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FINALS > Capsule > Flashcards

Capsule Flashcards

1
Q

Causes of cavitating lung mass

A 
Bacterial lung abscess
Metastatic SCC
GPA
Pulmonary infarct
Pneumonia
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2
Q

Bacteria which cause cavitation are common in homeless people

A

S Aureus
Klebsiella
Mycobacterium Tuberculosis

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3
Q

Ear pain and then facial muscle weakness

A

Bells palsy

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4
Q

Ear rash and then facial muscle weakness

A

Ramsay hunt syndrome

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5
Q

Which nerve supplies the anterior tongue taste

A

Facial

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6
Q

Which nerve causes bells palsy

A

Facial

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7
Q

Investigation for bells palsy

A

Nerve conduction studies if palsy persists (to look for axonal degeneration)

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8
Q

Whats the prognosis like for bells palsy

A

Most people recover

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9
Q

Causes of macrocytosis

A

Pregnancy, Alcohol, Folate deficiency, B12 deficiency

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10
Q

Treatment of alcohol withdrawal

A

Bezodiazepines based off symptom score

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11
Q

Wernickes treatment

A

Thiamine as rapid bolus

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12
Q

Thomas’ test

A

Fixed flexion deformity of opposite hip, osteoarthritis is the most common cause

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13
Q

Normal resp rate for under 5s

A

30

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14
Q

Upper limit of normal heart rate in under 5s

A

150

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15
Q

Risks for UTI

A

Diabetes, renal stones, sex

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16
Q

Which kids should get a renal ultrasound for UTI

A

1 UTI + Under 6 months= within 6 weeks
Recurrent UTI + Under 6 months= during admission
Recurrent UTI + over 6 months= 6 weeks

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17
Q

Which asthma drugs can cause hypokalaemia

A

Salbutamol, prednisolone and theophylline

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18
Q

Theophylline monitoring

A

Cardiac monitoring when giving IV

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19
Q

Salbutamol side effects

A

Tremor, tachycardia, sleep disturbance

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20
Q

What visual change would a lesion in the optic radiation cause

A

Superior quadrantopia

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21
Q

Symptoms of acromegaly not in the face

A

Cardiomegaly
Colonic polyps
Hepatosplenomegaly
Diabetic retinopathy

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22
Q

Investigations for acromegaly

A

Oral glucose tolerance test

MRI pituitary

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23
Q

40 year old hearing loss, bilateral

A

Otosclerosis

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24
Q

Most likely cause of hearing loss in a child

A

Glue ear

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25
Q

glue ear mechanism

A

Eustachian tube dysfunction results in negative pressure in the middle ear cleft and subsequent middle ear effusion

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26
Q

1st line treatment of glue ear

A

surveillance

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27
Q

Causes of secondary hypertension

A

Renal Artery stenosis
Polycystic kidney disease
Coarctation

Cushings
Conns
Phaeochromocytoma
Acromegaly
Hypothyroid
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28
Q

Treatment of phaochromocytoma

A

Alpha blockade then beta blockade

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29
Q

Pharmacological options for stopping smoking

A

NRT, varenicline, bupropion

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30
Q

Treatment of a SAH

A

Coiling and clipping of any aneursym

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31
Q

Inpatient fluids for dialysis patient

A

Dont need

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32
Q

Causes of surgical emphysema

A

Oesophageal tear
Fractured rib
Pleural biopsy

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33
Q

Child has jumped off a wall

A

Calcaneal fracture. Most commonly fractured talus bone, 10% bilateral and also associated with spinal injuries.

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34
Q

Salter harris classification

A

Describes how fractures involve the growth plate in children. 1-2 good prognosis, 5 involves the growth plate

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35
Q

Who gets PBC and autoimmune hepatitis

A

Women

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36
Q

3 tests for hereditary haemochromotasosi

A

Serum iron, total iron binding capacity and ferritin

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37
Q

Complications of haemochromatosis

A 
skin pigmentation
diabetes (pancreatic deposition)
cardiomyopathy
hepatic cirrhosis
chondrocalcinosis and arthropathy
hypogonadism and pituitary dysfunction
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38
Q

Why do people get AKI after shock

A

Acute tubular injury

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39
Q

Chance of recovery from AKI

A

80%

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40
Q

Hyperkalaemia ECG

A

Prolonged PR interval, small tall or “tented” T waves and wide QRS complex

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41
Q

J waves on ECG

A

Hypothermia

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42
Q

Phenylketonuria

A

AR, Low phenylamine diet and amino acid supplements

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43
Q

Smooth disc like swelling in one breast in a male

A

Gynaecomastia

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44
Q

Which drugs cause gynaecomastia

A

Finasteride, PPI, Spironolactone

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45
Q

Muscles responsible for shoulder abduction

A

Deltoid and supraspinatus

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46
Q

Nerve supplying deltoid

A

Axillary

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47
Q

S1

A

Sole of foot

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48
Q

L2

A

Upper anterior thigh

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49
Q

L1

A

Groin

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50
Q

S3

A

Buttock

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51
Q

L4

A

Calf

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52
Q

What does Coombs positive suggest

A

Autoimmune mediated so remove insult and give corticosteroids

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53
Q

Does CLL have a good prognosis

A

Incurable unless bone marrow transplant in young person

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54
Q

Splenectomy guidance

A

Vaccinations (Flu, pneumococcal, Men C, Hib) before surgery and prophylactic antibiotics for two years after

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55
Q

Laparoscopy or lapartomy if pelvic mass

A

Laparotomy as will need to remove mass

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56
Q

Amiodarone side effects

A

Blue-gray skin

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57
Q

Gram negative bacillus

A

E Coli, H influenza

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58
Q

Gram positive bacillus

A

Listeria monocytogenes, Bacillus cereus

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59
Q

Fitz hugh curtis syndrome

A

Hepatitis after PID

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60
Q

Common side effect of bacterial meningitis

A

Sensorineural deafness

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61
Q

Drug for chemoprophylaxis of meningitis

A

Rifampicin (ciprofloxacin ok but off license)

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62
Q

Do MR and Ultrasound use radiation

A

no

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63
Q

Raised mole surrounded by flat mole

A

Compound naevus

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64
Q

Flat and coloured mole

A

Junctional naevia

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65
Q

Raised mole

A

Dermal naevus

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66
Q

Benign mole in area prone to mechanical irritation such as razoring and irritation by clothes

A

Excision reasonable

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67
Q

malaise, a widespread maculopapular rash (involving palms and soles) and orogenital ulcers

A

secondary syphilis

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68
Q

Symptom of secondary syphilis

A

Macropapular rash

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69
Q

Testing for secondary syphilis

A

VDRL testing

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70
Q

Syphilis pupil

A

Argyll Robertson pupil

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71
Q

Which is the most common lung cancer

A

Adenocarcinoma

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72
Q

Tests for HCC

A

Also do AFP and CXR

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73
Q

Can hydroceles be felt seperate to the testes

A

No

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74
Q

What word is used to describe increased bone density

A

Sclerosis

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75
Q

Causes of osteosclerosis

A

Metastatic cancer

Sickle cell disease

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76
Q

Treatment of metastatic prostate cancer

A

Antiandrogens

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77
Q

Two common types of HPV

A

16 and 18

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78
Q

What type of ovarian cyst is most likely to tort

A

Dermoid

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79
Q

Whats the difference between BV and trichomonas

A

BV fishy, clue cells, no itch

Trichomonas, itchy, smelly, strawberry cervix

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80
Q

Treatment of Bartholins cyst

A

Marsupialisation

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81
Q

Treatment of imperforate hymen

A

Incision of hymen (not excision)

