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Published 04/08/2023 What are the clinical features of aortic stenosis (AS)?History[[oc1::Angina]][[oc2::Exertional syncope]][[oc3::Exertional dyspnoea]]ExamObs: [[oc…
Published 04/08/2023 Which investigations may be useful in suspected aortic stenosis (AS)?Most important: [[oc1::echocardiogram]]All the rest1. Bloods e.g. [[oc2…
Published 04/08/2023 What is the treatment for aortic stenosis (AS)?1. Conservative[[oc1::Patient education]] e.g. [[oc1::dental hygiene]]If [[oc2::left-sided heart faiure…
Published 04/08/2023 What are the causes of aortic regurgitation (AR)?Acute1. [[oc1::Aortic dissection]]2. [[oc2::Infective endocarditis]]Chronic1. [[oc3::C…
Published 04/08/2023 What are the clinical features of aortic regurgitation (AR)?HistorySymptoms of [[oc1::left-sided heart failure]] e.g. [[oc2::tiredness]], [[…
Published 04/08/2023 Which investigations may be useful in suspected aortic regurgitation (AR)?Most important: [[oc1::echocardiogram]] ([[oc1::diagnostic]])All the re…
Published 04/08/2023 What are the causes of sinus bradycardia?Most serious1. [[oc1::Raised ICP]] ([[oc1::Cushing reflex]])All the rest1. Physiological e.g. …
Published 04/08/2023 What are the clinical features of complete heart block?History[[oc1::Syncope]], [[oc1::presyncope]]Symptoms of [[oc2::heart failure]] e.g. […
Published 04/08/2023 What are the causes of left bundle branch block (LBBB)?1. [[oc1::Hypertension]]2. [[oc2::Coronary artery disease]]3. [[oc3::Cardiomyopa…
Published 04/08/2023 List the types of supraventricular tachycardiaRegular1. [[oc1::Sinus tachycardia]]2. [[oc2::AV junctional tachycardia]] e.g. [[oc2::AVN…
Published 04/08/2023 What classification system is used for antiarrhythmic drugs?[[oc1::Vaughan Williams class I-IV]]NOTES[[oc2::Class I]] are [[oc2::Na channel blockers]]…
Published 04/08/2023 What is atrioventricular reentry tachycardia (AVRT)?A type of [[oc1::supraventricular tachycardia]], due to [[oc2::an accessory pathway]] between…
Published 04/08/2023 What are the causes of atrial fibrillation (AF)?Most common1. [[oc1::Hypertension]]2. [[oc2::Ischaemic heart disease]]3. [[oc3::Valve d…
Published 04/08/2023 What are the complications of atrial fibrillation (AF)?1. [[oc1::Embolism]] e.g. [[oc2::stroke]], [[oc2::ischaemic bowel]], [[oc2::ischaemic…
Published 04/08/2023 [[oc1::Swelling in legs]][[oc2::Distended abdomen]][[oc3::Fatigue + weakness]]
Published 04/08/2023 [[oc1::Alveolar shadowing]][[oc2::Kerly B lines]][[oc3::Cardiomegaly]][[oc4::Dilated]], [[oc4::prominent upper lobe vessels]][[oc5::Pleural&…
Published 04/08/2023 What are the adverse effects of beta-blockers?1. CVS e.g. [[oc1::exacerbation]] of [[oc1::pulmonary oedema]], [[oc2::hypotension]], [[oc3::cold p…
Published 04/08/2023 What are the causes of mitral stenosis?Most common1. [[oc1::Rheumatic heart disease]]2. [[oc2::Congenital mitral stenosis]]All the rest1. [[oc3::Calci…
Published 04/08/2023 Which investigations may be useful in suspected mitral stenosis?Most important: [[oc1::echocardiogram]]All the rest1. [[oc2::ECG]] may …
Published 04/08/2023 What is the treatment for mitral stenosis?1. Conservative e.g. [[oc1::dental hygiene]], [[oc2::low salt diet]] and [[oc3::immunisations]] (if [[o…
Published 04/08/2023 What are the causes of mitral regurgitation (MR)?Acute1. [[oc1::Myocardial infarction]]2. [[oc2::Infective endocarditis]]Chronic1. [[oc…
Published 04/08/2023 What are the clinical features of mitral regurgitation (MR)?HistorySymptoms of [[oc1::left-sided heart failure]] e.g. [[oc2::tiredness]], [[…
Published 04/08/2023 Which investigations may be useful in suspected mitral regurgitation (MR)?Most important: [[oc1::echocardiogram]]All the rest1. [[oc2::Blood…
Published 04/08/2023 What is the long term treatment for mitral regurgitation (MR)?1. Conservative e.g. [[oc1::dental hygiene]]2. Meds (consider)Meds for [[oc2::…
