EMQ book key points Flashcards
(124 cards)
1
Q
slow rising pulse is in
A
aortic stenosis
2
Q
collapsing pulse is in
A
aortic regurgitation
3
Q
3 causes of bounding pulse
A
acute CO2 retention
hepatic failure
sepsis
4
Q
radiofemoral delay is in
A
coarctation of aorta
5
Q
jerky pulse is in
A
hypertrophic obstructive cardiomyopathy
mitral regurgitation
6
Q
absent ‘a’ waves in JVP is in
A
atrial fibrillation
7
Q
cannon ‘a’ waves in JVP is in
A
complete heart block
AV dissociation
ventricular arrhythmias
8
Q
rumbling mid-diastolic murmur at apex is in
A
mitral stenosis
9
Q
displaced apex beat and pansystolic murmur is in
A
mitral regurgitation
10
Q
narrow pulse pressure, soft second heart sound and ejection systolic murmur is in
A
aortic stenosis
11
Q
wide pulse pressure and early diastolic murmur is in
A
aortic regurgitation
12
Q
pansystolic murmur is in
A
tricuspid regurgitation
13
Q
harsh pansystolic murmur and left parasternal heaves are in
A
ventricular septal defect
14
Q
pulsatile hepatomegaly is in
A
tricuspid regurgitation
15
Q
bifid p wave is in
A
left atrial hypertrophy e.g. mitral stenosis
16
Q
peaked p wave is in
A
right atrial hypertrophy e.g. pulmonary hypertension, tricuspid stenosis
17
Q
2 causes of ST elevation
A
MI
left ventricular aneurysm
18
Q
saddle shaped ST elevation is in
A
acute constrictive pericarditis
19
Q
flattened t waves and prominent u waves are in
A
hypokalaemia
20
Q
long QT interval, tetany, perioral paraesthesia are in
A
hypocalcaemia
21
Q
impotence, SOB and cold peripheries are side effects of
A
beta blockers
22
Q
gynaecomastia is side effect of
A
digoxin
spironolactone
23
Q
hyper/hypothyroidism, corneal microdeposits and lung/liver fibrosis are side effects of
A
amiodarone
24
Q
gout is side effect of
A
thiazide diuretic
25
radiofemoral delay is in
coarctation of aorta
26
jerky pulse is in
hypertrophic obstructive cardiomyopathy
| mitral regurgitation
27
absent 'a' waves in JVP is in
atrial fibrillation
28
cannon 'a' waves in JVP is in
complete heart block
AV dissociation
ventricular arrhythmias
29
rumbling mid-diastolic murmur at apex is in
mitral stenosis
30
displaced apex beat and pansystolic murmur is in
mitral regurgitation
31
candidiasis mouth/pharynx can be side effect of
inhaled high-dose corticosteroid
32
saddle shaped ST elevation is in
acute constrictive pericarditis
33
flattened t waves and prominent u waves are in
hypokalaemia
34
long QT interval, tetany, perioral paraesthesia are in
hypocalcaemia
35
impotence, SOB and cold peripheries are side effects of
beta blockers
36
gynaecomastia is side effect of
digoxin
| spironolactone
37
hyper/hypothyroidism, corneal microdeposits and lung/liver fibrosis are side effects of
amiodarone
38
side effect of methotrexate, bleomycin and busulphan
pulmonary fibrosis
39
gout is side effect of
thiazide diuretic
40
stony dull percussion is in
pleural effusion
41
fine crepitations are in
pulmonary oedema
| pulmonary fibrosis
42
7 respiratory causes of clubbing
```
bronchial carcinoma
bronchiectasis
lung abscess
empyema
CF
mesothelioma
TB
```
43
2 respiratory things NOT causing clubbing
asthma
| COPD
44
Kerley B lines and batwing shadowing are in
heart failure
45
tramline shadowing is in
bronchiectasis
46
wedge-shaped infarct is in
PE
47
ground glass appearance on CXR is in
pulmonary fibrosis
48
6 signs of UMN lesion
- weakness in upper limb extensors and lower limb flexors
- increased tone
- hyperreflexia, clonus
- pronator drift
- loss of abdominal reflexes
- extensor plantar response
49
early onset emphysema plus liver disease can be found in
alpha-1 antitrypsin deficiency
50
occupation involving water systems can result in
legionella infection
51
HIV +ve and bilateral hilar shadowing can be a sign of
pneumocystis carinii pneumonia
52
candidiasis mouth/pharynx can be side effect of
inhaled high-dose corticosteroid
53
reticulocytosis on blood film is found in
bleeding, haemolysis
54
target cells on blood film are found in
liver disease, iron deficiency anaemia
55
macrocytic anaemia + glossitis + peripheral neuropathy =
vitamin B12 deficiency
56
macrocytic anaemia + phenytoin/trimethoprim =
folate deficiency
57
2 signs of posterior circulation stroke
CN palsies/cerebellar signs e.g. vertigo, dysarthria, ataxia, choking
isolated homonymous hemianopia
58
microcytic anaemia + menorrhagia/chronic NSAIDs =
iron deficiency anaemia
59
microcytic anaemia + increased HbF =
beta-thalassaemia
60
when can anaemia NOT be called anaemia of chronic disease
if Hb <8 (because AOCD is normocytic - endocrine dysfunction can cause normocytic anaemia)
61
when to use colchicine for gout
alternative to NSAIDs in acute presentation if NSAIDs contraindicated (e.g. allergy or heart failure)
62
flushing, abdo pain, diarrhoea and heart failure are signs of
carcinoid syndrome
63
side effect of methotrexate, bleomycin and busulphan
pulmonary fibrosis
64
drop foot after hip replacement is caused by
sciatic nerve injury
65
what else can phenytoin cause
folate-deficiency macrocytic anaemia
66
most common cause of pancreatic pseudocyst
