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1
Q

Wernicke’s encephalopathy triad and cause

Korsakoff syndrome

A

Opthalmoplegia:nystagmus
Ataxia
Confusion

Caused by thiamine deficiency, is life threatening

Korsakoff syndrome is progression of wernicke’s,associated with anterograde amnesia

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2
Q

Examples of air leak syndromes

A

Pneumothorax
Pneumomediastinum
Pneumoperitoneum
Subcutaneous emphysema

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3
Q

Most common cause of lambert eaton myasthenic syndrome

A

Para neoplastic syndrome secondary to small cell lung cancer

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4
Q

6 NOs of aminoglycosides

A

gram Negative Organisms?
NO pregnancy
NO myasthenia Gravis
Nephrotoxic and Ototoxic

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5
Q

Pathogen most responsible for GBS(Guillian barre syndrome)

A

Campylobacter jejuni from old seafood or post URTI

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6
Q

Drug used for chelation in Wilsons disease

A

Penicillamine

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7
Q

Mx of acquired hemochromatosis

A

Therapeutic Phlebotomy( Donating blood) or iron chelation

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8
Q

Methods of immunomodulation

A

Traditional immunosuppressants
Corticosteroids
Biologics

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9
Q

Sepsis 6

A

3+3

3 Mx: Empirical Abx, Oxygen and fluids

3 Invx: Lactate, Urine output and blood culture

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10
Q

Markers of inflammation

A

CRP
ESR
procalcitonin
Ferritin
Albumin(negative phase reactant)

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11
Q

Sx of hyponatremia

A

Seizures
Muscle cramps
Headache
Lethargy
AMS eg confusion, consciousness decreased

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12
Q

Causes of pseudohyponatremia

A

High blood cholesterol or proteins(HLD,hematological)

T2DM

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13
Q

Risk of running IV fluids too fast

A

Cerebral edema

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14
Q

Complications of running overly hypertonic IV fluids

A

Pontine demyelination

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15
Q

Immediate Mx of hyperK

A
  1. Calcium gluconate to stabilise cardiac membrane
  2. Insulin with dextrose to correct electrolytes
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16
Q

Cause of paradoxical aciduria in hypokalemic hypochloremic metabolic alkalosis

A

Body prioritises fluid volume over maintaining pH

At DCT, Na+ is reabsorbed in exchange for H+ and K+

Increased excretion of these leads to hypokalemia with paradoxical aciduria

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17
Q

Winters formula for calculating expected compensation for metabolic acidosis

A

Expected pCO2 =(1.5 X(conc bicarbonate)+8+-2mmHg

Measured>expected: concomitant respiratory acidosis

Expected>measured: compensatory respiratory alkalosis

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18
Q

Anion gap formula

A

Na-Cl-HCO3

Nornal is 5-14, measures unmeasured anions

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19
Q

Metabolic effects of salicylate poisoning

A

Metabolic acidosis with respiratory alkalosis

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20
Q

Causes of peripheral cyanosis

A

Cold environment
Hypothermia
Fever
Sepsis
Shock(except distributive)
Hypoglycemia
Acrocyanosis
Raynaud phenomenon

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21
Q

Anion gap formula

A

Na+K-Cl-Bicarb

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22
Q

4 Ts of mediastinal masses

A

Thyroid
Thymoma
Teratoma
Terrible Lymphoma

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23
Q

Holliday Segar method

A

4 2 1 or 100/50/20

24
Q

Caveats to Holliday Segar method

A

Renal failure
Cardiac failure
Neonates
Obese patients

25
Q

Immobility precautions

A

Wind,water and wound

Pneumonia/Atelactasis, UTI and decubitus ulcers

26
Q

Drugs for treatment of osteoporosis

A

Anti resorptives:bisphosphonates and denosumab

Osteoblast stimulants: Teriperatide(shown to be more effective)

