DPD Flashcards
1
Q
4 causes of splenomegaly
A
infection
inflammation
haematological
portal hypertension
2
Q
Gastritis
A
retrosternal
ETOH
3
Q
markers chronic pancreatitis
A
normal amylase
faecal elastase
loss of exocrine/endocrine function
4
Q
RUQ pain in appendicitis
A
- retrocaecal appendix
- pregnancy
5
Q
suprapubic pain ddx
A
cystitis
urinary retention
6
Q
diffuse abdo pain ddx
A
- obstruction
- peritonitis/gastroenteritis
- IBD
- mesenteric ischaemia (angina post-prandially)
medical-
- DKA
- Addison’s
- Hypercalcaemia
- Porphyria
- Lead poisoning
7
Q
what may be high in any cause of acute abdo?
A
amylase
8
Q
what ascitic tap would you see in SBP?
A
ascites neut >250 cells/mm3
9
Q
Transudate ascites (less protein)
A
Failures:
cirrhosis
cardiac failure
nephrotic syndrome
10
Q
Exudate ascites
A
malignancy (abdo, pelvic, mesothelioma)
infection (TB, pyogenic)
Budd chiari, portal vein thrombosis
11
Q
cause of pale stool in obstructive jaundice
A
low stercobilogen
12
Q
Bloody diarrhoea ddx
A
- Infective- CHESS
- IBD (young)
- Elderly (ischaemic)
13
Q
CEA marker
A
colon cancer
14
Q
Mx acute abdo
A
NBM IV fluid analgesics antibiotics anti-emetics
15
Q
GI bleeds
A
ABC
IV access
Fluids
OGD
if variceal- broad spectrum Abx + terlipressin (splanchnic vasoconstriction)
16
Q
Ix acute abdo
A
Bloods
Erect CXR
CT
17
Q
jaundice primary Ix
A
Bloods
USS (post fast)
18
Q
Dysphagia Wt loss primary Ix
A
OGD biopsy
19
Q
Ascites Mx
A
Diretics spironolactone +/-furosemide sodium restriction fluid restriction if hyponatraemia monitor daily weight therapetuic paracentesis with IV human albumin
20
Q
serum:ascites albumin gradient
A
>11 = cirrhosis/HF <11 = TB, cancer, nephrotic
21
Q
features of wound infection
A
erythematosus
discharge
22
Q
features of anastomotic leak
A
diffuse abdo tenderness
guarding, rigidity
shock
23
Q
features pelvic abscess
A
pain
fever, sweats
mucus diarrhoea
24
Q
peripheral neuropathy causes
A
infection
- HIV
inflammation
- GBS
- amyloidosis
metabolic/toxic
- diabetes
- ETOH
- B12
- drugs
- hypothyroidism
Tumour
- paraneoplastic syndrome
25
optic neuritis
aka papillitis
blurred optic disc + blurred vision
different to papilloedema = painless
sign of MS
26
Reduced PP sensation Al thigh
T2DM
Obese
what Mx + diagnosis?
```
= meralgia paraesthetica
compression of lateral femoral nerve
reasure, avoid tight garments
lose weight
carabezapine/gabapentin if persists
```
27
causes of radiculopathy
disc herniation
spinal canal stenosis
osteophytes
28
describe the abnormal sensation for pathology at:
- cortex
- SC
- nerve roots
- mononeurpathy
- polyneuropathy
- cortex = hemisensory
- SC = level eg umbilicus
- nerve roots = dermatomes
- mononeurpathy = specific area eg radial
- polyneuropathy = glove + stocking
29
lewy body dementia
alzheimers + PD + hallucinations
30
limited upgaze
supranuclear palsy
31
DDx of raised JVP
- RHF (2/2 LHF or pulmonary HTN- PE, COPD etc)
- TR (valve damage eg IE, R ventricular dilation)
constrictive pericarditis (TB, CTD, malignancy)
32
causes of palpitaitons
sinus tachy- SVT
AF
ventricular tachy
33
causes of sinus tachy
- sepsis
- hypovolaemia
- endocrine (thyrotoxicosis, phaeo)
34
causes of SVT
re-entry circuit (WPW)
35
Causes of AF
- thyrotoxicosis
- ischaemia
- chest infection/PE/cancer
- alcohol
36
Causes of VT
- ischaemia
- electrolyte abnormality
- long QT (hypo K/Mg, congenital)
37
sinus tachycardia on ECG
p before every QRS
| normal just fast
38
VT on ECG
NO p waves before QRS
regular
BROAD COMPLEX
39
SVT on ECG
```
short PR
delta wave (slurred upstroke)
```
40
Af principles
RHYTHM CONTROL
- <48h DC
- >48h 3-4 weeks anticoagulate
RATE
- BB (bisoprolol)
- Digoxin
- anticoagulate (CHADSVASC)
41
Pulseless VT Tx?
