MSCAA questions revision Flashcards by Neil Srivastava

Acute Pancreatitis vs Acute Cholecystitis

Both have raised amylase levels.

ALP will be raised

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Management of acute duration low back pain in fit person

Continue usual activity

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What is the management of a PE in hospitals (major)

IV heparin not a DOAC

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What is the CHADS2Vasc score

CHF - 1
H - Hypertension
A - Age (either 65+ is 1 or 75+ is 2)
D - Diabetes
S - Stroke (2)
Vasc - Vascular disease history

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How do we calculate the lifetime risk of having a stroke from chadsvasc

score of risk x years from life expectancy (83)

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Initial invetsigation of renal stones

Non enhanced CTKUB

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When should drugs be stopped in suspected CKD

Only if there is >30% increase in serum creatinine

If not, repeat 2-4 weeks later

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First line managemnet of hypoglycaemia

75ml of 20% glucose (IV)

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What diabetic drug is approved for use in CKD (the only one)

Sitagliptin (DPP4 inhibtor)

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In what condition is Pioglitazone contra-indicated for use

HF and bladder cancer

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WHat is the diagnostic investigation for sensineural hearing loss

MRI imaging

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What invetsigation must be done before suspectiing IBD

STool Cultures

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Management of osteoarthritis on the pain ladder

First: Paracetamol/ibuprofen gel

Second Line: EITHER Co-Codamol or an NSAID (depending on contraidnications)

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First line managemen of poisoning - is it gastric lavage or actiavted charcoal first

Activated charcoal

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What condition gives way to adhesive capsulitis

Diabetes

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What is an iatrogenic secondary pneumothorax cause

Chest drains themselves

Central lines

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Management of hypertension

<55:

ACEi/ARB

ACEI/ARB + CCB or thiazide like diuretic

> 55:
CCB

CCB + ACEi/ARB or thiazide

Both:

Triple therapy of the three

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What defines rapidly progressive glomerulonephritis

A drop in over 50% eGFR over 3 months

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What are the indications for an ascites tap

To determine what’s causing ascites if unkown

To check for suspected sponatenous bacterial peritonitis

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What diagnoses Spontaneous bacterial peritonitis

Neutrophil count >250 cells

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What does an ascitic tap show for potential malignancy

RBC <1,000 cells/mm^3

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What Serum albumin- Ascitic Albumin concentration indicates liekly cirrhosis and cardiac failure cause of ascites

> 11g/L

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Management of a red eye

ALWAYS refer to Opthalmologist (could be corneal abrasions, endopthlamitis, acute glaucoma

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What is the initial management of suspected bowel obstruction

NG tube striaght away for decompression

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What type of fluid is 1.8% Sodium CHolride also known as

HYPERtonic saline

What are the role of goblet cells

Secrete mucin (provides a mucosal layer to the stomach)

In what condition is urseodeoxycholic acid a mainstay treatment for

Primary Biliary Cirrhosis

Where are adenocarcinomas of the lungs typically located

Peripherally

Where are squamous cell carcinomas typically located

Centrally

What do squamous cell carcinomas typically secrete

PTHrP

What do small cell carcinomas typically secrete

Cushing's (ACTH) ADH

Until blood gas can be measures, what oxygen therapy should be initially started

24 or 28%

What is the main indication for low concentration oxygen therapy

Hypercapnia

When should Oxygen therapy be considered in patients with COPD

PaO2 < 7.3 kPA when stable and do not smoke

What is a contraindictaion to using IV Adenosine for supreventiruclar tachycardia

Asthma- use verapamil

Signs of supraventricular tacchycardia in an ECG

Absent p waves and sinus tacchycardia

Management of a suspected tension pneumothorax

NO chest x ray needed 14G cannula needle decompression

First line management of a primary pneumothorax with rim of air <2cm

Dishcarge + X-Ray

Management of a primary pneumothorax with >2cm air rim

Aspiration

If aspiration fials, what is second line treatment of a primary pneumothorax

Chest Drain

First line management of a secondary pneumothorax if >50 and rim of air >2cm

Chest drain

Management of a secondary pneumothorax if rim of air 1-2cm

Aspiration

On an X-ray reading, what differentiates between a penumothorax and tension pneumothorax

