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Practice Exams > artha deck1 > Flashcards

artha deck1 Flashcards

1
Q

Pharm for reducing ETOH effects

A

Naltrexone or Disulfiram (makes you feel worse/crap with ETOH)

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2
Q

Pharm to reduce ETOH cravings

A

Acamprosate

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3
Q

Post viral URTI with vertigo, hearing loss and tinnitus

A

Labyrinthitis

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4
Q

Post viral URTI with vertigo, NO hearing loss and tinnitus

A

vestibular neuronitis

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5
Q

Investigation for accoustic neuroma

A

MRI with gadolinium contrast

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6
Q

“What bld test to test annually in Down’s?”

A

TSH

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7
Q

How long to avoid sexual intercourse post AMI?

A

8 weeks

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8
Q

COCP medication components

A

ethinyloestradiol 30mcg levonorgesterol 150mcg

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9
Q

Mirena IUD medication component

A

Levonorgesterol 52mg

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10
Q

“3 Cx’s of haemachromatosis (systems)”

A
  • CLD - Heart failure (restrictive) - Arthritis (hands)
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11
Q

Gonorrhoea pharm Mx

A

500mg ceftriaxone IM + 1g azithromycin PO stat

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12
Q

Gonorrhoea contact tracing

A

2 months

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13
Q

Chlamydia test of re-infection

A

3 months

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14
Q

Chlamydia test of cure

A

4 weeks - pregnant or rectal chlamydia

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15
Q

Chlamydia pharm Rx

A

100mg doxycycline bd 7 days 1g azithromycin stat (pregnant)

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16
Q

Chlamydia contact tracing

A

6 months

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17
Q

Which anti-HTN can inc risk of T2DM

A

Thiazides

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18
Q

Which anti HTN causes HIGH calcium

A

Thiazides

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19
Q

Which anti HTN causes LOW calcium

A

Loop diuretics (Frusemide)

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20
Q

ICS example name and dose

A

Fluticasone proprionate 50mcg - child 125mcg - adult

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21
Q

SABA name and dose

A

salbutamol 100mcg

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22
Q

ICS/LABA name + dose

A

fluticasone proprionate 50 - 250mcg salmeterol 25mcg

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23
Q

LAMA name + dose

A

tiotropium 5mcg (respimat) daily

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24
Q

Metformin eGFR contraindication

A

<30

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25
Q

SGLT2 eGFR contraindication

A

<45

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26
Q

DPP4 eGFR contraindication

A

NONE, just dose adjustment (except linagliptin - no change)

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27
Q

Sulphonylureas eGFR contraindication

A

<30

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28
Q

Metformin eGFR reduce dose to 1g?

A

30-60

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29
Q

GLP1 agonist dose

A

dulaglutide 1.5mg weekly

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30
Q

Sulphonylurea + dose

A

Gliclazide 40mg daily

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31
Q

DPP4-i dose

A

Linagliptin 5mg

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32
Q

SGLT2 and dose

A

Empagliflozin 10mg daily

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33
Q

Shockable rhythms

A

V Fib, V tach

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34
Q

Shockable rhythms pharmacology

A

Adrenaline 1mg after 2nd shock Amiodarone 300mg after 3rd shock

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35
Q

Non-Shockable rhythms pharmacology

A

Adrenaline 1mg now, and then every 2nd cycle

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36
Q

“4 H’s of collapse”

A

Hypoxia Hypovolaemia Hyper/hypokalaemia/metabolic disorders Hypothermia

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37
Q

“4 T’s of collapse”

A

Toxins Tension pneumothorax Thrombosis Tamponade

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38
Q

AMI - GTN dose

A

300-600mcg sublingual every 5minsAlways check BP and avoid in inferior AMI

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39
Q

Indications for warfarin for AF Mx

A

eGFR <30 Valvular AF (mitral stenosis or mechanical valve)

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40
Q

NOAC dose for AF

A

Apixaban 5mg bd 2.5mg if At least 2 of: - 80+ years old - Weight under 60kg - Creatine over 133

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41
Q

Contraindications to NOAC and warfarin (3)

A
  • Previous intracranial bleed - Recent GI bleed - Pregnancy
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42
Q

Heart rate aim in AF

A

<80

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43
Q

Beta blocker dose in AF

A

Atenolol 25mg daily

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44
Q

Post AMI driving abstinence duration

A

2 weeks (private licence)

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45
Q

Post TIA driving abstinence duration

A

2 weeks (private licence)

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46
Q

Post CABG driving abstinence duration

A

4 weeks (private)

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47
Q

Post stroke driving abstinence duration

A

4 weeks (private)

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48
Q

2nd degree Type I ECG

A

Gradually elongating PR until drop (Wenkebach)

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49
Q

2nd degree Type II ECG

A

PR interval is normal Sudden drop in QRSUrgent cardio referral

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50
Q

CCF - Moderate on exertion (Class)?

A

Clas III

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51
Q

CCF - Mild on exertion (Class)?

A

Class II

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52
Q

CCF - Symptoms at rest (Class)?

A

Class IV

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53
Q

CCF - No symptoms (Class)?

A

Class I

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54
Q

BNP level for CCF

A

BNP >1800

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55
Q

LVEF <35% medication

A

Ivabradine

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56
Q

LVEF <40% medication

A

ANRI - Entresto

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57
Q

Heart Failure Medications + Dose (3)

A
  1. Perindopril 2.5mg daily 2. Spironolactone 25mg daily 3. Bisoprolol 1.25mg daily (2nd line if euvolaemic)
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58
Q

HOCM ECG criteria

A

Deep R waves anterior leads Tall Q waves lateral leads

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59
Q

Diabetic retinopathy medication and dose

A

Fenofibrate 145mg daily

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60
Q

Tamponade triad

A

“Beck’s”- Low BP- Muffled heart sounds, Jugular venous distension

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61
Q

Pericarditis meds + dose

A

Colchicine 500mcg (bd if >70kg, daily if <70kg) for 3 months

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62
Q

Acute Rheumatic Fever meds + dose

A

Benzathine benzylpenicillin IM as a single dose 1.2 million units (adults)

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63
Q

Groin Rash DDx (4)

A

Candida Intertrigo Tinea Cruris Flexural Psoriasis Erythrasma

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64
Q

PMHX Melanoma skin checks frequency

A
  • 3 monthly for 2 years - 6 monthly for 2 years- 12 monthly for lifetime
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65
Q

Cat Scratch Disease Rx

A

Azithromycin 500mg 1st day, 250mg daily for next 4 days

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66
Q

Chickenpox Rx - adults

A

Adults - Valaciclovir 1g tds 7 days

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67
Q

Chilblains Rx

A

Keep warm DO NOT RUB/MASSAGE If extensive or painful:- Strong topical steroid +/- occlusive dressing (betamethasone dipropionate 0.05% ointment bd)OR Severe/recurrent:- GTN spray- Nifedipine MR 20mg daily

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68
Q

Which infection is linked with Erythema Multiforme?