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82
Q

First line treatment of stress incontinence

A

Pelvic floor training

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83
Q

Surgeries for stress incontinence

A

Urethral bulking agent
Mid urethral sling
Burch colposuppression

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84
Q

Investigation for urgency incontinence

A

Frequency volume chart

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85
Q

Treatment of urgency incontinence

A

Bladder drill
Fluid advice
Local oestrogen
Smoking cessation

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86
Q

How do you treat non ruptured ectopics

A

Methotrexate

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87
Q

How do you treat ruptured ectopics

A

urgent laparoscopy

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88
Q

What should you complete after an someone falls on the ward

A

DATIX

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89
Q

What would you use to sedate an elderly patient

A

0.5mg lorazepam

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90
Q

What would you use to treat faecal impaction

A

8 sachets of laxedo

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91
Q

What counts as a postural drop

A

20+/10+

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92
Q

cANCA

A

Wegeners GPA

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93
Q

Is DDimer useful in pregnancy

A

No

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94
Q

CTPA or VQ in pregnancy

A

Discuss with mum, CTPA better, CTPA=Breast Ca, VQ=childhood cancer

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95
Q

Gestation sac but no evidence of foetal pole

A

Missed miscarriage

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96
Q

Drugs which cause uterine contractions so could be used in PPH

A 
Syntocin
Syntometrine
Ergometrine
Misoprostol
Carboprost
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97
Q

Management of PPH

A

ABCDE
Call for help
Rub up uterine contraction
Syntocin

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98
Q

What diabetes symptoms do you get in gestational diabetes

A

Polyuria
Thirst
Dysuria

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99
Q

What non glucose test should you do in a patient with gestational diabetes

A

Obstetric ultrasound

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100
Q

Monitoring for gestational diabetes

A

Monitor diet carefully and have daily plasma glucose levels

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101
Q

Treatment of preterm labour

A

Tocolysis and steroids

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102
Q

Name a tocolytic

A

Nifedipine

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103
Q

Liver signs in pregnancy

A

Pruritis
Spider naevi
Palmar erythema
Cholasma

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104
Q

Placenta praevia management

A

Depends on US and clinical findings
Cross match blood
Vaginal examination is contraindicated

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105
Q

Which syndrome is associated with preeclampsia

A

HELLP
Haemolysis
Elevated liver enzymes
Low platelets

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106
Q

3 methods used for fetal monitoring during labour

A

Intermittent auscultation
CTG
Fetal blood scampling

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107
Q

Treatment of suspicious CTG

A

IVI
Left lateral position
Turn down oxytocin infusion

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108
Q

Hormone levels in premature ovarian failure

A

High FSH and LH

Low oestrogen

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109
Q

Hormone levels in PCOS

A

LH raised

FSH normal

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110
Q

Hormone levels in pregnancy

A

LH and FSH are low

Oestradiol is high

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111
Q

Three common routes for HRT

A

Transdermal
Transvaginal
Oral

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112
Q

Unnoposed oestrogen HRT risks

A

Breast and endometrial cancer risk

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113
Q

Progestogen HRT risks

A

Bloating, constipation, irritability

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114
Q

Bromocriptine SE

A

Postural hypotension

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115
Q

Chance of successful vagina birth after caesarean first time

A

75%

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116
Q

VBAC (vaginal birth after caesarean) plan

A

Continous CTG

IV access

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117
Q

Grading of vaginal tears

A

First-degree tear: Injury to perineal skin and/or vaginal mucosa.
Second-degree tear: Injury to perineum involving perineal muscles but not involving the anal sphincter.
Third-degree tear: Injury to perineum involving the anal sphincter complex:
Grade 3a tear: Less than 50% of external anal sphincter (EAS) thickness torn.
Grade 3b tear: More than 50% of EAS thickness torn.
Grade 3c tear: Both EAS and internal anal sphincter (IAS) torn.
Fourth-degree tear: Injury to perineum involving the anal sphincter complex (EAS and IAS) and anorectal mucosa.

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118
Q

Follow up after vaginal tear inc anal sphincter

A

Analgesia
Laxatives
Physio appointment for pelvic floor exercises

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119
Q

Two options for morning after pill

A

Copper IUD

Levonorgestrel

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120
Q

Steps in prolonged labour

A
  1. artificial rupture of membranes
  2. start oxytocin infusion
  3. caesarean
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121
Q

What is defined as slow labour

A

Less than 2cm dilatation in 4 hours

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122
Q

1st line investigation of ectopic

A

TVUS

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123
Q

When do you use methotrexate for ectopic

A

If a mass isnt seen

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124
Q

What is the treatment of ectopci

A

Diagnostic laparoscopy with view towards laparoscopic salpingectomy

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125
Q

Which contraceptive is a risk factor for ectopic pregnancy

A

Copper IUD

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126
Q

Gram positive coccus

A

S pneumoniae

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127
Q

Gram positive bacillus

A

Ballis cerues, listeria monocytogenes

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128
Q

Are never events serious incidents

A

Yes

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129
Q

Does duty of candour apply to organisations or individuals

A

Organisations

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130
Q

Causes of ptosis

A

3rd nerve palsy

Horner syndrome

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131
Q

Mandibular fracture

A

orthopantomogram

maxillofacial surgeons

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132
Q

When can you give details to police about a crime

A

Only when threat to life or limb, not theft etc.

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133
Q

Questions for prognosis in dementia

A

Deteriorating function

Would you be surprised if they died in next few days, weeks, months

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134
Q

Does DOLS apply to all settings

A

No. All care settings but not patients own home

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135
Q

Signs of dying

A

Sleeping more
Eating less
Cheyne Stokes breathing
Cool peripheries

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136
Q

Preemptives

A

Midazolam, morphine sulfate, cyclizine and glycopyrronium.

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137
Q

Reversible causes of agitation at end of life

A 
infection
hypoxia
urinary retention
constipation
raised intracranial pressure
alcohol withdrawal
opioid toxicity
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138
Q

Death certification, 1a, 1b, 1c

A

Part 1 shows the immediate cause of death (part a), plus what may have caused this (part b,c). Part 1c should lead to 1b, which in turn should lead to part a

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139
Q

Risk factors for bowel cancer

A 
Male 
Diabetic
Smoker
Obese
UC
Familial Adenomatous Polyposis
HNPCC
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140
Q

Swallowing difficulties of solids and liquids from the start

A

Achalasia

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141
Q

Achalasia diagnostic investigation

A

Oesophageal manometry

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142
Q

Scans for babies with UTI

A

MCUG- ?reflux

DMSA- ?scarring

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143
Q

atypical UTI and under 1

A

Prophylactic abx

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144
Q

Treatment of vesicoureteric reflux

A

Improves with time

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145
Q

Pen allergic alternative to amoxicillin

A

Clarithromycin

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146
Q

Which antiemetic works directly on gut

A

Metoclopramide

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147
Q

How does ondansetron work

A

Ondansetron blocks 5HT3 receptors in the CNS and the GI tract

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148
Q

DABS

A 
Clopi 75
Aspirin 75
Ramipril 5
Bisoprolol 2.5
Atorvastatin 80
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149
Q

Risk of liver biopsy

A

Bleeding

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150
Q

Pompholyx

A

Eczema with tiny blisters on hands

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151
Q

Bleeding in one nostril not solved by silver nitrate cautery

A

Rapid rhino in each nostril

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152
Q

Consequences of C difficile

A

Peritonitis
Toxic megacolon
Pseudomembranous colitis

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153
Q

Severe C difficile treatment route

A

You give Metronidazole or Vancomycin orally as better absorption

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154
Q

Treatment of severe malaria

A

Urgent IV Artesunate

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155
Q

Whats the difference about vivax or ovale

A

More severe, benign, so you give primaquine afterwards

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156
Q

Seosis from something bowel treatment

A

Cefuroxime and metronidazole

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157
Q

Treatment of traumatic bowel perforation

A

Digital retrieval of rectal body

Lapartomy

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158
Q

Most common lung cancer

A

Adenocarcinoma

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159
Q

NICE lung cancer, What counts as chronic cough

A

3 weeks

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160
Q

Should you give antibiotic prophylaxis for kids with UTI

A

Not after just 1

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161
Q

Treatment of most uk food borne gastroenteritis

A

Ciprofloxacin

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162
Q

When shouldnt you give loperamide

A

IBD, high temperature

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163
Q

Most common cause of bowel obstruction

A

Colon cancer

Sigmoid volvolus

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164
Q

Are left or right sided bowel cancers more likely to obstruct

A

Left as poo more solid and smaller diameter

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165
Q

What do bony mets look like

A

Sclerotic

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166
Q

If someone has a breast abscess what should you screen for

A

Diabetes

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167
Q

ER positive medication

A

Tamoxifen

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168
Q

HER2 positive medication

A

Trastuzumab

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169
Q

Post menopausal medication for breast cancer

A

Anastrozole

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170
Q

Mammory duct ectasia treatment

A

2ww

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171
Q

Trauma then long standing breast lump history

A

Fat necrosis

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172
Q

Tests for CF

A

Guthrie heel prick
Reduced faecal elastase
Sweat test
Gene testing

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173
Q

Investigation for pyloric stenosis

A

Ultrasound

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174
Q

Investigation of tonsilitis

A

Throat culture

Rapid streptococcal antigen test

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175
Q

Treatment of GABHS tonsilitis

A

Phenoxymethylpenicillin and paracetamol

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176
Q

Which way is the shunt if it is cyanotic

A

Right to left

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177
Q

Steps in tetralogy of fallot

A 
Pulmonary stenosis
VSD
Overriding aorta
RVH
(they get more cyanotic on straining)
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178
Q

