Things I get wrong a lot Flashcards
1
Q
How to treat IHD?
A
Immediate = 300mg aspirin and GTN
Hospital = Morphine, Oxygen, Nitrates, Aspirin/Clopidogrel
Long term = Beta-blockers, ACEis, Clopidogrel, Aspirin, Statins
2
Q
Causes of left sided HF?
A
IHD, MI, Cardiomyopathy, Ventricular hypertrophy, Constrictive pericarditis, Cardiac tamponade
3
Q
S&S of left sided HF?
A
Dysponea, poor exercise tolerance, fatigue, orthoponea, nocturnal dysponea/cough, wheeze, nocturia and cold peripheries
4
Q
Causes of right sided HF?
A
LV HF, pulmonary stenosis, lung disease e.g. cor pulmonale
5
Q
S&S of right sided HF?
A
peripheral oedema, ascites, nausea, anorexia and epistaxis
6
Q
What causes Marfans and Ehlers-Danlos Syndromes?
A
Inherited Autosomal Dominant conditions
7
Q
What is Ehlers-Danlos syndrome?
A
A defective type 1 and type 2 collagen production
8
Q
What may trigger gout onset?
A
Red meat/alcohol binge, trauma/surgery to the joint, starvation, infection and diuretics
9
Q
What may trigger pseudo-gout onset?
A
Ilness, direct joint trauma or surgery
10
Q
Name some risk factors for pseudo-gout?
A
Old age, being female, hyperparathyroidism, hypophospataemia and haemochromatosis
11
Q
Name some common extra-articular manifestations of RA?
A
Rheumatoid nodules, vasculitis, pulmonary fibrosis and pericarditis
12
Q
What is scleroderma?
A
An autoimmune disease of the connective tissue leading to scarring and thickening of tissues
13
Q
How may scleroderma present?
A
Weight loss, fatigue, Reynauds phenomenom, Sclerodactyly and thickened skin on the face
14
Q
Red flag signs in diarrhoea?
A
Severe dehydration, electrolyte imbalance, renal decline/failure, severe abominal pain and immunocompromised patients
15
Q
What is the main cause of travellers diarrhoea? How does it present?
A
Enterotoxigenic E.coli.
Watery diarrhoea precceded by cramps and nausea
16
Q
Which antibiotics most commonly cause C.difficile infection?
A
clindamycin, cephalosporins, carbapenems, co‑amoxiclav and quinolones
17
Q
How is C.difficile treated?
A
Metronidazole, Vancomycin (main) and foecal transplant
18
Q
How do you treat cholera?
A
Oral rehydration salts/IV fluids and doxycycline/tetracycline
19
Q
Name 3 parasites commonly affecting the GI tract
A
Cryptosporidium, Entomeba histolytica and Giardia
20
Q
Non GI symptoms of Coeliac’s disease?
A
Osteomalacia, weight loss, fatigue, iron deficiency anaemia and weakness
21
Q
GI symptoms of Coeliac’s disease?
A
Steatorrhoea, diarrhoea, abdominal pain/cramps, abdominal bloating, nausea/vomiting
22
Q
Diseases associtated with Coeliac’s disease?
A
Dermatitis herpetiformis, Sjorgen’s sydrome, T1DM etc. (autoimmune diseases)
23
Q
What is gastritis?
A
Inflammation of the stomach mucosa following damage
24
Q
Treating gastritis?
A
Antacids, H2-receptor antagonists e.g. cimetidine, PPIs and treat H.pylorio infection (lansoprazole, clarithromycin and amoxicillin)
25
What are some consequences of hypoglycaemia?
```
Autonomic = sweating, anxiety, hunger, tremour, palpatations and dizziness
Neuroglycopenic = confusion, drowsiness, visual disturbances, seizures and coma
```
26
How does metformin work and what are its side effects?
Inscreases sensitivity to insulin, increases glucose absorption by the skeletal muscles, decreases liver glucose secretion and decreases glucose uptake at the intestines.