A

Herpes Simplex Virus

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69
Q

Commonest KNOWN cause of Erythema Nodusum

A

Sarcoidosis

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70
Q

4 causes of LVH

A
  • HOCM - HTN - Atrial regurg - Mitral regurg - Coarctation aorta
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71
Q

Actinic/Solar Keratosis Mx

A

Spot area = Cryotherapy or Shave + curettageLarge area = Imiquimod 5% 3xweekly for 4 weeks or Fluorouracil 5% daily for 3-4 weeks

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72
Q

Keratocanthoma Rx

A

3-5 excisional biopsy

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73
Q

SCC Ix

A

Punch biopsy

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74
Q

BCC Ix

A

Punch biopsy

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75
Q

SCC Rx

A

Superficial = Cryotherapy, shave+curettage, Imiquimod 5% 5xweekly for 6 weeksFluorouracil 5% daily for 3-4 weeks3D = surgical excision 3-5mm

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76
Q

Melanoma Ix

A

Excisional biopsy 2mm

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77
Q

Melanoma Rx

A

WLE + melanoma unit referral

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78
Q

BCC Rx

A

Superficial = Cryotherapy - double freeze thaw, shave+curettage, Imiquimod 5% 5xweekly for 6 weeksFluorouracil 5% daily for 3-4 weeks3D = surgical excision 3-5mm

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79
Q

BCC typical spread

A

Locally

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80
Q

SCC typical spread

A

Lymphatics

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81
Q

Causes of acne flares (4)

A
  • PCOS- Humidity- Occlusive cosmetics- Drugs - steroids
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82
Q

What features to examine when assessing for a burn? (4)

A

ColourBlistersSensationCap Refill

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83
Q

Deep dermal burn signs?

A

PainlessNon-blanchingWhite/mottled skinProlonged cap refill

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84
Q

Satellite lesions in skin folds

A

Candida Intertrigo

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85
Q

Candida intertrigo Rx

A

Clotrimazole 1% cream daily

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86
Q

Erysipelas pathogen

A

strep pyogenes

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87
Q

Chondrodermatitis nodularis Rx

A

Nitroglycerin ointment bd (1–2% glyceryl trinitrate)

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88
Q

1st line pharm to increase breastmilk supply

A

Domperidone

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89
Q

Compression mmHg to bandage ulcers

A

40mmHg

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90
Q

Secondary causes of hyperlipidemia (4)

A

CKDHypothyroidismT2DMCLD

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91
Q

4 contraindications to stress echo

A

Unstable anginaSevere aortic stenosisNew LBBBUncontrolled arrhythmia

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92
Q

Lateral STEMI leads + supply

A

I, AVL, V5, V6Left Circumflex artery

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93
Q

Inferior STEMI leads + supply

A

II, III, AVFRight Coronary Artery

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94
Q

Anterior STEMI leads + supply

A

V3-V4Left Anterior Descending

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95
Q

Septal STEMI leads + supply

A

V1-V2Left Anterior Descending

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96
Q

Posterior STEMI leads + supply

A

V7-V9Right Coronary Artery

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97
Q

Contraindications to performing Valsalva’s for SVT (4)

A

AMIHaemodynamic instabilityAortic stenosisGlaucoma

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98
Q

Takotsubo Cardiomyopathy Rx

A

ACEi or beta blockers until resolved systolic dysfunction ~ 1 month

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99
Q

Dandruff 1st line Rx

A

Selenium sulphide shampoo

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100
Q

Discoid Eczema Rx

A

Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)

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101
Q

What disease is dermatitis herpetiformis linked with?

A

Coeliac disease

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102
Q

Dermatofibroma distinctive features (2)

A

Pale centrePinch sign (central dimple)

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103
Q

Rash with target lesions

A

Erythema Multiforme

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104
Q

Treatment of Erythema Multiforme

A

Treat Cause, but otherwise self resolves- Aciclovir for HSV- ABx for mycoplasma pneumoniae

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105
Q

ASTI smoking screening age

A

12

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106
Q

ATSI fasting lipids, CVD check age

A

35

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107
Q

ATSI BP, UEC check age

A

18

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108
Q

Coral pink fluorescence under wood lamp

A

Erythrasma

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109
Q

Erythrasma Rx

A

Fusidate sodium 2% ointment bd for 14 days

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110
Q

Red swollen fingers+toes, linked with T2DM

A

Erythromelalgia

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111
Q

Itch/pain/burning rash in sun-exposed skin

A

Exercise-induced vasculitis or Golfer’s vasculitis

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112
Q

Exercise-induced vasculitis or Golfer’s vasculitis Rx

A

Self-resolving in 3-4 weeks

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113
Q

Folliculitis causative pathogens

A

Bacterial - Staph aureus, Pseudomonas aeruginosaFungi

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114
Q

Folliculitis Rx

A

Treat according to swab MCS- commonly - flucloxacillin or cephalexin 500mg QID

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115
Q

Rash with firm papules “string of pearls” ring

A

Granuloma Annulare

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116
Q

Granuloma Annulare associated conditions (3)

A

T2DMHyperlipidemiaAutoimmune Thyroiditis (children)

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117
Q

Granuloma Annulare Rx

A

Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)

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118
Q

Grover’s Disease Rx

A

Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)

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119
Q

Spotty itchy rash in children (trunk) sparing hands/feet?

A

Guttate psoriasis- linked with strep infection

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120
Q

Telogen Effluvium triad

A
  • Stressful event- 2-3 months to diffuse hair loss- white bulbs(Pull test = hair coming out)
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121
Q

Hair loss with chemo/radiotherapy

A

Anagen Effluvium

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122
Q

Exclamation mark hairs

A

Alopecia Areata

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123
Q

Androgenetic Alopecia Rx

A
  • Minoxidil to dry scalp - for 12+ months (not for females)- Finasteride for 2+ years - halts balding process (SE gynaecomastia)
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124
Q

What virus is associated with Hand, Foot & Mouth Disease?

A

Coxsackie virus

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125
Q

Management of Hand Foot & Mouth (2)

A
  • Supportive, fluids (can become dehydrated)- Keep home until blistered have dried/crusted
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126
Q

Herpes Simplex Virus Type I management?

A

First sensation - Aciclovir 5% cream 5 times daily for 5 daysSevere - Aciclovir 400mg tds for 5 days

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127
Q

Post-herpetic Neuralgia Rx (3)

A
  1. Simple analgesia/Ice massage2. Lidocaine 5% patch, 3. Amitriptyline 10–25 mg nocteGabapentin 300 mg nocte
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128
Q

Shingles Rx

A

Valaciclovir 1g tds for 7 days

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129
Q

Impetigo NON-PHARM Rx

A
  • Keep away until 24hrs after starting Abx- Cover wounds
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130
Q

Impetigo Rx (non-endemic) + multiple sores

A
  • Flucloxacillin 12.5 mg/kg up to 500mg QID 7 days. - Keep away until 24hrs after starting Abx
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131
Q

Impetigo Rx (Endemic)

A
  • Benzathine benzylpenicillin IM 1.2 million units- Keep away until 24hrs after starting Abx
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132
Q

Impetigo Rx (non-endemic) + localised sores (3)

A
  • Mupirocin 2% ointment tds for 5 days
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133
Q

Impetigo Rx (penicillin allergy)

A
  • Trimethoprim + sulfamethoxazole, bd for 3 days - child 4/20mg/kg up to 160/800mg
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134
Q

Bullous Impetigo pathogen

A

Staph aureus (infectious!)

