PTS SBA 2 corrections/notes

Question 1

three cardinal signs of heart failure

Answer 1

shortness of breath, fatigue, ankle oedema

Question 2

first line treatment for patients over 55 or of afrocaribbean descent

Answer 2

CCB- amlodipine

Question 3

6ps of critical limb ischaemia

Answer 3

Pain
pallor
paralysis
paraesthesia
perishingly cold
pulselessness

Question 4

four key features of tetralogy

Answer 4

ventricular septal defect
pulmonary stenosis
hypertrophy of right ventricle
overriding aorta

Question 5

does autoimmune gastritis cause peptic ulcers

Answer 5

NO

Question 6

what is the first line investigation for large bowel obstruction

Answer 6

abdominal xray

Question 7

when do duodenal ulcers cause pain

Answer 7

cause pain several hours after eating as the acid from the stomach passes over it.
the pain is relieved by eating

Question 8

what does blood present on wiping indicate

Answer 8

haemmorhoids

Question 9

will hypervolaemia or hypovolaemia cause AKI?

Answer 9

hypovolaemia

Question 10

why is trimethoprim avoided in pregnancy?

Answer 10

it is teratogenic in the first trimester as it inhibits folate synthesis

Question 11

is nephrotic syndrome associated with polycystic kidney disease?

Answer 11

NO

Question 12

list the risk factors for DVT?

Answer 12

recent surgery, immobilisation/leg fracture, oestrogens, malignancy, history of DVT or PE, long haul flights, inherited thrombophillia

Question 13

what is the treatment for thrombotic thrombocytopenic purpura? (TTP)

Answer 13

URGENT plasma exchange

Question 14

which protein does rituximab target?

Answer 14

CD20! only found on B cells.

Question 15

what does rituximab treat?

Answer 15

non hodgkins lymphoma, CLL

Question 16

treatment for severe/complicated malaria?

Answer 16

IV artesunate

Question 17

what is oral chloroquine used to treat?

Answer 17

uncomplicated malaria

Question 18

what reactions are mast cells found in?

Answer 18

allergic reactions- they release histamine

Question 19

when do neutrophils dominate a reaction?

Answer 19

during acute inflammation

Question 20

which cells dominate chronic inflammation

Answer 20

B lymphocytes, macrophages, T lymphocytes

Question 21

is atrial fibrillation linked to liver failure?

Answer 21

NO

Question 22

which condition are kayser fleischer rings found in?

Answer 22

Wilsons disease- deposits of copper around the iris of the eye

Question 23

how is ascending cholangitis and biliary colic differentiated

Answer 23

ascending cholangitis presents with charcots triad: jaundice, RUQ and fever with rigors.

Question 24

what can alendronic acid cause?

Answer 24

a bisphosphonate: it can cause oesophagitis

Question 25

what is 'pencil in a cup' X ray indicative of?

Answer 25

arthritis mutilans (severe psoriatic arthritis)

Question 26

how does pseudogout present

Answer 26

acute onset monoarthritis, often in the knee. fever unlike gout there is not normally a trigger

Question 27

what are risk factors for pseudogout?

Answer 27

hyperparathyroidism, hypothyroidism, hemochromatosis, electrolyte imbalances such as hypomagnesemia and hypophosphatemia, osteoarthritis, old age and prior joint injury

Question 28

what is the first line treatment for generalised seixures

Answer 28

sodium valporate

Question 29

is an intention tremor (shaking when reaching for something) indicative of PD

Answer 29

NO- a resting tremor (pill rolling) is present in PD

Question 30

what is the differential between compression of spinal cord and cauda equina syndrome

Answer 30

there is sensory loss in compression, one dermatome below the compression.

Question 31

does lymphoedema cause peripheral neuropathy?

Answer 31

no- it is swelling of the arms or legs due removal of the lymph nodes

Question 32

how long can you wait to use ALTEPLASE on a patient with a suspected stroke

Answer 32

should be administered within 4.5 hours of symptoms onset. EXCLUDE haemorrhagic cause first via head CT!

Question 33

what are the most common bacterial organisms which cause infective exacerbations of COPD?

Answer 33

-Haemophilus influenzae (most common cause) - Streptococcus pneumonia - Moraxella catarrhalis Respiratory viruses account for 30% of COPD exacerbations with rhinovirus being the most common viral cause.

Question 34

what is used to asses the support provided to patients with an exacerbation of COPD?

Answer 34

ABG sampling

Question 35

what type of drug is salbutamol

Answer 35

short acting beta agonist- works on beta 2 adrenergic receptors in lungs.

Question 36

what side effects can salbutamol have?

Answer 36

it is not completely selective so can cause tachycardia and a tremor. it can also cause hypokalaemia

Question 37

what is the most common form of lung cancer?

Answer 37

Adenocarcinoma- in both smokers and non smokers.

Question 38

Name the CURB65 criteria

Answer 38

Confusion (<8/10 on abbreviated mental test score) UREA >7mmol/L Resp rate >30/min Blood pressure: systolic <90 mmHg and/or diastolic <60mmHg Aged >65 yo