Aufio Flashcards
What is mastitis?
Inflammation +/- infection of breast tissue
Commonly occurs in lactating and non-lactating women.
What are the common features of mastitis?
- Painful breast
- Fever
- Malaise
- Purulent nipple discharge
- Red, tender, swollen breast areas
What is the most common cause of mastitis in lactating women?
Milk stasis → Staphylococcus aureus infection
What is the first-line antibiotic for managing mastitis in lactating women?
Flucloxacillin
What is a breast abscess?
Localized pus collection in the breast
What are the typical presentations of a breast abscess?
- Painful, tender lump
- +/- Fever
What is the recommended management for a breast abscess?
- Urgent referral to breast surgeon for ultrasound-guided drainage
- Continue breastfeeding or express milk
What are concerning features of nipple discharge?
- Unilateral discharge
- Single duct involved
- Spontaneous discharge
- Blood-stained/thin consistency
What is Paget’s disease of the nipple?
Eczematous red lesion that may indicate ductal or invasive carcinoma
What is the typical age range for the occurrence of breast cysts?
30–50 years
What is a fibroadenoma?
Common benign breast lump found in younger women (20–40 years)
What is the main risk factor for breast cancer?
Age
What are the types of breast cancer?
- Non-Invasive: Carcinoma in situ
- Invasive: Spread beyond breast
What are the referral criteria for suspected breast cancer?
- Over 30 with unexplained lump (+/- pain)
- Over 50 with unilateral nipple symptoms
What is the lifetime risk of breast cancer for BRCA1 mutation carriers?
65–85%
What are the two main types of contraception?
- Natural Family Planning
- Barrier Methods
What is the mechanism of the Combined Oral Contraceptive Pill (COCP)?
Inhibits ovulation
What are common side effects of COCP?
- Nausea
- Abdominal pain
- Breast pain
- Headaches
How long is the standard usage cycle for the COCP?
3 weeks on, 1 week off
What is the starting protocol for the COCP if started on days 1–5 of the cycle?
No extra protection needed
What is the mechanism of the Progesterone-Only Pill (POP)?
Thickens cervical mucus, inhibits ovulation
What is the duration of effectiveness for the implant contraception Nexplanon?
3 years
What are the two types of intrauterine devices (IUDs)?
- Hormonal Coil (IUS)
- Copper Coil (IUD)
What is the definition of primary infertility?
No prior conception
What are common causes of infertility in women?
- Ovulatory Disorders
- Tubal Damage
- Uterine/Peritoneal Causes
What is gestational diabetes?
New hyperglycemia in pregnancy that resolves post-birth
What dietary advice is recommended for managing gestational diabetes?
Low GI foods
What is the definition of menopause?
12 months amenorrhea
What are common symptoms of menopause?
- Hot flushes
- Vaginal dryness
- Mood swings
What is the key management for Type 1 diabetes?
Immediate insulin replacement
What are the risk factors for Type 2 diabetes?
- Family history
- Ethnicity
- Obesity
What is the fasting glucose level that indicates diabetes?
≥ 7 mmol/L
What is the genetic inheritance pattern of ODY (Monogenic Diabetes)?
Autosomal dominant
Younger onset
Define Gestational Diabetes.
Hyperglycemia in pregnancy, typically resolves postpartum.
What is Secondary Diabetes?
Due to drugs (e.g., steroids) or conditions (e.g., pancreatitis, acromegaly).
List the risk factors for Type 2 Diabetes.
- Family history
- Ethnicity: Asian, African, Afro-Caribbean
- Obesity, inactivity
- High glycemic index/low fiber diet
- Gestational diabetes, PCOS
What are the key numbers to remember for the diagnosis of diabetes?
7, 11.1, 48
What is the fasting glucose threshold for diabetes diagnosis?
≥ 7 mmol/L
What is the random/OGTT glucose threshold for diabetes diagnosis?
≥ 11.1 mmol/L
What is the HbA1c threshold for diabetes diagnosis?