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135
Q

Bullous Impetigo Rx

A
  • Flucloxacillin 500mg QID for 7 days- Do not share towels with other family members
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136
Q

Keratosis Pilaris Rx

A
  • Topical retinoids, salicyclic acid
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137
Q

Lichen Planus Rx

A
  • Symptomatic - potent steroid (beta. dip 0.05%)- Otherwise resolves in a few months
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138
Q

Molluscum Contagiosum causative pathogen

A

Pox virus

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139
Q

Nappy rash Rx

A

Dependent on causehydrocortisone 1% + nystatin 100 000 units BD or clotrimazole

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140
Q

Molluscum Contagiosum Rx

A

Self Resolves

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141
Q

Nappy rash causes (3)

A

Irritant dermatitisCandidaSeborrheic dermatitisPsoriasis

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142
Q

Nappy rash Rx

A

Dependent on causehydrocortisone 1% + nystatin 100 000 units BD

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143
Q

Lump with buttonhold invagination when pressed?

A

Neurofibroma

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144
Q

Perioral dermatitis Rx

A

Doxycycline 100mg daily for 8 weeks

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145
Q

Tiny black pits in soles of feet (Pitted Keratolysis) Rx?

A

Clindamycin 1% bd for 10 days

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146
Q

Pityriasis Rosacea Rx?

A
  • Self-limiting - 6-8 weeks- Use corticosteroid cream for itch
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147
Q

Pityriasis Versicolor Rx (2)

A

selenium sulfide shampoo 2.5% for 10 days OR antifungal creamsApply to wet skin and leave on for 10 minsIf ineffective, flucanozole 400mg oral stat

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148
Q

Pyogenic Granuloma Rx (1)

A

Imiquimod 5% 5xweekly for 6 weeks vs excision

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149
Q

Rosacea Non-pharm Rx (4)

A

Cleanser + moisturising routineSPF 30+Trigger avoidanceAvoid perfumes/colognes

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150
Q

Rosacea Pharm Rx (3)

A
  1. Topical metronidazole2. Azelaic acid3. Doxy 100mg daily 8 weeks
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151
Q

Scabies Rx

A

Permethrin 5% cream from jawline downwards overnightRepeat in 1 week

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152
Q

Scarlet fever causative pathogen

A

Strep Pyogenes

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153
Q

Lace-like/sandpaper rash

A

Scarlet Fever

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154
Q

Scarlet Fever Rx

A

Phenoxymethylpenicillin 500mg bd for 10 days

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155
Q

Seborrhoeic Dermatitis (infants) Rx

A

Salicylic acid 2% + LPC (liquor picis carbonis = coal tar solution) 2% + sulfur 2%

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156
Q

Which tinea locations need oral terbinafine?What dose?

A

Scalp, nails or widespread250mg oral terbinafine dailyToenails = 12 weeksFingernails = 6 weeks

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157
Q

Which tinea locations need topical terbinafine?

A

Everywhere except scalp/nails1% terbinafine cream bd 2 weeks

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158
Q

Venous Ulcer appearance

A

Ragged edge, slight pain, slough

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159
Q

Arterial Ulcer Appearance

A

Punched out, Pain +++, Cold. Relieved by hanging out of bed

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160
Q

Lump with buttonhold invagination when pressed?

A

Neurofibroma

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161
Q

Diabetic/Pressure Ulcer Mx (3)

A

Clean base with salineRelief of frictionIodosorb ointment/Foam dressing

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162
Q

Pityriasis Rosacea Rx?

A
  • Self-limiting - 6-8 weeks- Use corticosteroid cream for itch
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163
Q

Pityriasis Versicolor Rx

A

selenium sulfide 2.5% for 10 days Apply to wet skin and leave on for 10 mins

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164
Q

Rosacea Non-pharm Rx (4)

A

Cleanser + moisturising routineSPF 30+Trigger avoidanceAvoid perfumes/colognes

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165
Q

Rosacea Pharm Rx

A
  1. Topical metronidazole2. Doxy 100mg daily 8 weeks
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166
Q

T2DM assessment for low risk asymptomatic patients.

A
  • AUSDRISK >40yo
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167
Q

Scarlet fever causative pathogen

A

Strep Pyogenes

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168
Q

Lace-like scarlet rash

A

Scarlet Fever

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169
Q

Scarlet Fever Rx

A

Phenoxymethylpenicillin 500mg bd for 10 days

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170
Q

Seborrhoeic Dermatitis (infants) Rx

A

Salicylic acid 2% + LPC (liquor picis carbonis = coal tar solution) 2% + sulfur 2%

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171
Q

Which tinea locations need oral terbinafine?What dose?

A

Scalp, nails or widespread250mg oral terbinafine dailyToenails = 12 weeksFingernails = 6 weeks

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172
Q

Requirements for HbA1c to diagnose T2DM

A

> 6.5% on TWO occasions

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173
Q

Causes of low HbA1c

A

AnaemiaHaemoglobinopathiesCKD

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174
Q

Requirements for OGTT to diagnose T2DM

A

(EITHER)Fasting >72 hours >11

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175
Q

Neuropathic Ulcer Location

A

Plantar surface (pressure areas), well demarcated

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176
Q

What to examine for with foot ulcers (3)

A
  • Sensation with 10gm monofilament - Ankle Brachial Index Measurement- Dorsalis Pedis/Posterior Tibialis pulse
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177
Q

T2DM Driving license with insulin

A

2 yearly license review +/- conditional

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178
Q

Arterial Ulcer Mx

A

Urgent vascular surgeon review for reperfusion

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179
Q

Diabetic/Pressure Ulcer Mx (3)

A

Clean base with salineRelief of frictionIodosorb ointment/Foam dressing

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180
Q

Urticaria Rx

A

Loratadine 10mg daily

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181
Q

Who needs annual screening for T2DM? (FBGL) (2)

A

PrediabetesATSI

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182
Q

T2DM assessment for low risk asymptomatic patients.

A
  • AUSDRISK >40yo
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183
Q

FBGL intermediate range

A

5.5-6.9Mx = perform HbA1c or OGTT

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184
Q

HbA1c intermediate range

A

6.0-6.4% Mx = retest in one year

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185
Q

OGTT results for Impaired glucose tolerance

A

Fasting: <7 mmol/L2 hour : 7.8 - 11 mmol/L

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186
Q

OGTT results for Impaired fasting glycaemia

A

Fasting glucose: 6.1-6.92 hour glucose < 7.8

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187
Q

Addison’s Ix

A

Short Synacthen test ○ Gives synthetic ACTH, should normally increase cortisol ○ In Addison’s (underfunctioning adrenal), there is no increased cortisol - positive test

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188
Q

Requirements for HbA1c to diagnose T2DM

A

> 6.5% on TWO occasions

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189
Q

Causes of low HbA1c

A

AnaemiaHaemoglobinopathiesCKD

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190
Q

Requirements for OGTT to diagnose T2DM

A

(EITHER)Fasting >72 hours >11

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191
Q

OGTT results to Dx GDM

A

Fasting glucose >5.5 (reduce by 1.5)Two hour glucose >8.0 (reduce by 3.0)

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192
Q

T2DM Driving license with OHA’s

A

5 yearly license review +/- conditional

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193
Q

T2DM Driving license with insulin

A

2 yearly license review +/- conditional

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194
Q

Which diabetic patients need conditional licenses (4)

A
  • Severe hypoglycaemia- Acute hyperglycaemia- End-organ damage- Commercial drivers on OHA’s/insulin - specialist review
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195
Q

Pre-exercise BGL range for T2DM

A

5 - 13.9

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196
Q

How often to check BGL if on insulin or sulfonylureas

A

30-45 minutes

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197
Q

How long after exercise can you get hypoglycaemia with SU’s/insulin?

