wrong Qs 2.0 Flashcards
(99 cards)
1
Q
what heart murmur is corrigans sign associated with?
A
aortic regurgitation - heard best upright leaning forward
corrigans sign = collapsing pulse, visible carotid pulsation
2
Q
what cardiovascular problem can syphilis cause?
A
arterial aneurysm - ascending/arch of aorta common
3
Q
complication of AAA surgery
A
trash foot
surgeries - laparotomy / endovascular repair (EVAR, less invasive)
4
Q
prolong QT interval is a feature of what
A
hypocalcaemia
5
Q
what can conns syndrome cause?
A
secondary hypertension
conns syndrome = hyperaldosteronism
6
Q
IVC filter
A
for recurrent PEs
7
Q
respiratory cause of AF
A
pneumonia
8
Q
pathophysio of exercise in intermittent claudication
A
exercise encourages collateral artery development
9
Q
critical limb ischaemia
A
rest pain for 2 weeks
ankle pressire <50 mmHG
amputation may be required to prevent gangrene spread
10
Q
3rd heart sound characteristics
A
after S2 in early diastole
a sign of heart failure
11
Q
what time of day is peripheral vascular rest pain worse?
A
@ night
12
Q
what effect does constrictive pericarditis have on JVP?
A
raised JVP
13
Q
murmur in ventricular septal defect
A
pan-systolic murmur
14
Q
JVP in complete heart block
A
cannon waves
15
Q
JVP paradoxically rising on inspiration
A
constrictive pericarditis
Kussmaul’s sign - impaired RV filling
16
Q
risk factors of ischaemic HD
A
decreases HDL
hypothyroidism
17
Q
major cause of cardiomyopathy
A
alcohol
18
Q
a cause of high output heart failure
A
thyrotoxicosis
19
Q
complications of MI
A
LV aneurysm (late) cardiogenic shock - rupture of heart septum or papillary muscles oedema - heart failure AF pericarditis (dresslers)
20
Q
hyper resonant percussion note + decreased expansion
A
pneumothorax
21
Q
young patient, ST elevation in all leads (concave), radiates to neck + arm
A
acute pericarditis - angina/MI vibes but NOT !!
** relieved by sitting forward **
22
Q
ECG of someone on digoxin
A
concave ST depression in ALL leads with T wave inversion
23
Q
radio-femoral delay
A
coarctation of aorta
24
Q
myxoma
A
tumour of primitive tissue in heart atrium
“plop” sound early diastole
25
haphazard electrical activity, no recognizable complexes + no coordination
ventricular fibrillation
26
drugs that can cause gynaecomastia
spironolactone
digoxin
cimetidine - H2 blocker (stomach acid)
liver cirrhosis
27
atrial septal defect on auscultation
wide fixed splitting of S2
normal = split on inspiration, single on expiration
FIXED splitting = when respiration makes no difference to the interval between aortic + pulmonary components of S2
28
difference between osler nodes + janeway lesions
both signs of infective endocarditis
osler - tips of fingers/toes + painful/tender
janeway - palms/soles + NON-tender
29
what are roth spots
retinal haemorrhages - sign of infective endocarditis
30
which cardiac drug can cause pulmonary fibrosis + liver cirrhosis as a side effect
amiodarone
31
most common cause of ejection systolic murmur + S4 in U30s
hypertrophic cardiomyopathy
32
cheyne-strokes
alternating hyper/hypoventilation
--> sign of severe heart failure
33
side effect of adenosine
hyper/hypothyroidism
--> weight loss, tremor, weakness, palpitations, heat intolerance
34
test for orthostatic syncope
tilt table testing
"fainting after standing behind fish counter for 2hrs" lol
35
diagnosis of paroxysmal SVT
holter monitoring - 24hr ECG
36
signs of HOCM
jerky pulse
double apical impulse
S3 + S4
late systolic murmur
37
drug that can cause gout
bendroflumethiazide > thiazide diuretic > hyperuricaemia
gout symptoms -
sudden severe pain in a joint – usually your big toe, but it can be in other joints in your feet, hands, wrists, elbows or knees
hot, swollen, red skin over the affected joint
38
angina investigation for patient who can't exercise (non-invasive cardiac evaluation)
thallium scanning
stress echo - dobutamine used to stimulate heart + US used to look for wall motion abnormalities