Transposition of the great arteries

A

Presents on day 2

Give prostaglandin to maintain PDA

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179
Q

Patent Ductus arteriosus

A

Machinery murmur

NSAIDs

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180
Q

Coarctation

A

Increasing symptoms with age
Commonly at ductus arteriosus
Stent and surgical repair

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181
Q

Rheumatic fever causative organisum

A

S pyogenes, 2 weeks post tonsilitis

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182
Q

Skin sign of rheumatic fever

A

Erythema marginatum

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183
Q

Investigation of rheumatic fever

A

ASO swab

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184
Q

Treatment of Rheumatic fever

A

NSAIDs and prophylactic abx

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185
Q

Whats the difference between Exomphalos and Gastrochisis

A

Gastrochisis is uncovered

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186
Q

Treatmtent of developmental dysplasia of hip

A

Harness and surgery

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187
Q

Investigation of biliary atresia

A

Laparatomy

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188
Q

Treatment of biliary atresia

A

Surgical bypass

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189
Q

Types of cerebral palsy

A

Hemiplegic
Diplegic
Ataxic
Dyskinetic

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190
Q

What can babies do at 8 month

A

Sit unsupported
Pincer grip
Straigh back

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191
Q

at what age can they walk

A

1 year

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192
Q

Shapes and ages

A

Circle 3
Square 4
Triangle 5

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193
Q

Treatment of HSP and Nephrotic syndrome in children

A

Oral prednisolone

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194
Q

Tests to do in baby with jaundice

A

Coombs test and TORCH screening

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195
Q

Treatment of jaundice in baby

A

Phototherapy

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196
Q

Cause of jaundice in baby less than 24 hours old

A

Haemolytic anaemia

Infecgion

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197
Q

Cause of jaundice in baby up to 2 weeks old

A

Physiological

Breast milk

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198
Q

Define Hirshprungs

A

Failure to pass meconium in first 48 hours of life

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199
Q

investigation of hirschprungs

A

Suction rectal biopsy

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200
Q

Treatment of hirschprungs

A

Surgery

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201
Q

Gene defect in Turners

A

45XO

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202
Q

Abnormalities in Turners

A

Webbed neck
Short
Wide spaced nipples
Delayed puberty

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203
Q

Edwards syndrome

A

Trisomy 18
Kidneys and occiput
Die in 15 days

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204
Q

Patau syndrome

A

Trisomy 13
Polydactyly
Heat defects
Developmental delay

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205
Q

Tests for Downs

A

Triple at 12 weeks- hCG, PAPPA-A, nuchal US

Quad at 16 weeks- hCG, AFP, oestiol, inhibin A

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206
Q

What does guthrie test for

A 
CF
Sickle cell
Congenital hypothyroid
Phenylketonuria
MCAD
MSUD
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207
Q

What is 12 weeks test for

A

Chromosome tests

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208
Q

What is 20 weeks scan for

A

Neural tube
Heart
Renal
Brain

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209
Q

Chorionic villous sampling

A

12 weeks
2% miscarriage risk
Chromomes and inherited disorders

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210
Q

Amniocentesis

A

16 weeks
1% miscarriage risk
Chromosomes and gender

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211
Q

Meningitis cause in neonates

A

E Coli

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212
Q

Treatment of meningitis in community

A

IM BenPen

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213
Q

Treatment of meningitis in hospital

A

IV ceftriaxone

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214
Q

Prophylaxis of meningitis

A

PO rifampicin or ceftriaxone

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215
Q

Treatment of febrile seizures

A

Paracetamol

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216
Q

Who gets malar flush

A

Mitral stenosis

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217
Q

Hypertensive emergency

A

IV sodium nitroprusside
Reduce BP to 110 over 24 hours
CT scan head
Admit to monitored bed

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218
Q

When to treat hypertension in elderly

A

If still present after 3 months and lifestyle factors

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219
Q

How many samples for TB microbiology

A

3

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220
Q

Signs of opioid withdrawal

A

Yawning
Rasied BP
Cool/clammy skin

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221
Q

What drug is used for opioid abstinence in an inpatient setting

A

Naltrexone

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222
Q

Which disc prolapses in sciatica

A

L5/S1

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223
Q

Treatment of sciatica

A

Reassurance

NSAIDs, physio, mobilisation

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224
Q

Investigation of colonic abscess

A
  1. US

2. CT

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225
Q

Name causes of fistulae

A

Diverticular disease

Crohns

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226
Q

Pharmacodynamic interaction

A

Drugs competing at receptor site

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227
Q

Pharmacokinetic interaction

A

Drugs changing absorption of another drug

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228
Q

Phenytoin OD

A

Headaches, insomnia, tremor, nausea

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229
Q

Causes of SIADH

A

Cancer
Stroke
Lung abscess

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230
Q

Risk factors for smoking

A

FHx
Smoking
Head injury

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231
Q

NMDA receptor antagonist

A

Memantine

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232
Q

Acetylcholinestarase inhibitors

A

Rivastigmine
Donepezil
Galantamine

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233
Q

Cause of intraperitoneal air

A

Perforated oesophageal ulcer
Laparotomy 24hours ago
Perforated diverticulum

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234
Q

Which parts of the GI tract are retroperitoneal

A

3rd part of duodenum
Ascending colon
Descending colon

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235
Q

Which antibiotics should be avoided in first trimester of pregnancy and why

A

Trimethoprim (antifolate)
Ciprofloxacin
Cotrimoxazole

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236
Q

What is the most common ASD

A

PDD-NOS (pervasive developmental disorder-not otherwise specified)

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237
Q

Types of ASD

A

PDD-NOS (pervasive developmental disorder-not otherwise specified)
Rett syndrome
Aspergers

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238
Q

What can be a presenting feature of Polycythaemia

A

TIA

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239
Q

Causes of polycythaemia

A

CKD
HCC
COPD
Primary polycythaemia

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240
Q

Which heart medication can cause low mood

A

Beta blocker

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241
Q

Moclobemide

A

Tricyclic

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242
Q

Dosulepin

A

RIMA

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243
Q

How long should a first episode of depression be treated for

A

At least 6 months

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244
Q

How would you assess facial nerve

A

Ask the patient to raise their eyebrows, bare their teeth and close their eyes, respectively, and look for asymmetry of movement

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245
Q

Where do testicular lymphatics drain to

A

Paraaortic

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246
Q

High bHCG testicular cancer

A

Choriocarcinoma- think placenta

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247
Q

High AFP testicular cancer

A

terAtoma

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248
Q

High PLAP testicular cancer

A

Seminoma

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249
Q

Drugs for reducing regime for alcohol detox

A

Chlordiazepoxide

Diazepam (more than lorazepam)

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250
Q

A 41-year-old gentleman is brought to the ED with a history of heavy alcohol use now presenting with clouding of consciousness, agitation, paranoid delusions and tactile and visual hallucinations. His mental state is very fluctuant and he’s sweating profusely.

