Theory

Question 1

Symptoms of hyponatremia

Answer 1

Confusion
Headache
Nausea and vomiting
Muscle weakness/cramps

Question 2

Causes of hyponatremia

Answer 2

Fluid overloading - congestive heart failure
Dehydration - D&V
Medications I.e. diuretics
Endocrine - SIADH (water retention), Addisons

Question 3

Risks of acute hyponatremia

Answer 3

Brain swelling, coma,death

Question 4

What is the risk of increasing na+ too rapidly In Someone who is hyponatremic

Answer 4

CPM
Central pontine myelinolysis
Due to rapid shift of water in the brain cells

Question 5

What is the reference range for Na+?

Answer 5

135-145

Question 6

Symptoms of hypernatremia

Answer 6

Main one = thirst
Confusion (due to brain cell shrinkage)
Nausea 
Muscle cramps /weakness
Loss of appetite

Question 7

Causes of hypervolemic hypernaremia

Answer 7

Hyperaldosteroneism

excess IV saline (na+)

Question 8

Causes of normovolemic hypernatremia

Answer 8

Diabetes insipidus
(Failure of production of vasopressin from pit’ or kidneys lack response to vasopressin)
Tx w/ desmopresssin

Question 9

Causes of hypovolemic hypernatremia

Answer 9

Diuretics
Vomiting
Excessive sweating

Question 10

Peripheral signs of endocarditis

Answer 10

Janeway lesions
Oslers nodes
Splinter haemorrhages
Roth spots

Question 11

Signs of heart failure

Answer 11

Elevated JVP
Peripheral oedema
Pulmonary crackles

Question 12

What type of heart failure occurs when the left ventricle fails to relax fully (how does this affect the output of the heart)

Answer 12

Heart failure with preserved ejection fraction (disastolic dysfunction)

Question 13

What type of heart failure occurs when the LV fails to contract normally

Answer 13

Left sided HF with reduced EF (systolic dysfunction)

Question 14

What two conditions will effect the management of heart failure

Answer 14

AF

CKD

Question 15

Treatment for bradycardia

Answer 15

Digoxin

Question 16

Explain cor pulmonale

Answer 16

Lung congestion causes enlargement of the right ventricle and RHF

Question 17

Explain how LVHF can cause Rsided HF and what signs might elicited

Answer 17

Pulmonary veins are less able to drain into the LV, Causing back pressure in the lungs the pulmonary arteries are less able to remove blood from the RV so there is a back up of pressure. The body cannot be sufficiently drained by the VC so veins leak causing ascites

Question 18

Signs of right sided heart failure (cor pulmonale)

Answer 18

Ascites
Peripheral oedema
Enlarged liver and spleen
Distended JVP

Question 19

Signs of left sided heart failure

Answer 19

Peripheral cyanosis
Paroxysmal nocturnal dyspnea
Exertions dysnea

Question 20

How do you treat neutropenic sepsis

Answer 20

GCSF

Question 21

Reference ranges for Hb

Answer 21

115-160

Question 22

Reference ranges for wbc

Answer 22

4-12

Question 23

Treatment for hypercalcemia

Answer 23

Fluids + bisphosphonates

Question 24

Causes of hypercalcemia

Answer 24

Bone mets
Hyperparathyroidism
Ectopic PTH secretions

Question 25

What nerve is responsible for LR eye muscle

Answer 25

6 abducens

Question 26

Causes of headache

Answer 26

``` Sinister = SOL I.e. SAH Mets/ tumours hydrocephalus GCA ``` Primary Cluster Tension Migraine

Question 27

Short lasting, 10/10 pain headache with autonomic features (runny nose/ eyes)

Answer 27

Cluster headache (suicide headache)

Question 28

How would Fe deficient anemia present on blood film

Answer 28

Microcytic hypochromic

Question 29

What is the diagnosis for MS

Answer 29

Two lesions separated by space and time

Question 30

What three could components would you want to test for in microcytic anemia

Answer 30

Fe Ferritin B12 EPO

Question 31

Vitamin D deficiency presentation in children and adults

Answer 31

Children - rickets | Adults -osteomalacia

Question 32

What is asprin

Answer 32

Antiplatelet

Question 33

Important things to check with an overdose patient

Answer 33

Were all the tablets taken at once | Was it a mixed overdose (multiple types of tablet / w/alcohol

Question 34

CSF w/ raised protein and low sugar. What type of infection is this

Answer 34

Bacterial

Question 35

A common complication of hospital treatment with co-amoxiclav

Answer 35

C diff

Question 36

What can be the cause of a galloping heart sound

Answer 36

LVHF - fluid overloading (furosemide)

Question 37

K+ sparing diuretic

Answer 37

Spirolactone

Question 38

What is bisoperolol

Answer 38

Beta blocker - slows heart rate