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Extra Flashcards

1
Q

Management of childhood vulvovaginitis

A

Hygiene advice
Soothing creams
Topical antibiotic/antifungal
Oestrogen cream if resistant

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2
Q

Delayed puberty in female =

A

No breast development at 13y

Normal breast development but no menses 15y

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3
Q

Diagnosis of head lice

A

Live lice seen

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4
Q

Genital lichen sclerosis

A

Vulval itch, pain
Dyspareunia
White atophy
Never inside vagina

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5
Q

1st line for vulval lichen sclerosis

A

Very potent steroid OD 4 weeks

Taper to twice-weekly

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6
Q

2nd line for vulval lichen sclerosis

A

Refer gynae/derm (risk of vulval carcinoma)

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7
Q

All referrals for breast symptoms should be seen within

A

2 weeks

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8
Q

1st line management of cyclcical breast pain

A

Supportive bra

Analgesia

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9
Q

Consider referral of cyclical breast pain to 2 care if:

A

Affecting QOL/sleep

Present after 3m 1st-line measures

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10
Q

Blood test after vitamin D replacement

A

Adj calcium 1 month after starting Vit D

hyperparathyroidism

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11
Q

Best option for nicotine replacement in pregnancy

A

Gum/lozenges over patches

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12
Q

Congenital abnormalities seen with sodium valproate

A

NTD
Urinary trac malformation
Cleft palate

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13
Q

Congenital abnormalities seen with phenytoin

A

Cardiac malformation

Cleft palate

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14
Q

Congenital abnormalities seen with phenobarbital

A

Cardiac malformation

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15
Q

Congenital abnormalities seen with carbamazepine

A

Cleft palate

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16
Q

AEDs with lowest risks of major congenital abnormalities

A

Lamotrigine

Carbamazepine low-dose

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17
Q

In pregnancy, abdominal pain before light bleeding:

A

Ectopic pregnancy

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18
Q

Annual asthma monitoring in >=5y

A 
Spirometry/PF variability
Exacerbations
Nocturnal symptoms
Adherence + plan
Smoking exposure
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19
Q

Annual asthma monitoring in <5y

A

Childhood asthma control test/
Asthma control questionnaire

Growth

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20
Q

Best psychotherapy for medically unexplained symptoms

A

CBT

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21
Q

Young schizophrenics need physical health check

A

Annually

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22
Q

Screening tool for social anxiety disorder

A

Mini-Social Phobia Inventory (Mini-SPIN)

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23
Q

DVLA + elective angioplasty

A

1 week off

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24
Q

DVLA + CABG

A

4 weeks off

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25
Q

DVLA - ACS treated successfully by angioplasty

A

1 week off

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26
Q

DVLA - ACS (not treated successfully by angioplasty)

A

4 weeks off

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27
Q

DVLA - angina

A

Cannot drive if at rest/at wheel

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28
Q

DVLA - pacemaker insertion

A

1 week off

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29
Q

DVLA - ICD implanted due to sustained ventricular arrhythmia

A

6 months off

Group 2 ban

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30
Q

DVLA - ICD implanted prophylactically

A

1 month off

Group 2 ban

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31
Q

DVLA - successful ablation

A

2 days off

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32
Q

DVLA - aortic aneurysm >6cm

A

Notify DVLA, annual review

>6.5cm cannot drive

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33
Q

DVLA - heart transplant

A

6 weeks off, no need to notify

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34
Q

CAA - Flying after MI (no complications)

A

after 7-10 days

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35
Q

Return to heavy work after MI

A

after 12 weeks

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36
Q

Accuracy of a test

A

(TP + TN) / (TP + FP + TN + FN)

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37
Q

Principle of Middle ground research

A

Focusing healthcare on the needs and goals of patients

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38
Q

Prospective observational study

Follows groups of different exposure, to monitor for disease incidence

A

Cohort study

Calculates relative risk

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39
Q

Retrospective observational study

Groups with different disease status, analysed for exposure

A

Case-control study

Calculates odds ratio

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40
Q

Crossover study

A

Each subject receives treatment + placebo in random order

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41
Q

Crossover study is appropriate for

A

Symptomatic treatments in chronic disease

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42
Q

Cross-sectional study

A

Describe characteristics of a population, at one point in time.

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43
Q

Current UK state pension age

A

66y

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44
Q

Qualitative study

A

Non-numerical data

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45
Q

1 finger-tip unit =

A

0.5g

46
Q

1 finger-tip unit covers:

A

Both palms (adult)

47
Q

Actinic keratoses self-resolve in:

A

25%

48
Q

Treatment options for actinic keratoses - individual lesions

A

5-FU (+/- salicylic acid)

Cryotherapy

49
Q

Treatment options for actinic keratoses - small area of field change

A

5-FU (+/- salicylic acid)
Imiquimod 5%
Photodynamic therapy (PDT)

50
Q

Treatment options for actinic keratoses - large area of field change

A

3% diclofenac gel

Imiquimod 3.75%

51
Q

Form for statutory paternity pay

A

SC3 form

52
Q

CRVO

A

Widespread haemorrhages
Disc oedema
May be RAPD/retinal detachement

53
Q

Tuberous sclerosis inheritance

A

Autosomal dominant

54
Q

Hungtington’s Chorea inheritance

A

Autosomal dominant

55
Q

Hunter disease inheritance

A

X-linked recessive

56
Q

Spontaneous (neither parent has disease) X-linked recessive disorders only occur in:

A

Males

except Turner’s syndrome

57
Q

X-linked recessive traits cannot be passed

A

From father to son

58
Q

“25% chance of affected son”

