Everything Flashcards
Prophylaxis for different headaches:
Tension = nothing
Migraine = propranolol or topiramate (antiepileptic), riboflavin (B2), acupuncture, candesartan, CGRP mAbs
Cluster = CCB
Trigeminal neuralgia = carbamazepine or referral
IIH = acetazolamide, topiramate -> weight loss
Subclinical hypothyroidism TSH 7 in a 66yr old. Tx?
Watch and wait
If <65 you give thyroxine trial of 6 months if TSH 5.5-10 on two separate occasions AND they have symptoms
Bilateral parotid swelling with facial never palsy?
Sarcoid - most likely to be bilateral
Fungal nail infection?
Take nail clipping:
If dermatophyte -> limited: topical amorolfine; extensive: oral terbinafine (3months nails, 6months toenails)
If candida -> oral itraconazole ‘pulsed’
Tinea corporis?
Oral fluconazole
Tinea capitis?
Ketoconazole shampoo
Oral terbinafine
Which tone loss first in otosclerosis?
Low tone
CNS lymphoma scan?
Thallium SPECT homogenous enhancing lesion (just a single lesion)
Hepatic encephalopathy prophylaxis?
Lactulose - reduces ammonium
Rifaximin - modulates gut flora
Flushing predominant rosacea tx?
Bromocriptine
Pustules in rosacea?
topical ivermectin OR
topical ivermectin AND oral doxycycline OR
topical metronidazole OR
topical azelaic acid
18yr old previous constipation now diarrhoea with some bleeding and incontinence day and night, diagnosis?
IBD proctitis
Pruritus ani and bright red rectal bleeding and mass in anal region?
Anal cancer SCC
A 19-year-old man presents with bright red rectal bleeding. He has a longstanding history of irritable bowel syndrome. At flexible sigmoidoscopy a lesion is biopsied and reported as showing ‘fibromuscular obliteration’. Diagnosis?
solitary rectal ulcer syndrome - typically shows obliteration or extensive collagenous deposits
Jarisch Herxheimer treatment?
Paracetamol
Red eye after cataract surgery?
Postoperative endophthalmitis
The history of self-resolving cardiac chest pain on a background of ischaemic heart disease? Deep inverted T waves in V2 and V3
Wellen’s syndrome
Diarrhoea metabolic derangement on ABG?
metabolic acidosis with hyponatraemia and hypokalemia
NORMAL ANION GAP
Complications of surgery?
- Wind: day 1-2 - pneumonia, aspiration, atelectasis
- Water: day 3-5 - UTI (especially if the pt was catheterised)
- Wound: day 5-7 - infection at surgical site or abscess formation
- Walking: day 5+ - DVT, PE
- Wonder drugs: drug fever or reaction to blood products or line contaminations
Wilson’s tx?
Penicillamine
Pregabalin or amitrypyline in BPH?
Pregabalin
Amitryptiline can cause retention
Kussmaul’s positive?
Constrictive pericarditis NOT tamponade
But tamponade has pulsus paradoxus (drop in BP on inspiration)