25/05/2021 Flashcards by Olivia McNee

Which drugs can cause tinnitus?

Aspirin and other NSAIDs

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when you see thymoma think

myasthenia gravis

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what is a thymoma

most common tumour of anterior mediastinum

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what are thymomas associated with

myasthenia gravis
red cell aplasia
dermatomyositis
also: SLE, SIADH

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which drugs cause hypercalcaemia and hypocalciuria?

bendroflumethazide

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adverse effects of thiazide diuretics

common
> dehydration
> postural hypotension
> hyponatraemia, hypokalaemia, hypercalcaemia
> gout
> impaired glucose tolerance
> impotence

rare
> thrombocytopenia
> agranulocytosis
> photosensitivity rash
> pancreatitis

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which antibiotics have to be avoided in pregnancy

> tetracyclines
aminoglycosides
sulphonamides and >trimethoprim
quinolones

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which drugs (other than antibiotics) have to be avoided in pregnancy

ACE inhibitors
AIIRB
statins
warfarin
sulfonylureas
retinoids 
cytotoxic agents

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presentation of hodgkins lymphoma

neck mass due to lymphadenopathy - painful on alcohol consumption

night sweats

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characterisation of HL

normocytic anaemia, eosinophilia
LDH high
reed-stenberg

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pulsus paradoxus

abnormally large drop in BP during inspiration

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sigmoid volvulus management

rigid sigmoidoscopy with rectal tube insertion

UNLESS symptoms of peritonitis then go for urgent midline laparotomy

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HRT in woman with a uterus

oestrogen combined with a progesterone

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HRT in woman without a uterus

oestrogen-only therapy

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HRT if LMP <1 year ago

cyclical HRT

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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)

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meigs syndrome

benign ovarian tumour- usually a fibroma associated with ascites and pleural effusion

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most common benign ovarian tumour in women under the age of 25

dermoid cyst (teratoma)

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most common cause of ovarian enlargement in a women of reproductive age

follicular cyst

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BMD presentation

> develops after the age of 10 years

> intellectual impairment much less common

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diagnostic investigation for sbo

CT abdo

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median nerve motor supply in hand

LOAF
> lateral 2 umbricals
> opponens pollicis
> abductor pollicis brevis
> flexor pollicis brevis

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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.

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median nerve forearm innervation

>Pronator teres
>Flexor carpi radialis
>Palmaris longus
>Flexor digitorum superficialis
>Flexor pollicis longus
>Flexor digitorum profundus (only the radial half)

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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