CAP Year 4 Flashcards
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
What is the most common cause of reiters syndrome?
Chlamydia
What are the clinical features of carotid artery stenosis?
Ischaemic attacks e.g. amarosis fugax
What is the management of carotid artery stenosis?
Anti-platelet medication
If high grade >70% - carotid endarterectomy
How do you calculate the number of units in 1 litre of alcohol?
In 1 litre - % alcohol =no. of units
What is the first line treatment for intermittent claudication?
Life style modification
Is Olanzapine safe in pregnancy?
Yes
When is ECT indicated in depression?
Emergency presentations of severe depression where life is at risk
Management of viral gastroenteritis in children?
Advice re Hydration and fluid intake
When should a patient with bronchiolitis be admitted?
When they have low saturations
What drug can be used in Hyponatraemia cause by SIADH where fluid restriction is unsuccessful?
Demeclocycline
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
Signs of WARMD?
Neovascularisation and haemorrhage at the macula with eventual scarring.
What is Addison’s?
Auto immune adrenal failure
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
How can diagnosis of polymyositis be made?
Muscle biopsy
What is the most common causative organism of pneumonia?
Step pneumonia which is gram positive diplococci
What is the most common cause of encephalitis?
Herpes simplex
Which 3 groups are more likely to be affected by listeria?
Neonates
Elderly
Immunocompromised
What is the least teratogenic anti-epileptic for women of child bearing age?
Lamotrigine
What does delay of femoral pulses in a new born suggest?
Coarction of the aorta
What are defensins?
Small cysteine rich cationic proteins that bind to microbial cell membranes and asset in killing cells
What is seen on biopsy in dermatitis herpetiformis?
Granula IgA at the dermal papillae
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.
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?
No
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?
L4
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?
LH