S/Es = GI disturbances e.g. diarrhoea, nausea and vomiting
27
How can you treat PVD?
Angioplasty/stenting, encourage patient to walk through pain (to assist new vessel formation) and smoking cessation
28
What causes psuedohypoparathyroidism?
Genetic abnormalities - there will be PTH resistance.
| Short stature, short fingers, round face and a short neck are also seen
29
Describe 1st line hypertension treatment?
55 + and any age in black patients = CCBs
| <55 and white = ACEis
30
Which condition is most likely to cause thoracic aortic aneurysm?
Marfans syndrome - defective fibrillin 1 production
31
1st line treatment for PE
LMW Heparin
32
What is the staging for lymphoma?
Ann Arbor Staging
I = one area of lymph node involvment
II = 2+ lymph nodes involved but on the SAME side of the diaphragm
III = 2+ lymph nodes involved but on DIFFERENT sides of the diaphragm
IV = Extranodal involvment
33
What drug is used in disollution therapy and for which gall stones?
Ursodeoxycholic acid for cholesterol gall stones
34
Which disease matches these 3 classic symptoms:
| Urethritis, Conjunctivitis and arthritis
Reactive arthritis
35
Which disease causes bony growths (may lead to hearing loss, enlarged head etc.)
Pagets disease of bone - causes bones to become fragile and misshapen, usually affects pelvis, skull, spine and legs
36
First line BPH treatment?
Alpha-blockers e.g. tamulosin
37
Which cancer gives painless heamaturia?
Bladder (transitional cell bladder cancer)
38
Signs of meningitis?
neck stiffness, photophobia, Kernig's sign, non-blanching petechial rash, seizures and decreased GCS score
39
What are the two signs seen in hypocalcaemia?
Chvostek's (twitch in response to tapping of the facial nerve) and Trousseau's (spasm of hand when tightening blood pressure cuff) signs
40
Patient has UMN signs plus muscle wasting and fasiculation, what do they have?
Motor neruone disease
41
What is the syndrome of innapropriate aldosterone secretion called?
Conn's syndrome
42
What are the antibodies found in Graves and Hashimotos?
Thyroid Stimulating Receptor hormone antibodies in graves, anti-TPO in hashimotos
43
What may cause increased testosterone in a woman?
Polycystic ovary disease
44
What condition may present with periodic sweating, headaches, snoring and insomnia?
acromegaly
45
A fault with which protein is associated with eczema?
Filaggrin
46
How do you treat an arterial thrombus?
LMW heparin, aspirin and thrombolytic therapy
47
What imaging methods assess PE?
CT angiography and V/Q scan
48
How do you treat a PE?
LMW heparin, then thrombolysis (if haemodynamically unstable).
Long term = DOAC or warfarin (3 months if provoked and up to 6 months if unprovoked)
49
Define Myeloma?
Early malignant proliferation of bone marrow cells
50
What increases the risk of both types of lymphoma?
EBV, being male and immunosuppression
51
Treatments for non-hodgkin's lymphoma?
Low grade = Radiotherapy in local disease or palliative care
| High grade = R-CHOP chemotherapy
52
Clinical features of platelet dysfunction?
Epistaxis, Gum bleeding, Easy bruising, Petechiae/purpura, Traumatic haematoma
53
Tests for thalassaemia?
FBC, MCV, blood film, iron/Hb levels
54
Treatment for thalassaemia?
Life long transfusions, splenectomy, bone marrow transplant/stem cell transplant
55
What are the most commonly used antibiotics in UTIs?
Nitrofurantoin and Trimethoprin
56
What is Fanconi syndrome?
Damage to the PCT causing changes in the urinary content
57
How does membranoproliferative glomerulonephritis present?
Nephrotic and nephritic syndrome
58
What two organs does Goodpasture’s syndrome affect and how?
Kidneys - oedema and hypertension
| Lungs - dysponea, chest pain and haemoptysis
59
Risk factors for urinary stones?
