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Transition Block > 02/04/18 > Flashcards

02/04/18 Flashcards

1
Q

When are aromatase inhibitors used in breast cancer?

A

no endogenous ovarian function

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2
Q

What is the commonest adult leukaemia?

A

chronic lymphocytic leukaemia

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3
Q

What are the complications of CLL?

A

AI haemolysis; infections; marrow failure

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4
Q

What age group gets CLL?

A

> 55 (increases with age)

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5
Q

When does cyclical mastalgia usually occur?

A

3-7 days before menses and resolves iwth onset of menstruation

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6
Q

What treatment is effective in treating cyclical mastalgia in over 70% of cases?

A

evening primrose oil

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7
Q

What causes microcalcifications with DCIS?

A

as grows and outstrips blood supply- central necrosis which can calcify

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8
Q

What is the stage if there are internal mammary nodes?

A

N3

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9
Q

What is the most common cause of SAH?

A

berry aneurysm

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10
Q

What is Kernigs sign?

A

inability to extend knee when hip is flexed

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11
Q

What is the treatment for SAH?

A

nimodipine; surgical clipping of aneurysm

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12
Q

When can normal delivery with minor placenta praevia be attempted?

A

if placenta isn’t within 2cm of os

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13
Q

When should C/S for placenta praevia be carried out?

A

38 weeks

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14
Q

What causes maternal death in placental abruption?

A

renal failure and DIC

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15
Q

What is used for a sentinel node biopsy?

A

combination of blue dye and technetium

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16
Q

Which patients see the greatest benefit with chemotherapy with breast cancer?

A

premenopausal women with node positive disease

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17
Q

Who gets breast screening?

A

50-64 years

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18
Q

What is CA15-3?

A

a mucin marker elevated in breast cancer

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19
Q

What is the nottingham prognostic index?

A

size of tumourx0.2 +stage + grade

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20
Q

What does cold water in the EAM called?

A

caloric stimulation

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21
Q

Waht should caloric stimulation cause?

A

nystagmus if brainstem intact

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22
Q

What is the MOA of tamoxifen?

A

prevents transcription of oestrogen responsive genes

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23
Q

Waht drugs should be avoided in haemophiliacs?

A

NSAIDs and IM

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24
Q

What is the use of desmopressin in haemophilia A?

A

increases factor VIII levels

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25
What is the most effective treatment for vasomotor symptoms?
oestrogen
26
What type of HRT should be given to women with a uterus?
oestrogen and progesterone
27
what type of HRT should be given to patients without a uterus?
oestrogen only
28
What is a common side effect of HRT in the first 3 months?
unscehduled vaginal bleeding
29
What type of preparation of HRT should be considered in obese women?
transdermal
30
What is the risk of CVS disease in women under 60 on HRT?
no increase
31
What is the risk of stroke with oestrogen?
oral small increase
32
What type of HRT is associated with an increased risk of breast cancer?
combined
33
What is premature ovarian insufficiency?
<40 years
34
What is red degeneration of fibroid?
thrombosis of capsular vessels is followed by venous engorgement and inflam- abdo pain and tenderness
35
What are the CI to HRt?
oestrogen-dependent cacner; past PE; undiagnosed PV bleeding; increased LFTs; pregnancy; breastfeeding; phlebitis
36
What is seen with dyskinetic CP?
fluctuation tone; chorea and preserved intellect
37
What is Klumpe's palsy?
arm held in adduction; claw hand (also horners)
38
What triggers reflex anoxic attacks?
pain; fear anxiety
39
What are the sypmtoms of a reflex anoxic attack?
pale; hypotonia; rigidity; upward eye deviation; clonic movements; urinary incontinence
40
What is the prognosis of reflex anoxic attack?
benign- child will grow out of
41
What should alwasy be asked about in asthma?
nocturnal waking-dangerous
42
What is normal weight loss for bottle fed babies in the first 5-7 days of life?
5%
43
What is normal weight loss for breast fed babies in first 5-7 days of life?
7-10%
44
What is the sensation change seen with erbs palsy?
over deltoid; lateral forearm and hand
45
Why should SSRIs not be used in conjunction with aspirin?
increased bleeding risk
46
What should be prescribed with an SSRI if patient is taking NSAID or aspiring?
PPI
47
Which SSRIs have more drug interactions?
fluoxetine and paroxetine
48
Which SSRI is associated iwth highest incidence of discontinuation symptoms?
paroxetine
49
What is the risk with venlafaxine?
exacerbate cardiac arrhythmias and BP
50
Which drugs are associated with exacerbation of HT?
venlafaxxine and duloxteine
51
What are the risks with TCAs?
arrhytias and postural hypotension
52
Why should there be caution when switching from fluoxetine or paroxetine to a TCA?
they inhibit metabolism of TCAs- start at lower dose
53
What is needed if switching from a non-reversible MAOI?
2 week wash out period
54
What are the effects of mannitol?
reduces CSF production; brain volume and viscosity of blood
55
What are the effects of mannitol?
reduces CSF production; brain volume and viscosity of blood
56
What does cerebral perfusion pressure equal?
MAP-ICP
57
What CPP is needed for adequate cerebral oxygenation?
70mmHg
58
What is the gold standard for ICP monitoring?
ventriculostomy- ventricular catheterisation
59
Why are peripheral reflexes still present with brainstem death?
occur at spinal level
60
What are the neonatal symptosm of rhesus disease?
jaundice; CCF; hepatosplenomegaly; progressive anaemia; bleeding; kernicterus
61
What effect does the pill have on vWF?
icnreases
62
What is the most common inheritance of vWF deficiency?
AD
63
What causes Kernigs sign?
meningeal irritation/stretching

Transition Block (35 decks)

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