Year 1 Flashcards by Evie Brown

Define 3rd degree heart block

No relation between P wave and QRS complexes, but both are present

Abnormally shaped QRS

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Describe the CT findings seen in idiopathic pulmonary fibrosis

Basal and sub-pleural reticulonodular shadowing

Ground glass appearance (early phase change)

Honeycombing (late phase change)

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Name the coronary artery which supplies the left ventricle

Left marginal artery

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Define 2nd degree heart block - Mobitz type II

Each P wave is associated with a QRS complex until there is one atrial conduction or P wave that is not followed by a QRS

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Describe the sputum findings associated with pneumonia caused by Pseudomonas or Haemophilus

Green sputum

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Which antibiotics would you use to treat community-acquired pneumonia with a CURB score of 0-2?

Amoxicillin IV/PO (if penicillin allergic: doxycycline day 1 then course of doxycycline or IV clarithromycin)

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LFT interpretation:

Normal or ↑ ALT
↑↑ ALP
↑↑ GGT
↑↑ bilirubin

Cholestasis

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What is a normal QRS complex duration?

<0.1 secs

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Interpretation of ABG results: decreased pH, increased CO2, and normal HCO3

Uncompensated respiratory acidosis

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Name the antibody which is. the second least abundant; its role is not fully known

IgD

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Define sarcoidosis

Multisystem granulomatous (type IV) disorder to an unknown antigen

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Which type of lung cancer is typically a peripheral tumour, and is the least common type (10%)?

Large cell carcinoma

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What is the coronary sinus?

Short venous conduit located in the atrioventricular groove posteriorly which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

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Name the coronary artery which supplies the right atrium and the right ventricle

Right coronary artery

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Define pneumoconiosis

Lung disease caused by mineral dust exposure e.g. asbestosis

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Describe the findings on CXR seen in hypersensitivity pneumonitis

Widespread pulmonary infiltrates

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Interpretation of ABG results: normal pH, increased CO2, increased HCO3

Fully compensated metabolic acidosis

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Name the first antibody to be made in an infection; it is involved in B cell activation, agglutination, and activates complement via the classical pathway

IgM

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Name the antibody which is a monomer in serum but dimer in secretions

IgA

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List the clinical features which make up the CURB65 score

Confusion
Urea ≳ 7 mmol
Resp. rate > 30
BP - systolic < 90, diastolic ≲ 60
≳65 years

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Name the murmur: ejection systolic murmur best heard in the 2nd right intercostal space at the sternal edge, radiates to carotids

Aortic stenosis

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Describe the mechanism of a type IV hypersensitivity reaction, and give an example

T cell-mediated, e.g. rheumatoid arthritis, sarcoidosis

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Name the branches of the right coronary artery

Right marginal artery, posterior interventricular artery (in 80-85% of people - right dominant pattern)

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Interpretation of ABG results: decreased pH, increased CO2, and increased HCO3

Partially compensated respiratory acidosis

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Interpretation of ABG results: normal pH, increased CO2 and increased HCO3

Fully compensated respiratory acidosis

Name the coronary artery which supplies the SA node and AV node in the majority of patients

Right coronary artery

Name the coronary artery which supplies the right and left ventricles and the interventricular septum

Posterior interventricular artery

Name the antibody secreted in colostrum

IgA

ALT/AST __ ALP = hepatocellular

Which antibiotic would you use to treat atypical pneumonia apart from Legionella?

Doxycycline

Interpretation of ABG results: increased pH, increased CO2, increased HCO3

Partially compensated metabolic alkalosis

Which antibiotics would you use to treat non-severe hospital-acquired pneumonia?

PO amoxicillin (if penicillin allergic: PO doxycycline)

Which type of lung cancer is typically a central tumour, is the most common type in smokers, and can be associated with ectopic PTHrP release?

Squamous cell carcinoma

Name the heart rhythm (+ describe)

Torsade de pointes Specific polymorphic VT associated with a long QT interval QRS complexes appear to twist around the isoelectric line

Describe the sputum findings associated with pneumonia caused by Klebsiella

Red currant-jelly sputum

Which antibiotics would you use to treat severe hospital-acquired pneumonia?

