17/04/18 Flashcards
1
Q
What is an early deceleration?
A
starts with contraction and ends with contraction
2
Q
What causes an early deceleration?
A
increased fetal ICP resulting in increased vagal tone
3
Q
What is wet beri-beri?
A
cardiomyopathy with peripheral oedema; pleural effusion/ascites
4
Q
What causes beri-beri?
A
thiamine deficiency
5
Q
Waht is dry beri beri?
A
distal motor-sensory neuropathy
6
Q
When are Looser’s zones seen?
A
osteomalacia
7
Q
What causes hepatic bruits?
A
AV malformation
8
Q
Where does pain typically radiate with cholelithaisis?
A
to the back
9
Q
How is giardia treated?
A
metronidazole
10
Q
When are blue sclera seen?
A
osteogenesis imperfecta; Ehlers danlos; marfans; chronic steroid use; IDA
11
Q
What are the thyroid hormones stored bound to?
A
thryroglobulin
12
Q
what might happen to children on phenobarbitone?
A
hyperkinesia
13
Q
How much does one unit of blood usually raise the haemoglobin?
A
10g/L
14
Q
Why may patietns with neurofibromatosis have hypertension?
A
renal artery stenosis of phaechromocytoma
15
Q
Why might a patient with neurofibromatosis have neurosurgery?
A
meningioma; glioma; acoustic neuroma; clipping of berry aneurysm
16
Q
What may cause post-transplant hypertension?
A
ciclosporin toxicity or steroid therpay; chornic rejection
17
Q
What are the SE of amiodarone?
A
arrhythmias- torsades de pointes; QT prolongation; hepatotoxicity; pulmonary fibrosis; photosensitivity; neuropathy; hyperthyroidism
18
Q
What is seen in reflexes with hypothyroidism?
A
slow relaxation of the tendon jerk
19
Q
What is onychogyrphosis?
A
benign condition with overprolifetation of the germinal matrix leading to excessive grwoth of the nail palte
20
Q
What is onychogryphosis described as?
A
rams horn
21
Q
What is pseudoachalasia?
A
achalsia-pattern dilatation of the oesophagus due to narrowing of distal oesophagus from other causes than primary denervation
22
Q
What is the lining of the oesopahgus?
A
non-keratinsing stratified squamous epihtleium
23
Q
What is Barrett’s oesophagus?
A
simple columnar epithelium
24
Q
What causes an undisplaced apex beat with heaving nature?
A
aortic stenosis
25
What causes a displaced thrusting apex beat?
aortic regurgitation
26
What causes a tapping apex beat?
mitral stenosis
27
What does a lobulated goitre with no bruit suggest?
multinodular goitre
28
What does a continuous machinery murmur at the upper left apex suggest?
PDA
29
Why is there a tendency for hypoglycaemia in diabetics with end stage renal failure?
SUs and isnulins are partly excreted by the kidneys
30
Does smoking protect against UC or Crohns?
UC
31
Are cyrpt abscesses on rectal biopsy associated with UC or Crohns?
UC
32
What type of renal stones are assocaited with Crohns?
oxalate stones- increased colonic absoprtion of oxalate and dehydration from diarrhoea
33
How is 2,3 DPG created?
in erythrocytes during glycolysis by the Rpoport-Luebering shunt
34
What happens to 2,3 DPG in primary polycythaemia?
reduced
35
What is a complication of long standing Hashimotos thyroiditis?
lymphoma
36
What treatment for resistant adn atypicalt TB may cause vertigo?
cycloserine
37
What is a pseudoaneurysm?
wall made up from surrounding tissue
38
Waht type of organims is C.diff?
anaerobic gram positive, spore forming bacillus
39
What is seen in Miller-Fisher syndrome?
arefelxia; ataxia; ophthalmoplegia but no limb or truncal weakness
40
What is the treatment for complete heart block?
transvenous pacemaker
41
What should be written down when prescribing oxygen/nebulisers?
drug name; flow rate; device used; target sats; indication; signature; date
42
What is the inital treatment for sinus bradycardia?
atropine
43
What is the treatment for mycoplasma pneumoniae?
tetraceycline or erythromycin
44
What is a holoenyzme?
requires a magnsium ion as a ca-factor to function properly
45
What is the treatment for epiglottitis?
ceftrixaone
46
What is the treatment for acute rhinosinusitis?
pneicillin V- but avoid antibiotics as most will resolve in 2 weeks
47
What is the antibitiocs for native valve indolent endocardiits?
amox and gent
48
What is the treatment for native valve severe sepssi acute endocarditis?
fluclov
49
What is teh treatment for prosthetic valve or suspected MRSA?
vanc and rifampicin and gentamicin
50
What is the mechanism of DDAVP in vWf deficiency?
stimulate release of vWf from endothelial cells
51
What drug is commonly assocaited with acute tubular necrosis?
gentamicin
52
what happens to potassium in metabolic alkalosis?
hypo
53
What are yellow papules in the cornea characteristic of?
Gaucher disease
54
What is the action of montelukast?
LT receptor antagonist
55
What is the mechanism of sodium cromoglycate?
stabilises mast cell memrbaen
56
Waht is hte mechanism of oxitropium bromide and ipratropium?
anticholinergic drug
57
What is formoterol?
