Cardiology
What is its mechanism of action
Blocks the Na+/K+ pump.
45 year old male with 1 week history of shortness of breath
His chest is clear. When you examine him his saturations are 95% on room air. He requests to go to the bathroom. When he gets up from his chair and takes 3 steps, he stops and leans by the wall. You reassess his oxygen saturations. The reading is 83%.
Whats your diagnosis
PCP
A patient presents with right-sided weakness involving the face, arm and leg, together with expressive aphasia. Which cerebral hemisphere and vascular territory are most likely affected?
Left Middle Cerebral Artery
What is the most common cause of chronic kidney disease worldwide?
Diabetes
What is the most common cause of upper gastrointestinal bleeding worldwide?
Peptic Ulcer Disease
17 year old female recently had a positive group A Beta-haemolytic streptococcal infection
Name 2 major criteria required to make a diagnosis for Rheumatic Heart Disease
• Carditis: tachycardia, murmurs (mitral or aortic regurgitation, Carey Coombs’ murmur), pericardial rub, CCF, cardiomegaly, conduction defects (45–70%). An
apical systolic murmur may be the only sign
• Arthritis: a migratory, ‘flitting’ polyarthritis; usually affects larger joints (75%).
• Subcutaneous nodules: small, mobile, painless nodules on extensor surfaces of joints and spine (2–20%).
• Erythema marginatum: geographical-type rash with red, raised edges and clear centre; occurs mainly on trunk, thighs and arms in 2–10% (p562).
• Sydenham’s chorea (St Vitus’ dance): occurs late in 10%. Unilateral or bilateral involuntary semi-purposeful movements.
You look under a microscope and find gram positive cocci in chains
What is the name of this organism
S. aureus
A patient develops ascending weakness with absent reflexes one week after an episode of diarrhoea. What is the most likely diagnosis? Name 1 likely organism
GBS
C. jejuni
A patient has hyperkalaemia with ECG changes. What is the first drug that should be administered?
IV Calcium Gluconate
Name four major complications of portal hypertension.
Answer:
Any four:
A 34 year old Female recently had an acne breakout. She purchase oral contraceptive as an adjuvant treatment for her an acne. She recently travelled by air for a work conference. The trip spanned 13 hours in total. Whilst in her hotel room she felt out of breath and started experiencing shortness of breath. She was rushed to the emergency room. Her d-dimer levels were raised. What three features would you expect on her ECG
ECG findings may include: sinus tachycardia (commonest),
RBBB, right ventricular strain pattern (R-axis deviation, dominant R
wave and T-wave inversion/ST depression in V1 and V2,). Rarely, the ‘SIQIIITIII’ pattern
occurs: deep S waves in I, pathological Q waves in III, inverted T waves in III.
You examine a 58 year old woman who has exertional dyspnea and cough. She recently had a pelvic scan which showed an ovarian fibroma. Upon listening to her chest, you find that her right lung has reduced air entry and is stony dull on percussion.
What is the diagnosis
Meigs Syndrome
Name the three cardinal clinical features of Parkinson's disease.
(Postural instability is another important feature.)
Name the three major indications for emergency dialysis that are commonly tested
A patient with hepatitis B develops a markedly elevated alpha-fetoprotein level and a liver mass. What is the most likely diagnosis?
HCC
67 year old female presents to the emergency room with a history of shortness of breath for 2 months. Her blood pressure is 170/80mmHg
She has a collapsing radial pulse
What is your diagnosis
Aortic Regurgitation
What is the GOLD investigation used to diagnose COPD?
Spirometry demonstrating a post-bronchodilator FEV₁/FVC ratio <0.70.
A 32-year-old HIV-positive man presents with headache, fever, confusion and a focal neurological deficit. His CD4 count is 35 cells/µL. Brain CT demonstrates multiple ring-enhancing lesions. What is the most likely diagnosis?
A patient has nephrotic syndrome. Name the four classical features.
What is the most common cause of painless obstructive jaundice in an elderly patient?
Carcinoma of head of pancreas
A 37 year old man has Central chest pain worse on inspiration and on lying down flat. The symptoms are relieved when he sits forward. The heart sounds are difficult to appreciate.
Name 5 possible causes for his condition
• Viruses: eg coxsackie, echovirus, EBV, CMV, adenovirus, mumps, varicella, HIV.
• Bacteria: eg TB—commonest cause worldwide, Lyme disease, Q fever, pneumonia,
rheumatic fever, Staphs, Streps, mycoplasma, legionella, MAI in HIV.
• Fungi and parasitic: v rare, usually in immunocompromised.
• Autoimmune: systemic autoimmune diseases eg SLE, RA; vasculitides eg Behçet,
Takayasu; IBD; sarcoid; amyloid; Dressler’s (p698).
• Drugs: eg procainamide, hydralazine, penicillin, isoniazid, chemotherapy.
• Metabolic: uraemia, hypothyroidism, anorexia nervosa.
• Others: trauma, surgery, malignancy, radiotherapy, MI, chronic heart failure.
Which type of respiratory failure is characterised by hypoxaemia with hypercapnia?
Type 2
A patient suddenly develops the "worst headache of their life." What diagnosis must be excluded first?
Subarachnoid Headache
What acid-base disturbance is typically seen in prolonged vomiting?
Metabolic Alkalosis
Which virus is the most common cause of acute viral hepatitis worldwide?
Hep A