IV amoxicillin + gentamicin (if penicillin allergic: PO doxycycline + gentamicin)

Name the heart rhythm (+ describe)

Atrial flutter Rate: atrial 300 bmp, ventricular usually 150 bmp P wave: saw tooth ‘F’ wave QRS: normal Rhythm: regular, may be variable

Which channels do class II anti-arrhythmic drugs block?

β-adrenoceptors - decrease the rate of depolarization in the SA and AV nodes

Name the antibody that transfers across the placenta so is important in foetal immunity

IgG

Name the anti-arrhythmic drug class

Class III

What is a normal PR interval?

0.12-0.2 secs

Define hypersensitivity pneumonitis

Acute or chronic hypersensitivity type III reaction to an antigen e.g. thermophilic bacteria (farmer's lung), avian proteins (bird fancier's lung), and fungi (malt worker's lung)

Which antibody has a pentameric shape?

IgM

Hep B serology: HBsAG positive, anti-HBs negative, anti-HBc IgG positive

Chronic infection

Hep B serology: HBsAG negative, anti-HBs positive, anti-HBc negative

Vaccinated

Interpretation of ABG results: normal pH, decreased CO2, decreased HCO3

Fully compensated metabolic acidosis

How do you determine cardiac axis?

Lead I positive and lead II positive = normal cardiac axis Lead I positive and lead II negative = left axis deviation Lead I negative and lead aVF positive = right axis deviation

Name 3 common graft sites for coronary artery bypass grafting

Radial artery, internal thoracic artery, great saphenous vein

Describe the mechanism of a type II hypersensitivity reaction, and give an example

IgM or IgG binds to antigens of particular tissue types, resulting in complement activation e.g. Goodpasture's

Interpretation of ABG results: increased pH, decreased CO2, decreased HCO3

Partially compensated respiratory alkalosis

Describe the mechanism of a type III hypersensitivity reaction, and give an example

Antibody binds to excess soluble antigen resulting in immune complex formation e.g. SLE, hypersensitivity pneumonitis

Name the coronary artery which supplies the left atrium and the left ventricle

Left circumflex artery

Interpretation of ABG results: increased pH, normal CO2, increased HCO3

Uncompensated metabolic alkalosis

Name the murmur: pan-systolic murmur best heard at the apex, radiates to the axilla

Mitral regurgitation

Describe the sputum findings associated with pneumonia caused by S. pneumonia

Rust coloured sputum

Name the anti-arrhythmic drug class

Class IV

Which channels do class I anti-arrhythmic drugs block?

Na+ channels

Interpretation of ABG results: decreased pH, decreased CO2, decreased HCO3

Partially compensated metabolic acidosis

Name the arrhythmia (describe)

Wolff-Parkinson-White syndrome Sloping QRS complex (delta wave) - pre-excitation Short PR interval

Hep B serology: HBsAG negative, anti-HBs negative, anti-HBc negative

Susceptible

ECG interpretation: ST elevation in leads I, aVL, V3-6

Anterolateral MI - left coronary artery affected

Interpretation of ABG results: increased pH, decreased CO2, normal HCO3

Uncompensated respiratory alkalosis

Name the branches of the left coronary artery

Left anterior descending, left marginal artery, and the left circumflex artery

LFT interpretation: ↑↑ ALT Normal or ↑ ALP Normal or ↑ GGT ↑ or ↑↑ bilirubin

Acute hepatocellular damage

Describe the sputum findings associated with pneumonia caused by anaerobes

Foul smelling and bad-tasing sputum

Hep B serology: HBsAG negative, anti-HBs positive, anti-HBc positive

Past infection

Describe the CXR findings seen in sarcoidosis

Bilateral hilar or paratracheal lymphadenopathy

Hep B serology: HBsAG positive, anti-HBs negative, anti-HBc IgM positive

Acute infection

Name the heart rhythm (+ describe)

Atrial fibrillation Atrial rate \>300 bmp Irregularly irregular rhythm No P waves - irregular baseline Narrow QRS

Define primary sclerosing cholangitis

Chronic autoimmune condition that results in the fibrosis and destruction of intra-hepatic and extra-hepatic bile ducts

80% of patients with primary sclerosing cholangitis have what associated disease?

IBD (more likely to be UC)

Which antibiotics would you use to treat pneumonia caused by Legionella?

