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Finals Studying - Condensed > Exam Docs > Flashcards

Exam Docs Flashcards

1
Q

what drug does azothioprine interact with to cause a pancytopenia

A

allopurinol

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2
Q

interaction between azothioprine and allopurinol

A

pancytopenia

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3
Q

interaction between statin and clarithromycin

A

clarithromycin increases effect of station - rhabdomyolysis

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4
Q

interaction between methotrexate and trimethoprim

A

both folate antagonists - synergistic antifolate effects - pancytopenia

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5
Q

can u inform DVLA about pt if they refuse to do so

A

yes - only if you have persuaded them to stop driving and made efforts. If they continue to drive u can inform DVLA

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6
Q

conversion of oramorph to syringe driver morphine

A

divide by 2

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7
Q

antiemetic for drug induced n+v

A
  1. dopamine antagonist (metoclopramide) or haloperidol
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8
Q

antiemetic for motility disorders

A
  1. metoclopramide (its a prokinetic)
    or
  2. domperidone (if at high risk of EPSEs)
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9
Q

antiemetic for raised ICP/movement related nausea

A

cyclizine

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10
Q

antiemetic for multifactorial n+v

A

levomopromazine

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11
Q

conversion of oral morphine to oral oxycodone

A

divide by 2

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12
Q

oral morphine to SC oxycodone

A

divide by 4

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13
Q

oral codeine to oral morphine conversion

A

divide by 10

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14
Q

breakthrough dose

A

1/6th of total daily dose of morphine

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15
Q

conversion oral tramadol to oral morphine

A

divide by 10

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16
Q

oral morphine to SC diamorphine

A

divide by 3

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17
Q

acute heart failure Tx

A

‘PODMAN’

position 
oxygen 
diuretic (furosemide 40mg stat) 
morphine 
anti-emetic 
nitrate
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18
Q

chronic heart failure Mx

A
  1. ACEi + Beta-Blocker
    • Spironolactone
    • Ivabradine
    • Digoxin or Hydralazine/Isosorbide mononitrate

(Loop Diuretic - furosemide for symptom relief)

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19
Q

HTN Mx in preg

A
  1. labetalol
  2. methydopa
  3. nifedipine
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20
Q

Mx of recently healed venous ulceration

A

graduated compression stocking

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21
Q

Mx of enlarging ulcer in elderly pt with normal pulse and no venous problems

A

biopsy - suspected marjolin’s ulcer or SCC

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22
Q

Mx of a multifactorial ulcer with ABPI of 2.1

A

toe brachial index (more accurate ABPI as diabetic pts have calcification of the crural vessels)

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23
Q

Dx of a leg ulcer with brown patches

A

venous leg ulcer (haemosiderin staining)

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24
Q

J waves on ECG

A

hypothermia

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25
Q

U waves ECG

A

hyperkalaemia

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26
Q

hypocalcaemia presentation

A

tetany

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27
Q

effect of autonomic neuropathy on ECG

A

sinus arrhythmia

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28
Q

aortic dissection causing inferior MI, 1st line tx?

A

CT

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29
Q

what is used to monitor response to pneumonia Tx

A

CURB65 score

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30
Q

CXR appearance of atypical pneumonia

A

patchy consolidation, often bilateral

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31
Q

emphysema with hyper expanded chest - apex beaT?

A

loss of apex beat

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32
Q

reversal of warfarin if major bleed

A

prothrombin complex and vit K

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33
Q

reversal of warfarin if minor bleed

A

vit K

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34
Q

reversal of warfarin if INR > 8 and no bleeding

A

stop warfarin and give Vit K

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35
Q

reversal of warfarin if INR 6-8 and no bleeding

A

withold warfarin and restart when INR <5.0

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36
Q

INR therapeutic range

A

between 2 and 3 (ideal 2.5)

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37
Q

initial Ix for ?pancreatic ca

A

abdo US

gold standard diagnostic = CT

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38
Q

causes of oesophageal candidiasis

A

steroid inhalers

immunosuppression

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39
Q

Ix for IBS

A

clinical diagnosis

do bloods to rule out other causes - FBC/ESR/CRP/coeliac screen

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40
Q

Ix for IBD

A
  1. stool study - faecal calprotectin
  2. ?UC - flexible sigmoidoscopy
    ?Crohn’s - colonoscopy
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41
Q

