AMC Active Recall Flashcards

1
Q

AAA Surveillance Duration

A

US is preferred over CT

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2
Q

AAA Surveillance Duration

A

US is preferred over CT

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3
Q

AAA Surveillance Duration

A

US is preferred over CT

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4
Q

AAA Surveillance Duration

A

US is preferred over CT

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5
Q

Fundoscopy Spot Diagnosis

A

Chronic simple glaucoma

  1. Increased cup:disc ratio
    - Normal range: 0.2 to 0.3
    - Increased IOP can cause ratio to increase to >0.5
  2. Atrophic optic disc due blood vessel damage
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6
Q

Type 1 HIT
(Heparin-Induced Thrombocytopaenia)

Onset
Mechanism of Action
Course of Illness

A

Onset: Within 2 days of Heparin exposure
MOA: Non-immune pathophysiology

Course of Illness: Usually self-resolving even with continued Heparin treatment

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7
Q

Type 2 HIT
(Heparin-Induced Thrombocytopaenia)

Onset
Mechanism of Action
Course of Illness

A

Onset: Occurs 4-10 days after Heparin exposure
MOA: Immune-mediated pathophysiology

Course of Illness: Life and limb-threatening thrombotic complications

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8
Q

Type 2 HIT
(Heparin-Induced Thrombocytopaenia)

Treatment Considations [3]

A
  1. Most important step is to stop Heparin immediately
  2. Avoid Warfarin as it can lead to micro-thrombosis
  3. Limit platelet transfusions to severe thrombocytopaenia with ongoing bleeding / invasive procedures only, otherwise it may increase thrombogenic effect
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9
Q

Child Asthma Control

A
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10
Q

Child Asthma Control

A
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11
Q

Child Asthma Control

A
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12
Q

Child Asthma Ladder

A

Regular treatment with a theophylline is not recommended routinely for children.

For monoclonal antibodies or other fancier treatment, refer to specialist

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13
Q

Child Asthma Ladder

A
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14
Q

Alcohol Consumption Guidelines

A

Men
2 standard drinks per day
2 alcohol-free days per week

Women
1 standard drinks per day
2 alcohol-free days per week

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15
Q

Notifiable Conduct [4]

A
  1. Practicing while intoxicated
  2. Sexual misconduct related to work
  3. Impairment that leads to risk of public harm at work
  4. Significant departure from accepted professional standards, that leads to risk of public harm
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16
Q

Spot Diagnosis

Eye strain
Difficulty seeing in dim light
Problems focusing on small objects or fine print
Vision improves when looking through 1mm pinhole

A

Presbyopia

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17
Q

Spot Diagnosis

Cannot see distant objects
Can see near objects

A

Myopia

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18
Q

Spot Diagnosis

Monocular sudden-onset decrease in visual acuity
Floaters
Not painful
Normal eye inspection

A

Retinal Detachment

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19
Q

Spot Diagnosis

Slow progressive visual loss
Insidious onset
Usually in elderly patient

A

Age-Related Macular Detachment

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20
Q

Vit A deficiency can lead to which breast disease?

A

Periductal mastitis
aka subareolar abscess

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21
Q

Auditory Test Functions

Pure Tone Audiometry

A

Objectively distinguishes between conductive hearing loss and sensori-neural hearing loss

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22
Q

Auditory Tests Functions

Speech Discrimination Test

A

Essentially, tests integrity of cochlear nerve
Good for screening for acoustic neuroma
Helps to determine if patient will benefit from hearing aid

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23
Q

Auditory Test Functions

Electrocochleography

A

Measures electrical potentials generated in the inner ear as a result of sound stimulation

Helps to determine if there is excessive amount of fluid pressure (eg Meniere’s Disease, endo-lymphatic hydrops)

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24
Q

Spot Diagnosis
Investigations (2)

Dysarthria
Confusion
Wide-Based Gait

A

Wilson’s Disease

Look for Serum Copper (will be high in Wilson’s) and Caeruloplasmin (will be low in Wilson’s)

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25
Q

Absolute Contraindications to ACE-Is [4]

A
  1. History of angio-oedema, regardless of cause
  2. Pregnancy (due to harm to foetus)
  3. Bilateral renal artery stenosis
  4. Previous allergic reaction to ACE-Is
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26
Q

