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passmed qs > 19/06 > Flashcards

19/06 Flashcards

1
Q

upper vs lower GIB

A

ligament of Treitz

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2
Q

metastatic bone pain

A

analgesia
bisphosphonates
radiotherapy

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3
Q

BRCA2 assoc men

A

prostate cancer

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4
Q

ITP tx

A

prednisolone

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5
Q

iron deficiency anaemia

A

hypochromic microcytic anaemia
high TIBC
low ferritin and transferrin

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6
Q

anaemia of chronic disease

A

low TIBC
low transferrin
high ferritin

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7
Q

ITP invx

A

antiplatelet autoantibodies (usually IgG)
bone marrow aspiration to rule out leukaemia

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8
Q

decreased haptoglobin

A

intravascular haemolysis

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9
Q

abdo and neuro signs
blue lines on gums

A

lead poisoning

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10
Q

ovaries lymph drainage

A

para-aortic lymphatics via the gonadal vessels

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11
Q

uterine fundus lymph drainage

A

para-aortic nodes
inguinal nodes

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12
Q

body of uterus lymph drainage

A

iliac lymph nodes

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13
Q

cervix lymph drainage

A

external iliac nodes
presacral nodes
internal iliac nodes

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14
Q

methotrexate anaemia

A

macrocytic megaloblastic

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15
Q

‘chocolate’ cyanosis

A

Methaemoglobinaemia

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16
Q

myelodysplasia progression

A

acute myeloid leukaemia (AML)

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17
Q

unobtainable bone marrow biopsy - ‘dry tap’ therefore trephine biopsy needed

A

myelofibrosis

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18
Q

myeloma imaging

A

whole body MRI

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19
Q

monoclonal IgM paraproteinaemia

A

waldenstroms macroglobulinaemia

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20
Q

most common inherited bleeding disorder

A

vWF

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21
Q

tumour lysis syndrome electrolytes

A

high potassium
high phosphate
low calcium

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22
Q

clinical features of tumour lysis syndrome

A

increased serum creatinine
cardiac arrhythmia or sudden death
seizure

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23
Q

essential thrombocytosis mx

A

hydroxyurea (hydroxycarbamide) is widely used to reduce the platelet count
interferon-α is also used in younger patients
low-dose aspirin may be used to reduce the thrombotic risk

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24
Q

sideroblastic anaemia

A

deposits of iron in the mitochondria that form a ring around the nucleus called a ring sideroblast

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25
Q

basophilic stippling of red blood cells
ringed sideroblasts

A

sideroblastic anaemia

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26
Q

sickle cell diagnossi

A

haemoglobin electrophoresis

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27
Q

long term mx sickle cell

A

hydroxyurea

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28
Q

sickle cell crisis reduced reticulocyte count

A

aplastic crisis

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29
Q

sickle cell crisis increased reticulocyte count

A

sequestration crisis

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30
Q

post thrombotic syndrome tx

A

compression stockings

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31
Q

polycythaemia vera mx

A

aspirin
venesection
hydroxyurea

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32
Q

when to offer a platelet transfusion

A

count <30 if active bleeding
count <10 if no active bleeding or planned procedure

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33
Q

highest risk of bacterial contamination blood product

A

platelets

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34
Q

patients with acute, severe, symptomatic hyponatraemia (< 120 mmol/L)

A

hypertonic saline (3%)

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35
Q

stress incontinence

A

duloxetine

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36
Q

?angina invx

A

Contrast-enhanced CT coronary angiogram

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37
Q

when should abx be given in AOM

A

> 4 days or not improving
Systemically unwell but not requiring admission
Immunocompromised or high risk of complications
< 2 years old with bilateral otitis media
Otitis media with perforation and/or discharge in the canal