Published 04/08/2023 Recent history e.g. [[oc1::long distance travel]], [[oc2::surgery]], [[oc3::immobilisation]], [[oc4::high oestrogen]]PMHx e.g. [[oc5::previo…
Published 04/08/2023 Clinical presentation is [[oc1::variable]]History[[oc2::Collapse]][[oc3::Dyspnoea]] (may be [[oc3::exertional]])[[oc4::Pleuritic pain]][[oc5::Cough]][…
Published 04/08/2023 [[oc1::24]]-[[oc1::48h]] protocol. Measurements every [[oc2::20 mins]] during the [[oc2::day]] and every [[oc3::60 mins]] during [[oc3::slee…
Published 04/08/2023 [[oc1::7 day]] protocol. Measure BP [[oc2::morning]] and [[oc2::evening]] [[oc2::each day]]
Published 04/08/2023 What are the clinical features of an acute exacerbation of COPD?History[[oc1::Increased cough]][[oc2::Increased sputum]] (or [[oc2::change of colour]]…
Published 04/08/2023 [[oc1::Modified Duke]] criteriaDiagnosis requires any of following1. [[oc2::Two major criteria]]2. [[oc3::One major + three minor criteria]]3. [[…
Published 04/08/2023 What is the definition of type 1 respiratory failure?[[oc1::PaO2 <8.0 kPa]] with [[oc1::normal PaCO2]] ([[oc1::<6.0 kPa]])
Published 04/08/2023 History[[oc1::Morning headache]][[oc2::Restlessness]], [[oc3::anxiety]], [[oc4::poor concentration]][[oc5::Decreased consciousness]]ExamInspection:&nb…
Published 04/08/2023 History[[oc1::Paroxysmal episodes of wheeze]], [[oc1::cough]], [[oc1::dyspnoea]], and [[oc1::chest tightness]]Symptoms usually [[oc2::worse at night/e…
Published 04/08/2023 [[oc1::Salbutamol]] ([[oc1::short acting beta agonist]])
Published 04/08/2023 [[oc1::Beclometasone]] ([[oc1::corticosteroid]])
Published 04/08/2023 [[oc1::Fluticasone]] ([[oc1::corticosteroid]]) + [[oc2::salmeterol]] ([[oc2::long acting beta agonist]])
Published 04/08/2023 [[oc1::Budesonide]] ([[oc1::corticosteroid]]) + [[oc2::formoterol]] ([[oc2::long acting beta agonist]])
Published 04/08/2023 Which scoring system is used to calculate the risk of pulmonary embolism (PE)?[[oc1::Well's score]]NOTESScore [[oc2::≥4]] = PE [[oc2::likely…
Published 04/08/2023 Most common: [[oc1::sinus tachycardia]]All the rest (due to [[oc2::RV strain]])1. [[oc3::TWI and ST depression]] in [[oc3::anteros…
Published 04/08/2023 Demographics → [[oc1::young]], [[oc1::male]] (typical patient is [[oc1::tall]] and [[oc1::thin]])SHx → [[oc2::smoking]]FHx of [[oc3::pr…
Published 04/08/2023 History[[oc1::Dyspnoea]] ([[oc1::instantaneous]] onset)[[oc2::Pleuritic chest pain]]ExamObs: [[oc3::tachypnoea]], [[oc3::tachycardia]], [[oc4::hy…
Published 04/08/2023 ResusA+B - consider [[oc1::airway support]] and [[oc1::O2]]Size >2cm and/or breathless:[[oc2::Aspirate with 16-18G cannula]]If no improvement → [[o…
Published 04/08/2023 [[oc1::COPD]][[oc2::Cystic fibrosis]][[oc3::Lung malignancy]][[oc4::Necrotising pneumonia]] such as [[oc4::TB]] or [[oc4::PCP]][[oc5::Asthma]]
Published 04/08/2023 Clinical presentation [[oc1::variable]]History[[oc2::Progressive dyspnoea]][[oc3::Non - productive cough]][[oc4::Malaise]]ExamInspection: [[oc5::…
Published 04/08/2023 [[oc1::CXR]] → [[oc2::bilateral reticulonodular opacification]] mainly affecting lower zones[[oc3::High-resolution CT thorax]] → investigation of…
Published 04/08/2023 What are the clinical features of bronchiectasis? History[[oc1::Cough]][[oc2::Daily foul-smelling sputum production]][[oc3::Rhinosinusitis]][[oc4::Dys…
Published 04/08/2023 What are the causes of a transudative pleural effusion?1. [[oc1::High hydrostatic pressure]] e.g. [[oc2::left-sided heart failure]], [[oc3::…
Published 04/08/2023 What are the causes of an exudative pleural effusion?[[oc1::Infection]] e.g. [[oc1::pnuemonia]], [[oc1::TB]][[oc2::Neoplasia]][[oc3::Vascular]] e…
Published 04/08/2023 How can we differentiate transudative and exudative pleural effusions?Sort into 3 groups:1. [[oc1::Pleural fluid protein <25 g/l]]: [[oc1…
Published 04/08/2023 Which investigations may be useful in a pleural effusion?1. Bloods: [[oc1::FBC]], [[oc1::U&Es]], [[oc1::CRP]], [[oc2::LFTs]], [[oc2::TFTs]], …