Relative Contraindications to ACE-Is [2]

A
  1. Aortic stenosis
  2. Hypertrophic cardiomyopathy
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27
Q

Spot Diagnosis

3- to 6-weeks old baby
Projectile vomit then demands to be re-fed (“hungry vomiter”)
Palpable olive-like abdominal mass

A

Infantile hypertrophic pyloric stenosis

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28
Q

Spot Diagnosis
Eating Disorders

A
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29
Q

Spot Diagnosis
Eating Disorders

A
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30
Q

Spot Diagnosis
Eating Disorders

A
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31
Q

Indications for Teriparatide in osteoporosis treatment [3]

A
  1. BMD T-Score ≤ -3
  2. ≥ 2 minimal-trauma fractures
  3. ≥ 1 symptomatic new fracture after at least 12 months of anti-resorptive agent
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32
Q

Spot Diagnosis & Treatment

Generalized lymphadenopathy
Splenomegaly
Haematological derangement

A

Chronic Lymphoblastic Leukaemia (CLL)

Treatment
1st Line: Fludarabine
2nd Line: Chlorambucil

Prednisolone is used for cytoreduction

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33
Q

Spot Diagnosis

Painless, rubbery, nonerythematous, nontender lymphadenopathy
- Clasically cervical and supra-clavicular
B-Symptoms

A

Hodgkin’s Lymphoma

34
Q

Contraindications to POP Contraceptive
“PUB LAH”

A

Pregnancy
Undiagnosed genital tract bleeding
Breast cancer

Liver cirrhosis
Active liver disease
History or risk of ectopic pregnancy

35
Q

Spot Diagnosis

Unruly / argumentative behaviour
Attitude towards authority
At least 6 months

A

Oppositional Defiance Disorder (ODD)

36
Q

Spot Diagnosis

Ritualistic behaviour
Pre-occupation with activities / objects
Poor communication skills
Delayed speech development

A

Autism

(Asperger’s is similar, but with normal language development)

37
Q

Characteristics of physiological innocent murmurs
“7S”

A
  1. Sensitive - Changes with position or respiration
  2. Short duration - Not pan-systolic
  3. Single - No clicks
  4. Small area - No radiation
  5. Soft
  6. Sweet - Not harsh sounding, no thrill
  7. Systolic
38
Q

HIV Opportunistic Infections & Prophylaxis

A
39
Q

HIV Opportunistic Infections & Prophylaxis

A
40
Q

HIV Opportunistic Infections & Prophylaxis

A
41
Q

Spot Diagnosis

Fear of abandonment
You are hero or zero
Impulsive actions

A

Borderline Personality Disorder

42
Q

Spot Diagnosis

Sense of self-importance
Fantasy of success
Anger towards criticism

A

Narcissistic Personality Disorder

43
Q

Spot Diagnosis

Colourful, exaggerated behaviour
Shallow expression of emotions
Want to be centre of attention
Sexually seductive

A

Histrionic Personality Disorder

44
Q

DSM-5 Diagnosis of Schizophrenia [5]

A
  1. Delusions
  2. Hallucinations - Almost always auditory
  3. Disorganized speech
  4. Disorganized or catatonic behaviour
  5. Negative symptoms

At least 2 symptoms required
At least 1 of the symptoms musst be #1-3

45
Q

Psychotherapies

A
46
Q

Psychotherapies

A
47
Q

Psychotherapies

A
48
Q

Colles Fracture Cast Regime

A
  • Wrist should be fixed in partial flexion, with ulnar deviation
  • Forearm should be in slight probation
  • Below-elbow cast for 4-6 weeks
49
Q

Significance of Coombs Positive

A

High chance that a haemolytic anaemia is autoimmune in nature

50
Q

Spot Diagnosis

Female patient
Sudden onset unilateral LOV
Ipsilateral headaches
Hip and shoulder pain / stiffness

A

GCA with associated PMR

51
Q

Gonorrhoea Treatment

A

IM Ceftriaxone ONCE + PO Azitromycin ONCE

52
Q

Puerperal Haematoma Management
Size Criteria and Options [2]

A

<3cm : Analgesia, ice packs
>3cm: Surgical excision and evaluation

53
Q

Benign ECG Changes in Digoxin Use [4]

A
  1. TWI
  2. QT shortening
  3. Scooped ST segment, with ST depression
  4. Increased amplitude of U-wave
54
Q

Toxic Level ECG Changes in Digoxin Use [5]

A
  1. Frequent PVCs
  2. SVT
  3. 1st degree heart block (prolonged PR)
  4. Junctional escape rhythms
  5. Bidirectional VT with alternating axis of QRS [Rare but most specific sign]
55
Q

Bisphosphonate Treatment Duration

A

5-7 years

56
Q

After 20 weeks’ gestation, fundal height correlates with gestational age. A discrepancy of >2cm is significant.

