A Flashcards
Side effect of bisoprolol
Erectile dysfunction
Contraindications for statins
- Macrolides (erythromycin, clarithromycin)
- Pregnancy
Beck’s Triad for cardiac tamponade
ECG: electrical alternans
- Hypotension
- Raised JVP
- Muffled heart sound
ECG for acute pericarditis
- Widespread/global saddle-shaped ST elevation
- PR depression
Distinguish Cowden’s syndrome and familial juvenile polyposis
Familial juvenile polyposis — multiple polyps in the colon + NO oral lesion
Cowden — multiple polyps in the colon + oral mucosal papillomas, palmoplantar keratoses and trichilemmomas (benign tumour of hair follicle)
Crohn’s VS Ulcerative colitis (UC)
Crohn’s — skip lesion, anywhere from mouth to anus, non-bloody diarrhea, weight loss, abdominal mass palpable in RIF, stricture (Kantor’s string sign), proximal bowel dilatation, “rose thorn” ulcer, cobblestoning
UC — continuous disease, start at rectum, bloody diarrhea, abdo pain in LLQ, tenesmus, higher risk of colorectal cancer, crypt abscesses, pseudopolyps, loss of haustrations, “drainpipe colon” (short and narrow)
Primary biliary cirrhosis (PBC) — M rules
- IgM
- Anti-Mitochondrial antibodies, M2 subtype
- Midle aged female
Alcoholic VS Non-alcoholic Liver Disease
- AST : ALT > 2 = Alcoholic
- AST : ALT < 1 = Non-alcoholic
Scoring system to assess severity of liver cirrhosis
Child-Pugh classification
- Bilirubin
- Albumin
- Prothrombin time
- Encephalopathy
- Ascites
Tumour markers
- CA 125 = Ovarian
- CA 19-9 = Pancreatic
- CA 15-3 = Breast
- PSA = Prostate
- A-FP = HCC, teratoma
- CEA = Colorectal
Spontaneous Bacterial Peritonitis
- Ascites, abdominal pain, fever
- Diagnosed by paracentesis: neutrophil count > 250 cells/ul
- Most common organism found on ascitic fluid = E. Coli
- IV cefotaxime
- Joint aspiration showing weakly-positively birefrigent rhomboid shaped crystals
- X-ray show chondrocalcinosis (linear calcification of particular cartilage)
Pseudogout (deposition of calcium pyrophosphate)
Rheumatoid arthritis
Splenomegaly
Neutropenia (low WCC)
Felty’s syndrome
Absolutely contraindicated in pregnancy
- Methotrexate
- NSAIDs
Triad of Reiter’s syndrome (Reactive Arthritis)
- Arthritis (knee)
- Urethritis
- Conjunctivitis
Patient cant see, can’t pee, can’t bend the knee
HLA-B27
Ankylosing spondylitis develop in 50% of HLA B27 +ve patients
Patient develop arthritis following an infection
Episcleritis VS Scleritis
Scleritis = Painful
Episcleritis = NO pain
Ankylosing spondylitis features
A’s
- Apical fibrosis
- Anterior uveitis
- Aortic regurgitation
- Achilles tendonitis
- AV node block
- Amyloidosis
Hip fracture
- Shortened
- Abducted (out)
- Externally rotated leg
Unable to weight bear
Hip dislocation
- Shortened
- Adducted
- Internally rotated leg
Boxer’s fracture
- After punches hard surface
- Minimally displaced 5th metacarpal fracture
Ankylosing spondylitis
- Reduced lateral flexion
- Reduced forward flexion (Schober’s test)
- Reduced chest expansion
- Stiffness worse in the morning and improve with exercise
- Pain at night
Normal pressure hydrocephalus
Triad:
- Urinary incontinence
- Dementia
- Gait abnormality
CT: hydrocephalus, enlarged 4th ventricle
Mx: VP shunting (ventriculoperitoneal)
