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Year 3 Medicine > 2020 Paper > Flashcards

2020 Paper Flashcards

1
Q

What is contact dermatitis?

A

Red, itchy, irritating skin after coming into contact with an allergen

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2
Q

What is Erythrasma?

A

Redness or brownness under the armpits, groin and in between the toes that is well demarcated and occasionally scaly with some superficial fissures

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3
Q

What are some key triggers of psoriasis?

A

Stress and smoking

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4
Q

What is flexural psoriasis?

A

Psoriasis located in the skin folds and genitals, the scaly overlayer is commonly lost leaving red and shiny skin below

  • Breast folds
  • Axilla
  • Groin
  • Natal cleft
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5
Q

What is the most common solid, benign renal mass?

A

Angiomyolipoma, it can present with retroperitoneal bleeding due to the vascularisation of the mass

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6
Q

What are the first and second line medical treatments for BPH?

A
  1. Tamsulosin (alpha blocker)
  2. Finasteride (5 alpha reductase inhibitor)

Tamsulosin tends to work more quickly and is more effective at reducing the discomfort LUTS

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7
Q

What is the presentation of mastitis?

A
  • Systemic symptoms
  • Generalised swelling and tenderness of the breast
  • Erythema and inflammation
  • Breastfeeding
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8
Q

What is the difference in presentation between mastitis and a breast abscess?

A

Mastitis will be generalised inflammation, whereas abscess will be a local area of inflammation walled off by an area of pus and will be a fluctuant (lump)

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9
Q

What is the classic presentation of haemorrhoids?

A

Painless PR bleeding, frank blood on the toilet paper and in the stool

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10
Q

What is the investigation of choice for haemorrhoids?

A

Proctoscopy

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11
Q

Which investigation is used to distinguish between IBD and IBS?

A

Faecal calprotectin (IBS also tends to improve post-defecation)

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12
Q

How does diverticulitis present?

A

Painful mass (usually in the left iliac fossa) with spiking temperatures

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13
Q

What is the histology of Barrett’s oesophagus?

A
  • Columnar epithelial cells
  • Goblet cells
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14
Q

What is the presentation of haemochromatosis?

A

Skin

  • Bronzing of the skin

Liver

  • Cirrhosis
  • Hepatocellular carcinoma

Pancreas

  • Diabetes mellitus

Heart

  • Arrhythmias

Pituitary

  • Hypopituitarism

Joints

  • Arthralgia
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15
Q

What are the features of peritonitis?

A
  • Rigitdity
  • Rebound tenderness
  • Guarding
  • Diffuse abdominal pain
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16
Q

What is the first line investigation for suspected perforation of peptic ulcer?

A

Erect chest x-ray to screen for subphrenic gas

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17
Q

What is the Parkinsonian triad?

A
  • Rigidity
  • Bradykinesia
  • Tremor
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18
Q

Which drugs improve morbidity and mortality of heart failure?

A

ACE inhibitors

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19
Q

What is the function of digoxin?

A

It’s a glycoside that is cardioprotective and is especially useful in atrial fibrillation and reduced left ventricular output

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20
Q

What is the gram stain of haemophilus influenzae?

A

Gram negative cocculobacillus

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21
Q

What is the gram stain of Klebsiella pneumoniae?

A

Gram negative bacillus

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22
Q

What is the gram stain of staphylococcus aureus?

A

Gram positive cocci in clusters

(strep pneumoniae gram positive diplococci)

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23
Q

What is a dermoid cyst?

A

A benign congenital cyst formed when the layers of skin don’t grow together properly

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24
Q

What are the eye symptoms of a cluser headache?

A
  • Conjunctival injection
  • Lacrimation
  • Eyelid swelling

There is NO loss of vision, however there can be visual disturbance in migraine

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25
Q

What would fundoscopy show in benign intracranial hypertension?

A

Papilloedema

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26
Q

Are tension headaches pulsatile?

A

NO

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27
Q

Why is temporal arteritis an emergency?

A

Because it can lead to ischaemia of the retinal arteries leading to irreversible blindness

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28
Q

What is the inheritance pattern of neurofibromatosis?

A

Autosomal dominant

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29
Q

What is the difference in presentation between neurofibromatosis type 1 and 2?

A

Neurofibromatosis type 1:

  • Axillary freckling
  • Cafe au lait spots on the chest and back (>=6)
  • Renal artery stenosis
  • Lisch nodules
  • Phaeochromocytoma

Neurofibromatosis type 2:

  • Bilateral vestibular schwannomas
  • Meningiomas
  • Glioblastomas
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30
Q

What is the only condition that will lead to a painful thyroid goitre?

