MOCK.txt

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Author:
hradoc
ID:
249680
Filename:
MOCK.txt
Updated:
2013-11-29 18:43:18
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MOCK1
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Description:
MCEM PartA
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  1. Mobitz type I second degree AV block (Wenkebach block).
    • - not usually require treatment
    • - Inferior myocardial infarctions conduction abnormalities.
  2. Indications for the use of IV atropine in bradycardias are:
    • 1. Shock
    • 2. Syncope
    • 3. Myocardial ischaemia
    • 4. Heart failure
    • In addition to this extreme bradyardia with a rate less than 40 bpm is an indication for the use of IV atropine also.
  3. ECG changes may be normal during pregnancy:
    • -axis leftward
    • - Q waves normal finding in leads III and aVF.
    • -T wave flattening or inversion in the praecordial leads and in leads III and aVF
    • -increased frequency of ectopic beats during pregnancy.
  4. The APTT measures
    • -intrinsic and common coagulation pathways factors I, II, V, VIII, IX, X, XI and XII.
    • -1925 10-11-12- prolonged with heparin usage.
    • - not tend to become prolonged until end stage liver failure and will be normal in early liver failure.
  5. Drugs that commonly cause increased urate levels and gout include
    -aspirin, diuretics, cyclosporine and levodopa.
  6. Macrophages have a longer lifespan than
    • -neutrophils
    • -cytokines: TNF-alpha, interferon alpha, interferon beta, IL-1, IL-6, IL-10, IL-12 and IL-18.
    • -IL-1 production by monocytes and macrophages facilitates IL-2 production by T-lymphocytes
  7. A lactic acidosis is defined as a
    -pH of < 7.35 - lactate of > 5 mmol/L
  8. Type A lactic acidosis is due to
    - tissue hypoxia.
  9. Type B lactic acidosis is due to
    - non-hypoxic processes affecting the production and elimination of lactate.
  10. The mortality associated with lactic acidosis despite full supportive treatment remains at
    -60-90%.
  11. The majority of filtered potassium is reabsorbed in the
    proximal renal tubule.
  12. NSAIDs inhibit aldosterone
    hyperkalaemia.
  13. Bartter's syndrome
    • - inherited defectascending limb of the loop of Henle.
    • - hypokalaemic alkalosis + normal to low blood pressure.
  14. Rotavirus is responsible for
    50% of admissions for severe diarrhoea in infants and children.
  15. Cryptosporidia are protozoa with acid fast walls. They are resistant to
    chlorine treatment and conventional filtering methods.
  16. Norwalk virus
    • RNA virus.
    • noRwalk
  17. Coli strain 0157 causes
    enterohaemorrhagic diarrhoea Hemolytic uraemic syndrome (renal failure, haemolytic anaemia and thrombocytopenia).
  18. Ossification of the patellar occurs between
    3 and 6 years of age.
  19. During expiration
    ->the size of the thorax is reduced ->more blood from the pulmonary veins ->left atrium. ->filling of the left atrium is increased.
  20. Causes of nephrogenic diabetes insipidus include:
    • Inherited disorders of tubular ADH receptor Hypercalcaemia
    • Hypokalaemia
    • Renal disease
    • Drugs e.g. lithium and demeclocycline
  21. Glucagon acts
    via cyclic AMP
  22. Prolactin acts via
    receptor tyrosine kinases
  23. Causes cranial diabetes insipidus
    • Sarcoidosis
    • Histiocytosis X
  24. 72 year old man + severe epistaxis on Warfarin for a prosthetic aortic valve+ Platelets 160, INR 8.4.
    • vitamin K he would require is 5mg IV.
    • It would be reasonable to give intravenous prothrombin complex concentrate (Beriplex or Octaplex).
    • Beriplex or prothrombin complex concentrate (PCC) factors II, VII, IX and X as well as protein C and protein S
    • If this was not available he could be given FFP 15 ml/kg.
  25. Regarding the diaphragm:
    • The greater and lesser splanchnic veins pierce the crura at the level of T12.
    • The left dome reaches the 5th rib in expiration.
    • The sympathetic chain passes behind the medial arcuate ligament lying on psoas major.
    • The azygous vein is transmitted through the diaphragm at the level of T12.
  26. Onchocerciasis (river blindness) is
    • caused by Onchocerca volvulus, a nematode
    • transmitted black fly of the Simulium genus.
    • South America and West Africa.
    • world's second leading infectious cause of blindness.
    • skin rashes, skin lesions, intense itching and skin hypo-pigmentation.
  27. The following are causes of transudates:
    left ventricular failure, cirrhosis, hypoalbuminaemia, hypothyroidism, nephrotic syndrome, mitral stenosis, pulmonary embolism, constrictive pericarditis and Meig's syndrome (a benign ovarian tumour).
  28. Pulmonary embolism can cause an exudate or a transudate. Of effusions present in P.E.
    80% are exudates and 20% transudates.
  29. Meig's syndrome is a
    benign ovarian tumour ascites + pleural effusion.
  30. During inspiration
    ->increased venous return to -> atrium due to reduced intra-pleural pressure-> filling of the right atrium is increased.
  31. Regarding salicylate poisoning:
    • with mild toxicity
    • >125 mg/kg
    • moderate toxicity
    • >250 mg/kg
    • severe and potentially fatal toxicity
    • >500 mg/kg with.
  32. Risk factors for death in severe poisoning include:
    • Age < 10 or > 70 years
    • CNS features
    • Metabolic acidosis
    • Hyperpyrexia
    • Late presentation
    • Pulmonary oedema
    • Salicylate concentration > 700 mg/L
  33. Haematemesis is an uncommon feature of salicylate poisoning.
    Common features include:
    • Nausea and vomiting
    • Tinnitus
    • Lethargy
    • Dizziness
    • Restlessness
    • Sweating
    • Bounding pulses
    • Warm extremities
    • Hyperventilation
  34. Type III hypersensitivity reactions are implicated in:
    • Serum sickness
    • Drug induced haemolytic anaemia
    • Post streptococcal glomerulonephritis
    • Rheumatoid arthritis
    • SLE
    • Polyarteritis nodosa
    • Arthur reaction

    (NEMO: aMo llamado Arturo, se puso SICK, despus de tomar DRUG , para POST STREP cogiendo una Glomerulonefritis quedando Reumtico y Esclerosadndo con la orina a un Policia Nodular)
  35. The null hypothesis states that
    no statistical significance exists in a set of given observations.
  36. A 95% confidence interval is calculated at
    • ->+/- 1.96 times the standard error of the mean.
    • ->useful when comparing data with another population.
    • ->used for both parametric and non-parametric data but the calculations used are different

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