A

48 hours

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198
Q

Fasting BGL aim in T2DM

A

4-7

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199
Q

2 hour post-prandial BGL aim in T2DM

A

5-10

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200
Q

Severe hypoglycaemia event, driving restriction

A

6 weeks until stabilised by specialist

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201
Q

Late Onset Autoimmune Diabetes Ix (4)

A
  • glutamic acid decarboxylase (GAD) antibodies- insulinoma antigen-2 (IA2) antibodies- islet cell antibodies- Insulin antibodies
202
Q

How often to get eye Ax with T2DM?

A

24 monthly12 monthly if - ATSI, systemic disease, >15 years Dx, poor control

203
Q

What T2DM meds to cease on sick days or if BGL >15 on two occasions

A

Metformin, SLGT2 (dehydration risk)

204
Q

Acromegaly Ix

A

IGF-1 - insulin-like growth factor

205
Q

Carcinoid Syndrome Ix

A

24 hr urine 5-hydroxyindoleacetic acid

206
Q

Conn’s syndrome Ix

A

Plasma aldosterone-renin ratio

207
Q

Cushing’s Syndrome Ix (3)

A
  • Overnight 1mg dexamethasone suppression test- 2 measurements of late night salivary cortisol - 2 measurements of 24 hour urinary - free cortisol excretion
208
Q

Diabetes Insipidus triad

A

Weakness + Massive Polyuria + Polydipsia

209
Q

Diabetes Insipidus Rx

A

desmopressin intranasally bd

210
Q

DKA BGL and ketones diagnosis

A

BGL>11mmol/L and ketones > 0.6mmol/L

211
Q

Hyperosmolar Hyperglycaemic State BGL and ketones diagnosis

A

BGL >30mmol/L and ketones anything

212
Q

Mild hypoglycaemia Mx (BGL <4.0)

A

15 rule- 15g of sugar (half fruit juice glass)- Recheck in 15 mins- Test every hour for next 4 hours

213
Q

Severe hypoglycaemia Mx (reduced GCS)

A

Glucagon 1g IM statORDextrose 50% 20mL

214
Q

Severe hypoglycaemia event, driving restriction

A

6 weeks until stabilised by specialist

215
Q

When to assess risk for OP

A
  • Annually in post-menopausal women or men >50yo
216
Q

T1DM Ix (2)

A
  • Glutamic acid decarboxylase (GAD)- Insulinoma antigen-2 (IA-2) antibodies
217
Q

Osteopenia Dx

A

-1 to -2.5 T score

218
Q

Osteoporosis Dx

A

Less than -2.5 T score

219
Q

What Z score to be concerned for secondary causes

A

Less than -2.0 score

220
Q

After starting carbimazole, when to recheck TFT’s and adjust dose?

A

4-6 weeks

221
Q

Bisphosphonate dose

A

Alendronate 70mg oral weekly

222
Q

Denosumab dose

A

60mg subcut 6 monthly

223
Q

When to stop osteoporosis Rx?

A

5-10 years of Rx without any fractures and BMD >-2.5

224
Q

Osteoporosis new medication. When to review?

A

6 months

225
Q

Osteoporosis pt monitoring. When to review?

A

12 months

226
Q

Osteoporosis pt monitoring. When to DEXA?

A

2 yearly

227
Q

Non-osteoporotic, high-risk pt. When to review?

A

2-5 years (including DEXA)

228
Q

Which medication to use in CKD + osteoporosis

A

Denosumab

229
Q

Phaeochromocytoma Ix

A

24 hour urine metanephrines/catecholamines test

230
Q

SIADH Ix (3)

A
  • Urine osmolality >100- High urinary sodium- Low blood sodium (dilution)
231
Q

SIADH Mx (1)

A

Fluid restriction <800mL/day

232
Q

T1DM Ix (2)

A
  • Glutamic acid decarboxylase (GAD)- Insulinoma antigen-2 (IA-2) antibodies
233
Q

Imaging of choice for goitre with Hyperthyroidism (uptake)

A

Thyroid Scintigraphy scan

234
Q

Imaging for goitre with Hypothyroidism

A

Trial levothyroxine and check if nodule regresses firstIf not, consider ultrasound

235
Q

Drugs that can cause hypothyroidism (2)

A

Lithium, amiodarone (also hyper)

236
Q

Graves Ix

A

Anti TSH Receptor Antibodies

237
Q

Hashimoto’s thyroiditis Ix

A

anti-TPO (anti-thyroid peroxidase antibodies)(also elevated in thyroiditis)

238
Q

Hyperthyroidism Rx

A

Carbimazole 10-15mg bd

239
Q

After starting carbimazole, when to recheck TFT’s and adjust dose?

A

4-6 weeks

240
Q

When to use PTU instead of carbimazole?

A

Pregnancy, Thyroid storm, PreconceptionMultiply CBZ dose by 10 to get PTU dose

241
Q

Most important SE of carbimazole/PTU?

A

AgranulocytosisCease if febrile or pharyngitis

242
Q

Subclinical asymptomatic hypothyroidism Mx

A

Repeat TFT’s in 6 weeks. Commence thyroxine if:1. TSH >10 OR2. Thyroid peroxidase antibody

243
Q

When to consider partial hypothyroid replacement?25-50mcg daily

A
  • Elderly- High CVD risk- Subclinical (where TSH >10 on retesting)
244
Q

Hypothyroidism Rx dose

A

levothyroxine 1.6mcg/kg daily (to nearest 25mcg, (50-100mcg

245
Q

Thyroiditis Rx

A
  • propranolol 10mg bd if symptomatic- Repeat TFT’s in 6 weeks- If painful - NSAID’s too
246
Q

Allergic Rhinitis Examination signs (3)

A
  • turbinate hypertrophy- pale blue nasal mucousa- Suborbital oedema
247
Q

Oral thrush Rx

A

Under 2yo = 100 000 units nystatin 1mL QID for 1 weekOver 2yo = Micanozole 2% gel, 2.5mL QID 1 week

248
Q

Imaging of choice for cholesteatoma

A

CT temporal bone

249
Q

Examination findings of Infectious Mononucleosis (3)

A
  • Splenomegaly- Hepatomegaly- Jaundice- Rash
250
Q

Meniere’s Disease Triad

A

Vertigo, tinnitus, hearing loss - Unilateral

251
Q

Meniere’s Disease Mx (3)

A
  • Limit salt <2g/day, ETOH, caffeine, - Vestibular rehab- Prochlorperazine 10mg daily- Hydrochlorothiazide 25mg daily
252
Q

What age to refer Nasolacrimal duct obstruction to ED?

