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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
Q

What is the most effective treatment for vasomotor symptoms?

A

oestrogen

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26
Q

What type of HRT should be given to women with a uterus?

A

oestrogen and progesterone

27
Q

what type of HRT should be given to patients without a uterus?

A

oestrogen only

28
Q

What is a common side effect of HRT in the first 3 months?

A

unscehduled vaginal bleeding

29
Q

What type of preparation of HRT should be considered in obese women?

A

transdermal

30
Q

What is the risk of CVS disease in women under 60 on HRT?

A

no increase

31
Q

What is the risk of stroke with oestrogen?

A

oral small increase

32
Q

What type of HRT is associated with an increased risk of breast cancer?

A

combined

33
Q

What is premature ovarian insufficiency?

A

<40 years

34
Q

What is red degeneration of fibroid?

A

thrombosis of capsular vessels is followed by venous engorgement and inflam- abdo pain and tenderness

35
Q

What are the CI to HRt?

A

oestrogen-dependent cacner; past PE; undiagnosed PV bleeding; increased LFTs; pregnancy; breastfeeding; phlebitis

36
Q

What is seen with dyskinetic CP?

A

fluctuation tone; chorea and preserved intellect

37
Q

What is Klumpe’s palsy?

A

arm held in adduction; claw hand (also horners)

38
Q

What triggers reflex anoxic attacks?

A

pain; fear anxiety

39
Q

What are the sypmtoms of a reflex anoxic attack?

A

pale; hypotonia; rigidity; upward eye deviation; clonic movements; urinary incontinence

40
Q

What is the prognosis of reflex anoxic attack?

A

benign- child will grow out of

41
Q

What should alwasy be asked about in asthma?

A

nocturnal waking-dangerous

42
Q

What is normal weight loss for bottle fed babies in the first 5-7 days of life?

A

5%

43
Q

What is normal weight loss for breast fed babies in first 5-7 days of life?

A

7-10%

44
Q

What is the sensation change seen with erbs palsy?

A

over deltoid; lateral forearm and hand

45
Q

Why should SSRIs not be used in conjunction with aspirin?

A

increased bleeding risk

46
Q

What should be prescribed with an SSRI if patient is taking NSAID or aspiring?

A

PPI

47
Q

Which SSRIs have more drug interactions?

A

fluoxetine and paroxetine

48
Q

Which SSRI is associated iwth highest incidence of discontinuation symptoms?

A

paroxetine

49
Q

What is the risk with venlafaxine?

A

exacerbate cardiac arrhythmias and BP

50
Q

Which drugs are associated with exacerbation of HT?

A

venlafaxxine and duloxteine

51
Q

What are the risks with TCAs?

A

arrhytias and postural hypotension

52
Q

Why should there be caution when switching from fluoxetine or paroxetine to a TCA?

A

they inhibit metabolism of TCAs- start at lower dose

53
Q

What is needed if switching from a non-reversible MAOI?

A

2 week wash out period

54
Q

What are the effects of mannitol?

A

reduces CSF production; brain volume and viscosity of blood

55
Q

What are the effects of mannitol?

A

reduces CSF production; brain volume and viscosity of blood

56
Q

What does cerebral perfusion pressure equal?

A

MAP-ICP

57
Q

What CPP is needed for adequate cerebral oxygenation?

A

70mmHg

58
Q

What is the gold standard for ICP monitoring?

A

ventriculostomy- ventricular catheterisation

59
Q

Why are peripheral reflexes still present with brainstem death?

A

occur at spinal level

60
Q

What are the neonatal symptosm of rhesus disease?

A

jaundice; CCF; hepatosplenomegaly; progressive anaemia; bleeding; kernicterus

61
Q

What effect does the pill have on vWF?

A

icnreases

62
Q

What is the most common inheritance of vWF deficiency?

A

AD

63
Q

What causes Kernigs sign?

A

meningeal irritation/stretching

Transition Block (35 decks)

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