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Year 3 > PassMedicine > Flashcards

PassMedicine Flashcards

1
Q

Diarrhoea can cause:

  • metabolic alkalosis
  • metabolic acidosis
A
  • metabolic acidosis
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2
Q

Vomiting can cause:

  • metabolic alkalosis
  • metabolic acidosis
A
  • metabolic alkalosis
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3
Q

What finding on a blood test would support a diagnosis of lung cancer?

  • raised erythrocytes
  • raised platelets
  • raised lymphocytes
A
  • raised platelets
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4
Q

What is the most appropriate action to take with regards to antidepressant medication prior to ECT treatment?

  • increase the dose
  • decrease the dose
  • stop the medication
  • switch it to a ‘safer’ class
A
  • decrease the dose
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5
Q

Which of the following should be given to all patients with severe or life-threatening asthma?

  • broad-spectrum antibiotic
  • inhaled corticosteroid
  • nebulised ipratropium bromide
  • IV magnesium sulfate
A
  • nebulised ipratropium bromide
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6
Q

Which of the following spirometry results is most likely in a patient with pulmonary fibrosis?

  • FEV1 = 2.64, FVC = 3.41, TLCO = increased
  • FEV1 = 2.64, FVC = 4.19, TLCO = decreased
  • FEV1 = 2.79, FVC = 3.11, TLCO = increased
  • FEV1 = 2.79, FVC = 3.34, TLCO = decreased
  • FEV1 = 4.21, FVC = 5.10, TLCO = normal
A
  • FEV1 = 2.79, FVC = 3.34, TLCO = decreased

(restrictive pattern FEV1: FVS > 70%), impaired gas exchange - reduced TLCO)

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7
Q

What is the strongest risk factor for anal cancer?

A

= HPV infection

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8
Q

Most common cause of bilateral hilar lymphadenopathy?

A

= tuberculosis (TB)

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9
Q

TB typically causes which of the following on CXR?

  • diffuse fibrosis
  • isolated lower zone consolidation
  • upper zone fibrosis
  • lower zone fibrosis
A
  • upper zone fibrosis
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10
Q

What food should be avoided when taking monoamine oxidase inhibitors?

A

= cheese

(contains tyramine, could cause a hypertensive crisis)

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11
Q

Loperamide act to slow down bowel movements through the stimulation of which receptors?

A

= opioid receptors

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12
Q

Main ECG abnormality seen with hypercalcaemia

  • long QT-interval
  • short QT-interval
  • large T-waves
  • small T-waves
A
  • short QT-interval
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13
Q

What is the mechanism of action of fondaparinux?

  • Reversible direct thrombin inhibitor
  • Glycoprotein IIb/IIIa receptor antagonist
  • Inhibits antithrombin III
  • Inhibits ADP binding to its platelet receptor
  • Activates antithrombin III
A
  • Activates antithrombin III
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14
Q

Stable angina: Verapamil + beta-blockers should not be taken together as this risks,

A

= complete heart block

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15
Q

What is atrial fibrillation?

A

= condition where the electrical activity in the atria becomes disorganised, leading to fibrillation (random muscle twitching) of the atria and an irregularly irregular pulse

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16
Q

Key finding in AF?

A

= irregularly irregular pulse

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17
Q

ECG findings in AF (3)

A
  • no p-waves
  • narrow QRS complex tachycardia
  • irregularly irregular ventricular rhythm
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18
Q

What is paroxysmal AF?

A

= refers to episodes of AF that reoccur + spontaneously resolve back into sinus rhythm

These episodes can last between 30 seconds + 48 hours

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19
Q

In patients with a normal ECG + suspected paroxysmal AF, what is the next step of investigation?

A

= 24-hour ambulatory ECG (Holter monitor)

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20
Q

In patients who have a reversible cause for their AF, new onset AF (within the last 48 hours), or HF caused by AF. What is the best first-step?

  • rate control
  • rhythm control
A
  • rhythm control
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21
Q

What is usually offered first-line for rate control in AF?

A

= beta-blocker (e.g., Atenolol or Bisoprolol)

22
Q

Rhythm control options in AF (2)

A
  • cardio version
  • long-term rhythm control with drugs
23
Q

How long after AF presents is immediate cardioversion not advised, and delayed cardioversion is best?

