Things to know

Question 0

Hepatic drug toxicity liver: hepatitis

Answer 0

Statin
Rifampicin
Isoniazid
Ketokonazole
Paracetamol

Question 1

transaminases

Answer 1

• ALT more specific for liver damage than AST
• AST:ALT > 2.5 = Alcoholic
• AST:ALT <1 = hepatocellular damage, viral hepatitis, paracetamol OD, ischeamic necrosis, toxic hepatitis
• AST:ALT = 1 = ischeamia eg CCF

Question 2

Hepatic drug toxicity: cholestatic

Answer 2

Flucloxacillin
Erythromycin
Chlorpromazine
Oral contraceptive
Augmentin

Question 3

Iron studies

Answer 3

Transferrin:

• iron transporting protein
• may rise in iron deficiency (TIBC transferrin binding capacity)
• transferrin saturation may be low

Ferritin:

• protein that binds iron in cell,
• indicative for amount of iron available

Question 4

anisocytosis

Answer 4

Redblood cells of different shapes, indicative of: iron deficiency anemia esp in combination with folate def, Thalassemia Major, Thalassemia Intermedia and myelodysplastic syndromes.

Redcell Distribution Width (RDW) is meassurement.

Question 5

Thrombohilia screen

Answer 5

Anticardiolipin antibodies, lupus anticoagulant, protein C, protein S, anti thrombin, factor V-Leiden

Question 6

Poikilocytosis

Answer 6

• abnormal shaped redbloodcells

- nutrient deficiencies, myelodysplastic syndromes

Question 7

Cranial nerves

Answer 7

Oh, Oh, Oh, To Touch And Feel Very Good Velvet, Such Heaven.

• olfactory
• opticus
• oculomotor (moves eyes up, down and medial, raises eyelids, pupil adjustment; palsy: ptosis, downwards lateral gaze)
• Trochlear
• Trigeminal
• Abducens
• Facial
• Vestibulocochlear
• Glossopharyngeus
• Vagus
• Spinal Asseccory
• hypoglossal

Question 8

Tremor DDX

Answer 8

Must include OPTHALMOSCOY!!

Blood pressure, meningism, cranial nerves, general neurology, sinusses, vision

Question 9

Headache examination

Answer 9

Must include OPTHALMOSCOY!!

Question 10

aortic stenosis symptom triad

Answer 10

• syncope
• exertional dyspnoea
• angina

Question 11

Acute anterolateral infarction

Answer 11

• ST elevation I, aVL, V2-V6
• Q waves in aVL, V2, V3,
• Loss of R waves across chest leads

Question 12

Acute inferior myocardial infarction

Answer 12

• ST elevation in II, III, aVF

- common slow rate

Question 13

posterior-inferior MI

Answer 13

• ST elevation II, III, aVF
• Q wave in II, III, aVF,
• Can see ST depression in anterior leads

Question 14

postero-lateral infarction

Answer 14

• prominent R waves in V1, V2
• ST elevation V5, V6
• Q waves V5, V6
• Can see ST depression anterior leads

Question 15

posterior

Answer 15

• Tall R wave in V1, V2

- St depression V1-2

Question 16

weakness and recently started diuretics

Answer 16

diuretic –> Hypokalemia –> weakness

Question 17

PE ECG

Answer 17

S1Q3T3
S in I
Q wave in III
And inverted T in III as well.