Dx altered bowel habit - mass in elderly man with wt loss

A

colorectal ca

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42
Q

Dx altered bowel habit - constipation and bleeding with fleshy lumps palpable

A

haemorrhoids

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43
Q

Dx altered bowel habit - loose stools after ciprofloxacin

A

c. diff

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44
Q

Dx altered bowel habit - pain with passing stool and exquisitely tender PR

A

anal fissure

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45
Q

Ix for addisons diagnosis

A

short synacthen test

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46
Q

cause of proteinuria with Hx of recurrent UTI

A

reflux nephropathy

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47
Q

Ix of reflux nephropathy

A

MCUG

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48
Q

Mx complicated UTI

A

amox + gent

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49
Q

stepdown Tx complicated UTI

A

co-trimoxazole

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50
Q

Mx mild/mod CAP

A

amoxicillin PO

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51
Q

Mx severe CAP

A

co-amoxiclav + doxycycline

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52
Q

Mx CAP in HDU/ICU or NBM

A

co-amoxiclav + clarithromycin

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53
Q

Mx non severe HAP

A

amoxicillin PO

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54
Q

Mx severe HAP

A

amox + gent

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55
Q

Mx non-severe aspiration pneumonia

A

amox + met

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56
Q

Mx severe aspiration pneumonia

A

amox + met + gent

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57
Q

Mx giardiasis

A

metronidazole

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58
Q

Mx amoebiasis

A

metronidazole

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59
Q

Mx campylobacter

A

mild - no Tx

severe - erythromycin

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60
Q

Mx E.coli 0157

A

no abx!

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61
Q

does everyone with salmonella get Abx?

A

no - only if:
> 50 y
immunocompromised
have cardiac valve disease

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62
Q

Abx Mx of salmonella

A

ciprofloxacin

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63
Q

cause of croup

A

parainfluenza

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64
Q

cause of bronchiolitis

A

RSV

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65
Q

GCS motor scoring

A
  1. obeys commands
  2. localises to pain
  3. withdraws from pain
  4. abnormal flexion to pain (decorticate)
  5. extension to pain (decerebrate)
  6. none
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66
Q

GCS verbal scoring

A
  1. orientated
  2. confused
  3. words
  4. sounds
  5. none
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67
Q

GCS eye scoring

A
  1. spontaneous
  2. to voice
  3. to pain
  4. none
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68
Q

biceps reflex

A

C5

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69
Q

triceps reflex

A

C7

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70
Q

brachioradialis reflex

A

C6

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71
Q

knee jerk reflex

A

L4

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72
Q

ankle reflex

A

S1

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73
Q

visual defect - pituitary tumour

A

bitemporal hemianopia

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74
Q

visual defect - optic neuritis

A

ipsilateral central scotoma

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75
Q

visual defect - occipital cortex strok

A

contralateral homonymous hemianopia with macular sparing

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76
Q

CSF results - idiopathic intracranial HTN

A

normal

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77
Q

CSF bacterial meningitis

A

cloudy appearance
low glucose
high protein
polymorphs

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78
Q

CSF viral meningitis

A

clear appearance
60-80% of plasma glucose
normal protein
lymphocytes

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79
Q

CSF TB meningitis

A

slightly cloudy - ‘fibrin web’
low glucose
high protein
lymphocytes

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80
Q

sudden shooting back pain while performing heavy lifting - Dx?

A

prolapsed disc

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81
Q

low-grade fever, local tenderness at L3 - Dx?

A

discitis

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82
Q

lorry drive, stiff and tender back pain - Dx?

A

mechanical back pain

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83
Q

hemiparesis with homonymous hemianopia with macular sparing - artery affected?

A

posterior cerebral artery

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84
Q

ataxia, decreased conscious level, facial muscle weakness, facial sensory loss - area affected?

A

pontine

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85
Q

nystagmus of right eye looking to right and failure of left eye to cross midline on looking to right - Dx?

