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Finals Revision > 08/09 > Flashcards

08/09 Flashcards

1
Q

hypokalaemia + hypertension

A

primary hyprealdosteronism

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2
Q

blood test before carbimazole

A

FBC- can cause agranulocytosis

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3
Q 
warfarin administration 
PT
APTT
bleeding time
platelet count
A

PT- prolonged
APTT- normal
bleeding time- normal
platelet count- normal

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4
Q 
aspirin administration
PT
APTT
bleeding time
platelet count
A

PT- normal
APTT- normal
bleeding time- prolonged
platelet count- normal

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5
Q 
heparin
PT
APTT
bleeding time
platelet count
A

PT- often normal
APTT- prolonged
bleeding time- normal
platelet count- normal

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6
Q 
DIC
PT
APTT
bleeding time
platelet count
A

PT- prolonged
APTT- prolonged
bleeding time- prolonged
platelet count- prolonged

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7
Q

thresholds for treansfusion

A

patients with ACS= 80g/L, target is 80-100

patients without ACS= 70g/L target 70-90

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8
Q

pneumonic for transfusion reactions

A

Got a Bad Unit
G raft vs host disease
O verload
T hrombocytopaenia

A lloimmunisation

B lood pressure unstable
A cute haemolytic reaction
D elayed haemolytic reaction

U rticaria
N eutrophilia
I nfection
T RALI

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9
Q

Hyposplenism causes

A

post-splenectomy

coeliac disease

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10
Q

hyposplenism blood film

A 
target cells
howell-jolly bodies
pappenheimer bodies
siderotic granules
acanthocytes
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11
Q

iron-deficiency anaemia blood film

A

target cells
pencil poikilocytes
if combined with B12/folate deficiency a dimorphic film occurs with mixed microcytic and macrocytic cells

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12
Q

myelofibrosis blood film

A

tear-drop poikilocytes

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13
Q

intravascular haemolysis blood film

A

schistocytes

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14
Q

megaloblastic anaemia blood film

A

hypersegmented neutrophils

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15
Q

G6PD anaemia blood film

A

megaloblastic anaemia blood film

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16
Q

TIBC + transferrin levels are typically ______ in iron deficiency anaemia

A

raised

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17
Q

why must B12 deficiency be treated before folic acid deficiency

A

because replacing folic first can cause subacute degeneration of the cord

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18
Q

reed stenberg

A

hodgkin lymphoma

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19
Q

ALD bloods

A

thrombocytopenia and macrocytic anaemia

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20
Q

sudden anaemia and a low reticulocyte count

A

parvovirus

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21
Q

rouleax formation

A

stacking of RBCs- myeloma

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22
Q

where are spherocytes seen

A

autoimmune haemolytic anaemia and spherocytosis

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23
Q

patients with sickle cell should get the pneumococcal vaccine every

A

5 years

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24
Q

Mirror image nuclei

A

reed-stenberg

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25
Q

incubation period of gastroenteritis bugs

A

Staph aureus, bacillius cereus = 1-6 hours

salmonella, e. coli= 12-48hrs

shigella, campylobacter= 47-72 hours

> 7 days: giardiasis, ameobiasis

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26
Q

features of staphylococcal toxic shock syndrome

A

diffuse erythematous rash

desquamation of rash

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27
Q

swab site for chlamydia and gonorrhoea

A

vulvovaginal

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28
Q

investigation for mycoplasma

A
  • mycoplasma serology

- positive cold agglutination test

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29
Q

treatment for mycoplasma

A

doxycycline or a macrolide (erythromycin/clarithromycin)

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30
Q

what is dengue fever

A

form of DIC

20-30% develop dengue shock syndrome

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31
Q

features of dengue fever

A 
headache (often retro-orbital)
fever
myalgia
pleuritic pain)
facial flushing (dengue)
maculopapular rash
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32
Q

treatment of dengue fever

A

symptomatic e.g. fluid resuscitation, blood transfusion

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33
Q

hepatitis A incubation

A

2-4 weeks

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34
Q

spread of Hep A

A

faecal- oral

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35
Q

features of hep A

A 
flu-like prodrome
abdominal pain: RUQ
tender hepatomegaly
jaundice
cholestatic LFTs
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36
Q

who should be vaccinated for Hep A

A

travelling or residing in endemic area if >1 y/o

chronic liver disease

haemophilia

MSM

IVDU

lab worker, staff in residential institutions, sewage workers, people who work with primates

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37
Q

when should UTIs be tested for cure

A

in pregnant women- MSU culture

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38
Q

organism in central line infections

A

staph epi

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39
Q

treatment of legionella

A

macrolides- clarithromycin

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40
Q

features of typhoid

A 
systemic upset
bradycardia
abdo pain, distension
constipation 
rose spots on trunk
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41
Q

