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IMP3 Revision > Endo > Flashcards

Endo Flashcards

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1
Q

What thyroid disease has suppressed uptake on a scan?

A

Thyroiditis

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2
Q

Which one has regulated autonomic fn: toxic nodule or toxic multinodular goitre?

A

Toxic nodule

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3
Q

What are two classic features of Graves disease?

A

Exopthalmos and myxedema (deposition of mucopolysaccharides in the dermis)

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4
Q

Name 4 causes of hypothyroidism

A

Autoimmune (Graves), post-partum De Quervains, pituitary disorder, iatrogenic

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5
Q

What is the most common type of thyroid ca?

A

Papillary

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6
Q

What is Cushing’s disease?

A

an ACTH secreting tumour. (Syndrome is just excess cortisol)

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7
Q

Name 3 tests to screen for secondary HTN

A

1) Plasma metanephrins (phaeo)
2) Aldosterone:renin ratio
3) Screen for hypercortisolism

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8
Q

What are 3 screening tests to look for endogenous causes of Cushing’s syndrome?

A

1) Urine free cortisol for 24 hours
2) Low dexamethasone suppression testing
3) Late evening salivary cortisol
If more than two abnormal, then positive diagnosisName

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9
Q

Name 5 of the common symptoms/signs associated with hypoadrenalism

A

1) Postural hypotension
2) Weight loss
3) Lethargy
4) Hyponatraemia
5) Hyperkalaemia

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10
Q

What does CUSHINGOID stand for?

A 
C: cataracts, central adiposity
U: ulcers
S: straie
H: HTN
I: immunosuppression
N: necrosis of bone
G: GI upset and hyperglycaemia
O: osteoporosis
I: impaired wound healing
D: depression
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11
Q

What are the 4 steps to mgmt of an open fracture?

A

1) ABx and tetanus
2) Assess wound and gentle wash with saline
3) Bandage w/saline packs
4) Early operation (within 6 hours)

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12
Q

What are the 3 steps involved in operative mgmt of an open #?

A

1) washout and debridement
2) Further assess damage
3) Early # stabilisation

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13
Q

What are 4 complications of a fracture?

A

Fat embolism, infection, DVT, compartment syndrome

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14
Q

What is the most common site for compartment syndrome?

A

Anterior leg (has the tighest fascia)

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15
Q

What are 2 specific symptoms for compartment syndromes?

A

Severe pain, pain on passive stretching

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16
Q

What is an important part of ABCDE management post an MVA?

A

CHECK C-SPINE PRECUATIONS BEFORE HEAD TILT

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17
Q

In order of timing, name the common causes of fever post-op

A

Day 1-3: Atelectasis/Pneumonia
Day 4: UTI/VTE
Day 5: Anastamotic leak, suture site infection, drug fever

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18
Q

What is the Care of Critically Ill Surgical Patient pathway? (CRISP)

A
  1. ABCDE
  2. Patient assessment: chart r/v, Hx and systematic exam, results.
  3. Decide Plan: If stable, daily mgmt. If unstable/unsure, specific investigation and decide is medical/surgical/radiological mgmt.
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19
Q

What does the SAAG score need to be for SBP?

A

> 1.1, due to liver cirrhosis, alco hepatitis, malignancy etc

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20
Q

What are 2 causes of a SAAG <1.1?

A

Pancreatic asicitis, bowel obstruction, nephrotic syndrome

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21
Q

What is the bHCG for expectant mgmt of ectopic?

A

<1000

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22
Q

What is the bHCG for medical mgmt of ectopic?

A

<5000

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23
Q

What is the bHCG for surgical mgmt of ectopic?

A

> 5000

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24
Q

What is the 3 step treatment for hypoglycaemia in hospital?

A

1) 15g glucose (~7 jellybeans) and wait 15mins before retesting BSL.
2) If still low, give 15g more.
3) Change to complex carbs once feeling better (ie bread) and needs dose R/V of diabetic meds

