Passmed Flashcards
1
Q
How does oesophagitis present
A
Odonyphagia
Dysphagia
Systemically well
2
Q
Risk factors for oral candidiasis
A
HIV
Steroid inhalers
3
Q
Difference between primary and secondary addisons
A
Primary problem is at level of adrenals
Secondary problem is at level of pituitary
4
Q
Causes of primary adrenal insufficiency
A
TB
Autoimmune
Metastasised cancer
Waterhouse friederichsen syndrome
5
Q
Causes of secondary addisonian insufficiency
A
Tumours, radiation and infiltrative diseases of pituitary
6
Q
In which type of adrenal insufficiency is hyperpigmented skin seen
A
Primary
7
Q
What is most common complication of meningitis
A
Sensorineural hearing loss
8
Q
Complications of meningitis
A
Sensorineural hearing loss Intracerebral abscess Sepsis Hydrocephalus Epilepsy
9
Q
If have acute mastoiditis what is most important cause to rule out
A
Meningitis
10
Q
What factors would suggest rythm control as opposed to rate
A
Under 65
Symptomatic
Secondary to identifiable source like alcohol
First presentation
11
Q
What factors would suggest just rate control in a fib
A
Over 65
IHD history
12
Q
What is drug given in HF for AF
A
Digoxin
13
Q
Alternatives to beta blockers in AF rate control
A
CCB
Digoxin
14
Q
Rythm controlling drugs AF
A
Flecainide
Amiodarone
Sotalol
15
Q
Does ablation reduce stroke risk
A
No- must anticoagulate still for life
16
Q
If having ablation what is preparation
A
Anticoagulate for 4 weeks
17
Q
Complications of ablation
A
Cardiac tamponade
Pulmonary valve stenosis
Stroke
18
Q
What gives AF or an SVT a broad complex tachycardia
A
A bundle branch block
19
Q
Treatment for torsades des pointes
A
IV magnesium sulphate
20
Q
Contraindications for a chest drain
A
Bullae
INR less than 1.3
Platelets less than 75
Pleural adhesions
21
Q
What test is used to diagnose herpes
A
Nucleic acid amplification test
22
Q
Stage 1 AKI
A
Creatinine 1.5-1.9 x baseline
23
Q
Stage 2 AKI
A
Creatinine 2.0-2.9x baseline
24
Q
Stage 3 AKI
A
Creatinine >3X baseline or on RRT
25
What does tumour lysis syndrome lead to
AKI
26
Affected motility in ank spond
Reduced lateral flexion
| Reduced forward flexion
27
What happens to spine shape in ank spond
Loss of lumbar lordosis
| Accentuated thoracic kyphosis
28
What is main valvular disease associated with ehlers danlos
Mitral regurg
29
In questions how does ehlers danlos present
Hypermobility of joints
| Striae
30
What type of disorder is ehlers danlos
Collagen disorder
31
First line treatment for all generalised seizures
Sodium valproate
32
First line treatment for all focal seizures
Carbamezapine
33
Second line tx for tonic clonic seizures
Lamotrigine
34
Problem with carbamezapines for generalised seizures
Can exacerbate absence and myoclonic seizures
35
What does it mean if glucose unrecordable
That its extremely high not low as can always be measured no matter how low
36
Pathophysiology of DKA
Insulin should inhibit lipolysis but this process becomes poorly controlled leading to conversion of fatty acids to ketones
37
If patient has low GRACE risk what do
Dual antiplatelets
38
In NSTEMI and UAP when would you not immediately give fondaparinaux
If having PCI soon
39
When must EBV testing be done
In second week of disease
40
What is NICE diagnostic criteria for EBV
Monospot and FBC in second week of disease
41
Which are 2 beta blockes shown to improve mortality in HF
Carvedilol
| Bisoprolol
42
Causes of hyposplenism
Coeliac disease
| Splenectomy
43
Blood film findings of hyposplenism
```
target cells
Howell-Jolly bodies
Pappenheimer bodies
siderotic granules
acanthocytes
```
44
Investigations for subacute thyroiditis
ESR
| Iodine 131 radiouptake
45
Iodine 131 radio uptake finding de quervains
Reduced globally
46
Management of subacute thyroiditis
NSAIDS
| Normally self limiting
47
What is name of thyroid iodine 131 uptake scan
Thyroid scintigraphy
48
If present with STEMI after 12 hours what would indicate PCI
Cardiogenic shock
| On going ST elevation
49
What is associated spleen complication of coeliac
Hyposplenism
50
What do you do for someones regular insulin in DKA
Stop short acting and continue long acting insulin
51
What happens to PR segment in pericarditis
PR segment depression
52