IVDU with descending paralysis

A

clostridium botulinum

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42
Q

features of botulism

A

fully conscious with no sensory disturbance

flaccid paralysis

diplopia

ataxia

bulbar palsy

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43
Q

treatment of botulism

A

antitoxin if given early

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44
Q

what is lemierre’s syndroe

A

spread of oropharyngeal infection to the carotid sheath- infectious thrombophlebitis of the IJV

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45
Q

what are the variations of leishmaniasis

A

cutaenous, mucocutaneous, visceral

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46
Q

describe cutaenous leishmaniasis

A

crusted lesion at site of bite

south or central america must be treated

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47
Q

describe mucocutaenous leishmaniasis

A

caused by leishmania braziliensis

spread to involve mucosae of nose and pharynx

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48
Q

describe visceral leishmaniasis

A

occurs in med, asia, south america, africa

causes fever, sweats, rigors

massive splenomegaly, hepatomegaly

poor appetite ad weight loss

grey skin
pancytopenia

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49
Q

diagnosis of visceral leishmaniasis

A

bone marrow or splenic aspirate

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50
Q

who will now be offered the HPV vaccine

A

girls and boys aged 12-13

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51
Q

live attenuated vaccines

A 
BCG
MMR
influenza
oral rotavirus
oral polio
yellow fever
oral typhoid
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52
Q

inactivated preparations

A

rabies
hep A
influenza (intramuscular)

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53
Q

toxoid vaccines

A

tetanus
diptheria
pertussis

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54
Q

Complications of mycoplasma

A
  • cold agglutins: haemolytic anaemia
  • erythema multiforme, erythema nodosum
  • meningoencephalitis, guillain-barree
  • bullous myringitis
  • pericarditis/myocarditis
  • GI: hepatitis, pancreatitis
  • renal: acute glomerulonephritis
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55
Q

management of genital herpes outbreak

A

oral aciclovir

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56
Q

investigation of herpes

A

NAAT

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57
Q

what is an aspergilloma

A

mycetoma (mass-like fungus ball) which often colonises an existing lung cavity ]

cough, haemoptysis

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58
Q

investigation of aspergilloma

A

CXE- crescent sign

high titres aspergillus precipitins

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59
Q

cause of gas gangrene

A

clostridium perfringens

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60
Q

features of c. perfringens

A

a-toxin, causing myonecrosis and haemolysis

tender, oedematous skim with haemorrhagic blebs and bullae

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61
Q

trimethoprim is contraindicated by

A

methotrexate

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62
Q

india ink stain

A

cryptococcus neoformans

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63
Q

treatment of gonorrhoea

A

IM ceftriaxone

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64
Q

incubation period of ebola

A

2-21 days

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65
Q

when are people with ebola infectious

A

not until they develop symptoms

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66
Q

symptoms of ebola

A

sudden onset of fever, fatigue, muscle pain, headache and sore throat

followed by; vomitting, diarrhoea, rash, internal and external bleeding

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67
Q

respiratory syncytial virus Associated condition

A

bronchiolitis

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68
Q

parainfluenza virus Associated condition

A

croup

69
Q

rhinovirus Associated condition

A

common cold

70
Q

influenza virus Associated condition

A

flu

71
Q

streptococcus pneumoniae Associated condition

A

CAP

72
Q

haemophilus influenzae Associated condition

A

CAP, bronchiectasis, acute epiglottitis

73
Q

staphylococcus aureus Associated condition

A

pneumoina, particularly following influenzae

74
Q

mycoplasma pneumonia Associated condition

A

atypical pneumonia

dry cough, haemolytic anaemia, erythema multiforme

75
Q

legionella pneumophilia associated condition

A

atypical pneumonia

air-conditioning sytems, dry cough, lymphopenia, deranged LFTs and hyponatraemia

76
Q

pneumocystic jiroveci Associated condition

A

pneumonia in HIV patients

few chest signs and exertional dyspnoea

77
Q

mycobacterium tuberculosis associated condition

A

asymptomatic to disseminated disease

cough, night sweats and weight loss

78
Q

e coli gram stain

A

facultative anaerobe, gram -ve rod

79
Q

trichomonas vaginalis + bacterial vaginosis pH

A

> 4.5

80
Q

what is hepatitis E common in

A

shellfish and pork

81
Q

bloods in hep E

A

elevated bilirubin and significant transaminitis

82
Q

incubation of hep E

A

3-8 weeks

83
Q

management of gonorrhoea in needle phobia

A

oral cefixime + oral azithromycin

84
Q

post-exposure prophylaxis hep A

A

human normal immunoglobulin or Hep A vaccine

85
Q

post-exposure prophylaxis hep B

A

HBsAg +ve source: booster dose of vaccine, if in process of being vaccinated give Hepatitis B immune globulin (HBIG) and the vaccine

