Stage 4 CSIM2 - Vascular Medicine

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0 [{"id":633916,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:22:38","updated_at":"2018-12-02 15:24:07","questionName":"A 17-year-old girl shuffles awkwardly into clinic with her mother, who explains that her daughter has suffered from severe acne for the last few years and nothing that the GP has tried has shifted it. On examination, as well as several large pustules on her face and comedones, some scarring is beginning to develop. You would like to start oral isotretinoin (roaccutane).\r\n\r\nWhen counselling about side effects, which of the following would you NOT advise the patient?\r\n","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":5,"explanation":"Answer: No causal link found with depression + retinoids\r\nThis question is to demonstrate awareness that isoretinoids can cause hyperlipidaemia\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632115,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-11-30 09:21:03","updated_at":"2018-12-02 15:24:07","questionName":"Acute ischaemia in peripheral arterial disease is associated with the \"6 P's\". Which one of these is not one of the 6 P's?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":8,"explanation":"Acute ischaemia: The 6 Ps (pain, pallor, pulselessness, perishingly cold (poikilothermia), paralysis, paraesthesia)","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633911,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:18:02","updated_at":"2018-12-02 15:24:07","questionName":"Which channel is faulty in Brugada syndrome?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":1,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633910,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:16:50","updated_at":"2018-12-02 15:24:07","questionName":"What type of inheritance is demonstrated in Brugada syndrome?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":0,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633917,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:23:37","updated_at":"2018-12-02 15:24:07","questionName":"Which of the following is NOT typically seen in nephrotic syndrome?\r\n","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":6,"explanation":"Answer: Haematuria \u2013 \r\nOthers are characteristic of nephrotic syndrome. Hypercholesterolaemia will usually resolve when nephrotic syndrome is solved. If not, statins are indicated","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632121,"quiz_id":"30920","answer_id":null,"answerType_id":"2","created_at":"2018-11-30 10:17:20","updated_at":"2018-12-02 15:24:07","questionName":"Match the areas of the heart to the corresponding letters on the ECG for which the leads are reading...","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":"volume-1\/stage-4-csim2-vascular-medicine\/Contiguous_leads.svg.png","position":12,"explanation":"A = lateral\r\nB = inferior\r\nC = anterior\r\nD = septal","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633913,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:20:44","updated_at":"2018-12-02 15:24:07","questionName":"A teenage boy presents with severe epigastric pain. Physical examination reveals extensive eruptive xanthomas and hepatosplenomegaly. A blood sample reveals milky plasma. Which of the following is the most likely lipoprotein to be elevated?\r\n","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":3,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632116,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-11-30 09:39:21","updated_at":"2018-12-02 15:24:07","questionName":"You see a 65 year old male patient in clinic with intermittent pain in his left calf when walking up hills. He has a PMH of hypertension, T2DM and hypercholesterolaemia. His medical conditions are current well controlled with drug therapies. Which investigation would be most diagnostic?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":9,"explanation":"Out of these options ABPI would be most diagnostic. The ABPI provides the ratio of systolic BP at the ankle, to the BP at the brachial arteries (use the higher of the two).","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633915,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:20:59","updated_at":"2018-12-02 15:24:07","questionName":"Can QRISK3 be used for inherited dyslipidaemias?\r\n","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":4,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632114,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-11-30 09:15:30","updated_at":"2018-12-02 15:24:07","questionName":"Which one of this can be associated with carotid artery disease and transient ipsilateral visual loss?