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25
What are 3 common causes of hypoglycaemia in hospital?
Sulfonysureas, incorrect charting of medications, fasting, increased physical activity
26
What is the definition of hypoglycaemia?
BSL < 4
27
What are 4 common causes of hyperglycaemia in hospital?
Incorrect charting of medication, stress response to sickness, steroid medication, non-diabetic diet
28
What is the management for hyperglycaemia in hospital?
1) Check ketones- if high then DKA route | 2) Otherwise insulin: basal-bolus regimen is best.
29
What are two negatives about CTPA for PE?
Requires contrast (not everyone can handle) and provides irrelevant findings of minor abnormalities
30
What are 2 positives about the Vq scan?
Reduced radiation, can and should be used in pregnancy women/women of childbearing age
31
What are two negatives of using the VQ scan?
Low sensitivity and not specific in patients with heart and/or lung abnormalities.
32
What is the three pronged Abx approach for empirical Rx of adult sepsis?
Ceftriaxone, flucloxicillin and gentamycin
33
What are the 3 poor prognostic markers for CKD?
1) A: Raised ACR (proteinuria) 2) B: BP (HTN) 3) C: CrClearance (low)
34
What are the 4 management steps to prevent progression of CKD?
1) Reduce proteinuria via ACE/ARB 2) Control HTN 3) Control BSL (HbA1c<7%) 4) SGLT2 inhibitor (if eGFR>30)
35
What are 3 complications of a tonsillectomy?
Bleeding (primary and secondary), throat pain, dehydration, delayed feeding, voice change
36
When is the risk of post-op bleeding highest post tonsillectomy?
Day 3- when the fibrin clot breaks off
37
Name 3 red flags in a patient with reflux
Anaemia, dysphagia, weight loss, haematemesis, inadequate response to Rx, patient >55
38
Which one is a diagnostic and therapeutic? ERCP or MRCP
ERCP
39
What are the side effects of excess local anaesthetic? Name 3
Chest pain, palpitations, dyspnoea, MI, convulsions and hypotension
40
What are 3 complications of sinusitis?
Eye: cellulitis, abscess, proptosis Brain: meningitis, extradural abscess
41
What shows up as a thumbprint sign on lateral XR?
Epiglottitis
42
What is the difference between ischaemic colitis and mesenteric ischaemia?
Ischaemic colitis affects the large bowel, can be transient. Leads to diarrhoea. Mesenteric ischaemia leads to hypoperfusion of the small bowel--> infarction
43
How does chronic mesenteric ischaemia present?
Mesenteric angina, pain worse after eating.
44
What is the investigation of choice for ischaemic bowel?
CTA- to evaluate if arterial cause, mostly for acute mesenteric ischaemia
45
What is the diagnostic investigation for ischaemic colitis?
CTA or colonoscopy for diagnosis. Colonoscopy can lead to perforation
46
What are 3 features of colitis?
Diarrhoea, abdominal pain and haematochezia
47
What are the 3 ABx for when someone has a abdo perforation?
Amoxy, gent and metronidazole IV
48
What is the hallmark feature of Extra dural haehorrhage?
progressive drowsiness
49
What are 4 possible causes of homogenous opacification on a CXR?
Pleural effusion, consolidation, collapse or raised diaphragm
50
What % of FEV1 predicted is indicative of severe COPD?
<40%
51
What % of FEV1 predicted is indicative of mod COPD?
40-59%
52
What % of FEV1 predicted is indicative of mild COPD?
60-80%
53
What is the 5 step treatment for ascities?
1) Treat cause: liver vs renal 2) Fluid restriction: strict fluid chart, daily weights 3) salt restriction 4) Diuretics: spiro best 5) Gastro ref for ?liver Tx
54
What medication is given for primary prevention of variceal bleed in patients with liver cirrhosis?
Propranolol. | Checked once diagnosis confirmed and if varicies present, take propranolo.
55
Name 6 causes of congenital deafness
CMV, Toxoplasmosis, Herpes, Rubella, Varicella, Intrauterine trauma
56
List 3 contraindications to a cochlea implant
Cochlea agenesis, cochlear aplasia and chronic OM
57
Best sign for confirming likelihood of malignancy in a parotid mass
FACIAL NERVE PALSY
58
What has filling defects on IVU and a hyperechoic mass at level of pelvis?
TCC of renal pelvis
59
Diagnosis: bilateral ballotable kidneys
Likely polycystic kidney disease
60
where is the headache for SAH?
occipital region
61
What are the steps in management of an upper GI bleed?
1) Resuscitation with fluids (if hypotensive) 2) Warfarin reversal (if applicable) 3) Non-variceal bleed= PPI infusion Variceal bleed= terlipressin and broad spectrum Abx 4) Refer gastro for endoscopy and banding once stabilised
62
What is the Rx for nephritic syndrome?
Fluids, anti-HTN, low sodium diet
63
What is the Rx for nephrotic syndrome?
Statin, fluid restriction, diuretics, low protein diet, VTE prophylaxis!!
64
How does acute leukemia present?
Reduction in other blood counts so anaemia (fatigue), thrombocytopenia (bleeding) and/or neutropenia (infection)
65
What staging is used for lymphoma?
Ann Arbor
66
When is LDH released?
In tissue damage. Usually a marker of metabolism.
67
What nerve is commonly affected by lung ca and what the presenting syndrome?
Recurrent laryngeal nerve, hoarse voice
68
What are the 4 presenting signs/symptoms of obstructive cholestasis?
Jaundice, pale stools, pruritis and dark urine

IMP3 Revision (4 decks)

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