Capsule Flashcards
Causes of cavitating lung mass
Bacterial lung abscess Metastatic SCC GPA Pulmonary infarct Pneumonia
Bacteria which cause cavitation are common in homeless people
S Aureus
Klebsiella
Mycobacterium Tuberculosis
Ear pain and then facial muscle weakness
Bells palsy
Ear rash and then facial muscle weakness
Ramsay hunt syndrome
Which nerve supplies the anterior tongue taste
Facial
Which nerve causes bells palsy
Facial
Investigation for bells palsy
Nerve conduction studies if palsy persists (to look for axonal degeneration)
Whats the prognosis like for bells palsy
Most people recover
Causes of macrocytosis
Pregnancy, Alcohol, Folate deficiency, B12 deficiency
Treatment of alcohol withdrawal
Bezodiazepines based off symptom score
Wernickes treatment
Thiamine as rapid bolus
Thomas’ test
Fixed flexion deformity of opposite hip, osteoarthritis is the most common cause
Normal resp rate for under 5s
30
Upper limit of normal heart rate in under 5s
150
Risks for UTI
Diabetes, renal stones, sex
Which kids should get a renal ultrasound for UTI
1 UTI + Under 6 months= within 6 weeks
Recurrent UTI + Under 6 months= during admission
Recurrent UTI + over 6 months= 6 weeks
Which asthma drugs can cause hypokalaemia
Salbutamol, prednisolone and theophylline
Theophylline monitoring
Cardiac monitoring when giving IV
Salbutamol side effects
Tremor, tachycardia, sleep disturbance
What visual change would a lesion in the optic radiation cause
Superior quadrantopia
Symptoms of acromegaly not in the face
Cardiomegaly
Colonic polyps
Hepatosplenomegaly
Diabetic retinopathy
Investigations for acromegaly
Oral glucose tolerance test
MRI pituitary
40 year old hearing loss, bilateral
Otosclerosis
Most likely cause of hearing loss in a child
Glue ear
glue ear mechanism
Eustachian tube dysfunction results in negative pressure in the middle ear cleft and subsequent middle ear effusion
1st line treatment of glue ear
surveillance
Causes of secondary hypertension
Renal Artery stenosis
Polycystic kidney disease
Coarctation
Cushings Conns Phaeochromocytoma Acromegaly Hypothyroid
Treatment of phaochromocytoma
Alpha blockade then beta blockade
Pharmacological options for stopping smoking
NRT, varenicline, bupropion
Treatment of a SAH
Coiling and clipping of any aneursym
Inpatient fluids for dialysis patient
Dont need
Causes of surgical emphysema
Oesophageal tear
Fractured rib
Pleural biopsy
Child has jumped off a wall
Calcaneal fracture. Most commonly fractured talus bone, 10% bilateral and also associated with spinal injuries.
Salter harris classification
Describes how fractures involve the growth plate in children. 1-2 good prognosis, 5 involves the growth plate
Who gets PBC and autoimmune hepatitis
Women
3 tests for hereditary haemochromotasosi
Serum iron, total iron binding capacity and ferritin
Complications of haemochromatosis
skin pigmentation diabetes (pancreatic deposition) cardiomyopathy hepatic cirrhosis chondrocalcinosis and arthropathy hypogonadism and pituitary dysfunction
Why do people get AKI after shock
Acute tubular injury
Chance of recovery from AKI
80%
Hyperkalaemia ECG
Prolonged PR interval, small tall or “tented” T waves and wide QRS complex
J waves on ECG
Hypothermia
Phenylketonuria
AR, Low phenylamine diet and amino acid supplements
Smooth disc like swelling in one breast in a male
Gynaecomastia
Which drugs cause gynaecomastia
Finasteride, PPI, Spironolactone
Muscles responsible for shoulder abduction
Deltoid and supraspinatus
Nerve supplying deltoid
Axillary
S1
Sole of foot
L2
Upper anterior thigh
L1
Groin
S3
Buttock
L4
Calf
What does Coombs positive suggest
Autoimmune mediated so remove insult and give corticosteroids
Does CLL have a good prognosis
Incurable unless bone marrow transplant in young person
Splenectomy guidance
Vaccinations (Flu, pneumococcal, Men C, Hib) before surgery and prophylactic antibiotics for two years after
Laparoscopy or lapartomy if pelvic mass
Laparotomy as will need to remove mass
Amiodarone side effects
Blue-gray skin
Gram negative bacillus
E Coli, H influenza
Gram positive bacillus
Listeria monocytogenes, Bacillus cereus
Fitz hugh curtis syndrome
Hepatitis after PID
Common side effect of bacterial meningitis
Sensorineural deafness
Drug for chemoprophylaxis of meningitis
Rifampicin (ciprofloxacin ok but off license)
Do MR and Ultrasound use radiation
no
Raised mole surrounded by flat mole
Compound naevus
Flat and coloured mole
Junctional naevia
Raised mole
Dermal naevus
Benign mole in area prone to mechanical irritation such as razoring and irritation by clothes
Excision reasonable
malaise, a widespread maculopapular rash (involving palms and soles) and orogenital ulcers
secondary syphilis
Symptom of secondary syphilis
Macropapular rash
Testing for secondary syphilis
VDRL testing
Syphilis pupil
Argyll Robertson pupil
Which is the most common lung cancer
Adenocarcinoma
Tests for HCC
Also do AFP and CXR
Can hydroceles be felt seperate to the testes
No
What word is used to describe increased bone density
Sclerosis
Causes of osteosclerosis
Metastatic cancer
Sickle cell disease
Treatment of metastatic prostate cancer
Antiandrogens
Two common types of HPV
16 and 18
What type of ovarian cyst is most likely to tort
Dermoid
Whats the difference between BV and trichomonas
BV fishy, clue cells, no itch
Trichomonas, itchy, smelly, strawberry cervix
Treatment of Bartholins cyst
Marsupialisation
Treatment of imperforate hymen
Incision of hymen (not excision)
First line treatment of stress incontinence
Pelvic floor training
Surgeries for stress incontinence