Published 04/08/2023 What are the clinical features of a pleural effusion?History[[oc1::Dyspnoea]][[oc2::Cough]] (usually [[oc2::mild]] and [[oc2::nonproductive]])[[oc3::P…
Published 04/08/2023 Which scoring system is used to judge the severity of community acquired pneumonia (CAP)?[[oc1::CURB65 Score]]NOTESScore [[oc2::0-1]]: [[oc2…
Published 04/08/2023 Which micro-organisms cause CAP?Most common: [[oc1::Streptococcus pneumoniae]]All the rest1. [[oc2::Viral]] e.g. [[oc3::influenza]], [[oc3::RSV]]…
Published 04/08/2023 What are the clinical features of pneumonia?History[[oc1::Cough]], [[oc1::mucopurulent sputum]][[oc2::Pleuritic chest pain]][[oc3::Fever]] and [[oc3::…
Published 04/08/2023 Which investigations may be useful in suspected pneumonia?1. BloodsArterial: [[oc1::ABG]] ([[oc1::consider]])Venous: [[oc2::FBC]], [[oc2::CR…
Published 04/08/2023 What is the treatment for pneumonia?1. ResusA+B - consider [[oc1::airway support]] and [[oc1::O2]]C - consider [[oc2::IV access]] and [[oc2::fluids]]2…
Published 04/08/2023 What is bronchiectasis?[[oc1::A progressive respiratory disease]], characterised by [[oc2::dilated]], [[oc2::thick-walled bronchi]]
Published 04/08/2023 [[oc1::Idiopathic pulmonary fibrosis]][[oc2::Asbestosis]][[oc3::Drug-induced]]: amiodarone, bleomycin, methotrexate, nitrofurantoin[[oc4::Most connect…
Published 04/08/2023 History[[oc1::Loud snoring]][[oc2::Daytime tiredness]][[oc3::Morning headache]][[oc4::Nocturnal choking]]ExamObs: [[oc5::hypertension]]Inspection…
Published 04/08/2023 What is the clinical definition of chronic bronchitis?[[oc1::Productive cough]] on [[oc1::most days]] for [[oc2::≥3 months]] in [[oc2::2 consecutive y…
Published 04/08/2023 What is emphysema?[[oc1::Irreversible enlargement]] of [[oc1::alveolar air spaces]]NOTESUsually accompanied by [[oc2::destruction of walls]] but not […
Published 04/08/2023 What are the causes of restrictive lung disease?1. [[oc1::Intrinsic lung disease]] e.g. [[oc2::interstitial lung disease]], [[oc2::acute pne…
Published 04/08/2023 [[oc1::Respiratory failure]] + [[oc1::arrest]][[oc2::Pneumothorax]][[oc3::Pneumonia]]NOTESComplications usually relate to [[oc4::acute exacerbations]]
Published 04/08/2023 What is acute respiratory distress syndrome (ARDS)?[[oc1::Acute]], [[oc1::diffuse]], [[oc1::inflammatory lung injury]]NOTESClinically: [[oc2::hyp…
Published 04/08/2023 What are the causes of ARDS?1. [[oc1::Sepsis]]2. [[oc2::Hypovolaemic shock]] (including [[oc2::massive trauma]])3. [[oc3::Pneumoni…
Published 04/08/2023 [[oc1::Pulmonary arterial hypertension (PAH)]] e.g. [[oc2::idiopathic]] ([[oc2::primary PAH]]), [[oc3::connective tissue disease]]…
Published 04/08/2023 [[oc1::Staphylococcus aureus]] → most common cause overall associated with [[oc2::IV drug use]] + [[oc2::prosthetic heart valves]]; [[oc3::Staphy…
Published 04/08/2023 What is an Osler node?[[oc1::A sign]] of [[oc1::infective endocarditis]]NOTESSites: usually [[oc2::fingers]] or [[oc2::toes]]Lesions: [[oc3:…
Published 04/08/2023 What is a Janeway lesion?[[oc1::A skin lesion]] seen in [[oc1::infective endocarditis]]NOTESSites: [[oc2::palms]] and [[oc2::soles]], usually [[o…
Published 04/08/2023 What are the complications of infective endocarditis?1. Heart e.g. [[oc1::valve damage]], [[oc2::heart failure]], [[oc3::aortic root abscess]]2. …
Published 04/08/2023 What is the treatment for infective endocarditis?1. ResusA+B - consider [[oc1::airway support]] and [[oc1::O2]]C - [[oc1::IV access]]2. Meds[[oc2::IV …
Published 04/08/2023 What are the causes of pericarditis?Infection e.g. [[oc1::coxsackie virus]], [[oc2::Streptococcus pneumoniae]], [[oc3::tuberculosis]]Neoplasia&nb…
Published 04/08/2023 What are the causes of myocarditis?Most common: [[oc1::viral infection]] e.g. [[oc1::coxsackie virus]], [[oc1::parvovirus]]All the rest1. [[…
Published 04/08/2023 What are the clinical features of myocarditis?Clinical presentation is variableHistory[[oc1::Cardiac chest pain]][[oc2::Palpitations]]Symptoms of&nbsp…