A

If AF presents > 48 hours + patient stable opt for delayed cardioversion

24
Q

How long should anticoagulation be given to patient before delayed cardio version?

A

= at least 3 weeks before

25
Q

What is used for long-time rhythm control in AF (first-line)?

A

= beta-blocker

26
Q

AF: What is used for long-time rhythm control in patients who have had successful cardioversion, for maintenance?

  • Amiodarone
  • Adenosine
  • Dronedarone
  • Flecainide
A

= Dronedarone

27
Q

AF: What is used for long-time rhythm control in patients with HF or left ventricular dysfunction?

  • Amiodarone
  • Adenosine
  • Dronedarone
  • Flecainide
A
  • Amiodarone
28
Q

What is used in patients with paroxysmal AF who quality for ‘pill-in-the-pocket’ approach. To terminate AF when they feel symptoms?

  • Amiodarone
  • Adenosine
  • Dronedarone
  • Flecainide
A
  • Flecainide
29
Q

What is used first-line for anticoagulation in patients with AF?

A

= DOACs

30
Q

Apixaban, Edoxaban + Rivaroxaban MOA

  • direct factor Xa inhibitor
  • direct thrombin inhibitor
  • direct factor IX inhibitor
A
  • direct factor Xa inhibitor
31
Q

Dabigatran MOA

  • direct factor Xa inhibitor
  • direct thrombin inhibitor
  • direct factor IX inhibitor
A
  • direct thrombin inhibitor
32
Q

Warfarin MOA

A

= vitamin K antagonist

33
Q

Target INR for patients with AF

A

2-3

34
Q

What is CHA2DS2-VASc score?

A

= tool for assessing whether a patient with AF should start anticoagulation

35
Q

What does CHA2DS2-VASc stand for?

A

C - congenital HF
H - hypertension
A2 - age > 75 (2 points)
D - diabetes
S2 - previous stroke or TIA (2 points)
V - vascular disease
A - age 65-74
S - sex (female)

36
Q

What do CHA2DS2-VASc scores mean?

A

0 – no anticoagulation
1 – consider anticoagulation in men (women automatically score 2)
2 or more – offer anticoagulation

37
Q

Arrangements are made to start PCI and you are asked to prepare the site of insertion.

What is the best site for insertion?

  • brachial artery
  • femoral artery
  • femoral vein
  • jugular vein
  • radial artery
A
  • radial artery
38
Q

Fine end-inspiratory crepitations are suggestive of?

A

= idiopathic pulmonary fibrosis

39
Q

Second most common cancer patients are at risk of developing if they have HNPCC?

A

= endometrial cancer

40
Q

Which of the following are associated with heavy periods?

  • hyperthyroidism
  • hypothyroidism
A
  • hypothyroidism
41
Q

Which SSRI is the recommended choice for children + adolescents?

A

= Fluoxetine

42
Q

After a change in dose, lithium levels should be checked how long after?

A

= 1 week after dose change

43
Q

What type of therapy is helpful in managing personality disorders?

A

= dialectical behaviour therapy

44
Q

When is breast cancer screening offered? And how often?

A

= from 50-70, every 3 years

45
Q

Which of the following is most likely responsible for a metabolic ketoacidosis with normal or low glucose?

  • diabetic ketoacidosis
  • alcoholic ketoacidosis
  • gastroenteritis
  • hyperosmolar hyperglycaemic state
A
  • alcoholic ketoacidosis
46
Q

How long before surgery is Warfarin usually stopped?

A

= 5 days before

47
Q

Which of the following investigations leads to a definitive diagnosis of TB?

  • blood cultures
  • CT of chest
  • Mantoux test
  • Sputum sample
A
  • blood cultures
  • CT of chest
  • Mantoux test
  • Sputum sample
48
Q

Which valve is most commonly affected in infective endocarditis?

A

= mitral valve

49
Q

Most common organism in bronchiectasis exacerbation?

A

= Haemophilius influenzae

50
Q

For COPD patients, what are target oxygen saturations if CO2 is normal on ABG?

A

= 94-98%

Year 3 (10 decks)

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