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Pre-exam flashcards > FPE MED18 > Flashcards

FPE MED18 Flashcards

1
Q

Features of complete heart block (4)

A

Syncope
Heart failure
Wide pulse pressure
Bradycardia

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2
Q

Types of heart block and explain them (4)

A

First degree – prolonged PR interval
Second degree type 1: progressive prolongation and then drop.
Second degree type 2: consistently prolonged PR interval and then drop.
Third degree: no association between the p waves and the QRS complex.

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3
Q

Management of heart block (4)

A

Atropine
Transcutaneous pacing
Transvenous pacing.
Permanent implantable pacemaker.

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4
Q

Define orthostatic hypotension

A

A drop in BP (usually >20/10 mm Hg) within three minutes of standing.
“3, 2, 1 rule”
3 minutes, 20 drop in systolic, 10 drop in diastolic.

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5
Q

List 4 medications that can cause falls

A

Acetylcholinesterase inhibitors
Antiarrhythmics
Anticholinergics
Antidepressant
Antihistamines
Antihypertensives
Antipsychotics
H2 blockers
Hypoglycaemics
Laxatives (in excess)
NSAIDs
Opioids
Polypharmacy
PPIs
Sedative hypnotics
Steroids

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6
Q

List 4 other causes of loss of consciousness (apart from orthostatic hypotension)

A

Aortic stenosis
Dehydration
Hypoglycaemia
TIA/Stroke
Seizures

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7
Q

List 4 malignanct causes of cervical lymphadenopathy

A

Lymphoma
Leukaemia
Nasopharyngeal carcinoma – SSC
Gastric cancer (supraclavicular)

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8
Q

List 4 causes of lumps in the neck (apart from lymphoma)

A

Branchial cyst
Cystic hygroma
Thyroglossal cyst
Dermoid cyst
Lipoma

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9
Q

What are 2 B symptoms

A

> 10% weight loss in the past 6 months
Night sweats
Temperature >38 degree celsius

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10
Q

Describe this type of cell and describe it’s structure.

A

Reed-sternberg cell - large, abnormal lymphocytes (a type of white blood cell) that may contain more than one nucleus.
Mirror image cell

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11
Q

Describe the staging of lymphoma and what additional tests must be done prior.

A

Ann Arbor staging (describe each stage)
CT, MRI, PET, Lymph node biopsy, LDH.

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12
Q

What is an Odd’s ratio?

A

The odds ratio tells us how much higher the odds of exposure are among case-patients than among controls.
AD/CB

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13
Q

List 2 immediate and 2 delayed reactions of blood transfusions

A

2 immediate: Anaphylaxis, acute haemolytic transfusion reaction, Acute GVHD, TACO, TRALI
2 delayed: Chronic GVHD and delayed haemolytic transfusion reaction

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14
Q

List 4 types of prolapses

A

Uterocecole
Cystourethrocele
Vault prolapse
Uterine prolapse
Rectocele
Cystocele

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15
Q

List 3 conservative and 3 non-conservative treatments for prolapses.

A

Conservative: weight loss, vaginal oestrogen cream, physiotherapy, vaginal pessaries.
Surgical: hysterectomy, mesh repair, posterior colporrhaphy (Rectocele)

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16
Q

Name two examinations that must be completed when examining for prolapses.

A

Sims speculum examination
Cough test - to assess full descent of the prolapse
Dorsal and left lateral position to examine prolapse

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17
Q

4 symptoms of prolapses

A

Heaviness in the abdomen
Urinary incontinence - frequency, urgengy, retention
Bowel incontinence - constipation
Altered sexual experience

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18
Q

Investigations for someone presenting with incontinence

A

3 day bladder diary
Urine dipstick - to rule out infection
Urodynamic studies

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19
Q

List four signs of Parkinson’s

A

Rigidity
Bradykinesia/Akinesia
Shuffling gait
Tremor

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20
Q

Why would you use L-dopa and carbidopa instead of dopamine?

A

Carbidopa prevents levodopa being broken down in the peripheral nervous system.

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21
Q

Why do patients with Parkinson’s get choreiform movements?

A

Due to fluctuating levels of dopamine and continued loss of dopamine producing cells

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22
Q

Describe the pathophysiology of Parkinson’s.

A

Degeneration of dopamine neurons is particularly evident in a part of the substantia nigra called the pars compacta. Significantly, the loss of dopamine in the par’s compacta increases the overall excitatory drive in the basal ganglia,* disrupting voluntary motor control and causing the characteristic symptoms of PD.

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23
Q

List 4 types of Parkinson’s medications and their mechanisms of action.

A

L-dopa - converted into dopamine in the brain
MAO-B inhibitors - sellegiline
COMT inhibitors - Tolcapone
Amantadine - MOA unknown.
Dopamine agonists - bromocriptine
Antimuscarinics - procyclidine

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24
Q

Name 2 tests used for the screening of Down’s syndrome and the other conditions they test for.

A

Combined screening and quadrople testing
Patau’s (trisomy 13) and Edwards (trisomy 18)

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25
Q

4 features of a good screening test

A

Inexpensive
Sensitive
Not harmful
Easy to administer

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26
Q

List two features of Down’s syndrome.

A

Single palmar crease
Upslanting eyes
Low set ears
Flat face
Epicanthic folds

27
Q

How do VSDs cause tachypnoea?