A

internuclear ophthalmoplegia

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86
Q

internuclear ophthalmoplegia - sign of?

A

MS

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87
Q

Mx of DVT/PE in preg

A

LMWH - stop at onset of labour, continue for 3m postnatal

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88
Q

Dx of Downs at 16w gestation

A

amniocentesis

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89
Q

timing of amniocentesis

A

> 15w

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90
Q

timing of chorionic villus biopsy

A

11.5-15w

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91
Q

who performs amniocentesis

A

obstetrician

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92
Q

who review pt at 6/52 post-natal

A

GP

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93
Q

who repairs 2nd degree perineal tear

A

midwife

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94
Q

who repairs 3rd degree perineal tear

A

obstetrician

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95
Q

who performs any labour other than just a nroaml vag delivery

A

obstetrician

96
Q

who performs normal vaginal deliveries

A

midwives

97
Q

who performs epidurals and pudendal nerve blocks

A

anaesthetists

98
Q

arcuate scotoma

A

glaucoma

99
Q

pt with SNHL after being in intensive care for severe sepsis - cause?

A

aminoglycoside toxicity (gentamicin)

100
Q

SNHL with notch at 4000Hz - Dx?

A

noise induced HL

101
Q

how long must symptoms be present for Dx of PTSD

A

3m

102
Q

how long must symptoms be present for Dx of depressive ep

A

2w

103
Q

adjustment disorder

A

‘situational depression’
unable to cope with particular stress or life event
resolves once person is able to adapt

104
Q

presentation of measles

A

rash in mouth - koplick spot’s

then rash starts behind ears and spread to whole body

105
Q

presentation of scarlet fever

A

“strawberry tongue”

sandpaper texture rash - torso first, spares palms and soles

106
Q

Mx scarlet fever

A

penicillin V for 10d, can go back to school after 24h

107
Q

presentation of rubella

A

maculopapular rash starts on face and spread to whole of body

108
Q

child has an itchy, red rash and has a brother with asthma - Dx?

A

infantile eczema

109
Q

purplish lesions on elbows in elderly man - Dx?

A

lichen planus

110
Q

++ itch with ongoing Ix for GI problems - Dx?

A

dermatitis herpetiformis

111
Q

T2DM with urinalysis of 2+ protein - what Ix to do next?

A

urinary albumin:creatine ratio

normal: <3.5 female, <2.5 male

112
Q

Ix for addisons

A

short synacthen test

113
Q

pt with HbA1c of 66 - what do u start them on

A

metformin

114
Q

pt started on new diabetic drug, developed diarrhoea - what caused it

A

metformin

115
Q

old man, acute exacerbation (breathless), is already on inhalers for asthma, CXR shows hyperinflation, ECG - sinus tachy, bilateral wheeze - next Ix?

A

peak flow

116
Q

Mx primary spontaneous pneumothorax <2cm or asymptomatic

A

discharge

117
Q

Mx primary spontaneous pneumothorax >2cm or symptomatic

A

needle thoracocentesis (aspiration)

if this fails - chest drain

118
Q

Mx secondary spontaneous pneumothorax 0-1cm and aysymptomatic

A

give O2 and admit for 24h

119
Q

Mx secondary spontaneous pneumothorax 1-2cm and asymptomatic

A

needle thoracocentesis (aspiration)

if this fails - chest drain

120
Q

Mx secondary spontaneous pneumothorax if >2cm or symptomatic

A

chest drain

121
Q

pt with bilateral LMN symptoms & loss of proprioception & vibration sense up to ankle. What tract

A

DCML

122
Q

hemiparesis & hemisensory loss - what artery

A

anterior cerebral artery

123
Q

presentation of CN III palsy

A

eye located down and out (they cannot adduct and elevate eye)

124
Q

artery affected inferior MI

A

right coronary artery

125
Q

artery affected anterior MI

A

left anterior descending

126
Q

artery affected lateral MI

A

left circumflex

127
Q

CXR appearance pulmonary oedema

A

ABCDE

Alveolar oedema (bats wings) 
B kerley B lines 
Cardiomegaly 
Dilated prominent upper lobe vessels 
Effusion
128
Q

critical limb ischaemia definition

A

advanced chronic limb ischaemia:

chronic >2w ischaemic rest pain, necrosis or ulceration as a result of proven arterial disease

129
Q

patient had anterior MI - they have congestive heart fialure symptoms, low Na and normal potassium - what sort of renal injury do they have?

