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passmed qs > 20/06 > Flashcards

20/06 Flashcards

1
Q

tx of acute bacterial prostatitis

A

14 days quinolone eg ciprofloxacin

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2
Q

muddy brown casts in the urine

A

acute tubular necrosis

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3
Q

acute vs chronic urinary retention

A

painful vs painless

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4
Q

BPH mx

A

alpha 1 antagonists eg tamsulosin
5 alpha reductase inhibitors eg finasteride
both
TURP

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5
Q

alpha 1 antagonists eg tamsulosin SEs

A

dizziness
postural hypotension
dry mouth
depression

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6
Q

5 alpha reductase inhibitors eg finasteride SEs

A

erectile dysfunction
reduced libido
ejaculation problems
gynaecomastia

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7
Q

what is indicated if the patient has a significantly enlarged prostate and is considered to be at high risk of progression

A

5 alpha reductase inhibitors eg finasteride but takes 6 months to work

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8
Q

lump separate from the body of the testicle
found posterior to the testicle

A

epididymal cyst

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9
Q

ED normal libido

A

organic cause

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10
Q

ED decreased libido

A

psychogenic cause

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11
Q

oung man who has always had difficulty achieving an erection

A

refer to urology

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12
Q

which hydroceles are common in newborns

A

communicating -> usually resolves within first few months

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13
Q

Chronic upper urinary tract obstruction

A

ureteric stent or a pyeloplasty

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14
Q

urethral injury invx

A

ascending urethrogram

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15
Q

mx urethral injury

A

suprapubic catheter placed surgically

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16
Q

voiding symptoms

A

conservative measures: pelvic floor muscle training, bladder training, prudent fluid intake and containment products
alpha blocker if mod-severe
5alpha reductase if high risk of progression
voiding + storage - antimuscarinic

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17
Q

Predominately overactive bladder

A

moderate fluid intake and bladder retraining
antimuscarinic eg oxybutynin, tolteridone
mirabegron

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18
Q

nocturia

A

moderating fluid intake at night
furosemide 40mg in late afternoon
desmopressin

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19
Q

priapism invx

A

Cavernosal blood gas analysis to differentiate between ischaemic and non-ischaemic

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20
Q

mx priapism

A

> 4 hrs - aspiration of blood from the cavernosa
injection of phenylnephrine
surgery

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21
Q

prostate cancer hormonal tx

A

LHRH analogues and anti androgens

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22
Q

prostate cancer low risk

A

active surveillance

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23
Q

prostate cancer INVX

A

multiparamic MRI

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24
Q

prostate cancer tx

A

radical prostatectomy
radiotherapy: external beam and brachytherapy

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25
Q

anti-androgen therapy prostate cancer

A

GnRH agonists e.g. Goserelin (causes tumour flare)

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26
Q

most common renal cell cancer

A

clear cell

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27
Q

calcium oxalate stones

A

Hypercalciuria
radio opaque

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28
Q

cystine stones

A

inherited AR disorder
radio dense

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29
Q

uric acid

A

low urinary pH
malignancy
children with inborn errors of metabolism
radiolucent

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30
Q

calcium phosphate

A

renal tubular acidosis
radio-opaque (the most)

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31
Q

struvite

A

formed from magnesium, ammonium and phosphate
assoc with chronic infections
slightly radio-opaque
alkaline urine

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32
Q

Stone burden of less than 2cm in aggregate

A

lithotripsy

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33
Q

Stone burden of less than 2cm in pregnant females

A

uterescopy

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34
Q

Complex renal calculi and staghorn calculi

A

Percutaneous nephrolithotomy

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35
Q

Ureteric calculi less than 5mm

A

manage expectantly

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36
Q

cremasteric reflex is lost
elevation of the testis does not ease the pain (Prehn’s sign)

A

testicular torsion

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37
Q

ank spond xray findings

A

subchondral erosions
sclerosis
squaring of lumbar vertebrae

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38
Q

most likely inherited cancer

A

gastric

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39
Q

acute interstitial nephritis cause

A

drugs
penicillin
rifampicin
NSAIDs
allopurinol
furosemide

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40
Q

sterile pyuria
white cell casts

A

acute interstitial nephritis

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41
Q

exceptions to bilaterally small kidneys in ckd

A

autosomal dominant polycystic kidney disease
diabetic nephropathy (early stages)
amyloidosis
HIV-associated nephropathy

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42
Q

feature suggesting CKD > AKI

A

hypocalcaemia

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43
Q

definition oliguria

A

urine output of less than 0.5 ml/kg/hour

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44
Q

creatinine AKI criteria

A

a rise in serum creatinine of 26 or greater within 48 hours
a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days

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45
Q

imaging in AKI

A

renal USS

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46
Q

removal of potassium from the body

A
  • Calcium resonium (orally or enema)
  • Loop diuretics
  • Dialysis
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47
Q

microscopic haematuria/ renal failure
sensorineural deafness
retinitis pigmentosa

A

alports syndrome (x linked)

48
Q

renal biopsy: splitting of lamina densa seen on electron microscopy

A

alports syndrome

49
Q

Congo red staining: apple-green birefringence

A

amyloidosis

50
Q

pulmonary haemorrhage
rapidly progressive glomerulonephritis

51
Q

renal biopsy: linear IgG deposits along the basement membrane

52
Q

factors which affect egfr

A

eating red meat
muscle mass
pregnancy

53
Q

anti-hypertensives in CKD

A

ACEi
furosemide

54
Q

ckd mineral bone disease mx

A

reduced dietary intake of phosphate
phosphate binders
vitamin D: alfacalcidol, calcitriol
parathyroidectomy