If a patient has antiphospholipid syndrome and severe new onset headache what is most likely cause
Cavernous sinus thrombosis
53
Medical causes of third nerve palsies
DM
| Vasculitis
54
Associated conditions of IgA nephropathy
alcoholic cirrhosis
coeliac disease/dermatitis herpetiformis
Henoch-Schonlein purpura
55
Most common exacerbating organism for COPD and bronchiectasis
Haemophilus influenzae
56
Who is isolated systolic HTN seen in
The elderly
57
How is isolated systolic HTN managed
Same as normal HTN
58
How should patients on methotrexate or other immune modifying drugs be managed when have gastroenteritis
Stool sample and abx
59
Which BP drug gives cold peripheries
Beta blockers
60
Management of idiopathic bilateral adrenal hyperplasia
Spironolactone
61
What is conns syndrome
Aldosterone producing adenoma
62
What is most common cause of primary hypperaldosteronism
Idiopathic bilateral adrenal hyperplasia
63
2 most common cause of primary hyperaldosteronism
Idiopathic bilateral adrenal hyperplasia
| Conns syndrome
64
How does primary aldosteronism present
HTN
| Hypokalaemia sx like polyuria and weakness
65
First investigation for suspected primary hyperaldosteronism
Aldosterone/renin ratio
66
Rfx for carpal tunnel
Pregnancy
Diabetes
Acromegaly
67
2 tests for carpal tunnel
Tinnels- tap on the wrist to elicit tingling
| Phalensflexion of hands for 1 minute against eachother
68
What drug can lead to post prandial hyperglycaemia problems
Thiazides
69
When can aspirin only be given in stroke
Once CT performed
70
Most common source of mets to brain
Lung
71
What is test used to track eradication of H pylori
urease breath test
72
What conditions are associated with thymomas
MG
SLE
SIADH
Dermatomyositis
73
In NSTEMI if is high risk of bleeding what is given alongside aspirin
Clopidogrel
74
In NSTEMI if is no high risk of bleeding what is given alongside aspirin
Ticagrelor
75
How does a myxoedema coma tend to present
Confusion
| Hypothermia
76
How can macrocytic anaemia be classified
Megaloblastic
| Normoblastic
77
What rythm control is used AF in HF
Amiodarone
78
What antibiotic most commonly cause C diff
Ceftriaxone
79
What causes painful stiff joint after trauma in young person with normal x ray
Haemophilia A
80
Management plan for inducing remission crohns
1st line- glucocorticoids
2nd line- 5-ASA drugs
3rd line- mercatopurine or azathioprine/methotrexate
81
Management plan for maintaining remission crohns
1, azathioprine or mercatopurine
| 2. methotrexate
82
What causes recurrent hypoglycaemia in a chronic T1DM sufferer
Neuropathy of autonomic NS
83
Most important dietary tip with ascites
Restrict sodium
84
What is headache with swinging fever typically
Brain abscess
85
Causes of hypoglycaemia
```
Too much insulin
Missing meals
Liver disease
Insulinoma in pancreas
Autonomic neuropathy in long term T1DM
```
86
How does UC appear on barium swallow
loss of haustrations
superficial ulceration, 'pseudopolyps'
long standing disease: colon is narrow and short -'drainpipe colon'
87
What are fusion and capture beats
When P wave and QRS complex merge often seen in VT
88
When are only times try to manage rythm in AF
If HF
First presentation
Is reversible cause
89
What are 4 types of AF
First time detected
Paroxysmal
Permenant
Persistent
90
What is paroxysmal AF
Recurrent episodes that termiante spontaneously lasting less than 7 days
91
What is permenant AF
When AF refractory to cardioversion so is continuous
92
What is persistant AF
Episodes of AF lasting more than 7 days that dont spontaneously terminate
93
What is likely cause of parkinsons in a young person
Wilsons
94
What shows a starry night appearance on histology
Burkitts lymphoma
95
What presents with tall R waves in leads V1-4
Posterior MI
96
Features of beta thalassaemia trait
Disproportionate microcytic anaemia
| Raised HbA2
97
Causes of resp alkalosis
```
anxiety leading to hyperventilation
pulmonary embolism
salicylate poisoning early on
CNS disorders: stroke, subarachnoid haemorrhage, encephalitis
altitude
pregnancy
```
98
Wihch cause of nephrotic syndrome has strong association with malignancy
Membranous change nephropathy
99
What is PTH in tertiary hyperparathyroidism
Massive
100
O/E of liver abscess
RUQ tenderness
Fever
Hepatomegaly
Jaundice
101