A

Delerium tremens

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251
Q

Can ARB and ACEI be used together

A

Yes in renal

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252
Q

Causes of third nerve palsy

A

Rapidly expanding aneurysm
Internal carotid dissection
Thrombotic occlusion of blood supply

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253
Q

What should you give if its within 2 hours of ingestion of overdose

A

Activated charcoal by mouth

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254
Q

SE of NAC

A

Rash, but dont stop treatment because of it

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255
Q

Aspirin overdose Sx

A

Vomiting, hyperventilation, sweating, tinnitus

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256
Q

Most common cause of cushings syndrome

A

Exogenous steroids

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257
Q

Local anaesthetics

A

Lidocaine for short things

Bupivacaine for regional blocks

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258
Q

Which med could bring on gout

A

Aspirin

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259
Q

What does colchicine cause

A

Diarrhoea

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260
Q

SE of oxytocin

A

Water intoxication cos its similar structure to ADH (both released by posterior pituitary)

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261
Q

How long should you give an SSRI for if its a recurrence of depression

A

2 years

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262
Q

Name an Noradrenaline and specific serotonin antidepressant (NaSSA)

A

Mirtazepine

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263
Q

Name an Selective Noradrenaline reuptake inhibitor

A

Reboxetine

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264
Q

What type of drug is trazadone

A

TCA

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265
Q

What type of drugs are Duloxetine and venlafaxine

A

Serotonin and Noradrenaline reuptake inhibitor (SNRI)

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266
Q

Renal colic 1st line investigation

A

Non contrast CT KUB

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267
Q

When shouldnt you give PR diclofenac for renal colic

A

obstructed kidneys or sepsis, give IV paracetamol instead

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268
Q

When do you remove renal stone

A

After the infection has been treated

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269
Q

Carpal tunnel

A

Median nerve, Loss of sensation in the thumb, index, mid finger.
OCP, pregnancy, heart failure, wrist trauma, RA, hypothyroid

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270
Q

Gram positive cocci

A

Streptococcus pyogenes and MRSA (methicillin resistant Staphylococcus aureus)

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271
Q

Gram negative rods

A

Escherichia coli, Pseudomonas aeruginosa and Haemophilus influenza

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272
Q

Gram negative cocci

A

Neisseria meningitidis

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273
Q

Treatment of impetigo

A

A 7 day course of oral aciclovir

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274
Q

Investigations for myeloma

A

Blood film and bone marrow aspirate
MRI spine and thoracic and lumbar spine XR
Serum electrophoresis and free light chains
Skeletal survey

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275
Q

Investigation of urge incontinence

A

Bladder diary/ frequency volume chart

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276
Q

Leading cause or urge incontinence in both men and women

A

Overactive bladder (detrusor overactivity)

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277
Q

What is the most common cause of lung mets

A

Breast

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278
Q

Do drugs help BPPV

A

No

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279
Q

Treatment of oesophageal candidiasis

A

Oral Nystatin

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280
Q

What nerve is in the parotid gland

A

Facial nerve

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281
Q

Which type of nerves does multiple sclerosis affect

A

Upper only

282
Q

Hepatotoxic drugs

A

Paracetamol
Erythromycin
Simvastatin

283
Q

Which illicit drug can cause parkinsons

A

Heroin

284
Q

Tongue ulcer and cervical lymphadenopathy, lung signs

A

Metastatic scc

285
Q

Cannon waves in jvp

A

Ventricular tachycardia and complete heart block

286
Q

Oliguria definition

A

<0.5ml/kg/hr or <400ml in 24hrs

287
Q

Who gets a carotid doppler

A

Outpatient after TIA

288
Q

Bony swelling and tenderness

A

Suspect bone tumour

289
Q

HPV in genital warts

A

6 and 11

290
Q

HPV in CIN

A

16 and 18

291
Q

Steps in speeding up labour

A

1) Artifical rupture of membranes

2) oxytocin infusion

292
Q

What is established labour

A

4cm and regular contractions

293
Q

Treatment of orthostatic hypertension

A

Fludricortisone

294
Q

Which eye signs can be in any type of thyroid eye disease

A

Lid retraction and lid lag

295
Q

When to DC shock AF

A

HR over 150

Chest pain

296
Q

Who cant have combined COCP

A
  • smoker (15 a day) and over 35

- within 6 weeks of giving birth

297
Q

Causes of ptosis

A

3rd nerve palsy
Horners
Age
Myasthenia gravis

298
Q

Does RAPD suggest problem with that eye or opposite

A

That eye

299
Q

Which branch of the trigeminal is the opthalmic

A

1st

300
Q

Virus for shingles

A

Herpes Zoster

301
Q

Mydriasis

A

Fixed dilated pupil in acute angle glaucoma

302
Q

Treatment of acute angle closed glaucoma

A

IV acetazolamide
Topical steroids
Pilocarpine

303
Q

Treatment of pyelonephritis

A

IV coamoxiclav

304
Q

OA examination findings

A

Crepitus
Limited range of motion
Abnormal gait

305
Q

Describe sclerodactyly

A

Thickening and tightening of skin

306
Q

What are ENA antibodies

A

ANA antibody subtypes screen

307
Q

First line treatment of gout if theyve had a gastric ulcer

A

Oral colchicine

308
Q

Treatment of PMR

A

Oral pred

309
Q

Causes of death in Ank Spond

A

Amyloidosis and Aortic valve disease

310
Q

Investigation of erythema nodosum

A

CXR

311
Q

First line treatment of OA

A

Oral Paracetamol

312
Q

Main treatment of Ank Spond

A

Exercise therapy

313
Q

Treatment of achilles tendon rupture

A

Equinus cast

314
Q

Test for achilles test

A

Simmonds or squeeze test

315
Q

Which nerve roots comprise the radial and ulnar nerves

A

C5-T1

316
Q

Which nerve roots comprise the median nerve

A

C8-T1

317
Q

Most common cause of wrist drop

A

Trauma

318
Q

Causes of bone mets

A

Breast
Prostate
Lung
Kidney

319
Q

Where do bone mets commonly occur

A

Spine
Pelvis
Ribs

320
Q

Mosaic wart

A

Cluster of warts
Sole of foot
Contagious so use veruca sock if swimming, avoid sharing showers

321
Q

Paronychia

A

infection around the nail

322
Q

Isotretinoin vs tretinoin

A

Tretinoin for mild acne

Isotretinoin for treatment resistant

323
Q

Most common areas for melanoma in men and women

A

Men torso

Women legs

324
Q

What is the biopsy called if it is a big lesion

A

Incisional biopsy

325
Q

Bullous pemphigold

A

Bullous on top of erythema, big rash.

Emolient and Pred

326
Q

Scalp ringworm

A

Requires oral not topical antifungals

327
Q

Discoid eczema

A

Well demarcated round patches

Topical Steroids

328
Q

Diagnosis of secondary syphilis

A

VDRL

329
Q

Signs of neuro syphilis

A

Tabes Dorsalis

Argyll Robertson Pupil

330
Q

Causes of rash on soles of feet and palms of feet

A

Syphilis

331
Q

How long after exposure for HIV seroconversion

A

2 weeks to 12 weeks

332
Q

How long after exposure for Secondary Syphilis

A

6 weeks to 6 months

333
Q

Diagnosis of PCP

A

Bronchoscopy and bronchoalveolar lavage

334
Q

Giardia Lamblia treatment

A

Metronidazole

335
Q

Why do you CT head before LP

A

To exclude raised ICP

336
Q

Herpes in pregnancy

A

Oral aciclovir in first 2 trimesters
Suppressive therapy
Dont need c section

337
Q

Vaginal candidiasis diagnosis

A

Vulvovaginal swab taken for direct gram-stain microscopy from the anterior fornix

338
Q

How is trichomonas vaginalis diagnosed

A

Posterior fornix swab taken for wet mount, to look for Trichomonas vaginalis

339
Q

Candida treatment

A

Any topical Azole- clotrimazole vaginal pessary

340
Q

What must you suspect in any bone swelling and tendernesss

A

Bone cancer

341
Q

Where does osteosarcoma affect

A

End of the bone

342
Q

Where does ewings sarcome affect

A

Mid shaft

343
Q

Do falls have to be referred to coroner

A

Yes

344
Q

Can you put cardiac arrest as main cause of death

A

No, shouldnt, its a symptom

345
Q

Rash affecting hands and soles

A

HIV, Syphilis, Measles, Erythema Multiforme

346
Q

What causes sudden death in hypertrophic cardiomyopathy

A

Arrythmia

347
Q

Treatment of dental pain

A

NSAID analgesia

348
Q

Which CURB65 score= severe

A

3 or more

349
Q

Whats an alternative to calcium gluconate

A

Calcium chloride

350
Q

Carcinoid syndrome

A

flushing, diarrhoea, bronchospasm, weight loss and hyper and hypotension. Heat Disease