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":7,"explanation":"Carotid Artery Disease\r\n\u2022\tMay be associated with:\r\no\tAmaurosis fugax (transient ipsilateral visual loss) \r\no\tTransient ischemic attacks (TIAs) \r\no\tCrescendo TIAs \r\no\tStroke-in-evolution (progressive ischaemic stroke)\r\no\tCerebral infarction\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":643986,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-10 11:43:46","updated_at":"2018-12-10 11:43:46","questionName":"Which conditions does this ECG shows? (2)","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":"volume-1\/stage-4-csim2-vascular-medicine\/Brugada-type-1.jpg","position":null,"explanation":"Type 1 (Coved ST segment elevation >2mm in >1 of V1-V3 followed by a negative T wave) is the only ECG abnormality that is potentially diagnostic. This has been referred to as Brugada sign.","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632117,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-11-30 09:41:41","updated_at":"2018-12-02 15:24:07","questionName":"You see a 65 year old male patient in clinic with intermittent pain in his left calf when walking up hills. He has a PMH of hypertension, T2DM and hypercholesterolaemia. His medical conditions are current well controlled with drug therapies. Which investigation would confirm the diagnosis?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":10,"explanation":"Confirm diagnosis\r\n\r\nThe main method to confirm the diagnosis is Doppler ultrasonography (duplex scanning). The ratio of systolic blood pressure at the ankle and in the arm - ankle-brachial pressure index (ABPI) - provides a measure of blood flow at the level of the ankle. The ABPI is a strong marker of cardiovascular disease and is predictive of cardiovascular events and mortality.\r\nDuplex ultrasonography is also able to determine the site of disease and indicate the degree of stenosis and length of an occlusion.\r\nOther methods of investigation now include MR angiography and CT angiography. MR angiography may be offered prior to revascularisation.","question_score_id":null,"lang":"","questionAudioPath":null},{"id":643999,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-10 11:50:33","updated_at":"2018-12-10 11:50:33","questionName":"Which conditions does this ECG show? (3)","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":"volume-1\/stage-4-csim2-vascular-medicine\/long-qt-syndrome.jpg","position":null,"explanation":"normal QT = < 440ms (two large squares) \u2013 prolonged QT > 450ms\r\nproduces prolonged ventricular repolarisation -> predisposes to malignant ventricular arrhythmias","question_score_id":null,"lang":"","questionAudioPath":null},{"id":632120,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-11-30 09:50:14","updated_at":"2018-12-02 15:24:07","questionName":"You see a 65 year old male patient in clinic with intermittent pain in his left calf when walking up hills. He has a PMH of hypertension, T2DM and hypercholesterolaemia. His medical conditions are current well controlled with drug therapies. You perform an ankle-brachial pressure index, the highest systolic pressure in his arms is 140mmHg and the highest in his ankles is 111mmHg. What severity would his ABPI score give him?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":11,"explanation":"Answer = mild - ABPI = Ankle systolic pressure (highest ankle pressure for each leg) divided by the brachial systolic pressure (highest of the two arms) = 111\/140 = 0.79\r\n\r\nAnkle-Brachial Index\r\n>1.30\t\t\tNon-compressible (calcified)\r\n0.91-1.30\t\tNormal\r\n0.71-0.90\t\tMild\r\n0.41-0.70\t\tModerate\r\n0-0.40\t\t\tSevere\r\n","question_score_id":null,"lang":"","questionAudioPath":null},{"id":633912,"quiz_id":"30920","answer_id":null,"answerType_id":"0","created_at":"2018-12-02 15:20:02","updated_at":"2018-12-02 15:24:07","questionName":"James is a 30 year old Caucasian male that presented to his GP complaining of episodic chest pains that would last for 10 minutes whenever he exerts a lot of energy. The GP performed a lipid profile and he was found to have elevated LDL-c and elevated total cholesterol. Which of the following examination findings would confirm the diagnosis of heterozygous familial hypercholesterolaemia?","questionTimeSeconds":"0","questionTimeMinutes":"2","questionImagePath":null,"position":2,"explanation":"","question_score_id":null,"lang":"","questionAudioPath":null}]
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A 17-year-old girl shuffles awkwardly into clinic with her mother, who explains that her daughter has suffered from severe acne for the last few years and nothing that the GP has tried has shifted it. On examination, as well as several large pustules on her face and comedones, some scarring is beginning to develop. You would like to start oral isotretinoin (roaccutane). When counselling about side effects, which of the following would you NOT advise the patient?

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