Everything!!! Flashcards
1
Q
Name some scenarios in which HbA1c is UNreliable?
A
pregnant women, end stage renal disease, HIV infection, splenectomy
2
Q
A skin question with the buzz words “coin shaped lesion” that is dry
A
Think discoid eczema
3
Q
What is the name for the eczema affecting hands or feet?
A
pompholyx or dyshidrotic eczema
it causes tiny blisters - itchy
4
Q
what is the associated underlying systemic disease of CMV retinitis?
A
HIV
5
Q
What eye condition is Sjogren’s syndrome associated with?
A
keratoconjunctivitis sicca
- gritty eyes
6
Q
Name some conditions associated with HLA -B27
A
ank spond, reactive arthiritis, IBD, psoriasis, sarcoid
7
Q
What examination finding is suggestive for anterior uveitis
A
positive talbot’s test - pain increases as the eyes converge and pupils constrict
8
Q
What is Chvostek’s sign in hypocalcaemia?
A
facial muscle contraction upon tapping of the facial nerve
(moa low calcium, so nerve hyperexcitability)
9
Q
What is the risk of phimosis?
A
inability to clean under foreskin -> stones -> penile cancer
10
Q
What age range of children does Perthes disease present?
A
4-8 years
11
Q
sudden loss of vision + cherry red spot
A
central retinal artery occlusion
12
Q
Which chemo drug is used to treat CML?
A
Imatinib (Gleevec), it is a genetically targeted drug
13
Q
rash starting with one spot (herald patch) followed by multiple other pink-red circular/oval lesions
A
pityriasis rosea
14
Q
what blood gas would you expect in a patient with chronic renal failure?
A
metabolic acidosis with resp compensation
15
Q
small t waves, prominent u waves, prolonged PR and depressed ST - what is the cause?
A
HYPOkalaemia
16
Q
ST depression and inverted T waves in V5-6 (reverse tick)
A
Digoxin toxicity
Bonus: what is a side effect of dig .. green/yellow visual discoloration
17
Q
which antihypertensive drug interactions with simvatstation
A
amlodipine (weak cyp inhibitor) - dose of simvastatin must be restricted to 10mg
18
Q
Which drug can cause gynaecomastia
A
Gosrelein
19
Q
Shoulder exam shows reduced ROM, weakness, creps, and tenderness over the subacromial area
A
rotator cuff injury (most common is supraspinatus rupture)
20
Q
How do you test for supraspinatus strength?
A
test resistance to abduction
21
Q
What antibiotic do you give for toxoplasmosis?
A
Spiramycin
22
Q
child with nasal discharge that is initially watery then bloody
inflamed pharynx with greyish membrane
bull neck
A
Diptheria
23
Q
What bacterial infection is bullous myringitis associated with
A
mycoplasma
24
Q
what bacteria causes malignant otitis externa?
A
pseudomonas aurginosa
bonus: how does it present: purulent otorrhoea and red mass lesion in the ear canal
25
who is my fave person ever
Subo
26
What organism causes a quinsy
strep pyogenes
27
what is the next medical step after thrombolysis?
heparin or LMWH
28
What is the first line regular treatment for stable angina?
beta blocker or a CCB such as verapamil
29
what is an undetectable ACTH a strong indicator of?
adrenal adenoma
30
What is the most common epilepsy syndrome in children?
how does it present?
benign rolandic epilepsy
ages 7-10yrs
focal aware motor seizures
nighttime
one side of the face - gurgling, grunting, dribbling
31
eating broad beans increases risk of haemolysis in which condition?
G6PD
32
Radiating leg pain associated with walking but relieved with rest
pain lessens when patient bends forward
spinal stenosis
33
which laxative stains urine red?
co-danthramer
34
how do you calculate the anion gap?
(Na+K) - (HCO3- + Cl)
35
how do you diagnose diabetes in children?
Random blood glucose >11.1
36
What conditions are mefenamic acid contraindicated in?
IBD, severe heart failure
37
what gestation is downs syndrome screening , including nuchal tranlucency done
11-13+6 weeks
38
what is limited cutaneous systemic sclerosis?
what antibody is associated with it?
sclerodactlyly (hardening of the skin on the hands which causes fingers to curl inwards), telangectasia, raynauds
Anti-centromere
39
what does scleroderma mean?
tightening and fibrosis of the skin
40
sexual health: how do you treat solitary keratinised warts
cryotherapy
41
MOA of mini pill
thickens cervical mucus
42
MOA of injectable progesterone contraceptive
inhibits ovulation
+thickens cervical mucus
43
MOA of IUS
prevents endometrial proliferation
44
MOA of COCP
inhibits ovulation
45
MOA copper coil
decreases sperm motility and survival
46
how does emergency contraception work?
inhibits ovulation
47
Side effect of rifampicin
orange tears/urine
abdo pain
48
Abx for dental abcess
Amoxicillin
49
how do you distinguish viral labryrinthitis with vestibular neuronitis?
you get hearing loss with VL and not with VN
50
How do you differentiate vestibular neuronitis and posterior circulation stroke in patients with persistent vertigo?
