17/04/18 Flashcards

1
Q

What is an early deceleration?

A

starts with contraction and ends with contraction

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2
Q

What causes an early deceleration?

A

increased fetal ICP resulting in increased vagal tone

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3
Q

What is wet beri-beri?

A

cardiomyopathy with peripheral oedema; pleural effusion/ascites

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4
Q

What causes beri-beri?

A

thiamine deficiency

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5
Q

Waht is dry beri beri?

A

distal motor-sensory neuropathy

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6
Q

When are Looser’s zones seen?

A

osteomalacia

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7
Q

What causes hepatic bruits?

A

AV malformation

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8
Q

Where does pain typically radiate with cholelithaisis?

A

to the back

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9
Q

How is giardia treated?

A

metronidazole

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10
Q

When are blue sclera seen?

A

osteogenesis imperfecta; Ehlers danlos; marfans; chronic steroid use; IDA

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11
Q

What are the thyroid hormones stored bound to?

A

thryroglobulin

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12
Q

what might happen to children on phenobarbitone?

A

hyperkinesia

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13
Q

How much does one unit of blood usually raise the haemoglobin?

A

10g/L

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14
Q

Why may patietns with neurofibromatosis have hypertension?

A

renal artery stenosis of phaechromocytoma

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15
Q

Why might a patient with neurofibromatosis have neurosurgery?

A

meningioma; glioma; acoustic neuroma; clipping of berry aneurysm

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16
Q

What may cause post-transplant hypertension?

A

ciclosporin toxicity or steroid therpay; chornic rejection

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17
Q

What are the SE of amiodarone?

A

arrhythmias- torsades de pointes; QT prolongation; hepatotoxicity; pulmonary fibrosis; photosensitivity; neuropathy; hyperthyroidism

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18
Q

What is seen in reflexes with hypothyroidism?

A

slow relaxation of the tendon jerk

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19
Q

What is onychogyrphosis?

A

benign condition with overprolifetation of the germinal matrix leading to excessive grwoth of the nail palte

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20
Q

What is onychogryphosis described as?

A

rams horn

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21
Q

What is pseudoachalasia?

A

achalsia-pattern dilatation of the oesophagus due to narrowing of distal oesophagus from other causes than primary denervation

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22
Q

What is the lining of the oesopahgus?

A

non-keratinsing stratified squamous epihtleium

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23
Q

What is Barrett’s oesophagus?

A

simple columnar epithelium

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24
Q

What causes an undisplaced apex beat with heaving nature?

A

aortic stenosis

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25
Q

What causes a displaced thrusting apex beat?

A

aortic regurgitation

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26
Q

What causes a tapping apex beat?

A

mitral stenosis

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27
Q

What does a lobulated goitre with no bruit suggest?

A

multinodular goitre

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28
Q

What does a continuous machinery murmur at the upper left apex suggest?

A

PDA

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29
Q

Why is there a tendency for hypoglycaemia in diabetics with end stage renal failure?

A

SUs and isnulins are partly excreted by the kidneys

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30
Q

Does smoking protect against UC or Crohns?

A

UC

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31
Q

Are cyrpt abscesses on rectal biopsy associated with UC or Crohns?

A

UC

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32
Q

What type of renal stones are assocaited with Crohns?

A

oxalate stones- increased colonic absoprtion of oxalate and dehydration from diarrhoea

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33
Q

How is 2,3 DPG created?

A

in erythrocytes during glycolysis by the Rpoport-Luebering shunt

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34
Q

What happens to 2,3 DPG in primary polycythaemia?

A

reduced

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35
Q

What is a complication of long standing Hashimotos thyroiditis?

A

lymphoma

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36
Q

What treatment for resistant adn atypicalt TB may cause vertigo?

A

cycloserine

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37
Q

What is a pseudoaneurysm?

A

wall made up from surrounding tissue

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38
Q

Waht type of organims is C.diff?