A

renal hypoperfusion (pre renal aki)

130
Q

sharp central chest pain worse on lying flat, relieved by leaning forward, had an infection - Dx?

A

pericarditis

131
Q

pt with drooling and uvular deviation - Dx?

A

quinsy (peritonsillar abscess)

132
Q

pt with all centor criteria present - Mx ?

A

penicillin 500mg

133
Q

post-thyroidectomy, pt has hoarseness, what nerve has been affected?

A

recurrent laryngeal nerve (branch of vagus)

134
Q

1st line Mx urge incontinence

A
  1. bladder training
  2. anti-muscarinics e.g. oxybutinin, tolteridine
  3. b3 agonists e.g. mirabegron
135
Q

1st line Mx stress incontinence

A

pelvic floor exercises

136
Q

what is the active 1st stage of labour

A

from 4cm - full dilation

137
Q

GDM - lifestyle advice has been given (lost 3kg) but finger prick is still 8-14 - what do you start?

A

metformin

138
Q

eclampsia 1st line Mx

A

magnesium sulphate 4g IV over 5-10mins
then infusion of 1g/hr.
continue Tx for 24h after last seizure

139
Q

fishy smelling discharge, pH 5.5 - Dx?

A

bacterial vaginosis - give metronidazole

140
Q

Mx for kid with facial non-infective eczema

A

hydrocortisone 1%

141
Q

Mx oesophageal candidiasis

A

nyastatin suspension

142
Q

Ix for HSP

A

U&Es (renal involvement)

143
Q

kid who is overwght, snores, daytime somnolence and only breathes through their mouth - Dx?

A

adenoidal hypertrophy

144
Q

rptd unilateral rhinorrhoea - Dx?

A

foreign body

145
Q

Fhx of asthma, single crease on nose - Dx?

A

allergic rhinitis

146
Q

achilles tendon rupture - Ix?

A

ultrasound

147
Q

s/e of risedronate that means you need to discontinue the drug

A

oesophagitis or oesophageal ulcer

148
Q

pt had painful red eye with nausea and headache - Ix?

A

check IOP (AACG?)

149
Q

pt been to malawi - 2w later has swinging fevers and rigors - what Ix?

A

thick and thin blood film - ?malaria

150
Q

pt presents with reactive arthritis (cant see, cant pee, cant climb a tree) - what Ix?

A

chlamydia screen

151
Q

Mx if pt’s INR on warfarin is 6.1 and there is no bleed

A

omit warfarin and review INR

152
Q

Mx if pt’s INR is 8.1 on warfarin and they have an active GI bleed with Hb 11.1 and plt 156

A

FFP

153
Q

Ix for pt with back pain and high calcium

A

electrophoresis - ?multiple myeloma

154
Q

male, smoker with loin pain, haematuria and abdo mass - Dx?

A

RCC

155
Q

20y old who moved to UK from afghan recently, has # of pubic ramus.
high PTH, low Ca, high PTH - what next best Ix?

A

check Vit D level

156
Q

Left side BC>AC
webers lateralises to the left
right side AC>BC

whats the problem?

A

left conductive deafness§

157
Q

Mx drug induced parkonsonism

A

procyclidine

158
Q

OD and dont know what - tinnitus, tachy, not hypotensive, sweating - what drug have they probably takne?

A

aspirin

159
Q

pt with ascites - has fever and generalised abdo tenderness - Dx?

A

spontaneous bacterial peritonitis

160
Q

35 y/o with 5y Hx of alternating diarrhoea and constipation - Dx?

A

IBS

161
Q

pt 72h post-ip with generalised abdo tenderness, has not passed stool and no bowel sounds heard - Dx and Ix?

A

functional ileus

Ix - CT abdo/pelvis

162
Q

CXR provided (squamous cell ca) + hyponatraemia - Dx?

