4th Year CAP Flashcards
What strongly suggests congenital heart disease in a newborn?
delay in femoral pulses
What is smasmodic torticollis also known as?
cervical dystonia
Describe cervical dystonia.
Head turns to one side due to contraction of sternocleidomastoid muscle, patient finds it difficult to keep head facing forward
What is blepharospasm?
spasm of eyelid
What is hemiballismus?
uncontrolled flailing of the limbs
What causes bronchiolitis?
RSV
Treatment for campylobacter in an otherwise well individual?
supportive care only
Treatment for salmonella typhoid?
IV ceftriaxone
Rapidly contracting human muscle cells start producing lactic acid - why?
because the cells must convert NADH to NAD+
What certificate is needed is a psychiatrist wants to give ECT to a patient with severe depression, but the patient doesn’t want it as he believes it will kill him?
certificate of designated medical practitioner
What type of hearing loss occurs is otosclerosis?
conductive hearing loss
In what condition do the vessels cross fetal membranes, causing severe fetal distress and intrapartum bleeding following rupture of membranes?
vasa previa
What are responsible for elevating the section of the respiratory tract containing the vocal cords?
longitudinal muscles of the pharynx
Which muscles are just superficial to the transversus abdominus?
internal obliques
What muscle acts as a respiratory accessory muscle and is attached to rib 1?
Scalenus anterior
6 week histoy of sore throad and hoarse voice?
laryngopharyngeal reflux
Paraproteins associated with?
multiple myeloma
Which neurotransmitter is most involved in appetitive and approach
systems?
Dopamine
Treatment of MODY Diabetes?
Low dose sulfonylureas eg gliclazide
A 16 year old man presents with a 48 hour history of cramping lower
abdominal pain, associated with diarrhoea and vomiting. The pain is worst
just prior to defecation. On examination he has a temperature of 37.5, heart
rate of 84bpm and his abdomen is soft but generally tender
Gastroenteritis
A 40 year old lady presents with a 3 day history of progressive, sharp, right
upper abdominal pain. She states that the pain radiates to her right shoulder
and is worse on inspiration. On examination she has a temperature of 38.9,
heart rate of 102bpm and is tender in her right upper quadrant
Cholecystitis
A 21 year old man presents with a 6 hour history of severe, constant, central
abdominal pain. He has vomited twice and describes shaking
uncontrollably at times. On examination he is bent over with the pain, his
temperature is 38.5 and heart rate 128bpm.
Appendicitis
What allows detention of a patient in hospital for 6 months in the first instance?
compulsory treatment order
. A 78 year old female presents with a gradual painless loss of vision in both
eyes. Visual acuities are 6/12 in the right and 6/18 in the left eye. Red
reflexes are diminished on examination
cataracts
An 84 year old male presents with a sudden painless loss of central vision
in his right eye. He has been aware of distorted vision from this eye for the
past few days. Ophthalmoscopy reveals a large solitary haemorrhage at the
fovea in the affected eye.
wet age related macular degeneration
A long-sighted 52 year old male presents with a sudden loss of vision in his
left eye which is painful and red. He has noticed halos around lights, is
nauseated and has vomited. On examination the pupil is mid-dilated and
non-reactive.
Acute closed angle glaucoma
Highest mortality rate out of bipolar, schizoaffective disorder, depression and anorexia nervosa?
Anorexia nervosa (approx 18% mortality rate)
A change from one mature cell type to another is known as what?
metaplasia
abnormal cell
proliferation?
neoplasia
A 30 year old presents with itchy blisters on extensor surfaces.
Immunofluorescence reveals granular IgA at the dermal papillae.
What is the most likely diagnosis?
dermatitis herpetiformis
A 54 year old man presents with cough, fever and right sided chest pain. Chest
x-ray shows right sided consolidation. Blood cultures are positive.
Which is the most likely organism and what is its stain?
strep pneumonia
Gram positive diplococci
What antibody would be involved in the following: A 45 year old woman who has experienced red hot swollen joints,
symmetrically in her hands and feet. Her inflammatory markers are raised.