Risk factors for liver abscess
Underlying biliary tree disease
Intrahepatic procedures
DM
102
When cant aspirate liver abscess
If entamoeba suspected
103
Main way to tell if ramsay hunt syndrome
Vesicles in ear
104
What presents with red eye lids
Blepharitis
105
Management abx for COPD infective excacerbation
Amox then either clarithomycin or doxycycline
106
If Chad Vasc score is 0 in recently diagnosed AF what is next step in management
Do an echo to exclude valvular disease
107
What is main condition get torsades des pointes from
Long QT
108
How to assess volume status
Skin turgor
Mucosal membranes
Look at BP and HR
Cap refill
109
What can cause ST elevation with no coronary blockage
Takotsubo
110
What is drug given in myxoedema coma
Liothyroxine as is active T3
111
What type of MI do you often see new onset HB
Inferior as AVN is supplied by RCA
112
What oxygen should all critically ill COPD patients be given
15L as hypoxia kills
113
What causes AKI in patients who have fallen and been there dor a while
Rhabdomyolysis
114
Most appropriate fluid replacement in rhabdomyolysis
Normal saline
115
What happens to calcium in rhabdomylolysis
Low as binds to myoglobin
116
What happens to phosphate in rhabdomyolysis
High as releases from myocytes
117
What can give disproportionately high creatinine
Rhabdomyolysis
118
What is eplerenone
Aldosterone antagonist
119
First line management of HF long term
Beta blocker or ACEi- ideally just start 1 at a time
120
Second line management of HF long term
K+ sparing diuretics
121
What must be measure constantly when on spironolactone or eplerenone
K+ levels
122
Third line management of HF long term
Done by specialist
- digoxin
- resynchronisation therapy
- ivabradine
- hydralazine if afro carribean
123
What is management plan of someone in acute heart block
Atropine if bradycardic
| External pacing
124
SEs of hypothyroid therapy
hyperthyroidism: due to over treatment
reduced bone mineral density
worsening of angina
atrial fibrillation
125
How long must patient eat gluten for before being tested
6 weeks
126
Thing to remember with 80 in CORD-80
If over 80 and stage 1 dont treat
127
If COPD isnt a chronic retainer what is O2 sats target
94-98
128
How to tell from ABG if chronic retainer of CO2
Look if HCO3 raised
129
What condition is associated with takayashus
Renal artery stenosis
130
Which thyroid cancer appears in young females
Papillary
131
Which is heart site where have problem of supplied by 80% in most people and 20 in others
Posterior
Circumflex in 80%
Right in 20%
132
Which blood test is most useful in eliciting cause of hypocalcaemia
PTH
133
What are 3 early signs of haemochromatosis
Erectile dysfunction
Arthralgia
Fatigue
134
Other than hands what can an essential tremor affect
The vocal chords- see change in voice
135
Gold standard diagnosis for PSC
MRCP
136
Management of psittacosis
Doxycycline 1 st line
| Erythomycin 2nd line
137
In an asymptomatic patient how many abnormal Hba1c's are needed
2
138
What causes SOB in Lupus
Pleursiy
139
In SLE what are the types of pleural effusion
Exudative
140
How often can you repeat adrenaline in anaphylaxis
Every 5 mins
141
What commonly do children with migraines also have
GI disturbances
142
Complications of mycoplasma pneumonia
Haemolytic anaemia
Erythema multiforme
GBS
143
What electrolyte disturbances does long term PPI use cause
Hypomagnesia
| PPIs
144
Causes of AKI if had resp infection 3 weeks ago and started on abx
Could be post strep glomerulonephritis
| ATN from abx
145
How does ATN respond to fluids
Very poorly
146
CNS complications of HIV
Toxoplasmosis
| CNS primary lymphoma
147
How to differentiate CNS lymphoma from toxoplasmosis in HIV patient
CNS lymphoma normally only one lesion
148
What is buergers disease also caused
Thromboangiitis obliterans
149
What is main risk factor for buergers disease
Smoking
150
How does buergers disease present
Raynauds phenomena
| Limb ischaemia signs
151
Strongest risk factor for bell palsy
Pregnancy
152
Which dementia tends to have the most fluctuating episodes of cognition
LBD
153
NICE definition of NASH
Must have consumption of less than 20g (2.5 units) per day in women, and less than 30g (3.75 units) per day in men
154
