Mock 2 Flashcards
(109 cards)
1
Q
What is the CHADS VASc score used for?
A
Assessing stroke risk and anticoagulation need in AF patients
2
Q
Which parameter isn’t in the scoring system used to calculate the stroke risk in patients with Atrial Fibrillation? A. Age B. Blood Pressure C. Congestive Heart Failure D. Diabetes E. Family History
A
Family History
3
Q
What is an irregularly irregular pulse seen in?
A
AF
4
Q
What is pulses paradoxus?
A
When the BP drops significantly during inspiration
5
Q
What is radio-radial delay?
A
Where pulse is significantly stronger in one arm than the other
6
Q
What condition is radio-radial delay seen in?
A
Coarctation of the aorta
7
Q
What produces early diastolic decrescendo murmur?
A
Aortic regurgitation
8
Q
What produces ejection systolic crescendo murmur heard loudest on expiration?
A
Aortic stenosis
9
Q
What causes pan systolic murmur?
A
Mitral regurgitation
10
Q
What causes mid-diastolic murmur?
A
Mitral stenosis
11
Q
What causes an ejection systolic murmur heart loudest on inspiration?
A
Pulmonary stenosis
12
Q
What are the 3 cardinal signs of HF?
A
- SOB
- Fatigue
- Ankle oedema
13
Q
What does an R wave resemble on an ECG?
A
An M
14
Q
What does a slurred S wave resemble on an ECG?
A
A W
15
Q
What are the 6 Ps of critical ischaemia?
A
Pain Pallor Paralysis Paraesthesia Perishingly cold Pulselessness
16
Q
What are the 4 features of teratology of fallow?
A
- RVH
- VSD
- Overriding aorta
- Stenosis of pulmonary outflow track
Think of the VSD overloading the already narrow Pulmonary outflow tract- which causes RVH
17
Q
What is stage 1 clinical HTN?
A
More than 140/90
18
Q
What is stage 2 clinical HTN?
A
More than 160/100
19
Q
What is severe HTN?
A
More than 180/100
20
Q
Give 5 signs of infective endocarditis
A
- Splinter haemorrhages
- Osler’s nodes
- Janeway lesions
- Roth spots
- Fever
21
Q
What are xanthelasma?
A
Cholesterol deposits around the eyes
22
Q
What usually presents with pale smelly stools that are hard to flush away?
A
Coeliac disease
23
Q
What presents with generalised abdominal pain which gets better after passing wind/defecation and bloating + change in bowel habit?
A
IBS - A type of functional bowel disorder
24
Q
What side of the abdomen does crohns pain usually present with?
A
Right side (cRohns)
25
What presents with RS abdomen pain, bloody stools, mouth ulcers?
Crohns
26
Where would you get abdominal pain in UC?
LLQ
27
What behaviours increase the likelihood of developing a Mallory-Weiss tear?
Retching and vomiting
28
A 35 year-old-male comes to the A&E department because he has been vomiting blood. He said he had been having some abdominal pain, feeling very nauseous and had been retching several times a day before finally vomiting this morning and it had blood in it. He hasn’t noticed any weight loss, fevers or any other systemic symptoms. He drinks 2/3 pints every evening and has been eating/drinking as normal. He doesn’t take any prescribed or over the counter medication. What is the most likely diagnosis?
A. Peptic ulcer rupture
B. Oesophagealmalignancy
C. Gastroesophagealrefluxdisease D. Achalasia
E. Mallory Weiss tear
Mallory Weiss tear
29
What is sulfasalazine used to treat?
UC and Crohns
30
What is omeprazole?
A PPI
31
What is a first line medication for GORD?
PPI e.g. omeprazole
32
What is ranitidine?
A H2 antagonist
33
Give 4 causes of peptic ulcers
H.pylori
Increased acid production
NSAID use
Mucosal ischaemia
34
What could present with middle/upper abdominal pain, vomiting, constipation and bloating?
Small bowel obstruction
| HINT - Previous surgery causing adhesions
35
How do you treat H.Pylori infection?
REMEMBER WITH CAP
TRIPLE THERAPY OF:
Clarithromycin/Metronidazole
Amoxicillin
PPI e.g. omeprazole/lansoprazole
36
Give 4 risk factors for developing GORD
Obesity
Hiatus hernia
Smoking
Pregnancy
37
What is the first line investigation in large bowel obstruction?
Abdominal X-Ray
38
What is a potential diagnosis for left iliac fossa mass, abdominal pain, bloating and constipation?
Large bowel obstruction
39
What is achalasia?
The LOS doesn't open in swallowing causing a backup of food in the oesophagus
40
Give 3 consequences of untreated GORD
Barretts oesophagus
Oesophagitis
Oesophageal ulcers
41
How do duodenal ulcers present?
They cause pain several hours after eating- pain gets better after eating
42
Why do people with duodenal ulcers get pain hours after eating?
Stomach acid in the duodenum
43
Which has a stronger genetic link, Crohns or UC?
Crohns
44
Which sex is affected more in Crohns and UC?
UC is 50/50
| Crohns - females affected more
45
What is dermatitis herpetiformis?
The dermatological manifestation of coeliac disease - often seen as a rash on extensor surfaces e.g. elbow
46
What is the first line treatment for coeliac?
Gluten free diet
47
Give 4 risk factors for oesophageal cancer
Achalasia - due to increase in vomiting
Alcohol
Obesity
Smoking
48
What is the gold standard investigation in bowel cancer?
Colonoscopy
49
Where is colon cancer most likely to be seen?
Distal colon
50
Why is it easier to detect distal colon cancer?
The closer the cancer is to the outside of the body the more visible the blood and mucus is
51
Pt presents with umbilical pain that has migrated to RIF- with fever and vomiting - diagnosis?