86
Q

post-exposure prophylaxis hep C

A

monthly PCR - if seroconversion then interferon +/- ribavirin

87
Q

post-exposure prophylaxis HIV

A

risk is small from bites/needlesticls

a combination of oral antiretrovirals (e.g. Tenofovir, emtricitabine, lopinavir and ritonavir) as soon as possible (i.e. Within 1-2 hours, but may be started up to 72 hours following exposure) for 4 weeks

serological testing at 12 weeks following completion of post-exposure prophylaxis

reduces risk of transmission by 80%

88
Q

post-exposure prophylaxis varicella zoster

A

VZIG for IgG -ve pregnant woman/immunosuppressed

89
Q

HIV, neuro symptoms, widespread demyelination

A

progressive multifocal leukoecephalopathy

90
Q

when should anti-retroviral therapy be started in HIV

A

as soon as diagnosed

91
Q

what is antiretroviral therapy

A

2 x nucleoside reverse transcriptase inhibitors (zidovudine, abacavir)

and either protease inhibitor ( indi-navir) or a non-nucleoside reverse transcriptase inhibitor (nevirapine)

integrate- gravir

92
Q

chlamydia management

A

doxycycline

93
Q

most common cause of infective diarrhoea in HIV +ve patients

A

cryptosporidium

94
Q

treatment of chlamydia in pregnancy

A

azithromycin, erythromycin or amoxicillin

95
Q

treatment of pubic lice

A

malathion or permethrin cream

96
Q

treatment of trichomonas vaginalis

A

metronidazole

97
Q

cellulitis in pregnancy in penicillin allergy

A

erythromycin

98
Q

s. pneumonia is a ____ ___ ______/_____

A

s. pneumonia is a gram +ve diplococci/chain

99
Q

h. influenzae is a ____ ______ ________

A

h. influenzae is a gram negative coccibacilli

100
Q

L. monocytogenes is a ____ _____ _____

A

L. monocytogenes is a gram +ve rod

101
Q

neisseria meningitidis is a ____ ______ _______

A

neisseria meningitidis is a gram negative diplococci

102
Q

bacterial meningitis CSF

A

cloudy
low glucose
high protein
10-5000 wcc polymorhps

103
Q

viral meningitis CSF

A

clear/cloudy
60-80% of plasma glucose
normal/raised protein
15-1000 lymphocytes

104
Q

tuberculous CSF

A

slightly cloudy, fibrin web
low glucose
high protein
30-300 lymphocytes

105
Q

fungal CSF

A

cloudy
low glucose
high protein
20-200 lymphocytes

106
Q

when are antibiotics indicated in sinusitis

A

if symptoms are present for prolonged period of time

107
Q

antibiotic treatment of sinusitis

A

phenoxymethylpenicillin, doxycline or clari

108
Q

management of prostatisi

A

ciprofloxacin

109
Q

UTI in breastfeeding

A

trimethoprim over nitro- (nitro-G6PD)

110
Q

farmer, fever, transaminitis

A

q fever

111
Q

what is Q fever

A

caused by coxiella burnetti- from abattoir, cattle/sheep

112
Q

features of Q fever

A 
typically prodrome: fever, malaise
pyrexia of unknown origin
transaminitis
atypical pneumonia
endocarditis (culture-neg)
113
Q

treatment of q-fever

A

doxycycline

114
Q

amoebic liver abscess

A

anchovy sauce

115
Q

itchy bumps of arms, torso or legs

A

bed bugs- topical hydrocortisone

hot-washing linen and using mattress covers

116
Q

commonest most severe type of malaria

A

falciparum malaria

117
Q

features of severe malaria

A 
schizonts on blood film
parasitaemia
hypoglycaemia
acidosis 
temperature > 39
severe anaemia
118
Q

complications of malaria

A 
cerebral malaria
acute renal failure 
ARDS
hypo
DIC
119
Q

treatment of uncomplicated falciparum malaria

A

artemether plus lumefantrine

120
Q

treatment of complicated falciparum malaria

A

parasite >2% = parenteral treatment

IV artesunate

if parasite count >10% then exchange transfusion

shock = coexistent bacterial septicaemia

121
Q

management of herpes in pregnancy

A

women who present with 1st episode of genital herpes in pregnancy (3rd trimester) should be managed with daily oral aciclovir 400mg until delivery- then c-section

