Propedeutics Past Paper MCQ

Renal failure
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Terms in this set (118)
Renal failure
<0,25 ml/s (maybe CT angiography? - if GFR <60 ml/min then NO CT-angiography)
background radiation
ventilation/perfusion scintigraphy
Soor is caused by
candida albicans
When may a pregnant mother undergo ionizing radiation diagnostics?
acute hazard only
Atrial Flutter on ECG
Flutter waves, regular shape, regular action (suggestion:Atrial "flutter activity " of p-waves is always regular, while QRS may (1:1) or may not (3:1) follow in regular pattern.)
Atrial fibrillation on ECG
no p-wave, 350-600 bpm
Which hand joints are affected in rheumatic arthritis?
carpometacarpal and metacarpophalangeal joints
Angina pectoris on ECG
horizontal or descending/transient ST-segment depression and a negative T wave present in leads V4-5
Swelling on right lower leg
deep vein thrombosis, lymphadema, cardiac edema
CT angiography
non-invasive (according to slide)
Tomography examinesbest choice may be e.g. examination of musculoskeletal system especially in trauma; not very probable: tumor (MRI is better) and metabolic disruption/disorder (there were no answer records)Chronic kidney diseaseACR >3 mg/µmol/l and GFR <1 ml/s for more than 3 monthsBP measurement in practicedeflate cuff after measurement is done (slide also tells to have both feet on the ground and arm has to be on heart level)What is wrong in BP measurement in office?both arms (other answers: both foot on ground, release air out of cuff; all answers seem to be correct, presentations don't require to measure on both arms, although this is advantageous in diagnostics!)Blood pressure in office with cuff on arm (maybe this is another BP-question or a duplicate)(reported answers: MAP, systole, diastole)What is the orthopneic position?(person sits upright to overcome dyspnoe and may use accessory muscles to breathe)What is orthopnoe?Dyspnoe when lying in horizontal position (disappears when sitting upright)Acute proteinuria value>150 mg/24hLiver palpationright upper quadrant (other submissions: 8 cm over midclavicular line or "must not exceed 8 cm"; always upper liver edge percussion on midclavicular line: liver is dull/flat, lung is resonant/hyperresonant) (suggestion: upward palp. from r. lower abd. in cranial direction, liver goes caudally when inspirating)Auscultation sites for heart valvesA: 2nd ICS R; P: 2nd ICR L; T: 4th ICS L; M: 5th ICS L (medioclavicular line)Surface marking of apex cordis4th - 5th ICS left(trans)esophageal echocardiographythrombus detection (and e.g. valvular vegetations)Range of ankle-arm indexca. 0,9 - 1,3 (minimal variantions acccording to different sources)Examination of the abdomenalways start palpation in less painful area; superficial palpation firstErythrocyte life span100 - 120 daysWBC 15x10⌃9 meansleukocytosis (bacterial infection)What is leukopenia?decrease in number of leukocytesLeukemialeukemia always is leukocytosis, but not every leukocytosis is leukemiaAnkle examination (probably ankle BP measurement)with doppler probeHUTT (head up tilt test)examination of vasovagal syncopeNYHA (New York Heart Association)developed 4-stage-system with left heart insufficiency evaluationGlasgow coma scaleeyes open, verbal response, motor response; (scale from 3-15, <8 is considered coma)Which patient is at risk in diagnostics with iodine application?70 year old man with thyroid cancerWBC reference range4 - 10 x10⌃9 counts/literFemale, 25 years old(maybe echocardiography - there were no better records of this question)Acute myocaridal infarction(answer may include BP, troponin or ST elevation on ECG, positive troponin test and symptom duration 20 minutes minimum - there were no better records of this question)Preexcitation syndromesupraventricular arrhytmia (WPW - Wolff-Parkinson-White syndrome)Breast quadrant most associated with cancerupper lateral quadrantWhat is odynophagia?pain when swallowingWorst (severe) kind of myocaridal infarctionloss of consciousness (suggestion: abberant QRS and maybe ST-elevations, most probably of any kind)Less worse (less severe) kind of myocardial infarctiondyspnea, angina pectoris (suggestion: horizontal or descending ST-depressions)Size of liver15 - 20 cm (acording to presentation 8 - 12 cm in medioclavicular line)aPTT (how many seconds)ca. 30 +/- 2 seconds"radiation dose" (included in question)5 mSv/5 yearsHyperproteinuriafrom 150 mg/24 h and higher18F-Fluorodeoxyglucosemost probably PET for metabolism e.g. in tumors; other suitable answers: hemat. tumor, other tumorsHow is CT-angiography done?with contrast agent and CT (other possible