Trachea not deviated vs devaited trachea

What medication improves motor symptoms in Parkinson'

Levodopa

What type of nutrition is given to patients with motor neurone disease

Percutaneous gastrostomy tube

First line management of asystole

Chest compression and ventilation

Once chest compressions and ventilation are started, what should be done in asystole

IV Adrenaline/epinerphine

Investigations of an unprovoked DVT

CT of the abdomen and pelvis

Log term anticoagulation for people with mechanical valves

Aspirin + Warfarin

What anaesthetic airway device protects the lungs from stomach contents

Tracheal tube

What is the first investigation for someone with a suspected PE

First do a chest X-Ray to rule out other things, then do the well's score

INvestigation of choice for a thyroid neck swelling

USS of the neck

What are the maintenance fluid requirmenets for someone with underlying cardiac disease

20-25ml/kg not 25-30

What needs to be monitored in someone with MG exacerbation

FVC

Most common cause of cellulitis

Strep pyogenes

Drainage of the ovary

Para-aortic nodes

How to calculate GCS

Eye: None Opens to pain Open to commands or speech Open spontaneously Motor: No motor response Extensors response Abnormal flexion Withdraws from pain Moves purposefully to painful stimulus Obeys commands

WHat is diagnostic for nephrotic syndrome

Renal biopsy

What is the initial screening tool for Syphillis

EIA

What is used to monitor syphillis

RPR (decreasing means succerssful treatment)

Management of asymptomatic aortic stenosis

If LV function is impaired (less than 55%) - they need to be referred for aortic valve replacement Signs of Heart Failure with AS

At what mean gradient across the aortic valve, should someone be referred for aortic valve replacement

>40 mmHg

Complication of aortic stenosis

Herat Failure

What is the most likely outcome of HZV opthalmicus

Usually complete resolution with no sequelae

What is the normal urine output

800 to 2,000 mls a day

PTH levels in primary hyperparathyroidism

NORMAL

Species that causes Infective endocarditis in IVDU users

Staph aureus Strep viridian's - dental care

What fibre deficiencies can cause colon cancer

Fibre Folate Calcium

What chronic condition can cause colic cancer

UC and Crohn's DM

Clinical features of right colon cancers

Weight loss Anaemia Masses

Clinical features of left colon cancers

Increased frequency of stools (change in bowel habits) Bowel obstruction Rectal bleeding

First line investigation for colon cancers

Proctoscopy with or without sigmoidoscopy

Sounds heart in a ventricular septal rupture

Sudden harsh pan systolic murmur at the apex

Clinical features of a ventricular septal rupture

Sudden angina/hypotension and pulmonary oedema

Clinical features of a free wall rupture (MI)

Cardiac tamponade

How do we diagnose a pseudo aneurysm

ECHO

Management of a papillary muscle rupture

Mitral valve replacement - cause mitral regurgitation (pan systolic murmur)

Most common type of arrhythmia seen post MI

Ventricular fibrillation

Management of obesity (25-29.9)

General advice on lifestyle;e

management of obese people with 27 BMI + Diabetes, HTN or dysplipidaemia

Consider Orlostat (definitive management at 30+)

Management of Obesity in T2DM with BMI 30-35+

Refer to bariatric surgery

Management of BMI >40 with no other health issues

Consider bariatric surgery Definitive first line if BMI is over 50

Management of asymptomatic AF

As long as rate is controlled - no further treatment is needed

Management of cord compression in palliative care

Radiotherapy and then bisphosphonates

What lobe of the brain does Alzheimer's effect

Temporal lobe

Management of pain postoperatively in people with respiratory distress risk

Epidural anaesthesia