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C TO REVISE - PHASE 3A > EXTRA NUGGETS FROM QUESTIONS > Flashcards

EXTRA NUGGETS FROM QUESTIONS Flashcards

1
Q

FALLS
What are the risk factors for falls in elderly?

A

DM
rheumatoid arthritis
>65
previous falls
depression

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2
Q

FALLS
What are the two recommended tests from NICE to assess patients at risk of falls?

A
  • turn 180 test
  • timed up and go test
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3
Q

FALLS
what are the management options to try and prevent further falls in future?

A
  • strength and balance training
  • home hazard assessment
  • medication review
  • vision assessment
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4
Q

NEPHRITIC SYNDROME
IgA deposition on renal biopsy would indicate which cause of nephritic syndrome?

A

IgA nephropathy

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5
Q

NEPHRITIC SYNDROME
Raised antistreptolysin O titre on blood serum would indicate which cause of nephritic syndrome?

A

Post strep glomerulonephritis

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6
Q

NEPHRITIC SYNDROME
Anti-GBM antibodies on blood serum would indicate which cause of nephritic syndrome?

A

goodpastures

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7
Q

NEPHRITIC SYNDROME
c-ANCA antibodies on blood serum would indicate which cause of nephritic syndrome?

A

glomerulomatosis with polyangitis

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8
Q

NAS
In a neonate with neonatal abstinence syndrome (NAS) what is the medical management?

A

IV phenobarbital

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9
Q

NEPHRITIC SYNDROME
ANA positive blood test would indicate which cause of nephritic syndrome?

A

SLE

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10
Q

TONSILITIS
what are the scoring systems that can be used to determine how likely there is a bacterial infection?

A

CENTOR
FeverPAIN

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11
Q

TONSILITIS
what are the components of the FeverPAIN criteria?

A
  • Fever during previous 24hrs
  • Purulence (pus on tonsils)
  • Attend rapidly (within 3 days of symptom onset)
  • Inflamed tonsils (severe)
  • No cough or coryza
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12
Q

TONSILITIS
what do the FeverPAIN scores mean?

A

0 or 1 = low chance of strep infection (18%)
2 or 3 = moderate chance of strep infection (40%)
4 or 5 = high chance of strep infection (62-65%)

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13
Q

TONSILITIS
what are the components of CENTOR criteria?

A
  • tonsillar exudate
  • tender anterior cervical lymphadenopathy/lymphadenitis
  • history of fever (>38)
  • absence of cough
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14
Q

TONSILITIS
what do the scores for CENTOR criteria mean?

A

0-2 = low chance of strep (3-17%)
3-4 = higher chance of strep (32-56%)

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15
Q

TONSILLITIS
what is the antibiotic management for tonsillitis?

A

1st line = phenoxymethylpenicillin
for 10 days

If penicillin allergic 1st line = clarithromycin

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16
Q

TONSILLITIS
what safety netting advice can be given if antibiotics are not indicated?

A
  • use simple analgesia
  • return if pain has not settled after 3 days or if fever rises above 38.3
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17
Q

TONSILLITIS
what are the bacterial causes?

A
  • Group A strep (S. Pyogenes)
  • S. Pneumoniae
  • H. Influenzae
  • M. Catarrhalis
  • S. Aureus
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18
Q

PREGNANCY BLOOD LEVELS
what is the cut off for Hb levels in:
i) first trimester
ii) second trimester
iii) third trimester

A

i) 110
ii) 105
iii) 100

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19
Q

PREGNANCY BLOOD LEVELS
A raised level of which liver enzyme is considered normal in pregnancy?

A

ALP

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20
Q

MOLAR PREGNANCY
what is a complete molar pregnancy?

A

when two sperm fertilise an ovum that contains no genetic material.
The sperm combine genetic material
No foetal material forms

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21
Q

MOLAR PREGNANCY
what is the karyotype of a complete molar pregnancy?

A

46 XX

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22
Q

MOLAR PREGNANCY
what is an incomplete/partial molar pregnancy?

A

two sperm fertilise a normal ovum at the same time
the cell has 3 sets of chromosomes

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23
Q

MOLAR PREGNANCY
what is the karyotype of a partial molar pregnancy?

A

69 XXY, 69XXX or 69XYY

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24
Q

ADHD
what should be measured at initiation of methylphenidate, following each dose adjustment and every 6 months?

A

pulse
BP
psych symptoms
appetite
weight
height

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25
Q

PARACETAMOL OVERDOSE
what is the definition of a staggered paracetamol overdose?

