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YR3: MM FC Ed. > DPD: Amir Sam 5 > Flashcards

DPD: Amir Sam 5 Flashcards

(46 cards)

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1
Q

In what cases would you give IV or IM adrenaline?

A

IV: Cardiac arrest
IM: Anaphylaxis

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2
Q

What antibiotic would you give in add-on to amoxicillin to cover the atypical organisms causing pneumonia?

A

Clarithromycin (Macrolide)

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3
Q

List 3 atypical organisms that cause pneumonia

A

Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella pneumophila

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4
Q

What investigations are performed in patients with microcytic anaemia?

A

Haematinics (Ferritin, B12, folate)
Coeliac screen (TTG Ab)
Top (OGD) + Tail (colonoscopy)

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5
Q

Give 5 differentials for bloody diarrhoea

A 
Infection: Infective colitis
Inflammation: UC/ Crohns (Younger pts)
Ischaemia: Ischaemic colitis (Older pts)
Malignancy
Diverticulitis
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6
Q

How do you treat a patient with AF within and after 48 hours of onset?

A

<48 hours: DC Cardioversion

>48 hours: Rate control (Digoxin/ Metoprolol) + Anticoagulation (Reduce risk of thromboembolism)

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7
Q

What is Trousseau syndrome? In which disease is it seen?

A

Acquired blood clotting disorder that results in migratory thrombophlebitis (inflammationof a vein due to a blood clot).
Pancreatic cancer

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8
Q

What is Troisier’s sign? What does it indicate?

A

Presence of Virchows node= lymphadenopathy in supraclavicular fossa
Abdominal Malignancy

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9
Q

Give 4 signs of portal hypertension

A

Encephalopathy
Ascites
Spontaneous bacterial peritonitis (>250 WCC)
Variceal bleeds

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10
Q

Give 3 causes of microangiopathic haemolytic anaemia

A

Disseminated Intravascular Coagulation (DIC)
Haemolytic Uraemic Syndrome (HUS)
Thrombotic Thrombocytopenic Purpura (TTP)

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11
Q

Give 3 haematological features of DIC

A

Low platelets + fibrinogen (as forming clots)
High PT + APTT (as used clotting factors)
High D-dimer + fibrin degradation products (as start breaking clots)

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12
Q

Give 3 haematological features of HUS

A

Low Hb + High BR (haemolysis)
Uraemia
Low platelets (using in clotting process)

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13
Q

Give 3 features of TTP

A

HUS
Fever
Neurological manifestations

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14
Q

Give 3 hereditary causes of haemolytic anaemia

A

Red cell membrane (hereditary spherocytosis)
Enzyme deficiency (G6PD deficiency)
Haemoglobinopathy (SCD, Thalassemias)

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15
Q

Give 4 acquired causes of haemolytic anaemia

A

AI
Drugs
Infection
Microangiopathic haemolytic anaemia (MAHA)

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16
Q

What 2 features on a blood film indicate MAHA?

A

Schistocytes

Anaemia

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17
Q

How do haustra and valvulae conniventes differ?

A

Haustra: In Large bowel. Don’t traverse bowel

Valvulae conniventes: In Small bowel. Traverse small bowel

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18
Q

What do prominent valvulae conniventes indicate?

A

Small bowel obstruction

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19
Q

What are the 3 states hyponatraemia can arise in?

Study These Flashcards
A

Hypovolaemia
Euvolaemia
Hypervolaemia

20
Q

What occurs in hypovolaemic hyponatraemia? How may you detect this?

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A

Hypovolaemia stimulates ADH secretion
Kidneys re-absorb salt + water
Low urine Na+
Postural hypotension

21
Q

List 3 causes of euvolaemic hyponatraemia. How do you test for each of these?

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A

Hypothyroidism: TFTs (low T4)
Adrenal insufficiency: Short synACTHen test
SIADH: plasma (low)+ urine (high) osmolality

22
Q

How does cardiac failure cause hypervolaemic hyponatraemia? How may you detect this?