A

De Quervain’s thyroiditis (sub-acute thyroidits)

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31
Q

What is MR angiography used for?

A

MR angiography is used for imaging the carotid arteries and intracranial vessels

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32
Q

Which drug causes cholestatic hepatitis?

A

Co-amoxiclav

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33
Q

What are the most common areas for a fragility fracture?

A

The neck of femur, spine and wrists

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34
Q

What is a skeletal survey?

A

A series of x-ray scans of all the bones in the body, commonly used for mutliple myeloma where the bones demonstrate punched out lesions

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35
Q

What’s seen in the urine of multiple myeloma patients?

A

Bence Jones proteins

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36
Q

What DEXA scan score would indicate osteoporosis?

A

t= -2.5

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37
Q

What is the diagnostic test for AAA?

A

Abdominal ultrasound

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38
Q

Which AAA patients should CT angiography be offered to?

A

>5.5cm or query rupture

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39
Q

Where are inguinal hernias usually located?

A

Superior and medial to the pubic tubercle

40
Q

Where are femoral hernias usually located?

A

Inferior and lateral to the pubic tubercle

41
Q

How long after surgery do incisional hernias occur?

A

3-6 months

42
Q

What is sephena varix?

A

Dilation of the saphenous vein due to an incompetent valve proximal to the saphenofemoral junction

43
Q

Why is there tachypnoea in DKA?

A

Attempt of correcting the metabolic acidosis

44
Q

What is one of the side effects of Carbamazepine?

A

Hyponatraemia

Presentation:

  • Coma
  • Somnolence
  • Cerebellar symptoms
45
Q

What is the presentation of ecstasy overdose?

A

Hyperactivation of the sympathetic nervous system

46
Q

What is the most common presentation of alcoholic liver disease on FBC?

A

Thrombocytopaenia

47
Q

What is the most important investigation for suspected thyroid malignancy?

A

Fine needle aspiration and cytology

48
Q

When are Calcitonin levels ascertained in the thyroid context?

A

If there is query medullary thyroid cancer

49
Q

What is physiologic jaundice?

A

Jaundice that occurs days after birth due to increased rate of haemolysis and reduced hepatic clearance in new-borns 2-3 days after birth

50
Q

How are Warfarin’s effects monitored?

A

Via INR

51
Q

How many days prior to surgery should Warfarin be stopped?

A

3-5 days prior to surgery, unless there are contra-indications such as life threatening emboli

52
Q

If warfarin cannot be stopped 3 days prior to surgery, what actions should be taken?

A

An INR of less than 2.5 should be achieved and heparin therapy should be given

53
Q

How can lymphoma present on chest x-ray?

A

Bilateral hilar lymphadenopathy

54
Q

How does mesothelioma tend to present on x-ray?

A
  • Pleural thickening
  • Plerual effusion
  • Tumour tends to be peripheral
55
Q

What is retrograde ejaculation?

A

Ejaculation from the penis into the bladder, commonly as a consequence of TURP`

56
Q

What is the most common malignancy in men 20-40?

A

Testicular

57
Q

What is the first line investigation for intestinal obstruction?

A

Supine abdominal x-ray

58
Q

What is IV crystalloid?

A

IV crystalloid is fluid containing electrolytes eg. NaCl saline

59
Q

What is a Sengstaken-Blakemore tube?

A

A tube inserted into the oesophagus with a balloon inflated in order to reduce variceal bleeding (commonly in oesophageal varices)

60
Q

What is orthostatic proteinurea?

A

Abnormal amount of protein passed in the urine when the patient is upright and a normal amount of protein passed when the patient is supine

61
Q

Which organs are most commonly affected by primary amyloidosis?

A

Kidenys

62
Q

Does amyloidosis cause nephrotic or nephritic syndrome?

A

Amyloidosis causes nephrotic syndrome

63
Q

What is the most common symptom of interstitial nephritis?

A

Fever

64
Q

What is the first line managment of perianal abscess?

A

Incision and drainage

65
Q

Which patients with peri-anal abscesses should be given broad spectrum antibiotics?

A
  • Immunocompromised
  • Elderly
  • Patients showing signs of related cellulitis
  • Cardiac valvular disease
  • Diabetes
66
Q

What is the post-surgical care of peri-anal abscesses?

A

Salt baths and analgesia

67
Q

What is the difference between peri-anal and peri-rectal abscess management?