Urethral bulking agent
Mid urethral sling
Burch colposuppression
Investigation for urgency incontinence
Frequency volume chart
Treatment of urgency incontinence
Bladder drill
Fluid advice
Local oestrogen
Smoking cessation
How do you treat non ruptured ectopics
Methotrexate
How do you treat ruptured ectopics
urgent laparoscopy
What should you complete after an someone falls on the ward
DATIX
What would you use to sedate an elderly patient
0.5mg lorazepam
What would you use to treat faecal impaction
8 sachets of laxedo
What counts as a postural drop
20+/10+
cANCA
Wegeners GPA
Is DDimer useful in pregnancy
No
CTPA or VQ in pregnancy
Discuss with mum, CTPA better, CTPA=Breast Ca, VQ=childhood cancer
Gestation sac but no evidence of foetal pole
Missed miscarriage
Drugs which cause uterine contractions so could be used in PPH
Syntocin Syntometrine Ergometrine Misoprostol Carboprost
Management of PPH
ABCDE
Call for help
Rub up uterine contraction
Syntocin
What diabetes symptoms do you get in gestational diabetes
Polyuria
Thirst
Dysuria
What non glucose test should you do in a patient with gestational diabetes
Obstetric ultrasound
Monitoring for gestational diabetes
Monitor diet carefully and have daily plasma glucose levels
Treatment of preterm labour
Tocolysis and steroids
Name a tocolytic
Nifedipine
Liver signs in pregnancy
Pruritis
Spider naevi
Palmar erythema
Cholasma
Placenta praevia management
Depends on US and clinical findings
Cross match blood
Vaginal examination is contraindicated
Which syndrome is associated with preeclampsia
HELLP
Haemolysis
Elevated liver enzymes
Low platelets
3 methods used for fetal monitoring during labour
Intermittent auscultation
CTG
Fetal blood scampling
Treatment of suspicious CTG
IVI
Left lateral position
Turn down oxytocin infusion
Hormone levels in premature ovarian failure
High FSH and LH
Low oestrogen
Hormone levels in PCOS
LH raised
FSH normal
Hormone levels in pregnancy
LH and FSH are low
Oestradiol is high
Three common routes for HRT
Transdermal
Transvaginal
Oral
Unnoposed oestrogen HRT risks
Breast and endometrial cancer risk
Progestogen HRT risks
Bloating, constipation, irritability
Bromocriptine SE
Postural hypotension
Chance of successful vagina birth after caesarean first time
75%
VBAC (vaginal birth after caesarean) plan
Continous CTG
IV access
Grading of vaginal tears
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.
Follow up after vaginal tear inc anal sphincter
Analgesia
Laxatives
Physio appointment for pelvic floor exercises
Two options for morning after pill
Copper IUD
Levonorgestrel
Steps in prolonged labour
- artificial rupture of membranes
- start oxytocin infusion
- caesarean
What is defined as slow labour
Less than 2cm dilatation in 4 hours
1st line investigation of ectopic
TVUS
When do you use methotrexate for ectopic
If a mass isnt seen
What is the treatment of ectopci
Diagnostic laparoscopy with view towards laparoscopic salpingectomy
Which contraceptive is a risk factor for ectopic pregnancy
Copper IUD
Gram positive coccus
S pneumoniae
Gram positive bacillus
Ballis cerues, listeria monocytogenes
Are never events serious incidents
Yes
Does duty of candour apply to organisations or individuals
Organisations
Causes of ptosis
3rd nerve palsy
Horner syndrome
Mandibular fracture
orthopantomogram
maxillofacial surgeons
When can you give details to police about a crime
Only when threat to life or limb, not theft etc.
Questions for prognosis in dementia
Deteriorating function
Would you be surprised if they died in next few days, weeks, months
Does DOLS apply to all settings
No. All care settings but not patients own home
Signs of dying
Sleeping more
Eating less
Cheyne Stokes breathing
Cool peripheries
Preemptives
Midazolam, morphine sulfate, cyclizine and glycopyrronium.
Reversible causes of agitation at end of life
infection hypoxia urinary retention constipation raised intracranial pressure alcohol withdrawal opioid toxicity
Death certification, 1a, 1b, 1c
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
Risk factors for bowel cancer
Male Diabetic Smoker Obese UC Familial Adenomatous Polyposis HNPCC
Swallowing difficulties of solids and liquids from the start
Achalasia
Achalasia diagnostic investigation
Oesophageal manometry
Scans for babies with UTI
MCUG- ?reflux
DMSA- ?scarring
atypical UTI and under 1
Prophylactic abx
Treatment of vesicoureteric reflux
Improves with time
Pen allergic alternative to amoxicillin
Clarithromycin
Which antiemetic works directly on gut
Metoclopramide
How does ondansetron work
Ondansetron blocks 5HT3 receptors in the CNS and the GI tract
DABS
Clopi 75 Aspirin 75 Ramipril 5 Bisoprolol 2.5 Atorvastatin 80
Risk of liver biopsy
Bleeding
Pompholyx
Eczema with tiny blisters on hands
Bleeding in one nostril not solved by silver nitrate cautery
Rapid rhino in each nostril
Consequences of C difficile
Peritonitis
Toxic megacolon
Pseudomembranous colitis
Severe C difficile treatment route
You give Metronidazole or Vancomycin orally as better absorption
Treatment of severe malaria
Urgent IV Artesunate
Whats the difference about vivax or ovale
More severe, benign, so you give primaquine afterwards
Seosis from something bowel treatment
Cefuroxime and metronidazole
Treatment of traumatic bowel perforation
Digital retrieval of rectal body
Lapartomy
Most common lung cancer
Adenocarcinoma
NICE lung cancer, What counts as chronic cough
3 weeks
Should you give antibiotic prophylaxis for kids with UTI
Not after just 1
Treatment of most uk food borne gastroenteritis
Ciprofloxacin
When shouldnt you give loperamide