A

<1 month of age

253
Q

Otitis Media risk factors (3)

A
  • Smoking exposure- Childcare- Down’s syndrome- Adenoid disease
254
Q

Otitis Media ABx

A

Amoxicillin 15mg/kg tds for 5 daysReview in 48 hours

255
Q

Otitis Media ABx if not improving with amoxi

A

If not improving in 48 hours,Augmentin DF 875/125 bd for 5 days

256
Q

Otitis Media ABx if allergic to penicillin

A

Cefuroxime 500mg bd for 5 days

257
Q

Recurrent AOM criteria and Rx

A

3+ episodes in 6 monthsamoxicillin 25mg/kg bd for 6 months

258
Q

Glue ear (AOM with effusion) Mx?

A
  • Tend to self drain in 4 weeks- Refer if >3 months, or if causing hearing issues
259
Q

Chronic Suppurative Otitis Media Dx criteria

A

> 6 weeks of perforated TM with discharge

260
Q

Chronic Suppurative Otitis Media Mx (3)

A
  • Ear toileting (rolled tissue spear QID until ear dry)- Ciprofloxacin 0.3% ear drops (x5) bd until discharge free for 3 days- Refer to audiology for hearing assessment- ENT referral
261
Q

Grommets +/- adenoidectomy indications (2)

A
  • Chronic otitis media (>3 months) with effusion and hearing loss- Recurrent otitis media with effusion
262
Q

Otitis Externa Mx (3)

A
  • Sofradex ear drops - 3 drops tds for 7 days- Paracetamol 15mg/kg QID PRN- Dry aural toileting QID PRN until canal is dry
263
Q

Otitis Externa prevention (2)

A
  • Aqua-Ear after water exposure- Keep ear-dry, use earplugs or bathing cap during showering/swimming
264
Q

Otosclerosis - what bone does it affect?

A

Stapes

265
Q

Otosclerosis Mx (1)

A
  • Referral to ENT for stapedectomy
266
Q

Perforated TM broad causes (3)

A

Infection, trauma, growths

267
Q

Safe perforated TM Mx (3)

A
  • Dry toileting with tissue spear- Self-resolving in 4 weeks- Amoxicillin 500mg tds for 5 days if infected
268
Q

Antibiotic indications for rhinosinusitis (3)

A
  • Discoloured purulent discharge- 38oC- Severe localised pain
269
Q

Sialoliths Mx (2)

A
  • Conservative with massage and analgesia, warm liquids- Infected = 7 days Flucloxacillin 500mg QID
270
Q

Tonsillectomy Indications

A

Tonsillectomy Indications (6-4-2, 1-2-3 rule)- 6+ episodes/year for more than 1 year- 4+ episodes/year for more than 2 years- 2+ episodes/year for more than 3 years

271
Q

When to treat tonsillitis with ABx?

A
  • Bacterial likely- Immunosuppressed- Previous complications- ATSI
272
Q

Bacterial tonsillitis Rx

A

Phenoxymethylpenicillin 500mg bd for 10 daysPenicillin allergy - azithromycin 500mg daily for 5 days

273
Q

Vestibular Neuronitis Rx (1)

A
  • Prednisolone 1mg/kg (up to 75mg) for 5 days
274
Q

Anal fissure Mx? (4)

A
  • Topical lignocaine- Treat constipation - stool softeners, high fibre diet- Sitz bath- Topical GTN/diltiazem- Local injection of botox
275
Q

Bowel cancer 4 flag criteria for moderate risk

A

First degree relative <55yo (4)First degree relative >55yo (2)Second degree relative any age (1)

276
Q

If moderate risk bowel cancer, screening?

A

FOBT every 2 years from 40-49Colonoscopy every 5 years from 50-74Aspirin 2.5 years from 50-74yo

277
Q

If high risk bowel cancer, screening?

A

(Reduce age points by 5 years compared to mod risk)Refer to family cancer clinicFOBT every 2 years from 35yoColonoscopy every 5 years from 45-74yo

278
Q

Medication for liver cirrhosis from portal HTN

A

carvedilol

279
Q

Risk factors for coeliac disease (3)

A

HypothyroidismT1DM DiabetesAutoimmune thyroid diseaseDown’s syndrome

280
Q

Diverticulitis non-severe attack Mx (3)

A
  • Clear liquids for 2-3 days- Amoxicillin + clavulanic acid 875/125mg bd for 5 days- Penicillin allergy = Trimethoprim + sulfamethoxazole 960mg bd AND metronidazole 600mg bd 5 days
281
Q

Gastro in nursing home. When to notify public health unit

A
  • 2+ more residents
282
Q

ABx indications for gastro (3)

A
  • Septic- Immunocompromised- Salmonella or severe C.Diff (all other bacterial causes don’t require Abx)
283
Q

When do you avoid loperamide for gastro? (3)

A

○ Children○ Bloody diarrhoea○ High fever- Systemic symptoms

284
Q

Lifestyle Mx for GORD (4)

A
  • Avoid spicy food- Remain upright after eating- Weight loss- Stop smoking
285
Q

Urea Breath Test preparation advice (3)

A
  • No Abx for 4/52 - No PPI for 2/52 before test- Nil water in morning- Nil brushing teeth
286
Q

H. Pylori Rx (3)

A

HP7 treatment. ACE - all given BD- Amoxicillin 1g (metronidazole 400mg bd if hypersensitive)- Clarithromycin 500mg - Esomeprazole 20mg

287
Q

When to repeat UBT post H.Pylori Rx

A

4 weeks

288
Q

Haemochromatosis Ix

A

Elevated transferrin + ferritin

289
Q

Typical arthritis region for haemochromatosis

A

MCPJ 2nd/3rd joint

290
Q

Hep A Mx

A
  • Self limiting - 6 weeks- Avoid fats, ETOH, panadol and smoking- Wash hands, do not share cutlery
291
Q

surface antigensurface antibodycore antibodyAcute Hep B

A

POSITIVE surface antigenNEGATIVE surface antibodyPOSITIVE core antibody

292
Q

surface antigensurface antibodycore antibodyChronic Hep B

A

POSITIVE surface antigenNEGATIVE surface antibodyPOSITIVE core antibody

293
Q

surface antigensurface antibodycore antibodyVaccinated Hep B

A

NEGATIVE surface antigenPOSITIVE surface antibodyNEGATIVE core antibody

294
Q

surface antigensurface antibodycore antibodyResolved Hep B

A

NEGATIVE surface antigenPOSITIVE surface antibodyPOSITIVE core antibody

295
Q

When does Hep C Mx need referring to specialist? (2)

A
  • If HIV/HBV co-infection- Cirrhosis present
296
Q

When does Hep C Mx need referring to specialist? (2)

A
  • If HIV/HBV co-infection- Cirrhosis present
297
Q

Assessment of cure for Hep C

A
  • Hepatitis C RNA PCR and LFT’s at 12 weeks post treatment
298
Q

IBD - pain before defecation?