Published 04/08/2023 [[oc1::Post-MI pericarditis]] → in few days[[oc2::Cardiac arrest/tachyarrhythmias]][[oc3::Bradyarrhythmias]][[oc4::Cardiogenic shock]][[oc5::Ventricul…
Published 04/08/2023 What are the causes of dilated cardiomyopathy?[[oc1::Idiopathic]][[oc2::Infection]] e.g. [[oc2::Chagas disease]], [[oc2::HIV]][[oc3::Vascular]]&n…
Published 04/08/2023 List the types of cardiomyopathy1. [[oc1::Dilated]] e.g. [[oc2::idiopathic]], [[oc2::ischaemic]], [[oc3::alcoholic]], [[oc3::hyperthyroid]],…
Published 04/08/2023 What are the clinical features of stable angina?History[[oc1::Chest]] pain (SOCRATES)S - [[oc2::central]]O - triggered by [[oc3::a predictable level o…
Published 04/08/2023 Which investigations may be useful in suspected stable angina?1. Bloods e.g. [[oc1::FBC]], [[oc1::U&Es]], [[oc2::lipids]], [[oc2::HbA1c]], [[…
Published 04/08/2023 1. [[oc1::Volume overload]] e.g. kidney failure2. [[oc2::Anaemia]]3. [[oc3::Pregnancy]]4. [[oc4::Hyperthyroidism]]5. [[o…
Published 04/08/2023 First-line :[[oc1::Beta-blocker + ACE inhibitor]]: start one drugIf ACEI not tolerated, try [[oc2::angiotensin receptor blocker]] /[[oc2::hydrala…
Published 04/08/2023 What are the adverse effects of thiazide diuretics?1. [[oc1::Electrolyte derangement]] e.g. [[oc1::hypokalaemia]], [[oc1::hyponatraemia]]2.&…
Published 04/08/2023 What are the adverse effects of calcium channel blockers (CCBs)?1. CVS e.g. [[oc1::hypotension]], [[oc2::peripheral oedema]], [[oc3::facial flush…
Published 04/08/2023 List the families of calcium channel blocker (CCB)1. [[oc1::Dihydropyridine]] e.g. [[oc2::amlodipine]], [[oc2::felodipine]], [[oc2::nifedipi…
Published 04/08/2023 What are the adverse effects of angiotensin receptor blockers (ARBs)?1. [[oc1::Hypotension]]2. [[oc2::Diarrhoea]]3. [[oc3::Acute kidney…
Published 04/08/2023 What are the adverse effects of alpha-blockers?1. CVS e.g. [[oc1::hypotension]], [[oc1::oedema]]2. CNS e.g. [[oc2::light-headedness]], [[oc2…
Published 04/08/2023 Which stroke risk stratification score is used in atrial fibrillation (AF)?[[oc1::CHADS-VASC score]]NOTES[[oc2::0 points]] = [[oc2::no anticoagul…
Published 04/08/2023 Which drug families may cause postural hypotension?1. [[oc1::Diuretics]]2. [[oc2::Antihypertensives]] e.g. [[oc3::ACE-i]]/[[oc3::ARBs]]…
Published 04/08/2023 Which investigations may be useful in suspected cardiac tamponade?Most important: [[oc1::echocardiogram]]All the rest1. Bloods: [[oc2::U&amp…
Published 04/08/2023 What are the cardiac causes of clubbing?1. [[oc1::Congenital cyanotic heart disease]]2. [[oc2::Subacute bacterial endocarditis]]3. [[oc…
Published 04/08/2023 What are the clinical features of advanced pulmonary hypertension?HistorySymptoms of [[oc1::heart failure]] e.g. [[oc2::exertional dyspnoea]…
Published 04/08/2023 Which heart abnormalities are present in tetralogy of Fallot?1. [[oc1::Overriding aorta]]2. [[oc2::Pulmonary stenosis]]3. [[oc3::Right …
Published 04/08/2023 What are the clinical features of infective endocarditis?History[[oc1::Constitutional symptoms]] e.g. [[oc2::fever]], [[oc2::night sweats]], [[oc…
Published 04/08/2023 What are the causes of an irregularly irregular pulse?1. [[oc1::Atrial fibrillation]]2. [[oc2::Atrial flutter with variable block]]3. […
Published 04/08/2023 What are the causes of a collapsing pulse?1. [[oc1::Aortic regurgitation]]2. [[oc2::Hyperdynamic circulation]] e.g. [[oc3::pregnancy, a…
Published 04/08/2023 What are the causes of pulsus paradoxus?1. [[oc1::Obstructive airways disease]] e.g. [[oc1::COPD]], [[oc1::asthma]]2. [[oc2::Pneumothor…
Published 04/08/2023 What are the causes of a raised JVP?1. Low output:[[oc1::Inflow obstruction]] e.g. [[oc1::SVC compression]], [[oc1::cardiac tamponade]][[oc2::Pump fai…
Published 04/08/2023 What are the causes of a non-palpable apex beat?1. Chest wall e.g. [[oc1::apex behind a rib]], [[oc1::fat]]2. Lungs e.g. [[oc2::pneumothorax…