A

X-linked recessive

59
Q

“50% chance of affected child”

A

Autosomal dominant

60
Q

“25% chance of affected child”

A

Autosomal recessive

61
Q

Indication for treatment in CLL

A

Symptomatic
Hepatosplenomegaly
Anaemia
Lymphadenopathy

62
Q

Neuropathic pain relief to avoid in severe liver disease

A

Amitriptyline

63
Q

EOL care - oxycodone can be given down to GFR

A

eGFR 10

64
Q

Head injury - refer to ED if:

A 
GCS <15
LOC
Focal neurology
Sign of skull fracture
Persistant headache
Vomiting
Seizure
High-energy injury
Previous neurosurgery
Bleeding disorder/anticoagulation
Intoxicated
Safeguarding concern
Ongoing clinical concern
65
Q

Subcutaneous lump at insulin injection site

A 
Lipodystrophy
Cutaneous amyloidosis
(risk of hypos when switching area)
66
Q

Insulin dose in pregnancy, frequently needs:

A

Increase in 2nd/3rd trimesters

Refer diabetes specialist

67
Q

Insulin dose in breastfeeding

A

Refer diabetes specialist

68
Q

Insulin in hepatic impairment

A

May need decreased dose

69
Q

Insulin in renail impairment

A

Greater risk of hypo

70
Q

Adult on insulin - target 24-hr blood glucose range

A

4 - 9 mmol/l

71
Q

Adult on insulin - target blood glucose range pre-meal

A

4 - 7 mmol/l

72
Q

Adult on insulin - target blood glucose range after meals

A

<9 mmol/l

73
Q

Child on insulin - target 24-hr blood glucose range

A

4 - 10 mmol/l

74
Q

Child on insulin - target blood glucose range pre-meal

A

4 - 8 mmol/l

75
Q

Child on insulin - target blood glucose range after meals

A

<10 mmol/l

76
Q

Patient input in fixed-dose insulin regime

A

Regulate carb intake to match insulin regimen

77
Q

Patient input in variable/multiple injection insulin regime

A

Adjust insulin dose according to carb intake

78
Q

Can diagnose T1DM clinically in adult if random glucose >11 and 1+:

A 
Ketosis
Rapid weight loss
Onset <50y
BMI <25
PMH/FH AI disease
79
Q

Diagnosed T1DM in adult

A

Same-day referral

80
Q

T1DM should be suspected in child if hyperglycaemia and:

A

Polyuria
Polydipsia
Weight loss
Excessive tiredness

81
Q

Suspect T1DM in child?

A

Same-day referral for diagnosis

82
Q

If symptomatic, can diagnose T2DM in adult if:

A

HbA1c >= 48 (6.5%)

Fasting glucose >7.0

83
Q

Persistent hyperglycaemia - random glucose

A

> 11

84
Q

Humalog (insulin lispro)

A

Rapid-acting

85
Q

Novorapid (insulin aspart)

A

Rapid-acting

86
Q

Actrapid

A

Short-acting

87
Q

Rapid-acting insulins

A

Onset 15 min

Last 2-5hr

88
Q

Short-acting insulins

A

Onset 30-60min

Last 8hr

89
Q

Humulin S

A

Short-acting

90
Q

Intermediate-acting (Isophane) insulins

A

Max effects 3-12hr

Last 11-24hr

91
Q

Long-acting insulins

A

Last up to 24hr

92
Q

Humulin I

A

Intermediate-acting

93
Q

Insuman Basal

A

Intermediate-acting

94
Q

Insulatard

A

Intermediate-acting

95
Q

Lantus (insulin glargine)

A

Long-acting

96
Q

Levemir (insulin detemir)

A

Long-acting

97
Q

Tresiba (insulin degludec)

A

Long-acting

98
Q

Xultophy

A

Insulin degludec + liraglutide combo

99
Q

Basal-bolus regime

A

Rapid/short-acting before meals
+
1+ intermediate/long-acting /day

100
Q

Biphasic/mixed regime

A

1-3 injections/day of combo:

short/rapid + intermediate

101
Q

Continuous sc insulin infusion/pump

A

Continuous infusion of rapid/short acting insulin

102
Q

1st choice regime for T1DM

A

Basal-bolus with:
BD detemir
rapid-acting pre-meals

103
Q

Covid anti-viral pathway criteria:

A

Symptoms <5d (P, S, M) or <7d (R)
LFT/PCR +ve
High-risk
No new O2 requirement

104
Q

1st-line ‘anti-viral’ for high-risk covid (non-hospitalised)

A

nirmatrelvir/ritonavir

sotrovimab (nMAB)

105
Q

2nd-line anti-viral for high-risk covid (non-hospitalised)

A

Remdesivir

106
Q

3rd-line anti-viral for high-risk covid (non-hospitalised)

A

Molnupiravir

107
Q

Considered high-risk in COvid

A 
Down's
Cancer
Chemo <3/m
Stem cell/organ transplant
eGFR <30
Cirrhosis
Immunodeficiency
On certain immunomodulators
High risk HIV
MS
MND
Myasthenia gravis
108
Q

1st-line covid ‘antiviral’ (if required) in 12-18y

A

Sotrovimab

109
Q

1st-line covid ‘antiviral’ (if required) in pregnant

A

Sotrovimab

110
Q

Post-covid syndrome

A

Symptoms develop during/after covid
Continue >12wk
Not explained by anything else

111
Q

Acute covid

A

Symptoms up to 4wk

112
Q

Ongoing symptomatic Covid

A

Symptoms 4wk - 12wk

AKT (28 decks)

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