351
Q

Testing for infectious mononucleosis

A

Monospot

Paul Bunnell

352
Q

Which part of the colon is intraperitoneal

A

Transverse

353
Q

What should you do if doesnt respond to SSRI in anxiety

A

Swap to another

354
Q

Maximum duration of benzos for anxiety

A

2-4 weeks

355
Q

How does post op uti present

A

Asymptomatic

356
Q

Atypicals used for psychosis

A

Quetiapine, Olanzapine, Aripiprazole

357
Q

Which antihypertensive drug can cause low mood

A

Beta blockers

358
Q

% manic patients which get depression

A

Over 90

359
Q

Acute mania treatment

A

Antipsychotics and benzos

360
Q

Diagnosing post natal depression

A

Ask about anhedonia and low mood

Then give Edinburgh Post Natal Depression Score

361
Q

Bulimia symptoms

A

hypokalemia, hypocalcaemia, hypotension and a decreased red blood cell count

362
Q

Tool for assessing risk of violence

A

HCR 20

363
Q

Tool for assessing psychopaths

A

PCL-R

364
Q

Treatment of EUPD in GP

A

Refer to community mental health team for formal diagnosis

365
Q

Most common cause of a learning disability

A

Low socioeconomic class

366
Q

What is overshadowing

A

When presenting symptoms are assumed to be caused by background diagnosis but are actually not

367
Q

Atypicals

A

Aripiprazole
Olanzapine
Risperidone

368
Q

First line for severe Alzheimers

A

Memantine

369
Q

When do paracetamol levels peak after overdose

A

4 hours

370
Q

Wehn should you give activated charcoal

A

If present within an hour

371
Q

Which drugs go IV

A

Heroin
Cocaine
Amphetamines

372
Q

Most common cause of suicide in both men and women

A

Hanging

373
Q

% people who attempt suicide who have mental illness

A

Over 90%

374
Q

% suicide who have self harmed before

A

50%

375
Q

Islet autoantibodies to rule out T1DM

A

Islet cell autoantibody, GAD65, ZnT8

376
Q

Non diabetic causes of hyperglycaemia

A

Endocrine: Cushing’s, acromegaly, phaeochromocytoma
Medications: steroids, SGA
Exocrine pancreas: CF, pancreatitis, amyloidosis, haemochromatosis

377
Q

DKA triad

A

Diabetic = glucose>11
Keto = ketones in blood/ urine
Acidosis HCO3<15, pH<7.3

378
Q

Common differential for depression

A

Hypothyroidism

379
Q

Treatment of moderate- severe depression

A

Refer for CBT and offer to start sertraline

380
Q

Which hallucination is a schneiderian 1st rank symptom

A

3rd person- commentary or discussing them

381
Q

Examinations for lower mn facial palsy

A

Otoscopy
Palpation of the parotid gland and neck
Movement of the facial muscles

382
Q

Causes of facial nerve palsys

A

Bells
Heerfort’s syndrome- sarcoidosis
Mucoepidermoid carcinoma of the parotid- most common parotid cancer

383
Q

What causes hyperacusis (sensisitivity to loud noise)

A

Facial nerve palsy as supplies the motor supply to the stapedis

384
Q

Swallowed foreign body possible complications

A

Oesophageal perforation

Retropharyngeal abscess

385
Q

Lung mets are what cancer until proven otherwise

A

Colon

386
Q

When would you use central venous access

A

If elderly and risk of heart failure so need accurate idea of fluid statsu

387
Q

Treatment of a non shockable rhythm

A

Adrenaline every 3-5 minutes and cpr

388
Q

Scarlet fever

A

Strawberry tongue and pharyngitis.

389
Q

Complications of tonsilitis

A

Quinsy- urgent ENT referral ?tonsillectomy

390
Q

Depression causing medication

A 
Corticosteroids
Oral Contraceptives
Statins
Ranitidine 
Beta blockers
391
Q

Bloods for IBS

A

FBC
ESR and CRP
TFT

392
Q

Which serum level do you need in order to interpret CSF results

A

Plasma glucose

393
Q

Treatment of ringworm

A

Oral terbinafine

394
Q

Which ethnic group gets obstetric cholestasis

A

Asian

395
Q

Is ESR reliable in pregnancy

A

No will be raised anyway

396
Q

How many UTIs needed for child to have renal ultrasound

A

Under 6 months=1

Over 6 months= recurrent

397
Q

Contraindications to HRT

A

Undiagnosed vaginal bleeding
Pregnancy
History of venous thrombosis

398
Q

Which drug can bring on gout

A

Aspirin§

399
Q

Investigations for acute epilepsy

A

Blood glucose
MRI
(EEG used in opd setting)

400
Q

Why does asthma get worse in pregnancy

A

People often get GORD in pregnancy

401
Q

Which antibody in breastmilk

A

IgA

402
Q

Does breast milk or formula cause more diarrhoea and vomitting in infants

A

Breast milk causes less diarrhoea and vomitting

403
Q

Indurated ulcer on side of tongue, smoker

A

Squamous cell carcinoma

404
Q

Heavy dragging feeling of the testes

A

Suggestive of tumour

405
Q

Testicular cancer surgery

A

radical inguinal orchidectomy

406
Q

Which testicular tumour produced AFP

A

Teratoma

407
Q

What cause gout

A

Meat, seafood, alcohol (not cheese)

408
Q

In children does high fever suggest bacterial

A

Not necessarily

409
Q

How do you change steroid doses in hypoadrenalism when ill

A

Double

410
Q

Sail sign

A

Left lower lobe collapse

411
Q

Why does asthma get worse in pregnancy

A

People often get GORD in pregnancy

412
Q

Which antibody in breastmilk

A

IgA

413
Q

Does breast milk or formula cause more diarrhoea and vomitting in infants

A

Breast milk causes less diarrhoea and vomitting

414
Q

Indurated ulcer on side of tongue, smoker

A

Squamous cell carcinoma

415
Q

Heavy dragging feeling of the testes

A

Suggestive of tumour

416
Q

Testicular cancer surgery

A

radical inguinal orchidectomy

417
Q

Which testicular tumour produced AFP

A

Teratoma

418
Q

What cause gout

A

Meat, seafood, alcohol (not cheese)

419
Q

In children does high fever suggest bacterial

A

Not necessarily

420
Q

How do you change steroid doses in hypoadrenalism when ill

A

Double

421
Q

Sail sign

A

Left lower lobe collapse

422
Q

Can you take paracetamol when you give vaccine

A

No dont cos wanna be able to see if fever

423
Q

Investigation when upper GI bleed but not seen on OGD

A

Mesenteric Angiography

424
Q

What electrolyte changes happen after vomiting

A

hypochloraemic, hypokalaemic metabolic alkalosis

425
Q

Diagnostic test for pyloric stenosis

A

Ultrasound abdomen

426
Q

pyloric stenosis treatment

A

Ramstedt’s pyloromyotomy

427
Q

What causes rheumatic fever

A

Group A beta haemolytic strep

428
Q

Treatment of rheumatic fever

A

Admit and bed rest
Im benpen
10 day oral amox

429
Q

Symptoms of rheumatic fever

A

Sore throat then new murmur.

