AKT Flashcards
120mg oral morphine daily dose is equivalent to __mg in a subcut driver
60
BNF antibiotic guidelines: mastitis
Flucloxacillin
Prediabetic obese class II patients should be considered for which medication
Liraglutide
BNF antibiotic guidelines: dental abscess
Amoxicillin
Arteriolar narrowing + tortuosity, silver wiring, AV nipping, cotton wool exudates, flame and blot haemorrhages are features of
Hypertensive retinopathy
How long is Mirena licensed for use as part of HRT?
4 years
_____ may be used in patients with stress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention
Duloxetine
Statistical test that compares two sets of observations on a single sample, e.g. a ‘before’ and ‘after’ test on the same population following an intervention
Wilcoxson signed-rank test
Attendance Allowance is a benefit paid to help with personal care due to physical or mental disability to those aged over ___
65
UKMEC 3 for COCP if BMI is over ___
35
Absolute risk reduction =
Experimental event rate - Control event rate
Emergency treatment for acute angle closure glaucoma in primary care is topical ______
pilocarpine
Are strawberry naevi present at birth?
No
Metformin is contraindicated in those with eGFR <___
30
____________ is the only test recommended for H. pylori post-eradication therapy
Urea breath test
Palsy results in ptosis, down and out eye, dilated, fixed pupil - which nerve?
Oculomotor CN III
Palsy results in defective downward gaze - vertical diplopia - which nerve?
Trochlear CN IV
Palsy results in loss of corneal reflex, deviation of jaw to weak side, loss of facial sensation, paralysis of mastication muscles - which nerve?
Trigeminal CN V
Palsy results in defective abduction - horizontal diplopia - which nerve?
Abducens CN VI
Lesion results in flaccid paralysis of upper + lower face, loss of corneal reflex, loss of taste, hyperacusis - which nerve?
Facial CN VII
Lesion results in hypersensitive carotid sinus reflex, loss of gag reflex - which nerve?
Glossopharyngeal CN IX
Lesion results in uvula deviating away from site of lesion, loss of gag reflex - which nerve?
Vagus CN X
Lesion results in weakness turning head to contralateral side - which nerve?
CN XI accessory
Lesion results in tongue deviating towards side of lesion - which nerve?
CN XII hypoglossal
Specificity =
TN / (TN + FP)
In a woman who has an undiagnosed breast mass continuing the combined hormonal contraceptive pill is classified as UKMEC ___
2
If angina is not controlled with a beta-blocker, a longer-acting _____ should be added
CCB e.g. amlodipine
What is the first sign of puberty in boys?
Increase in testicular volume
Impaired fasting glycaemia (IFG) is defined as a fasting plasma glucose level between ___ mmol/l and ___ mmol/l
6.1, 6.9
_______ is a good first line anti-emetic for intracranial causes of nausea and vomiting
Cyclizine
Most appropriate study design to investigate an infectious outbreak - ___________
Case control study
Type _ error - the null hypothesis is rejected when it is true
I
Likelihood ratio for a positive test result =
Sensitivity / (1 - specificity)
Best test to measure correlation in parametric (normally distributed) data
Pearson’s coefficient
Best test to measure correlation in non-parametric data
Spearman’s coefficient
Of the SSRIs, ______ has the highest incidence of discontinuation symptoms
Paroxetine
A 21 day progesterone of over ____nmol/l is generally considered to be indicative of ovulation
30
Vaccines needed pre-dialysis x3
Pneumococcal, influenza, hepatitis B
Positive predictive value =
True positives / (True positives + false positives)
Which antibiotic commonly used for treating UTIs may cause peripheral neuropathy?
Nitrofurantoin
If the COCP is started within the first __ days of the cycle there is no need for additional contraception
5
Impaired glucose tolerance: OGTT 2 hour value between
7.8 and 11
Positive likelihood ratio =
Sensitivity / (1 - specificity)
Sensitivity =
TP / TP + FN
Specificity =
TN / TN + FP
Which drug is used for prophylaxis of cluster headaches?
Verapamil
Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test
Which nerve root is being compressed?
L3
Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test
Which nerve root is being compressed?
L4
Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test
Which nerve root is being compressed?
L5
Sensory loss posterolateral aspect of leg and lateral aspect of foot
Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test
Which nerve root is being compressed?
S1
Number needed to treat =
1 / Absolute risk reduction
A haemoglobin cut-off of ___ g/L should be used in the first trimester to determine if iron supplementation should be taken
110
What type of study is this?
Participants randomly allocated to intervention or control group (e.g. standard treatment or placebo)
Practical or ethical problems may limit use
RCT
What type of study is this?
Observational and prospective. Two (or more) are selected according to their exposure to a particular agent (e.g. medicine, toxin) and followed up to see how many develop a disease or other outcome.
The usual outcome measure is the relative risk.
Examples include Framingham Heart Study
Cohort study
What type of study is this?
Observational and retrospective. Patients with a particular condition (cases) are identified and matched with controls. Data is then collected on past exposure to a possible causal agent for the condition.
