Blue Flashcards
No menstrual periods until 1 wk ago when she had episode of light vaginal bleeding for 7 days.
Taking Tamoxifen since 3 years ago for adjuvant chemotherapy on her breast malignancy. What is the cause for the recent bleeding?
Endometrial POLYP formation due to the TAMOXIFEN
Most effective antibiotic to use locally for a patient with a mucopurulent eye discharge and a red eye?
Chloramphenicol
Pain in her Left shoulder when hanging out washing and raising the arm above the head away from the body. Unable to lift the arm up at all. Limit on abduction of the arm. Deltoid muscle contracting. The arm can be moved passively to full abduction. Diagnosis?
Rupture of the Supraspinatus Tendon
Acutely Painful defecation with spotting of blood in the toilet paper. Diagnosis?
Anal Fissure
Colicky
Intussuception
Profuse blood loss
Meckel’s diverticulum
Blood is mixed with the stool not in the paper
Juvenile Polyp
Painful joints, abdominal pain and vasculitic rash
Henoch Schonlein Purpura
20yo, Pap smear done , grade 3 cervical intraepithelial neoplasia (CIN 3), Mgt?
Colposcopy
Eight week history of pervasive sadness, bouts of crying, anorexia and weight loss, a feeling that his life is not worth living, fatigue and disrupted sleep. Which of the ff abnormal sleep patterns is the most likely to complain?
Early waking after initial sleep - Middle Insomnia
Diagnosis: Depression
14 days return from hitchhiking through Asia. He complains of explosive, watery and foul-smelling diarrhea of six to eight motions daily. Weight loss, afebrile and abdominal distention. The stool examination shows greasy and contains mucus. Diagnosis?
Giardiasis
Overcrowding and poor sanitation
Fecal Oral spread, stool culture, tx: Ciprofloxacin
Shigellosis
Fecal Oral, Tx: Metronidazole
Amebiasis
Traveller’s diarrhea, self-limiting without treatment
Enterotoxigenic E coli infection
Immunossuppression patients (HIV or patients on Chemotherapy)
Cryptosporidial infection
Maintained BMI, 13 years of food restriction and obsessional daily exercise routine. Management of Whiplash injury after a car accident. Which of the ff is most likely to be found on general physical examination of this young woman?
Loss of breast Development
(due to weight loss and malnutrition)
Intermittent lower abdominal pain, diarrhea and recurrent lower urinary tract infections with Coliform organisms. History of noticing bubbling in the urinary stream with “whistling down my pipe” What causes this problem?
Diverticular disease of the colon
6 month history of weakness of the Right arm and Right leg, 2 months ago had headaches.
Over the last 5 years had number of blackouts which were associated with incontinence. Weakness of the Right upper and lower limbs. Papilloedema. Diagnosis?
A Left Frontal Meningioma
Lower abdominal pain lasting for 3 days each month for the last 12 months. When not in abdominal pain shows no evidence of any suprapubic mass or tenderness. Blood test ovulating. What causes her abdominal pain?
Mullerian (Paramesonephric) Agenesis
35 yo presents with cyclical mastalgia. Mother had breast cancer at the age of 45 yo and died from metastases. Maternal Grandmother also had breast cancer before age of 50. Mammography normal and is on Oral contraceptive pill. USG shows an uncomplicated cyst with no concerning features in the Right breast. Apart from the simple analgesics and evening Primrose oil for her mastalgia. Which of the ff is the most appropriate advice in the patient’s regimen?
Remain on the OCP, six monthly clinical review,
yearly mammography and Ultrasound
31 male with endoscopically proven duodenal ulcer treated with PPI, tested positive for H. pylori. Which of the ff most appropriate ff up for the patient?
Urea breath Test at six weeks
MMSE should be more than 26
Normal Ageing Process
Decline in memory and self-care skills, suffers from urge incontinence. Disoriented in time and place. MMSE of 18/30. Poor short term memory, mild dysphasia and impaired arithmetic , plannign and visuospatial skills, Normocytic Normochromic Blood film.
Alzheimers dementia
Urge incontinence but the absence of focal neurologic signs
Carcinoma of the Prostate
SIADH, <125, confusion and sleepiness
Hyponatremia
Muscle twitching, drowsiness and coma
Chronic Renail Failure
Very heavy bleeding causing her to use ten sanitary pads per day and the bleeding does not seem to be decreasing. What causes this problem?
Bleeding / Coagulation profile
Dx: Von Willebrand Disease
65 male presents with increasing weakness in his legs over six months. Upper limbs, bilateral wasting and weakness in the biceps muscles. No sensory charges, spastic paraparesis, increased ankle and knee reflexes.
Cervical Spondylosis with Cervical Myelopathy
- depressed biceps tendon reflexes - cervical cord lesion - C5 and C6
Primigravida 39 wks gestation by uncertain dates, fundal height measures 30 cm above the pubic symphysis. P: cervix is long and closed and the baby is presenting cephalically. Most appropriate management?
Ultrasound
Bruising and excessive cyclical menstrual loss, enlarged spleen palpable 3 cm below the left costal margin. Decreased platelet count. Diagnosis?
Systemic Lupus Erythematosus
Dressmaker had a puncture wound from a sewing needle. In the proximal interphalangeal flexor crease her Left index finger, became swollen along its entire length. Passive extension of the digit elicited severe pain. Diagnosis?
Flexor Tenosynovitis
Increasing dyspnea, raised jugular venous pressure (JVP), and displacement of the apex beat.
MItral Regurgitation
2 month history of a cramping pain at the Right buttock. The pain occurs when he is walking and comes out after several minutes. Pain radiates from the buttock down to the Right thigh and goes away when he stops walking to rest. Explanation of the symptom?
Stenosis of the Right Common Iliac Artery
Severe abdominal pain, abdominal rigidity and intense lower back pain.
Leaking Aortic Aneurysm
70F presents blood-stained vaginal discharge. Estocervix and the vagina look atrophic. Cervical cytology shows no evidence of malignant cells although no ectocervical cells were seen. Most appropriate next step in the management?
Hysteroscopy and dilatation and curretage