39
non-metastatic extrapulmonary manifestation of bronchial carcinoma
cushings syndrome
--> due to ectopic adrenocorticotrophic hormone (ACTH) secretion
40
kartangeners syndrome
ciliary dysfunction (autosomal recessive)
causes bronchiectasis, situs inversus, chronic sinusitis,
41
reduced chest wall movement + increased vocal resonance
lung consolidation
42
ECG + respiratory failure type in PE
type 1 resp failure
ECG - RBBB
43
meningioma
benign
44
liver failure cause trans or exudative pleural effusion
transudative
--> hypoalbuminaemia - decrease in hydrostatic pressure
45
a cause of hypertrophic pulmonary osteoarthropathy
bronchial carcinoma - NSCLC
46
common causes of clubbing
bronchiectasis, empyema, bronchial carcinoma, mesothelioma, pulmonary fibrosis
if u say COPD ur a gimp
47
goodpastures syndrome
vasculitic disorder featuring proliferative glomerulonephritis + pulmonary haemorrhage
-->autoimmune
causes haemoptysis
anti-GBM antibodies are characteristic
48
pneumonia after influenza
staph aureus
49
smoker, 6 month gradual SOB, CXR = hyperexpanded lung fields + no focal lesions
COPD
50
rusty sputum
pneumococcal / strep pneumoniae
51
terbutaline
SABA
52
fluticasone
ICS - beclometasone
53
impotent + buttock claudication
peripheral vascular disease
54
23 y/o, SOB, just returned from africa, o2 sats 92%, CXR normal
PE from long haul - CTPA
55
68 y/o, pancreatic cancer, 5hr history of haemoptysis + SOB, 92 o2 sats, high RR, CXR = small triangular area of increased density in right lung field
PE
wedged shaped lesion = infarct
56
COPD patients, bone fractures/issues due to medication
steroids - prednisolone
57
dry mouth caused by inhaler
ipratropium bromide - blocks parasympathetic bodily functions such as salivation (LAMA)
58
bronchial carcinoma, swollen face, dilated veins over thorax
SVC obstruction - complication of lung cancer
59
lethargy, constipation, abdo pain, nocturia, low mood, doesnt enjoy activities she once did, what type of cancer?
squamous - ectopic parathyroid hormone related peptide (PTHrP) causing hypercalcaemia
60
bronchial carcinoma, drooping eyelids, after repeated attempts to open eyes fully, droopiness disappears
eaton-lambert syndrome - small cell
characteristically weakness improves with repeated activity
61
suspected PE, CT pulmonary angiogram requested, what is the most important consideration before the test can go ahead?
normal renal function
62
name of proteins which catalyse phosphorylation reactions
kinases
63
gram positive rods
c diff
| bacillus cereus
64
glossitis
smooth red sore tongue
caused by iron, folate or b12 deficiency
65
treatment of mallory-weiss tear
usually heals spontaneously
66
symptoms of cholera gastroenteritis
watery diarrhoea - rice water
67
what kind of diet can cause diverticular disease
low fibre
68
small intestine valvulae conniventes on AXR
cross entire lumen
69
risk factors for squamous cell carcinoma
achlasia
alcohol
coeliac disease
70
painless jaundice, palpable mass in RUQ, weight loss, dark urine + pale stools
carcinoma of head of pancreas
71
acute bloody diarrhoea in children
medical emergency
72
A 43-year-old businessman presents to his general practitioner with fever, headache, and diarrhoea. He has not had any coughs, nausea, or vomiting. He is normally fit and well. The only history of note is that he returned from a business trip in India 3 weeks ago. He has been eating and drinking the same things as his family since his return, and they are all well. On examination, the man appears dehydrated and has right upper quadrant tenderness.
What is the most likely diagnosis?
hep A
Hepatitis A has an incubation period of 2-4 weeks, meaning that patients in the UK often present after returning home from travelling to at-risk countries
Traveller's diarrhoea is when there are at least 3 episodes of diarrhoea in a 24 hour period, either during or shortly after foreign travel. 3 weeks after travel is too late.