A

anaerobic gram positive, spore forming bacillus

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39
Q

What is seen in Miller-Fisher syndrome?

A

arefelxia; ataxia; ophthalmoplegia but no limb or truncal weakness

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40
Q

What is the treatment for complete heart block?

A

transvenous pacemaker

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41
Q

What should be written down when prescribing oxygen/nebulisers?

A

drug name; flow rate; device used; target sats; indication; signature; date

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42
Q

What is the inital treatment for sinus bradycardia?

A

atropine

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43
Q

What is the treatment for mycoplasma pneumoniae?

A

tetraceycline or erythromycin

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44
Q

What is a holoenyzme?

A

requires a magnsium ion as a ca-factor to function properly

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45
Q

What is the treatment for epiglottitis?

A

ceftrixaone

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46
Q

What is the treatment for acute rhinosinusitis?

A

pneicillin V- but avoid antibiotics as most will resolve in 2 weeks

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47
Q

What is the antibitiocs for native valve indolent endocardiits?

A

amox and gent

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48
Q

What is the treatment for native valve severe sepssi acute endocarditis?

A

fluclov

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49
Q

What is teh treatment for prosthetic valve or suspected MRSA?

A

vanc and rifampicin and gentamicin

50
Q

What is the mechanism of DDAVP in vWf deficiency?

A

stimulate release of vWf from endothelial cells

51
Q

What drug is commonly assocaited with acute tubular necrosis?

A

gentamicin

52
Q

what happens to potassium in metabolic alkalosis?

A

hypo

53
Q

What are yellow papules in the cornea characteristic of?

A

Gaucher disease

54
Q

What is the action of montelukast?

A

LT receptor antagonist

55
Q

What is the mechanism of sodium cromoglycate?

A

stabilises mast cell memrbaen

56
Q

Waht is hte mechanism of oxitropium bromide and ipratropium?

A

anticholinergic drug

57
Q

What is formoterol?

A

LABA

58
Q

What diameter of AAA is an indication for intervention in an asymptomatic patient?

A

> =5.5cm

59
Q

What does the popeye sign refer to?

A

rupture of hte long head of biceps

60
Q

What is hte main electrolyte problem in refeeding syndrome?

A

hypophsophataemia

61
Q

what is needed for exchange transufions?

A

plasma reduced whole blood; irradiated and less than 5 days old

62
Q

Why is gentamicin and benzylpenicillin syngergistic?

A

benzylpenicillin inhibits cell wall synthesis allowing gentamcin to enter the bacterail cell and inhibit protein synthessi at ribosomal level

63
Q

What often recedes intussception?

A

URTI

64
Q

What are the causes of abdo pain in nephrotic syndrome?

A

peritonitis; renal vein thrombosis and hypovolaemia

65
Q

What type of virus is HPV?

A

DNA virus

66
Q

What happens to refelxes in pre-eclampsia?

A

hyperreflexia

67
Q

When might there be hirsutism with normal testosterone levels?

A

reduction in sex hormone bidning globulin–increased free testosterone

68
Q

What is the action of azathioprine?

A

purine analogue to interrupt DNA synthesis and drive rapidly diving cells to apoptosis

69
Q

What is the function of core biopsy rather than FNa?

A

allows assessment of both invasive and insitu carcinoma

70
Q

What are epitheloid cells?

A

modified macrophages with abundant cyoplasm and footprint shaped nucleus

71
Q

What is the otehr name for a collection of epithelioid cells?

A

granuloma

72
Q

What are the non-infectious causes of granulomatous inflammation?

A

sarcoid; Crohn

73
Q

What mutations are associated with melanoma?

A

BRAF mutations

74
Q

What does the progression from radial to vertical grwoth phase in melanoma indicate?

A

metastatic potential of the melanoma

75
Q

What is the difference between a nodule and a papule?

A

nodule is >0.5cm whereas a papule is <0.5cm

76
Q

What is a vesicle/

A

blister <0.5cm

77
Q

What is the fasting blood gucose level diagnostic of GDM?