CHRONIC pancreatitis
67
2 side effects of lamotrigine
rash and blisters in mouth
| flu symptoms
68
what is increased if lamotrigine and sodium valproate are used together
risk of TEN/SJS
69
drug to treat AACG
acetazolamide
70
treatment of GCA
high dose oral prednisolone
71
drug to treat trigeminal neuralgia
carbamazepine
72
what can a headache worsening on coughing/sneezing indicate
mass lesion
73
6 signs of UMN lesion
- weakness in upper limb extensors and lower limb flexors
- increased tone
- hyperreflexia, clonus
- pronator drift
74
3 signs of LMN lesion (lesion at level of anterior horn cells or distal to it)
fasciculation and wasting
loss of reflexes
hypotonia
75
type of tremor in PD
pill-rolling
76
what is Shy-Drager syndrome
combination of parkinsonism plus primary autonomic failure e.g. postural hypotension
77
triad in Wernicke's encephalopathy (caused by thiamine deficiency)
nystagmus
ophthalmoplegia
ataxia
78
type of gait in peripheral neuropathy
high stepping/stamping (sensory ataxia)
79
type of gait in cerebellar lesion
wide-based
80
ptosis, eye deviated laterally and downwards is
CN III lesion (defective elevation, depression, adduction)
81
3 signs of anterior circulation stroke
unilateral weakness/sensory deficit
homonymous hemianopia
higher cerebral dysfunction e.g. dysphasia, neglect
82
2 signs of posterior circulation stroke
CN palsies/cerebellar signs e.g. vertigo, dysarthria, ataxia, choking
isolated homonymous hemianopia
83
2 signs of SLE
- symmetrical joint inflammation (no bony erosion)
| - lung involvement (50%) e.g. pleuritic chest pain, pleural effusion, pneumonitis
84
radiological bone erosions in psoriatic arthritis vs RA
psoriatic = central erosions
85
what does Schirmer's test do
identify insufficient production of tears in Sjogren's
86
when to use colchicine for gout
alternative to NSAIDs in acute presentation if NSAIDs contraindicated (e.g. allergy or heart failure)
87
why do renal and liver tests for methotrexate
cumulative toxicity
88
side effect of sulphonamides
exfoliative dermatitis (emergency)
89
drop foot after hip replacement is caused by
sciatic nerve injury
90
bile stained vomit shows an obstruction in the
small bowel
91
most common cause of pancreatic pseudocyst
CHRONIC pancreatitis
92
gynaecomastia, testicular atrophy and Dupuytren's contracture can be a sign of
chronic liver disease 2
93
where do direct hernias push through
directly through the posterior wall of the inguinal canal
94
where does diverticular disease mostly occur
sigmoid colon
95
symptoms of duodenal vs gastric ulcer
```
duodenal = relieved by eating and drinking milk
gastric = aggravated by easting
```
96
main treatment of Mallory-Weiss tear
antiemetic therapy
97
what is pseudomembranous colitis
inflammation of colon due to C. diff
98
test for coeliac disease with greater sensitivity and specificity than anti-gliadin antibodies
anti-endomysial antibodies (serum IgA)
99
5 symptoms of hypercalcaemia
```
thirst
tiredness
depression
bone pain
constipation
```
100
most common cause of upper GI bleed when patient has known cirrhosis
varices (otherwise usually PUD) - do upper GI endoscopy
101
treatment of severe UC
IV hydrocortisone
102
anti-spasmodic agent used in IBD
mebeverine
103
buccal pigmentation is found in
Addison's disease
104
aphthous ulceration is found in
IBD
| coeliac disease
105
10 signs of chronic liver disease
```
clubbing
flapping tremor
Dupuytren's contracture
palmar erythema
gynaecomastia
spider naevi
splenomegaly
testicular atrophy
ascites
encephalopathy
```
106
barium enema result in CD vs UC
```
CD = cobble stoning and rose-thorn ulcers
UC = loss of haustra
```
107
do ACEis cause hyperkalaemia or hypokalaemia
hyperkalaemia (opposite of diuretics)
108
2 things raised in tertiary hyperparathyroidism
calcium
phosphate
unlike secondary hyperparathyroidism - calcium low or normal
109
what is necrobiosis lipoidica
shiny areas on shins + yellow colour and overlying telangiectasia (often in diabetes)
110
reduced QT interval is found in
hypercalcaemia
111
can nitrofurantoin be used in pregnancy
not if at term or breastfeeding (can earlier on)
112
what to avoid when taking tetracyclines
milk products - decrease absorption
113
antibiotic to use in severe CAP
IV combo of co-amoxiclav/cephalosporin + macrolide (e.g. clarithromycin + erythromycin)
114
antibiotic for meningococcal meningitis
IV benzylpenicillin
115
what do TCAs e.g. amitriptyline do to pupils
dilate them
116
side effect of amiodarone
photosensitive rash
117
type of diuretic precipitating gout
thiazide
118
when is metformin contraindicated
in patients who are at risk of lactic acidosis (e.g. significant renal impairment)
119
proximal myopathy can be a side effect of
corticosteroids (iatrogenic Cushing's syndrome)
120
spironolactone and digoxin can both cause
gynaecomastia
121
flushing and ankle swelling can be caused by
nifedipine (CCB)
122
acute dystonic reactions are a side effect of
metoclopramide
123
acute pancreatitis is an adverse effect of
sodium valproate
124
dyspepsia is a common side effect of
NSAIDs
