CAP Year 4 Flashcards by Claire Milne

What is the management of a patient identified as MRSA positive on routine screening?

Daily skin washing
Single room
PPE for staff
Clean furniture and equipment
No antibiotics

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What is the most common cause of reiters syndrome?

Chlamydia

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What are the clinical features of carotid artery stenosis?

Ischaemic attacks e.g. amarosis fugax

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What is the management of carotid artery stenosis?

Anti-platelet medication

If high grade >70% - carotid endarterectomy

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How do you calculate the number of units in 1 litre of alcohol?

In 1 litre - % alcohol =no. of units

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What is the first line treatment for intermittent claudication?

Life style modification

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Is Olanzapine safe in pregnancy?

Yes

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When is ECT indicated in depression?

Emergency presentations of severe depression where life is at risk

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Management of viral gastroenteritis in children?

Advice re Hydration and fluid intake

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When should a patient with bronchiolitis be admitted?

When they have low saturations

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What drug can be used in Hyponatraemia cause by SIADH where fluid restriction is unsuccessful?

Demeclocycline

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What are the two functions of parathyroid hormone?

Increases calcium levels by increased reabsorption from the kidneys
Increases conversion of Vitamin D to 1,25 hydroxy vitamin D which increased calcium absorption from the gut

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Signs of WARMD?

Neovascularisation and haemorrhage at the macula with eventual scarring.

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What is Addison’s?

Auto immune adrenal failure

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Why does Addison’s cause tanning of skin?

Additions has low cortisol and high ACTH.

ACTH comes from a pro-hormone which also makes melanocyte stimulating hormone

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How can diagnosis of polymyositis be made?

Muscle biopsy

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What is the most common causative organism of pneumonia?

Step pneumonia which is gram positive diplococci

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What is the most common cause of encephalitis?

Herpes simplex

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Which 3 groups are more likely to be affected by listeria?

Neonates
Elderly
Immunocompromised

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What is the least teratogenic anti-epileptic for women of child bearing age?

Lamotrigine

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What does delay of femoral pulses in a new born suggest?

Coarction of the aorta

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What are defensins?

Small cysteine rich cationic proteins that bind to microbial cell membranes and asset in killing cells

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What is seen on biopsy in dermatitis herpetiformis?

Granula IgA at the dermal papillae

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What fluid management should be given in severe pre-eclampsia?

Fluid restriction due to poor renal function. 80mls NaCL if urine output low - measure output.

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What is the long term management of SIADH?

Long term fluid restriction

Name 1 common cause of SIADH?

Lung cancer

What fluid management should be given in acute dehydration e.g. gastroenteritis?

Rapid replacement using an isotonic crystalloid e.g. IV NaCl 500ml per 30 minutes

Serum iron, reticulocytes and lactate dehydrogenase in acute haemolysis?

Serum iron - normal Reticulocytes - increased Lactate dehydrogenase - Increase

Iron and ferritin in anaemia of chronic disease?

Iron - normal | Ferritin - increased

When are hyperhsegmented neutrophils with macrocytosis seen?

In B12 or folate deficiency

Which paediatric condition presents with bile stained vomit?

Volvulus

Which condition presents in young babies with projectile vomiting and a hungry child?

Pyloric stenosis

What are the signs of reflux in babies?

Small vomits after every feed, infant otherwise well

In which bone is the trochlea?

The frontal bone

What is a common cause of dermatofibromas?

Insect bites - feel firm on palpation

What is the definition of bowens disease?

Full thickness epidermal dysplasia and a pre-cursor to SCC development

What % of prostate cancer cases have locally advanced and metastatic disease at presentation?

65%

What the most important complication of thyroidectomy?

Damage to recurrent laryngeal nerve - hoarseness of voice

What type of medication can be used for urge incontinence?

Anti-cholinegric

How is the dose of acetylcysteine calculated?

Based on weight

What is the gold standard test for confirming placement of an endotracheal tube?

End tidal CO2

What type of murmur is aortic stenosis?

Ejection systolic murmur

What type or murmur is heard in aortic regurgitation and mitral stenosis?

Diastolic murmur

What sort of murmur is heard in mitral and tricuspid regurgitation?

Pan systolic murmurs

Which statistical test compares two proportions?

Fishers exact

Which statistical test compares two matched samples?

Paired t-test

Symptoms of laryngopharyngeal reflux?

Hoarseness, sore throat, cough

What is the name for a severe acute superficial desquamating eruption often secondary to a drug?

Toxic epidermal necrolysis

First line treatment for a partial seizure?

Lamotrigine or carbamazepine

Neutrophile and lymphocytes - viral or bacterial?

Neutrophils - bacterial | Lymphocytes - viral

What condition is SPECT useful in diagnosing?

Lewy body dementia

How long does a compulsory treatment order allow detention for?

6 months

First line depression treatment?

SSRI e.g. citalopram

Where is JAK2 gene mutation seen?