IBD, high temperature
Most common cause of bowel obstruction
Colon cancer
Sigmoid volvolus
Are left or right sided bowel cancers more likely to obstruct
Left as poo more solid and smaller diameter
What do bony mets look like
Sclerotic
If someone has a breast abscess what should you screen for
Diabetes
ER positive medication
Tamoxifen
HER2 positive medication
Trastuzumab
Post menopausal medication for breast cancer
Anastrozole
Mammory duct ectasia treatment
2ww
Trauma then long standing breast lump history
Fat necrosis
Tests for CF
Guthrie heel prick
Reduced faecal elastase
Sweat test
Gene testing
Investigation for pyloric stenosis
Ultrasound
Investigation of tonsilitis
Throat culture
Rapid streptococcal antigen test
Treatment of GABHS tonsilitis
Phenoxymethylpenicillin and paracetamol
Which way is the shunt if it is cyanotic
Right to left
Steps in tetralogy of fallot
Pulmonary stenosis VSD Overriding aorta RVH (they get more cyanotic on straining)
Transposition of the great arteries
Presents on day 2
Give prostaglandin to maintain PDA
Patent Ductus arteriosus
Machinery murmur
NSAIDs
Coarctation
Increasing symptoms with age
Commonly at ductus arteriosus
Stent and surgical repair
Rheumatic fever causative organisum
S pyogenes, 2 weeks post tonsilitis
Skin sign of rheumatic fever
Erythema marginatum
Investigation of rheumatic fever
ASO swab
Treatment of Rheumatic fever
NSAIDs and prophylactic abx
Whats the difference between Exomphalos and Gastrochisis
Gastrochisis is uncovered
Treatmtent of developmental dysplasia of hip
Harness and surgery
Investigation of biliary atresia
Laparatomy
Treatment of biliary atresia
Surgical bypass
Types of cerebral palsy
Hemiplegic
Diplegic
Ataxic
Dyskinetic
What can babies do at 8 month
Sit unsupported
Pincer grip
Straigh back
at what age can they walk
1 year
Shapes and ages
Circle 3
Square 4
Triangle 5
Treatment of HSP and Nephrotic syndrome in children
Oral prednisolone
Tests to do in baby with jaundice
Coombs test and TORCH screening
Treatment of jaundice in baby
Phototherapy
Cause of jaundice in baby less than 24 hours old
Haemolytic anaemia
Infecgion
Cause of jaundice in baby up to 2 weeks old
Physiological
Breast milk
Define Hirshprungs
Failure to pass meconium in first 48 hours of life
investigation of hirschprungs
Suction rectal biopsy
Treatment of hirschprungs
Surgery
Gene defect in Turners
45XO
Abnormalities in Turners
Webbed neck
Short
Wide spaced nipples
Delayed puberty
Edwards syndrome
Trisomy 18
Kidneys and occiput
Die in 15 days
Patau syndrome
Trisomy 13
Polydactyly
Heat defects
Developmental delay
Tests for Downs
Triple at 12 weeks- hCG, PAPPA-A, nuchal US
Quad at 16 weeks- hCG, AFP, oestiol, inhibin A
What does guthrie test for
CF Sickle cell Congenital hypothyroid Phenylketonuria MCAD MSUD
What is 12 weeks test for
Chromosome tests
What is 20 weeks scan for
Neural tube
Heart
Renal
Brain
Chorionic villous sampling
12 weeks
2% miscarriage risk
Chromomes and inherited disorders
Amniocentesis
16 weeks
1% miscarriage risk
Chromosomes and gender
Meningitis cause in neonates
E Coli
Treatment of meningitis in community
IM BenPen
Treatment of meningitis in hospital
IV ceftriaxone
Prophylaxis of meningitis
PO rifampicin or ceftriaxone
Treatment of febrile seizures
Paracetamol
Who gets malar flush
Mitral stenosis
Hypertensive emergency
IV sodium nitroprusside
Reduce BP to 110 over 24 hours
CT scan head
Admit to monitored bed
When to treat hypertension in elderly
If still present after 3 months and lifestyle factors
How many samples for TB microbiology
3
Signs of opioid withdrawal
Yawning
Rasied BP
Cool/clammy skin
What drug is used for opioid abstinence in an inpatient setting
Naltrexone
Which disc prolapses in sciatica
L5/S1
Treatment of sciatica
Reassurance
NSAIDs, physio, mobilisation
Investigation of colonic abscess
- US
2. CT
Name causes of fistulae
Diverticular disease
Crohns
Pharmacodynamic interaction
Drugs competing at receptor site
Pharmacokinetic interaction
Drugs changing absorption of another drug
Phenytoin OD
Headaches, insomnia, tremor, nausea
Causes of SIADH
Cancer
Stroke
Lung abscess
Risk factors for smoking
FHx
Smoking
Head injury
NMDA receptor antagonist
Memantine
Acetylcholinestarase inhibitors
Rivastigmine
Donepezil
Galantamine
Cause of intraperitoneal air
Perforated oesophageal ulcer
Laparotomy 24hours ago
Perforated diverticulum
Which parts of the GI tract are retroperitoneal
3rd part of duodenum
Ascending colon
Descending colon
Which antibiotics should be avoided in first trimester of pregnancy and why
Trimethoprim (antifolate)
Ciprofloxacin
Cotrimoxazole
What is the most common ASD
PDD-NOS (pervasive developmental disorder-not otherwise specified)
Types of ASD
PDD-NOS (pervasive developmental disorder-not otherwise specified)
Rett syndrome
Aspergers
What can be a presenting feature of Polycythaemia
TIA
Causes of polycythaemia
CKD
HCC
COPD
Primary polycythaemia
Which heart medication can cause low mood
Beta blocker
Moclobemide
Tricyclic
Dosulepin
RIMA
How long should a first episode of depression be treated for
At least 6 months
How would you assess facial nerve
Ask the patient to raise their eyebrows, bare their teeth and close their eyes, respectively, and look for asymmetry of movement
Where do testicular lymphatics drain to
Paraaortic
High bHCG testicular cancer
Choriocarcinoma- think placenta
High AFP testicular cancer
terAtoma
High PLAP testicular cancer
Seminoma
Drugs for reducing regime for alcohol detox
Chlordiazepoxide
Diazepam (more than lorazepam)
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.