LABA
58
What diameter of AAA is an indication for intervention in an asymptomatic patient?
>=5.5cm
59
What does the popeye sign refer to?
rupture of hte long head of biceps
60
What is hte main electrolyte problem in refeeding syndrome?
hypophsophataemia
61
what is needed for exchange transufions?
plasma reduced whole blood; irradiated and less than 5 days old
62
Why is gentamicin and benzylpenicillin syngergistic?
benzylpenicillin inhibits cell wall synthesis allowing gentamcin to enter the bacterail cell and inhibit protein synthessi at ribosomal level
63
What often recedes intussception?
URTI
64
What are the causes of abdo pain in nephrotic syndrome?
peritonitis; renal vein thrombosis and hypovolaemia
65
What type of virus is HPV?
DNA virus
66
What happens to refelxes in pre-eclampsia?
hyperreflexia
67
When might there be hirsutism with normal testosterone levels?
reduction in sex hormone bidning globulin--increased free testosterone
68
What is the action of azathioprine?
purine analogue to interrupt DNA synthesis and drive rapidly diving cells to apoptosis
69
What is the function of core biopsy rather than FNa?
allows assessment of both invasive and insitu carcinoma
70
What are epitheloid cells?
modified macrophages with abundant cyoplasm and footprint shaped nucleus
71
What is the otehr name for a collection of epithelioid cells?
granuloma
72
What are the non-infectious causes of granulomatous inflammation?
sarcoid; Crohn
73
What mutations are associated with melanoma?
BRAF mutations
74
What does the progression from radial to vertical grwoth phase in melanoma indicate?
metastatic potential of the melanoma
75
What is the difference between a nodule and a papule?
nodule is >0.5cm whereas a papule is <0.5cm
76
What is a vesicle/
blister <0.5cm
77
What is the fasting blood gucose level diagnostic of GDM?
>5.6mmol/L
78
What is the 2hr plasma glucose level diagnostic of GDM?
>7.8mmol/L
79
When can fetal blood sampling take place?
>34 weeks
80
What are the conservative measure for a non-reassuring CTG?
encourage mobilisation or different position; IV fluids; reduce contraction frequency
81
What should beoffered before fetal blood sampling?
digital fetal scalp stimulation- should cause acceleration
82
What is normal fetal pH?
above 7.25
83
What is definitely pathological fetal pH?
<7.2
84
What rise in beta-hCG over 48 hours is normal?
>66%
85
When should an intra-uterine pregnancy be visible on TVUS in terms of beta-hCG levels?
>1500
86
What is normal semen volume?
>1.5ml
87
What is the minimum normal sperm concentration?
>15 million/ml
88
What is normal sperm count per ejaculate?
>39 million
89
What is hte minimum for motility ?
>40%
90
What is hte minimum sperm morphology?
>4%
91
What is the management for borderline fetal pH?
repeat in 30 minutes
92
What is normal fetal heart rate?
110-160
93
What is the treatment for patients with borderline smear changes and HPV postiive?
colposcopy in 6 weeks
94
What is the referral for colposcoy time for all smear results apart from borderline?
2 weeks
95
What are second degree tears?
lacerations which involve perineal muscle
96
what is a third degree tear?
damage involves in the anal phincter muscle
97
What is a 4th degree tear?
if anal mucosa is involved
98
What is amniotic fluid index indicating polyhydramnios?
>22cm
99
What type of protein are immunoglobulins?
glycoproteins
100
What type of hypsesensitivity reaction is the mantoux test?
type 4
101
Where is complemetn produced?
liver
102
How do NK cells kill?
release perforin and granzyme
103
Describe listeria monocytogenes?
gram positive bacillus
104
Where is neisseria meningitides foudn as a commensal?
nasopharynx
105
What type of strep causes glomerulonephritis?
GAS
106
What type of virus are the herpes viruses?
DNA
107
What otehr name is EBV known as?
human herpes virus 4
108
How should hair removal before surgery be prerfemed?
with clippers rather than a razor
109
What organism causes gas gangrene?
clostridium perfringens
110
What factors increase reisk of HIV vertical transmission?
prematurity; chorioamniotis; PROM; breastfeeding
111
Waht is the most common problem in babies born to rubella infected mothers?
SNHL
112
What is a Dukes C tumour?
extending to muscle layer with lymph noe involvemetn
113
What artery is involved in posteiror epistaxis?
sphenopalatine artery
114
what is indapamide?
thiazide
115
What type of drug can preiciptate acute angle closure?
anticholinergics
116
What would be painful erythema limited to a quadrant of an eye suggest?
scleritis
117
What type of vaccine is the yellow fever vaccine?
live
118
What is the function of the smooth endoplasmic reticulum?
synthesis of lipids and steroid hormones
119
What is the MOA of clozapine?
D4 antagonist
120
What is the typical presentation og a fat embolism?
respiratory failure; cerebral dysfunction and petechiae
121
What happensto the ability of the LV to relax with LV hypertrophy?
impaired- increased LV end diastolic pressure
122
What are the causes of second-trimester miscarraige?
abnormal uterus; cervical incompetence; APS or SLE