In myeloproliferative polycythaemia

In what condition is the Philadelphia chromosome seen?

Chronic myeloid leukaemia - reciprocal translocation between chromosomes 9 and 22

Which drug does Phenytoin reduce the effectiveness of?

Contraceptives

What type of drug is amlodipine?

Calcium channel blocker

What is the first line treatment for hypertension in someone over 55, or afrocarribean origin?

Calcium channel blocker

What is the first line treatment for paroxysmal AF?

Bisoprolol

What type of drug is Amiodarone?

Anti-arrythmic

What type of drug is Hydralazine and what is it used for?

Vasodilator - severe hypertension

Name 3 indications for digoxin?

AF, atrial flutter, heart failure

Name 1 important side effect of digoxin?

Gynaecomastia

Over what weight is the COCP contraindicated?

BMI >39

Is the POP contraindicated in high BMI?

What two blood markers are raised in GCA?

ESR and PV

What is Atropine used for?

Used to correct bradycardia and heart block

Why might patients become bradycardia during ocular surgery?

Oculocardiac reflex

What is the first line treatment of sudden AF in an unstable patient?

Cardioversion

What drug is used for intra-operative hypotension?

Metaraminol

What is adenosine used for and how does it work?

Used for SVT - causes transient heart block in the AV node

Name 3 uses for adrenaline?

Cardiac arrest, anaphylaxis, superficial bleeding

Name 2 uses for noradrenaline?

Low BP and shock

What is ephedrine used for?

To prevent low BP during spinal anaesthesia

What antibodies are present in myasthenia gravis?

auto antibodies against post synaptic Act receptors

What antibodies are present in Lambert eaton myasthenia syndrome?

Auto antibodies against calcium fluxes in pre synaptic calcium channels

What intervention do patients with GORD need during anaesthetic?

Intubation

What are the features of the confinement assessment method?

Acute onset and fluctuating course Inattention Disorganised thinking Altered conscious level

What treatment is needed in a breast abscess?

Aspiration

Name 2 symptoms of atypical depression?

Hypersomnia and feeling of heaviness in limbs

What is the typical pattern of pityriasis Rosea?

Herald patch followed by eruption of patches

What typically causes a rash of itchy vesicles on extensor surfaces?

Dermatitis herpetiformis

What symptom is caused by digoxin toxicity?

Blurred vision

What baseline bloods should be done before commencing lithium?

Baseline U&E's

What nerve root controls leg extension, patellar reflex and ankle dorsiflexion?

Which endocrine organ is commonly affected by small cell lung cancer mets?

Adrenal

1:1000 solution, how many grams in mls?

1g in 1000ml

Are myopic eyes large or small?

Large (long)

Anti biotic for epiglottitis?

Ceftriaxone

Investigation for PE?

CTPA

Function of cyclizine?

Anti emetic - will slow gut, constipating

Function of ondansetron?

Prevent nausea and vomiting caused by chemo, causes constipation

Uses for Levomepromazine?

Anti emetic used in palliative care

Function of Metoclopramide?

Helps with emptying of stomach used for nausea and vomiting

What is the target INR for someone with recurrent DVT/PE or an artificial valve?

3.5

What drug should be used for anti coagulation in patients with a prosthetic valve?

Warfarin - NOAC's not licensed

Name 2 risk factors for necrotising enterocolitis?

Prematurity IUGR Absent end diastolic flow of placenta Hypoxic insult

What is the investigation of choice for suspected spinal cord compression?

Whole spine MRI

What are the symptoms of vasa previa?

Small intrapartum bleed following Rom and severe fetal distress

What is the first choice sulfonylurea?

Gliclazide

Which oral diabetic drug causes diarrhoea?

Metformin

What should you prescribe 2nd line for a diabetic patient who is a HGV driver?

TZD (sulfonylurea has a hypo risk)

What is the treatment of choice for an oesophageal stricture?

Balloon dilation

What is the treatment of achalasia in a fit person?

Hellers cardiomyotomy

1st line investigation in ?bowel perforation?

Erect CXR

What effect does parasympathetic have on the detrusor muscle?

Contraction - aiding bladder voiding

What effect does sympathetic have on the detrusor muscle?

Relaxes - inhibits urge to void

What is the most common for poisoning?

Campylobacter

What treatment must be tried before commencing clozapine in schizophrenia?

2 different anti psychotics

What are the symptoms of a varicocele?

none - usually painless

What is the most common cause of encephalitis and what lob does it most commonly affect?

Herpes simplex - temporal lobe

Important cause of bilious vomiting in newborn?

Malrotation and volvulus - X-ray

What is an important cause of projectile vomiting in a baby that is weeks old?

Pylori stenosis - USS

What is a normal urinary volume and 24 hour volume?

400ml and 2 litres

Up to what level of blood loss is BP maintained?

30%

What is the abnormality in di George syndrome?

deletion in chromosome 21 - heart defects, cleft lip

What hormone trigger ovulation?