A

SIADH

163
Q

Most appropriate first Ix for PE

A

D dimers

164
Q

pt with sinusitis, haemoptysis, urinary problems & cANCA

A

GPA

165
Q

Mx otitis media

A

delayed Abx - amoxicillin

166
Q

Ix to diagnose anaphylaxis

A

serum tryptase

167
Q

pt on triple insulin in the day + lantus in the evening. they are preop. how do you change the lantus dose?

A

continue on original dose

168
Q

biphasic insulin before lunch is low (BG=2.1), what do you change?

A

give lucozade and change morning dose

169
Q

SIADH test

A

urine:serum osmolality

170
Q

pt with symptoms of diabetes, fasting and OGTT done - fasting is normal (<6) and OGTT 8.5 - Dx?

A

impaired OGTT (pre DM)

171
Q

pt with big jaw and teeth growing apart - what visual deformity is expected?

A

bitemporal hemianopia

172
Q

34 yo female, never had children, has high LH and FSH, low oestradiol and no menses for 4m - Dx?

A

premature ovarian failure

173
Q

53 y/o, hot flushes, sweats, amenorrhoea for 7m - what HRT do you give?

A

cyclical combined HRT

174
Q

symptoms of a perimenopausal lady

A

hot flushes, has irregular periods

175
Q

lady ovuatory, seems well, tried for 18m, male fit and well - what first Ix do you do for infertility?

A

semen analysis

176
Q

lady 8w preg, os is open with POC visible, US shows non viable preg, doesnt want to watch and wait - what do you do?

A

give misoprostol

177
Q

AXR given (dilated loops - small bowel - venae commintantes), Hx of abdo hysterectomy 15y ago, hernia fixation 2y ago - Dx?

A

obstruction due to adhesions

178
Q

mother on methadone, what would u expect in baby

A

withdrawn and inactive baby

179
Q

mother took alcohol in preg what symptoms expected in baby

A

agitated baby

180
Q

pt post-hysterectomy, has numbness over medial thigh - what nerve is affected

A

obturator nerve

181
Q

binge eating + compensating - Dx?

A

bulimia

182
Q

pt cant look down and in - what CN

A

CN IV (eye floats upwards and head tilts)

183
Q

kid with strabismus - if they close their right eye their left eye moves in - what do they have

A

left exotropia (the eye is out and you see inward movement) - divergent squint

184
Q

pt with SCZ, has been changed from risperidone to olanzapine and has wt gain. Has tried other drugs and they dont work - who to refer to?

A

dietician

185
Q

pt has vascular dementia and wants independence - who to refer to?

A

OT

186
Q

old man wants to move into care home - who can help?

A

care home liason nurse

187
Q

leg ulcer with ABPI of 1.1 - Mx?

A

compression stockings (ABPI is normal, therefore can do compression as probable venous)

188
Q

diabetic foot ulcer over 1st MT, XR shows bone changes and is dischaging - Mx?

A

IV Abx - osteomyelitis

189
Q

prostate ca - sudden onset bilateral leg weakness, saddle anaesthesia and urinary incontinence - Dx?

A

spinal cord compressoin

190
Q

pt lifts up arm and has dimpling present - Dx?

A

breast ca

191
Q

what do you warn a pt who is about to undergo XRT for prostate ca

A

rectal bleed? dysuria?

192
Q

Tx for hodgkin’s lymphoma

A

biological chemo

193
Q

pt with peripheral neuropathy - blood Ix show macrocytosis - what do you Tx with?

A

hydroxcobalamin (b12 deficiency)

194
Q

kardex provided - problems with it?

A

furosemide @ 10pm
Penicillin allergy - stop co-amoxiclav
has rhabdo - stop statin

195
Q

medication used to induce labour if cervix closed

A

misoprostal

196
Q

post-coital bleeding in 8w preg lady?

A

cervical ectropion

197
Q

severe RIF pain, bHCG -ve - Dx?

A

ovarian torsion

198
Q

lady with Cu coil just inserted, has pain, septic on speculum has red cervix with discharge - Dx?

A

uterine perforation

199
Q

regular narrow complex tachy. vagal manoeuvres have failed - what is the next step?