Anti-CCP antibodies (Rheumatoid arthritis)
What antibody would be involved in the following: A middle-aged woman who complains of her fingers turning blue in the
cold, and heartburn. Her echocardiogram shows elevated pulmonary arterial
pressures.
Anti-centromere antibody (Systemic sclerosis)
A 40 year old man is admitted with fever and confusion. A CT scan is
performed prior to lumbar puncture and shows evidence of inflammation in
the right temporal lobe.
Herpes Simplex encephalitis
A preterm neonate born at 32 weeks becomes floppy and cyanosed.
Meningitis is suspected. CSF is obtained and gram positive cocci in chains
are observed. Mum was noted to be carrying this organism in the vagina
earlier in pregnancy
Group B Strep
Which neurotransmitter is most involved in aversive and defensive
systems?
Serotonin
What is important to note about phenytoin in woman’s health?
It reduces contraceptive efficacy as it induces liver enzymes.
Is bradycardia or tachycardia a side effect of Anticholinesterase inhibitors?
Bradycardia
Describe how the detrusor muscle is inhibited.
Sympathetic innervation acts via beta adrenergic receptors to inhibit the detrusor
A 75 year old man with COPD, ischaemic heart disease and hypertension
who has a painful ulcer on the right foot. ABPIs are left 0.76, right 0.68
Arterial Disease
A 58 year old lady with an undiagnosed mixed connective tissue disease
has multiple superficial ulcers over both lower legs from the knee down.
Purpura is evident on the intact skin
Vasculitis
An 82 year old lady with ulcers on both malleoli of the left leg and
lipodermatosclerosis of surrounding skin. ABPI left 1.13, right, 0.96.
Venous insufficiency
Drainage of the aqueous humour is via what?
Trabecular meshwork
A 2 day old infant born at term after uneventful pregnancy started vomiting.
The vomit is non projectile, mild and green in colour.
volvulus
A 2 week old infant who was born at term after uneventful pregnancy and
developed vomiting at the age of four days. The infant has been breast fed.
The vomiting is projectile and associated with constipation. The infant
appeared well and eager to feed.
Pyloric stenosis
. A 3 week old infant born at term, bottle fed, who started vomiting on day
seven. The vomit is of small amount, effortless and after almost every feed.
The infant appears well and gains weight appropriately. The infant is taking
around 150 ml/kg/day of milk.
Gastri-oesophageal reflux
A 27 year old man presents to the Emergency Department stating he has taken
an overdose of paracetamol (approximately 16 tablets) 6 hours ago. Blood tests
show a paracetamol level of 100mg/L What should be done?
start acetylcysteine infusion
Most common symptom in compartment syndrome?
pain out of proportion
Treatment for endometriosis?
combined oral contraceptive pill/IUD
A 56 year old woman with proximal muscle pain and weakness for 4
months. On examination, her muscle power is 3/5 on the MRC scale. Her
inflammatory markers are elevated and her creatinine kinase is 12,000.
(normal range between 40 and 320)
Polymyositis
A 56 year old woman with proximal muscle pain and stiffness for 4 months.
On examination, her muscle power is 5/5 on the MRC scale. Her
inflammatory markers are elevated. Her creatinine kinase is normal
Polymyalgia rheumatica
How does lamotrigine work?
Blockade of voltage
sensitive sodium
channels
What is the age (in months) at which it is recommended that child height rather
than length should be measured.
24
The percentage of children that will have a height within 2 standard
deviations of the mean?
95%
Complication of thyroidectomy?
damage to recurrent laryngeal nerve can lead to hoarse voice
. A 24 year old man with schizophrenia is brought to hospital by the police.
He is very agitated and attempts to punch one of the nurses. He is restrained
and given 5mg haloperidol intramuscularly. He initially becomes calmer
but two hours later he becomes agitated again. The psychiatrist examines
him and finds him to be sweaty with pyrexia and rigidity.
Neuroleptic malignant sydrome
An 82 year old woman with dementia is agitated in the evenings. No
physical cause is found and she is prescribed amisulpride 25mg at 6pm. She
is reviewed the following week and is found to have muscular rigidity,
tremor and reduced mobility
Parkinsonism
Common signs of digoxin toxicity?
blurred vision