A

Crohn’s

299
Q

IBD commonly blood and mucous stools

A

Crohn’s

300
Q

IBS Mx (4)

A
  • Regular meal times- Avoid triggers- Low FODMAP diet- Referral to dietitian- Referral to psych for CBT
301
Q

NAFLD Ix diagnosis

A
  • AST and ALT >2x ULN- AST/ALT < 1 - Needs USS/MRI/Imaging
302
Q

NASH monitoring

A

6 monthly liver US +/- AFP

303
Q

NAFLD Mx

A

Cirrhosis/NAFLD fibrosis score high = gastro referral, fibroscan +/- biopsyNAFLD fibrosis score Low = manage risk factors

304
Q

NAFLD Monitoring

A

6 monthly LFT’s

305
Q

NASH monitoring

A

6 monthly liver US +/- AFP

306
Q

Acute Pancreatitis Ix (Dx)

A

Lipase >3 UNL

307
Q

Acute Pancreatitis Mx

A
  • ED Mx for IV hydration due to high mortality
308
Q

PBC or PSCMales commonly

A

PSC

309
Q

PBC or PSCLinked with Ulcerative colitis

A

PSC

310
Q

PBC or PSCFemale

A

PBC

311
Q

PBC and PSC symptoms (4)

A
  • Abdo pain- Fever- Fatigue- Pruritis- Jaundice
312
Q

PBC or PSCColorectal cancer risk

A

PSC

313
Q

PBC or PSCIntrahepatic ducts only

A

PBC

314
Q

Dx, pain in throat with cold/hot food

A

Oesophageal spasm

315
Q

Gastric peptic ulcer. Pain after eating time frame?

A

Pain 30 mins after eating

316
Q

Dudodenal peptic ulcer. Pain after eating time frame?

A

Relieved when eating, Pain starts 2-3 hours later

317
Q

External haemorrhoids difference

A

PainfulVisible/palpable lump on outside

318
Q

What type of haemorrhoids is treated with banding?

A

Internal

319
Q

External haemorrhoids difference

A

PainfulVisible/palpable lump on outside

320
Q

When can you break consent? (4)

A
  • Patient permission- Mandatory by law- Necessary discussion with other health professional- Duty to public health
321
Q

What age to screen smoking in ATSI?

A

12yo

322
Q

What age screen CVD (risk calculator)

A

45+ yo (ATSI >30yo)

323
Q

Adrenaline dose for anaphylaxis in children

A

0.01mL/kg every 5 mins

324
Q

My Aged Care referral criteria

A

> 65yo or >50 with homelessness/complex needs

325
Q

Disabled Parking criteria

A
  • Sig mobility deficit- Sig neuro/cognitive deficit- Standard parking bay is not big enough for equipment
326
Q

Varenicline CI’s

A

Psychosis, suicidal thoughts, CVD, pregnancy/BF

327
Q

Smoking cessation - Champix dose

A

Varenicline - 0.5mg for 3/7 -> 0.5mg BD for 4/7, then 1mg BD for 12/52

328
Q

Smoking cessation 3 options (Rx)

A

NortriptylineVareniclineBupropion

329
Q

NRT dosing

A

> 12yo - 10+ cigs or smoking within 30 mins wake up▪ 21mg/24hr patch >45kg ▪ 14mg/24hr patch <45kg Quick acting = 2mg chewable every 2 hours

330
Q

NO false negatives = what statistical term

A

100% sensitivity

331
Q

NO false positives = what statistical term

A

100% specifiicity

332
Q

What helps to rule out disease (sensitivity or specificity)

A

SNOUT - Sensitive tests, where negative helps rule OUT

333
Q

What helps to rule out disease (sensitivity or specificity)

A

SNOUT - Sensitive tests, where negative helps rule OUT

334
Q

How to calculate number needed to treat?

A

1/Absolute risk increase

335
Q

Incidence definition

A

number of new cases

336
Q

Prevalence definition

A

number of exisiting cases

337
Q

1st line investigations for easy bruising (4)

A

○ FBE + blood film○ APTT○ PT/INR- Fibrinogen

338
Q

Pernicious anaemia Rx (1)

A

IM 1mg hydroxocobalamin every second day for 2 weeksand lifelong:1 mg hydroxocobalamin IM every 3 months

339
Q

Pernicious anaemia Rx (1)

A

IM 1mg hydroxocobalamin every second day for 2 weeksand lifelong:1 mg hydroxocobalamin IM every 3 months

340
Q

Iron deficiency Rx (1)

A

100mg elemental iron daily for 3 months

341
Q

Assessment for DVT?

A

Well’s scoreLow = D dimerHigh = Venous doppler of affected

342
Q

DVT Mx

A

Apixaban 10mg bd for 7 days, then 5mg bd for 3 monthsExcept if pregnant or eGFR <30

343
Q

Lymphoma’s how to diagnose

A

Excisional biopsy only

344
Q

CRAB criteria multiple myeloma

A

Calcium - elevatedRenal - uremiaAnaemiaBones - pain and fractures

345
Q

Risk Factors for temporal arteritis (3)

A

FemaleAge >50yoPMR

346
Q

Rotavirus vaccine age cutoff

A

1st dose by 14 weeks, 2nd dose by 24 weeks

347
Q

Live vaccines CI (2)

A

○ Cancer patients on immunosuppressive therapy (e.g RTx/CTx)High dose immunosuppressive therapy (>90mg pred/day or >2mg/kg children)Pregnancy

348
Q

Meningococcal B dosage for age groups

A

6 weeks – 12 months, 3 doses12+ months, 2 doses

349
Q

Pneumococcal ages for people who are well

A

70+yoATSI 50+yo

350
Q

Shingles vaccine age

A

Recommended 60+, but anyone 50+ can request

351
Q

Influenza dosing

A
  • 6 months – 9yo need two doses 4 weeks apart only if first ever influenza vaccine
352
Q

What vaccines can you not give for egg allergy (2)

A

Yellow FeverQ fever

353
Q

Causes of vaccines not working in patient (3)

A
  • Expired vaccine given- Cold chain breach of vaccine- Manufacturing defect of vaccine- Individual’s immune response was ineffective
354
Q

Malaria Prophylaxis (1)

A

PROMOZIO start 2 days before continue 7 days afterORDoxycycline 100mg daily 2 days before, 4 weeks after

355
Q

Fever + rash, travelled to NSW

A

Barmah Forest Virus

356
Q

Fever, been with sheep and pigs

A

BrucellosisBruce Willis looks like sheep/pig

357
Q

Fever, SE asia, retroorbital pain

A

Dengue Fever

358
Q

Dengue Fever Mx

A

Conservative Mx, advise about possible risk of haemorrhage and shock

359
Q

Giardia symptoms (2)

A
  • Steatorrhoea- Anorexia/LOW- Fatigue
360
Q

Giardia Rx (1)

A
  • Metronidazole 400mg tds for 5 days
361
Q

Fever, stupor, vomiting, returned from overseas

A

Japanese B Encephalitis

362
Q

Fever, conjuncitivitis, headache, farmer

A

LeptospirosisEPT = PET = Farmer petsOr meat industry

363
Q

Gastro symptoms after someone had poorly stored milk

A

ListeriosisLi for milk

364
Q

Listeriosis Rx (1)