A

> 5.6mmol/L

78
Q

What is the 2hr plasma glucose level diagnostic of GDM?

A

> 7.8mmol/L

79
Q

When can fetal blood sampling take place?

A

> 34 weeks

80
Q

What are the conservative measure for a non-reassuring CTG?

A

encourage mobilisation or different position; IV fluids; reduce contraction frequency

81
Q

What should beoffered before fetal blood sampling?

A

digital fetal scalp stimulation- should cause acceleration

82
Q

What is normal fetal pH?

A

above 7.25

83
Q

What is definitely pathological fetal pH?

A

<7.2

84
Q

What rise in beta-hCG over 48 hours is normal?

A

> 66%

85
Q

When should an intra-uterine pregnancy be visible on TVUS in terms of beta-hCG levels?

A

> 1500

86
Q

What is normal semen volume?

A

> 1.5ml

87
Q

What is the minimum normal sperm concentration?

A

> 15 million/ml

88
Q

What is normal sperm count per ejaculate?

A

> 39 million

89
Q

What is hte minimum for motility ?

A

> 40%

90
Q

What is hte minimum sperm morphology?

A

> 4%

91
Q

What is the management for borderline fetal pH?

A

repeat in 30 minutes

92
Q

What is normal fetal heart rate?

A

110-160

93
Q

What is the treatment for patients with borderline smear changes and HPV postiive?

A

colposcopy in 6 weeks

94
Q

What is the referral for colposcoy time for all smear results apart from borderline?

A

2 weeks

95
Q

What are second degree tears?

A

lacerations which involve perineal muscle

96
Q

what is a third degree tear?

A

damage involves in the anal phincter muscle

97
Q

What is a 4th degree tear?

A

if anal mucosa is involved

98
Q

What is amniotic fluid index indicating polyhydramnios?

A

> 22cm

99
Q

What type of protein are immunoglobulins?

A

glycoproteins

100
Q

What type of hypsesensitivity reaction is the mantoux test?

A

type 4

101
Q

Where is complemetn produced?

A

liver

102
Q

How do NK cells kill?

A

release perforin and granzyme

103
Q

Describe listeria monocytogenes?

A

gram positive bacillus

104
Q

Where is neisseria meningitides foudn as a commensal?

A

nasopharynx

105
Q

What type of strep causes glomerulonephritis?

A

GAS

106
Q

What type of virus are the herpes viruses?

A

DNA

107
Q

What otehr name is EBV known as?

A

human herpes virus 4

108
Q

How should hair removal before surgery be prerfemed?

A

with clippers rather than a razor

109
Q

What organism causes gas gangrene?

A

clostridium perfringens

110
Q

What factors increase reisk of HIV vertical transmission?

A

prematurity; chorioamniotis; PROM; breastfeeding

111
Q

Waht is the most common problem in babies born to rubella infected mothers?

A

SNHL

112
Q

What is a Dukes C tumour?

A

extending to muscle layer with lymph noe involvemetn

113
Q

What artery is involved in posteiror epistaxis?

A

sphenopalatine artery

114
Q

what is indapamide?

A

thiazide

115
Q

What type of drug can preiciptate acute angle closure?

A

anticholinergics

116
Q

What would be painful erythema limited to a quadrant of an eye suggest?

A

scleritis

117
Q

What type of vaccine is the yellow fever vaccine?

A

live

118
Q

What is the function of the smooth endoplasmic reticulum?

A

synthesis of lipids and steroid hormones

119
Q

What is the MOA of clozapine?

A

D4 antagonist

120
Q

What is the typical presentation og a fat embolism?

A

respiratory failure; cerebral dysfunction and petechiae

121
Q

What happensto the ability of the LV to relax with LV hypertrophy?

A

impaired- increased LV end diastolic pressure

122
Q

What are the causes of second-trimester miscarraige?

A

abnormal uterus; cervical incompetence; APS or SLE