DPD Amir Sam 5 Flashcards Preview

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Flashcards in DPD Amir Sam 5 Deck (56)
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1

24M
Breathless, facial swelling
Had a chinese takeaway

A. IM adrenaline
B. IV adrenaline
C. IM hydrocortisone
D. IV hydrocortisone
E. IV fluids

A. IM adrenaline

1:1000 dose
This Pt has had an anaphylactic reaction to peanuts

2

45M
Cough, breathless, recent travel
Hyponatraemia, deranged LFTs
Coarse crepitations and bronchial breathing
What would you give with amoxicillin?

A. Cefuroxime
B. Clarithromycin
C. Co-amoxiclav
D. Tazocin
E. Vancomycin

B. Clarithromycin

This Pt has an atypical pneumonia caused by Legionella pneumophila (Pt has recently travelled, and is hyponatraemic).


Cefuroxime- not given in pneumonia
Co-amoxiclav- replaces amoxicillin
Tazocin- for G-ve HAP
Vancomycin- MRSA

3

What are the atypical causes of pneumonia?

Legionella pneumophila
Chlamydia pneumoniae
Mycoplasma pneumoniae

4

50M
Dyspepsia
Wt loss
Hb 70, MCV 70

A. Abdo CT
B. Abdo US
C. Erect CXR
D. Colonoscopy
E. OGD

E. OGD

5

What investigations should you do when a Pt has microcytic anaemia?

Haematinics
Coeliac antibody (anti-TTG)
Top and tail (OGD and colonoscopy)

6

What are the duodenal biopsy findings indicative of Coeliac disease?

Villous atrophy

7

70M
Bloody diarrhoea
Stool MC+S: -ve
Stool C Diff toxin:-ve

A. Infective colitis
B. Ischaemic colitis
C. Ulcerative colitis
D. Appendicitis
E. Gastroenteritis

B. Ischaemic colitis

No infection
Old for a new presentation of UC
Appendicitis doesn't give bloody diarrhoea
Could be GE but more likely to be ischaemic colitis with said Hx

8

What are the causes of bloody diarrhoea?

Infection- infective colitis
Inflammation- UC/CD (younger)
Ischaemia- ischaemic colitis (older)
Malignancy
Diverticulutus

9

40M
Palpitations 4 hrs ago
ECG- AF
How would you treat him?

A. Adenosine
B. Amiodarone
C. Digoxin
D. Metoprolol
E. DC cardioversion

E. DC cardioversion

Give to someone if they present <48 hrs

10

When can you do cardioversion?

If a Pt is arrhythmic with haemodynamic instability
A Pt with AF <48 hrs

11

What would you do if a Pt has presented with AF >48 hrs and you want to cardiovert them?

TOE to assess for an embolus

12

What are caput medusae?

Distended superficial veins with the flow of the veins below the umbilicus towards the legs

13

What is Trousseau's sign of malignancy?

Thrombophlebitis secondary to cancer

14

What is Troisier's sign?

Palpable Virchow's node secondary to cancer

15

What is Grey Turner's sign?

Bruising of the flanks due to retroperitoneal bleeding
eg. acute pancreatitis, trauma

16

What are the complications of portal hypertension?

Encephalopathy
Ascites
SBP
Variceal bleeds

17

What two things are given to Pts with variceal bleeds?

ABx
Terlipressin/octreotide

18

20M
Recent diarrhoea + malaise
Hb 70 Creatinine 300
Blood film- schistocytes
Diagnosis?

Haemolytic uraemic syndrome

19

What are the three types of microangiopathic haemolytic anaemia?

DIC (disseminated intravascular coagulation)
HUS (haemolytic uraemic syndrome)
TTP (thrombocytic thrombocytopaenic purpura)

20

What is the triad seen in DIC?

Dec Plt
Inc PT/APTT
Inc D-dimer

21

What is the triad seen in HUS?

Dec Hb/inc BR
Uraemia
Dec Plt

22

What is the pentad seen in TTP?

HUS
Fever
Neurological manifestations

23

What are the two subtypes of haemolytic anaemia?

Hereditary OR acquired

24

What are the causes of hereditary haemolytic anaemia?

Hereditary spherocytosis
Hereditary elliptocytosis
G6PD deficiency
Sickle cell
Thalassaemia

25

What are the causes of acquired haemolytic anaemia?

MAHA (DIC, HUS, TTP)
Autoimmune
Drugs
Infection

26

What are the names of the small circular fold seen in the small and large bowel?

SI: valvulae conniventes
LI: haustrae

27

What are the diameters which indicate SBO/LBO?

SI >3cm
LI >5cm

28

What are the causes of hypovolaemic hyponatraemia?

Diarrhoea
Vomiting
Diuretics

29

What are the causes of euvolaemic hyponatraemia?

SIADH
Hypothyroidism
Adrenal insufficiency

30

What are the causes of hypervolaemic hyponatraemia?

CHF
Liver cirrhosis
Nephrotic syndrome