Obesity, diuretics, IBD, PKD, structural abnormalities of the urinary tract and past occurance
60
How does renal colic present?
Unilateral flank pain which radiates to the groin associated with nausea/vomiting
61
How do uriany stones present?
Dysuria, Urinary urgency, Urinary frequency and Haematuria
62
Complications of urianry stones?
Chronic renal damage, Recurrent stones, Renal abscess and Renal fistula
63
Medical treatment for CKD?
EPO/Iron supplementation, Frusemide, Losartan/Ramipril and Atorvastatin/simvastatin
64
What is Beck's triad?
Hypotension, jugular venous distention (raised JVP) and muffled heart sounds
This is a sign of cardiac tamponade
65
What is pheochromocytoma?
An endocrine tumour, this in an important differential in hyperthyroidism
66
What is Charcot's triad?
Jaundice, fever and right upper quadrant pain indicating ascending cholangitis
67
How do loop diuretics work?
Inhibition of the sodium/potassium/chloride symporter in the loop of Henle
68
How do thiazide diuretics work?
Inhibition of the sodium chloride transporter in the distal convoluted tubule
69
How do potassium sparring diuretics work?
Inhibition of aldosterone receptor in the distal tubules
70
What is the ABCD2 score used to calculate?
Risk of stroke after TIA
Age 60+ - 1 point
BP >/= 140/90 - 1 point
Clinical features: unilateral weakness - 2 points, slurred speach no weakness - 1 point
Duration: >/= 1 hour - 2 points, 10-59mins - 1 point
Diabetes - 1 point
71
What is the QRISK2 score used to calculate?
Risk of heart attack
72
How does sarcoidosis affect 1,25-dihydroxyvitamin D production?
It becomes uncontrolled so will eventually lead to hypercalcaemia
73
How does hyperthyroidism affect calcium levels?
It causes hypercalcaemia
74
How do you identify suspected coeliac's diseases cases which should be sent for biopsy?
IgA tissue transglutaminase (tTg) and IgA endomysial (EMA) antibodies present in the blood
75
How can you tell between IBS and IBD?
Faecal Calprotectin is raised in IBD but not in IBS
76
What is the most common composition of renal stones?
Calcium oxalate
77
What are the stages in CKD grading?
Stage 1 > 90 ml/min with evidence of renal damage
Stage 2 60-89 ml/min with evidence of renal damage
Stage 3a 45-59 ml/min with or without renal damage
Stage 3b 30-44 ml/min with or without renal damage
Stage 4 15-29 ml/min with or without renal damage
Stage 5 <15 ml/min, established renal failure
ml/min is in refference to eGFR
78
A patient in their twenties presents with b syptoms and an asymmetrical painless lymphadenopathy worse on drinking alcohol what is the likely diagnosis?
Hodgkin's lymphoma
79
Where are auer rods found?
AML
80
How does multiple myeloma present?
C - calcium increse
R - renal impairment
A - anaemia (and pancytopenia)
B - bone lesions/pain/fractures
81
What is leukocytosis?
An increased number of WBCs e.g. in CML
82
Name some side effects of amitriptyline?
It is anticholinergic so causes blurred vision, confusion, dry mouth and urinary retention
83
What are the TB drugs? Give SEs of each?
Rifampicin - Red/orange discolouration of urine/tears
Isoniazid - Peripheral neuropathy
Pyrazinamide - High uric acid levels → gout
Ethambutol - Colour blindness/reduced visual acuity
84
What are the known casues of tension headaches?
Depression, lack of sleep, missed meals and stress
85
What is the initial treatment for PE/DVT?
LMW Heparin, you perform thrombolysis in haemodynamically unstable patients
86
Patient (25-40) presents with long term dry cough, SOB and erythma nodosum. X-ray shows bilateral hilar lymphadenopathy and biopsy shows non-caseating granulomas with epithelioid cells. What is the likely diagnosis?
Sarcoidosis
87
What are the cardinal signs of carcinoid syndrome?