defibrillate
42
LVH (hypertension) ECG signs
Deep S in V1/2
Tall R in V5/6
>7 LARGE SQUARES
43
Heart sounds- for each, state the association
S1 = closure of mitral
S2 = closure of aortic
Fixed splitting of S2 = atrial septal defect
S3 = rapid ventricular filling
S4 = atrial contraction against stiffened ventricles (hypertophy)
44
AHF failure management
sit up
oxygen 60-100%
Diuretics (furosemide)
GTN if pain
treat underlying cause
45
Symptomatic level for anaemia
Hb <80
46
Primary pneumothorax management
<2cm - discharge, repeat CXR
| >2cm/SOB- aspirate + chest drain if unsuccessful
47
Secondary pneumothorax management
<2cm - aspiration
| >2cm - chest drain
48
what might you see in PE
RBBB + RAD
49
why do you give clarithromycin in pneumonia
cover atypicals
50
AF started 4 hours ago how to treat
<48h so DC cardioversion
51
3 causes/types of MAHA
- DIC
- HUS
- TTP
52
Features of DIC
low plt + fibrinogen
high PT/APTT
high D-dimer/FDP
53
Features of HUS
haemolysis- low Hb, high Br
uraemia
low plt
54
Features of TTP
HUS + fever + neurological signs
55
why does MAHA occur?
some coagulation occurs, fibrin slices RBCs
56
Hereditary causes of haemolytic anaemia
- hereditary spherocytosis
- G6PD deficiency
- Hb-opathy - SCD, thalassaemia
57
Acquired causes of haemolytic anaemia
- Autoimmune
- Drugs
- Infection
- MAHA
58
small bowel lines
valvulae conniventes
59
causes of hypovolaemic hyponatraemia
D + V
Diuretics
Would have low urine sodium
60
causes of euvolaemic hyponatraemia
Hypothyroidism
Adrenal insufficiency
SIADH
normal/high urine sodium
61
causes of hypervolaemic hyponatraemia
CF
Cirrhosis
Nephrotic syndrome
Would have low urine sodium
62
tests for euvolaemic hyponatraemia
TFTs
Short synacthen
Plasma/urine osmolality
63
What is the cause of the majority of hyponatraemia
high ADH
64
Causes of SIADH
- CNS/lung pathology
- drugs- SSRI, TCA, opiates, carbamezapine)
- Tumours
65
oncholysis causes
trauma
thyrotoxicosis
nail bed infection
Psoriasis
66
How can PTH determine whether someone has malignancy in the context of hypercalcaemia?
low PTH = supressed so mailgnancy
High = hyperPTH
67
high ALP causes
Paget's
obstructive jaundice
Bony mets
68
Causes of cavitating lung lesions
- Infection- TB, staph, klebsiella (alcoholics)
- Inflammation- RA
- PE
- Malignancy- SCC
69
nephrotic syndrome
high GBM permiability- so protein leaks out
proteinuria >3g/day
hypoalbuminaemia
oedema (oncotic pressure)
70
What is hereditary haemorrhagic telangiectasia?
AD condition
abnormal blood vessels in:
- skin
- Mucous membranes
- lungs
- liver
- brain
71
low sodium + high potassium endocrine cause
Adrenal insufficiency
72
in what type of thyroid condition would TFTs be normal?
multinodular goitre