If started on PPIs for suspected GORD and they dont work what is next management
Test for H pylori
155
What is difference in use of rockall and batchford
use the Blatchford score at first assessment, and
| the full Rockall score after endoscopy
156
Why is sushi chef significant in dysphagia history
Means eaten a lot of fish that contain nitrosamines a known carcinogen
157
What can stomach fullness in SBA mean
Splenomegaly
158
Management of necrotising fasciitis
IV abx and surgical debridement
159
First line treatment for c diff
Metronidazole then vancomycin if not responding
160
When can aspirin be continued if in AKI
If aspirin is cardioprotective
161
What type of seizure is parasthesia seen in
Parietal
162
What type of seizure are plucking at clothes and hallucinations seen in
Temporal
163
What type of seizures are floaters seen in
Occipital
164
DDx for floaters seen on vision
Epilepsy
165
What are ddx for floaters seen in vision
Migraine
| Epilepsy
166
What is hyperthyroidism even in absence of exopthalmos and pretibial myxoedma
Graves
167
Blood findings of antiphospholipid syndrome
Very paradoxical as have prolonged APTT and reduced plts
168
Way to remember thyroid cancer
Please follow my arse
169
Which thyroid cancer most commonly presents with compression sx
Anaplastic
170
Which thyroid cancer secretes calcitonin
Medullary
171
What arthritis gives pencil in a cup appearance
Psoriatic arthritis
172
Diagnostic test for haemochromatosis
Liver biopsy showing perl stain
| HFE genetic testing
173
Differentials for sun tanning
Haemochromatosis
| Primary addisons
174
What is most common organ causing infection secondary to peritoneal dialysis
Staph epidermis
175
What antibodies are tested for in polymyositis
Anti jo
| Anti Mi 2
176
Which bone does pagets most commonly affect
Pelvis
177
Which bones does pagets generally affect
Pelvis
Long bones
Skull
178
What is prefferred anticoagulant for stroke prevention
Clopidogrel
179
What is second line stroke anticoagulant
Aspirin and MR dipyramidole
180
What happens to complement in SLE
C3 and C4 are very low
181
How long does it take for HIV abs to form
up to 12 weeks
182
Long term management of coeliac
Avoid gluten
| Pneumococcal vaccination
183
What murmur is associated with carcinoid syndrome
Plmonary stenosis
184
Management plan for barretts oesophagus
endoscopic surveillance with biopsies
high-dose proton pump inhibitor: whilst this is commonly used in patients with Barrett's the evidence base that this reduces the change of progression to dysplasia or induces regression of the lesion is limited
Endoscopic surveillance
for patients with metaplasia (but not dysplasia) endoscopy is recommended every 3-5 years
If dysplasia of any grade is identified endoscopic intervention is offered. Options include:
endoscopic mucosal resection
radiofrequency ablation
185
O/E of TB
```
Fever
Bronchial breath sounds
Crackles
Erythema nodosum
Cachexia
```
186
What is cough like in TB
In first 2 weeks dry then becomes productive
187
What is in posterior stroke classification
LOC
Isolated homonymous hemianopia
Cerebellar signs or brainstem signs
188
What is in lacunar stroke syndrome
Full sensory loss
Weakness in 2 together of face arms and leg
Ataxic hemiparesis
189
What are 5 types of lacunar stroke
```
Pure sensory loss
Mixed sensorimotor
Clumsy hand
Ataxic hemiparesis
Pure motor
```
190
What do clumsy hand strokes present with
Dysarthria
| Weakness of hands when epsecially writing
191
What happens in ataxic hemiparesis
Ataxic signs with weakness on that side too- stroke is contralateral
192
What causes flash pulmonary oedema in an MI
Mitral regurg
193
Management of listeria meningitis
Ampicillin plus gentamycin
194
What is aphasia called when lesion on arcuate fasiculus
Conduction aphasia- difficulty repeating self, speech fluent and comprehension intact
195
Causes of hep b flare ups
Alcohol
| Hep D superinfection
196
What ab can be positive in UC
pANCA
197
What cancer does H pylori infection predispose you to
Gastric lymphoma in the antrum
198
How do gastric lymphomas present from H pylori
Fever
Dyspepsia
Wt loss
199
What causes shooting pains after shingles
Post herpetic neuralgia
200
Treatment for post herpetic neuralgia
Amitryptiline
Gabapentin
Duloxetine
