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HLB Flashcards

1
Q

When doing a respiratory examination, what is indicated by a finding of: Cold peripheries

A

Hypovolemia

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2
Q

When doing a respiratory examination, what is indicated by a finding of: Clubbing

A

Fibrosis
Lung Cancer
Bronchiectasis/ CF

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3
Q

When doing a respiratory examination, what is indicated by a finding of: Cap refil >2secons

A

Hypovolemia or hypoxia

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4
Q

When doing a respiratory examination, what is indicated by a finding of: Fine tremour

A

Salbuatmol use

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5
Q

When doing a respiratory examination, what is indicated by a finding of:Flapping tremour

A

CO2 retention

COPD- T2 resp failure

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6
Q

When doing a respiratory examination, what is indicated by a finding of:Raised JVP

A

R heart failure secondary to pulmonary hypertension

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7
Q

When doing a respiratory examination, what is indicated by a finding of: Drooped eyelid, contricted pupil, sunken eyes

A

Horner’s syndrome

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8
Q

When doing a respiratory examination, what is indicated by a finding of: Dullness to percussion

A

Consolidation, fluid, tumor or collapse

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9
Q

When doing a respiratory examination, what is indicated by a finding of: Stony dull to percussion

A

Pleural effusion

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10
Q

When doing a cardiovascular examination, what is indicated by a finding of: Jayneway lesions

A

Endocarditis

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11
Q

When doing a cardiovascular examination, what is indicated by a finding of: Oslers nodes

A

Endocarditis

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12
Q

When doing a cardiovascular examination, what is indicated by a finding of: Splinter haemorrhages

A

Endocarditis

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13
Q

When doing a cardiovascular examination, what is indicated by a finding of: Clubbing

A

Endocarditis, cyanotic congenital heart disease (i.e. tetrology of fallot or patent ductus arteriorsus)

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14
Q

When doing a cardiovascular examination, what is indicated by a finding of: Raised JVP

A

Right heart failure

Fluid overload

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15
Q

When doing a cardiovascular examination, what is indicated by a finding of: Malar flush

A

Mitral stenosis

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16
Q

When doing a cardiovascular examination, what is indicated by a finding of: Corneal arcus

A

Hypercholesterolaemia

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17
Q

When doing a cardiovascular examination, what is indicated by a finding of: Xanthelasma

A

Hypercholesterolaemia

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18
Q

When doing a cardiovascular examination, what is indicated by a finding of: Angular stomatitis

A

IDA

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19
Q

When doing a cardiovascular examination, what is indicated by a finding of: Poor oral hygiene

A

Can be a route of spread for infective endocarditis

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20
Q

When doing a cardiovascular examination, what is indicated by a finding of: Sternotomy scar

A

Previous CABG or valve surgery

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21
Q

When doing a cardiovascular examination, what is indicated by a finding of: Ejection systolic murmur

A

Aortic stenosis

louder on expiration

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22
Q

When doing a cardiovascular examination, what is indicated by a finding of: Pan systolic mumur

A

Mitral regurgitation

Louder with expiration and roll onto left

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23
Q

When doing a cardiovascular examination, what is indicated by a finding of: Early diastolic murmur

A

Aortic Regurgitation

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24
Q

When doing a cardiovascular examination, what is indicated by a finding of: Mid-late diastolic murmur