A

Amoxicillin 1g tds for 2 weeks (pneumonia)

365
Q

Leptospirosis Rx (1)

A

Doxycycline 100mg 7 days

366
Q

Malaria Ix (1)

A

Thick and thin blood films for 3 days (initial may be too early to detect)

367
Q

Malaria Examination findings (3)

A

SplenomegalyConjunctival changesCervical lymphadenopathy

368
Q

Resp infection caught by birds

A

Psittacosis

369
Q

Weakness, fever, abbatoir worker

A

Q fever

370
Q

Q fever Rx (1)

A
  • Usually spontaneously resolves in 2-6 weeks - Doxycycline 100mg bd for 14 daysCan do Q fever vaccines for those at high risk
371
Q

Insect bite, Queenslander

A

Queensland Tick Typhus

372
Q

Queensland Tick Typhus Rx (1)

A

Doxycycline 100mg bd for 7 days

373
Q

Painful animal bite + pain with drinking

A

Rabies

374
Q

Rabies Rx

A

Vaccinate, even if after bite

375
Q

Farmer, sparse spotty rash, fever

A

Ross River Virus

376
Q

Parasitic worms in - Sub-Saharan Africa, the Middle East, Southeast Asia and the Caribbean

A

Schistosomiasis from contaminated faeces

377
Q

Cat litter and contaminated/uncooked foodFever, muscle aches

A

Toxoplasmosis

378
Q

Traveller’s diarrhoea Rx

A

azithromycin 1g oral stat

379
Q

Gradually worsening fever and abdo fever in returned traveller

A

Typhoid

380
Q

Typhoid Rx (1)

A

Azithromycin 1g oral daily for 7 days

381
Q

Eschar rash - Transmitted through bites, Asia

A

Typhus

382
Q

Typhus Rx (1)

A
  • Doxycycline 100mg bd
383
Q

Anal warts Rx (1)

A

Podophyllotoxin 0.15% cream bd for 3 days, then nothing for 4 days. Repeat x4

384
Q

Hairy leukoplakia is a sign of?

A

HIV

385
Q

Time frame for post-exposure HIV prophylaxis

A

Within 72 hours of exposure

386
Q

How long to take PrEP for HIV until covered

A

Males - 7 daysFemales - 20 days

387
Q

Exposure to influenza, but negative result Mx (1)?

A

Vaccinate

388
Q

Influenza Rx (1)

A

Oseltamivir up to 75mg bd for 5 days

389
Q

What Ix to do for needlestick injury (3)

A
  • Hep B (anti-HBs, HBsAg)- Hep C (anti-HBc IgG, Hepatitis C serology HCV RNA PCR) - HIV serology
390
Q

When to repeat testing for needlestick injury?

A

3 and 6 months

391
Q

Indications for tetanus booster after injury

A

> 5 years since last dose + DIRTY or MAJOR wound

392
Q

Indications for tetanus immunoglobulin after injury

A

Not completed 3 course of tetanus + DIRTY or MAJOR wound

393
Q

Primary syphillis symptom (1)

A

Painless ulcer (Chancre)

394
Q

Secondary syphillis symptom (1)

A

Rash

395
Q

Tertiary syphillis symptom (1)

A

Systemic paralysis

396
Q

Acute syphillis infection Ix (1)

A
  • Syphillis Rapid Plasma Reagin (RPR) testing AND enzyme ImmunoassayThis is also used for test of cure in 3, 6, 12 months
397
Q

Chronic syphillis infection Ix (1)

A

Enzyme Immunoassay (EIA), positive for lifetime

398
Q

Syphillis chancre investigation (1)

A

NAAT swab of ulcer

399
Q

Rash, fever and myalgia after syphilis treatment?

A

Jarisch-Herxheimer reaction

400
Q

Syphilis Rx (1)

A

Benzathine benzylpenicillin 1.8 g IM injection statPen allergy - Doxycycline 100mg bd for 14 days

401
Q

Duration of therapy for provoked, distal DVT

A

6 weeks +

402
Q

Duration of therapy for unprovoked DVT

A

3 months +

403
Q

Duration of therapy for proximal DVT

A

3 months +

404
Q

What is Pott’s disease?

A

MSK TB (TB in spine)

405
Q

Tuberculosis Ix for acute disease (1)

A
  • Sputum acid-fast bacilli smear
406
Q

Tuberculosis Ix for chronic disease (1)

A
  • Quantiferon Gold (does not check for active disease)
407
Q

Prostate cancer screening age

A
  • Offer 50-69yo every 2 years - Offer 45-69yo every 2 years if risk factorsEven if high risk, controversial with screening
408
Q

Prostatitis empirical Rx

A

Trimethoprim 300mg daily for 14 days

409
Q

Epididymo-orchitis causes (4)

A

MumpsUrinary sourceSTI sourceAmiodarone

410
Q

Epididymo-orchitis examination specific finding (1)

A

Prehn’s sign - relief of pain upon lifting of scrotum Ehn happening to me - BXO

411
Q

Blue dot sign

A

Torsion of testicular appendage

412
Q

Indirect hernia vs Direct herniaCommon in young

A

Indirect

413
Q

Indirect hernia vs Direct herniaCan descend into scrotum

A

Indirect

414
Q

Indirect hernia vs Direct herniaMedial to inguinal vessels

A

Direct

415
Q

Balanitis Rx

A

Canesten (1% clotrimazole) bd for 7 days after symptoms resolve

416
Q

Peyronie’s disease associated conditions (3)

A

HTNT2DMObesity

417
Q

When to Rx Peyronie’s disease

A
  • Only if causing pain or sexual interference 1. Surgical 2. Injections - collagenase
418
Q

Erectile Dysfunction Rx (1)

A

Sildenafil 50mg PRN (max 1/day)- Have on empty stomach

419
Q

Erectile Dysfunction non-pharm Mx (3)

A
  • Quit smoking- Exercise- Avoid ETOH/caffeine- Weight loss- Psychology
420
Q

Premature Ejaculation Rx (2)

A
  1. Topical anaesthetic to penile shaft (lignocaine)2. Dapoxetine 30mg 1-3 hours before intercourse
421
Q

SPC monitoring Ix (2)

A

Yearly:1. bladder USS2. UEC’s

422
Q

When to use triangular sling?

A

supports elbow - for fractures where traction would make it worseE.g AC joint or clavicle #

423
Q

When to use collar + cuff sling?

A
  • when you need traction for fracture to healHumerus shaft or SNOH fractures, shoulder dislocation (internal rotation)
424
Q

Shoulder dislocation Mx (1)

A

Collar and cuff

425
Q

AC joint dislocation Mx (1)

A

Triangular sling (clavicle traction isn’t good)

426
Q

Humerus fractures Mx (1)

A

Unless in corners, or displaced since it’s non WB bone, mostly conservative

427
Q

What structure can get injured with humerus shaft fractures?

A

Radial nerve

428
Q

Ulnar nerve palsy findings?

A
  • Claw hand- Unable to abduct fingers
429
Q

Radial nerve palsy findings?

