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Year 3 Medicine > Formative 1 2020 > Flashcards

Formative 1 2020 Flashcards

(48 cards)

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1
Q

What are the antibodies present in autoimmune hepatitis?

A

Type 1 (adults)

  • ANA
  • Anti-smooth muscle
  • pANCA

Type 2 (kids)

  • Anti-LKM1
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2
Q

Which antibodies are present in primary biliary cirrhosis?

A

Anti-mitochondrial, cANCA

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3
Q

What is the presentation of primary biliary cirrhosis?

A
  • Female patient
  • Jaundice
  • Pruritis
  • Xanthelasma
  • Hepatosplenomegaly (if advanced)
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4
Q

What is the moa of Carbamazepine?

A

Anti-convulsant

Na+ channel inhibitor

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5
Q

What is the first step for someone presenting with suspected acute limb ischaemia?

A

Immediate IV unfractionated heparin, DO NOT delay treatment for investigations

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6
Q

What are the 6 Ps of acute limb ischaemia?

A
  • Pale
  • Pulseless
  • Perishingly cold
  • Paraesthesia
  • Paralysis
  • Pain
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7
Q

What is the management of actively bleeding peptic ulcer?

A
  1. Ensure the patient is haemodynamically stable
  2. Endoscopy
  3. IV PPI (some trusts use oral)
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8
Q

What is the management of actively bleeding variceal ulcer?

A
  1. Ensure the patient is haemodynamically stable
  2. Terlipressin or somatostatin analogue
  3. Broad spectrum antibiotic (ceftriaxone)
  4. Endoscopy with variceal band ligation
  5. Stent/ balloon tamponade
  6. Transjugular intrahepatic portosystemic shunt
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9
Q

What does a transjugular intrahepatic portosystemic shunt connect?

A

The hepatic portal vein with intrahepatic veins

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10
Q

What are the investigations for bladder cancer?

A
  1. Urinalysis to look for haematuria
  2. Urine cytoscopy- second voided preserved urine should be used
  3. Flexible cystoscopy
  4. Ultrasound kidneys, ureters, bladder for mets
  5. CT urogram
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11
Q

What is the most common complication of TURP?

A

Retrograde ejaculation

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12
Q

What are the investigations for pancreatic cancer?

A
  • Pancreatic protocol CT
  • Abdominal ultrasound
  • LFTs
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13
Q

Why are LFTs done in suspected pancreatic cancer?

A

They can indicate the level of obstruction but can’t specify that it’s due to pancreatic cancer

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14
Q

What is cholestatic hepatitis?

A

Any form of liver disease that causes inflammation of the liver and issues with bile transport

Triad

  • Pruritis
  • Dark urine/ light stools
  • Jaundice
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15
Q

What medications can lead to cholestatic hepatitis?

A
  • Co-amoxiclav
  • The -mycins
  • The -floxacins
  • The -itidines
  • Phenytoin
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16
Q

Why can tuberculosis not be detected on gram-staining?

A

Because it has a high lipid content and therefore has to be detected via Ziehl-Neelsen staining

(Acid-fast bacillus)

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17
Q

When should anticoagulants be stopped preoperatively?

A

Anticoagulants should be stopped 2-4 days before surgery and commenced as soon as the surgery is over

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18
Q

When should antiplatelets be stopped preoperatively?

A

Antiplatelets should be stopped 5-7 days before surgery and commenced as soon as the surgery is over

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19
Q

What are the characteristics of neuropathic ulcers?

A
  • Pressure loading sites
  • Painless
  • Risk factors of diabetes rather than cardiovascular
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20
Q

What is osteomalacia?

Study These Flashcards
A

Softening of the bone in adults due to a lack of vitamin D, in children it is called Rickets

21
Q

What is the difference between dihydropyridines and non-dihydropyridines?

Study These Flashcards
A

Dihydropyridines (amlodipine) act primarily on the smooth muscles of the vasculature to encourage vasodilation

Non-dihydropyridines (verapamil) act primarily on the heart muscle to decrease strength of contraction and heart rate

22
Q

Why are non-dihydropyridine calcium channel blockers contra-indicated in heart failure?

Study These Flashcards
A

Because they can lead to bradycardia and reduced cardiac output which can lead to pulmonary effusion and increased breathlessness

23
Q

Which drugs have a -sartan suffix?

Study These Flashcards
A

Angiotensin II receptor blockers (ARBs)

24
Q

What is the management of COPD?

25
What are the ECG changes for hyperkalaemia?
- Tented T waves - Absent P waves - Broad QRS complexes
26
What are the ECG changes for hypokalaemia?
- Flattened T waves - U waves - ST depression
27
What are the surgical management pathways of nephrolithiasis?
- \<10mm that doesn't pass with conservative management, show wave lithotripsy - 10-20mm uretoscopy or show wave lithotripsy (uretoscopy more invasive) - \>20mm or staghorn stone percutaneous nephrolithotomy
28
What is the general management for atypical pneumonias?
Clarithromycin
29
What is the inheritance pattern of neurofibromatosis?
Autosomal dominant
30
Where does psoriasis tend to affect?
The extensor surfaces
31
Where does eczema tend to develop?
The flexor surfaces
32
Where does eczema tend to develop in kids?
The extensor surfaces
33
What is metaplasia?
Change in the cell type
34
What is dysplasia?
Change in the cell shape/ formation of abnormal cells
35
What is neoplasia?
Uncontrolled, abnormal growth of cells in tissues
36
What is granuloma annulare?
A hypersensitivity reaction with idiopathic origin
37
What is necrobiosis lipodica?
Usually associated with diabetes, it's a disorder of collagen degeneration with a granulomatous response, thickening of blood vessels and fat deposition
38
What skin manifestation can indicate PCOS?
Acanthosis nigricans
39
What is De Quervain's thyroiditis?
A viral infection of the thyroid that is characterised by a painful multinodular goitre and hyperthyroidism followed by hypothyroidism after viral induced cell death most commonly seen in women 20-50
40
How does infectious mononucleosis present?
- University student - Splenomegaly (can't play sport for 3-4 weeks) - Bilateral grey exudate on the tonsils
41
What is the management of infectious mononucleosis?
Supportive + corticosteroids If patients are given amoxicillin, they develop a widespread rash
42
How does a subphrenic abscess present?
- Fever (systemic symptoms) - Costal margin tenderness - Shoulder pain - Dyspnea - Upper quadrant pain - Hiccoughs
43
What cancers is EBV a risk factor for?
Lymphona, particular Burkitt's lymphoma
44
What is the most likely organism to cause encephalitis?
HSV1
45
What is a pilonidal sinus?
An abnormal sinus at the top of the natal cleft commonly due to friction causing folliculitis and the follicle extending into the subcutaneous tissue forming a sinus
46
How does a pilonidal sinus present?
Usually patient is afebrile and has noticed a tract/ bump/ pus at the top of their natal cleft
47
What is intertrigo?
Inflammation and rash of the areas of folded skin due to friction
48
Which murmur is Rheumatic fever associated with?
Mitral regurgitation (pan-systolic)

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