Cardiac involvment, bronchoconstriction, diarrhoea and flushing
88
What are the common causative orgnaisms of UTIs?
Klebsiella, E. Coli, Enterococcus, Proteus/pseudomonas and Staphylococcus saprophyticus
89
What are the causes of megaloblastic anaemia? How do you tell betweeen them?
B-12/folate defficiency
B-12 is found in fish, meat and pultory products so is often deficient in vegans. It is absorbed at the terminal ileum and deffiency also leads to neurological signs
90
What are teh beta-lactams?
Penicillins, Cephalosporins (e.g. ceftriaxone and cefotaxime) and Carbapenems (e.g. Ertapenem and Biapenem)
91
What are the red flags in bone pain and what do they signify?
Pain at rest/night - cancer, infection or fracture
92
Name some clinical features seen in spondlyarthropathies?
Sausage fingers, Psoriasis, Inflammatory back pain, NSAIDs response, Enthesitis, Arthritis, CRP elevation, HLAB27, Eye issues
93
What is fibromyalgia?
Widespread pain > 3 months in >11 of the 18 tender spots when no other cause can be identified
94
Give some extra-articular manifestations of RA?
Nodule formation, lymphadenopathy, vasculitis, interstital fibrosis, IHDs, pericarditis, pericardial effusion, carple tunnel syndrome
95
What makes up the crystals in gout and pseudogout?
Urate in gout, calcium phosphate in pseudo gout
96
Pink puffers vs blue bloaters?
PP - Exhilation issues due to emphysema, perfusion is maintained - weight loss and breathlessness
BB - reduced perfusion causing cyanosis and chest expansion (take large breaths) - due to chronic bronchitis so there will be a productive cough and respiratory failure may occur
97
S&S of acute asthma attack?
Dysponea, coughing, chest pain/tightness, tachyponea, tachycardia, cyanosis, drowsiness/confusion
98
What are the two steroids you can use in acute asthma attack and how do you deliver them?
Hydrocortiosne - IV
| Prednisolone - PO
99
How does pneumonia occur?
Bacterial infection of the alveolar space leads to neutrophils and fluid moving into the lungs
100
How much fluid is neded to diagnose pleural effusion?
Clinically - 500ml
| CXR - 350ml
101
Transudate vs exudate?
Transudate <25g/L of proteins due to CHF/liver cirrhosis/nephrotic syndrome
Exudate >35g/L protein due to infection e.g. TB or pneumonia/inflammation/malignancy
102
What are the tests used to diagnose TB?
Latent disease = mantoux skin test
| Active disease = ziehl-neelson stain/acid fast bascilli
103
What is miliary TB and how do you test for it?
TB infection which has spread to the CNS - test using lumbar puncture
104
What is polycythemia?
Relative polycythaemia = decreased plasma volume but normal RBC mass
Absolute polycythaemia = increase in RBC mass
105
Name a thrombolysis drug?
Streptokinase and Alteplase
106
What causes huntington's disease?
CAG repetes on chromosome 4
107
What is a Jacksonian March?
Where a seizure spreads from the distal part of the limb towards the ipsilateral face - seen in frontal lobe seizures
108
What is the defining freature of a trigeminal neuraliga?
Sudden severe shooting facial pain lasting only for a few seconds
109
What are the triggers of migraine?
Chocolate, Hangovers, Orgasms, Cheese/Caffine, Oral-contraceptives, Lie-ins, Alcohol, Travel, Exercise, Stress
110
Where in the nervous system does demyelination NOT occur in MS
Cerebellum
111
Name the causes of macrocytic anaemia?
B-12 deficiency, alcohol excess/liver damage, hypothyroidism, haemolysis, BM failure and pernicious anaemia
112
Name the causes of iron deficieny anaemia?
Blood loss, poor diet, malabsorption and hook worm
113
What medications prevent an angina attack and what medications reduce complications?
Angina attack prevention =Beta-blockers and CCBs
| Complications prevention = Aspirin, statins and ACEis
114
How does acute pericarditis appear on ECG?
