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Practice Exams > 7/10/21 > Flashcards

7/10/21 Flashcards

1
Q

Treatment Options of Androgenic Alopecia? (6 points)

A
  1. No Treatment
  2. Hair Piece
  3. Topical Minoxidil 2-5%
  4. Oral Finasteride 1mg Daily
  5. Oral Dutasteride 0.5mg daily
  6. Surgery
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2
Q

How does Finasteride work and Side effects of Finasteride (give me 4)

A
  • Mode of Action: inhibits 5-alpha-reductase (5AR)
  • Infrequent → impotence, decreased libido, ejaculation disorder
  • Rare → breast tenderness + enlargement, allergic reaction, poor semen quality, infertility and depression
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3
Q

Treatment of Hyperhidrosis (4 steps)

A
  1. Antiperspirant
  2. Iontophresis
  3. Iontophresis + Anticholinergic, Anticholinergic, Botox
  4. Surgical Sympatectomy
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4
Q

What cause of neck pain are patients with Down’s Syndrome more prone to? How do you diagnose this? What are the associated symptoms? (Give me 3)

A

Atalanto-Axial Instability

  • excessive mobility of the articulation of the atlas (C1) and the axis (C2) → may lead to subluxation of the cervical spine.
  • diagnosis: lateral neck radiographs
  • symptoms: neck pain, torticollis, gait abnormalities, loss of bowel or bladder control or quadriplegia or quadriplegia
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5
Q

What are red flags of neck pain? (12 points - name as many, at least 9)

A
  1. Significant Trauma
  2. Infective symptoms including Fever >38
  3. Constant Pain (day and night)
  4. Down’s Syndrome
  5. History of Cancer
  6. Constitutional Symptoms - night sweats, weight loss
  7. History of RA or Ankylosing Spondylitis
  8. Age >50yo
  9. Pain at Multiple Sites
  10. Neurology - radicular pain down arm, spinal cord pathology
  11. Anterior Neck (Throat) Pain
  12. Ripping/Tearing Neck Sensation
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6
Q

How do you treat hyperprolactinaemia? Be Specific.

A
  1. Cabergoline 0.5mg weekly in 1 or 2 doses → increasing by 0.5mg in monthly intervals up to maximum 3mg
    • Treatment of medical indicated lactation suppression (post-still birth/severe mastitis)/galactorrhoea
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7
Q

8 categories of causes of hyperprolactinaemia.

A
  1. Prolactinoma
  2. Medications -> quite a few.
  3. Neurogenic Causes -> stress, chest wall trauma, breast stimulation
  4. Pseudohypnatraemia
  5. Pregnancy
  6. Pituitary Stalk Pathology -> trauma, surgery and tumour
  7. Systemic Illness > thyroid, kidney, liver, epilepsy
  8. Hypothalamic Disorder -> tumour, infiltration, surgery
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8
Q

Medication that can cause hyperprolactinaemia. (9 drugs - give me 4)

A
  • antipsychotics, methyldopa, metoclopramide, domperidone, opioids, SSRIs, TCAs, cannabis, OCP
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9
Q

Other than dopamine agonist therapy, name 3 other therapies for hyperprolactinaemia?

A
  • Combined Oral Contraceptive Therapy → used for women with a microprolactinoma who do not desire fertility and do not have distressing symptoms
  • Pituitary Surgery → patients who cannot tolerate or are resistant to dopamine agonists
  • Radiotherapy → reserved for prolactinomas that continue to expand despite surgical and drug therapy
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10
Q

What neurological conditions are cluster headaches a subgroup of? What are cluster headaches associated with?

A
  • subtype of trigeminal autonomic cephalgia → associated with structural lesions of the pituitary
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11
Q

What are cluster headaches aka? What is the nature and frequency and duration of cluster headaches?

A
  • aka “suicide headaches” → stabbing, boring headaches

- 0.5 to 8 episodes daily, each lasting 15mins-3 hours

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12
Q

What are the main charateristics of a cluster headache? Males or Female predominance? Triggers?

A
  • male > female
  • Unilateral and side-locked (always affects same side of head), usually follows distribution of first division of the trigeminal nerve
  • Unilateral autonomic features → tearing, conjunctival irritation/injection, ptosis, nasal stuffiness/rhinorrhoea, fullness of the ear, tinnitus, facial flushing or sweating). Possible photophobia and phonophobia
  • Patient is usually agitated and restless
  • Triggered by alcohol
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13
Q

Treatment of an acute cluster headache? 2 points + 1 bonus

A
  1. Sumatriptan 6mg subcut
    - Get relief from high flow O2 → if effective oxygen can be used at home
    - A greater occipital nerve block can be used a bridging treatment
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14
Q

Prophylaxis of cluster headaches + point of consideration given this treatment choice.

A
  1. Verapamil IR 80mg TDS for 2/52 then 120mg TDS for 2/52 then 160mg TDS. Repeat ECG
    • Fewest side effects
    • Heart block may only arise 10/7 after starting or increasing dose
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15
Q

What is Diabetic Amyotrophy? How does it progress?

A
  • Acute, asymmetric focal onset of pain followed by weakness involving the proximal leg, with associated autonomic failure and weight loss.
  • Progression occurs over months and is followed by partial recovery in most patients
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16
Q

4 categories of neuropathic complications of diabetes

A
  1. Autonomic Dysfunction
  2. Sensory Polyneuropathy
  3. Isolated or Multiple Polyneuropathy
  4. Diabetic Lumbosacral Radiculoplexus Neuropathy
17
Q

What are the types of autonomic neuropathy that can occur as complication of diabetes? (8 points, name 4)

A 
Erectile Dysfunction
Postural Hypotension + Syncope
Gastroparesis (impaired gastric emptying)
Diarrhoea
Delayed or Incomplete Bladder Emptying
"Silent" Ischaemia
Hypoglycaemic "Unawareness"
Sudden Arrest
18
Q

Diagnostic Triad for Diverticulitis

A
  1. Fever
  2. Acute Pain
  3. Left-Sided Radiation
19
Q

Investigation of choice for Diverticulitis and 2 main findings.

A

CT Abdo → bowel wall thickening, presence of colonic diverticular

20
Q

Key Features usually present in PMR - 3 points

A
  • Age >50yo
  • Bilateral Shoulder Ache
  • Elevated ESR and/or CRP concentration
21
Q

Supportive Features to PMR other than 3 main features

A
  • Morning Stiffness lasting more than 45 mins
  • Hip Girdle Discomfort or limited ROM
  • Absence of involvement of other joints other than the hip and shoulder
22
Q

Location for Pathological Fractures (3 points)

A
  • subtrochanteric femur
  • humeral head and metaphyseal junction
  • vertebral body

Practice Exams (45 decks)

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