If isnt working you switch dont add drugs
201
Examples of neuropathic pain
Trigeminal neuralgia
Diabetic neuropathy
Prolapsed inter-vertebral disc
Post herpetic neuralgia
202
What patch can be used for post herpetic neuralgia
Caspaicin
203
What causes a DKA patient to become confused after being treated
Cerebral oedema
204
Complications of DKA
gastric stasis
thromboembolism
arrhythmias secondary to hyperkalaemia/iatrogenic hypokalaemia
iatrogenic due to incorrect fluid therapy: cerebral oedema*, hypokalaemia, hypoglycaemia
acute respiratory distress syndrome
acute kidney injur
205
What post MI complications leads to persistent ST elevation and LVF
Aneurysm formation
206
What is most sensitive blood part to measure to see if patient with chronic liver disease has progressed to cirrhosis
Platelets less than 90
207
In liver cirrhosis what does LFT picture look like
AST>2XALT
208
How is liver cirrhosis managed
Stop drinking
When first diagnosed OGD to look for varices
US every 6 months to look for liver hepatocellular carcinoma and measure serum AFP
209
Most specific imaging for diagnosing liver cirrhosis
Liver biopsy showing regenerative nodules
210
Modern less invasive way of determining if progressed to cirrhosis
Transient elastography
211
What is transient elastography
US waves is passed through liver and determines how 'elastic' the liver is
212
What is anticoagulation given to severe renal failure patients for a PE
LMWH
213
How does shingles present on chest
Pain precedes the rash
214
Main examination sign for boerhaves perforation
Crepitus over mediastinum
215
What is triad for boerhaves perforation called
Mackler
216
What is in mackler triad
vomiting
thoracic pain
subcutaneous emphysema
217
CXR finding of mitral stenosis
Left atrial enlargement
218
What are main risk factors for dermatomyositis
CTD
| Underlying malignancy from normally ovarian, breast and lung
219
What is main feature of dermatomyositis skin rashes
Photosensitive
220
Investigations for dermatopolymyositis
ANA
Anti Jo 1
Anti Mi 2
221
How do you differentiate between unilateral and bilateral adrenal hyperplasia if CT is unremarkable
Adrenal venous sampling
222
What happens in adrenal venous sampling
Adrenal veins are cannulated
223
If someone with addisons is vomiting in their illness what is management step
Switch to IM steroids
224
How does AIN present
Normally following abx prescription
Widespread erythematous rash
Joint pain
AKI signs
225
Investigations for AIN and findings
```
HTN on obs
Bloods
- eosinophilia
- mild AKI
Urinalysis
- white cell casts
- sterile pyuria
```
226
What is 4th heart sound heard in
HTN
Aortic stenosis
HOCM
227
Investigations for a vestibular schwannoma
audiogram and gadolinium-enhanced MRI head scan
228
For stable angina what CCB must be given alongside a beta blocker
Amlodipine or nifedipine
229
If on a CCB monotherapy in stable angina what drugs can be given
Verapamil or diltiazem
230
Why cant beta blockers and verapamil/diltiazem be given together
Risk of complete HB
231
If patient with stroke is under 55 and ECG shows no abnormalities what is next investigation
Autoimmune and thrombophilia screen
232
What causes excess bleeding in the elderly with increased APTT
Acquired haemophilia
233
What can cause acquired hemophilia
Malignancy
Pregnancy
Old age
234
What is the hepatomegaly in budd chiari
Tender
235
If spirometry is negative for suspected asthma what is next step
FeNO testing as asthma cant be ruled out
236
What is used for rate control in AF if b blockers contraindicated
CCB like diltiazem
237
What is whipples triad
hypoglycaemia with fasting or exercise
reversal of symptoms with glucose
recorded low BMs at the time of symptoms is hallmark for an insulinoma
238
What are insulinomas associated with
MEN
239
What is electrical alternans seen on ECG of
Cardiac tamponade
240
How to differentiate between ATN and AIN on standard urine dip
AIN has high WCC
241
What presents with more pain on swallowing saliva
Globus pharyngis( feeling of lump in throat)
242
What tumours are NF1 associated with
phaeochromocytromas
243
How does NF1 affect children
Can delay growth
244
How can sepsis affect neutropenic count
Neutropenia
245
What tends to precipitate G6PD crises
Broad beans
Ciprofloxacin