Saddle shaped ST elevation and PR depression
115
What criteria is used to diagnose IE?
Duke criteria
116
What are common SEs of CCBs?
Oedema, flushing and palpatations
117
What are common SEs of amioderone?
Sun sensitivity, Hyperthyroidism, Corneal deposits, Interstitial pneumonitis, Hepatic disorders and Nausea
118
How do you manage acute AF?
Rate control = Bisoprolol or Diltiazem
| Anticoagulation = LMW Heparin (until emboli risk is assed) then if high risk DOAC (e.g. apixaban) or warfarin
119
What are the steps in chronic asthma management?
Step 1 = Short acting Beta-2 agonists (if >1 daily/night time symptoms go to step 2)
Step 2 = Add standard dose inhaled steroids
Step 3 = Add long acting Beta-2 agonists
120
What is Virchow's triad?
Factors which contribute to thrombosis:
Hypercoagulability
Haemodynamic Changes (stasis/turbulence)
Endothelial injury/dysfunction
121
Define chronic bronchitits?
A cough with sputum production for >3 months for over 2 years
122
Type 1 vs 2 respiratory failure?
Type 1 = Low PaO2, Normal/low PaCO2
| Type 2 = High PaCO2, Normal/low PaO2
123
What is the most common microorganism to cause osteomyelitis?
Staph. aureus
124
What is the mode of action of gliclazide?
Stimulates beta cells to secrete insulin
125
What visual disturbance occurs in acromegaly?
Bitemporal hemianopia
126
What is the first treatment in DKA?
Replace volume with fluids - then give insulin
127
What is the most common cause of primary hyperthyroidism?
Graves disease
128
What is the first line treatment for thyroid storm?
Propanolol (consider diltiazem if contraindicated) - to slow heart
Then give carbimazole
129
What can gram -ve bacteria release?
Endotoxins
130
How do viruses cause diesease?
Direct destruction of host cells, Cell proliferation and cell immortalisation, Inducing immune system mediated damage and Modification of host cell structure or function
131
What is a protazoa?
A single celled eukaryotic organism, causes malaria
132
Where do viruses replicate?
DNA viruses = nucleus, RNA viruses = cytoplasm
133
What is the best way to identify gall stones?
Abdominal US
134
What are adenomas?
Benign tumours - may become cancerous
135
What is Reynold's pentad?
Charcot's triad (Jaundice, RUQ pain and fever in ascending cholangitis) PLUS hypotension and decreased consiousness - this indicates sepsis onset
136
What causes severe abdominal pain radiating to the back, nausea and vomiting?
Acute pancreatitis
137
What is cobalamin deficiency?
B-12 deficiency - caused by disorders of the stomach, small bowel, pancreas and seen in strict vegitarians
138
What is Choledocholithiasis?
Bile duct stones/gall stones, will cause intermittent pain which is worse after eating
139
What is a lentivirus?
A genus of retroviruses which casue severe diseases with long incubation periods e.g. HIV
140
What dies innate immunity depend on?
Leukocytes e.g. natural killer cells, mast cells, eosinophills and basophils
141
What is a malignant neoplasm of glandular epithelium called?
Adenocarcinoma
142
What does Emax describe?
The potency of a drug
143
Describe the types of hypersensitivity reactions?
```
T1 = IgE mediated in allergic response/anaphylaxis
T2 = IgG and IgM mediated in autoimmune disease e.g. Rheumatic fever/Grave's/Good Pastures
T3 = immune complex mediated in IgA nephropathy and SLE
T4 = pre-sensitized T lymphocytes coming into contact with antigens in contact dermatitis and Gullain-Barre syndrome
```
144
How does Botox work?
Inhibits the release of acetylcholine from the pre-synaptic neurones at the neuromuscular junction leading to muscle paralysis
145
What antibiotics are used in diverticulitis?
Ciprofloxacin and metronidazole
146
Where are NSAIDs most likely to cause ulceration?
