25/05/2021 Flashcards
Which drugs can cause tinnitus?
Aspirin and other NSAIDs
when you see thymoma think
myasthenia gravis
what is a thymoma
most common tumour of anterior mediastinum
what are thymomas associated with
myasthenia gravis
red cell aplasia
dermatomyositis
also: SLE, SIADH
which drugs cause hypercalcaemia and hypocalciuria?
bendroflumethazide
adverse effects of thiazide diuretics
common > dehydration > postural hypotension > hyponatraemia, hypokalaemia, hypercalcaemia > gout > impaired glucose tolerance > impotence
rare > thrombocytopenia > agranulocytosis > photosensitivity rash > pancreatitis
which antibiotics have to be avoided in pregnancy
> tetracyclines
aminoglycosides
sulphonamides and >trimethoprim
quinolones
which drugs (other than antibiotics) have to be avoided in pregnancy
ACE inhibitors AIIRB statins warfarin sulfonylureas retinoids cytotoxic agents
presentation of hodgkins lymphoma
neck mass due to lymphadenopathy - painful on alcohol consumption
night sweats
characterisation of HL
normocytic anaemia, eosinophilia
LDH high
reed-stenberg
pulsus paradoxus
abnormally large drop in BP during inspiration
sigmoid volvulus management
rigid sigmoidoscopy with rectal tube insertion
UNLESS symptoms of peritonitis then go for urgent midline laparotomy
HRT in woman with a uterus
oestrogen combined with a progesterone
HRT in woman without a uterus
oestrogen-only therapy
HRT if LMP <1 year ago
cyclical HRT
continuous combined HRT
> taken cyclical combined for at least 1 year
OR
it has been at least 1 year since their LMP
OR
it has been at least 2 years since their LMP, if they had premature menopause (menopause below the age of 40)
meigs syndrome
benign ovarian tumour- usually a fibroma associated with ascites and pleural effusion
most common benign ovarian tumour in women under the age of 25
dermoid cyst (teratoma)
most common cause of ovarian enlargement in a women of reproductive age
follicular cyst
BMD presentation
> develops after the age of 10 years
> intellectual impairment much less common
diagnostic investigation for sbo
CT abdo
median nerve motor supply in hand
LOAF > lateral 2 umbricals > opponens pollicis > abductor pollicis brevis > flexor pollicis brevis
hand sensation median nerve
> Over thumb and lateral 2 ½ fingers
On the palmar aspect this projects proximally, on the dorsal aspect only the distal regions are innervated with the radial nerve providing the more proximal cutaneous innervation.
median nerve forearm innervation
>Pronator teres >Flexor carpi radialis >Palmaris longus >Flexor digitorum superficialis >Flexor pollicis longus >Flexor digitorum profundus (only the radial half)
side effects of EPO
> accelerated hypertension potentially leading to encephalopathy and seizures (blood pressure increases in 25% of patients)
> bone aches
flu-like symptoms
skin rashes, urticaria
pure red cell aplasia* (due to antibodies against erythropoietin)
raised PCV increases risk of thrombosis (e.g. Fistula)
iron deficiency 2nd to increased erythropoiesis
failure to respond to epo
> iron deficiency > inadequate dose > concurrent > infection/inflammation > hyperparathyroid bone disease > aluminium toxicity
adrenaline dose ALS
1mg
reversible causes of cardiac arrest
H's > hypoxia > hypovolaemia > hyperkalaemia, hypokalaemia, hypoglycaemia, hypocalcaemia > hypothermia
T's > thrombosis > tension pneumothorax > tamponade > toxins
Patients with chronic urinary retention should be …
taught intermittent self catheterisation before a long term catheter is offered.
strawberry cervix
trichomonas
management of BV
oral metronidazole for 5-7 days
dopamine and galactorrhoea
Dopamine acts as the primary prolactin releasing inhibitory factor and hence dopamine agonists such as bromocriptine may be used to control galactorrhoea.
features of excess prolactin
men: impotence, loss of libido, galactorrhoea
women: amenorrhoea, galactorrhoea
causes of raised prolactin
> prolactinoma > pregnancy > oestrogens > physiological: stress, exercise, sleep > acromegaly: 1/3 of patients > polycystic ovarian syndrome > primary hypothyroidism (due to thyrotrophin releasing hormone (TRH) stimulating prolactin release)
drug causes of raised prolactin
> metoclopramide, >domperidone
phenothiazines
haloperidol
very rare: SSRIs, opioids
Patients using methotrexate require effective contraception during and for at least ______ after treatment in men or women
6 months
acne vulgaris in pregnancy
oral erythromycin if treatment needed
productive cough, haemoptysis, and vague abdominal pain for the past 2 weeks.
Chest X-ray shows multiple large, round, well-circumscribed masses in both lungs
cannonball mets
renal cell carcinoma
causes of hyperkalaemia
> acute kidney injury > drugs*: potassium sparing > diuretics, ACE inhibitors, angiotensin 2 receptor blockers, spironolactone, ciclosporin, heparin** > metabolic acidosis > Addison's disease > rhabdomyolysis > massive blood transfusion
CURB 65 parameters
C= Confusion (abbreviated mental test score <= 8/10)
R= Respiration rate >=30/min B= Blood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65 Aged >= 65 years
presentation of anastamotic leak
days 5-7
fast AF
Children and young people with unexplained bone swelling or pain
very urgent direct access X-ray to assess for bone sarcoma
treatment of diarrhoea in IBS
loperamide
mammary duct ectasia
> Dilatation of the large breast ducts
around the menopause
tender lump around the areola +/- a green nipple discharge
inflammation, sometimes referred to as ‘plasma cell mastitis’
mammary duct ectasia rupture
diagnostic test for OSA
polysomnography
Spirometry shows a restrictive picture with reduced transfer factor and coefficient.
IPF
AOM with perforation
oral antibiotics
life long ban on deep sea diving
pneumothorax
Cervical cancer screening: if 2nd repeat smear at 24 months is still hrHPV +ve →
colposcopy
FEV1
ability to exhale as much as you can in 1 second
obstructive lung disease
COPD
Asthma
bronchitis
FEV1/FVC ratio
increased = restrictive >0.7
decreased= obstructive
restrictive lung disease
fibrosis
ARDS
Obstructive pattern
O= out (air) B= below (PFTs) S T R U= upper number (numerator) C T
(low)FEV1/FVC
Restrictive pattern
R- inside E - elevated (PFTs) S T R I- inferior (denominator) C T
(low)FEV1/(very low)FVC
MOA of contraceptive implant
inhibition of ovulation
kartageners syndrome
dextrocardia or situs inversus
bronchiectasis
recurrent sinusitis
subfertility
pathogenesis of kartageners
dynein arm defect results in immotile cilia
risk factors for SDLD
> prematurity > male sex > maternal diabetes > caesarean section > second born of premature twins
boas sign
In acute cholecystitis there is hyperaesthesia beneath the right scapula
Staphylococcus aureus is a …
is a gram+ve bacterium, catalase +ve, coagulase +ve organism
Witnessed cardiac arrest while on a monitor
up to three successive shocks before CPR
