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MSRA wrong questions > 26 November > Flashcards

26 November Flashcards

1
Q

What are investigation findings of hereditary spherocytosis?

A

Increased MCHC
Increased unconjugated bilirubin
Increased LDH
Decreased haptoglobin
Increased reticulocytes (due to increased RBC production)
Increased urinary urobilinogen

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2
Q

What are features of pernicious anaemia?

A

Low B12
Low intrinsic factor (due to antibodies- specific for diagnosis)
Parietal cell antibodies

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3
Q

What are features of thalassaemia?

A

Hypochromic microcytic anaemia
High iron and ferritin
low TIBC

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4
Q

What are features of Infectious mononucleosis?

A

Tonsillitis picture
Splenomegaly
Heterophile antibodies- found on monospot test

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5
Q

What are symptoms of CML?

A

Anaemia- lethargy
Weight loss and sweating
Splenomegaly/abdo discomfort
Massive increase in WBC

Imatinib is treatment for chronic phase

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6
Q

What is the management of warfarin if INR 5-8?

A

No bleeding- withold 1-2 doses and reduce maintenance dose
Minor bleeding- stop warfarin, give IV Vit K 1-3mg and restart when INR <5

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7
Q

What is the management of warfarin when INR >8

A

No bleeding- stop warfarin, PO Vitamin K 1-5mg and restart when INR <5
Minor bleeding- stop warfarin, IV Vit K 1-3mg, restart when INR <5

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8
Q

What is the management of warfarin in major bleeding?

A

Stop warfarin
Vitamin K IV 5mg
Dried Prothrombin complex 25-30units/kg

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9
Q

What is seen on blood film in iron deficient anaemia?

A

Target cells

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10
Q

What is seen on bone marrow film in in AML?

A

Auer rods

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11
Q

What are features of AML?

A

Symptoms of pancytopenia
Blas cells/ rod cells on blood film
Treat with chemotherapy or bone marrow transplant if relapse

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12
Q

What are features of CLL?

A

No symptoms- often incidental finding of lymphocytosis
May have anorexia and weight loss
Bleeding/infections
More marked cervical lymphadenopathy

Smudge cells on blood film

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13
Q

What are features of myelofibrosis?

A

Elderly person with symptoms of anaemia
Massive splenomegaly
Anorexia, weight loss, night sweats

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14
Q

What is found on investigation of myelofibrosis?

A

Tear drop cells
Anaemia
High WCC and platelet in early disease
High LDH and urate

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15
Q

What is the management for nocturnal eneuresis in children?

A

Look for underlying causes e.g. constipation/UTI
General advice- fluid intake, toileting patterns
Reward system
Enuresis alarm
Desmopressin- for short term or if alarms do not work

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16
Q

What are Ottawa rules for ankle X rays

A

Any pain in the malleolar zone with one of the findings
- bony tenderness at lateral malleolar zone
- bony tenderness at the medial malleolar zone
- inability to walk 4 steps immediately after or in ED

17
Q

What are risk factors for umbilical cord prolapse?

A

Prematurity
Multiparity
Polyhydraminos
Twin pregnancy
Cephalopelvic disproportion
Abnormal presentations

50% occur due to artifical rupture of membranes

18
Q

What is the management of COPD with asthma features if SABA not working?

A

LABA and inhaled ICS

19
Q

What are side effects of acetylcholinesterase inhibitors e.g. donepezil?

A

Bradycardia
GI- nausea/vomiting
Agitation
Hallucinations
Syncope

20
Q

What are features of pityriasis versicolor?

A

Due to fungal infection
Commonly affects trunk with hypopigmented patches- more noticeable post sun tan

Managed with ketoconazole shampoo- if not working consider alternative diagnosis and oral itraconazole

21
Q

What are features of anterior uveitis?

A

Acute onset
Painful red eye
Pupil small/irregular shaped
Blurred vision
Photophobia
Hypopyon
Ciliary flush

22
Q

What are features of viral labrinythitis?

A

Vertigo
N&V
Hearing loss
Tinnitus
Following URTI

23
Q

What are signs of viral labrinythitis?

A

Unidirectional horizontal nystagmus towards unaffected side
Sensorineural hearing loss
Gait disturbance

24
Q

What are features of pseudogout?

A

Knee/wrist/shoulder commonly affected
Joint aspiration- positive birefringent rhomboid shaped crystals
X ray- chondrocalcinosis

25
Q

What is the management of haemorrhoids?

A

Soften stools- fibre intake
Topical LA and steroids
Rubber band ligation as outpatient
Surgery only for large symptomatic haemorrhoids that do not respond to treatment

26
Q

What is the management of sulphonylurea administration on the day of surgery?

A

Omit day of surgery
Unless surgery is in morning and patient takes BD dose- can have PM dose

27
Q

What are features of episcleritis?

A

Red eye
Mild irritation
Watering
Mild photophobia

MSRA wrong questions (15 decks)

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