Delerium tremens
Can ARB and ACEI be used together
Yes in renal
Causes of third nerve palsy
Rapidly expanding aneurysm
Internal carotid dissection
Thrombotic occlusion of blood supply
What should you give if its within 2 hours of ingestion of overdose
Activated charcoal by mouth
SE of NAC
Rash, but dont stop treatment because of it
Aspirin overdose Sx
Vomiting, hyperventilation, sweating, tinnitus
Most common cause of cushings syndrome
Exogenous steroids
Local anaesthetics
Lidocaine for short things
Bupivacaine for regional blocks
Which med could bring on gout
Aspirin
What does colchicine cause
Diarrhoea
SE of oxytocin
Water intoxication cos its similar structure to ADH (both released by posterior pituitary)
How long should you give an SSRI for if its a recurrence of depression
2 years
Name an Noradrenaline and specific serotonin antidepressant (NaSSA)
Mirtazepine
Name an Selective Noradrenaline reuptake inhibitor
Reboxetine
What type of drug is trazadone
TCA
What type of drugs are Duloxetine and venlafaxine
Serotonin and Noradrenaline reuptake inhibitor (SNRI)
Renal colic 1st line investigation
Non contrast CT KUB
When shouldnt you give PR diclofenac for renal colic
obstructed kidneys or sepsis, give IV paracetamol instead
When do you remove renal stone
After the infection has been treated
Carpal tunnel
Median nerve, Loss of sensation in the thumb, index, mid finger.
OCP, pregnancy, heart failure, wrist trauma, RA, hypothyroid
Gram positive cocci
Streptococcus pyogenes and MRSA (methicillin resistant Staphylococcus aureus)
Gram negative rods
Escherichia coli, Pseudomonas aeruginosa and Haemophilus influenza
Gram negative cocci
Neisseria meningitidis
Treatment of impetigo
A 7 day course of oral aciclovir
Investigations for myeloma
Blood film and bone marrow aspirate
MRI spine and thoracic and lumbar spine XR
Serum electrophoresis and free light chains
Skeletal survey
Investigation of urge incontinence
Bladder diary/ frequency volume chart
Leading cause or urge incontinence in both men and women
Overactive bladder (detrusor overactivity)
What is the most common cause of lung mets
Breast
Do drugs help BPPV
No
Treatment of oesophageal candidiasis
Oral Nystatin
What nerve is in the parotid gland
Facial nerve
Which type of nerves does multiple sclerosis affect
Upper only
Hepatotoxic drugs
Paracetamol
Erythromycin
Simvastatin
Which illicit drug can cause parkinsons
Heroin
Tongue ulcer and cervical lymphadenopathy, lung signs
Metastatic scc
Cannon waves in jvp
Ventricular tachycardia and complete heart block
Oliguria definition
<0.5ml/kg/hr or <400ml in 24hrs
Who gets a carotid doppler
Outpatient after TIA
Bony swelling and tenderness
Suspect bone tumour
HPV in genital warts
6 and 11
HPV in CIN
16 and 18
Steps in speeding up labour
1) Artifical rupture of membranes
2) oxytocin infusion
What is established labour
4cm and regular contractions
Treatment of orthostatic hypertension
Fludricortisone
Which eye signs can be in any type of thyroid eye disease
Lid retraction and lid lag
When to DC shock AF
HR over 150
Chest pain
Who cant have combined COCP
- smoker (15 a day) and over 35
- within 6 weeks of giving birth
Causes of ptosis
3rd nerve palsy
Horners
Age
Myasthenia gravis
Does RAPD suggest problem with that eye or opposite
That eye
Which branch of the trigeminal is the opthalmic
1st
Virus for shingles
Herpes Zoster
Mydriasis
Fixed dilated pupil in acute angle glaucoma
Treatment of acute angle closed glaucoma
IV acetazolamide
Topical steroids
Pilocarpine
Treatment of pyelonephritis
IV coamoxiclav
OA examination findings
Crepitus
Limited range of motion
Abnormal gait
Describe sclerodactyly
Thickening and tightening of skin
What are ENA antibodies
ANA antibody subtypes screen
First line treatment of gout if theyve had a gastric ulcer
Oral colchicine
Treatment of PMR
Oral pred
Causes of death in Ank Spond
Amyloidosis and Aortic valve disease
Investigation of erythema nodosum
CXR
First line treatment of OA
Oral Paracetamol
Main treatment of Ank Spond
Exercise therapy
Treatment of achilles tendon rupture
Equinus cast
Test for achilles test
Simmonds or squeeze test
Which nerve roots comprise the radial and ulnar nerves
C5-T1
Which nerve roots comprise the median nerve
C8-T1
Most common cause of wrist drop
Trauma
Causes of bone mets
Breast
Prostate
Lung
Kidney
Where do bone mets commonly occur
Spine
Pelvis
Ribs
Mosaic wart
Cluster of warts
Sole of foot
Contagious so use veruca sock if swimming, avoid sharing showers
Paronychia
infection around the nail
Isotretinoin vs tretinoin
Tretinoin for mild acne
Isotretinoin for treatment resistant
Most common areas for melanoma in men and women
Men torso
Women legs
What is the biopsy called if it is a big lesion
Incisional biopsy
Bullous pemphigold
Bullous on top of erythema, big rash.