A

first and last paracetamol more than 1 hour apart

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26
Q

OCD
what class of medication is clomipramine?

A

tricyclic antidepressant

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27
Q

OCD
what is the medical management of OCD?

A

1st line = SSRI
2nd line = clomipramine

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28
Q

ANTIPSYCHOTICS
what is the treatment for tardive dyskinesia?

A

tetrabenazine

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29
Q

ANTIPSYCHOTICS
what is the medical management of neuroleptic malignant syndrome

A

bromocriptine or dantrolene

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30
Q

ANTIPSYCHOTICS
what is the medical management of acute dystonia?

A

procyclidine or benzatropine

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31
Q

OPIOID USE
what is the definition of opioid use disorder?

A

a harmful pattern of use is evident over a 12 month period or at least 1 month if use is continuous

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32
Q

THE BLACK REPORT
What did The Black Report show?

A

Confirmed social class health inequalities in overall mortality and that health inequalities were widening

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33
Q

THE BLACK REPORT
What were the recommendations from The Black Report?

A

Material - environmental causes
Artefact - product of how inequality is measured
Cultural/Behavioural - poor people to unhealthy things, own responsibility
Selection - ill sink in society

34
Q

THEORIES OF CAUSATION
Name 3 theories of causation

A

Psychosocial
Neo-material
Life-course

35
Q

THEORIES OF CAUSATION
What is the psychosocial theory of causation?

A

Effect of poverty on us psychosocially
Stressors are mainly social
Stress –> BP, cortisol levels

36
Q

THEORIES OF CAUSATION
What is the neo-material theory of causation?

A

Poverty exposes people to health hazards
Hierarchy to public good
Money = goods

37
Q

THEORIES OF CAUSATION
Explain the life-course theory of causation

A

Critical periods – greater impact at certain points in life course primarily childhoods (e.g. measles in pregnancy)
Accumulation – hazards and their impacts add up (e.g. hard blue collar work –> injuries –> reduced work opportunities)
Interactions and pathways – (e.g. sexual abuse in childhood –> poorer partner choices, increases exposure to violence etc.)

38
Q

ETHICAL ANALYSIS
Name 2 approaches to ethical analysis

A
  1. Seedhouse’s ethical grid

2. The four quadrant approach

39
Q

ETHICAL ANALYSIS
Describe the inner layer of Seedhouse’s ethical grid

A

Asks the question of whether the intervention is going to create autonomy, respect autonomy and treat all equally

40
Q

ETHICAL ANALYSIS
Describe the second layer of Seedhouse’s ethical grid

A

Duties and motives
Is the intervention consistent with moral duties - keeping promises, telling the truth, minimising harm and maximising benefit

41
Q

ETHICAL ANALYSIS
Describe the third layer of Seedhouse’s ethical grid

A

Consequentialist layer
Is the intervention going to provide the greatest benefit for the greatest number?
Who will benefit, society, individuals, a group?

42
Q

ETHICAL ANALYSIS
Describe the outer layer of Seedhouse’s ethical grid

A

Is the intervention likely to be affected by external considerations e.g. risk, law, use of resources?

43
Q

ETHICAL ANALYSIS
What are the advantages of Seedhouse’s ethical grid?

A

It provides structure and function for analysing ethical problems
Based on moral theory

44
Q

ETHICAL ANALYSIS
What are the heading which make up the four quadrants approach?

A
  1. Medical indications - beneficence and non-maleficence
  2. Patient preferences - respect for autonomy
  3. Quality of life - beneficence and non-maleficence
  4. Contextual features - loyalty and fairness
45
Q

DDH
what are the risk factors for developmental dysplasia of the hip?

A

female
FHx - 1st degree relative
breech after 36 weeks
multiple pregnancy
firstborn child
oligohydramnios
macrosomic baby

46
Q

PYLORIC STENOSIS
what is the pathophysiology?

A

hypertrophy of the pyloric sphincter resulting in narrowing of the pyloric canal

47
Q

CAH
what is the management of a salt-losing crisis?

A

IV fluids
dextrose
hydrocortisone

48
Q

TETRALOGY OF FALLOT
what are the symptoms?

A
  • blue tinge to lips, tongue and skin
  • recurrent chest infections
  • poor feeding
  • breathlessness
49
Q

who should be notified about notifiable diseases?

A

local health protection team

50
Q

DUCHENE MUSCULAR DYSTROPHYY
what is the pathophysiology?

