All Random Facts Flashcards
How many days before POP takes effect?
48 hours
What is given for meningococcal meningitis in a community setting?
IM Benzyl Penicillin
When can IUS/IUD be inserted postnatally?
Within 48 hours birth/ >4 weeks post-partum
What is the contraindication of COCP in postnatal women and why?
Contraindicated in women <6weeks postpartum + breastfeeding. Due to risk of VTE and contamination of breast milk
Management for mild/moderate otitis externa?
Topical drops including combined Abx/steroids/acetic acid
How is IUD licensed as an Emergency Contraceptive?
5 days post UPSI or 5 days post earliest possible ovulation
What is the relationship between bupropion and epilepsy and why?
Bupropion is a dopamine reuptake inhibitor (also serotonin and noradrenaline) and hence lowers the seizure threshold.
What is the window for ulipristal acetate and levonorgestrel as an emergency contraceptive?
Ulipristal Acetate - within 120 hours, Levonorgestrel - within 72 hours
What is the treatment for LUTS in men?
Trimethoprim/Nitrofurantoin 7 days
What is the contraindication of COCP in postnatal women not breastfeeding?
<3 weeks postpartum with other risks of VTE
What are the long term usage S/E of levodopa?
End of dose deterioration, On and Off states, dyskinesia
S/E of Depo-Provera in young women?
Reduces bone mineral density
Describe roseola infantum rash and timeline?
Erythematous maculopapular rash that is preceded by high fever
What is the alternative to Oxybutynin in urge incontinence and what is the MOA?
Mirabegron. B-3 agonist which relaxes the detrusor muscle
What is the difference between tennis vs. golfer’s elbow
Golfer’s elbow has pain localised to medial epicondyle but Tennis elbow is pain localised to lateral epicondyle
Is a stroke forehead sparing?
Yes
What is Bacillus Cereus caused GE normally caused by?
Reheated rice
CT indications post head injury?
GCS <13, GCS <15 2hours post initial assessment, suspected/depressed skull fracture, signs of basal skull fracture, >1 episode of vomiting, focal neurological deficit, post-traumatic seizure
Is LMN facial paralysis ipsilateral or contralateral?
Ipsilateral
What are the two commonest causes for otitis externa
Pseudomonas aeruginosa , Staphylococcus Aureus
How long must the patient be hospitalized for to be considered HAP?
> 48 hours
What is the 2 week referral criteria for colorectal cancer patients >40?
> 40: Unexplained weight loss and abdominal pain
What is the 2 week referral criteria for colorectal cancer patients >50?
Unexplained rectal bleeding
What is the 2 week referral criteria for colorectal cancer patients >60?
Any of iron deficiency anaemia, changes in bowel habit, faecal occult blood, rectal/abdominal mass
Which leukemia has the cytogenics T(15:17) translocation?
AML
Which pneumonia causing bacteria is associated with erythema multiforme?
Mycoplasma pneumoniae
When is a FIT test usually used?
When patient does not meet criteria for 2 week urgent referral but has Sx for colorectal cancer
Opiate intoxication and withdrawal: What are some features of opiate intoxication?
Drowsiness, Confusion, Decreased HR & RR, Constricted pupils
Opiate withdrawal features?
Unpleasant but not life threatening. Agitation, Runny eyes and nose, increased HR and BP, cramps nausea diarrhoea and vomiting
What is a section 5(2)?
Temporary detainment of a Voluntary patient in hospital up to 72 hours during who should receive assessment that determines if further detainment under the MHA is necessary. No treatment should be given.
Who is needed to conduct a section 3
1 Approved Mental Health Professional and 2 Doctors both of who have seen patient in the last 24 hours
What is a section 136?
Police are able to remove patients from a public place to a place of safety i.e. police station/ A and E
What is a section 2?
Admission for assessment up to 28 days, not renewable. Patient can be given treatment.
Who organises a section 2?
Approved mental health professional or nearest relative based on recommendation of 2 doctors, one of which must be approved under section 12(2). Usually consultant psychiatrist.
What is a section 4?
Detainment in hospital up to 72 hours for assessment. Used as an emergency where section 2 would cause a delay. (Usually done by GP and an AMHP)
What is a section 3?
Detainment of patient up to 6 months to receive treatment. Can be renewed.
What is the treatment for transient global amnesia?
No treatment needed
How long should Sx last to be considered as a prolonged grief disorder?
> 6 months
What is the pathological finding in Pick’s disease?
Accumulation of TAU proteins in neurons
What are the negative symptoms of schizophrenia?
Alogia, Anhedonia, Avolition, Affective incongruity or blunting
What is the association with hyperventilation and calcium levels?
Hyperventilation can reduced arterial CO2 and increase blood pH. Alkalosis promotes calcium binding to albumin causing hypocalcaemia.
What are the type B personality disorders?
Antisocial, Borderline, Histrionic, Narcissistic
What is the pathophysiology of refeeding syndrome?
Rapidly increasing insulin levels move potassium, magnesium and phosphate extracellularly intracellularly
What are examples of typical antipsychotics?
Haloperidol, Chlopromazine
What are the side effects of typical antipsychotics?
Parkinsonism, Acute dystonia, akathisia, tardive dyskinesea
What are Schneider’s first rank symptoms?
Auditory hallucinations, Thought disorder, Passivity phenomena, Delusional perceptions
What is neologism?