Pericardial rub, sydenhams chorea, conduction defects

430
Q

Do you need to wait for troponin for acute mi diagnosis

A

No

431
Q

Cardiogenic shock and low blood pressure treatment

A

CPAP. CPAP pushes fluid back into vessels

432
Q

Type A aortic dissection

A

Ascending aorta

433
Q

Type B aortic dissection

A

Descending aorta

434
Q

LV Strain pattern on ECG

A

Big R waves in V6

435
Q

RV Strain pattern on ECG

A

Big R waves in V1

Big S waves in V5/6

436
Q

LV strain pattern on ECG

A

Big S waves in V1

Big R waves in V5/6

437
Q

Bleeding and warfarin

A

Prothrombin complex

438
Q

Why do you ultrasound in infective endocarditis

A

Splenic infarcts

439
Q

Criteria for IE

A

Major diagnostic criteria include more than one positive blood culture (typical organism in 2 separate cultures or presistently positive blood cultures), or positive echocardiogram findings of vegetation, abscess or abscess prosthetic valve.

Minor criteria include:

predisposition (cardiac lesion, IV drug abuse);
fever over 38 °C;
vascular signs, e.g. mycotic emboli, Janeway lesions (painless palmar/plantar macules);
immunological signs e.g. Oslers nodes (painful swelling fingers/toes), positive RhF, glomerulonephritis
microbiological evidence not fitting major criteria.
Diagnosis is made on 2 major, 1 major/3minor or >5 minor criteria.

440
Q

Digoxin ECG

A

Sloping ST depression in V5 and V6

441
Q

If the TB is drug resistant what do you add

A

streptomycin and ciprofloxacin

442
Q

What type of hypersensitivity is asthma

A

1

443
Q

Angle of safety position

A

6th intercostal space, mid-axillary line

444
Q

Causes of pneumothorax

A 
Marfans
Asthma
COPD
Mechanical ventilation
rib fracture
445
Q

where are the ascending and descending aorta in the body

A

Ascending near the front, descending near the back

446
Q

What posture is helpful for svc

A

head up

447
Q

What type of drug is theophylline

A

Phosphodiesterase inhibitor

448
Q

What causes consolidation on chest x ray

A

alveoli filled with something- air, fluid, mass

449
Q

Treatment of pen allergic pneumonia

A

Clarithromycin

450
Q

Features of sarcoid

A

Hypercalcaemia
Lung fibrosis
Hepatosplenomegaly
Uveitis

451
Q

What should the CO2 be like in severe asthma and what is a worrying sign

A

Should be low, so if it is normal then that is concerning that it is going up

452
Q

Steroid side effects

A

Osteoporosis
Diabetes
Weight gain
Increased rates of infection

453
Q

How do you notify the authorities of a disease

A

Notify the Health Protection Consultant in office hours/through a notification form

454
Q

Which asthma medications should you change during pregnancy

A

None, keep them the same

455
Q

Treatment of oesophageal stricture

A

Balloon dilatation

456
Q

Which extra GI manifestations are due to the activity of the colitis

A

Episcleritis

Erythema nodosum

457
Q

IV PPI in varices

A

Dont give ppi before endoscopy

458
Q

Treatment of varices if banding hasnt worked

A

Insertion of Sengstaken-Blakemore tube

459
Q

How long to give LMWH for when giving warfarin too

A

5 days or until therapeutic INR, whichever is longer

460
Q

What is the cause of ascites in alcoholic hepatitis

A

Cirrhosis

461
Q

Treatment of autoimmune hepatitis

A

Pred and azathioprine

462
Q

Pancreatic cancer options

A 
Mild= Whipples Procedure
Severe= stent
463
Q

Chronic pancreatitis on AXR

A

Calcification in the pancreatic area

464
Q

Imaging fo chronic pancreatitis

A

CT

465
Q

Anti smooth muscle antibodies

A

Autoimmune hepatitis

466
Q

Biologic options for crohns

A

Anti-integrin therapy (Vedolizumab)
Anti-interleukin therapy (Ustekinumab)
Anti-TNF antibody treatment (Infliximab or Adalimumab)

467
Q

Cause of duodenal ulcer when not on nsaid

A

H pylori (if confirmed on colonoscopy you dont have to test for)

468
Q

tests for IDA

A

Colonoscopy and gastroscopy

469
Q

Which organisms can mimic crohns

A

TB

Yersinia

470
Q

Pancreatitis management

A

IV fluids
IV analgesia
ABG

471
Q

Complications of acute pancreatitis

A

Pancreatic pseudocyst

472
Q

Faecal elastase

A

Exocrine pancreatic function

473
Q

Which solid organ is most commonly injured in trauma

A

Spleen. May need laparotomy and splenectomy

474
Q

Symptomatic gallstone without CBD stone or dilation

A

Lap Chole this admission

475
Q

Glasgow score for pancreatitis

A 
PaO2
WCC
Serum calcium
urea
LDH
Albumin
Glucose
476
Q

Imaging of fibroadenoma or cysts etc

A

First mammogram then US then core biopsy/needle aspiration then either discharge or excise if big

477
Q

How long should you continue insulin infusion for

A

Until ketones are under 0.3

478
Q

Sedation in parkinsons

A

Lorazepam as haloperidol contraindicated

479
Q

Rhabdomyolysis CK

A

Over 10000

480
Q

How to detect C spine fracture

A

CT neck

481
Q

How long after surgery do you get PE

A

10 days

482
Q

Investigation for IE

A

Transoesophageal echo

483
Q

Do you always treat AF

A

Not if asymptomatic and rate controlled and chadsvasc is 0

484
Q

Bleeding duodenal ulcer

A

Gastroduodenal artery

485
Q

Gout and CKD

A

Give pred not nsaid

486
Q

All the fluid in the lungs, low BP, no urine output.

I.e. overloaded but in the wrong places

A

Noradrenaline is used for vasoconstriction

487
Q

Which part of the brain is affected first in alzheimers

A

Temporal

488
Q

Fibrosis but without clubbing

A

From amiodarone

489
Q

Treatment of acute mania

A

antipsychotic- quetiapine, risperidone, olanzapine

490
Q

Mitral stenosis

A

Apex beat tapping, low rumbling murmur, caused by rhuematic fever

491
Q

What are blast cells suggestive of

A

Acute leukaemia

492
Q

CLL

A

Smudge

493
Q

Translocation 9:22

A

Philadelphia chromonsome

494
Q

Myeloma causes what in bones, what do mets cause

A 
Myeloma= lytic
Mets= sclerotic
495
Q

Initial steps for nose bleed

A

Sit the patient up with the neck flexed, and tell the patient to press the soft part of the nose below the nasal bones
Ice pack

496
Q

First investigation for ITP

A

Blood film

497
Q

Treatment of frequent sickle cell crisis

A

Hydroxycarbamide

498
Q

When does subacute degeneration of the cord occur

A

When you replace folate without B12

499
Q

Tumour lysis syndrome

A

Hyperkalaemia
Hyperphosphataemia
Hyperuricaemia
Hypocalcaemia

500
Q

Cause of purpuric rash

A

Meningococall sepsis

Pneumococcal sepsis
Staphylococcal

501
Q

When would you not give ceftriaxone for meningitis

A

Only if previus life threatening reaction

502
Q

What perspective is imaging

A

You are always looking up from feet

503
Q

Most common cause of TIA

A

Carotid artherosclerosis

504
Q

In young adults whats the most common cause of meningitis

A

Viral

505
Q

Should you LP and blood culture before antibiotics in meningitis

A

Only if it wont delay treatment

506
Q

Hypokalaemia causes

A

Reduced ingestion
Increased excretion
Loop or thiazide diuretics

507
Q

Hypokalaemia features

A 
Absent reflexes
Constipation
Cramps
Weakness
Tiredness
508
Q

Reintroduction of potassium

A

Not at a rate of more than 10mmol/hr

509
Q

Chornic management of hyperkalaemia

A

Low potassiumd diet

510
Q

Nephrotic in adults

A

Membranous glomerulonephritis

511
Q

Enlarged gall bladder is always suspicious for what

A

Head of pancreas tumour

512
Q

Incubation period for HCV

A

4-20 weeks

513
Q

Complications of legionnaires

A

Endocarditis, pericarditis, pancreatitis, pulmonary fibrosis, respiratory failure