The duodenum
147
What is the first line investigation in appendicitis?
Abdo US
148
What does bloody diarrhoea and a recent trip to hospital suggest is the causative organism?
```
Bloody = bacerial
Hoptial = C. difficile
```
149
What is C.difficile?
A gram positive, spore forming, obligate anaerobe
150
What is deontology?
Acts are right or wrong and people have a duty to act accordingly
151
Where are tamulosin and finasteride used?
Symptomatic BPH
152
What are the treatments for prostate cancer?
Radical prostectomy, orchidectomy, antigonadotrophins e.g. goserelin/buserelin, androgen receptor blockers e.g. bicalutamide/futamide
153
What stimulates the external urethral sphincter to contract?
The pudendal nerve
154
Where are calcium levels monitored?
The parathyroid gland
155
What causes syphyllis?
Treponema pallidum
156
What causes a rise in PSA?
Benign prostate enlargement, Urinary tract infection, Prostatitis and Prostate cancer
157
What is teh Rome III criteria for IBS?
Abdo pain for at least 3 days a month for the last 3 months + two or more of:
Change in frequency
Change in form of stools
Pain improves upon defecation
158
What drugs can treat IBS?
Anti-spasmodics e.g. dicyclomine for cramps
Loperamide for diarrhoea
Laxatives for constipation
Tricyclic antidepressants
159
What are the initial treatments for UC and Chron's?
```
UC = 5 ASAs e.g. mesalazine
Chron's = prednisolone
```
160
What can be seen on ECG in hyperkalaemia?
Absent P waves, long PR interval, wide QRS and tall tented T waves
161
What can be seen on ECG in hypokalaemia?
U waves
162
S&S of sepsis?
Shiver/fever/cold, Extreme pain, Pale/discoloured skin, Sleepy/difficult to wake, Impending doom, Shortness of breath
Septic shock = warm peripheries and bounding pulse
163
Main symptom of pericarditits?
Sharp pleuritic chest pain worse when lying flat
164
What is the most common cause of secondary hypoadrenalism?
Long term corticosteroid use
165
What is seen in Barret's oesophagus?
change from stratified squamous to simple colunmar
166
What is angular stomatitis?
Sores in the corner of the lips, seen in coeliac's disease alongside apthous ulcers
167
What is Trosier's sign?
Englarged Virchow's nodes seen in gastric cancer
168
What are the most common leukaemias?
```
Adults = AML
Children = ALL
```
169
Symptoms of Polycythaemia Vera?
Headaches, dizziness, tinnitus, visual disturbances, itching after a hot bath and erythromelagia. It can also cause haemorrhage and thrombosis.
It this is the primary cause for polycythemia
170
How will RBCs appear in iron defficiency anaemia?
Abnormally shaped (polikilocytosis), pale (hypochromic), vary in size (anisocytosis) and small (microcytosis)
171
When does asterixis occur?
Type 2 respiratory failure or liver failure
172
How does liver failure affect oestrogen levels and what does this lead to?
Increased oestrogen (as the liver can no longer break it down), this causes spider navaei and gynaecomastia
173
What is Kussmaul breathing?
A deep breathing done in DKA (it is a form of hyperventilation to remove excess CO2)
174
What are the definitions of liver failure?
INR > 1.5, onset duration of <26 weeks, mental alteration without cirrhosis, no previous liver disease
175
What is painless jaundice a red flag for in teh UK?
Cancer of the pancreatic head (could also be cholangiocarcinoma howevere this is rare in the Western World)
176
S&S and test for addisons?
Hyperpigmentation, fatigue, tearfulness, weakness and anorexia
ACTH stimulation test/Synacthen test
177
Test for Wilson's disease?
24hr urinary copper secretion
| Liver biopsy - DIAGNOSTIC
178
S&S of haemachromatosis?
Skin bronzing/goes slate grey, joints pain, erectile dysfunctions/amenorrhoea, liver failure and kidney issues
179
Which antibiotics inhibit nucleic acid synthesis?