Emolient and Pred
Scalp ringworm
Requires oral not topical antifungals
Discoid eczema
Well demarcated round patches
Topical Steroids
Diagnosis of secondary syphilis
VDRL
Signs of neuro syphilis
Tabes Dorsalis
Argyll Robertson Pupil
Causes of rash on soles of feet and palms of feet
Syphilis
How long after exposure for HIV seroconversion
2 weeks to 12 weeks
How long after exposure for Secondary Syphilis
6 weeks to 6 months
Diagnosis of PCP
Bronchoscopy and bronchoalveolar lavage
Giardia Lamblia treatment
Metronidazole
Why do you CT head before LP
To exclude raised ICP
Herpes in pregnancy
Oral aciclovir in first 2 trimesters
Suppressive therapy
Dont need c section
Vaginal candidiasis diagnosis
Vulvovaginal swab taken for direct gram-stain microscopy from the anterior fornix
How is trichomonas vaginalis diagnosed
Posterior fornix swab taken for wet mount, to look for Trichomonas vaginalis
Candida treatment
Any topical Azole- clotrimazole vaginal pessary
What must you suspect in any bone swelling and tendernesss
Bone cancer
Where does osteosarcoma affect
End of the bone
Where does ewings sarcome affect
Mid shaft
Do falls have to be referred to coroner
Yes
Can you put cardiac arrest as main cause of death
No, shouldnt, its a symptom
Rash affecting hands and soles
HIV, Syphilis, Measles, Erythema Multiforme
What causes sudden death in hypertrophic cardiomyopathy
Arrythmia
Treatment of dental pain
NSAID analgesia
Which CURB65 score= severe
3 or more
Whats an alternative to calcium gluconate
Calcium chloride
Carcinoid syndrome
flushing, diarrhoea, bronchospasm, weight loss and hyper and hypotension. Heat Disease
Testing for infectious mononucleosis
Monospot
Paul Bunnell
Which part of the colon is intraperitoneal
Transverse
What should you do if doesnt respond to SSRI in anxiety
Swap to another
Maximum duration of benzos for anxiety
2-4 weeks
How does post op uti present
Asymptomatic
Atypicals used for psychosis
Quetiapine, Olanzapine, Aripiprazole
Which antihypertensive drug can cause low mood
Beta blockers
% manic patients which get depression
Over 90
Acute mania treatment
Antipsychotics and benzos
Diagnosing post natal depression
Ask about anhedonia and low mood
Then give Edinburgh Post Natal Depression Score
Bulimia symptoms
hypokalemia, hypocalcaemia, hypotension and a decreased red blood cell count
Tool for assessing risk of violence
HCR 20
Tool for assessing psychopaths
PCL-R
Treatment of EUPD in GP
Refer to community mental health team for formal diagnosis
Most common cause of a learning disability
Low socioeconomic class
What is overshadowing
When presenting symptoms are assumed to be caused by background diagnosis but are actually not
Atypicals
Aripiprazole
Olanzapine
Risperidone
First line for severe Alzheimers
Memantine
When do paracetamol levels peak after overdose
4 hours
Wehn should you give activated charcoal
If present within an hour
Which drugs go IV
Heroin
Cocaine
Amphetamines
Most common cause of suicide in both men and women
Hanging
% people who attempt suicide who have mental illness
Over 90%
% suicide who have self harmed before
50%
Islet autoantibodies to rule out T1DM
Islet cell autoantibody, GAD65, ZnT8
Non diabetic causes of hyperglycaemia
Endocrine: Cushing’s, acromegaly, phaeochromocytoma
Medications: steroids, SGA
Exocrine pancreas: CF, pancreatitis, amyloidosis, haemochromatosis
DKA triad
Diabetic = glucose>11
Keto = ketones in blood/ urine
Acidosis HCO3<15, pH<7.3
Common differential for depression
Hypothyroidism
Treatment of moderate- severe depression
Refer for CBT and offer to start sertraline
Which hallucination is a schneiderian 1st rank symptom
3rd person- commentary or discussing them
Examinations for lower mn facial palsy
Otoscopy
Palpation of the parotid gland and neck
Movement of the facial muscles
Causes of facial nerve palsys
Bells
Heerfort’s syndrome- sarcoidosis
Mucoepidermoid carcinoma of the parotid- most common parotid cancer
What causes hyperacusis (sensisitivity to loud noise)
Facial nerve palsy as supplies the motor supply to the stapedis
Swallowed foreign body possible complications
Oesophageal perforation
Retropharyngeal abscess
Lung mets are what cancer until proven otherwise
Colon
When would you use central venous access
If elderly and risk of heart failure so need accurate idea of fluid statsu
Treatment of a non shockable rhythm
Adrenaline every 3-5 minutes and cpr
Scarlet fever
Strawberry tongue and pharyngitis.
Complications of tonsilitis
Quinsy- urgent ENT referral ?tonsillectomy
Depression causing medication
Corticosteroids Oral Contraceptives Statins Ranitidine Beta blockers
Bloods for IBS
FBC
ESR and CRP
TFT
Which serum level do you need in order to interpret CSF results
Plasma glucose
Treatment of ringworm
Oral terbinafine
Which ethnic group gets obstetric cholestasis
Asian
Is ESR reliable in pregnancy
No will be raised anyway
How many UTIs needed for child to have renal ultrasound
Under 6 months=1
Over 6 months= recurrent
Contraindications to HRT
Undiagnosed vaginal bleeding
Pregnancy
History of venous thrombosis
Which drug can bring on gout
Aspirin§
Investigations for acute epilepsy
Blood glucose
MRI
(EEG used in opd setting)
Why does asthma get worse in pregnancy
People often get GORD in pregnancy
Which antibody in breastmilk
IgA
Does breast milk or formula cause more diarrhoea and vomitting in infants
Breast milk causes less diarrhoea and vomitting
Indurated ulcer on side of tongue, smoker
Squamous cell carcinoma
Heavy dragging feeling of the testes
Suggestive of tumour
Testicular cancer surgery
radical inguinal orchidectomy
Which testicular tumour produced AFP
Teratoma
What cause gout
Meat, seafood, alcohol (not cheese)
In children does high fever suggest bacterial
Not necessarily
How do you change steroid doses in hypoadrenalism when ill
Double
Sail sign
Left lower lobe collapse
Why does asthma get worse in pregnancy
People often get GORD in pregnancy
Which antibody in breastmilk
IgA
Does breast milk or formula cause more diarrhoea and vomitting in infants
Breast milk causes less diarrhoea and vomitting
Indurated ulcer on side of tongue, smoker
Squamous cell carcinoma
Heavy dragging feeling of the testes
Suggestive of tumour
Testicular cancer surgery
radical inguinal orchidectomy
Which testicular tumour produced AFP
Teratoma
What cause gout
Meat, seafood, alcohol (not cheese)
In children does high fever suggest bacterial
Not necessarily
How do you change steroid doses in hypoadrenalism when ill
Double
Sail sign
Left lower lobe collapse
Can you take paracetamol when you give vaccine
No dont cos wanna be able to see if fever
Investigation when upper GI bleed but not seen on OGD
Mesenteric Angiography
What electrolyte changes happen after vomiting
hypochloraemic, hypokalaemic metabolic alkalosis
Diagnostic test for pyloric stenosis
Ultrasound abdomen
pyloric stenosis treatment
Ramstedt’s pyloromyotomy
What causes rheumatic fever
Group A beta haemolytic strep
Treatment of rheumatic fever
Admit and bed rest
Im benpen
10 day oral amox
Symptoms of rheumatic fever
Sore throat then new murmur.
Pericardial rub, sydenhams chorea, conduction defects
Do you need to wait for troponin for acute mi diagnosis
No
Cardiogenic shock and low blood pressure treatment
CPAP. CPAP pushes fluid back into vessels
Type A aortic dissection
Ascending aorta
Type B aortic dissection
Descending aorta
LV Strain pattern on ECG
Big R waves in V6
RV Strain pattern on ECG
Big R waves in V1
Big S waves in V5/6
LV strain pattern on ECG
Big S waves in V1
Big R waves in V5/6
Bleeding and warfarin
Prothrombin complex
Why do you ultrasound in infective endocarditis
Splenic infarcts
Criteria for IE
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.
