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Bitchy passmedicine questions Flashcards

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1
Q

People with severe renal impairment - LMWH or heparin?

A

LMWH more likely to cause really bad bleeding - give unfractioned heparin

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2
Q

Pain medications more suitable if someone has chronic kidney disease?

A

Buprenorphine, fentanyl

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3
Q

NSAIDs and warfarin?

A

BAD!!!!

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4
Q

Risk of PPIs?

A

Osteoporosis

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5
Q

What is Leiden V?

A

Factor V has mutated so not broken down by protein C

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6
Q

Which zones affected in idiopathic pulmonary fibrosis?

A

Lower zones

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7
Q

Most common type of non-Hodgkin lymphoma

A

Diffuse large B cell

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8
Q

What can be used to differentiate between a seizure and a pseudoseizure?

A

Prolactin

becomes elevated 10-20 minutes after a real seizure

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9
Q

Varenicline mechanism of action

A

Partial nicotinic receptor partial agonist

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10
Q

When is bupoprion contraindicated?

A

In epilepsy

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11
Q

When is varenicline contraindicated?

A

Self-harm/depression

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12
Q

Buprenorphine mechanism of action

A

Noradrenaline and dopamine reuptake inhibitor and nicotinic antagonist

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13
Q

Most common ECG findings of hypercalcaemia

A

Shortened QT interval

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14
Q

Alteplase mechanism of action?

A

Activates plasminogen to form plasmin

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15
Q

Nerve responsible for pronation of the hand

A

Median

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16
Q

Responsible for erysipelas, impetigo, cellulitis, type 2 necrotising fasciitis, tonsillitis

A

Group A strep - strep pyogenes

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17
Q

What can CLL transform into?

A

Can transform to non-hodgkin’s lymphoma

this is Rithcer’s transformation

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18
Q

What is Ritcher’s transformation?

A

When CLL transforms to Non-hodgkins

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19
Q

The three criteria of typical angina

A
  • constrictive pain
  • precipitated by physical exertion
  • relieved by GTN within 5 minutes
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20
Q

What is the purpose of steroids in COPD?

A

To reduce the frequency of exacerbations

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21
Q

How does pontine haemorrhage present?

A

Reduced GCS, quadriplegia, miosis and absent horizontal eye movements

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22
Q

Which vaccinations are given to pregnant women

A

Influenza and pertussis

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23
Q

Stage 2 hypertension

A

Clinic BP above 160/100

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24
Q

Why is epidural anaesthesia preferred in GI surgery?

A

Faster return of normal bowel function

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25
When do VTE's present post-operatively?
Normally present 5-10 days post operatively | blood transfusion, cellulitis etc present earlier
26
What is reynold's pentad?
Carcot's triad plus low blood pressure and confusion
27
Investigations for peripheral arterial disease?
Duplex ultrasound is first line | Then do MRA (magnetic resonance angiography)
28
Difference between O negative and O positive
O negative - rhesus negative | O positive - rhesus positive
29
VTE prophylaxis for someone undergoing surgery (patient has no bleeding risk factors)
TED stockings and dalteparin at least 6 hours post operation
30
Useful for monitoring response to colorectal cancer treatment
CEA
31
Double bubble sign on AXR
Duodenal atresia
32
Treatment of malignant hyperthermia
Dantrolene - prevents release of Ca2+ from the sarcoplasmic reticulim
33
Isograft
Transplant to identical sibling
34
Xenograft
E.g. porcine heart valve
35
Allograft
Transplant from someone else (not twin)
36
Autograft
From yourself
37
Difference between RBCs in CSF and breakdown products in CSF?
RBCs could be from a traumatic tap | The presence of breakdown products is indicative of an SAH
38
What does cryoprecepitate contain?
Contains factor VIII and fibrinogen
39
How does malignant hyperthermia present?
Presents with muscle rigidity and increased temperature
40
A common complication following intraventricular haemorrhage
Hydrocephalus
41
Most common organism causing cholangitis
E. coli
42
What is marjolin's ulcer?
A squamous cell carcinoma occurring at the site of chronic inflammation or previous injury
43
Treatment of scabies
Permethrin 5% is first line
44
Pilocarpine mechanism of action
Muscarinic agonist
45
Difference between caput succedaneum and cephalohaematome?
Caput succimmediate - noticed immediately, may cross suture line Cephalohaematoma - noticed several hours after birth - may take several months to resolve. Will not cross suture lines
46
Which organism is responsible for causing scarlet fever?
Group A haemolytic streptococci (strep pyogenes)
47
Risk factors for sudden infant death syndrome
``` Prone sleeping Being male Parental smoking Bed sharing Hyperthermia and head covering Prematurity ```
48
Progesterone only pill and antibiotics?
No need for extra precautions
49
The only method of contraception associated with weight gain?
Depo provera
50
ECG findings of TCA overdose
Prolonged QT Widening of the QRS complex Sinus tachycardia
51
Treatment of TCA overdose
IV bicarbonate | lipid emulsion is increasingly being used
52
A child has an exacerbation of asthma, what else can you add to their therapy?
Can give them oral prednisolone for 3 days
53
How might laryngomalacia present?
Usually presents with noisy breathing, if severe may lead to noisy breathing when eating/low weight centile/poor food intake
54
Risk factors for surfactant lung deficiency
``` Prematurity Male sex Diabetic mothers Caesarean section Second born of premature twins ```
55
Side effects of nicorandil
Headache Flushing Anal ulceration
56
Side effects of nitrates?
Headache Postural hypotension Tachycardia
57
pCO2 and life-threatening asthma?
A normal pCO2 in asthma indicates a life-threatening asthma attack, as it is indicative of a reduced respiratory effort
58
Explain pCO2 and asthma?
Initially, in an asthma exacerbation, the patient will hyperventilate to blow off CO2 to compensate for the hypoxia. When the patient becomes tired, this is when they stop trying to breathe it off, so they end up with a NORMAL CO2 --> this is a very bad sign!!!§
59
Treatment for haemorrhage in cervical cancer?
Palliative radiotherapy
60
These may mimic amelanotic melanoma?
Keratoacanthoma
61
How would you diagnose perthes disease?
Plain x-ray | Do technetium bone scan or MRI if x-ray is normal
62
Which virus causes hand, foot and mouth disease?
Coxsackie A16
63
How does laryngomalacia present?
Noisy breathing on inspiration - most common cause of stridor in children
64
Treatment of choice for atypical endometrial hyperplasia
Total hysterectomy with bilateral salpingo-oophrectomy (due to risk of malignant progression)
65
Swelling or locking of knee in teenager
Osteochondritis dissecans
66
Croup peak incidence
6 months to 3 years
67
Most common cause of first trimester spontaneous miscarriages
Antiphospholipid syndrome
68
Most important cause of ventricular tachycardia
Hypokalaemia (followed by hypomagnesaemia)
69
Causes of torsades de pointes
Hypothermia, hypokalaemia, hypomagnaesemia
70
How to differentiate between Knight's move thinking and flight of ideas
Knight's move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas
71
When would you use hyoscine butylbromide or hyoscine hydrobromide?
Hyoscine hydrobromide for respiratory secretions | Hyoscine butylbromide for bowel
72
Which nerves can be affected in acoustic neuroma?
CNV: absent corneal reflex CNVII: facial palsy CNVIII: hearing loss, vertigo, tinnitus
73
INVESTIGATION IF YOU SUSPECT PLACENTA PRAEVIA
DO A TRANSVAGINAL ULTRASOUND - better than abdominal - better accuracy

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