Creation of new words comprehensible to only the patient
What is the triad for normal pressure hydrocephalus?
Wet Wobbly Weird or Urinary incontinence, gait abnormality, dementia and bradyphrenia
What are some side effects of SSRIs?
GI upset, GI bleeding, Hyponatraemia, Anxiety & Agitation, QT prolongation (Citalopram)
What are the features of cannabis intoxication?
Drowsiness, impaired memory, increased HR, appetite & paranoia, dry mouth, slowed reflexes
What are the features of LSD intoxication?
Increased HR, Temperature, BP, labile mood, hallucination, sweating, insomnia, dry mouth
What causes CJD?
Prions, which are misfolded proteins that induce other proteins to misfold. This causes neurones to die leaving holes in brain tissue.
What is the triad for Wernicke’s Encephalopathy?
Confusion, Ataxia, Ophthalmoplegia
What AMT score is indicative of dementia?
<8/10
What are the S/E of lithium TOXICITY?
Coarse tremor, Visual disturbance, Confusion, Cardiac arrhythmias, CNS disturbances like seizures, impaired coordination, dysarthria
What is a S/E of venlafaxine?
Increase BP & HR. Contraindicated in uncontrolled HTN
What is the difference between PAD and GAD
PAD happens in short bursts, no identifiable trigger, feels well in between episodes
Sildenafil and erectile dysfunction?
Treatment for erectile dysfunction
Which part of the brain is responsible for flight or flight response?
Amygdala
What’s the difference between OCD and OCPD?
OCPD pleasurable, OCD distressing
What are the features of clozapine toxicity?
Confusion, drowsiness, ataxia, tachycardia
What is the timeline difference between embolic vs thrombotic cause of ALI?
Embolic cause symptoms over few minutes, thrombotic develops over hours to days
Where does the tongue point in a hypoglossal lesion?
Tongue classically deviates to side of lesion
What is buerger’s disease?
Non atherosclerotic vasculitis affecting small and medium arteries
Which artery is affected in Leriche Syndrome?
Aortoiliac artery stenosis
What is the screening outcome for AAA
<3cm no further action, 3-4.4 Rescan 12 months, 4.5-5.4 Rescan 3 months, >5.5 Refer for intervention
What is the initial management for ALI?
ABC, Analgesia, IV unfractionated heparin, Vascular review
What is the secondary prevention management for PAD?
Statin and Clopidogrel
What is the investigation of choice in varicose veins/chronic venous insufficiency?
Venous Duplex Ultrasound - will show retrograde flow
What is the screening for AAA?
One off for males >65
What is the treatment in an EVAR?
A stent is placed in the abdominal aorta via the femoral artery to prevent blood from collecting in the aneurysm
What are the criteria for a high risk rupture AAA
> 1cm/year enlargement, symptomatic, >5.5cm
What are some risk factors for AAA?
Smoking, HTN, syphilis, Ehler Danlos, Marfans
When is compression bandaging considered appropriate?
When ABPI <0.8
Features of Venous Insufficiency?
Oedema, brown pigmentation, lipodermatosclerosis, eczema
Management for Venous Ulcers
4 layer compression following exclusion of arterial disease
What is a marjolin’s ulcer?
Squamous Cell Carcinoma occurring at sites of chronic inflammation or previous injury
What are features suggestive of thrombotic ALI?
Pre-existing claudication with sudden deterioration, no obvious source for emboli, reduced/absent pulse in contralateral limb, Evidence of widespread vascular disease - TIA, MI, Stroke
What are features suggestive of embolic ALI?
Sudden onset, No history of claudication, Clinically obvious source of emboli (AF/ recent MI), No evidence of PVD (normal pulses in contralateral limb), Evidence of proximal aneurysm
Which artery block is likely to cause calf pain/buttock pain?
Femoral artery - Calf pain, Iliac artery - Buttock pain
What is the management for severe PAD/ CLI?
angioplasty +/- stent if <10cm vs bypass/endarterectomy if >10cm
What is the investigation for a ruptured AAA?
Depends. Haemodynamically stable - CT , unstable - diagnosis is clinical
What is the features of a ruptured AAA?
Severe, central abdominal pain radiating to back, pulsatile expansile mass, patients may be shocked
What is superficial thrombophlebitis?
Inflammation associated with thrombosis of one of the superficial veins, usually the long saphenous veins of the leg
What are risk factors for varicose veins?
Female, Obesity, Pregnant, Increasing age
When to refer varicose veins to secondary treatment?
Significant lower limb symptoms i.e. pain, discomfort, swelling , previous bleeding from sites, skin changes, superficial thrombophlebitis, ulcers
What is temporal arteritis?
Vasculitis affecting medium and large sized vessels
Features of temporal arteritis?
Rapid onset (<1 months), Headache, Jaw claudication, tender palpable temporal artery, vision changes, associations with PMR
What are the investigations for temporal arteritis?
Raised ESR/CRP, skip lesions on temporal artery biopsy
Temporal arteritis management?
High dose glucocorticoid: IV methylprednisolone for vision, otherwise prednisolone if none. Urgent ophthalmology review.
What are features of PMR?
Aching and morning stiffness of proximal limb muscles
Management for PMR?
Prednisolone
What are the S/E of carbimazole?
Agranulocytosis; WBC count to be done if signs of infection. Increased risk of congenital malformations; especially first trimester
What are the S/E of Mirtazapine?
Sedative, increased appetite