Digoxin ECG
Sloping ST depression in V5 and V6
If the TB is drug resistant what do you add
streptomycin and ciprofloxacin
What type of hypersensitivity is asthma
1
Angle of safety position
6th intercostal space, mid-axillary line
Causes of pneumothorax
Marfans Asthma COPD Mechanical ventilation rib fracture
where are the ascending and descending aorta in the body
Ascending near the front, descending near the back
What posture is helpful for svc
head up
What type of drug is theophylline
Phosphodiesterase inhibitor
What causes consolidation on chest x ray
alveoli filled with something- air, fluid, mass
Treatment of pen allergic pneumonia
Clarithromycin
Features of sarcoid
Hypercalcaemia
Lung fibrosis
Hepatosplenomegaly
Uveitis
What should the CO2 be like in severe asthma and what is a worrying sign
Should be low, so if it is normal then that is concerning that it is going up
Steroid side effects
Osteoporosis
Diabetes
Weight gain
Increased rates of infection
How do you notify the authorities of a disease
Notify the Health Protection Consultant in office hours/through a notification form
Which asthma medications should you change during pregnancy
None, keep them the same
Treatment of oesophageal stricture
Balloon dilatation
Which extra GI manifestations are due to the activity of the colitis
Episcleritis
Erythema nodosum
IV PPI in varices
Dont give ppi before endoscopy
Treatment of varices if banding hasnt worked
Insertion of Sengstaken-Blakemore tube
How long to give LMWH for when giving warfarin too
5 days or until therapeutic INR, whichever is longer
What is the cause of ascites in alcoholic hepatitis
Cirrhosis
Treatment of autoimmune hepatitis
Pred and azathioprine
Pancreatic cancer options
Mild= Whipples Procedure Severe= stent
Chronic pancreatitis on AXR
Calcification in the pancreatic area
Imaging fo chronic pancreatitis
CT
Anti smooth muscle antibodies
Autoimmune hepatitis
Biologic options for crohns
Anti-integrin therapy (Vedolizumab)
Anti-interleukin therapy (Ustekinumab)
Anti-TNF antibody treatment (Infliximab or Adalimumab)
Cause of duodenal ulcer when not on nsaid
H pylori (if confirmed on colonoscopy you dont have to test for)
tests for IDA
Colonoscopy and gastroscopy
Which organisms can mimic crohns
TB
Yersinia
Pancreatitis management
IV fluids
IV analgesia
ABG
Complications of acute pancreatitis
Pancreatic pseudocyst
Faecal elastase
Exocrine pancreatic function
Which solid organ is most commonly injured in trauma
Spleen. May need laparotomy and splenectomy
Symptomatic gallstone without CBD stone or dilation
Lap Chole this admission
Glasgow score for pancreatitis
PaO2 WCC Serum calcium urea LDH Albumin Glucose
Imaging of fibroadenoma or cysts etc
First mammogram then US then core biopsy/needle aspiration then either discharge or excise if big
How long should you continue insulin infusion for
Until ketones are under 0.3
Sedation in parkinsons
Lorazepam as haloperidol contraindicated
Rhabdomyolysis CK
Over 10000
How to detect C spine fracture
CT neck
How long after surgery do you get PE
10 days
Investigation for IE
Transoesophageal echo
Do you always treat AF
Not if asymptomatic and rate controlled and chadsvasc is 0
Bleeding duodenal ulcer
Gastroduodenal artery
Gout and CKD
Give pred not nsaid
All the fluid in the lungs, low BP, no urine output.
I.e. overloaded but in the wrong places
Noradrenaline is used for vasoconstriction
Which part of the brain is affected first in alzheimers
Temporal
Fibrosis but without clubbing
From amiodarone
Treatment of acute mania
antipsychotic- quetiapine, risperidone, olanzapine
Mitral stenosis
Apex beat tapping, low rumbling murmur, caused by rhuematic fever
What are blast cells suggestive of
Acute leukaemia
CLL
Smudge
Translocation 9:22
Philadelphia chromonsome
Myeloma causes what in bones, what do mets cause
Myeloma= lytic Mets= sclerotic
Initial steps for nose bleed
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
First investigation for ITP
Blood film
Treatment of frequent sickle cell crisis
Hydroxycarbamide
When does subacute degeneration of the cord occur
When you replace folate without B12
Tumour lysis syndrome
Hyperkalaemia
Hyperphosphataemia
Hyperuricaemia
Hypocalcaemia
Cause of purpuric rash
Meningococall sepsis
Pneumococcal sepsis
Staphylococcal
When would you not give ceftriaxone for meningitis
Only if previus life threatening reaction
What perspective is imaging
You are always looking up from feet
Most common cause of TIA
Carotid artherosclerosis
In young adults whats the most common cause of meningitis
Viral
Should you LP and blood culture before antibiotics in meningitis
Only if it wont delay treatment
Hypokalaemia causes
Reduced ingestion
Increased excretion
Loop or thiazide diuretics
Hypokalaemia features
Absent reflexes Constipation Cramps Weakness Tiredness
Reintroduction of potassium
Not at a rate of more than 10mmol/hr
Chornic management of hyperkalaemia
Low potassiumd diet
Nephrotic in adults
Membranous glomerulonephritis
Enlarged gall bladder is always suspicious for what
Head of pancreas tumour
Incubation period for HCV
4-20 weeks
Complications of legionnaires
Endocarditis, pericarditis, pancreatitis, pulmonary fibrosis, respiratory failure
Which cancers are associated with EBV
Nasopharyngeal cancer and Burkitt lymphoma
Types of noicieptive pain
Somatic and visceral pain
Types of neuropathic pain
Allodynia
Dysesthesia
Opioids for renal failure
Alfentanil
What imaging if confused after seizure and hasnt returned to baseline
CT head
features of aura (smell and fear) and posturing with automatisms without complete loss of consciousness
Temporal epilepsy
Treatment of Guillain Barre
IVIG and plasma exchange
Investigation of Guillain Barre
Lumbar puncture
Nerve conduction studies
Prognosis of GBS
90% fully recover
Which nerve causes foot drop
Common peroneal nerve
Visual symptoms of papilloedema
Enlarged blind spots and constricted fields
