league of legends

naomi low beer

100

type 1 respiratory failure vs type 2 respiratory failure

type 1 respiratory failure - hypoxaemia with no hypercapnea 

type 2 resp failure - hypoxaemia with hypercapnea 

200

how are cirgler najar type 1 and type 2 different 

crigler najar type 1 is an absense of the gene causing absence of UDP G transferase type 2 is less but not absent

300

what type of renal pathology would you NOT expect to see in a patient who comes in with significant proteinuria ?

a. diabetic nephropathy

b. renal artery stenosis 

c. Iga nephropathy 

d. focal segmental glomerulosclerosis 

e. minimal change disease

b. renal artery stenosis 

400

Patient ( Male, 15) comes in with itchy jaundice,  tremor in both hands for 5 months along with mood changes and difficulty speaking. Upon ecamination, you note a golden ring around the ocrnea. What are your impressions?

wilson's 

500

Patient (male, 50) comes in with fever, abdominal pain, unintentional weight loss, diarrhoea, shortness of breath and chest pain that has been going on for 5 days. He has a background of high blood pressure and works as a farmer. You see non temder lumps in his axillary lymph nodes. He has raised inflammatory markers and low Hb with normal MCV. His LFTs, and U&Es show nothing too concerning. Chest X ray and Quantiferon was normal.  US abdomen shows thickened small bowel and retroperitoneal lymphadenopathy. Micro has ruled out Brucellosis and E coli infection. Biopsy of the small bowel has shown PAS positive ma

1) coeliac's disease

2) sarcoidosis 

3) Chron's disease 

4) Whipple's disease 

 

whipples 

lux

100

what do you see in abg results for dka 

low ph, low paCO2, low bicarb, 

200

what is cushings triad

1) bradycardia 

2) low resp rate 

3) hypertension

300

treating a patient with a severe ulcerative colitis flare up 

corticosteroids ( prednisolone, budeosinede) and immunomodulators 

400

Patient ( male, 65y) presents with painless jaundice, dark urine, pale stools and unintenional weight loss. He complains of dull ache in epigastric area radiating to the back worse when lying flat. He denies gallstones and does not have any history of alcohol. Examination reveals Courvoiser's sign. INvestigations show raised LFTs and raised CA 19-9. What are your impressions and what further steps would you do?

biopsy to confirm adenocarcinoma and ultrasound/ CT abdomen 

impression : pancreatic carcinoma

500

Patient ( male, 42) presents with mild epigastric pain, heartburn, and vomitting for the past 9 months with watery diarrhoea ( 5-6 times a day) ( nil blood or steatorrhea ). He was given a trial of omeprazole but the symptoms had minimal relief. He has a history of peptic ulcer disease and multiple stubborn gastric ulcers that did not heal. Micro rules out H pylori infection No history of NSAID use. Investigations showes a low gastric pH and endocscopy shows multiple duodenal ulcers in distal duodenum. He reports his father had similar presentations at a similar age. What are your impressions

Zollinger Ellison syndrome with a background of peptic ulcer disease

sion

100

what is beck's triad? 

1) muffled, distant heart sounds

2) hypotension 

3) distended neck veins 

indicates cardiac tamponade

200

what is charcot's triad and what does it indicate

(bonus 50 if you know reynolds pentad )

1) right upper quadrant tenderness 

2) fever 

3) jaundice

4) AMS 

5) hypotension

300

what is the treatment for hypercholestraemia if the patient ahs statin allergies

PCSK9 inhibitors or Bempedoic acid

400

Patient ( male, 16) presents to the clinic because he is worried about being different from his peers. He has not had his puberty yet and has difficulty smelling things what does he have

Kallman's syndrome 

500

Patient presents with AKI, and is known to have alcoholic liver disease with cirrhosis. THe impression is hepatorenal sydrome. First line for treating this?

Terlipressin with IV albumin  for 7 days to see renal improvement 

( terlipressin is a synthetic vasopressin analogue) 

MOA 

acts on the vascular smooth muscle of splanchnic circulation -> leads to vasoconstriction -> decreased portal venous pressure -> increases renal perfusion

katarina

100

what are the most common secondary diseases you would expect in a patient with chronic kidney disease

1. honestly any cardiac  

2. bones 

3. anaemia

4. bone disorders 

200

what investigations do you do to differentiate type 1 v type 2 diabetes  ( name 2)

islet autoantibodih testing, c peptide measurement 

300

when managing a spesis patient, you are treating them for their low blood pressure (90/60). You have given IV fluids and see improvement but it is still low. What are your next steps of management? 

1) vasopressors 

2) inotropic agents 

400

A patient comes in via ambulance with shortness of breath and is coughing up green coloured sputum. His basic obs show that he has an oxygen saturation of 83% and you check his notes that says his normal readings are usually 89% due to his 20 year old history of COPD. What oxygen would you prescribe?

1) 15L non-rebreather mask 

2) 15L nasal cannulae 

3) blue venturi mask ( 24% at 2-4L/min) 

4) do nothing he is fine 

500

Patient ( female, 48y) comes into the clinic presenting with increasing fatigue and joint pain over hte past 8 months. She describes darkening of her skin on forearms and face. Incvestigations find raised iron and significantly raised ferritin levels and joint x rays show cartilage calcification. She doesn't have hepatitis or autoimmune diseases. Upon exmaination, you find hepatomegaly and splenomegaly. She reports her mother had similar symptoms in her 60s as well and she is worried about any genetic cause. What may you suspect

hereditary haemochromatosis