Causes of fundal height being LESS than gestational age include… [4]

A
  1. Dating error
  2. Oligohydramnios
  3. Transverse / oblique lie
  4. Small for gestational age
57
Q

After 20 weeks’ gestation, fundal height correlates with gestational age. A discrepancy of >2cm is significant.

Causes of fundal height being MORE than gestational age include… [5]

A
  1. Dating error
  2. Large for gestational age
  3. Multiple pregnancy
  4. Polyhydramnios
  5. Molar pregnancy
58
Q

License to drive after seizure - Standard criteria for private driver [3]

A
  1. Seizure-free for 12 months
  2. Adherence to treatment
  3. Annual review by licensing authority

Different rules apply for commercial drivers

59
Q

Indications for Group B Strep treatment during labour [5]

A
  1. Maternal history of GBS disease
  2. GBS+ swab or urine culture
  3. PROM > 18hrs or unknown duration
  4. Maternal pre- or intra-partum fever
  5. Unknown status of GBS colonization

Treat with prophylactic IV Penicillin

60
Q

CRC Screening

A
61
Q

CRC Screening

A
62
Q

CRC Screening

A
63
Q

CRC Screening

A
64
Q

Predisposing Factors to Postpartum Haemorrhage [5]

A
  1. Antepartum haemorrhage (including placenta abruption, placenta praevia)
  2. Previous postpartum haemorrhage
  3. Placenta accreta
  4. Multiple pregnancy
  5. Coagulopathy
65
Q

Croup Severity Grading

A
66
Q

Croup Severity Grading

A
67
Q

Croup Severity Grading

A
68
Q

Red Flags for Renal Masses [3]
(Suggestive of Malignancy)

A
  1. Completely solid lesion
  2. Mixed solid and cystic lesion
  3. Contrast-enhancing cystic lesion
69
Q

Suspected Renal Malignancy
Indications for Total Nephrectomy [5]

A
  1. Tumour size ≥ 7cm
  2. Central location
  3. Suspected lymphnode involvement
  4. Associated venous thrombus
  5. Direct extension into ipsilateral adrenal gland
70
Q

Pancreatic Pseudocyst
Indications for Laparatomy [6]

A
  1. Compression of large vessels
  2. Gastric or duodenal outlet obstruction
  3. CBD stenosis from compression
  4. Infected pseudocyst
  5. Haemorrhagic pseudocyst
  6. Pancreatico-pleural fistula
71
Q

Contraindications to HRT
Absolute [2], Relative [4]

A
72
Q

HRT Comparisons in Menopause (Hot Flushes)

A
73
Q

HRT Comparisons in Menopause (Hot Flushes)

A
74
Q

HRT Comparisons in Menopause (Hot Flushes)

A
75
Q

Types of Spontaneous Abortion
Threatened Abortion
- Any bleeding?
- Cervix open or closed?
- Visible POC on pelvic exam?
- Fetal heart rate present?

A
76
Q

Types of Spontaneous Abortion
Inevitable Abortion
- Any bleeding?
- Cervix open or closed?
- Visible POC on pelvic exam?
- Fetal heart rate present?

A
77
Q

Types of Spontaneous Abortion
Incomplete Abortion
- Any bleeding?
- Cervix open or closed?
- Visible POC on pelvic exam?
- Fetal heart rate present?

A
78
Q

Types of Spontaneous Abortion
Complete Abortion
- Any bleeding?
- Cervix open or closed?
- Visible POC on pelvic exam?
- Fetal heart rate present?

A
79
Q

Types of Spontaneous Abortion
Missed Abortion
- Any bleeding?
- Cervix open or closed?
- Visible POC on pelvic exam?
- Fetal heart rate present?

A
80
Q
A