4 December Flashcards
What are features of pernicious anaemia?
Lethargy
Pallor
Pins and needles
Mild jaundice
Stomatitis
Atrophic glossitits
Dyspnoea
What is diagnostic criteria for IBS?
Symptoms for 6 months
- abdo pain
- bloating
- change in bowel habit
OR
Abdo pain with two of folloing
- passage of rectal mucous
-symptoms worse on eating
- abdominal bloating
- altered passafe of stool
What are features of cholecystitis?
RUQ pain
Fever
Murphys sign +ve
Occasionally mild LFT derrangement
What are features of Weils disease?
Early phase lasts around a week
- mild fever/flu, subconjunctival redness
Second phase- more severe (Weils disease)
-AKI
-hepatitis, jaundice,hepatomegaly
-aseptic meningitis
What can affect 13C urea breath test results?
Abx use within 4 weeks
PPI use within 2 weeks
What is the most common cause of travellers diarrhoea?
E.coli
What are symptoms of Bacillus cereus?
Food poisonin
Watery diarrhoa
Abdo cramps
6-15 hours post consumption of contaminated food
What is the management of H.pylori infection?
Full dose PPI with amoxicillin and clarithromycin
What are features of patellar tendonitits?
anterior knee pain worsened by activity
Tenderness along the course of patellar tendon
Pain reporduced on extension of the knee against resistance
What are features of mitral stenosis?
Dyspnoea
Haemoptysis
Mid-late diastolic murmur
Loud S1
Opening snap
Malar flush
AF
What is the management of tachyarrythmia?
Unstable= DC cardioversion- 3 shocks if unsuccessful amiodarone and then repeat shock
Stable narrow complex- try vagal maneouvres
1) Adenosine 6mg
2) Adenosine 12mg
3) Adenosine 18mg
4) Verapamil or beta blocker
Broad complex- likely VT with pulse
1) Amiodarone
What are 2 week wait criteria for bladder ca?
45+ AND
- unexplained haematuria with no infection
-visible haematuria which persists after UTI treated
60+ with
- unexplained non visibile haematuria and either elevated WCC or dysuria
What are features of MEN1 mutation?
Hyperparathyroidism
Pituitary tumour
Pancreatic tumour- insulinoma/gastrinoma
What are features of MEN2 mutation?
2a) Phaeochromocytoma, hyperparathyroidism, medullary thyroid cancer
2b) phaeochromocytoma, medullary thyroid cancer, marfanoid body habitus and mucosal neuroma
What are features of breast fibroadenoma?
young patients
Rubbery, firm and non tender
Highly mobile
What is the management of Kawasaki disease?
High dose aspirin and IV immunoglobulins
What is the function of the common peroneal nerve?
Motor- foot dorsiflexion and eversion
Sensory- lateral leg and bottom of foot
What is the management of pericarditis?
NSAIDS and colchicine
What are features of Pneumocystis Jirovecii pneumonia?
Fever, dry cough SOB
CXR- bilateral infiltrates, often pneumothorax
Treat with co-trimoxazole (steroids too if hypoxic), initiate prophylaxis if CD4 <200
What is the management of myoclonic seizure?
Valproate
Keppra, if women of childbearing ageW
What is the management of a staggered paracetamol overdose?
Commence NAC regardless of concentration
What is the management of endocarditis?
Native valve
- Amox and gentamicin initially
- if Staph then fluclox
- if strep then benpen
Prosthetic valve
-Vanc, gent and rifampicin
What are side effects of lithium?
Tremor
N&V
Hypothyroidism
Weight gain
Hyperparathyroidism and hypercalcaemia
What is meningococcal prophylaxis?
1) Ciprofloxacin
Or rifampicin