What should you also prescribe in diseases with gait disturbance
Physiotherapy
Investigations for essential tremor
Clinical, just do bloods to exlude hyperthyroid and anaemia
First lines for essential tremor
Primidone
Propranolol
Things present in true parkinsons but not drug induced
Dyskinesia
Levodopa improved symptoms
Unilateral rest tremor
Scan for parkinsons
DaTscan
How is CIN different from cervical cancer
Cells have not invaded the basement membrane
Which lobe causes Somatosensory neglect
Parietal
Further investigtions after EEG in epilepsy
ECG
Refer to neurology
Which drugs do you give when giving chemo
Aciclovir
Allopurinol
Cotrimoxazole
Lifetime risk of breast cancer in women
1 in 8
Chemo after surgery
Adjuvant chemo
Chemo before surgery
Neo adjuvant chemo
Side effects of anastrozole
Joint aches
Metastatic cord compression treatment
Radiotherapy and surgical decompression
5Ds of charcot arthropathy on CXR
Density changes Destruction Debris (loose bodies and bone fragments) Distension (joint effusion) Dislocation
Causes of pneumothorax
Asthma
COPD
Liver biopsy
Chest drain insertion
Sigmoid vs Caecal volvolus
Sigmoid= LBO cAECAL= sbo
Differences between LBO and SBO
Peripheral distribution
Presence of haustration
Presence of faeces
Lines across the bowel in LB vs SB
LB= haustration SB= valvular conniventes
When do you use an IVC filter
When recurrent PEs despite coagulation
High fever and bone pain
Osteomyelitis
Diseases associated with pseudogout
hyperparathyroidism, hypothyroidism or haemochromatosis
Which drug is contraindicated in heart block
Beta blockers
How long after ingestion do you take a paracetamol level
4hours
What do you need to do with all patients who have had an OD
Psych referral
Most sensitive marker of liver dysfunction after paracetamol overdose
PT or INR
Advice to people with HTN
Salt restrict and lose weight
Should you up dose of existing or start new drug for HTN
Up dose of existing
Bendroflumethiazide action
It inhibits sodium reabsorption in the early distal tubule via the Na-Cl co-transporter
What to call fibrosis when suspected but not confirmed cause
Fibrosing alveolitis
Drugs which cause fibrosis
Nitrofurantoin
Amiodarone
Sulfasalazine
Can you use amiodarone for bradycardias
No
Risk of stroke doubles and risk of MI x1.5 for each …mmHg rise in HTN
15
What is the cause of renal artery disease in young women
Angiodysplasia
Amlodipine and atorvastatin can cause
GORD
How does H pylori eradication improve GORD symptoms
It doesnt
Risk factors for H Pylori
Low socioeconomic status
Crowded living conditions
FAP
Thousands of polyps
HNPCC
One big polyp
Peutz Jheuger
Polyps and pigemented mouth lesions
Treatment of single lung met
Surgical removal
Which fibres are acted on by local anaesthetic as they transmit pain and temprature sense
Small C fibres
Physical threat from a patient response
Leave situation and call security
Which electrolyte abnormality can heparins cause
Hyperkalaemia
patient perception of pain 7-8
Strong opioid is appropriate
which antiemetics can be used in parkinsons
Ondansetron
Cyclizine
OTC for OA pain
Paracetamol
Which drugs shouldnt be taken with antiretrovirals
Statins
Fluticasone
Contraindications to atropine
MG
Paralytic ilues
Faecal softener
Docusate
Osmotic laxatives
Lactulose
Macrogol
How long does lactulose take to act
2-3days
What type of drug is digoxin
Cardiac glycoside
When do you commence detox regime with chlordiazepoxide
Only when sobered up
Define pain
unpleasant sensory and emotional experience associated with actual or potential tissue damage
Something to tell people taking methotrexate and folic acid
Avoid multivitamins as these will include folate which they are already taking
Drug good against MRSA
Vancomycin
How many standard errors is the confidence interval
2 either side
What type of drug is adrenaline
Non selective adrenergic agonist
25 micrograms fentanyl patch is equivalent to what dose of morphine
90
Which laxative to go with morphine
senna
Which structures go through the parotid gland
Facial nerve
External carotid artery
Retromandibular vein
Most common thyroid cancer
Papillary carcinoma
Midline neck lumps
thyroid nodule, a thyroglossal duct cyst and a dermoid cyst
Treatment of primary haemorrhage after thyroid surgery
High flow oxygen and remove surgical clips
If someone comes in with teeth out what should you do
Anaesthetise and reimplant teeth asap
Upper aerodigestive tract tumours
Squamous cell
Common non accidental injury sites
Retinal Haemorrhages
Rib Fractures
Treatment of osteomyelitis
IV antibiotics then surgical debridement
Which foot condition is associated with developmental dysplasia of the hip
Talipes
Slapped cheek disease
Parvovirus B19
Two XRay views for SUFE
AP and frog lateral
Haemophilia inheritance
X linked recessive
Consequence of neonatal jaundice
Kernicterus
What should you give haemolytic anaemia jaundiced babies to prevent further anaemia
Folic acid
Investigations for diagnosis of HSP
FBC, clotting screen, renal function, and urine dipstick
Causes of bloody diarrhoea
Salmonella
E Coli
Describe the mass in intussuseption
Right upper quadrant, sausage shaped mass
What is the most common type of intussuseption
Ileocolic
Two investigations to confirm air enema
Ultrasound and air contrast enemas
Twice as potent as oral morphine
Subcut morphine
options for respiratory distress when normal oxygen saturations
Hand held fan
Teaching him/ his wife acupressure points
Good medications for opioid constipation
Glyceride suppositories
Senna
Requirements for advanced decision to refuse treatment
Must be written down
Must be hand signed by patient
Must be created when patient has capacity
Must be witnessed
Bad signs for end stage COPD prognosis
Low BMI
LV failure
Frequent exacerbations
Investigations for hydronephrosis
KUB
then
IV urogram
Haematuria first line imaging
Ultrasound renal tract
RF for RCC
Smoking
FH
Obesity
Von HIppel Laudua
Torsion first line investigation cos its really quick