Ciprofloxacin, Metronidazole, Rifampicicin and Trimethoprim
180
What is a common cause of neonate meningitis?
Strep. agalactiae
181
How do you differentiate between teh non-lactose fermenting (pale on MacConkey) aerobic bacilli?
Oxidase test
Positive = pseudomonas
Negative = proteus, salmonella and shigella
182
What are the two types of alpha-haemolytic strep?
Optochin resisitant e.g. strep. viridans
| Optochin sensitive e.g. strep pneumoniae
183
What are the two types of beta-haemolytic strep?
Lancefield A = strep. pyogenes
| Lancefield B = strep. agalactiae
184
What is teh first line test for lung cancer?
CXR
185
What is seen in pleural effusions?
Stony dull percussion
186
What is the immediate management for a TIA?
300mg aspirin
187
What is the duke's staging of colonc cancer?
```
A = The cancer is in the inner lining of the bowel or it is slightly growing into the muscle layer.
B = The cancer has grown through the muscle layer of the bowel.
C = The cancer has spread to at least 1 lymph node close to the bowel.
D = The cancer has spread to another part of the body
```
188
S&S of Conn's syndrome?
Weakness, cramps, polyuria, polydypsia, parasthesia and increased BP
189
How do you serologically differentiate between UC and Chron's?
```
UC = pANCA positive
Chrons = ASCA positive
```
190
What are owls eyes inclusions?
A radiological/histological pattern that is highly specific to cytomegalovirus
191
What is the most common cause of foot drop?
Compression of the peroneal nerve
192
Which types of leukaemia have blast cells?
AML and ALL
193
What are candersartan and amlodipine?
```
Candasartan = ARB
Amlodipie = CCB
```
194
Risk factors for GORD?
Lower oesophageal hypotension, hiatus hernia, oesophageal dysmotility, obesity, gastric acid hypersecretion, delayed gastric emptying, smoking, alcohol, pregnancy and drugs e.g. tricyclics
195
What is the first line test for a bowel obstruction?
X-ray
196
Describe duodenal ulcers?
Worse several hours after eating and relieved by eating
197
What is the dignostic test for bowel cancer?
Colonoscopy
198
Where do the majority of colon cancers occur?
Distal colon
199
Name the complications of PKD?
Liver cyst formation, Increased blood pressure => CVD, berry aneurysm and kidney stones
200
How do you treat malaira?
```
Uncomplicated = oral chloroquine
Complicated/severe = IV artesunate
```
201
What is seen in acute inflammation?
Rubour (redness), Dolor (pain), Calor (heat), Tumour (swelling) and loss of function
There will be neutrophil polymorph infiltration
202
What is amaurosis fugax?
Unilateral painless progressive vison loss 'like a curtain descending' typically seen in TIA due to retinal artery occlusion
203
Risk factors for peripheral neruopathies?
Diabetes, alcohol abuse, vitamin B deficiencies, autoimmune diseases e.g. sjorgens and SLE, immunocompromised patients (due to increased risk of infection e.g. lyme disease, shingles, EBV, HBV/HCV and HIV)
204
What are the most common bacterial and viral causes for COPD exacerbation? Which is the most common?
Bacterial - H.influenzae
Viral - rhinovirus
Bacterial exacerbations are more common
205
What is seen in RBBB and LBBB?
WILLIAM MARROW
LBBB = slurred S wave in V1, R wave in V6
RBBB = R wave in V1, slurred S wave in V6
206
S&S of IE?
Fever, Roth spots, Osler nodes, Murmur, Janeway lesions, Anaemia, Nail bed (splinter) haemorrhages, Emboli (FROM JANE)
207
What is xanthelasma?
Build up of yellow plaques on the eyelid seen in hyperlipidaemia
208
RFs for oesophageal cancer?
poor diet, alcohol, smoking, oesophagitis, barretts oesophagus, obesity, hot drinks and reflux
209
Causes of diverticular disease?