A

Peri-anal abscesses can be drained in office (surgery, clinic etc) whereas peri-rectal abscesses need to be drained in an opperating theatre where there is adequate access to anaesthetics

68
Q

What is the most common cause of osteomalacia?

A

Vitamin D deficiency

69
Q

What does anticonvulsant therapy increase the risk of?

(particularly carbamazepine and phenytoin)

A

Catabolism of vitamin D and decreased Ca2+ absorption

Carbamazepine can also induce hyponatraemia

70
Q

What does a diagnosis of Sjorgen’s syndrome require?

A

3/4 of:

  • Positive anti-Ro and anti-La antibodies
  • Objective ocular involvement eg positive Schirmer’s test
  • Objective salivary gland involvement eg. salivary gland scintigraphy
  • Salivary gland histopathology
71
Q

What is Schirmer’s test?

A

A strip of paper is placed inside the lower eyelid and the moisture length measured

<5mm within 5 minutes is a postive test

Normal is 15mm within 5 minutes

72
Q

What is the ideal INR for patients with AF taking Warfarin?

A

Between 2-3

73
Q

What is the WHO pain ladder?

A
74
Q

Measurement of which parameter is the most effective in measuring iron levels?

A

Ferritin

75
Q

How long do cluster headaches typically last for?

A

15 mins- 3 hrs

76
Q

What is the definition of significant hyperkalaemia?

A

K+ >6mmol/L

77
Q

What tends to exacerbate essential tremors?

A

Movement

78
Q

What is the most common location for obstruction in acute cholecystitis?

A

Cystic duct

79
Q

What is the most common cause of acute pancreatitis?

A

Gallstones, followed by alcohol

80
Q

What is the traid for Budd Chiari syndrome?

A
  • Hepatomegaly
  • Abdominal pain
  • Ascites

Blood clots blocking drainage from the liver

81
Q

What is a cherry red fovea a sign of?

A

Central retinal artery occlusion

82
Q

What is typical for a history of allergic bronchopulmonary aspergillosis?

A
  • Bronchiectasis
  • Eosinophilia
83
Q

How is eosinophilic granulomatosis with polyangiitis distinguished from allergic bronchopulmonary aspergillosus?

A

Eosinophilic granulomatosis with polyangiitis often includes sinusitis, whereas sinusitis is not present in ABPA

84
Q

Which dermatological sign can present with pneumocystis jerovecii?

A

Kaposi’s sarcomas

85
Q

Which antibodies are positive in PBC?

A

Anti-mitochondrial

86
Q

What is the difference on neurological examination between myaesthenia gravis and lambert eaton myaesthenic syndrome?

A

Reflexes will be preserved in myaesthenia gravis, however they will be diminished/ absent in LEMS

87
Q

Which leukocytes are markedly raised in a bacterial infection compared to viral?

A

Neutrophils

88
Q

Where is acanthosis nigricans commonly found?

A
  • Vulva
  • Groin
  • Umbilicus
  • Axillae
  • Mammary folds
  • Nape of the neck
  • Elbows
  • Knuckles
89
Q

What are the symptoms of anastamotic leak?

A
  • Abdominal pain
  • Prolonges ileus
    • Delayed bowel movements
    • Delayed passage of flatus
  • Faeculent drainage
  • Prurulent drainage

Usually 5-7 days post operatively

90
Q

What is the presentation of atelectasis?

A
  • Dysponea
  • Tachycardia
  • Febrile

One of the most common complications following surgery:

  • Basal actelectasis following abdo surgery
91
Q

What should be suspected in a patient with a catheter, fever but no urinary signs?

A

UTI

92
Q

What is the first line investigation in suspected hepatobiliary disease?

A

Abdominal ultrasound

93
Q

What should be done if an ultrasound scan is normal, but there is clinical suspicion of pancreatic cancer?

A

Pancreas-specific CT

94
Q

What are plasma tumour markers generally used for?

A

Guidance in treatment rather than diagnosis

95
Q

What is acute rheumatic fever?

A

An autoimmune disease following a group A strep infection, typically 2-3 weeks after an URTI has been cleared

96
Q

What are the 5 manifestations of rheumatic fever?

A
  • Carditis (most common)
  • Arthritis (most common)
  • Chorea
  • Subcutaneous nodules
  • Erythema marginatum
97
Q

Why is raised urea a risk in pneumonia?

A

Water deprevation developes rapidly in patients with pneumonia therefore urea is an indicator of dehydration

Year 3 Medicine (22 decks)

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