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PP2 Flashcards

1
Q

Hypokalaemia effects

A

nephrogenic DI –> polyuria/ polydipsia

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2
Q

ECG changes hypokalaemia

A

U waves, ST depression, flattened T waves, prolonged PR interval

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3
Q

Microscopic Haematuria causes

A

NEPHRITIC SYNDROME/ Urinary tract calculi

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4
Q

Macroscopic Haematuria causes

A

BLADDER CANCER

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5
Q

Young person with Hypertension causes

A
  • Conn’s syndrome
  • Coarction of aorta
  • Renal artery stenosis
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6
Q

Treatment of hyperkalaemia

A

1) 10ml 10% IV calcium gluconate = stabilise myocardium

2) IV insulin + glucose (nebulise salbutamol) = treat hyperkalaemia

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7
Q

Drugs to avoid with AKI

A

aminoglycosides, NSAIDS, ACEi

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8
Q

Criteria for haemodialysis

A

AEIOU
A = metabolic Acidosis
E = electrolytes = hyperkalaemia
I = intoxication = drug overdose
O = refractory pulmonary oedema (fluid overload)
U = uraemic complication (pericarditis, encaphalopathy)

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9
Q

Pleuritic chest pain

A

5 Ps (PE, pneumothorax, pericarditis, pleural effusion, pneumonia) + abcess, rib fracture, costochondritis

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10
Q

Hypertension treatment

A

after ABPM (ambulatory blood pressure monitoring) –> treatment
1) < 55 yrs = ACEi (enalopril) or ARB (losartan)
> 55 yrs/ afro = CCB (amlodipine) or Thiazide diuretic (bendroflumethiazide)
2) (ACEi + CCB) or (ACEi + thiazide diuretic)
3) ACEi + CCB + Thiazide diuretic
4) resistant HTN = spirinolactone

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11
Q

Prostate cancer triad

A

backpain (bone metastasis), hypercalcaemia (paraneoplastic syndrome), FLAWS

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12
Q

Investigations for Prostate Cancer

A

GOLD = transrectal US guided biopsy
Post-diagnosis = CT (local invasion + lymph nodes)
Isotope bone scan = bone metastases
Screening = PSA

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13
Q

Diagnostic criteria for diabetes

A

• One fasting blood glucose measurement > 7 mmol/L in a symptomatic patient (2 asymptomatic)
patient
• One random blood glucose measurement > 11.1 mmol/L in a symptomatic
patient (2 asymptomatic)
• Oral glucose tolerance test – 2 hr blood glucose > 11.1 mmol/L
• HbA1c > 48 mmol/mol or > 6.5%

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14
Q

Lewy body dementia (DLB) triad

A

hallucinations, confusion, resting tremor (parkinsonian sym)

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15
Q

Epi of dementia

A

Alzheimers (1), DLB (2)

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16
Q

Vascular dementia symptoms

Depressive pseudodementia symptoms

A

stroke like symptoms, stepwise decline

depression (trauma) –> dementia like symptoms

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17
Q

What is the red reflex?
what is used to look at it?
what does it mean if you cannot see it?

A

reflextion of light from retina
fundoscope
obscuring retina = cataract (opacified lens) / retinoblastoma (cancer of retina cells)

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18
Q

What is Herpes simplex keratitis

A

infection of cornea –> dendritic ulcer

adults with HSV

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19
Q

Histological differences between:

  • Ulcerative Collitis
  • Crohn’s disease
  • Coeliac disease
  • barrets oesaphagus
A

UC: mucosal ulcers, goblet cell depletion, crypt abcesses
Cr: non-ceseating granulomas
Coeliac: villous atrophy + crypt hyperplasia
Barrets: stratified squamous –> simple columnar

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20
Q

Polycthaemia (increased Hb conc.) types

A

Relative = normal RBC mass BUT decreased plasma volume

Absolute = increased RBC mass

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21
Q

Symptoms of polycthaemia

A

Hyperviscoity (blurred vision, headache, hearing loss)

Pruritus (after hot bath) = scratch marks

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22
Q

Causes of polycthaemia

A 
Primary = low EPO =  Polycthaemia rubra vera (proliferation of myeloid stem cells)
Secondary = high EPO (natural - hypoxia/COPD, artificial - athletes/ blood dopping)
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23
Q

what is subclavian steal syndrome

A

blackout due to stenosis (e.g. compression of rib, lump) of subclavian artery (comes off vertebral artery)
Retrograde blood flow back from brain down vertebral artery to arm (likely to occur when writing - increased demand)

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24
Q

Nephrotic syndrome quartet

A

proteinuria (>3.5g/24hr)
hypoalbuminaemia (<25g/L)
oedema
hyperlipidaemia

25
Q

Causes of nephrotic syndrome

A

Primary renal disease = minimal change disease (kids), membranous nephropathy (adult)
secondary to systemic disorder = SLE, amyloidosis

26
Q

what is Guillian Barre syndrome

A

acute demyelinating polyneuropathy
ascending symmetrical limb weakness –> incontinence
loss of sensation

27
Q

empirical antibiotics = co-amoxiclav + clarithromycin treat?