suggestions: contrast agent, patient does not have to be in fasting condition)Oscillography (probably BP measurement)probably correct: direct measurement of MAP, mathematical algorithms; probably wrong: direct measurement of diastole and systoleIndirect blood pressure measurement1 answer with "direct and systolic and diastolic", but most probably indirect (per definition) measurement of sys. and dia. BP, MAP can be calculatedMost common atrial flutterregular shape and regular actionWhen does SVT (supraventricular tachycardia) occur?preexcitationAcute coronary syndrome time20 minutes to confirm diagnosis(*potentially duplicated question: Time of chest pain in myocaridal infarction*)after 20 minutes heart tissue necrosis startsRBC count4,3 - 5,6 x10⌃6 cells/µlVES (ventricular extrasystole)probably correct: compensatory pause (other submitted answers: , bigeminy, ...) (compensatory pause: extrasystole is followed by pause longer than extrasystole itself)Main cause of sinus tachycardiaphysical excerciseWhat is main sinus tachycardia? (probably a duplicate of question above)(not approved: Respiratory tachycardia; otherwise if duplicate: physical excercise)Which cardiac intervention is not invasive?(most probably echocardiography - there were no better records of this question)Always check before MRIelectronic devices (metallic objects!)Aortic stenosissystolic murmur = ejection murmur (cresc.-decresc.), propagation towards carotid arteryMitral stenosisdiastolic murmur = opening snap and/or murmur (cresc.), propagation towards axillaMydriasiswidening of pupils (miosis is the opposite)Blood sample tube question(s) - associated with case report (!)colours red, blue, violet, green and black (these colours have been reported) of "Vacutainers" are to be discussedCalculation of sensitivity: n= 100, 52 positive, 28 heart failure, 24 left heart failure (left heart failure is searched)answers were: 80, 82, 84, 86; n=100,52 - correct is: 86Crepitus (rheumatology)clicking sounds in joints (popping of joints) (there was at least one similar answer)How do you examine muscle and bonesmovement, palpation etc. (maybe the longest anwer - no other answers reported) (suggestion: examination in standing and lying position)Distinction between asthma cardiale and asthma bronchiale(orthopnoe was suggested for asthma cardiale; other submitted answers: looking, tapping, bronchophony)Blood pressure measurement on lower lega. dorsalis pedis, a. tibialis posteriorNot associated with liver damagediarrheaWhat is the greatest Danger in diabetic condition?most probably: organ dysfunction (other known answers: uncompensated diabetus; other ideas: hyperglycemia etc.)Intermittend claudicationassociated with limb ischemia, the distance you can walk until pain sets inHeart sounds1st - AV; 2nd - SLUTI: WBC high, Nitrates high, Troponin positiveECGPossibly life threatening methodsubmitted answer: CT (probably wrong); other possibilities ramain unclear (suggestion: coronary angiography)Which indicator is used in diabetes?glycated Hemoglobin (HbA1c)(What do we use) "tomography" for?probably correct: musculoskeletal system; other options were: tumors, metabolic disruption (example: 18-F-Deoxyglucose PET)What is wrong in abdominal examination?correct: is the less important examination (incorrect: from superficial to deep - from less painfull to more - reaction of patient)Something with junctional rhythm(no known answers - junctional rythm means nodal rhythm by AV node, J-point is the beginning of ST-segment to determine the isoelectric level)Characteristics of bursitisswelling at/over joint (no other answers known)CT angiography vs. Angiography(suggestions for possible answers: radiation dose, clinical indication)CT angiography of coronary arteriessuggestion: If angiography with CT = NON-invasive; If angiography with standard X-ray tube in 2D and CATHETER (!) = invasiveWhat is fundamental in CT?most probably: head; other options: lung & heart - abdominal (maybe it's CCT, because other body regions have alternative diagnostic methods available)What's the risk of invasive heart examination?internal bleeding - infection - contrast agent (suggestion: arrhythmia can also be caused by catheter, internal bleeding and infection both seems to be correct)Ultrasound examinationdetection of fluidDetection of injury of gastrointestinal wall(suggestion: maybe MRI or CT and sonography in acute trauma; no answers known)What clinical devices are used in Pneumonia?