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Yr 5 - Passmed Corrections > Corrections 2 > Flashcards

Corrections 2 Flashcards

1
Q

Can a patient in VF be conscious?

A

No - not compatible with a cardiac output

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2
Q

How can a splenectomy affect HbA1c level?

A

Can give a falsely high HbA1c level due to the increased lifespan of RBCs.

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3
Q

What antibiotic prophylaxis can be given in ascites (for SBP)?

A

Ciprofloxacin or norfloxacin

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4
Q

Mx of a myxoedemic coma?

A

Thyroxine & hydrocortisone

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5
Q

What is conduction aphasia classically due to?

A

A stroke affecting the arcuate fasciculus - the connection between Wernicke’s and Broca’s area

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6
Q

Features of conduction aphasia?

A
  • Speech is fluent
  • Repetition is poor
  • Comprehension is normal
  • Aware of the errors they are making
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7
Q

Location of lesion in Wernicke’s (receptive) aphasia?

A

Lesion of the superior temporal gyrus (typically supplied by the inferior division of the left MCA).

This area ‘forms’ the speech before ‘sending it’ to Broca’s area.

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8
Q

Features of Wernicke’s aphasia?

A
  • Comprehension is impaired
  • Sentences make no sense but speech remains fluent
  • Word substitution and neologisms - ‘word salad’
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9
Q

Location of lesion in Broca’s (expressive) aphasia?

A

Lesion of the inferior frontal gyrus

It is typically supplied by the superior division of the left MCA

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10
Q

Features of Broca’s aphasia?

A
  • Comprehension is normal
  • Speech is non-fluent, laboured, and halting
  • Repetition is impaired
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11
Q

Features of global aphasia?

A

Large lesion affecting all 3 of the above areas resulting in severe expressive and receptive aphasia

May still be able to communicate using gestures

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12
Q

Weak or potent steroid in plaque psoriasis mx?

A

Potent steroid e.g. betamethasone

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13
Q

Location of lesion in a painful 3rd nerve palsy?

A

Posterior communicating artery aneurysm

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14
Q

Why can myasthenia gravis present with distended neck veins and a flushed face?

A

Due to SVCO –> can be a complication of a thymoma.

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15
Q

Investigation of choice in myasthenia gravis?

A

Antibody screen –> antibodies against acetylcholine receptors.

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16
Q

Triad of features in acute liver failure?

A

1) encephalopathy
2) jaundice
3) coagulopathy

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17
Q

What INR defines coagulopathy?

A

> 1.5

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18
Q

mx of acute limb ischaemia?

A

1) analgesia

2) IV heparin

3) vascular review

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19
Q

What is standard for the diagnosis and screening of HIV?

A

HIV p24 antigen & HIV antibody tests (combination)

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20
Q

Mx of an acute anal fissure (<1 week)?

A

Soften stool (bulk-forming laxatives), dietary fibre, analgesia and topical anaesthetic cream if necessary

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21
Q

CSF glucose vs serum glucose in bacterial meningitis?

A

CSF glucose is less than half of the serum glucose in bacterial meningitis

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22
Q

Which nerve is affected in Bell’s palsy affecting the L hand side of the face?

A

Left CN VII LMN lesion (L lesion = L side of face)

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23
Q

What class of drug is rivastigmine?

A

Acetylcholinesterase inhibitor

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24
Q

Mx of new-onset dysphagia?

A

It is a red flag symptom that requires urgent endoscopy, regardless of age or other symptoms

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25
Q

Why is diabetes a risk factor for CN III palsy?

A

due to microangiopathy related neuropathy

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26
Q

2 key causes of an exudative pleural effusion?

A

1) empyema
2) malignancy

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27
Q

Mx of an empyema?

A

Insert a chest drain & commence abx

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28
Q

Features of a radial nerve injury?

A

1) impaired wrist extension (i.e. wrist drop)

2) impaired sensation over the dorsal aspect of the 1st and 2nd metacarpal bones

29
Q

What fractures can result in radial nerve damage?

A

Humeral shaft fractures

30
Q

What infection can trigger guttate psorasis?

A

Strep infection

31
Q

What acid base disturbance can be seen in prolonged diarrhoea?

A

Metabolic acidosis with hypokalaemia

32
Q

What class of medication is brimonidine eye drops?