Dipstick urine
Most common group for testicular torsion
11-30
Causes of raised PSA
BPH, UTIs, Acute and chronic prostatitis, retention, on catheterisation, taking biopsies of the prostate, TURP, ejaculation
Common presenting complaint of RCC
Haematuria
Tachypnoea, hypoxia, hypotension and pulmonary oedema within 6 hours of transfusion
TRALI- transfusion related acute lung injury
Mild temperature rise shortly after transfusion
A febrile, non haemolytic reaction
Allergic reaction to transfusion symptoms
Urticaria, angioedema, wheeze and pruritis
Increase in temperature and pulse rate, abnormal bleeding and Low BP after transfusion
ABO incompatbility
Which artery causes posterior nose bleeds
Sphenopalatine
What do you want to do if you think someone might have broken their nose
Anterior rhinoscopy to exclude septal haematoma
ENT clinic in 7-10days
Mesenteric adenitis
Appendicitis and URTI
How to treat appendicitis
Appendectomy
Post op reduced bowel sounds
Small bowel ileus
Pseudoobstruction
Post surgery, can be caused by electrolyte disturbance
Colonic decompression
Pseudomembranous colitis
From C dificile, before toxic megacolon
Threshold for transfusing patients without cardiovascular disease
80g/L
Does intraop hypothermia increase or decrease blood loss
Increases as impairs clotting
Colorectal cancer diagnosis
Colonoscopy with biopsy
Most common inguinal hernia
Indirect
How can you differentiate a femoral and inguinal hernia
Inguinal is superior and medial to the pubic tubercle
Inguinal canal contents
Spermatic cord
What should you do if routine operation and anaemic
Correct and delay operation
How to reduce risk of aspiration during surgery
Rapid sequence induction
Administer antacid before anaesthesia
Liver biopsy risks
Pneumothorax
Biliary peritonitis
Shoulder pain
Upper age limit of baby for abortion
24 weeks
Who can make an advanced directive
Anyone over 18
Which pathway does warfarin affect and INR measure
Extrinsic
Which pathway does APTT measure
Intrinsic
Which routes can warfarin be given
Only oral
Dose for immediate NAC
150mg/kg
Major bleed and needs warfarin reversal
Prothrombin complex
Does the patient have a pulse with ventricular fibrillation
No
Electrolyte abnormality caused by hypothyroid
Hyponatraemia
What causes pseudo dementia
Depression
Where is the blockage for a TACS
Middle cerebral artery
Ischaemic stroke: should you treat high blood pressure
No, monitor for now
Two most common types of dementia
Alzheimers and Vascular
Dementia brain scan
CT (excludes space occupying lesion)
Who can fill out cremation form 5
Someone from a different team or practise who has been qualified for atleast 5 years
Which diabetes drug causes fluid retention/ heart failure
Glitazones
Which diabetes drug causes lactic acidosis and diarrhoea
Metformin
On metformin and normal weight
Sulfonylurea- gliclazide
On metofrmin and no risk factors for osteoporosis
Pioglitazone
Confusion Bloods
U&E, FBC, LFT, glucose, CRP, calcium, B12 & folate, ferritin, iron and transferrin, TFT, vitamin D.
COMT inhibitor
Entacapone
Dopamine agonist
Bromocryptine
MAOB inhibitor
Selegiline
Essential tremor
Symmetrical
Improves with alcohol
Propanolol and primdione
Experiencing pain from stimuli that are not normally painful
Allodynia
Causes of peripheral neuropathy ABCDE
Alcohol B12 deficiency Cancer CKD Diabetes Drugs (isoniazid) Every vasculitis
Triggering pathogens for guillain barre
Campylobacter jejuni
Cytomegalovirus
EBV
First line treatment of chronic open angle glaucoma
Prostaglandin eye drops (causes eyelash growth and eyelid pigmentation) (latanoprost)
Name three medications for open angle glaucoma
Latanoprost (prostaglandin)
Timolol (beta blocker)
Brinzolamide (carbonic anhydrase inhibitor)
Brimonidine (alpha 2 antagonist)
Which medications can cause acute angle closure glaucoma
Tricyclic antidepressants
Anticholinergic medications
Halos around lights
Acute angle closure glaucoma
Treamtent of acute angle closure glaucoma
Supine without pillow
Pilocarpine
Acetazolamide
Laser iridotomy
5 signs of hypertensive retinopathy
AV nipping
then just same signs as diabetic
Cataracts reflex
Red reflex missing
Starbusts around lights
Cataracts
How to treat episcleritis
Lubricating eye drops (baso just injured episclera)
Stain used in opthalmology
Fluroescin
Management of painful red eye in GP
Same day opthalmology referrale
Eye drops to test for horners
Cocaine
Painless flashes and floaters
Posterior vitreous detachment
Treatment of posterior vitreous detachment
None.
Exclude retinal tear and retinal detachment
Treatment of retinal tear
Laser therapy
Treatment of retinal detachment
Vitrectomy and replacement
Causes of CRVO
Leukaemia
Myeloma
HTN
Diabetes
Cause of CRAO
GCA
Night blindness
Retinitis pigmentosa
Give two causes. of dementia
HIV
Parkinsons
Doses for anaphylaxis
200mg IV hydrocortisone
10mg IV chlorphenamine
Which rule is used for estimating burns coverage
Rule of 9s
How to calculate fluid requirement in burns
4ml x weight in kg x % burnt
What should you do with blisters in burns
De-roof blistered areas, dress with non-adherent dressing and review in dressing clinic in 48 hours.
Monitoring for oral terbinafine
LFTs
Thickened and scaly skin with fissures
Contact dermatitis
Psoariasis treatmetn
Calcipotriol
What are seborrheic warts also known as
Basal cell papilloma
Amoxicillin and EBV
Avoid
Bupropion
Start 7 days before stop smoking
CI seizures, liver, anorexia
Options for steroid delivery for RA
IM
Intraarticular
Oral
Septicaemia definition
multiplication of bacteria in the bloodstream
Migraine prophylaxis
propranolol, amitriptyline and topiramate
Alternative to statins
Ezetimibe
Rash which starts behind ears
Measles
Complications of measles
Encephalitis
Subacute sclerosing panencephalitis
Bronchopneumonia
Keratoacanthoma differential diagnosis
SCC
ALARMS symptoms
Anaemia Loss of weight Anorexia Recent Mass Swallowing difficulties