Low fibre diet, Obesity, NSAIDs and Smoking
210
What is Thrombotic Thrombocytopenic Purpura and how do you treat it?
Blood condition presenting with low platelets, RBC fragmentation, renal failure, neurological deficit and fever as blood clots occur in the small vessels throught the body
Treat first line with urgent plasma exchange
211
What is hydroxycarabimide?
A bone marrow suppressive drug used to treat polycythaemia rubra vera and sickle cell disease
212
What is cytopenia?
Whe one or more of your blood cell types are low
213
What is leukonychia?
White discolouration of the nails due to injury of the nail base
214
PBC vs PSC?
```
PBC = autoimmune (affects small interlobular ducts), more common in women and associated with AMA
PSC = associated with UC (affects intra/extra-hepatic ducts), more common in men and associated with ANCA and ANA
```
215
How do you treat myasthenia gravis?
Neostigmine/pyridostigmine - block the action of actelycholinesterase so increase the amount of ACh in the synapse
216
Define the thresholds for life-threatening asthma attack?
PEF <33%, silent ches/cyanosis, arrythmia/hypotension, exhaustion/confusion/coma, PaCO2 >4.6kPa, SaO2 <92%/PaO2 <8kPa
217
Define the thresholds for a severe asthma attack?
Inability to complete scentences in one breath, RR >/= 25, pulse >/= 110, PEF 33-50%
218
S/Es of salbutamol?
Headaches, restlessness, fine tremour, palpatations and sore throat
219
S&S of aortic vs mitral stenosis?
```
Aortic = ejection systolic murumr, non-displaced apex beat, slow rising narrow pressure pulse
Mitral = mid-diastolic murmur, non-displaced apex beat, low volume pulse, malar flush
```
220
S&S of aortic vs mitral regurgitation?
```
Aortic = early diastolic murumr, displaced hyperdynamic apex beat, colapsing wide pressure pulse
Mitral = pansystolic murmur, displaced hyperdynamic apex beat, AF
```
221
How does HF appear on CXR?
Alveoar oedema, kerley B lines, Cardiomegaly, Dilated promient upper lobe veins, pleural Effusions (ABCDE)
222
S&S/test of Addison's ?
Lean, tanned, tired, tearful, dizziness, postural hypotension, generally feeling unwell
Short ACTH stimulation test (Synacthen test)
223
Causes of SIADH?
Malignacy, CNS issues, Chest disease, Drugs e.g. opiates, trauma, alcohol withdrawal and major abdo/chest surgery
224
Treatment of carcinoid syndome?
Somatostatin anologue e.g. octerotide
225
What are the two types of buising seen in pancreatitis?
Cullen's sign = periumbillical bruising
| Grey Turner's sign = flank bruising
226
Bacteria vs viral on a lumbar puncture?
```
Bacterial = raised nutrophils, turbid, high protein, low glucose
Viral = raised lymphocytes, clear, normal glucose/protein
```
227
Main causative organisms of bronchiectasis?
H. influenzae, Strep. pneumoniae, Staph. aureus and Psuedomonas aeruginosa
228
Treatment of COPD?
1) SAMA/SABA
2) LAMA/LABA
3) Inhaled corticosteroids
229
How can you localise focal seizures (frontal vs parietal)?
```
Frontal = Motor features (retained awarness), Jacksonian march, dysphasia and post-ictal weakness
Parietal = sensory disturbances and parasthesia
```
230
How can you localise focal seizures (temporal vs occipital)?
```
Temporal = Motor features e.g. lip smacking/grabbing (impaired awareness), dysphasia, deja vu, emotional disturbances/hallucinations
Occipital = visual phenomona
```
231
S&S of a PCA stroke?
Contralateral homonomous hemianopia/cortical blindness, visual agnosia/prospagnosia, dyslexia and unilateral headache
232
S&S of an ACA stroke?
Les weakness/sensory disturbances, gait apraxia/truncal ataxia, akinetic mutism and incontinence
