CAP TEST Flashcards
why does serum phosphate tend to rise in CKD
it isn’t efficiently removed by dialysis
which vitamin is often prescribed in CKD
activated vitamin D
how are phosphate levels managed in advanced CKD
phosphate binders to remove free phosphate from serum
which vessels make up the left venous angle
subclavian and internal jugular veins
which vessels drain in to the chamber of the heart with the SA node
IVC and SVC
where do the intercostal veins from the anterior aspect of the chest drain into
internal thoracic
what effect do BDZs have on delirium
worsen and lengthen delirium
what is the best treatment for delirium
haloperidol
what are the diagnostic criteria of delirium
acute onset
inattention
disorganised thinking/altered level of consciousness
at what stage does the embryo implant onto the uterus
blastocyst (day 6-10)
where does fertilisation normally occur
ampulla of Fallopian tube
what are features of duct ectasia
green/cream nipple discharge
more common in smokers
lump felt under nipple
what type of breast pathology is common after trauma
fat necrosis
elderly lady with a hot, tender breast and overlying cellulitis that has not responded to 2 courses of antibiotics
suspect inflammatory breast cancer
what effect does phenytoin have on OCP efficacy
reduces OCP efficacy as it induces liver enzymes
which antibiotic is contraindicated in pregnancy and why
tetracycline
discolours the infant’s teeth
can a patient <16 year consent to an abortion
yes, if they have capacity
need written permission from someone over 18 for surgical procedure
what consent is needed for non-emergency treatment in a severely brain damaged patient
apply to courts for consent
patient in labour and has reassuring CTG but meconium discharge, management?
reassure and re-examine in 2 hours
what is the recommended contraception post-partum
BMI <39 COCP
BMI >39 POP
which STI causing organism is a flagellated protozoa
trichomonas vaginalis
what is radial-femoral delay a sign of
coarctation of aorta
what are signs of placental abruption
severe bleeding + uterus tender and tense +/- severe fetal distress /intrauterine death
when is mid-forceps delivery appropriate
when foetal head is below the ischial spines
what supplements are recommended for all women to take during pregnancy
folic acid 400 mcg
vitamin D 10 mcg
how much folic acid should be given to high risk groups
5 mg
which hormone should be measured to detect if a woman has ovulated
progesterone
which hormone should be measured to assess ovarian reserve prior to IVF
anti-mullerian hormone
which artery can be damaged during insertion of lateral abdominal port during female laparoscopic sterilisation
inferior epigastric
which artery can be damaged during incision of bartholin’s abscess
internal pudendal
which artery can be damaged during dissection of the lower end of the ureter
uterine artery
which hormone causes enlargement of the mammary glands in breasts to prepare for production of milk
prolactin
why is anaemia common in patients with CKD
reduced renal EPO
what treatment can help patients with CKD maintain adequate Hb
EPO
what monitoring is necessary for LMWH
only monitor if patient is pregnancy or has renal impairment
use anti-Xa assay
what monitoring is required for dabigatrarin
no routine monitoring
what is the mechanism of action of dabigatran
direct thrombin inhibitor
what monitoring is necessary for unfractionated heparin
APTT
why does roleaux occur
when the charge on the surface of cells is altered as a consequence of cell being labelled with proteins
what does low ferritin suggest
iron deficiency
what to suspect in anaemia + jaundice
haemolysis
what do spherocytes suggest
autoimmune haemolysis or hereditary spherocytosis
when is HRT contraindicated
active or recent arterial thromboembolic disease eg angina or MI
when would you recommend a blood transfusion for anaemia
Hb <8
dactylitis is a common presentation of which anaemia
sickle cell
what is the test for sickle cell anaemia
HPLC (Hb high performance liquid chromatography)
what type of inheritance does hereditary shperocytosis show
autosomal dominant
man presents with back pain, proteinuria and microscopic haematuria
multiple myeloma
presents with high lymphocyte count and lymphadenopathy
CLL
atypical mononuclear cells
EBV
29 yo acute mania that may be pregnant, drug management?
prescribe olanzapine
30 yo with schizophrenia, non-response to quetiapine and haloperidol, drug management?
clozapine
how long does a compulsory treatment order last
6 months in hospital
what test should be done before starting lithium
U&Es
what is the first line treatment in depression
SSRI eg citalopram
reduced GABA is a sign of
withdrawal from sedative-hyponotic slugs
excessive activation of dopamine receptors is present in
schizophrenia
serotonin is low in
depression
what is malingering
faking illness for secondary gain
which neurotransmitter is most involved in appetitive and approach systems
dopamine
what are features of migraine
unilateral pulsating moderate-severe aggravated by routine activities last between 4-72 hours
what can make benign intracranial HTN worse
coughing/sneezing (raise ICP)
COCP
what is dystonia
sustained abnormal posture caused by persistent contraction
how is dystonia managed
anticholinergics
phenothiazines
botulinim toxin
what is a spasm
uncontrolled contraction of a muscle
what is blepharospasm
spasm of eyelid
what is hemiballismus
uncontrolled flailing of limbs
nerve roots for biceps reflex
C5/6
nerve roots for ankle reflex
S1
nerve roots for knee reflex
L3/4
acute dystonic reaction is a side effect of what type of drugs
EPS side effect
typical antipsychotics
what is metabolic syndrome
central obesity
HTN hypercholesterolaemia
insulin resistance
metabolic syndrome is associated with which class of psych drugs
atypical antipsychotics
receptive aphasia is due to a lesion in
wernicke’s area
how does receptive aphasia present
speech is fluent but words spoken are incorrect
expressive aphasia is due to a lesion in
frontal lobe of dominant hemisphere
broca’s area
how does expressive aphasia present
able to understand but lose fluency
unable to get words out despite knowing what to say
what is the first area affected by Alzheimer’s
nucleus basalts of meynert
lesion to which cranial nerve can cause pain in the posterior triangle of the neck
CN VII
what pattern go inheritance does Huntington’s show
autosomal dominant
how does lamotrigine work
block voltage sensitive sodium channels
reduces release of glutamate
what is the first line treatment of simple partial seizures
lamotrigine or carbamazepine
oligoclonal bands in CSF is associated with
MS
what does xanthochromic CSF indicate
presence of blood
?subarachnoid haemorrhage
which drugs improve survival in heart failure
ACEI
desire to void occurs with bladder is how full
250 ml
what is the definition of polyuria
> 2.8 L of urine a day
parasympathetic nerve stimulation has what effect on the detrusor muscle
contracts
how long is the female urethra
3-4 cm
what causes a right shift in the O2-Hb dissociation curve
acidosis (lower pH)
increased CO2
increased 2,3-DPG
increased temp
what causes myasthenia graves
antibodies directed against postsynaptic ACh receptors
is treponema pallidum a true anaerobe
nope
its a bacterium
