5 December Flashcards
What is leukoplakia?
Pre malignant condition
White thickening of the oral mucosa that cannot be scraped off
What are features of necrotising otitis externa?
Extension of infection from ear canal into mastoid and temporal bones
Pain out of proportion to clinical signs
Facial palsy can be present
Occurs in diabetics and immunosuppressed
What is otosclerosis?
Increase in bony turnover in the ear leading to conductive hearing loss
What is the management of long term tympanic membrane perforation?
Myringoplasty to improve hearing and prevent further infections
What is treatment of acute otitis media?
1) Amoxicillin
2) Co-amoxiclav for resistant H.influenzae
Erythromycin if pen allergic
What are features of nasal polyps?
Men >40 associated with asthma, chronic sinusitis and allergic rhinitis
Symptoms- nasal blockage, watery discharge and changes in voice
Treat with steroid nasal drops followed by steroid nasal sprays
When should a different diagnosis be considered in children with bronchiolitis?
High fever >39
Persistently focal crackles
What is first line management of CHF?
1) Beta blocker and ACEi
2) Aldosterone antagonist
What is Puerperal pyrexia?
Temperature >38 within 14 days post partum
Causes
-endometritis- IV abx clindamycin and gent
-UTI
-wound infections
- VTE
-mastitis
How can you differentiate between vestibular neuronitis and viral labyrinthitis?
Neuronitis= NO no auditory symptoms
What are side effects of alpha 1 antagonists?
Tamsulosin
Dizziness
Postural hypotension
Dry mouth
Depression
What are side effects of 5 alpha reducates inhibitors?
finasteride
Erectile dysfunction
Reduced libido
Ejaculation problems
Gynaecomastia
What are the most common cardiac complications in Down Syndrome?
1) Arterioventricular septal defect
2) VSD
3) ASD
4) ToF/PDA
What are investigations into asthma?
Child <17 Spirometry with bronchodlator reversibility testing
>17 Spirometry with BDR and FeNO testing
What is the management of miscarraige <6 weeks?
Expectant miscarriage- repeat urine pregnancy test in 7-10 days
What are features of alcohol withdrawal?
Symptoms begin 6-12 hours post last drink
Tremor
Tachycardia
Confusion
Sweating
What are features of delirium tremens?
Coarse tremor
Confusion
Hallucinations
What is the management of PE in haemodynamic instability?
Thrombolysis e.g. streptkinase
What are features of left ventricular wall rupture?
1-2 weeks post MI
Features of cardiac tamponade- acute HF, raised JVP quiet heart sounds
What is the management of cluster headaches?
Oxygen and SC triptain
Prophylaxis- verapamil
What antibodies are present in gullain Barre syndrome?
Anti ganglioside antibodies
What are features of discoid lupus?
Anular erythematous scaly lesions on face/head
Keratin plugs which can be seen by removing superficial scale- carpet tack appearance
Leads to scarring alopecia
Treated with steroids and hydroxychlorquine second line
What is the management of scalp psoriasis?
Either potent steroid or vitamin D analogue or coal tar shampoo
If not working then combined steroid and Vit D analogue
What is the management of UTI in pregnnacy?
1- nitrofurantoin
2- Amoxicillin or Cefalexin