A

Unable to extend wrist

430
Q

Median nerve palsy findings?

A

Unable to make OK sign (finger opposition)

431
Q

Simple forearm fracture Mx (1)

A

Above elbow cast (to avoid supination/pronation)Always do 1 joint below and above

432
Q

Simple Wrist fracture Mx (1)

A

Below elbow cast

433
Q

Olecranon fracture Mx (1)

A

ORIF (intrarticular normally)

434
Q

Pulled elbow Ix (1)

A

None

435
Q

Pulled elbow Mx (1)

A

Passive pronation and flex elbow

436
Q

Maxillary # Mx (1)

A

Send to maxfax as can affect teeth modelling

437
Q

Nasal # Mx?

A

Non-displaced = conservativeDisplaced = Max-fax referral

438
Q

Orbital # Mx?

A

Send to ED urgently

439
Q

Facial fracture ED referral indications? (3)

A

Pain with eye movementsDiplopiaDepressed malar eminenceHyphaema

440
Q

Pelvic # Mx

A

Usually conservative if non-displaced

441
Q

Patellar # signs

A

Unable to straighten (extend) knee or SLR(as pulls on quads tendon)

442
Q

Patellar # Mx

A

No displacement = Immobilise walking plaster cylinder 4 weeksDisplacement or unable to extend knee = K wires

443
Q

Distal fibular # Mx

A

POP back slab/moon boot

444
Q

Repetitive back rotational movements leading to pain. Dx?

A

Spondylosis

445
Q

Spondylosis Mx (1)

A

Rest from aggravating activity for 6 weeks

446
Q

Radius/Ulnar # Mx

A
  • If both fractured and aligned = heals well with cast- Rotational deformities = reduction- Displaced = operation
447
Q

Colles # Mx

A
  • Non-displaced = below elbow cast 4 weeks- Displaced = reduction
448
Q

Scaphoid # Mx

A
  • Displaced = ortho referral- Non-displaced = thumb spica cast
449
Q

Mallet finger Mx

A
  • Simple = Full extension splint- Fracture/complex = surgery
450
Q

Subscapularis action

A

Internal rotation

451
Q

Teres minor action

A

External rotation

452
Q

Infraspinatus action

A

External rotation

453
Q

SLE Ix (3)

A

ANA +veanti-dsDNAanti smith antibodies

454
Q

RA Ix (3)

A

RF +veanti CCPANA +ve

455
Q

Scleroderma Ix (1)

A

Limited anti centromereSystemic anti SCL 70”anti topoisomerase 1

456
Q

Cut off for normal endometrial thickness post-menopause

A

<4mm

457
Q

During what time of menstrual cycle is it best to get a TV US done to Ix?

A

Day 5-10 of menstrual cycle

458
Q

Normal endometrial thickness PRE-menopausal

A

<12mm

459
Q

Normal endometrial thickness PERI-menopausal

A

<5mm

460
Q

What medication to give to stop breastmilk production

A

Cabergoline 1mg stat dose

461
Q

COCP given and patient develops migraine with aura

A

Stop COCP

462
Q

COCP Smoker >35 but quit last year

A

Stop COCP

463
Q

COCP FHx of breast cancer <30yo

A

Okay to take COCP. Only PHx of breast ca

464
Q

Major surgery with immobilisation, okay for COCP

A

No. high risk VTE

465
Q

Sudden onset neck pain with RA/Down’s syndrome

A

Atlanto-axial disruption

466
Q

Examination findings for cervical radiculopathy

A

Spurling test, slightly lateral flexion neck and push down head causes pain

467
Q

Middle finger nerve root distribution

A

C7

468
Q

Shoulder pain + stifness in all directions, active and passive movement pain

A

Frozen shoulder

469
Q

Shoulder pain, active movements only, external rotation, abduction

A

Rotator cuff injury

470
Q

Shoulder pain with Passive overhead movements

A

Bursitis/Impingement

471
Q

Repetitive throwing -> shoulder pain

A

Glenoid Labrum Tear

472
Q

How to assess for AC joint disruption

A

Paxinos sign - pinching AC joint togetherPassive adduction of shoulder

473
Q

When to consider radicular back pain imaging?

A

> 6 weeks, trial physical therapy

474
Q

Ankylosing spondylitis triad

A

<40yoLasting >3 monthsMorning stifness improving with exercise

475
Q

Repetitive rotation causing back pain

A

SpondyloLYsis

476
Q

Teenager with kyphosis, can’t touch toes

A

Scheuermann’s disease

477
Q

Osteomyelitis and arthritis across multiple vertebrae

A

Pott’s disease

478
Q

Risk Factors for Carpal Tunnel Syndrome (4)

A
  • Diabetes- Hypothyroidism- Pregnancy- Trauma
479
Q

When to give ABX for rhinosinusitis? 3 criteria

A

Fever > 38Discoloured purulent discharge Severe localised pain

480
Q

Pain on lateral thigh, worse on pressure and climbing stairs

A

Greater Trochanteric Pain Syndrome (including bursitis)

481
Q

Young athlete, tenderness in pubic symphysis

A

Osteitis Pubis

482
Q

Young person who jumps a lot, pain inferior knee cap

A

Patellar Tendinopathy

483
Q

Female and obesity, anterior knee pain ,worse with sitting prolonged period of time (movie theatre sign)

A

Patellofemoral Pain Sydrome

484
Q

Teenager with pain on tibial tuberosity

A

Osgood Schlatter Disease

485
Q

Painful knee clicking

A

Meniscal tear

486
Q

Suprapatellar pain after overuse, worse at night

A

Quadriceps Tendonitis

487
Q

Marathon runner with lateral pain on thigh

A

Iliotibial Pain syndrome

488
Q

Pain in knees after kneeling prolonged period

A

Prepatellar bursitis

489
Q

MRI knee rebatable conditions (2)

A

16-49 yo with either- Acute ACL concern (following trauma)- Acute unable to straighten knee (meniscal tear)

490
Q

Unfit tennis player with calf pain during lunge

A

Gastrocnemius tear

491
Q

Spa folliculitis. Causative organism + ABx choice?

A

Pseudomonas AeruginosaCiprofloxacin

492
Q

Shaving folliculitis causative organism + Rx

A

Staph aureusMupirocin 2% ointment bd

493
Q

RF for scabies (3)

A

Nursing homesATSIHIV

494
Q

Onycholysis Rx (2)

A

Keep nails shortAvoid exposure to contact irritantsWait for nail to regrow (separated nail won’t reattach)

495
Q

Dermatoscopy - thrombosed capillaries

A

Warts

496
Q

Plane (flat) warts on face treatment

A

tretinoin 0.05% cream daily for 3 months

497
Q

RF for DDH (3)

A

FemaleBreechFHx

498
Q

When to do US for DDH

A

6 weeks - 6 months, after this XR is better

499
Q

Organic causes of constipation in children (3)

A

AllergyCoeliac DiseaseHypothyroidismHypercalcaemia

500
Q

Examination components for child constipation (2)

A

Abdominal palpation for faecal matterInspect anus for fissures/patency

Practice Exams (45 decks)

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