≥ 48 mmol/mol
What is required for the diagnosis of diabetes in asymptomatic patients?
2 positive results
What are the criteria for pre-diabetes?
- IFG (Impaired Fasting Glucose): 6.1-7 mmol/L
- IGT (Impaired Glucose Tolerance): 7.8-11.1 mmol/L (post-OGTT)
When should HbA1c not be used for diabetes diagnosis?
- Children
- Pregnancy
- <2 months postpartum
- Acute symptoms <2 months
- Acute illness, steroids, pancreatic damage, HIV infection
What is the management strategy for Type 2 Diabetes according to NICE CKS?
Education, foot care, lifestyle changes, medication
What is the first-line medication for Type 2 Diabetes?
Metformin
What are the options for dual therapy in Type 2 Diabetes management?
- Metformin + DPP4 inhibitor (e.g., Sitagliptin)
- Metformin + Sulfonylurea (e.g., Gliclazide)
- Metformin + Pioglitazone
What is the target HbA1c for lifestyle/diet control?
≤ 48 mmol/mol
What are the side effects of Metformin?
- GI upset
- Lactic acidosis
- B12 deficiency
What are common examples of Sulfonylureas?
- Gliclazide
- Glibenclamide
What is a key feature of Acute Lymphoblastic Leukemia (ALL)?
Common in children
What is a characteristic of Hodgkin’s Lymphoma?
Presence of Reed-Sternberg cells
What symptoms are associated with Hyperthyroidism?
- Weight loss
- Anxiety
- Tremors
- Tachycardia
- Heat intolerance
What is a common presentation of Multiple Myeloma?
- Weight loss
- Fever
- Fatigue
- Bone symptoms (e.g., back pain)
- Renal impairment
What is the initial management for acne?
12-week topical treatment
What are the non-inflamed lesion types in acne?
- Open comedones (blackheads)
- Closed comedones (whiteheads)
What are the management options for moderate to severe acne?
- Topical Adapalene + Benzoyl Peroxide
- Topical Adapalene + Benzoyl Peroxide + Oral Antibiotic
- Topical Tretinoin + Clindamycin
What is the mechanism of action of Metformin?
Decreases gluconeogenesis, increases glucose utilization.
What is the key feature of Acute Myeloid Leukemia (AML)?
Common in adults (especially elderly)
What are the common symptoms of Eczema?
- Red, itchy, dry skin
- Thickening (lichenification)
- May become infected
What triggers can exacerbate Eczema?
- Irritants
- Allergens
- Infections
- Temperature extremes
What is the management for infected eczema?
- Topical: Fusidic Acid (local)
- Oral: Flucloxacillin (1st line) or Clarithromycin (penicillin allergy)
What are the symptoms of Dyspepsia?
- Pain
- Reflux
- Vomiting
- Indigestion
- Heartburn
What is the first-line treatment for uninvestigated dyspepsia?
Full-dose PPI for 1 month
What is the management for peptic ulcer disease?
- Gastric Ulcer: Requires repeat endoscopy in 6–8 weeks to confirm healing
- Duodenal Ulcer: Repeat H. pylori test only if symptoms persist
What are the risk factors for peptic ulcer disease?
- H. pylori infection
- Medications: NSAIDs, steroids
What is the first-line treatment for H. pylori infection?
mg BD or Metronidazole 400mg BD
BD refers to twice daily dosing.
What are the second-line treatment options for H. pylori infection?
Levofloxacin, tetracycline
These are alternatives when first-line treatments fail.
What is the long-term management strategy for peptic ulcers?
Lowest effective dose of PPI or H2RA
PRN antacid/alginates may also be used.
What are the referral criteria for peptic ulcer disease?
Persistent symptoms despite treatment
What are the types of peptic ulcers?
- Gastric Ulcer
- Duodenal Ulcer
Gastric ulcers require repeat endoscopy for healing confirmation.
What are the risk factors for peptic ulcer disease?
- H. pylori infection
- Medications: NSAIDs, steroids, bisphosphonates
- Smoking
- Stress
What are the potential complications of peptic ulcer disease?