Appendicitis
52
Straining to go to the toilet and blood when wiping - no weight loss - diagnosis?
Haemorrhoids - straining loosens and bulks the spongy vascular tissue
53
What would you see when doing a blood test in a Crohns patient?
1. Anaemia due to iron and folate deficiency
| 2. Raised ESR and CRP
54
What is the most common cause of AKIs?
Acute tubular necrosis
55
How can prostatic hyperplasia cause post-renal AKI?
It increases intra-tubular pressure, which decreases GFR - Causing rising urea and creatinine serum levels
56
Give 4 risk factors of CKD
Diabetes
FHx
Increasing age
Recurrent UTIs
57
Does pregnancy increase the risk of CKD?
No - but CKD increases the risk of pregnancy complications
58
What is the most common causative organism in pyelonephritis ?
E-coli
59
What is the best investigation to use in the management of pyelonephritis?
Midstream urine microscopy, culture and sensitivity
60
What is the first line treatment for UTIs in pregnancy?
Nitrofuratoin
61
Why is trimethoprim contraindicated in treating UTIs and pregnancy?
It inhibits folate synthesis
62
What is Charcot's triad?
Fever, RUQ pain and jaundice
63
What is reiter's syndrome?
Also known as reactive arthritis:
Conjunctivitis
Urethritis
Arthritis
64
Describe how PKD is usually passed on
Autosomal dominant
65
Give 4 complications of PKD
Cardiovascular disease
Kidney stones
Polycystic liver disease
Berry aneurysms leading to SAH
66
How do you differentiate between Hodgkin and Non-Hodgkin lymphoma?
HL has Reed-Sternberg cells
67
How do you differentiate acute myeloid leukaemia from other leukemias?
Auer rods are seen histologically In AML
68
Is the progesterone only pill a risk factor for DVT?
No- NICE actually recommends it for DVT risk women over the OCP
69
What is the immediate treatment for thrombotic thrombocytopenic purpura?
Plasma exchange ASAP
THIS IS A MEDICAL EMERGENCY DO NOT CONFIRM DIAGNOSIS FIRST
70
What should you NOT give in TTP?
Platelets
71
What score is used to asses for DVT?
DVT Wells score
72
When should suspected DVT lead to same day assessment and management?
A woman who is pregnant/ has given birth in the past 6 weeks
73
What score estimates major bleeding risk in patients on anticoagulants for AF?
HAS-BLED score
74
What score is used to calculate stroke/MI risk in the next 10 years?
QRISK
75
What is the treatment for a DVT?
LMWH and Oral anticoagulant e.g. warfarin
76
What is the first line treatment for severe/complicated malaria?
IV Artesunate
77
What is ferritin?
A protein that STORES iron - it is usually found in cells
78
What is transferrin?
A protein that combines with ferritin to transport iron i.e. a taxi for iron
79
What is the treatment for uncomplicated malaria?
Oral chloroquinine
80
What is hyperplasia?
Increased size of tissue due to an increase in the number of cells
81
What is hypertrophy?
Increased tissue size due to increase in constituent cell size
82
What is a granuloma?
An aggregate of epithelioid histiocytes
83
What is the definition of granulation tissue?
New connective tissue with microscopic blood vessels forming on a wound surface
84
What is Barretts oesophagus?
Metaplasia of stratified squamous cells to simple columnar cells in the distal oesophagus -usually as a result of GORD
85
What cancers spread to bone?
```
The 5 B's
Brain
Bronchus
Byroid
Bidney
Brostate
```
86
What is the treatment for paracetamol overdose?
N-acetyl cystine
87
What is Horner's syndrome?
A neurological condition characterised by unilateral loss of sweating, dilated pupil and drooping eyelid
88
What could be the diagnosis of somebody with raised ANA, anti-dsDNA and antiphospholipids?
Lupus
89
What is the first line treatment for alcohol/ drug withdrawal seizure?
Chlordiazepoxide
90
What is methadone used for?
Heroin addiction
91
What is Wernicke's Encephalopathy caused by?
Vitamin B1/Thiamine deficiency in the brain of chronic alcoholics
92
What is a side effect of bisphosphonates?
Oesophagitis
93
What is sjorgen's syndrome?
The immune destruction of exocrine glands presenting with arthritis, dry eyes and dry mouth
94
What is the test for sjorgen's syndrome?
Schirmer's test
95
What is the first line management of ankylosing spondylitis?
Ibuprofen
96
Knee/one joint affected pain with fever- diagnosis?
Pseudogout - often presents with mono arthritis of the knee
97
What is the first line treatment for gout?
Colchine or ibuprofen
98
What does a T score of -1 - -2.5 suggest?
Osteopenia
99
What does a T score of under -2.5 suggest?
Osteoporosis
100
What is osteomalacia?
The adult version of rickets - softening of bones due to vitamin D/ Calcium deficiency
101
What should a patient who has had their first seizure be offered on discharge?
Sodium valproate
102
What is intention tremor seen in?
Huntingtons disease
103
What is resting tremor seen in?
Parkinsons - it stabilises upon active movement of the body part
104
What is the first line treatment for giant cell arteritis?
Oral steroids
105
How does cauda equina syndrome present?
Inability to open bowels/urinate
Reduced anal tone
Saddle anaesthesia
106
Within what time frame should ischaemic stroke patients receive alteplase treatment after symptom onset?
Within 4.5 hours
107
What is the most common infective cause of COPD exacerbation?
Haemophilius influenzae
108
Give a sign of a life threatening asthma attack
SpO2 < 92%
109
What asthma medication is known to cause tachycardia and resting tremor?
Salbutamol inhaler