Published 04/08/2023 List two thiazide-like diuretics1. [[oc1::Indapamide]]2. [[oc2::Metolazone]]
Published 04/08/2023 What are the complications of infective exacerbation of COPD?1. [[oc1::Respiratory failure]], [[oc1::typically with CO2 retention]]2. [[oc2:…
Published 04/08/2023 What are the indications for long term O2 therapy (LTOT) in COPD?Either of the following:1. [[oc1::PaO2]] [[oc1::<7.3kPa]]2. [[oc2::PaO2]] [[oc2::7…
Published 04/08/2023 Which scale is used to describe murmur intensity?[[oc1::Levine Scale]]NOTES[[oc2::Grade 1]]: [[oc2::Just audible with optimal conditions]][[oc3::…
Published 04/08/2023 Which clinical features suggest severity in aortic stenosis (AS)?History[[oc1::Any symptoms]] i.e. [[oc2::angina]], [[oc2::exertional syncope]], [[oc2…
Published 04/08/2023 Which clinical features suggest severity in mitral regurgitation (MR)?HistorySymptoms of [[oc1::heart failure]] e.g. [[oc2::tiredness]], [[o…
Published 04/08/2023 Which clinical features suggest severity in aortic regurgitation (AR)?HistorySymptoms of [[oc1::heart failure]] e.g. [[oc2::tiredness]], [[o…
Published 04/08/2023 Which clinical features suggest severity in mitral stenosis?HistorySymptoms of [[oc1::heart failure]] e.g. [[oc2::tiredness]], [[oc2::dyspno…
Published 04/08/2023 Why is S1 loud in mitral stenosis?[[oc1::Increased pressure]] forces the [[oc1::valve leaflets]] to [[oc1::close from a wider excursion]]NOTESIn the h…
Published 04/08/2023 What mechanism causes the fourth heart sound?[[oc1::Atrial filling]] of the [[oc1::ventricles]]NOTESCoincides with [[oc2::atrial contraction]], heard …
Published 04/08/2023 What is Graham Steell's murmur?[[oc1::Pulmonary regurgitation]], due to [[oc1::pulmonary hypertension]]NOTESThis [[oc2::an early diastolic]] murmur, h…
Published 04/08/2023 What are the adverse effects of amiodarone?1. Thyroid e.g. [[oc1::hypo-]] or [[oc1::hyperthyroidism]]2. Heart e.g. [[oc2::bradycardia]], [[o…
Published 04/08/2023 Any of following:[[oc1::RR ≥25]][[oc2::HR ≥110]][[oc3::Inability to complete sentences in 1 breath]][[oc4::Peak flow 33-50% of predicted]]
Published 04/08/2023 Any of following (in context of acute asthma):Obs e.g. [[oc1::Sats <92%]], [[oc2::hypotension]]Inspection e.g. [[oc3::cyanosis]], [[oc4::poor …
Published 04/08/2023 What monitoring is required for amiodarone?1. Before starting: [[oc1::LFTs]], [[oc1::TFTs]], [[oc2::ECG]], [[oc2::CXR]]2. Every 6 months: [[…
Published 04/08/2023 What is the treatment for acute exacerbation of COPD?1. ResusA+B - consider [[oc1::airway support]] and [[oc1::O2 titrated to sats of 88-92%]][[oc2::S…
Published 04/08/2023 What is the long term treatment for COPD?1. [[oc1::Patient education]] e.g. [[oc2::smoking cessation]], [[oc3::pulmonary rehabilitation prog…
Published 04/08/2023 In which medical emergencies are patients likely to require controlled O2 with target sats 88-92%?[[oc1::In patients with suspected chronic CO2 retent…
Published 04/08/2023 What are the adverse effects of loop diuretics?1. [[oc1::Electrolyte derangement]] e.g. [[oc2::low K]], [[oc2::low Na]], [[oc3::low Mg]], [[…
Published 04/08/2023 What is the treatment for acute pulmonary oedema?1. ResusA+B - [[oc1::Sit upright]], [[oc2::O2]] to [[oc2::target sats 94-98%]]C - [[oc3::IV access]],…
Published 04/08/2023 What are the causes of a midline sternotomy scar?1. [[oc1::Heart]] e.g. [[oc2::CABG]], [[oc2::valve surgery]], [[oc2::transplant]]2. [[…
Published 04/08/2023 What are the indications for inhaled corticosteroids in COPD?Both of the following:1. [[oc1::Exacerbations of COPD]] or [[oc1::persistent breathlessne…
Published 04/08/2023 What is Beck's triad?1. [[oc1::Raised JVP]]2. [[oc2::Muffled heart sounds]]3. [[oc3::Hypotension]]
Published 04/08/2023 What is allergic bronchopulmonary aspergillosis (ABPA)?[[oc1::A hypersensitivity reaction]] to [[oc1::colonisation with aspergillus]]NOTESPredominantl…