(suggestion: auscultation with stethoscope, thorax x-ray or CT, SpO2, bronchoalveolar lavage etc.; no answers known)After which examination there will still be radioation coming from the patient?correct: PET (other answers were: CT, MRI, Tomography; other possible correct answers: radioiodine therapy, scintigraphy etc.)Mitral insufficiency (murmur, when?)probly correct: holosystolic systole; (wrong: holodiastolic); suggestions: 2nd heart sound is often overlapped by the murmur, murmur may be classified as holosystolic, murmur can be stronger in left lateral position, propagates to the left axilla)Auscultation of aortic valve (maybe this questoin is a duplicate)Varices are(suggestion: protuding superficial veins on lower legs)For what do you use Chest X-Ray most of the time?imaging of lung and heartMost common complication in angiographyprobably correct: allergic reaction; other options: bleeding, peripheral thrombosis, infection (probably bleeding and allergic reaction to contrast agent is correct)Examination of the musculoskeletal systemmost used methods: tapping (palpation), listening, looking...Central cyanosissubmitted: cardiac pathologies; (suggestions: impaired cardiac function, heart shunt, lung disease)Listening to the heartmost used method "direct or indirect auscultation" - if one of these is correct, then indirect = with stethoscope is correctWhat is dyspnoea?suggestion: patient has the feeling not getting enough air, problems with breathing(Instead of listening to the aortic valve) ("Místo poslechu aortální chlopně")(After the BP measurement...)we squeeze the air out of the cuff; we read the diastolic pressure on the V. Korotkoff phenomenon.What are the scratching sounds? (original: Co jsou to drásoty?)they rub the joint surfaces together or something, are they a pathological symptom, are they not a pathological symptom, ... (suggestion for "scratching": pleuritis sicca, pericarditis, joint crepitus, auscultatory scratching for lung/liver border)(Decompensated Diab. Mel., asthma bronchiale, asthma cardiale differential diagnosis)Whats the difference between angina pectoris and (myocardial infaction?) ? What happens to the P-wave?maybe they asked for "T-wave": negative T-wave in MI after two weeks; deep Q-wave pathology after days (subacute phase)Calculate specificity - 100 people, 24 of them were negative, 58 were positive and of those 28 were false positives.answers: 60%, 62%, 64% and 61%. Correct: 61%(incomplete: there were 100 people and 24 had left-sided heart failure) (probably duplicated)answers were 80%, 81%, 82%, 84%Symptoms of pneumoniadry cough, hacking, some tapping (or listening, can't remember exactly now) and bronchophony?What are the physical signs of pneumonia? (maybe this question os a duplicate of the one above)hypersonic hearing, cartilage, ... (original: hypersonorni poslech, chrupky, ...)(When do I not apply iodine (contrast agent) - contraindication?) (original: Kdy nepouzívám jodovou kontr. I.)(Question about heart murmurs)(submitted: filling of the ventricles, ...)How to recognize liver failure?submitted: diarrhoea, ascites (probably correct); suggestions: icterus, ascites, portal hypertension, caput medusae (portocaval and cavocaval anastomoses), hepatic encephalopathy, palmar erythema, spider naevusCase report: a woman has a burning sensation on urination, leukocytosis and high nitrile. What do we do?(submitted answers: ECG, troponin, ...) (suggestion: urine culture etc. would be better)What is one of the most immportant physical parameters?maybe heart function (suggestions: BP, HF, RF, SpO2 etc.)What belongs to interventional radiology?(suggestions: coronary angiography with catheter etc.)"What is the dule of Zite before administration of fluorodeoxyglucose?" (original: Co je dule Zité pred podáním...)(submitted: 4 hours)What are tremors?probably correct: they are a pathological sign; other submitted answers: they are not a pathological sign, the joint rubs against something (wrong); suggestions: morbus Parkinson(unknown question)patient must remain in hospital after examination, whether to use radionuclides, examination with vascular leakage/angiography (original: zda pac musí züstat po vysetrení v nemocnici, zda pouzíváme radionuklidy, jde o vysetrení s prusvitem cév nebo tak nèco)Computed tomography as a first line diagnostic method (maybe this is a duplicate, but "acute cases" suggests it's not)probably correct: acute cases; other options: tumors, metabolic discordersWhat is typical for orthopnoe?involvement of auxiliary muscles18-alpha-fructose - What needs to be done before administration? (probably 18-Fluorodeoxyglucose)suggestion: contraindications, allergy, 6 hrs fasting before examinationHow does ST-segment look like in angina pectoris?suggestion: horizontal or descending depressions, 1mm and more