1 Flashcards
acromegaly management
trans-sphenoidal surgery
octreotide (somatostatin analogue)
anaesthesia
opiate (remifentil)
induction agent (propfol)
muscular blockade (rocoronium)
sevofluarane
z-score is adjusted for
age, gender, and ethnic factors
autoimmune haemolytic anaemia
positive direct antiglobulin test (Coombs’ test)
1st line: corticosteroids (reduce the amount of circulating antibodies causing haemolysis)
seizures management
myoclonic
females: levetiracetam
males: sodium valproate
Sheehan’s syndrome
postpartum hypopituitarism
Saturday night palsy
radial nerve palsy
Turner’s syndrome
ejection systolic murmur due to bicuspid aortic valve
placenta accreta -> increta -> percreta
myometrium -> invade myometrium -> invade perimetrium
ankle swelling
dihydropyridines (amlodipine, felodipine)
acute delirium
oral haloperidol
pituitary apoplexy
bleeding/infarction within the pituitary macroadenoma
IV hydrocortisone
unilateral sensorineural deafness or tinnitus
acoustic neuroma
vertigo, tinnitus + sensorineural deafness
Meniere’s disease
haemochromatosis
fatigue, erectile dysfunction and arthralgia
postpartum haemorrhage secondary to uterine atony
mechanical
medical: oxytocin, ergometrine, carboprost and misoprostol
knee pain after exercise, locking and ‘clunking’
Osteochondritis dissecans
Branchial cyst
present during intercurrent upper respiratory tract infection
smooth swelling in between the sternocleidomastoid muscle and the pharynx.
fluctuant but doesn’t transilluminate or move during swallowing.
Thyroglossal cyst
painless, midline, cystic swelling noted in the region of the hyoid bone.
moves upwards upon swallow or tongue protrusion
nephritic syndromes
IgA glomerulonephritis
post-streptococcal glomerulonephritis
nephrotic syndromes
minimal change disease
focal segmental glomerulosclerosis
membranous glomerulonephritis
quincke’s sign
nailbed pulsation - clinical sign of aortic regurgitation
risks of an ectopic pregnancy
pelvic inflammatory disease - Chlamydia
pacemaker ecg
presence of long straight lines preceding QRS complexes
failure to correct childhood squints may lead to
amblyopia
COPD stages
stage 1: FEV 80%
stage 2: FEV1 50-79%
stage 3: FEV1 30-49%
stage 4: FEV1 <30%
hyperemesis gravidarum management
IV normal saline with potassium chloride
pre-renal disease
raised serum urea:creatinine ratio
hyponatraemia/ hypernatreamia correction complications
hyponatraemia correction - osmotic demyelination syndrome (central pontine myelinolysis)
- spastic quadriparesis
- pseudobulbar palsy
- emotional lability (pseudobulbar affect)
hypernatreamia correction - cerebral oedema
bradycardia
IV atropine 500 micrograms
tachycardia
amiodarone
rate control: bisoprolol
DC cardioversion
SAAG gradient
low (<11g/L) - exudate
- malignancy, infection, pancreatitis and nephrotic syndrome
high (>11g/L) - transudate
- liver cirrhosis, hepatic failure, venous occlusion
longer-term systemic corticosteroids
suppress the natural production of endogenous steroids
should not be withdrawn abruptly
may precipitate an Addisonian crisis
poorly controlled hypertension, already taking an ACE inhibitor and a calcium channel blocker
thiazide-like diuretic
ptosis + dilated pupil
third nerve palsy
ptosis + constricted pupil
Horner’s
total parenteral nutrition
administered via a central vein as it is strongly phlebitic
pseudogout
chondrocalcinosis
psoriatic arthritis
asymmetrical polyarthritis
- DIP swelling
- dactylitis
coarctation of the aorta seen in adults
postductal variety
- aortic narrowing is distal to the ductus arteriosus
aminosalicylates adverse effects