HiNTs exam
head impulse- corrective saccade = VN, normal reflex intact = central cause
unidirectal nysagmus pos = VN
test of skew normal = VN
51
which medication is associated with spider naevi?
COCP
52
what age should children be able to combine two words?
2 yrs
53
child can say mama and dada and understands no - how old are they
9 months
54
what age can a child respond to own name?
12 months
55
what age can a child talk in short sentences?
3 yrs
56
how do you treat minimal change glomerulonephritis?
prednisolone
57
what is a test for cervical myelopathy?
Hoffman's sign - flicking a finger on the patients hand - if the other fingers twitch then it is positive
58
what abx is given as prophylaxis to contacts of patients with meningococcal meningitis?
oral cipro one of dose or rifampicin
59
what are the features of keratitis?
red eye, photophobia and gritty
60
what are the 3 M's in primary biliary cholangitis?
igM
Anti Mitochondrial antibiodies
Middle ages females
61
what UKMEC is positive antiphospholipid antibiodies when considering COCP
4
62
how do you treat actinic keratosis?
topical fluoroucil 2-3 weeks
63
what is Auspitz's sign?
bleeding when scratching off psoriasis plaques
64
what is the initial treatment for kawasaki disease?
high dose aspirin
65
child, high grade fever (resistant to antipyretics) , maculopapular rash, conjunctivitis, erythematous/cracked lips, strawberry tongue, cervical lymphaednopathy
diagnosis
kawasaki
66
why is an echo important to do in kawasaki kids
screen for coronary artery aneurysms
67
how do you treat whooping cough?
Azithromycin or Clarithromycin if onset of cough is within 21 days
68
anti HBc IGG positive, IGM negative, antiHBs negative, HbsAG positive
Chronic hep B infection
if HBsAg remains positive for 6 months then the patient has a chronic infection
igm is produced in ACUTE infections which is then gradually replaced with igg = G for gradual
69
what blood tests would show immunity to hep B following previous infection
positive anti-HBc IgG and Anti HBs. HbsAg negative
this vs vaccine --> igG would not be positive in vaccinated
70
blurred vision and shadow in the red reflex
cataracts
71
what electrolyte abnormality do you get in addisons
HYPOnatraemia and HYPERkalaemia
72
neonate with swelling on head that crosses suture lines
caput succedaneum - resolves in few days
73
common cause of RAPD
optic neuritis
74
side effect isoniazid (3)
peripheral neuropathy, psychosis, hepatotoxicity
75
side effects pyrazinamide
arthralgia, gout, hepatotoxicity
76
Treatment of chlamydia in pregnancy?
Azithromycin, erythromycin or amox (doxy is contraindicated)
77
name 5 live vaccines
BCG, MMR, oral polio, yellow fever, oral thypoid
78
What is the argyll robertson pupil
small, irregular pupils
no response to light but there is a response to accommodate
Causes
diabetes mellitus
syphilis
79
what is bartters syndrome
autosomal recessive
severe hypokalaemia due to defective chloride absorption in the ascending loop of Henle
Features
usually presents in childhood, e.g. Failure to thrive
polyuria, polydipsia
hypokalaemia
normotension
weakness
80
Tenderness distal to the common extensor origin
It is most common in gymnasts, racquet players and golfers who frequently hyperextend at the wrist or carry out frequent supination/pronation. Patients can also complain of hand paraesthesia or aching at the wrist.
Radial tunnel syndrome
81
Hoovers sign (msk)
Hoover's sign is used to differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension
82
What is berger's disease
iga nephrtopathy, presents visible haematuria, 24-48 hours post URTI
83
Pain on wrist extension against resistance when elbow is extended - diagnosis?
lateral epicondylitis (tennis elbow)
84
what other blood test helps to determine the cause of high ferritin?
transferrin saturation - if normal then this excludes iron overload as a cause (such as haemochromatosis)
85
Pain is elicited during wrist flexion and pronation - diagnosis?
medial epicondylitis
86
The delusion that a friend or partner has been replaced by an identical-looking impostor
Capgras syndrome
87
Most common cause of diarrhoea in HIV patients?
Cryptosporidium
88
First line maintenance therapy for Crohn's?
Azathioprine or mercaptopurine
89
man with mitral stenosis with worsening dysphagia
left atrial hypertrophy - as the atria enlarges it compresses the oesophagus =dysphagia
90
most common location for a dermoid cyst
lateral aspect of the eyebrow
91
what are the 3 main features in haemolytic uraemic syndrome?