The usual outcome measure is the odds ratio.
Inexpensive, produce quick results
Useful for studying rare conditions
Prone to confounding
Case-control study
What type of study is this?
Provide a ‘snapshot’, sometimes called prevalence studies
Provide weak evidence of cause and effect
Cross-sectional study
The most common organism causing infective exacerbations of COPD is ____________
H influenzae
Urea breath test: no antibiotics in past ___ weeks, no antisecretory drugs in past ___ weeks
Abx: 4 weeks
Antisecretory: 2 weeks
RA Drug associated with myelosuppression, liver cirrhosis, pneumonitis
Methotrexate
RA drug associated with rashes, oligospermia, Heinz body anaemia, ILD
Sulfasalazine
RA drug associated with liver impairment, ILD, hypertension
Leflunomide
RA drug associated with retinopathy, corneal deposits
Hydroxychloroquine
RA drug associated with proteinuria
Gold
RA drug associated with proteinuria, exacerbations of myaesthenia gravis
Penicillinamine
RA drug associated with demyelination, reactivation of TB
Etanercept
RA drug associated with reactivation of TB x 2
Infliximab, adalimumab
RA drug commonly associated with infusion reactions
Rituximab
75mg of oral morphine is equivalent to ___ mg of subcut oxycodone
25
NNT =
1 / ARR
Statistical significance test that compares ordinal, interval, or ratio scales of unpaired data
Mann-Whitney U test
What is the medical exemption certificate code?
FP92A
Fitness to fly after uncoplicated MI
7-10 days
Fitness to fly after complicated MI
4-6 weeks
Fitness to fly after CABG
10-14 days
Fitness to fly after PCI
3 days
Fitness to fly after stroke
10 days, but if stable 3 days
Fitness to fly after successful drainage of pneumothorax
CAA: 2 weeks
BTS: 1 week post-check X ray
Fitness to fly after abdominal surgery
10 days
Fitness to fly after laparoscopic surgery
24 hours
Fitness to fly after colonoscopy
24 hours
Fitness to fly after application of plaster cast
24 hours if flight <2h
48 h if flight >2h
Drug monitoring: Amiodarone
TFT, U&E, LFT, CXR prior to treatment
TFT, LFT every 6 months
Drug monitoring: Methotrexate
FBC, LFT, U&E before starting treatment
Weekly until therapy stabilised
Once stabilised, every 2-3 months
Drug monitoring: Azathioprine
FBC, LFT before treatment
FBC weekly for first 4 weeks
FBC, LFT every 3 months
Drug monitoring: Lithium
TFT, U&E pre treatment & 6 monthly
Lithium levels weekly until stabilised then every 3 months
Drug monitoring: Sodium valproate
LFT, FBC before treatment
LFT ‘periodically’ during first 6 months
Glitazones
LFT before treatment & ‘regularly’ during treatment
Statistical test used to compare proportions or percentages e.g. compares the percentage of patients who improved following 2 different interventions
Chi-squared test
Dermatome landmarks: Posterior half of the skull
C2
Dermatome landmarks: High turtleneck shift
C3
Dermatome landmarks: Low-collar shirt
C4
Dermatome landmarks: Ventral axial line of upper limb
C5
Dermatome landmarks: Thumb + index finger
C6
Dermatome landmarks: Middle finger + palm
C7
Dermatome landmarks: Ring + little finger
C8
Dermatome landmarks: Nipples
T4
Dermatome landmarks: inframammary fold
T5
Dermatome landmarks: Xiphoid process
T6
Dermatome landmarks: Umbilicus
T10
Dermatome landmarks: Inguinal ligament
L1
Dermatome landmarks: Knee caps
L4
Dermatome landmarks: Big toe, dorsum of foot (except lateral aspect)
L5
Dermatome landmarks: Lateral foot, little toe
S1
Dermatome landmarks: Genitalia
S2, S3
Residual weakness after ___ months in Bell’s palsy is an indication for referral to plastics
6
Gestational diabetes - insulin should be commenced if fasting glucose level is >= ___ mmol/l at the time of diagnosis
7
ECG changes in V1-V4
Anteroseptal - LAD
ECG changes in II, III, aVF
Inferior - RCA
ECG changes in V1-V6, I, aVL
Anterolateral - proximal LAD
ECG changes in I, aVL +/- V5-V6
LCx
A second drug should be added in type 2 diabetes mellitus if the HbA1c is > __ mmol/mol
58
Which antibiotics may worsen seizure control in epilepsy patients?
Ciprofloxacin, levofloxacin
_______ and _______ are the most important antiepileptic drugs to prescribe by brand
Phenytoin & carbamazepine
Epilepsy treatment: Generalised tonic clonic seizures
M: Sodium valproate
F: lamotrigine or levetiracetam
Epilepsy treatment: focal seizures
1st line: lamotrigine or levetiracetam
2nd line: carbamazepine, oxcarbazepine or zonisamide