- Bleeding
- Perforation
- Obstruction
- Malignancy
What lifestyle changes are recommended for managing GORD?
- Raise bed head
- Weight loss
What medications are used in the management of GORD?
- PPIs
- Antacids
What is GORD?
Chronic acid reflux causing esophagitis
What are the classic symptoms of GORD?
- Heartburn
- Regurgitation
What are the atypical symptoms of GORD?
- Chronic cough
- Laryngitis/hoarse voice
- Asthma
- Chest pain
What are the complications of GORD?
- Esophagitis
- Barrett’s esophagus
- Esophageal strictures
- Esophageal adenocarcinoma
How is GORD diagnosed?
Clinical diagnosis based on symptoms; endoscopy for alarm features or unresponsive cases
What is the gold standard for diagnosing non-erosive reflux?
24-Hour pH Monitoring
What lifestyle advice is recommended for GORD management?
- Avoid trigger foods
- Weight loss
- Raise head of bed
- Smaller, frequent meals
- Stop smoking
What is the first step in medical management for GORD?
Full-dose PPI for 4–8 weeks
What is Barrett’s esophagus?
Metaplasia: Squamous epithelium of the esophagus → columnar epithelium due to chronic reflux
What are the risk factors for Barrett’s esophagus?
- Chronic untreated GORD
- Obesity
- Male sex
- Smoking
- Family history
What is the main complication associated with Barrett’s esophagus?
Increased risk of esophageal adenocarcinoma
How is Barrett’s esophagus diagnosed?
Endoscopy confirms metaplasia and biopsies detect dysplasia
What is the management strategy for Barrett’s esophagus?
GORD management with high-dose PPI and surveillance
What are the causes of upper gastrointestinal bleeding?
- Peptic Ulcer Disease
- Esophageal Varices
- Gastritis
- Mallory-Weiss Tear
- Malignancy
What are the signs of upper gastrointestinal bleeding?
- Hematemesis
- Melena
- Shock
What is the initial management for upper gastrointestinal bleeding?
Initial Resuscitation: ABCDE Approach
What is the Blatchford Score used for?
Pre-endoscopy risk stratification
What is the Rockall Score used for?
Post-endoscopy assessment of rebleed/mortality risk
What is the most common cause of lower gastrointestinal bleeding?
Diverticular Disease
What are the symptoms of diverticulitis?
- Left lower quadrant pain
- Fever
- Change in bowel habit
What investigations are used for lower gastrointestinal bleeding?
- FBC
- U&Es
- LFTs
- Coagulation
- Flexible Sigmoidoscopy/Colonoscopy
What is the management for mild diverticulitis?
Oral antibiotics
What characterizes Ulcerative Colitis?
Chronic inflammation of the colon and rectum affecting the mucosa and submucosa only
What are the systemic symptoms of Ulcerative Colitis?
- Fatigue
- Fever
- Weight loss
What is the first-line treatment for inducing remission in Ulcerative Colitis?
Topical 5-ASA (Mesalazine)
What is Crohn’s Disease?
Chronic inflammation of the entire GI tract from mouth to anus
What are the complications of Crohn’s Disease?
- Bowel obstruction
- Perforation
- Abscess formation
- Fistulas
- Malnutrition
What is the definitive diagnosis for Coeliac Disease?
Duodenal biopsy showing villous atrophy
What is the management for Coeliac Disease?
Strict gluten-free diet
What are the symptoms of Irritable Bowel Syndrome (IBS)?
- Abdominal pain
- Altered bowel habits
- Bloating
- Mucus in stool
What is the clinical diagnosis criteria for IBS?
Rome IV Criteria
What is Diverticulosis?
Presence of diverticula (pouches in colon wall)
What are the symptoms of Diverticulitis?
- Left lower quadrant pain
- Fever
- Change in bowel habit
What is the most common cause of liver inflammation?
Viral infections, alcohol, drugs, autoimmune conditions
What is the management for Hepatitis B?