A

IV adenosine

200
Q

ECG after burns. What is the cause for his ECG appearance?

A

hyperkalaemia

201
Q

rate control of AF

A

bisoprolol

202
Q

old man with PMR on steroids - cause of hyperlipidaemia?

A

corticosteroid Tx

203
Q

47y/o male with MI, achilles tendon was thickened cause of hyperlipidaemia?

A

familial hypercholesterolaemia

204
Q

lady with temporal epilepsy.
Pre-statin she has high cholesterol,
Post 80mg of atorvastatin she has only had a small reduction in lipids - cause?

A

drug-induced

205
Q

Mx campylobacter diarrhoea

A

erythromycin

206
Q

50 yo female with RUQ pain. USS showed thickened gallbladder and stones in cystic duct. Comes back for rv, pain free. What to Ix to do?

A

MRCP

207
Q

AMA +ve - Dx?

A

PBC

208
Q

16w old baby, fever and irritable lasting for 24h after immunisation which started 3h after immunisation. Precautions for next immunisation?

A

no precautions required

209
Q

Extensive bowel cancer disease, cannot take PO. He has back pain which was controlled with max codeine before but now in pain (cannot take the meds orally). Normal renal function. What do you change this to?

A

CSCI morphine

210
Q

pt with multiple stuck on keratotic lesions on her neck - first thing you would do?

A

reassurance (seborrhoeic keratosis)

211
Q

whole fam have itch, mother has interdigital eczema, grandma has crusty itchy palms and 2y old has itchy palms and soles. Tx?

A

permethrin (scabies)

212
Q

ECG most common in pulmonary embolism

A

sinus tachy

213
Q

chronic counterpart of guillain barre syndrome

A

chronic inflammatory demyelinating polyneuropathy (CIDP) - develop over 6m

214
Q

bells palsy Tx

A

steroids - oral pred

215
Q

48y/o male with changes in behaviour (aggressive to wife), trouble with moving, disinhibited

A

picks disease

216
Q

viral infection, hearing loss and vertigo - Dx?

A

labyrinthitis

217
Q

guy in garden, suddenly dizzy and dropped tools and staggered home. nystagmus. headache started a while later. Dx?

A

cerebellar stroke

218
Q

boxer, cannot look up nose

A

nasal septal haematoma

219
Q

RTA, airbag hit face. face oedematous and eye painful. slowly losing vision

A

orbital haematoma

220
Q

22 y/o post infection, noticed mass at lower 1/3 anteromedial aspect of SCM - Dx?

A

branchial cyst

221
Q

plummer vinson syndrome

A 
difficulty swallowing 
iron deficiency anaemia 
glossitis 
cheilosis 
oesophageal webs
222
Q

causative agent of dendritic ulcer

A

herpes simplex

223
Q

Mx dendritic ulcer

A

topical aciclovir

224
Q

presentation of keratoconjunctivitis sicca

A

punctate lesion on conjunctiva and cornea

225
Q

antidepressant medications taken in OD. pt is hyper-reflexic, tachycardic and pupils dilated. Tx?

A

IV sodium bicarb (TCA overdose)

226
Q

pt hyperkalaemic - what HTN drug cant they be on

A

ACEi

227
Q

teenager with DKA, BM 18 and is hypotensive what is your initial Tx?

A

IV fluids

228
Q

mnemonic for brachial plexus nerves

A

my aunty raped my uncle

musculocutaneous 
axillary
radial 
median 
ulnar
229
Q

nerve roots muculocutaneous nerve

A

C5,6,7

230
Q

nerve roots axillary nerve

A

C5,6

231
Q

nerve roots radial nerve

A

C5-T1

232
Q

nerve roots median nerve

A

C5-T1

233
Q

nerve roots ulnar nerve

A

C8-T1

234
Q

what does a ratio concentration of drug mean (e.g. 1:1000)

A

number of grams in mls of solution

e.g. 1g of adrenaline in every 1000mls of saline

235
Q

what does a % solution of a drug mean

A

grams of drug per 100mls of solution

236
Q

what does 1g = ? in mls

A

1 ml

237
Q

what does 1 ml = ? in g

A

1g

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