A

Mitral stenosis

Rumbling, low pitched

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25
Where would an ejection systolic murmur radiate to?
Carotid arteries
26
Where would a mid-late diastlic murmur radiate to?
The axilla
27
How would you accentuate a murmur if you suspected aortic stenosis?
Hold expiration
28
How would you accentuate a murmur if you suspected mitral stenosis?
Ask Px to roll onto L hand side | Hold expiration
29
How would you accentuate a murmur if you suspected Aortic Regurgitation?
Ask Px to lean forward | Hold expiration
30
How would you accentuate a murmur if you suspected Mitral Regurgitation?
Ask Px to roll onto L hand side | Hold expiration
31
How would you accentuate a murmur if you suspected it was left sided?
Hold expiration
32
How would you accentuate a murmur if you suspected it was right sided?
Hold inspiration
33
Name 6 things you could check when examining for Aortic Stenosis?
``` Ejection systolic mumur Made louder by expiration Radiates to caroitds Slow rising pulse Narrow pulse pressure Powerful apex beat ```
34
Name 4 things you could check for when examining for mitral regurgitation?
``` Pansystolic murmur Radiates to axilla Louder when on left side + expiration Apex beat displaced to the left AF possible with mitral problems ```
35
Name 6 things you could check for when examining for aortic regurgitation?
``` Early diastolic murmur Louder when leaning forward + expiration Radiates to carotids Wide pulse pressure Collapsing pulse Capillary nail bed pulsation (Quinke's sign) ```
36
Name 4 things you could check for when examining for mitral stenosis?
Rumbling mid-late diastolic murmur Radiates to axilla Louder on left lean + epxiration Malar flush
37
When starting a patient on a statin, what monitoring must be done?
Cholesterol and LFT's before | Check again in 1-3 months and again at 12 months
38
How should a patient be advised to take a statin (including lifestyle changes due to medication)?
OD at night | Avoid grapefruit and cranberry juice
39
What must a patient being counselled for a statin be cautioned on if they develop a chest infection?
Statins interact with macrolides (clarithromycin)
40
What are the common SE of statins?
Headache, tummy pain, diarrhoea
41
What is the rare but serious complication of statins?
Stain induced myopathy > rhabdomyolysis Any muscle pain/ weakness/ cramps go and see GP (do CK)
42
What are the names of the two waves you see in a JVP?
A wave and V wave
43
JVP is a way of assessing pressure in which part of the heart?
Right atrium
44
A JVP will be raised in which heart conditions?
R sided heart failure CCF Fluid overload
45
A patient is on warfarin for how long if they have had a provoked DVT?
3 months
46
A patient is on warfarin for how long if they have had an unprovoked PE?
6 months
47
A patient is on warfarin for how long if they have had an unprovoked DVT?
6 months
48
A patient is on warfarin for how long if they have had a provoked PE?
3 months
49
A patient is on warfarin for how long if they have had a recurrent DVT when on warfarin already?
Lifelong
50
A patient is on warfarin for how long if they are on it for stroke prevention due to AF?
Lifelong
51
What advice should be given regarding warfarin and pregnancy?
Avoid in 1st trimester or if planning to be pregnant
52
What drinks should be avoided when on warfarin?
Cranberry juice
53
What are the most common SE's which must be counselled for warfarin?
More likely to bleed!
54
What are the first 6 things you should check on a CXR?
``` Name/ DOB Date of X-ray Quality Rotation Area covered PA or AP ```
55
What is the ABCDE of a CXR interpretation?
``` A- Airway and mediastinum B- Breathing (lung field) C- Circulation (heart) D- Diaphragm E- Extra ```
56
What blood tests should be done when counselling a patient to start an ACEI?
Renal function before starting then 7-10 days after starting
57
What absolute contraindications should be checked for a patient planning to start an ACEI or an ARB?
Hx Angioedema Pregnancy Renal artery stenosis Moderate aortic stenosis
58
What is the first line anti-hypertensive for a diabetic patient with a BP of 147/89 on ABPM?
ACEI | For all diabetics regardless of age
59
If the patient is afro-caribbean what medication should be started after amlodipine to control BP?
ARB | Always before ACEI in afro-carribean, even if diabetic
60
What is first line treatment for angina?
Statin, aspirin, GTN spray for as required | 1st line: Beta blocker (Verapamil or diltazem if CI)
61
Name the key area's to check in a hydration status examination?
IV fluids, temprature, pulse (volume), BP (sitting and standing), sunken eyes, dry mouth, JVP, carotid volume, cap refil on sternum, skin turgor, ausculate lung bases, ascites, peripheral oedema
62
How would you state the completion of examination for hydration status exam?
History + obs chart Check U+E's Check fluid balance chart

OSCE (6 decks)

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