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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

Study These Flashcards
A

4 2 1 or 100/50/20

24
Q

Caveats to Holliday Segar method

Study These Flashcards
A

Renal failure
Cardiac failure
Neonates
Obese patients

25
Immobility precautions
Wind,water and wound Pneumonia/Atelactasis, UTI and decubitus ulcers
26
Drugs for treatment of osteoporosis
Anti resorptives:bisphosphonates and denosumab Osteoblast stimulants: Teriperatide(shown to be more effective)
27
Histology of Henoch Schonlein Purpura
IgA deposits
28
Types of large vessel arteritis
GCA and Takayasu
29
Types of Medium vessel arteritis
Kawasaki and PAN
30
Types of small vessel arteritis
IgA vasculitis, Polyangiitis
31
Variable vessel Vasculitis
Behcet and Cogans
32
Cx of Necrotising Fasciitis
1. Sepsis 2. Renal failure 3. Severe scarring 4. Limb loss?
33
Risk factors for necrotising fasciitis
1. Chronic disease eg DM, Malignancy 2. Peripheral vascular disease 3. Chronic alcoholism 4. Malnutrition 5. Obesity 6. Trauma/Iatrogenic 7. Varicella
34
Vaccinations for herpes zoster
Shingrix: 2 doses of recombinant inactivated virus Zostavax: Live vaccine
35
What to look for on PE and CXR in Suspected pneumothorax or pleural effusion
Tracheal deviation
36
Causes of bilateral LL swelling
Pitting - cardiac - Liver - Renal - drugs eg CCB Non pitting - pretibial myxedema - lympedema - venous insufficiency
37
How to screen microvascular cx of DM
Eye: vision changes, past laser, past injections PVD: prev amputations
38
Causes of chlye in uria
CCBs and one other drug? Parasites: filiariasis Thoracic duct obstruction
39
Examples of negative phase reactants
Albumin Ferritin Uric acid Lipid/LDL
40
Cx of SVCO
1} Cerebral Edema 2) Stridor and respi failure
41
Symptoms of Hypercalcemia
Stones: Urinary stones/ colic Groans: Abdo pain, constipation, N/V Moans: Psychiatric eg AMS, confusion Bones: Bone pain Thrones: Urinary frequency
42
Mx of HyperCa
1) Mainstay is IV hydration 2) Calcitonin within 1st 48hrs 3) Bisphosphonates 4) Denosumab
43
44
Endocrine causes of transient urinary incontinence
Diabetes Mellitus Diabetes Insipidus HyperCa?
45
Clinical definition of Anaphylaxis
1. Acute onset 2. 2 or more systems involved post exposure( Mucocutaneous, CVS, Respi, GI) 3. Hypotension post exposue
46
Mx of anaphylaxis
1. IM adrenaline 1:1000 2. Bronchodilator 3. IV Hydrocortisone 4. Antihistamines, both H1 and H2 blockers
47
Common causative agents of SJS/TENS
1) Antibiotics 2) Antiepileptics( Valproate, carbamazepine) 3) Sulfonamides 4) NSAIDs 5) Antiretrovirals 6) Allopurinol
48
Mx of SJS/TENS
1. ABCs and supportive 2. Withdraw offending drug 3. Burns Mx, cold compresses 4. Broad spectrum Abx and Anti tetanus
49
ECG Festures of HyperK
1. Tall tented t waves 2. Absent p waves 3. QTc prolongation 4. Broad QRS complexes 5. Sine wave pattern
50
HyperK Mx
1. Calcium gluconate 2. IV Insulin 3. IV dextrose 4. Resonium 5. Dialysis if refractory
51
Contraindications to central lines
Absolute: Overlying infection Vein thrombosis Relative Coagulopathy
52
Indications for Central lines
Vasoactive drugs( Noradrenaline) Dialysis TPN Chemotherapy CVP measurement Frequent blood taking Long term drugs eg abx
53
Mx of refeeding syndrome
1. Refer dietician 2. Electrolyte replacement and trend 3. Thiamine repalcement 4. Telemetry
54
Metabolic and Electrolyte imbalances of refeeding syndrome
HypoK HypoMg Hypophosphatemia Thiamine deficiency
55
Numbers for UFEME
5 3 5

Internal medicine (15 decks)

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