A

Alpha agonists

33
Q

What is a positive Nikolsky sign?

A

the epidermis separates with mild lateral pressure e.g. seen in TEN

34
Q

Any person on anticoagulants with a head injury must receive a CT head within what time frame?

A

8 hours

35
Q

Mx of severe urticaria?

A

A short course of an oral corticosteroid may required in addition to a non-sedating antihistamine

36
Q

Severe, sudden abdominal pain + out-of-keeping physical exam findings + AF?

A

Acute mesenteric ischaemia

37
Q

Can dry ARMD progress into wet ARMD?

A

Yes

38
Q

Following panretinal laser photocoagulation up to 50% of patients have what complication?

A

Reduction in visual fields

39
Q

What can be used for short-term reduction of erythema in rosacea?

A

Topical brimonidine

40
Q

What is ischaemic colitis?

A

An acute but transient compromise in the blood flow to the large bowel.

41
Q

What is the gold standard test for diagnosis venous sinus thrombosis?

A

MR venogram

42
Q

D-dimer in venous sinus thrombosis?

A

Raised d-dimer

43
Q

What is the anatomical site in gallstones least associated with jaundice?

A

Cystic duct

Blockage of the cystic duct is not associated with jaundice as bile is still able to flow through the common hepatic duct and common bile duct to the sphincter of Oddi, where is it secreted into the duodenum.

44
Q

Location of the cystic duct?

A

Connects the gallbladder to the common bile duct

45
Q

Location of bridging veins?

A

Between the cortex and venous sinuses

46
Q

What 3 conditions are seen in MEN type IIa?

A

1) medullary thyroid cancer

2) parathyroid hyperplasia (leading to hypercalcaemia)

3) phaeochromocytoma

47
Q

What 2 oral abx can be used in the mx of acne?

A

1) lymecycline
2) doxycycline

48
Q

What is the most common identifiable cause of postcoital bleeding?

A

Cervical ectropion

49
Q

IV fluid resuscitation formula in paeds?

A

10ml/kg over 10 minutes

50
Q

injury to which nerve can cause groin pain after an inguinlal hernia repair?

A

ilioinguinal nerve

51
Q

What are salmon patches?

A

A kind of vascular birthmark which can be seen in around half of newborn babies.

They are pink and blotchy, and commonly found on the forehead, eyelids and nape of the neck.

52
Q

Prognosis of salmon patches?

A

They usually fade over a few months, though marks on the neck may persist.

53
Q

Fever, facial spasms, dysphagia in an intravenous drug user?

A

Tetanus

note - botulism would cause a flaccid paralysis

54
Q

What acid base disturbance does renal tubular acidosis cause?

A

Hyperchloraemic metabolic acidosis (normal anion gap)

55
Q

What is a common cause of osteoporosis in men?

A

Hypogonadism –> hypergonadotropic or hypogonadotropic

Check testosterone!

56
Q

When should women who have been treated for CIN II be offered cervical screening?

A

6 months later

57
Q

Define recurrent vaginal candidiasis?

A

≥4 episodes in a year

58
Q

Where does paget’s disease of the bone typically affect?

A
  • skull
  • spine
  • pelvis
  • long bones of lower extremities (femur & tibia)

think - drawing a line down middle of patient

59
Q

Formula for positive predictive value?

A

TP / (TP + FP)

60
Q

What is the preferred DIAGNOSTIC test for chronic pancreatitis?

A

1st line –> CT abdomen

faecal elastase may be used to assess exocrine function if imaging inconclusive

61
Q

Conservative mx of an STEMI?

A

Aspirin plus;

  • ticagrelor (if patient is not high bleeding risk)
  • clopidogrel (if patient is high bleeding risk)
62
Q

Dose of statins inopatients with established CVD?

A

High dose –> 80mg

63
Q

When is S3 (third heart sound) considered normal?

A

If <30 y/o

64
Q

Most common site of metatarsal stress fracture?

A

2nd metatarsal shaft

65
Q

How soon should category 2 c-sections be performed?

A

Within 75 minutes

66
Q

Fundoscopy in anterior ischemic optic neuropathy?

A

A swollen pale disc and blurred margins

67
Q

Mx of patients with sudden-onset sensorineural hearing loss?

A

1) Referral to ENT

2) High dose oral steroids

68
Q
A

Yr 5 - Passmed Corrections (8 decks)

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