55
Q

mx of proteinuria in CKD

A

ACEi or ARB
SGLT2

56
Q

AMPLE

A

A llergies
M edications
P ast medical history
L ast meal or other intake
E vents leading to presentation

57
Q

copd abx prophylaxis

A

azithromycin

58
Q

which cardiac drug can worse glucose tolerance

A

thiazides eg indapamide

59
Q

CI to peritoneal dialysis

60
Q

what is needed prior to discharge following an acute asthma attack

A

PEF >75% of best or predicted

61
Q

what determines the HIV transmission risk following a needle stick injury

A

viral load

62
Q

eczema herpeticum cause

A

herpes simplex 1

63
Q

what type of DI does haemochromatosis cause

64
Q

tx of nephrogenic DI

A

thiazides
low salt/protein diet

65
Q

central diabetes insipidus tx

A

desmopressin

66
Q

monitoring of diabetic nephropathy

A

ACR ratio from early morning specimen

67
Q

focal and segmental sclerosis and hyalinosis on light microscopy
effacement of foot processes on electron microscopy

A

focal segmental glomerulosclerosis

68
Q

haemolytic uraemic syndrome triad

A

acute kidney injury
microangiopathic haemolytic anaemia
thrombocytopenia

69
Q

HSP

A

IgA mediated small vessel vasculitis

70
Q

mx of hyperkalaemia

A

stablise cardiac membrane - IV calcium gluconate
shift K from ECF - ICF - insulin + dextrose infusion, neb salbutamol
removal of potassium from body - calcium resonium, loop diuretic, dialysis

71
Q

nephrotic syndrome in adults

A

Membranous glomerulonephritis

72
Q

Membranous glomerulonephritis tx

A

ACEi or ARB
steroid

73
Q

nephrotic syndrome in kids

A

minimal change disease

74
Q

minimal change disease mx

75
Q

nephrotic syndrome

A
  1. Proteinuria (> 3g/24hr) causing
  2. Hypoalbuminaemia (< 30g/L) and
  3. Oedema
76
Q

confirmation of strep infection for post-strep glomerulonephritis

A

raised anti-streptolysin O titre

77
Q

formation of epithelial crescents in the majority of glomeruli

A

rapidly progressive glomerulonephritis

78
Q

red cell casts

A

nephritis syndrome

79
Q

ongoing jaundice and pain after cholecystectomy

A

gallstones in the common bile duct

80
Q

venous leg ulcers loc

A

above the ankle

81
Q

deep venous insufficiency

82
Q

superficial venous insufficiency

A

varicose veins

83
Q

majolins ulcer

A

squamous cell carcinoma occuring at sites of chronic inflammation

84
Q

arterial ulcers loc

A

toes and heels

85
Q

deep punched out ulcer

86
Q

neuropathic ulcer loc

A

plantar surface of metatarsal head and plantar surface of hallux

87
Q

mx of neuropathic ulcers

A

cushioned shoes to reduce callous formation

88
Q

pyoderma gangrenosum

A

ulcer assoc with IBD/RA
can occur at stoma sites

89
Q

acute limb threatening ischaemia invx

A

handheld doppler exam
if signals present -> ABPI

90
Q

pre-existing claudication with sudden deteriorationand widespread evidence of vascular disease

91
Q

sudden onset of painful leg with no pre-existing claudication or vascular disease

92
Q

what is given to prevent thrombus propagation

A

intravenous unfractionated heparin

93
Q

rest pain in foot for more than 2 weeks
ulceration
gangrene

A

critical limb ischaemia

94
Q

6 PS

A

acute limb ischaemia

95
Q

peripheral arterial disease meds

A

statin and clopidogrel

96
Q

peripheral arterial disease tx

A

stop smoking
exercise training

97
Q

short segment stenosis (e.g. < 10 cm), aortic iliac disease and high-risk patients

A

endovascular revascularisation

98
Q

long segment lesions (> 10 cm), multifocal lesions, lesions of the common femoral artery and purely infrapopliteal disease

A

surgical revascularisation

99
Q

Patients with clinical signs of superficial thrombophlebitis affecting the proximal long saphenous vein

A

uss to exclude concurrent DVT

100
Q

superficial thrombophlebitis tx

A

anti-embolism stockings
prophylactic doses of LMWH for up to 30 days or fondaparinux for 45 days (or NSAIDs)

101
Q

varicose veins invx

A

venous duplex USS
this will demonstrate retrograde venous flow

102
Q

varicose veins tx

A

graduated compression stockings

103
Q

if pt is having PCI for stemi what meds should be given

A

prasugrel + aspirin
if already on anticoag, clopidogrel

104
Q

refractory anaphlaxis

A

IV adrenaline (under expert guidance) + IV fluid bolus

105
Q

maintaining remission in crohns

A

Azathioprine or mercaptopurine

106
Q

kussmauls sign (jvp doesnt fall with inspiration)
dyspnoea
peripheral oedema

A

constrictive pericarditis

107
Q

what does the BCG protect against

A

TB meningitis and disseminated TB in children

108
Q

PUVA

A

squamous cell cancer

109
Q

MASSIVE PE AND HYPOTENSION

A

THROMBOLYSE

110
Q

which cardiac drug exacerbates gout

111
Q

low lying placenta at 20 week scan

A

rescan at 32 weeks

112
Q

ejection systolic murmur louder on inspiration

A

atrial septal defect

113
Q

stage IA cervical cancer

A

cone biopsy

114
Q

housebond pt

115
Q

vomiting/aspiration

A

metabolic alkalosis

116
Q

raised ESR and osteoporosis

117
Q

most common cause of primary hyperparathyroidism

A

A solitary parathyroid adenoma

passmed qs (18 decks)

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