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38
Q

sinusitis symptoms >10 days

A

intranasal steroids

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39
Q

most common cause tonsilitis

A

strep pyogenes

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40
Q

what does everything need to be above for a normal audiogram

A

20dB line

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41
Q

+ve dixhallpike manouvre BPPPV

A

rotatory nystagmus

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42
Q

neck lump anterior and lateral to SCM muscle

A

branchial cyst

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43
Q

foul-smelling, non-resolving discharge

A

cholesteatoma

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44
Q

chronic sinusitis mx

A

avoid allergen
intranasal corticosteroids
nasal irrigation with saline solution

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45
Q

bilateral high-frequency hearing loss

A

presbycusis

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46
Q

‘flamingo tinge’ tympanic membrane

A

otosclerosis

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47
Q

ototoxic drugs

A

aminoglycosides eg gent
furosemide
aspirin

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48
Q

ear wax tx

A

ear syringing and ear drops
olive oil
sodium bicarbonate 5%
almond oil

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49
Q

mx of epistaxis

A

pinch soft part of nose and lean forward for 20 mins
naseptin (unless peanut soy or neomycin allergy)

cautery if bleed is visible

nasal packing

ligation of the sphenopalantine artery in theatre

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50
Q

gingival hyperplasia drug causes

A

phenytoin
ciclosporin
calcium channel blockers

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51
Q

gingivitis mx (before dentist)

A

oral metronidazole for 3 days
chlorhexidine or hydrogen peroxide mouth wash
simple analgesia

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52
Q

tx of glue ear

A

grommets
adenoidectomy

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53
Q

ludwigs angina

A

progressive cellulitis that invades the floor of the mouth and soft tissues of the neck
tx - IV abx and airway mx