Antivirals (e.g., Entecavir, Tenofovir)
What is the most common cause of pancreatitis?
Gallstones
What are the symptoms of pancreatitis?
- Severe epigastric pain radiating to the back
- Nausea and vomiting
What is the management for acute pancreatitis?
IV fluids, analgesia, supportive care
What is the definition of colorectal cancer?
Malignancy of the colon or rectum
What are the risk factors for colorectal cancer?
- Age >50 years
- Family history
- Genetic syndromes
- Low fiber, high red/processed meat diet
- Inflammatory Bowel Disease
What is the primary treatment for localized colorectal cancer?
Surgical resection
What is the primary mode of transmission for Hepatitis C?
Bloodborne
What percentage of Hepatitis C cases become chronic?
> 80%
Name a direct-acting antiviral used in the management of Hepatitis C.
Sofosbuvir
Which virus does Hepatitis D require for coinfection?
Hepatitis B
What is the primary mode of transmission for Hepatitis E?
Fecal-oral
How is Hepatitis E characterized in pregnant women?
Self-limiting but severe
What is the primary cause of Alcoholic Hepatitis?
Excess alcohol intake
List three symptoms of Alcoholic Hepatitis.
- Jaundice
- Hepatomegaly
- Ascites
What is the general management for Alcoholic Hepatitis?
- Abstinence
- Supportive care
- Steroids if severe
What is the definition of Liver Cirrhosis?
Irreversible fibrosis and scarring of the liver
List three causes of Liver Cirrhosis.
- Chronic alcohol intake
- Chronic viral hepatitis (B, C)
- Non-Alcoholic Fatty Liver Disease (NAFLD)
What are some symptoms of Liver Cirrhosis?
- Fatigue
- Weight loss
- Jaundice
- Ascites
- Hepatomegaly
- Splenomegaly
- Gynecomastia
- Spider naevi
- Palmar erythema
What is a major complication of Liver Cirrhosis?
Portal Hypertension
What investigation findings suggest Liver Cirrhosis?
- Raised ALT/AST
- Low albumin
- Raised bilirubin
What management is recommended for patients with ascites due to Liver Cirrhosis?
- Low sodium diet
- Diuretics: Spironolactone ± Furosemide
- Paracentesis for large ascites
What is the progression of Non-Alcoholic Fatty Liver Disease (NAFLD)?
Simple Steatosis → Non-Alcoholic Steatohepatitis (NASH) → Cirrhosis → Hepatocellular Carcinoma
What are common risk factors for Non-Alcoholic Fatty Liver Disease (NAFLD)?
- Obesity
- Type 2 Diabetes
- Metabolic syndrome
- Hyperlipidemia
What is the definition of Cholelithiasis?
Stones in the gallbladder
What are the components of Charcot’s Triad in Cholangitis?
- Fever
- RUQ pain
- Jaundice
What is the first-line imaging for gallstones?
Ultrasound
What are common risk factors for Gallstone Disease?
- Female
- Forty
- Fat
- Fertile
What is a key symptom of Pancreatic Cancer?
Painless jaundice
List two risk factors for Pancreatic Cancer.
- Smoking
- Chronic pancreatitis
What is the main cause of MRSA?
Staphylococcus aureus resistant to beta-lactam antibiotics
What is the common presentation of Clostridium Difficile Infection?
Watery diarrhea
What type of bacteria causes Tuberculosis?
Mycobacterium tuberculosis
What is the main cause of Bacterial Meningitis in neonates?
Group B Streptococcus
What are common symptoms of Meningitis?
- Fever
- Headache
- Photophobia
- Nausea/vomiting
What test is used to diagnose Latent TB?
Mantoux Test
What is the treatment regimen for active Tuberculosis?
RIPE Therapy: Rifampicin, Isoniazid, Pyrazinamide, Ethambutol
Fill in the blank: Allergy is the immune system’s adverse response to a _______.
substance (allergen)
What is the difference between an allergy and intolerance?
Allergy: Adverse immune response; Intolerance: Non-immunological reaction