Procedures

Question 1

What medications can be given via SC injection?

Answer 1

LMWH and insulin

Question 2

At what angle do you pierce the skin for a SC injection?

Answer 2

45 degrees

Question 3

What are 4 causes of tachycardia?

Answer 3

anxiety, supraventricular tachycardia, hypovolaemia, hyperthyroidism

Question 4

What are 4 causes of bradycardia?

Answer 4

healthy athletic individuals, atrioventricular block, medications, sick sinus syndrome

Question 5

What is a cause of bradypnoea?

Answer 5

opiate overdose

Question 6

What is a cause of tachypnoea?

Answer 6

acute asthma

Question 7

What are causes of low specific gravity in urine?

Answer 7

conditions that result in the production of dilute urine such as diabetes insipidus and acute tubular necrosis

Question 8

What are causes of raised specific gravity in urine?

Answer 8

Conditions that result in the production of strong urine dehydration, glycosuria (e.g. diabetes mellitus) and proteinuria (e.g. nephrotic syndrome)

Question 9

What causes raised nitrites in urine?

Answer 9

Nitrites are a breakdown product of gram-negative organisms such as E.Coli: UTI

Question 10

What can altered levels of urobilinogen in the urine be caused by?

Answer 10

The presence of increased levels of urobilinogen in the urine can be caused by haemolysis (e.g. haemolytic anaemia, malaria).
Low levels of urobilinogen can be caused by biliary obstruction.

Question 11

What does raised leukocyte esterase in urine indicate?

Answer 11

Leukocyte esterase is an enzyme produced by neutrophils and therefore, when positive, it indicates the presence of white cells in the urine:

Question 12

What is right axis deviation associated with?

Answer 12

right ventricular hypertrophy

Question 13

What does a prolonged PR interval suggest?

Answer 13

AV block

Question 14

What is a first degree heart block?

Answer 14

a fixed prolonged PR interval

Question 15

What is second degree heart block also known as?

Answer 15

Mobitz typwe 1 heart block or Wenckebach phenomenon

Question 16

What are typical ECG findings in Mobitz type 1 AV block?

Answer 16

include progressive prolongation of the PR interval until eventually the atrial impulse is not conducted and the QRS complex is dropped
AV nodal conduction resumes with the next beat and the sequence of progressive PR interval prolongation and the eventual dropping of a QRS complex repeats itself.

Question 17

What is a delta wave on an ECG?

Answer 17

A delta wave is slurring of the upstroke of the QRS complex. This occurs because the action potential from the SAN is able to conduct to the ventricles very quickly through the accessory pathway, and thus the QRS occurs immediately after the P wave, making the delta wave.

Question 18

What could be a cause of a tall QRS complex on an ECG?

Answer 18

vetricular hypertrophy

Question 19

What can isolated Q waves indicate?

Answer 19

they can be normal

they can indicate a previous MI

Question 20

What does ST depression show?

Answer 20

ST depression ≥ 0.5 mm in ≥ 2 contiguous leads indicates myocardial ischaemia.

Question 21

What are some causes of tall T waves?

Answer 21

Hyperkalaemia (“tall tented T waves”)

Hyperacute STEMI

Question 22

What may flattened T waves represent on a ECG?

Answer 22

Flattened T waves are a non-specific sign, that may represent ischaemia or electrolyte imbalance.
These become larger the slower the bradycardia

Question 23

What view of the heart do leads V1 and V2 represent?

Answer 23

septal

Question 24

A patient is noted to have an abnormally shortened PR-interval on their ECG. What is the most likely cause?

Answer 24

Wolff-Parkinson-White syndrome

Question 25

What view of the heart do leads I, aVL, V5 and V6 represent?

Answer 25

lateral

Question 26

What would it suggest if lead I became more positive than lead II and lead III became negative?

Answer 26

left axis deviation

Question 27

What view of the heart do leads V3 and V4 represent?

Answer 27

anterior

Question 28

What view of the heart do leads II, III and aVF represent?

Answer 28

inferior

Question 29

Name all 4 views of the heart and the corresponding leads.

Answer 29

Septal - V1 and V2 Anterior - V3 and V4 Inferior - II III avF Lateral - I avL V5 V6

Question 30

What may ST depression be caused by?

Answer 30

ischaemia

Question 31

What might hypercalaemia show up on an ECG?

Answer 31

short QT

Question 32

What may a prominent U wave on a ECG be caused by?

Answer 32

hypokalaemia

Question 33

What can S1Q3T3 be caused by?

Answer 33

PE

Question 34

What may pericarditis show up on the ECG?

Answer 34

PR depression and saddle shape ST interval

Question 35

What is the FEV1/FEV ratio in obstructive disease?

Answer 35

reduced because FEV1 is low but FEV is normal

Question 36

What is the FEV1/FEV ratio in restrictive disease?

Answer 36

normal because both FEV1 and FEV are reduced

Question 37

Give some examples of obstructive lung disease

Answer 37

asthma, COPD, bronchiestasis, CF

Question 38

Give some examples of restrictive lung disease

Answer 38

obesity, spinal abnormalities such as kyphosis, ILD, pulmonary fibrosis

Question 39

Which side does the trachea deviate to with a pneumothorax?

Answer 39

away from the pneumothorax

Question 40

What may a flat diaphragm indicate on a CXR?

Answer 40

COPD

Question 41

What does blunting of costphrenic angles on a CXR show?

Answer 41

pleural effusion

Question 42

What is the meniscus sign?

Answer 42

crescent shape costophrenic angle on CXR

Question 43

What can a meniscus sign indicate?

Answer 43

pleural effusion

Question 44

Describe the CXR findings of a patient with heart failure

Answer 44

``` Alveolar shadowing B-lines Cardiomegaly Diversion of blood to upper lobe Effusion ```

Question 45

What may a stable chronic COPD patient ABG result show?

Answer 45

``` pH normal O2 low CO2 high bicarb high resp failure type 2 fully compesated respiratory acidosis ```

Question 46

What may a patient hyperventilating show on an ABG blood test?

Answer 46

``` pH high (alkalosis) O2 high CO2 low bicarb normal respiratory alkalosis lungs overdrive ```

Question 47

What may a heaving apex beat indicate?

Answer 47

aortic stenosis

Question 48

What may a narrow pulse pressure indicate?

Answer 48

aortic stenosis

Question 49

What are some symptoms of aortic stenosis?

Answer 49

syncope, exertional dysponea, angina

Question 50

What are signs of mitral regurgitation?

Answer 50

AF, thrusting displaced apex beat, pulmonary hypertension, palpitations

Question 51

Where might a mitral regurgitation murmur radiate to?

Answer 51

left axilla