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54
Q

malignant otitis externa biggest RF

A

diabetes

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55
Q

malignant otitis externa cause

A

Pseudomonas aeruginosa

56
Q

acute attacks menieres

A

buccal or intramuscular prochlorperazine

57
Q

prevention menieres

A

betahistine and vestibular rehabilitation exercises

58
Q

nasal polyps mx

A

refer to ENT
topical steroids can shrink size

59
Q

Unilateral serous otitis media

A

?nasopharyngeal carcinoma

60
Q

nasopharyngeal carcinoma mx

A

radiotherapy

61
Q

otitis externa tx

A

topical antibiotic or a combined topical antibiotic with a steroid

62
Q

pleomorphic adenoma tx

A

surgical excision

63
Q

ramsay hunt syndrome tx

A

oral aciclovir and corticosteroids

64
Q

horizontal nystagmus

A

vestibular neuronitis

65
Q

vestibular neuronitis/vestibular neuronitis drug tx

A

prochlorperizene or an antihistamine

66
Q

what meds should be stopped in c diff

A

opiods

67
Q

raised AFP and HCG

A

non-seminomatous testicular cancer

68
Q

murmur turners syndrome

A

bicupsid aortic valve - ejection systolic murmur

69
Q

H pylori test post eradication

A

urea breath test

70
Q

rectal tumours

A

anterior resection

71
Q

complication of fluid resus in young pt DKA

A

cerebral oedema

72
Q

where can a gallstone block that does NOT cause jaundice

A

cystic duct

73
Q

medical mx of a miscarriage

A

vaginal misoprostol

74
Q

symptoms of mania in primary care

A

URGENT referral to CMHT

75
Q

symptoms of hypomania in primary care

A

ROUTINE referral to CMHT

76
Q

bilous vomiting first day

A

intestinal atresia

77
Q

medical abortion

A

mifepristone followed by prostaglandins

78
Q

GBS prophylaxis

A

benzypenicillin

79
Q

drug that can precipitate digoxin toxicity

A

thiazides eg indapamide

80
Q

cushings biochem abnormality

A

hypokalaemic metabolic alkalosis

81
Q

anaphylactoid reaction to Nacetylcysteine

A

stop infusion and consider at a slower rate

82
Q

if at the time of diagnosis of GDM, the fasting glucose level is >= 7 mmol/l

A

insulin

83
Q

long saphenous vein superficial thrombophlebitis

A

USS to exclude DVT

84
Q

IM B12

A

IM hydroxocobalamin

85
Q

oral codeine to morphine

A

divide by 10

86
Q

symptom control in bronchiectasis

A

inspiratory muscle training + postural drainage

87
Q

severe flare UC tx

A

IV steroids

88
Q

AACG predisposing factors

A

hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age

89
Q

AACG invx

A

tonometry
gonioscopy

90
Q

AACG definitive mx

A

laser peripheral iridotomy

91
Q

DRY ARMD

A

drusen

92
Q

wet ARMD

A

choroidal re-vascularisation

93
Q

dry ARMD tx

A

zinc with anti-oxidant vitamins A,C and E

94
Q

wet ARMD tx

A

anti-VEGF

95
Q

HLAB27 aka ank spond
eye

A

anterior uveitis

96
Q

cataracts old age

A

nuclear

97
Q

cataracts steroid use

A

subscapular

98
Q

proliferative diabetic retinopathy

A
99
Q

pre-proliferative diabetic retinopathy

A
100
Q

DIABETIC RETINOPATHY TX

A

panretinal laser photocoagulation
intravitreal VEGF injections

101
Q

IBD, rheumatoid arthritis
eye

A

episcleritis

102
Q

not painful red eye with mobile injected vessels

A

episcleritis

103
Q

dendritic corneal ulcer

A

herpes simplex keratitis

104
Q

herpes zoster ophthalmicus tx

A

oral antiviral treatment for 7-10 days

105
Q

holmes adie pupil

A

dilated

106
Q

Anhidrosis of the face, arm and trunk

A

Stroke
Syringomyelia
Multiple sclerosis
Tumour
Encephalitis

107
Q

Anhidrosis of the face

A

Pancoast’s tumour
Thyroidectomy
Trauma
Cervical rib

108
Q

No anhidrosis

A

Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache

109
Q

hypertensive retinopathy

A
110
Q

bacterial conjuncitivitis

A

purulent discharge

111
Q

viral conjunctivitis

A

serous discharge

112
Q

keratitis contact lens user

A

Pseudomonas aeruginosa

113
Q

persistent watery eye in a newborn

A

nasolacrimal duct obstruction - teach pts to massage duct

114
Q

orbital cellulitis invx

A

CT with CONTRAST

115
Q

sudden appearance of flashes and floaters

A

posterior vitreous detachment

116
Q

primary open angle glaucoma tx

A

selective laser trabeculoplasty
prostaglanding eye drops

117
Q

peripheral visual field loss

A

glaucoma

118
Q

Dense shadow that starts peripherally progresses towards the central vision

A

retinal detachment

119
Q

uncorrected squint leads to

A

amblyopia

120
Q

painful red eye

A

scleritis

121
Q

night blindness and tunnel vision

A

Retinitis pigmentosa

122
Q

retinal detachment sight RF

A

myopia

123
Q

small, fixed oval pupil, ciliary flush

A

anterior uveitis

124
Q

Investigating suspected PE: if the CTPA is negative

A

consider a proximal leg vein ultrasound scan if DVT is suspected

125
Q

cannot get above the swelling

A

inguinal hernia

126
Q

can get above the swelling

A

hydrocele

127
Q

LP finding guillan barre

A

elevated protein with normal white cell count

128
Q

indapamine

A

thiazide

129
Q

mild-moderate flare of distal ulcerative colitis

A

rectal aminosalicylates

130
Q

secondary prevention post MI

A

ACEi
Beta Blocker
Cholesterol lowering agent (Statin)
Dual antiplatelet therapy

131
Q

pyloric stenosis

A

Hypochloremic, hypokalaemic metabolic alkalosis

132
Q

cytotoxic agent pulmonary fibrosis

A

bleomycin

133
Q

lynch syndrome/HNPCC

A

development of bowel cancer (among other cancers) with little formation of adenomatous polyps

134
Q

when would you thrombolyse in PE

A

hypotension

135
Q

small bowel overgrowth syndrome

A

hydrogen breath test

passmed qs (18 decks)

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