514
Q

Which cancers are associated with EBV

A

Nasopharyngeal cancer and Burkitt lymphoma

515
Q

Types of noicieptive pain

A

Somatic and visceral pain

516
Q

Types of neuropathic pain

A

Allodynia

Dysesthesia

517
Q

Opioids for renal failure

A

Alfentanil

518
Q

What imaging if confused after seizure and hasnt returned to baseline

A

CT head

519
Q

features of aura (smell and fear) and posturing with automatisms without complete loss of consciousness

A

Temporal epilepsy

520
Q

Treatment of Guillain Barre

A

IVIG and plasma exchange

521
Q

Investigation of Guillain Barre

A

Lumbar puncture

Nerve conduction studies

522
Q

Prognosis of GBS

A

90% fully recover

523
Q

Which nerve causes foot drop

A

Common peroneal nerve

524
Q

Visual symptoms of papilloedema

A

Enlarged blind spots and constricted fields

525
Q

What should you also prescribe in diseases with gait disturbance

A

Physiotherapy

526
Q

Investigations for essential tremor

A

Clinical, just do bloods to exlude hyperthyroid and anaemia

527
Q

First lines for essential tremor

A

Primidone

Propranolol

528
Q

Things present in true parkinsons but not drug induced

A

Dyskinesia
Levodopa improved symptoms
Unilateral rest tremor

529
Q

Scan for parkinsons

A

DaTscan

530
Q

How is CIN different from cervical cancer

A

Cells have not invaded the basement membrane

531
Q

Which lobe causes Somatosensory neglect

A

Parietal

532
Q

Further investigtions after EEG in epilepsy

A

ECG

Refer to neurology

533
Q

Which drugs do you give when giving chemo

A

Aciclovir
Allopurinol
Cotrimoxazole

534
Q

Lifetime risk of breast cancer in women

A

1 in 8

535
Q

Chemo after surgery

A

Adjuvant chemo

536
Q

Chemo before surgery

A

Neo adjuvant chemo

537
Q

Side effects of anastrozole

A

Joint aches

538
Q

Metastatic cord compression treatment

A

Radiotherapy and surgical decompression

539
Q

5Ds of charcot arthropathy on CXR

A 
Density changes
Destruction
Debris (loose bodies and bone fragments)
Distension (joint effusion)
Dislocation
540
Q

Causes of pneumothorax

A

Asthma
COPD
Liver biopsy
Chest drain insertion

541
Q

Sigmoid vs Caecal volvolus

A 
Sigmoid= LBO
cAECAL= sbo
542
Q

Differences between LBO and SBO

A

Peripheral distribution
Presence of haustration
Presence of faeces

543
Q

Lines across the bowel in LB vs SB

A 
LB= haustration
SB= valvular conniventes
544
Q

When do you use an IVC filter

A

When recurrent PEs despite coagulation

545
Q

High fever and bone pain

A

Osteomyelitis

546
Q

Diseases associated with pseudogout

A

hyperparathyroidism, hypothyroidism or haemochromatosis

547
Q

Which drug is contraindicated in heart block

A

Beta blockers

548
Q

How long after ingestion do you take a paracetamol level

A

4hours

549
Q

What do you need to do with all patients who have had an OD

A

Psych referral

550
Q

Most sensitive marker of liver dysfunction after paracetamol overdose

A

PT or INR

551
Q

Advice to people with HTN

A

Salt restrict and lose weight

552
Q

Should you up dose of existing or start new drug for HTN

A

Up dose of existing

553
Q

Bendroflumethiazide action

A

It inhibits sodium reabsorption in the early distal tubule via the Na-Cl co-transporter

554
Q

What to call fibrosis when suspected but not confirmed cause

A

Fibrosing alveolitis

555
Q

Drugs which cause fibrosis

A

Nitrofurantoin
Amiodarone
Sulfasalazine

556
Q

Can you use amiodarone for bradycardias

A

No

557
Q

Risk of stroke doubles and risk of MI x1.5 for each …mmHg rise in HTN

A

15

558
Q

What is the cause of renal artery disease in young women

A

Angiodysplasia

559
Q

Amlodipine and atorvastatin can cause

A

GORD

560
Q

How does H pylori eradication improve GORD symptoms

A

It doesnt

561
Q

Risk factors for H Pylori

A

Low socioeconomic status

Crowded living conditions

562
Q

FAP

A

Thousands of polyps

563
Q

HNPCC

A

One big polyp

564
Q

Peutz Jheuger

A

Polyps and pigemented mouth lesions

565
Q

Treatment of single lung met

A

Surgical removal

566
Q

Which fibres are acted on by local anaesthetic as they transmit pain and temprature sense

A

Small C fibres

567
Q

Physical threat from a patient response

A

Leave situation and call security

568
Q

Which electrolyte abnormality can heparins cause

A

Hyperkalaemia

569
Q

patient perception of pain 7-8

A

Strong opioid is appropriate

570
Q

which antiemetics can be used in parkinsons

A

Ondansetron

Cyclizine

571
Q

OTC for OA pain

A

Paracetamol

572
Q

Which drugs shouldnt be taken with antiretrovirals

A

Statins

Fluticasone

573
Q

Contraindications to atropine

A

MG

Paralytic ilues

574
Q

Faecal softener

A

Docusate

575
Q

Osmotic laxatives

A

Lactulose

Macrogol

576
Q

How long does lactulose take to act

A

2-3days

577
Q

What type of drug is digoxin

A

Cardiac glycoside

578
Q

When do you commence detox regime with chlordiazepoxide

A

Only when sobered up

579
Q

Define pain

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage

580
Q

Something to tell people taking methotrexate and folic acid

A

Avoid multivitamins as these will include folate which they are already taking

581
Q

Drug good against MRSA

A

Vancomycin

582
Q

How many standard errors is the confidence interval

A

2 either side

583
Q

What type of drug is adrenaline

A

Non selective adrenergic agonist

584
Q

25 micrograms fentanyl patch is equivalent to what dose of morphine

A

90

585
Q

Which laxative to go with morphine

A

senna

586
Q

Which structures go through the parotid gland

A

Facial nerve
External carotid artery
Retromandibular vein

587
Q

Most common thyroid cancer

A

Papillary carcinoma

588
Q

Midline neck lumps

A

thyroid nodule, a thyroglossal duct cyst and a dermoid cyst

589
Q

Treatment of primary haemorrhage after thyroid surgery

A

High flow oxygen and remove surgical clips

590
Q

If someone comes in with teeth out what should you do

A

Anaesthetise and reimplant teeth asap

591
Q

Upper aerodigestive tract tumours

A

Squamous cell

592
Q

Common non accidental injury sites

A

Retinal Haemorrhages

Rib Fractures

593
Q

Treatment of osteomyelitis

A

IV antibiotics then surgical debridement

594
Q

Which foot condition is associated with developmental dysplasia of the hip

A

Talipes

595
Q

Slapped cheek disease

A

Parvovirus B19

596
Q

Two XRay views for SUFE

A

AP and frog lateral

597
Q

Haemophilia inheritance

A

X linked recessive

598
Q

Consequence of neonatal jaundice

A

Kernicterus

599
Q

What should you give haemolytic anaemia jaundiced babies to prevent further anaemia

A

Folic acid

600
Q

Investigations for diagnosis of HSP

A

FBC, clotting screen, renal function, and urine dipstick

601
Q

Causes of bloody diarrhoea

A

Salmonella

E Coli

602
Q

Describe the mass in intussuseption

A

Right upper quadrant, sausage shaped mass

603
Q

What is the most common type of intussuseption

A

Ileocolic

604
Q

Two investigations to confirm air enema

A

Ultrasound and air contrast enemas

605
Q

Twice as potent as oral morphine

A

Subcut morphine

606
Q

options for respiratory distress when normal oxygen saturations

A

Hand held fan

Teaching him/ his wife acupressure points

607
Q

Good medications for opioid constipation

A

Glyceride suppositories

Senna

608
Q

Requirements for advanced decision to refuse treatment

A

Must be written down
Must be hand signed by patient
Must be created when patient has capacity
Must be witnessed