Clarithromycin/erythromycin or levofloxin

Name the heart rhythm (+ describe)

Ventricular fibrillation Bizarre irregular waveform No recognizable QRS complexes Random frequency and amplitude Uncoordinated electrical activity

Which channels do class IV anti-arrhythmic drugs block?

Ca2+ channels - slow conduction in SA and AV nodes, decrease force of cardiac contraction

Name the most abundant antibody in plasma; it is dominant during the secondary response

IgG

Which channels do class III anti-arrhythmic drugs block?

K+ channels - prolong AP duration, increasing refractory period

LFT interpretation: Normal or ↑ ALT Normal or ↑ ALP Normal or ↑ GGT Normal or ↑ bilirubin

Chronic hepatocellular damage

Interpretation of ABG results: decreased pH, normal CO2, decreased HCO3

Uncompensated metabolic acidosis

Which antibiotics would you use to treat community-acquired pneumonia with a CURB score of 3-5?

Co-amoxiclav IV + doxycycline IV (if penicillin allergic: levofloxin)

ECG interpretation: ST elevation in V1-V4

Left anterior descending artery affected V1 and V2 - anterior V3 and V4 - septal

ALP __ ALT/AST = cholestasis

Interpretation of ABG results: normal pH, decreased CO2, decreased HCO3

Fully compensated respiratory alkalosis

Define 2nd degree heart block - Mobitz type I

Progressive lengthening of the PR interval, eventually resulting in a dropped beat (P wave with no QRS)

Name the anti-arrhythmic drug class

Class II

Name the heart rhythm (+ describe)

Polymorphic VT QRS complex varies in amplitude

Which antibiotics would you use to treat severe aspiration pneumonia?

IV amoxicillin + gentamicin + metronidazole (if penicillin allergic: PO doxycycline + IV gentamicin + metronidazole)

Which type of lung cancer is typically a peripheral tumour and is the type most closely associated with asbestos exposure (most likely in non-smokers)?

Adenocarcinoma

Name the coronary artery which supplies the right ventricle, left ventricle, and interventricular septum

Left anterior descending artery

Which antibiotics would you use to treat community-acquired pneumonia where the patient is in ICU?

Co-amoxiclav IV + clarithromycin IV (if penicillin allergic: levofloxin)

Name the murmur: ejection systolic murmur best heard at the left sternal edge, made louder if you ask the patient to sit forward, breathe out and hold, collapsing pulse

Aortic regurgitation

Describe the mechanism of a type I hypersensitivity reaction, and give an example

IgE-mediated response to external antigen e.g. asthma, anaphylaxis

Define 1st degree heart block

PR interval greater than 0.2 seconds (5 small squares)

Name the murmur: mid-diastolic murmur best heard at the apex, malar flush, tapping apex beat

Mitral stenosis

Which antibiotics would you use to treat non-severe aspiration pneumonia?

PO amoxicillin + metronidazole (if penicillin allergic: doxycycline + metronidazole)

ECG interpretation: ST elevation in I, aVL, V5, V6

Lateral MI - left circumflex artery affected

ECG interpretation: ST elevation in II, III and aVF

Inferior MI - right coronary artery affected

Name the coronary artery which supplies the right ventricle and the apex

Right marginal artery

Name the second most abundant antibody

IgA

Describe the findings on imaging (CXR and CT) seen in chronic hypersensitivity pneumonitis

CXR - pulmonary fibrosis, most commonly in upper zones CT - ground-glass attenuation and patchy micronodules of fibrosis in the upper lobes

Name the anti-arrhythmic drug class

Class I

Which type of lung cancer is typically a central tumour, and can be associated with ectopic ACTH secretion and SIADH?

Small cell lung cancer

Define primary biliary cholangitis

Autoimmune disease of the liver which causes the destruction of the small bile ducts - liver only

Name the antibody which is the least abundant in plasma; it mediates type I hypersensitivity

IgE

Name the heart rhythm (+ describe)

Monomorphic VT Constant QRS morphology Board complex rhythm Rapid rate

Describe the CXR findings seen in pneumoconiosis

Simple pneumoconiosis - non-calcified multiple round opacities in the upper zone Complicated pneumoconiosis - bilateral, upper-mid zone fibrotic masses, develops from periphery to hilum

Year 1 Flashcards

(105 cards)