A

community acquired pneumonia (CAP)

  • co-amoxiclav (strep.pneumonia)
  • clarithromycin (atypical organisms)
28
Q

Co-trimexazole (trimethoprim + sulfamethoxazole) treat?

A

pneumocystitis pneumonia in HIV pts
UTIs
Resp tract infections

29
Q

Metronidazole treat?

A

against anaerobes
severe GI infections (c. difficile colitis)
pelvic inflammatory disease
aspiration pneumonia

30
Q

Flucloxacillin (type of penicillin) treat?

A

against gram +ve bacteria (s. aureus)

skin and soft tissue infection

31
Q

what analgesic is used for post-op pain?

A

morphine sulphate

32
Q

Side effects of morphine sulphate?

A

constipation –> confusion
resp. depression
nausea + drousyness

33
Q

side effects of anti-muscarinics (atropine)?

A

blurred vision

34
Q

side effects of ACEI (enalopril)?

A

cough

35
Q

side effects of B-adrenoceptor agonist (salbutamol)?

A

tremor

36
Q

side effects of ampicillin + amoxicillin (glandular fever)

A

rash

37
Q

Gout (cause, place, investigation)

A
  • monosodium urate crystals
  • metatarsopharyngeal joint of big toes (podagra)
  • synovial fluid aspirate –> polarised microscopy (negative
    befringement and needle shaped crystals)
38
Q

Pseudogout (cause, place, investigation)

A
  • calcium pyrophosphate crystals
  • knees + wrists
  • synovial fluid aspirate –> polarized microscopy (positive
    befringement and rhomboid shaped crystals)
39
Q

Septic arthritis investigation

A

turbid synovial fluid and high WCC

40
Q

what is Adrenal insufficiency?

A

low cortisol and low aldosterone by adrenal glands

41
Q

causes of adrenal insufficiency

A

autoimmune (uk)

TB (worldwide)

42
Q

adrenal insufficiency triad of symptoms?

A

increased skin pigmentation
dark palmar creases
vitiligo

43
Q

investigation of adrenal insufficiency?

A

short Synacthen test (inject synthetic ACTH then see cortisol response) = <550nmol/l after 30 mins

44
Q

Colorectal cancer triad of symptoms

A

change in bowel habit
PR bleed
weight loss

L = early = bowel habit + pr bleed
R = late = abdo pain and anaemic symptoms
45
Q

where is colorectal cancer

A 
1 = rectum
2 = sigmoid colon
3 = caecum
46
Q

investigations of colorectal cancer

A

DRE (1st line)
CEA
Colonoscopy + biopsy (gold)

47
Q

Gastric cancer triad symptoms

A

dyspepsia + vomitting
early satiety + bloating
melaenia

48
Q

Pancreatic cancer + cholangiocarcinoma symptoms

A

courvoisier’s law = painless jaundice + palpable gallbladder

49
Q

cerebral artery blockages and consequences

A

ACA = medial frontal + parietal = behaviour change, weak
contralateral leg > arm
MCA = lateral frontal + parietal = weak contralateral
face > arm > leg, aphasia
PCA = occipital lobe = contralateral half of visual field loss

50
Q

sodium, potassium and calcium levels

A

Na+ : 135-145 mmol/l
K+ : 3.5-5 mmol/l
Ca2+ : 2.2-2.6 mmol/l

51
Q

Hyponatraemia symptoms

A

severe < 120
headache, nauseas, neuro-problesm, cerebral oedema
high lipids can dilute the extracellular fluid = decrease apparent na conc. = erroneus reading

52
Q

lung collapse signs on CXR

A

R upper lobe = golden S sign

L lower lobe = L tracheal deviation, second heart border, sail shape

53
Q

Bowel obstruction cardinal signs

A

vomitting
colicky pain
constipation (absolute)
abdo distention

PMHx of surgery
SB = vomit earlier than LB, pain high in abdo
LB = less vomit, pain constant

54
Q

Investigation of bowel obstruction

A

1st line = abdo XRAY = dilated loops

3(SB)/6(LB)/9(Caecum) rule = normal dilation

55
Q

Management of bowel obstruction

A

ABCDE
Drip (IV) + Suck (NG - aspiration)
Look for peritonism (strangulated/ perforated)

56
Q

surgical indications of bowel obstruction

A

conservative tx not improve in 48hrs
peritonism
palpable mass
virgin abdomen (no previous surgery)

57
Q

Criteria for Congestive cardiac failure

A

Framingham criteria

2 major/ 1 major + 2 minor

58
Q

what is meralgia paraesthesia

A

wt gain/ tighten belts –> injure lateral femoral cutaneous nerve –> numb/ pain of skin outside thigh

59
Q

what causes dilation and hypertrophy of heart

A

dilation (volume overload) = HF

hypertrophy (pressure overload) = HTN, aortic stenosis

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