A

Increased pulmonary blood flow leads to congestive heart failure causing tachynponea

28
Q

Work out the maintence fluids to a 14 kg child.

A

1200ml

29
Q

A child comes in with a barking cough, shortness of breath, tachycardia and poor feeding. A diagnosis of croup is made. What medication would you prescribe and at what dose? (Weight = 14kg)

A

Dexamethasone 0.15 mg/Kg = 2.1 mg

30
Q

Name two viruses that cause croup.

A

Parainfluenza and RSV

31
Q

How would you assess for the severity of croup?

A

Westley’s croup severity score: Level of consciousness, cyanosis, stridor, air entry and retractions.
<2 - mild
3-7 - moderate
8-11 - severe
>12 - life threatening

32
Q

List 2 symptoms of croup

A

Barking cough
Fever
Stridor
Coryzal symptoms

33
Q

List 2 medications used in severe croup

A

Dexamethasone, nebulised adrenalaine and nebulised budesonide

34
Q

A male patient with a history of prostatic cancer presents to A&E with new onset lower back pain. What is your initial management of this patient?

A

Refer for urgent MRI within 24 hours
Oral dex

35
Q

List 3 findings you would see on MRI for spinal cord compression

A

Collapsed vertebral body
Bone oedema
Cord oedema

36
Q

List two symptoms of metastatic spinal cord compression

A

Lower back pain
Lower limb weakness
Sensory loss and numbness

37
Q

List 4 findings on examination of a patient with MSCC

A

Sensory loss
Numbness
Abnormal reflexes
Urinary or stool incontinence
Gait abnormalities

38
Q

List 2 non-pharmacological management options for a patient with MSCC

A

Radiotherapy
Vertebroplasty

39
Q

List 2 non-medical teams you would refer a patient with MSCC to?

A

Community physiotherapy
District nurses

40
Q

List 4 questions you would ask a pregnant woman presenting with abdominal pain.

A

?Vaginal bleeding
?Location
?PMH
?Dysuria
?Abnormal discharge
?Duration

41
Q

4 differentials of preterm labour

A

UTI
Placental abruption
Appendicitis
Ovarian torsion
Ovarian cyst

42
Q

4 steps in management of pre-term labour

A

Foetal monitoring
Tocolysis with nifedipine
Maternal corticosteroids
IV magnesium sulfate
Delayed cord clamping

43
Q

List two ways to monitor a pregnant woman after all basic testing.

A

CTG and urinary dipstick

44
Q

How would you immediately management of airway?

A

Jaw thrust
Head tilt, chin lift

45
Q

How would you diagnose a pneumothorax

A

Chest x-ray

46
Q

Immediate managemnet of a pneumothorax

A

<2cm - discharge
>2 cm and SOB - aspiration
Chest drain
(tension) - Large bore cannula - fifth intercostal space mid-axillary line

47
Q

What do you need to do after a insertion of a chest drain?

A

Prescribe analgesia

48
Q

List the structures a chest drain must pass through

A

Skin
Superficial fascia
Intercostal muscles
Parietal pleura

49
Q

List 4 risk factors for epistaxis.

A

Haemophilia
ITP
Trauma
Granulomatosis with polyangitis
Foreign body insertion

50
Q

List 4 local management options for a nosebleed

A

Leaning forward
Pinching nasal labial folds
Spit out any blood
Ice pack

51
Q

List 2 ways to resevere high INR from Vitamin K antagonist

A

Vitamin K
Prothrombin complex

52
Q

List 2 indications for warfarin use and its mechanism of action

A

Vitamin K antagonist
Metallic heart valves and Atrial fibrillation

53
Q

Describe a comple geriatric assessment

A
54
Q

Name 4 frailty syndromes apart from falls.

A

DIIE

Delirium
Immobility
Incontinence
S/E of medications

55
Q

List 4 causes of falls in the elderly.

A

Anaemia
Sepsis
Hypoglycaemia
Medications
Alcohol
Seizures
Stroke/TIA
Dysarrythmias.

56
Q

What is an advanced directive?

A

A document written at the time when a person is of sound mind that outlines an individual’s preferences with respect to medical treatment should they later become unable to express those wishes directly.

57
Q

List 2 things that a lasting power of attorney can do in terms of a patient’s health and welfare.

A

Manage their medical and property and affairs

58
Q

List two organisms causing otitis externa.

A

Acanthoemeba
Staphylococcus aureus
Pseudomonas aeruginosa

59
Q

List two treatments of otitis externa other than antibiotics.

A

Canal debridgement
Antifungal medications - clotrimazole

First-line: topical antibiotic and steroid
Failure to respond - refer to ENT

60
Q

List four important aspects of antibiotic stewardship.

A

Educating staff
Using the shortest duration of antibiotics based on evidence
Promoting compliance
Prescribing only when necessary

61
Q

How would you differentiate between an UMN and LMN cause of facial nerve palsy?

A

Upper - forehead sparing

62
Q

List two causes of UMN and LMN facial nerve palsies.

A

UMN - stroke, trauma, tumour
LMN - ramsay hunt syndrome, MS, bell’s palsy

63
Q

Management of warfarin overdose

A

Pre-exam flashcards (5 decks)

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