Quinines
246
What can be done to prevent SVTs from happening
Beta blockers
| Ablation
247
What drug is contraindicated in VT
Verapamil
248
Other than myelofibrosis what else can PCV transform to
AML
249
What is first investigation for a thyroid nodule
Ultrasonography
250
If a black diabetic is diagnosed with HTN waht drug started on
ARB
251
If patient needs to be cardioverted in 3 weeks due to AF sx>48hrs what is management
Oral anticoagulation
Bisoprolol
DC cardioversion in 3 weeks not chemical as if sx over 2 days then has to be DC
252
What is seen in mouth of someone with haemochromatosis
Grey slate areas
253
Investigations ordered for haemochromatosis
```
Bloods
- serum transferrin and TIBC low
- Hba1c up
HFE gene testing
Liver biopsy and MRI can show iron concentrations in liver
```
254
What tests can be used to measure iron in liver
MRI
| Biopsy
255
What valvular disease can pulmonary HTN cause
Tricuspid regurg
256
What are investigations for wilsons
Bloods- low serum copper, high blood free copper, low caeruplasmin
Liver biopsy showing high copper conc
MRI of brain showing face of giant panda sign, typically affects basal ganglia
257
What is face of giant panda seen in
Wilsons disease
258
Which thyroid cancer spreads quickly to lymph nodes
Papillary
259
What is management of severe c diff infection ie with hypotension
Metro and vanco
260
What is livedo reticularis seen in
Anti phosopholipid syndrome seen in
261
What is done immediately for unstable NSTEMI patients
PCI
262
If in status elipticus what are 2 things to immediately rule out
Hypoxia
| Glucose problems
263
Aneurysm in what artery tends to cause third nerve palsy
Posterior communicating
264
What can lead to elevated CK
Polymyositis
265
What tends to cause polymyositis
Underlying cancer
266
What gastroenteritis often presents with a flu like prodrome
Campylobacter
267
If thrombolysing a patient what must be given alongside alteplase
An antithrombin drug like enoxaparin
268
Rfx for pseudogout
haemochromatosis
hyperparathyroidism
low magnesium, low phosphate
acromegaly, Wilson's disease
269
How to differentiate between aortic stenosis and aortic sclerosis on auscultation
Sclerosis doesnt radiate to carotids
270
What site of gall stones may prompt surgical intervention
Common bile duct
271
What blood test can differentiate between T1DM and T2DM
C-peptide will be high in T2
272
What is a slit lamp test
Used in wilsons diagnosis- very complicated machine
273
What can be heard on auscultation of pulmonary HTN
Loud S2
274
Prophylaxis of meningitis given to contacts
Ciprofloxacin
275
DDx for acute joint pain
Septic arthritis
Crystal arthritis
Reactive arthritis
Haemoarthritis
276
What is CREST syndrome a subtype of
Limited cutaneous systemic sclerosis
277
What is main complication of diffuse systemic sclerosis
ILD
Others include
Pulmonary HTN
Severe renal disease
278
How does a severe systemic sclerosis renal crisis present
abrupt onset severe hypertension alongside a rapidly progressing, often anuric or oliguric, renal failure
279
What presents with sudden onset headaches and oligouria
Malignant HTN
| Often think about systemic sclerosis
280
What can be seen on x ray of aortic coarctation
Notching of the inferior part of the ribs
281
Which CKD causes lead to enlarged kidneys
Diabetic nephropathy
PCKD
Amyloidosis
282
On MCS of CSF what gives gram positive diplococci/chain
Strep pneumoniae
283
On MCS of CSF waht gives gram negative bacilli
E coli
284
On MCS what gives gram negative coccobacilli
H influenzae
285
On MCS what gives gram positive rod
L monocytogenes
286
What cant be given to patient prior to upper gi endoscopy
PPIs
287
Pneumonia with skin changes
Mycoplasma
288
What can present with sudden onset weight loss
NASH
289
What is given to afro carribean patient moving onto second step of HTN management
ARB not ACEi
290
What causes nephrotic syndrome in a 30 year old male
FSGS- can be often idiopathic
291
Cuases of predominantly hypercholesterolaemia
nephrotic syndrome
cholestasis
hypothyroidism
292
Causes of predominantly hypertriglyceridaemia
```
diabetes mellitus (types 1 and 2)
obesity
alcohol
chronic renal failure
drugs: thiazides, non-selective beta-blockers, unopposed oestrogen
liver disease
```