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A

Less renal perfusion- body thinks its hypovolaemic, activates RAAS, increases aldosterone, increases water + Na+ retention
Low urine Na+ due to secondary hyperaldosteronism
Peripheral oedema

23
Q

List 3 causes of hypovolaemic hyponatraemia.

Study These Flashcards
A

Diarrhoea
Vomiting
Diuretics

24
Q

List 3 causes of hypervolaemic hyponatraemia.

Study These Flashcards
A

Cardiac failure
Cirrhosis
Nephrotic syndrome

25
List 2 sites of pathology where cause of SIADH may be found
CNS pathology: infection, malignancy, drugs | Lung pathology: infections, malignancy, drugs
26
List 5 drugs that can cause SIADH
``` SSRI TCA Opiates PPIs Carbamazepine ```
27
List 4 conditions that onycholysis can be a feature of
``` Drugs (e.g. tetracyclines, OCP, diabetes drugs) Reactive arthritis, Reiter’s syndrome Psoriais Infection (especially fungal) Trauma Hyper + Hypothyroidism Sarcoidosis, Scleroderma ```
28
Give 2 features of left ventricular hypertrophy on ECG. What valvular disease may this be a result of?
Deep S in V1 Tall R in V6 Aortic stenosis
29
Which condition causes widespread saddle-shaped ST elevation in an ECG?
Pericarditis
30
What investigation should you perform if you suspect renal colic?
CT KUB
31
What physiological picture is seen in primary hyperparathyroidism? What is seen in secondary?
Primary: High PTH, high Ca2+ Secondary: High PTH, low Ca2+
32
List 3 causes hypercalcaemia when PTH is low
Malignancy Sarcoidosis Myeloma
33
What are the 2 sources of ALP? What can cause elevated ALP?
Liver: Obstructive liver disease (+raised GGT) Bone: Malignancy, Fracture, Paget's Disease
34
Why is ALP normal in myeloma?
In the bone, ALP is produced by osteoblasts | Plasma cells in myeloma SUPPRESS the osteoblasts
35
What cancer causes ALP to rise?
Metastases to bone
36
Give 4 features of multiple myeloma
Calcium high Renal impairment Anaemia Bone pains
37
List 4 causes of cavetating lung lesions
Infection: TB, Staph aureus, Klebsiella (e.g. alcoholics) Inflammation: RA Infarction: PE Malignancy: SqCC
38
List 3 broad causes of oedema. How would you test for each?
Heart failure: Echocardiogram Albumin loss in bowel: Endoscopy Albumin loss in urine: Urinalysis
39
What is nephrotic syndrome?
increased permeability of the glomerular basement membrane to protein Proteinuria > 3.5 g/day hypoalbuminaemia (<30 g/L) Peripheral oedema
40
What are those with nephrotic syndrome prone to?
``` Thromboembolic disease (lose natural anticoagulants in urine along with protein). May present with renal vein thrombosis ```
41
What is the inheritance pattern of hereditary haemorrhagic telangiectasia? What does it cause?
``` Autosomal dominant Abnormal blood vessels in: Skin Mucous membranes Lungs Liver Brain ```
42
What condition would cause hyperkalaemia, hyponatraemia and a failed short synACTHen test?
Primary adrenal insufficiency
43
What would cause a high prolactin, low testosterone, low FSH and low LH?
Prolactinoma | Prolactin inhibits reproductive axis, suppresses LH + FSH thus testosterone will be low
44
What would cause high IGF1, high prolactin and a failed OGTT?
Acromegaly
45
What would cause high FSH and LH, with low oestradiol ?
Premature ovarian insufficiency | Reduced negative feedback on LH + FSH
46
What would cause low T4, high TSH and high prolactin?
Myxoedema (hypothyroidism) TSH high (reduced negative feedback) TRH is also high due to reduced negative feedback High TRH stimulates prolactin

YR3: MM FC Ed. (46 decks)

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