Published 04/08/2023 What are the clinical features of allergic bronchopulmonary aspergillosis (ABPA)?HistoryTypical patient has [[oc1::known asthma]] or [[oc1::cystic fib…
Published 04/08/2023 Which investigations may be useful in suspected allergic bronchopulmonary aspergillosis (ABPA)?Most important: [[oc1::skin prick test]] ([[oc1::a…
Published 04/08/2023 Which CXR changes are seen in bronchiectasis?1. [[oc1::Linear atelectasis]]2. [[oc2::Dilated and thickened airways]] ([[oc3::tram lines…
Published 04/08/2023 What are the causes of haemoptysis?[[oc1::Infection]] e.g. [[oc1::pneumonia]], [[oc2::bronchiectasis]], [[oc2::TB]][[oc3::Neoplasia]][[oc4::Vascular]]…
Published 04/08/2023 What are the causes of instantaneous dyspnoea?1. [[oc1::Pneumothorax]]2. [[oc2::Pulmonary embolism]]
Published 04/08/2023 What are the causes of acute dyspnoea? (onset mins-hours)[[oc1::Airways]] e.g. [[oc2::anaphylaxis]], [[oc3::asthma]], [[oc4::IECOPD]][[oc5::Parenchyma…
Published 04/08/2023 What are the causes of subacute dyspnoea? (onset over days)[[oc1::Airways]] e.g. [[oc1::COPD exacerbation]][[oc2::Parenchyma]] e.g. [[oc2::LRTI]][[oc3…
Published 04/08/2023 What are the causes of chronic dyspnoea? (onset over months-years)[[oc1::Airways]] e.g. [[oc2::asthma]], [[oc3::COPD]], [[oc4::bronchiectasis]][[oc5::…
Published 04/08/2023 [[oc1::Occurs following drainage]] of [[oc1::a moderate sized pneumothorax]] or [[oc1::pleural effusion]]
Published 04/08/2023 What is the treatment for smoking cessation?1. Conservative e.g. [[oc1::education re]]: [[oc1::withdrawal symptoms]]; consider [[oc1::smoking ces…
Published 04/08/2023 What is the long term treatment for a patient who has suffered a myocardial infarction (MI)?1. [[oc1::Patient education]] e.g. [[oc2::smokin…
Published 04/08/2023 [[oc1::ECG]][[oc2::Troponin]] → for STEMI + NSTEMI, [[oc2::troponin]] levels will begin to elevate 4-6 hours after injury[[oc3::Coronary ang…
Published 04/08/2023 What are the causes of right axis deviation on ECG?1. [[oc1::Conduction block]] e.g. [[oc2::RBBB with left posterior hemiblock]] ([[oc2::unu…
Published 04/08/2023 What are the causes of left axis deviation on an ECG?1. [[oc1::Conduction block]] e.g. [[oc2::left anterior fascicular block]], [[oc2::LBBB]…
Published 04/08/2023 What is a transcatheter aortic valve implantation (TAVI)?[[oc1::A mechanism]] for [[oc1::aortic valve replacement]]NOTESMay be performed under [[oc2::…
Published 04/08/2023 [[oc1::Increased production]] (myocardial work) →[[oc2::MI]], [[oc2::PE]], [[oc3::sepsis]], [[oc3::heart failure]], [[oc3::tachyarrhythmia]][[oc4::Dec…
Published 04/08/2023 1. [[oc1::Drugs]] e.g. [[oc2::diuretics]], [[oc2::antihypertensives]], [[oc3::beta-blockers]], [[oc3::levodopa]]2. [[oc4::Volume deplet…
Published 04/08/2023 If asthma suspected based on symptoms, [[oc1::offer 6 week trial course of beta-agonist + inhaled corticosteroid]] + [[oc2::assess response with valid…
Published 04/08/2023 [[oc1::Airborne allergens]] e.g. [[oc2::dander]], [[oc2::pollen]], [[oc3::house dust mite]], [[oc3::fungal spores]][[oc4::Drugs]] e.g. [[oc5…
Published 04/08/2023 Which investigations may be useful in a stable patient with suspected COPD?Most important: [[oc1::spirometry]] ([[oc1::obstructive picture]])All …
Published 04/08/2023 Which investigations may be useful in suspected bronchiectasis?1. [[oc1::Bloods]] e.g. [[oc2::FBC]], [[oc2::CRP]], [[oc3::immunoglobulins]],…
Published 04/08/2023 What is the long term treatment for bronchiectasis?1. Respiratory physician[[oc1::Immunisations]][[oc2::Meds]] e.g. [[oc2::prophylactic antibiotics]] …
Published 04/08/2023 What are the clinical features of cystic fibrosis?HistoryResp: [[oc1::chronic productive cough]], [[oc2::chronic sinusitis]]Pancreas: [[oc3:…
Published 04/08/2023 What is the long term treatment for cystic fibrosis?1. Respiratory e.g. [[oc1::immunisations]]; [[oc2::meds]] ([[oc3::CFTR modulators]], [[oc4::p…
Published 04/08/2023 What are the causes of acquired AV nodal block?Most common1. [[oc1::Fibrosis]] ([[oc1::degenerative change]])2. [[oc2::Ischaemic heart …