73
18 y/o, 1 week history of lethargy, headaches, painful sore throat, not travelled abroad
no rash until GP gave antibiotics
sore abdomen when examined over liver, spleen + lymphadenopathy, yellow eyes
most appropriate test to perform?
monospot test
diagnosis = infectious mononucleosis (glandular fever, epstein-barr virus)
74
12 y/o, decreased pigmentation of skin + eyes, history of severe bacterial + viral infections + bleeding abnormalities
Chediak-Higashi (auto recessive)
--> decreased phagocytosis resulting in pyogenic infection, partial albinism + peripheral neuropathy
75
1 y/o, well until 6 months - developed recurrent otitis media
severe pneumonia @ 8 months
now presents with seizure, reduced GCS, high fever, globally reduced tone
Bruton's agammaglobulinemia
X-linked primary immunodeficiency disease with absence of IgG
condition presents in young children with sino/pulmonary infections
76
drug that HIV patient with pneumocystis pneumonia responds to
co-trimoxazole
77
22 y/o backpacker, travelled trough southern russia for months. presents with iron deficiency anaemia
most appropriate test?
distal duodenal biopsy
differentials = Giarda or coeliac
distal duodenal = gold standard for both
** (not sure about that luv but its what the q says) **
78
most common malignant tumour in colon? where does it metastases first?
adenocarcinoma
metastases in liver first
79
what stage of lung maturation does branching of the terminal bronchioles occure?
pseudoglandular
80
reducing agent in conversion of pyruvate to lactate
NADH
81
very low infectious dose, effects mediated by toxin, most common cause of renal failure in under 5s
E coli 0157
82
units of alcohol in litre of 40% proof spirits
40 units
83
30 y/o, RIF pain, previous gynae surgery
investigations?
laparoscopy
differentials = appendix or ovarian pathology
would exclude both
84
what does increased pulmonary arterial vasoconstriction result in?
increased pulmonary vascular resistance - associated pulmonary hypertension
--> this in turn leads to increased RV afterload + initially RV hypertrophy, eventually followed by RV dilation + failure (Cor pulmonale)
85
medication used for rapid relief of thyrotoxic symptoms including atrial fibrillation
bisoprolol - selective beta blocker
86
20 y/o, lethargy, headaches, fever, nausea, abdo pain for 4 days. no rash. returned from backpacking india 28 days ago, yellow eyes
hep A
| dengue fever typically has rash
87
pathology seen in person not attending barretts review sessions with worsening symptoms
uncontrolled proliferation of MUCOUS GLAND cells in lover 1/3 of oesophagus
--> adenocarcinoma = GLAND cells
88
62 y/o man w alcohol related cirrhosis + alcoholic hepatitis who is anuric + CVP = 12
most appropriate initial management?
terlipressin
--> has developed hepato-renal syndrome = has been adequately fluid resuscitated - terlipressin will improve renal flow
(anuria = failure of kidneys to produce urine)
89
55 y/o with know PBC, bilirubin rose to 110 over 6 months, abdominal US show normal bile ducts
most appropriate initial management?
liver transplant
--> raised bilirubin in absence of biliary disease shows deteriorating liver function + liver failure requiring transplantation
90
artery located inferior to retroinguinal space
femoral
--> retroinguinal space lies deep to inguinal ligament through which structures pass between abdominopelvic cavity + lower limb
(external iliac artery becomes femoral as it passes under inguinal ligament)
91
healthy start vitamins are provided to low-income pregnant woman
this is most likely to reduce the prevalence of which deficiency disease?
rickets/osteomalacia (vit D)
--> the vitamins contain folic acid + vitamins C+D
92
what acts on membrane bound beta2 adrenoceptor on airway smooth muscle to mediate relaxation?
adrenaline
93
confidentiality
confidentiality is about the importance of keeping medical info private + secure
94
50 y/o alcoholic with history of recurrent abdominal pain + central abdominal calcification on AXR
Ix to confirm diagnosis?
faecal elastase
--> recurrent abdo pain makes chronic pancreatitis likely, this is supported by calcification on AXR, also alcohol is big cause
> best test of pancreatic function = faecal elastase
95
severe aspiration pneumonia treatment
IV amoxicillin, gentamicin + metronidazole
96
most appropriate treatment for grade C oesophagitis
PPI
97
tight benign peptic stricture seen on endoscopy - most appropriate management?
balloon oesophageal dilatation
--> rapid relief of symptoms, safer that bougie
98
choosing between hellers cardiomyotomy + balloon oesophageal dilatation for achlasia
myotomy - young, fit, has advantage of not requiring repeat procedures
99
causes of of Beri-Beri + Pellagra
Beri-Beri - thiamine deficiency (vit B1)
Pellagra - niacin deficiency (vit B3)