27
Q

Histology of Henoch Schonlein Purpura

A

IgA deposits

28
Q

Types of large vessel arteritis

A

GCA and Takayasu

29
Q

Types of Medium vessel arteritis

A

Kawasaki and PAN

30
Q

Types of small vessel arteritis

A

IgA vasculitis, Polyangiitis

31
Q

Variable vessel Vasculitis

A

Behcet and Cogans

32
Q

Cx of Necrotising Fasciitis

A
  1. Sepsis
  2. Renal failure
  3. Severe scarring
  4. Limb loss?
33
Q

Risk factors for necrotising fasciitis

A
  1. Chronic disease eg DM, Malignancy
  2. Peripheral vascular disease
  3. Chronic alcoholism
  4. Malnutrition
  5. Obesity
  6. Trauma/Iatrogenic
  7. Varicella
34
Q

Vaccinations for herpes zoster

A

Shingrix: 2 doses of recombinant inactivated virus

Zostavax: Live vaccine

35
Q

What to look for on PE and CXR in Suspected pneumothorax or pleural effusion

A

Tracheal deviation

36
Q

Causes of bilateral LL swelling

A

Pitting
- cardiac
- Liver
- Renal
- drugs eg CCB

Non pitting
- pretibial myxedema
- lympedema
- venous insufficiency

37
Q

How to screen microvascular cx of DM

A

Eye: vision changes, past laser, past injections

PVD: prev amputations

38
Q

Causes of chlye in uria

A

CCBs and one other drug?
Parasites: filiariasis
Thoracic duct obstruction

39
Q

Examples of negative phase reactants

A

Albumin
Ferritin
Uric acid
Lipid/LDL

40
Q

Cx of SVCO

A

1} Cerebral Edema
2) Stridor and respi failure

41
Q

Symptoms of Hypercalcemia

A

Stones: Urinary stones/ colic
Groans: Abdo pain, constipation, N/V
Moans: Psychiatric eg AMS, confusion
Bones: Bone pain
Thrones: Urinary frequency

42
Q

Mx of HyperCa

A

1) Mainstay is IV hydration
2) Calcitonin within 1st 48hrs
3) Bisphosphonates
4) Denosumab

43
Q
A
44
Q

Endocrine causes of transient urinary incontinence

A

Diabetes Mellitus
Diabetes Insipidus
HyperCa?

45
Q

Clinical definition of Anaphylaxis

A
  1. Acute onset
  2. 2 or more systems involved post exposure( Mucocutaneous, CVS, Respi, GI)
  3. Hypotension post exposue
46
Q

Mx of anaphylaxis

A
  1. IM adrenaline 1:1000
  2. Bronchodilator
  3. IV Hydrocortisone
  4. Antihistamines, both H1 and H2 blockers
47
Q

Common causative agents of SJS/TENS

A

1) Antibiotics
2) Antiepileptics( Valproate, carbamazepine)
3) Sulfonamides
4) NSAIDs
5) Antiretrovirals
6) Allopurinol

48
Q

Mx of SJS/TENS

A
  1. ABCs and supportive
  2. Withdraw offending drug
  3. Burns Mx, cold compresses
  4. Broad spectrum Abx and Anti tetanus
49
Q

ECG Festures of HyperK

A
  1. Tall tented t waves
  2. Absent p waves
  3. QTc prolongation
  4. Broad QRS complexes
  5. Sine wave pattern
50
Q

HyperK Mx

A
  1. Calcium gluconate
  2. IV Insulin
  3. IV dextrose
  4. Resonium
  5. Dialysis if refractory
51
Q

Contraindications to central lines

A

Absolute:

Overlying infection
Vein thrombosis

Relative

Coagulopathy

52
Q

Indications for Central lines

A

Vasoactive drugs( Noradrenaline)
Dialysis
TPN
Chemotherapy
CVP measurement
Frequent blood taking
Long term drugs eg abx

53
Q

Mx of refeeding syndrome

A
  1. Refer dietician
  2. Electrolyte replacement and trend
  3. Thiamine repalcement
  4. Telemetry
54
Q

Metabolic and Electrolyte imbalances of refeeding syndrome

A

HypoK
HypoMg
Hypophosphatemia
Thiamine deficiency

55
Q

Numbers for UFEME

A

5
3
5

Internal medicine (15 decks)

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