Published 04/08/2023 What are the ECG features of LVH?([[oc1::S wave in V1]] plus [[oc1::R wave in V5/V6]]) [[oc1::≥ 3.5mV]] ([[oc2::Sokolow-Lyon criteria]])NOTESYoung, at…
Published 04/08/2023 List two potassium-sparing diuretics1. [[oc1::Amiloride]] ([[oc1::ENaC blocker]])2. [[oc2::Spironolactone]], [[oc2::epleronone]] ([[oc2::aldosterone a…
Published 04/08/2023 What are the causes of aortic stenosis (AS)?1. [[oc1::Senile calcification]] of [[oc1::a tricuspid]] or [[oc1::bicuspid aortic valve]]2.&nbs…
Published 04/08/2023 History[[oc1::Exertional dyspnoea]][[oc2::Tiredness + weakness]][[oc3::Orthopnoea]][[oc4::Paroxysmal nocturnal dyspnoea]][[oc5::Syncope]][[oc9::Cough …
Published 04/08/2023 What are the clinical features of tricuspid regurgitation (TR)?HistorySymptoms of [[oc1::right heart failure]] e.g. [[oc2::tiredness]], [[oc…
Published 04/08/2023 [[oc1::NT-proBNP]][[oc2::ECG]] → broad QRS complexes, with evidence of left ventricular hypertrophy[[oc3::CXR]][[oc4::Transthoracic echocardiogram]] →…
Published 04/08/2023 What are the complications of prosthetic heart valves?1. Local e.g. [[oc1::infective endocarditis]], [[oc2::valve failure]], [[oc3::haemolysis]]2…
Published 04/08/2023 Define Light's criteriaPleural fluid is an exudate if any of the following is true:1. [[oc1::Pleural fluid/serum protein ratio >0.5]]2. [[oc2:…
Published 04/08/2023 What are the typical spirometry findings in obstructive lung disease?1. [[oc1::FEV1 is disproprtionately reduced]] ([[oc1::typically &l…
Published 04/08/2023 What are the typical spirometry findings in restrictive lung disease?1. [[oc1::FVC is disproportionately low]] due to [[oc1::reduction …
Published 04/08/2023 List the types of second degree heart block[[oc1::Wenckeback type]] ([[oc1::Mobitz 1]]) = [[oc2::progressive lengthening]] of [[oc2::PR interval]], fo…
Published 04/08/2023 What are the clinical features of uncomplicated pericarditis?History[[oc1::Chest pain]] (SOCRATES)S - [[oc2::central chest]]C - [[oc3::sharp]]A - [[oc…
Published 04/08/2023 What is meant by 'mild' COPD?[[oc1::COPD with FEV1 50-80% predicted]]
Published 04/08/2023 What is meant by 'moderate' COPD?[[oc1::COPD with FEV1 30-50% predicted]]
Published 04/08/2023 What is meant by 'severe' COPD?[[oc1::COPD with FEV1 <30% predicted]]
Published 04/08/2023 What are the causes of crackles on lung auscultation?1. [[oc1::Infection]] e.g. [[oc2::pneumonia]], [[oc3::bronchiectasis]]2. [[oc4::Va…
Published 04/08/2023 Which investigations may be useful in suspected cystic fibrosis?Most important1. [[oc1::Sweat test]]2. [[oc2::Genetic testing for CFTR …
Published 04/08/2023 [[oc1::Up to 10 days]]
Published 04/08/2023 [[oc1::2]]-[[oc1::3 days]]
Published 04/08/2023 What are the ECG features of first degree heart block?[[oc1::Prolonged PR interval >200ms]], with [[oc2::1:1 ratio]] of [[oc2::P to QRS]]
Published 04/08/2023 What are the ECG features of second degree heart block?[[oc1::Intermittent dropped QRS]], with [[oc1::each QRS still preceded]] by [[oc1::a P wav…
Published 04/08/2023 What are the ECG features of third degree heart block?[[oc1::No relation between P waves]] and [[oc1::QRS]]NOTESThird degree heart block is also calle…
Published 04/08/2023 What is the rhythm control treatment for atrial fibrillation (AF) with onset <48h ago? (no haemodynamic compromise)1. [[oc1::Pharmacological c…
Published 04/08/2023 What is the rate control treatment for permanent atrial fibrillation (AF)?1. MedsFirst line: [[oc1::monotherapy]] with [[oc1::beta-blocker]] or […
Published 04/08/2023 In persistent atrial fibrillation (AF), when is rhythm control preferable to rate control?Rate control is first line, unless:1. [[oc1::AF has a revers…
Published 04/08/2023 Risk-stratified using the [[oc1::GRACE score]][[oc2::Clinically unstable]] → [[oc2:: immediate angiogram and PCI]][[oc3::Intermediate or high ris…