1. Acute renal failure
2. Microangiopathic haemolytic anaemia
3. Thrombocytopenia
92
what is PSC? and what is it associated with?
chronic inflammation and fibrosis of the bile duct
associated with IBD, esp UC
93
what is PBC?
autoimmune disease of the live with destruction of the bile canalicui
94
mode of inheritance of haemochromatosis?
autosomal recessive
95
CT shows bilateral hypodensities in the temporal lobes
herpes simplex encephalitis
96
what are the characteristic features of tetralogy of falot?
- VSD
- right ventricular hypertrophy
-right ventricular outflow tract obstruction (pulmonary stenosis)
- overriding aorta
97
what is behcet's syndrome
rare
vasculitis
- mouth ulcers painful
- genital sores
- eye inflammation
-increase risk VTE
98
what is reiter's syndrome?
reactive arthritis
cant see cant pee cant climb tree
anterior uveitis/conjunctivitis, urethritis and arthritis
99
A newborn baby is noted to have low-set ears, rocker bottom feet and overlapping of her fingers.
Edwards syndrome
100
cleft lip or palate, polydactyly (extra digits), microphthalmia (small eyes), scalp defects, and congenital heart disease.
Patau's syndrome
101
This genetic condition is associated with 'elfin' facies, supravalvular aortic stenosis, high calcium, learning disability and outgoing personality
Williams syndrome
102
what is fragile X?
intellectual disability
long face, large ears, hyperextensible joints
ADHD/Autism
big ballzzzzzzz
103
micrognathia, glossoptosis (downward displacement/retraction of the tongue), cleft palate
Pierre-Robin
104
when can kids go back to school if they get:
1. rubella
2. scarlet fever
3. measles
4. chicken pox
5. mumps
6. whooping cough
7. impetigo
1. 5 days from onset of the rash
2. 24 hours after abx started
3. 4 days from onset of the rash
4. all lesions crustyyyy
5. 5 days from onset of swollen glands
6. 2 days after abx or 21 dats from symptoms if no abx
7. lesions crusty and healed or 48hrs after abx started
104
how soon can u drive after tia
This condition is a rare skin disorder that typically presents in middle-aged women with diabetes. well-demarcated erythematous plaques on the shins
105
1 month symptom free - no need to tell dvla
necrobiosis lipoidica
106
which type of antidepressants is contraindicated in pts taking warfarin
ssri
107
abx for human or dog bite
co-amox
108
which autoantibody is associated with sjorgens
anti ro
109
p450 inducers (9)
phenytoin,
carbamazepine
phenobarbitone
rifampicin
St John's Wort
chronic alcohol intake
griseofulvin
smoking
sulphoylureas
110
First line treatment for acne rosacea
Topical ivermectin
111
Symptoms of SSRI discontinuation
Mood change, restless, poor sleep, unsteady, sweat, GI, parasthesia
112
Secondary prevention Treatment of TIA
Clopidogrel 75mg long term
If not then aspirin and dipyrindamole
113
What day post Partum do women need contraception
After 21 days
114
When can you start cocp post pregnancy if breastfeeding
After 6 weeks
115
Second line COPD with asthmatic features if SAMA of SAMA failed
LABA AND ICS
116
Second like COPD NO asthmatic features
LABA and LAMA
117
What is lights criteria pleural effusion
Pleural fluid protein / serum protein >0.5
Pleural fluid LDH/ Serum LDH >0.6
Pleural fluid LDH >2/3 serum LDH upper limit of normal
118
Most commonly sprained ligament in inversion injuries of the ankle
Anterior talofibular ligament
119
Smear - positive high risk - cytology normal then what?
Repeat test at 12 months
If normal then back to normal routine
If positive then rpt cycle
If positive again at 24 months - colposcopy
120
Cervical smear sample inadequate
Rpt in 3 months
2 consecutive inadequate then colposcopy
121
Which RA drug should be avoided in patients with aspirin hypersensitivity
Sulfasalazine
122
Second treatment of angina if on beta blocker
Long acting CCB - MR nifedipine or amlodipine
123
What medications are known to exacerbate plaque psoriasis
Beta blockers, NSAIDS initiation, lithium
124
Management of chronic anal fissure
Topical GTN
125
Bradycardia with shock
IV atropine 500 micrograms - can repeat up to 3gm
126
What is bechets disease
Oral ulcers, genital ulcers, uveitis
127
Management of TIA presenting within 7 days
Aspirin 300 and review in 24 hrs
128
Initial management of acute limb ischemia
Analgesia IV heparin and vascular review
129
Mx of intracapsular hip fracture in healthy pts vs unfit
Total hip replacement vs hemiathroplasty
130
When do u use intrameduallsfy nail
Subtrochanterjc fracture
131
p450 inhibitors
SICKFACES.COM
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Acute alcohol
Chlorampenicol
Erythomycin
Sulphonamides
.
Ciprofloxacin
Omeprazole
Metronidazole
132
