reivsion

Question 1

slow rising pulse

Answer 1

aortic stenosis

Question 2

collapsing pulse

Answer 2

aortic regurg

Question 3

irregular pulse

Answer 3

AF

Question 4

jerky pulse

Answer 4

hocm

Question 5

pulsus alterans

Answer 5

left ventricular systole failure

Question 6

pulsus pardoxus- fading on insipiration

Answer 6

cardiac tamponade/pericarditis

Question 7

raised JVP fixed

Answer 7

lung tumour- SVC obstruction

Question 8

jvp raised on inspiration- kussmal sign

Answer 8

constrictive pericarditis/ cardiac tamponade

Question 9

large V waves

Answer 9

tricuspid regugrg

Question 10

cannon waves

Answer 10

complete heart block

Question 11

absent a waves

Answer 11

AF

Question 12

prominent a waves

Answer 12

tricuspid stenosis/ pulmonary stenosis/ pulmonary HT causing right v hypertrophy

Question 13

infective endocarditis diagnosis criteria?

Answer 13

Duke’s (2,1+ 3, 5) major= +ve blood culture 2x certain time apart, sign of endocardial involvement

Question 14

organism in IE?

Answer 14

group a haemolytic strep viridans, staph aureus in IVD users

Question 15

criteria for rheumatic heart disease? + organism?

Answer 15

duckett jones- arthiritis carditis, carey coombs murmur- mid diastolic murmur. sydenham chorea, erythema marginatum strep b haemolytic- strep pyogenes

Question 16

signs of aortic stenosis?

Answer 16

narrow pulse pressure, heaving displaced apex beat, ejection systolic crescendo murmur- aortic area radiate to axilla + carotids

Question 17

signs of aortic regurg?

Answer 17

wide pulse pressure, crescendo decrescendo early diastolic murmur, collapsing pulse severe = austin flint murmur volume overload displaced apex beat

Question 18

signs of mitral regurg?

Answer 18

overloaded apex beat + displaced, pansystolic murmur

Question 19

signs of mitral stenosis?

Answer 19

tapping apex beat, rumbling mid diastolic murmur

Question 20

graham steel murmur?

Answer 20

pulmonary hypertension due to mitral stenosis causing pulmonary valve regurg

Question 21

atrial septal defect murmur?

Answer 21

ejection systolic murmur

Question 22

VSD murmur?

Answer 22

pansystolic murmur

Question 23

malar flush sign=?

Answer 23

mitral stenosis

Question 24

Aortic regurg
corrigan sign?
De mussets?
quinckes?
traube's?

Answer 24

Carotid pulsation (Corrigan’s sign)
Head nodding (De Musset’s sign)
Capillary pulsations in nail bed (Quincke’s sign)
Pistol-shot heard over femorals (Traube’s sign

Question 25

what are roth's spots

Answer 25

infective endocardidtis- boat shaped retinal haemorrhage with a white centre

Question 26

what is beck's triad?

Answer 26

criteria for cardiac tamponade signs = (Low BP + Increased JVP + Muffled heart sounds)

Question 27

causes of absent p waves?

Answer 27

sinoatrial block, af

Question 28

cause of peaked p waves?

Answer 28

right ventricle hypertrophy

Question 29

pericarditis ecg changes?

Answer 29

saddle shaped st segment + PR depression

Question 30

PE ECG sign?

Answer 30

S1Q3T3

Question 31

hyperkalaemia ecg signs?

Answer 31

tented t waves, sine wave- QRS

Question 32

hypokalaemia ecg signs?

Answer 32

flattened t waves, u waves present

Question 33

side effect of b blocker

Answer 33

impotence, SOB, cold peripheries

Question 34

ACEi side effect?

Answer 34

persistent dry cough

Question 35

simvastatin side effect?

Answer 35

hepatotoxicity- LFTs every 12 months, myositis

Question 36

GTN SE?

Answer 36

hypotension, tachycardia, flushing, headaches, worsening GORD

Question 37

frusemide SE?

Answer 37

hypokalaemia

Question 38

digoxin SE?

Answer 38

hypokalaemia, hypercalcaemia, hypo Mg

Question 39

amiodarone SE?

Answer 39

lung liver fibrosis, thyroid issues as iodine

Question 40

verapamil se?

Answer 40

LV failure

Question 41

anaphylaxis treatment?

Answer 41

0.5mg IM (1:1000) adrenaline + 200mg Hydrocortisone + 10mg chlorphenamine

Question 42

pemberton's sign?

Answer 42

facial congestion when lifting arm

Question 43

pleural effusion dx?

Answer 43

light's criteria- Pleural aspiration with ultrasound recommended to reduce the complication rate Fluid should be sent for pH, protein, lactate dehydrogenase (LDH), cytology and microbiology • Exudates have a protein level of >30 g/L, transudates have a protein level of <30 g/L

Question 44

Diagnostic criteria of ARDS

Answer 44

Bilateral infiltrates on CXR, Pulmonary capillary wedge pressure <18 (no clinical evidence of increased left atrial pressure) , Refractory hypoxaemia (PaO2:FiO2 <200), lack of clinical congestive heart failure, acute onset

Question 45

leigonella treatment?

Answer 45

ciprofloxaxin- flucoxacillin

Question 46

CF pneumonia?

Answer 46

Pseudomonas Aeruginosum

Question 47

Positive cold agglutinins, low grade fever Eyrthema nodosum. Younger adolescents and adults Headache, malaise which preceded chest Sx, dry cough

Answer 47

mycoplasma pneumonia- treat using clarithromycin

Question 48

most common hospital acquired pneumonia?

Answer 48

kliebsiella pneumonia

Question 49

copd pneumonia?

Answer 49

haemophilus

Question 50

CURB 65 criteria?

Answer 50

AMTS <8, Urea >7, RR >30/min, SBP<90 or DBP<60mmHg, | Age >65

Question 51

Mx of aspiration pneumonia

Answer 51

IV cefuroxime and metronidazole (need to | cover anaerobic bacteria)

Question 52

Longstanding COPD, SOB, cough with coloured sputum MX

Answer 52

28% O2 blue venturi mask, nebulised salbutamol + ipratropium, PO prednisolone, amoxicillin (in that order)

Question 53

when is magnesium sulphate used in asthma

Answer 53

life threatining situation

Question 54

how is hiatus hernia managed?

Answer 54

nissen fundoplication

Question 55

Signs of chron's?

Answer 55

cobble stone + rose thorn ulcers, barium swallow

Question 56

toxic mega colon dx?

Answer 56

12cm dilation of transverse colon with colonic wall thickening

Question 57

dx + mx of haemachromotosis

Answer 57

pearl stain liver biopsy show haemosiderin deposits. MX = dexoferoxamine

Question 58

portal HTN criteria

Answer 58

10mmhg