122
Q

BV organism

A

gardnerella

123
Q

atypical lymphocytes

A

glandular fever

124
Q

primary features of syphillis

A

chancrea

local non-tender lymphadenopathy

125
Q

secondary features of syphillis

A

6-10 weeks after infection

  • systemic symptoms: fevers: lymphadenopathy
  • rash on trunk, palms and soles
  • buccal snail track ulcers
  • condylomata lata
126
Q

tertiary syphillis features

A 
gummas (granulomatous lesions of skin and bone)
Ascending AA
general paralysis of the insane
tabes dorsalis
argyll-robertson pupil
127
Q

features of congenital syphillis

A 
blunted upper incisors
rhagades (linear scars at angle of mouth)
keratitis
saber shins
saddle nose
deafness
128
Q

reinfection with syphillis

A

rpr rises by 4 fold or more

treat with benzathine penicillin G

129
Q

1st line treatment for early lyme disesae

A

14-21 day course of oral doxy

130
Q

management of early syphillis in pregnancy

A

IM benzathine penicillin G

131
Q

If patients over 16 years need intravenous fluid resuscitation, use crystalloids that contain sodium in the range 130–154 mmol/litre with a bolus of ____ ml over less than 15 minutes.

A

500

132
Q

commonest caus of encephalitis

A

herpes simplex

133
Q

cause of mumps

A

RNA paramyxovirus - winter and spring

134
Q

spread of mumps

A
  • droplets
  • respiratory tract epithelial cells -> parotid glands -> other tissues
  • infective 7 days before anf 9 days after swelling starts
135
Q

clinical features of mumps

A

fever
malaise, muscluar pain
parotitis

136
Q

management of mumps

A

rest
praracetamol
notifiable disease

137
Q

complications of mumps

A

orchitis
hearing loss
meningoencephalitis
pancreatitis

138
Q

HAP

A

piptaz

139
Q

most common cause of travellers diarrhoea

A

e. coli

140
Q

management of pneumocystis jivroveci

A

co-trimoxazole

141
Q

most worrying complication of chagas

A

cardiomyopathy

142
Q

treatment of severe campylobacter

A

clarithromycin

143
Q

what causes kaposi’s sarcoma

A

Human herpes virus 8

144
Q

treatment of kaposi’s sarcoma

A

radiotherapy + resection

145
Q

meningococcal sepsis management

A

benzylpenicillin

146
Q

testing for HIV in asymptomatic patients should be done at _ ___ after possible exposure

A

testing for HIV in asymptomatic patients should be done at 4 weeks after possible exposure

147
Q

LRTI causes in CF patients

A

pseudomonas aeruginosa

148
Q

how does miliary TB spread

A

through the pulmonary venous system

149
Q

immunocompromised patients with toxoplasmosis are treated with

A

pyrimethamine plus sulphadiazine

150
Q

immunocompetent patients with toxoplasmosis

A

don’t usually require treatment

151
Q

EBV associated malignancies

A

burkitt’s lymphoma
hodgkin’s lymphoma
nasopharyngeal carcinoma

152
Q

testing after syphillis

A

cardiolipin tests- VRDL ad RPR
negative after treatment

treponemal specific antibody tests: TPHA remains +ve

153
Q

ground glass hepatoxytes on light microscopy

A

chronic hep B

154
Q

single lesion and +ve thallium SPECT

A

positive

155
Q

genital wart treatment

A

multiple- topical podophyllum

solitary- cryotherapy

156
Q

patients with haemachromatosis are at increased risk for

A

hepatocellular carcinoma

157
Q

MSH2

MLH1

A

HNPCC

158
Q

APC gene

A

FAP

159
Q

PTEN gene

A

cowden

160
Q

LKB1 STK11

A

peutz-jeghers

161
Q

p53

A

li-fraumeni

sarcoma and leukaemia

162
Q

who are DPP-4 inhibitors useful inn

A

obese patients

163
Q

causes of hypoglycaemia

A

EXPLAIN

e xogenous drugs (sulfonylureas, insulin)
p ituitary insUfficiency
L iver failure
a ddisons
i slet cell tumours
n on pancreatic neoplasms
164
Q

glucocorticoid treatment can induce

A

neutrophilia

165
Q

acronymn for thyroid ca

A

PFMAL

166
Q

treatment of MODY

A

sulfonylureas- gliclazide

167
Q

MODY inheritance

A

autosomal dominant

168
Q

Diabetic drug contraindicated in HF

A

pioglitazone- thiazoledinedione

Finals Revision (29 decks)

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