609
Q

Bad signs for end stage COPD prognosis

A

Low BMI
LV failure
Frequent exacerbations

610
Q

Investigations for hydronephrosis

A

KUB
then
IV urogram

611
Q

Haematuria first line imaging

A

Ultrasound renal tract

612
Q

RF for RCC

A

Smoking
FH
Obesity
Von HIppel Laudua

613
Q

Torsion first line investigation cos its really quick

A

Dipstick urine

614
Q

Most common group for testicular torsion

A

11-30

615
Q

Causes of raised PSA

A

BPH, UTIs, Acute and chronic prostatitis, retention, on catheterisation, taking biopsies of the prostate, TURP, ejaculation

616
Q

Common presenting complaint of RCC

A

Haematuria

617
Q

Tachypnoea, hypoxia, hypotension and pulmonary oedema within 6 hours of transfusion

A

TRALI- transfusion related acute lung injury

618
Q

Mild temperature rise shortly after transfusion

A

A febrile, non haemolytic reaction

619
Q

Allergic reaction to transfusion symptoms

A

Urticaria, angioedema, wheeze and pruritis

620
Q

Increase in temperature and pulse rate, abnormal bleeding and Low BP after transfusion

A

ABO incompatbility

621
Q

Which artery causes posterior nose bleeds

A

Sphenopalatine

622
Q

What do you want to do if you think someone might have broken their nose

A

Anterior rhinoscopy to exclude septal haematoma

ENT clinic in 7-10days

623
Q

Mesenteric adenitis

A

Appendicitis and URTI

624
Q

How to treat appendicitis

A

Appendectomy

625
Q

Post op reduced bowel sounds

A

Small bowel ileus

626
Q

Pseudoobstruction

A

Post surgery, can be caused by electrolyte disturbance

Colonic decompression

627
Q

Pseudomembranous colitis

A

From C dificile, before toxic megacolon

628
Q

Threshold for transfusing patients without cardiovascular disease

A

80g/L

629
Q

Does intraop hypothermia increase or decrease blood loss

A

Increases as impairs clotting

630
Q

Colorectal cancer diagnosis

A

Colonoscopy with biopsy

631
Q

Most common inguinal hernia

A

Indirect

632
Q

How can you differentiate a femoral and inguinal hernia

A

Inguinal is superior and medial to the pubic tubercle

633
Q

Inguinal canal contents

A

Spermatic cord

634
Q

What should you do if routine operation and anaemic

A

Correct and delay operation

635
Q

How to reduce risk of aspiration during surgery

A

Rapid sequence induction

Administer antacid before anaesthesia

636
Q

Liver biopsy risks

A

Pneumothorax
Biliary peritonitis
Shoulder pain

637
Q

Upper age limit of baby for abortion

A

24 weeks

638
Q

Who can make an advanced directive

A

Anyone over 18

639
Q

Which pathway does warfarin affect and INR measure

A

Extrinsic

640
Q

Which pathway does APTT measure

A

Intrinsic

641
Q

Which routes can warfarin be given

A

Only oral

642
Q

Dose for immediate NAC

A

150mg/kg

643
Q

Major bleed and needs warfarin reversal

A

Prothrombin complex

644
Q

Does the patient have a pulse with ventricular fibrillation

A

No

645
Q

Electrolyte abnormality caused by hypothyroid

A

Hyponatraemia

646
Q

What causes pseudo dementia

A

Depression

647
Q

Where is the blockage for a TACS

A

Middle cerebral artery

648
Q

Ischaemic stroke: should you treat high blood pressure

A

No, monitor for now

649
Q

Two most common types of dementia

A

Alzheimers and Vascular

650
Q

Dementia brain scan

A

CT (excludes space occupying lesion)

651
Q

Who can fill out cremation form 5

A

Someone from a different team or practise who has been qualified for atleast 5 years

652
Q

Which diabetes drug causes fluid retention/ heart failure

A

Glitazones

653
Q

Which diabetes drug causes lactic acidosis and diarrhoea

A

Metformin

654
Q

On metformin and normal weight

A

Sulfonylurea- gliclazide

655
Q

On metofrmin and no risk factors for osteoporosis

A

Pioglitazone

656
Q

Confusion Bloods

A

U&E, FBC, LFT, glucose, CRP, calcium, B12 & folate, ferritin, iron and transferrin, TFT, vitamin D.

657
Q

COMT inhibitor

A

Entacapone

658
Q

Dopamine agonist

A

Bromocryptine

659
Q

MAOB inhibitor

A

Selegiline

660
Q

Essential tremor

A

Symmetrical
Improves with alcohol
Propanolol and primdione

661
Q

Experiencing pain from stimuli that are not normally painful

A

Allodynia

662
Q

Causes of peripheral neuropathy ABCDE

A 
Alcohol
B12 deficiency
Cancer
CKD
Diabetes
Drugs (isoniazid)
Every vasculitis
663
Q

Triggering pathogens for guillain barre

A

Campylobacter jejuni
Cytomegalovirus
EBV

664
Q

First line treatment of chronic open angle glaucoma

A

Prostaglandin eye drops (causes eyelash growth and eyelid pigmentation) (latanoprost)

665
Q

Name three medications for open angle glaucoma

A

Latanoprost (prostaglandin)
Timolol (beta blocker)
Brinzolamide (carbonic anhydrase inhibitor)
Brimonidine (alpha 2 antagonist)

666
Q

Which medications can cause acute angle closure glaucoma

A

Tricyclic antidepressants

Anticholinergic medications

667
Q

Halos around lights

A

Acute angle closure glaucoma

668
Q

Treamtent of acute angle closure glaucoma

A

Supine without pillow
Pilocarpine
Acetazolamide
Laser iridotomy

669
Q

5 signs of hypertensive retinopathy

A

AV nipping

then just same signs as diabetic

670
Q

Cataracts reflex

A

Red reflex missing

671
Q

Starbusts around lights

A

Cataracts

672
Q

How to treat episcleritis

A

Lubricating eye drops (baso just injured episclera)

673
Q

Stain used in opthalmology

A

Fluroescin

674
Q

Management of painful red eye in GP

A

Same day opthalmology referrale

675
Q

Eye drops to test for horners

A

Cocaine

676
Q

Painless flashes and floaters

A

Posterior vitreous detachment

677
Q

Treatment of posterior vitreous detachment

A

None.

Exclude retinal tear and retinal detachment

678
Q

Treatment of retinal tear

A

Laser therapy

679
Q

Treatment of retinal detachment

A

Vitrectomy and replacement

680
Q

Causes of CRVO

A

Leukaemia
Myeloma
HTN
Diabetes

681
Q

Cause of CRAO

A

GCA

682
Q

Night blindness

A

Retinitis pigmentosa

683
Q

Give two causes. of dementia

A

HIV

Parkinsons

684
Q

Doses for anaphylaxis

A

200mg IV hydrocortisone

10mg IV chlorphenamine

685
Q

Which rule is used for estimating burns coverage

A

Rule of 9s

686
Q

How to calculate fluid requirement in burns

A

4ml x weight in kg x % burnt

687
Q

What should you do with blisters in burns

A

De-roof blistered areas, dress with non-adherent dressing and review in dressing clinic in 48 hours.

688
Q

Monitoring for oral terbinafine

A

LFTs

689
Q

Thickened and scaly skin with fissures

A

Contact dermatitis

690
Q

Psoariasis treatmetn

A

Calcipotriol

691
Q

What are seborrheic warts also known as

A

Basal cell papilloma

692
Q

Amoxicillin and EBV

A

Avoid

693
Q

Bupropion

A

Start 7 days before stop smoking

CI seizures, liver, anorexia

694
Q

Options for steroid delivery for RA

A

IM
Intraarticular
Oral

695
Q

Septicaemia definition

A

multiplication of bacteria in the bloodstream

696
Q

Migraine prophylaxis

A

propranolol, amitriptyline and topiramate

697
Q

Alternative to statins

A

Ezetimibe

698
Q

Rash which starts behind ears

A

Measles

699
Q

Complications of measles

A

Encephalitis
Subacute sclerosing panencephalitis
Bronchopneumonia

700
Q

Keratoacanthoma differential diagnosis

A

SCC

701
Q

ALARMS symptoms

A 
Anaemia
Loss of weight
Anorexia
Recent
Mass
Swallowing difficulties

FINALS (8 decks)

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