Phase 3B 2004/2005 Flashcards

1
Q

What test would you do to confirm Legionnaires disease

A

Urinary antigen test

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2
Q

Treatment of Legionnaires

A

Azithromycin
Eryhtromycin
Doxycycline
Clairthromycin

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3
Q

Signs of sepsis

A
increased HR
Increased cap refill
Increased RR 
Rash 
Temperature 
Drowsy
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4
Q

Mechanism of action of SSRIs

A

Selectively inhibit the reuptake of 5HT at the prefrontal cortex

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5
Q

Features of TGA overdose

A
Tachycardia 
Dilated pupils 
Hypotension 
Arrthymias 
Seizures 
Absent bowel sounds 
Urinary retention
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6
Q

Examples of infectious diseases that causes splenomegaly

A
Salmonella typhi 
Malaria 
Leishmanias 
Viral hepatitis 
Typhoid fever 
Trypanosomiasis
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7
Q

Define empirical

A

Basis of a clinically educated guess in the absences of a complete information

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8
Q

What cells are affected in EBV

A

B lymphocytes

Epithelial cells

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9
Q

Signs of anaphylaxis

A
Flushed 
Swelling of the tongue 
Swelling of the lips 
SOB
Stomach pain 
Fainting 
Sweating
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10
Q

Outline the mechanism in which hypotension occurs in anaphylaxis

A

An allergen reacts with specific IgE antibodies on mast cells and basophils (type 1 hypersensitivity reaction), triggering the rapid release of stored histamine and the rapid synthesis of newly formed mediators. These cause capillary leakage, mucosal oedema and ultimately shock and asphyxia.

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11
Q

What drugs are given in anaphylaxis

A

Corticosteriods
IM adrenaline
Chloramphenamine

Beware of a biphasic reaction a couple of hours later

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12
Q

ECG changes defining an MI

A

ST elevation of 1mm in at least 2 contiguous limb leads
Hyperacute T waves
New onset BBB
ECG changes of ST elevation in 2mm in at least 2 contiguous chest leads

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13
Q

Contra indications to thrombolysis

A
Previous intracranial bleed 
Aortic dissection 
GI bleed 
Neuro 
Severe HTN
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14
Q

Mechanism of action of statins

A

Competitively inhibits HMG-CoA reductase

Decrease the production of cholesterol

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15
Q

Drug to treat postural hypotension

A

Fludrocortisone

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16
Q

ECG signs of hyperkalaemia

A

Tall tented T waves
Absent P waves
Widened QRS complex
Increased PR interval

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17
Q

Modality of imaging in Intussusception and what will be seen

A

Ultrasound

Doughnut or target sign

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18
Q

Complications of CF seen in neonates

A

Meconium illeus

Pancreatic obstruction

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19
Q

Common disease causing organism in CF

A

Staph aureus
Haemophilus influenza
Pseudomonas aerginuosa

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20
Q

What organism requires isolation treatment in CF patients

A

Burkhoderi cepacia

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21
Q

Chromosomal abnormality in Down

A

Non disjunction of chromosomes
Transloaction
Mosacism

22
Q

Examples of trisomys and which chromosomes are affected

A

Pateaus (13)
Edwards (18)
Down’s (21)

23
Q

Non infective causes of splenomegaly

A

Leukaemia
Hepatitis
Sickle cell

24
Q

Examples of gram - ve bacillus

A
Klebsiella 
E.coli 
Enterobacter
Salmonella 
Shigella
25
Q

Give an example of a DNA gyros inhibitor

A

Ciprofloxacin

26
Q

Define incidence

A

Measure of probability of occurrence of a disease

27
Q

Define absolute risk

A

Actual numbers involved

28
Q

Define relative risk

A

Risk of those in the exposed group compared to risk of those in the unexposed

29
Q

Name the three types of cells found in the ovary and what tumours can arise from them

