vaccines
pneumoccocal + annual flu --> due to hyposplenism other complications - vit deficiency, osteoporosis, subfertility, small bowel adenocarcinoma
57
2nd line ix in cholecystitis
cholescintography - HIDA scan
58
pancreatits scoring
glasgow score - PANCREAS mneumonic
59
pancreatitis management
ABCDE IV fluids analgesia monitoring - treat underlying causes/complications
60
cirrhosis scoring
child-pugh MELD - percentage 3 month mortality
61
diet for people with cirrhosis
high protein | low sodium
62
stable varices treatment
propanolol - non-selective BB band ligation injection of sclerosant maybe TIPSS
63
bleeding varices treatment
terlipressin vit K + fresh frozen plasma prophylactic broad-spectrum antibiotics urgent endoscopy - sclerosant / banding sengstaken-blakemore tube if fails - balloon inflates to stop bleeding
64
management of spontaneous bacterial peritonitis (SBP)
culture then antibiotics | usually IV cephalosporin - cefotaxime
65
fatty liver investigations
raised gamma-GT elevated MCV elevated (ALT/AST) US + CT show fatty infiltration --> fatty changes on US = *increased echogenicity*
66
what vitamin is sometimes given to patients with fibrosis
vit E
67
cholangiocarcinoma tumour
CA19-9
68
bowel cancer screening in scotland
50-72 y/o home FIT every 2 years FAP, HNPCC, IBD - regular colonoscopy * FIT can be used in GP for those who dont meet 2 week referral
69
difference between anterior resection + APR
anterior - sigmoid + upper rectum (faecal incontinence) APR - rectum + anus (permanent colostomy, anus sutured)
70
difference between zero and first order kinetics
zero - elimination of a constant AMOUNT of a drug (alcohol, eg 4g every hour) - metabolic pathway is saturated first - elimination of a constant PERCENTAGE (eg always half)
71
% bioavailability of an IV drug
100% bioavailability = amount of drug which enters the systemic circulation - will always be 100% for an IV preparation
72
first line drug in reducing cholesterol
statins
73
overwhelming compensatory mechanism thats activated to combat volume loss
increased sympathetic activity
74
most likely group of oraganisms to cause hospital acquired pneumonia
gram negative
75
trisomy 13
pateau
76
how does intracellular calcium contribute to cell death
by increasing mitochondrial permeability
77
where do robertsonian translocations take place on the chromosome
near or at centromeres
78
lectin-like molecules function
as PRRs
79
2 cell types predominantly found in granulation tissue
endothelial cells | myofibroblasts
80
yellow sharps bin with blue lid
medicine vials with residual medicines
81
red bag
soiled laundry

first year med (15 decks)

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