Past paper pop quiz 4 Flashcards Preview

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Flashcards in Past paper pop quiz 4 Deck (32)
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1

How do the 2 forms of systemic sclerosis differ?

Limited: face + limbs distal to knees + elbows 'CREST'
Diffuse: entire body

2

What are the features of limited systemic sclerosis?

Calcinosis
Raynaud’s phenomenon
oEsophageal dysmotility
Sclerodactyly
Telangiectasia

3

How does a tension pneumothorax arise?

When damaged area of pleura forms a 1-way valve resulting in the progressive accumulation of air in the pleural space

4

What is a positive Brudzinskis sign?

Passive flexion of neck causes involuntarily flexion of hip.

5

What is a positive Kernigs sign?

Lying supine, with hip flexed + knee flexed at 90 degrees to the hip joint.
Passive extension of knee causes pain

6

What 2 signs may be seen in MS?

Uhthoff’s sign: Worsening of neuro symptoms when body is overheated
Lhermitte’s sign: flexion of the neck causes a shooting pain running down the spine.

7

How are haemodynamically unstable patients in AF treated, irrespective of the time of onset?

DC cardioversion.

8

How are stable patients with AF presenting within 48 hours of onset treated?

DC cardioversion or chemical cardioversion

9

How are stable patients with AF presenting >48 hours since onset be treated?

Anticoagulation, using LMWH followed by warfarin, for > 3 weeks before elective cardioversion.

10

Name 2 drugs that can be used for chemical cardioversion

Flecainide- contraindicated in those with hx of IHD
Amiodarone.

11

Describe the pattern of features in MEN2a. What acronym can be used for this?

Thyroid: Medullary thyroid cancer
Adrenal: Phaeochromocytomas
Parathyroid hyperplasia
TAP

12

What could you investigate if you suspected a Phaeochromocytoma?

24 hr urine metanephrines

13

Which virus is implicated in ~50% of cases of Hodgkin’s lymphoma

EBV

14

List 6 causes of a high SAAG

Portal HTN
Cirrhosis
Constrictive pericarditis
Congestive cardiac failure
Budd-Chiari syndrome
Hepatic venous obstruction

15

List 5 causes of a low SAAG

Nephrotic syndrome
Malignancy
Pancreatitis
Infection
Bowel obstruction

16

What are the lower urinary tract symptoms?

FUN (storage/ irritative) WISE (Voiding/ obstructive)
Frequency
Urgency
Nocturia
Weak stream
Intermittency
Straining
incomplete Emptying

17

Name 2 causes of a prolonged PT

Warfarin (depletion of factors II, VII, IX + X)
Liver disease

18

Name 3 causes of a prolonged APTT

Heparin
Haemophilia A (factor VIII)
Haemophilia B (factor IX)

19

What clotting results are seen in haemophilia A and B?

Prolonged APTT
Normal PT

20

Give 2 indications of a ruptured abdominal aortic aneurysm

Sudden-onset flank pain
Features of circulatory collapse (e.g. tachycardia + hypotension)

21

In a patient with perforated diverticulitis what is the most appropriate procedure?

Hartmann's procedure
Removal of sigmoid colon with formation of a rectal stump + end colostomy.
Allows time for inflammatory process to resolve + can be reversed, forming an anastomosis.

22

What condition may present with paresis, weakness, sensory loss, sphincter dysfunction and erectile problems?

Spinal cord compression

23

How can you distinguish between acute cord compression (Cauda equina) and gradual cord compression (spinal stenosis)?

Acute: LMN signs
Gradual: UMN signs

24

What mnemonic can be used to remember the major criteria for rheumatic fever?

JONES:
Joints (arthritis)
O – looks like a heart (carditis e.g. tachycardia, murmurs)
Subcutaneous Nodules
Erythema marginatum (a rash with red, raised edges + clear centre)
Sydenham’s chorea (involuntary semi-purposeful movements)

25

What is rheumatic fever usually caused by?

Streptococcus pyogenes

26

Where do testicular tumours spread? What symptom may this occasionally cause?

Para-aortic lymph nodes
(may cause backache)

27

Define the parameters for type 1 and type 2 respiratory failure?

Type 1: PaO2 < 8 kPa, PaCO2 = normal
Type 2 = PaO2 < 8 kPa + PaCO2 > 6 kPa

28

What is an anal fissure?

Painful tear in squamous lining of lower anal canal

29

Give 4 features of an anal fissure?

Pain on defecation
Bright red blood streaked on toilet paper/ stools but not mixed in with the stools.
Low fibre diet
Poor fluid intake
(May be constipated + strain at the stool)

30

What triad characterises Felty's syndrome?

Rheumatoid arthritis
Splenomegaly
Neutropenia