A

Granulosa cells
- Granulosa cell tumours

Germ cells
- Teratomas

Theca cells
- Thecoma

30
Q

Management of ovarian cancer

A

Bilateral salingo-oophrectomy with hysterectomy and lymph node clearance

31
Q

What investigations would you do in a case of suspected SIADH

A
U&Es: sodium and potassium 
Osmolality 
- Serum osmolality (expect it to be low)
- Urine osmolality (expect it to be high)
- Urine sodium (expect it to be high
TFTs
Adrenal function (ensure not in a salt losing crisis) 
Imaging (may be an ectopic)
32
Q

Three ECG features of WPW

A

Delta wave
Widened QRS
Shorten PR interval

33
Q

Causes of a palpitations

A
AF 
Atrial flutter 
Palpatations 
AVNRT 
Frequent ectopics 
Hyperthyroid 
Alcohol 
Anxiety
34
Q

Types of AF

A
Paroxysmal Af ( ~7 days)
Persistent AF 
Chronic AF (>12mnths)
35
Q

Causes of AF

A
Hyperthyroid 
Mitral stenosis 
Alcohol 
Infraction 
Iscahemia 
Inflammation 
Metabolic
36
Q

List the components of CHADsVASc

A
Congestive heart failure 
Hypertension 
Age > 75
Diabetes 
Vascular disease 
Age >60
Sex
37
Q

What options do you have for rate controlling AF

A
Calcium channel blocker
Beta blockers
(must be cardioselective)
Digoxin 
Pill in pocket (flecanide)
38
Q

What is the danger with WPW

A

If you go into AF you have a risk of slipping into VF

39
Q

Sides of a previous MI on an ECG

A

T wave inversion

Pathological Q waves

40
Q

Name the cardiac enzymes that may be measured in MI

A
Troponin T or I
Creatine Kinase Myocyctes 
Creatine kinase skeletal muscle
AST 
Lactate dehydrogenase
41
Q

Name some causes other than MI for a raised trop

A
Myocardiits 
Endocarditis 
Pericarditis 
Trauma to the heart 
CKD 
Sepsis
42
Q

Reversible cause of MI

A

4 Ts

  • Toxins
  • Tamponade
  • Tension pneumothorax
  • Thrombosis

4H’s

  • Hyperkalaemia
  • Hypothermia
  • Haemoorhage
  • Hypoglycaemia
43
Q

Investigations in case of microcytic hypochromic anaemia

A
Blood film 
HB electrophoresis
Iron studies 
- Fe
- Ferritin (is an acute phase reactant can be skewed)
- TIBC
44
Q

Foetal complications in a mother with DM

A
Macrosomia 
Sudden uterine death 
Structural congenital defects 
Hypoglyaemia 
Shoulder dystocia
45
Q

Sings of Down syndrome

A
Epicanthic folds 
Brush field spots 
Wide saddle gap 
Single palmer crease 
Falt occiput 
Low set ears
46
Q

What is the biochemical picture typically seen in bulmia nervosa

A

Hypocholoraemia hypokalaemia hypophosphataemia hypomagnesium metabolic alkalosis

if laxatives are being used it is a metabolic acidosis

47
Q

Signs of hypokalaemia

A
Hypotonia 
Cramps 
Tetany
Palpatations 
Muscle weakness 
Reduce reflexes 
Arrythymias
48
Q

List the side effects associated with the TB drugs

A

Rifampacin: orange sercretion
Isoniazid: peripheral neuropathy
Pryzidamide: hepatitis
Ethamabutol: Colour blindness, loss of peripheral vision

49
Q

Treatment for MS

  • flares
  • maintenance
A

Flares
- IV methlypred

Maintenance

  • IFN-beta
  • Natilizumab
  • Alemtuzumab
50
Q

6 causes of rectal bleeding

A
Haemorroids 
Constipation 
Inflammatory bowel disease 
Malignancy 
ischaemic colitis 
infective colitis
51
Q

Management of HONK

A

IV fluids (0.9% NaCl)
- Rehydrate slowly
Replace any lost K+
If glucose doesn’t fall by 5mmol/L by the hour with rehydration think about starting an insulin sliding scale

52
Q

What is the bradford hill criteria

A
Strength of association 
Consistency 
Temporality 
Biological gradient 
Specificity 
Biological plausible 
Coherence 
Anaology