agranulocytosis
- FBC is a key investigation
adenocarcinoma of the lung
gynaecomastia
digoxin side effects
may cause anorexia
antipsychotics side effects
acute dystonic reactions
- upwards and inward deviation
- blinking repeatedly
beta-thalassaemia trait
disproportionate microcytic anaemia
early sign of LVF
gallop rhythm (S3)
meniscal tears diagnosis
MRI
appropriate time to take blood samples for therapeutic monitoring of phenytoin
immediately before next dose
diabetes mellitus diagnosis
HbA1c of 48 mmol/mol (6.5%)
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amiodarone side effects
bradycardia
interstitial lung fibrosis
thyroid (hypo/hyper)
corneal deposits
hepatitis
grey skin
metabolic ketoacidosis with normal or low glucose
think alcohol
statins should be given to patients with a
Q risk >= 10%
west’s syndrome
infantile spasms
look like colic
acute severe hyponatraemia
cerebral oedema
painful, bright red rectal bleeding
anal fissure
-> bulk forming laxatives
complication of Kawasaki disease
coronary artery aneurysm
- screened for with an echocardiogram
severe pre-eclampsia management
IV magnesium sulphate and plan immediate delivery
Churg-Strauss syndrome
- asthma or allergic rhinitis
- eosinophilia
- vasculitis
pANCA positive
thrombosed haemorrhoids
stool softeners, ice packs and analgesia
kawasaki management
high dose aspirin and a single dose of intravenous immunoglobulin
richter’s hernia
strangulation without symptoms of obstruction
tricyclic antidepressant (TCA) overdose
anti-cholinergic effects
- dilated pupils
- dry skin
- confusion
- urinary retention
- tachycardia
erythema nodosum
no - no cause (idiopathic)
d - drugs: penicillin, sulphonamides
o - oral contraceptives, pregnancy
s - sarcoidosis, TB
u - ulcerative colitis/crohns disease, Behcet’s
m - microbiology - strep, mycoplasma, EBV …
felty’s syndrome
RA, splenomegaly and low white cell count
long-term prophylaxis of cluster headaches
verapamil
unexplained symptoms
Somatisation = Symptoms
hypoChondria = Cancer
raynaud’s phenomenon with extremity ischaemia
Buerger’s disease (or thromboangiitis obliterans)
patient with hypertension who is already taking an ACE inhibitor + history of gout
calcium channel blocker
(instead of a thiazide)
first investigation of possible endometrial cancer
trans-vaginal ultrasound scan - measure the endometrial thickness
Kyphoscoliosis
restrictive lung defect on spirometry
hypokalaemia
U waves
borderline PR interval
consequence of subarachnoid haemorrhage
SIADH
-> hyponatraemia
intrahepatic cholestasis of pregnancy
induction of labour at 37 weeks
hyperkalaemia
tall ‘tented’ T waves in the anterior leads
AICA vs PICA
aica - hearing loss
facial paralysis (motor) - aica
facial pain (sensory) - pica
pica: horners. dysphagia
pancreatic cancer investigation
high resolution CT pancreas
Beta-blockers
exacerbate plaque psoriasis
monitoring
- methotrexate
- amiodarone
methotrexate: FBC, LFT, U&E
amiodarone: TFT, LFT
colorectal cancer (CRC) investigation
Colonoscopy
left homonymous hemianopia
right optic radiation or occipital cortex
homonymous quadrantanopias
PITS (Parietal-Inferior, Temporal-Superior)
incongruous defects
optic tract lesion
congruous defects
optic radiation lesion or occipital cortex
ITP
Type II hypersensitivity reaction
type 2 is antibody-mediated
munchausen’s syndrome
purposefully causing symptoms
galeazzi fracture
dislocation of the distal radioulnar joint with an associated fracture of the radius
guttate psoriasis
precipitated by streptococcal throat infection
Behcet’s
oral ulcers + genital ulcers + anterior uveitis
