Everything Flashcards

1
Q

Prophylaxis for different headaches:

A

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

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2
Q

Subclinical hypothyroidism TSH 7 in a 66yr old. Tx?

A

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

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3
Q

Bilateral parotid swelling with facial never palsy?

A

Sarcoid - most likely to be bilateral

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4
Q

Fungal nail infection?

A

Take nail clipping:
If dermatophyte -> limited: topical amorolfine; extensive: oral terbinafine (3months nails, 6months toenails)
If candida -> oral itraconazole ‘pulsed’

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5
Q

Tinea corporis?

A

Oral fluconazole

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6
Q

Tinea capitis?

A

Ketoconazole shampoo
Oral terbinafine

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7
Q

Which tone loss first in otosclerosis?

A

Low tone

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8
Q

CNS lymphoma scan?

A

Thallium SPECT homogenous enhancing lesion (just a single lesion)

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9
Q

Hepatic encephalopathy prophylaxis?

A

Lactulose - reduces ammonium
Rifaximin - modulates gut flora

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10
Q

Flushing predominant rosacea tx?

A

Bromocriptine

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11
Q

Pustules in rosacea?

A

topical ivermectin OR
topical ivermectin AND oral doxycycline OR
topical metronidazole OR
topical azelaic acid

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12
Q

18yr old previous constipation now diarrhoea with some bleeding and incontinence day and night, diagnosis?

A

IBD proctitis

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13
Q

Pruritus ani and bright red rectal bleeding and mass in anal region?

A

Anal cancer SCC

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14
Q

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?

A

solitary rectal ulcer syndrome - typically shows obliteration or extensive collagenous deposits

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15
Q

Jarisch Herxheimer treatment?

A

Paracetamol

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16
Q

Red eye after cataract surgery?

A

Postoperative endophthalmitis

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17
Q

The history of self-resolving cardiac chest pain on a background of ischaemic heart disease? Deep inverted T waves in V2 and V3

A

Wellen’s syndrome

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18
Q

Diarrhoea metabolic derangement on ABG?

A

metabolic acidosis with hyponatraemia and hypokalemia
NORMAL ANION GAP

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19
Q

Complications of surgery?

A
  • 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
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20
Q

Wilson’s tx?

A

Penicillamine

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21
Q

Pregabalin or amitrypyline in BPH?

A

Pregabalin

Amitryptiline can cause retention

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22
Q

Kussmaul’s positive?

A

Constrictive pericarditis NOT tamponade
But tamponade has pulsus paradoxus (drop in BP on inspiration)

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23
Q

Non-treponemal tests?

A

VDRL
RPR

24
Q

Anterior uveitis tx?

A

cycloplegic e.g. Atropine, cyclopentolate
steroid

25
Q

Holmes-Adie pupil description?

A

dilated pupil that remains small for an abnormally long time once it has constricted

26
Q

Specific ECG finding in pericarditis?

A

PR depression

27
Q

Does HbA1c <48 exclude diabetes?

A

No - HbA1c not as sensitive as fasting glucose

28
Q

PE ECG change?

A

RBBB from straight on right heart

29
Q

Finasteride MOA? Use?

A

5-alpha reductase inhibitor - reduces PSA. Prevents breakdown of testosterone into DHT.

1st line (with 1 alpha antagonists) for BPH
Used also for male pattern baldness

30
Q

Otitis media vs externa mangement?

A

Otitis media - 3 days delayed abx - amoxicillin (if <2yo then immediate)

Otitis externa - topical abx and steroid immediately e.g. ciprofloxacin and dexamethasone. If getting worse then oral flucloxacillin or swab.

31
Q

Pneumonia associated with cold sores?

A

S. pneumoniae

32
Q

Reversing bleeding on dabigatran?

A

Idarucizumab

33
Q

Reversal of rivaroxaban and apixaban?

A

Andexanet alfa

34
Q

What is Trastuzumab?

A

Herceptin

35
Q

Types of crackles in IIF?

A

Fine end INSPIRATORY

36
Q

Pseudo Pelger-Huet cells ? Auer Rods?

A

CML
Auer Rods = AML

37
Q

Crypt abscesses?

A

UC

38
Q

Nicorandil use?

A

Potassium channel opener in ANGINA

39
Q

Metabolic abnormality in Addison’s?

A

Metabolic acidosis to excrete the potassium (this explains the hypercalcaemia)

40
Q

Dantrolene MOA?

A

skeletal muscle relaxant used for reversal of malignant hyperthermia (caused by depolarising neuromuscular blocking drugs Suxamethonium and volatile inhaled anaesthetic halothane)

41
Q

Which anaesthetic are MG patients resistant to?

A

Suxamethonium

Treated with neostigmine

42
Q

Common paraneoplastic syndrome with squamous cell carcinomas of lung?

A

Hypertrophic pulmonary osteoarthropathy

43
Q

What are some long term complications of PV in terms of progression of disease?

A

Myelofibrosis
AML

44
Q

Fondaparinux MOA?

A

Antithrombin III activator -> Xa inhibitor

45
Q

Heparin monitoring?

A

APTT - standard heparin
Anti-Xa levels - LMWH

46
Q

Treating diarrhoea which floats in the toilet after cholecystectomy 6 months ago?

A

Cholestyramine - helps with bile acid malabsorption by binding them in the small intestine

47
Q

HFrEF unresponsive to BB, ACEi and aldosterone antagonist. Tx next?

A

Ivabradine OR ARNI OR hydralazine/nitrate mix.

48
Q

Filgrastim?

A

GCSF - for constant neutropenia in patients on chemo without sepsis

49
Q

Severe anaemia and dysphagia?

A

Severe iron deficiency anaemia can cause dysphagia due to post-cricoid webs (Plummer-Vinson syndrome)

Triad of dysphagia, glossitis and iron-deficiency anaemia (some definitions additionally include cheilitis in the syndrome).

50
Q

Anisocoria meaning?

A

Unequal pupils - if more evident in bright light then there is a problem with the dilated pupil.

51
Q

Causes of massive splenomegaly?

A

MF
CML
malaria
kala-azar (leishmaniasis)
Gaucher syndrome

52
Q

Galactorrhoea causing drugs?

A

Metoclopramide/domperidone
Phenothiazines
Haloperidol

Sometimes: SSRIs, opioids

53
Q

Pericarditis vs myocarditis ?

A

Widespread ECG changes after recent virus VS
Localised ECG changes after recent virus

NB: both cause chest pain and may have some level of troponin increase

54
Q

Name a H1 agonist vs antagonist

A

H1 agonist = anacid
H1 antagonist = antihistamine like loratadine

55
Q

Which blood test in incidental NAFLD diagnosis?

A

ELF test = enhanced liver fibrosis test