Part 2 set I

  1. What Ecg changes would you see with an ASD?
    Right Bundle Branch Block in all ASDs

    • If its primum (low) - LAD
    • If its secundum (high) - RAD
  2. Learning disability + epilepsy lead you to think of 3 diagnoses - how do you differentiate between them?
    NF1 - Basal ganglia calcifications on CT, Cafe-au-lait spots.

    Tuberous sclerosis - calcified phakomas in the periventricular white matter,
  3. Early stage head and neck cancers without local spread - what are the treatment options?
    • External beam radiotherapy
    • Surgery
  4. Which vaccines are recommended for HIV patients?
    • Hep B - coz they get it
    • Pneumococcal - coz they get it
    • Yearly influenza - coz they get it really bad
  5. What is the most concerning progression of SAH?
    • Delayed cerebral ischaemia due to Vasospasm
    • Secondary to a variety of factors
    • Typically starts on day 3 post bleed
    • Maximal at day 5-12 and resolves by 21
    • Nimodipine is given prophylactically and they need Neuro ITU
    • Leading cause of death following SAH
  6. What is the most common glomerulonephritis in SLE?
    • Grade IV
    • A.K.A. Diffuse Proliferative Glomerulonephritis
    • Worst prognosis of all of them
    • Treat with IV cyclophosphamide and High dose pred
  7. What is Felty's syndrome?
    • Leg ulcers
    • Pancytopenia
    • Splenomegaly

    In a patient with long standing seropositive RA
  8. What can you do for Pretibial myxodema?
    Reassure them, most of them will go away

    If its really painful and swollen, consider Topical fluocinolone (potent steroid)
  9. What is Relapsing Polychondritis?
    What it says on the tin.

    • Affects:
    • auricle of ear - Sparing of earlobe
    • Costochondral joints - pleuritic CP
    • Eyes
    • Joints
    • Tracheal cartilage leading to stenosis and life threatening stridor
    • Can damage kidneys
  10. Failure of the BP to increase when exercising?
    Evidence of Left main stem disease causing a dysfunctional ventricle.

    Arrange angiography urgently.
  11. What do you do with a thyrotoxic pregnant lady?
    • Give them carbimazole at the lowest possible dose.
    • If its the first trimester - give propylthiouracil at lowest possible dose.
    • Propranalol, Radioiodine and potassium percholate are contraindicated in pregnancy.
  12. How do you differentiate between LGV, Chancroid and Granuloma inguinale
    • Chancroid (h.ducreyi) -ve = painful ulcers
    • LGV = initial painless ulcer
    • Granuloma inguinale (donovanosis) = indolent painless ulcers
  13. Which factors bypass chads vasc and mean that you go straight to warfarin?
    • Valvular disease
    • Previous VTE
    • Intracardiac thrombus
  14. When do you stop antiobesity drugs?
    • If weight loss is less than 5% at 12 weeks.
    • Also you cant use them in conjunction
  15. broad complex irregular tachycardia caused by an accessory pathway.
    Which drug would you use to stop it and which drugs would you avoid like the plague?
    AVOID Verapamil, adenosine and digoxin - they all block the AV node and will cause the all the impulses to go down the accessory

    USE flecanide.
  16. Red, angry painful mid foot in a diabetic with peripheral neuropathy?
    DO NOT give antibiotics unless signs of infection

    • This is the beginning of charcot foot and you need to plaster it and fully immobilise it.
    • Change the plaster every week or 2 to protect the skin and then use a full foot brace after 12 weeks.
  17. What is co-danthramer and whats it for?
    • Its a mix of dantron + poloxamer.
    • Dantron is a peristaltic
    • Poloxamer relaxes the effect of opioid induced constipation. also causes colon and liver tumors.
    • Use it for terminally ill patients on loads of opioids only.
Card Set
Part 2 set I