Published 04/08/2023 What is the definition of paroxysmal atrial fibrillation (AF)?[[oc1::AF]] that [[oc1::self-terminates within 7 days]]
Published 04/08/2023 What is the definition of persistent atrial fibrillation (AF)?[[oc1::AF]] that [[oc1::fails to self-terminate within 7 days]]
Published 04/08/2023 What are the adverse effects of ACE-inhibitors?1. [[oc1::Hypersensitivity]] e.g. [[oc1::angioedema]]2. [[oc2::Hypotension]], [[oc2::esp…
Published 04/08/2023 What are the causes of tricuspid regurgitation (TR)?1. [[oc4::Primary]] ([[oc4::damage to valve]]) e.g. [[oc5::infective endocarditis]], [[o…
Published 04/08/2023 What are the diagnostic criteria for rheumatic fever?Both of the following:1. [[oc1::Recent group A Streptococcus infection]]2. [[oc2::Two major crite…
Published 04/08/2023 List the major diagnostic criteria for infective endocarditis1. [[oc1::Positive blood cultures]] from [[oc1::typical organisms]]2. [[oc…
Published 04/08/2023 List the minor diagnostic criteria for infective endocarditis[[oc1::History]]: [[oc1::predisposition]][[oc2::Exam]]: [[oc3::fever >38°C]]…
Published 04/08/2023 What are the diagnostic criteria for ARDS?All of the following:1. [[oc1::Acute onset]] ([[oc1::within 7 days of insult]])2. [[oc2::Bila…
Published 04/08/2023 [[oc1::Increased intrathoracic volume]]-> [[oc2::Decreased intrathoracic pressure]]-> [[oc3::Blood pools in the lungs]]-> [[oc4::Reduced retu…
Published 04/08/2023 What are the clinical features of cardiac tamponade?History[[oc1::Syncope]][[oc2::Chest pain]][[oc3::Dyspnoea]]ExamObs: [[oc4::tachycardia]], [[o…
Published 04/08/2023 What is the treatment for cardiac tamponade?1. [[oc1::Resus]]A+B - [[oc2::consider airway support]] and [[oc2::O2]]C - [[oc3::IV fluids]] ([[oc3:…
Published 04/08/2023 What are the clinical features of mitral stenosis?HistorySymptoms of [[oc1::AF]] e.g. [[oc1::embolic event]], [[oc1::palpitations]]Symptoms …
Published 04/08/2023 Which investigations may be useful in suspected infective endocarditis?1. [[oc1::Bloods]] e.g. [[oc1::cultures]], [[oc2::FBC]], [[oc2::U&amp…
Published 04/08/2023 List the major diagnostic criteria for rheumatic feverHistory: [[oc1::migratory large joint polyarthritis]]Exam: [[oc2::erythema marginatum]…
Published 04/08/2023 List the minor diagnostic criteria for rheumatic feverHistory: [[oc1::arthralgia]]Exam: [[oc2::fever]]; [[oc3::prolonged PR interval]]Investigations: …
Published 04/08/2023 What is the rhythm control treatment for atrial fibrillation (AF) with onset >48h ago? (no haemodynamic compromise)1. [[oc1::Electrical cardio…
Published 04/08/2023 What is the rhythm control treatment for paroxysmal atrial fibrillation (PAF)?1. MedsFirst line: consider [[oc1::'pill in the pocket' therapy]] (…
Published 04/08/2023 [[oc1::Thrombolysis]] e.g. [[oc1::alteplase or tenecteplase]][[oc2::Anticoagulation]] → [[oc2::unfractionated heparin]] usually gi…
Published 04/08/2023 [[oc1::Symptom onset within 12 hours]] + [[oc1::access to PCI within 120 minutes]]If not eligible:[[oc2::Anticoagulation]] + [[oc3::further antiplatel…
Published 04/08/2023 [[oc1::Morphine 10mg]][[oc2::Oxygen]] - aim for 94% to 98%[[oc3::Nitrates]][[oc4::Aspirin 300mg ]][[oc5::Prasugrel or clopidogrel]] if under…
Published 04/08/2023 Which leads on the ECG represent the inferior wall of the heart?[[oc1::II]], [[oc1::III]], and [[oc1::aVF]]
Published 04/08/2023 Which leads on the ECG represent the septum of the heart?[[oc1::V1]] and [[oc1::V2]]
Published 04/08/2023 Which leads on the ECG represent the anterior wall of the heart?[[oc1::V3]] and [[oc1::V4]]
Published 04/08/2023 Which leads on the ECG represent the lateral wall of the heart?[[oc1::V5]], [[oc1::V6]], [[oc2::I]], and [[oc2::aVL]]
Published 04/08/2023 Asymptomatic on [[oc1::ordinary physical activity]]
Published 04/08/2023 Symptomatic on [[oc1::ordinary physical activity]]Asymptomatic on [[oc2::minimal activity + at rest]]
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