A

gene mutation of Xp21
dystrophin is absent so muscle is lost and replaced by adipose tissue

51
Q

DUCHENE MUSCULAR DYSTROPHY
what are the investigations?

A

serum creatine kinase
electromyogram (EMG)
muscle biopsy
genetic testing
muscle MRI

52
Q

DUCHENE MUSCULAR DYSTROPHY
what is the MDT management?

A

medical - corticosteroids
surgical - correct contractures
respiratory ventilation
physiotherapy
exercise
education
counselling
palliative care

53
Q

at what point in time does physiological jaundice typically resolve in a preterm neonate and a term neonate?

A
  • preterm = 21 days
  • term = 14 days
54
Q

what are the causes of jaundice in newborns within first 24 hours?

A

rhesus disease of newborn
sepsis
congenital infections (TORCH)

55
Q

what are the two main treatments for jaundice in neonates?

A

phototherapy
exchange transfusion

56
Q

CHRONIC OTITIS MEDIA WITH EFFUSION
why is it important for there to be middle ear ventilation?

A

crucial for equalising pressure, preventing fluid build-up and maintaining optimal hearing

57
Q

CHRONIC OTITIS MEDIA WITH EFFUSION
what is the conservative management?

A

nasal irrigation
antibiotics for acute exacerbations

58
Q

NOONAN SYNDROME
what are the cardiovascular complications?

A

pulmonary valve stenosis
hypertrophic cardiomyopathy
ASD

59
Q

NOONAN SYNDROME
what cancers are individuals at risk of getting?

A

leukaemia
neuroblastoma

60
Q

what are the symptoms of neuroblastoma?

A

palpable abdominal mass
blueberry muffin rash
dark circles around eyes (racoon eyes)
proptosis
weight loss
bone pain
constipation
lymphadenopathy

61
Q

what type of fracture is a “toddlers fracture” and where is it most commonly found?

A

spiral fracture
tibia

62
Q

after treatment for nephrotic syndrome, what is the chance of recurrence?

A

20%

63
Q

which is the most common heart defect in trisomy 21?

A

AVSD

64
Q

SCHIZOPHRENIA
What features of voices would indicate a diagnosis of schizophrenia?

A
  • hearing her own thoughts spoken aloud
  • auditory third person hallucinations
  • running commentary
  • not command
65
Q

what features of a mental state exam would support a diagnosis of bipolar disorder?

A
  • over dressed/unusual dress
  • agitation/overactivity
  • pressure of speech
  • thought disorder/flight of ideas
  • elevated mood
  • grandiose delusions
  • expansive ideas
  • hallucinations in keeping with mood
  • disinhibition
66
Q

what psychological therapies are considered in first episode psychosis?

A

CBT
psychoeducation
psychoanalytical therapy

67
Q

IUGR
what are the risk factors for IUGR?

A
  • booking BMI
  • pre-existing HTN
  • history of pre-eclampsia
  • smoking
  • substance abuse
68
Q

what is the role of magnesium sulfate in premature births?

A

it provides neuroprotection

69
Q

what causes low Hb in a person with suspected cancer?

A
  • poor intake of folic acid/Fe
  • anaemia of chronic disease
  • presence of tumour
70
Q

GUILLAIN BARRE
what are the findings of a lumbar puncture?

A
  • raised protein
  • normal WCC
  • normal RBC
  • raised opening pressure
  • normal glucose
71
Q

GUILLAIN BARRE SYNDROME
why should ABG not be used to monitor respiratory function?

A

Changes in ABG would occur after the onset of respiratory compromise and would be late in identifying the problem.

72
Q

GUILLAIN BARRE
what is the management whilst in hospital?

A

IV immunoglobulins (IVIG)
prophylactic anticoagulation (dalteparin)
physiotherapy
ventilator support

73
Q

ALCOHOL DEPENDENCE
name two blood tests to screen for alcohol dependence and how it is affected

A

GGT
MCV
CDT

they are all raised

74
Q

MENINGITIS
describe the appearance of meningococcal bacteria on microscopy

A

gram negative diplococci

75
Q

what is the first line treatment for morning sickness?

A

promethazine

76
Q

what are the first line treatments for spasticity in multiple sclerosis?

A

baclofen or gabapentin

77
Q

VARICOCELE
what is the most common presentation of a varicocele?

A

asymptomatic

78
Q

ALCOHOL DEPENDENCE
what is the mechanism of action of acamprosate?

A

reduces cravings by activating GABA transmission

79
Q

ALCOHOL DEPENDENCE
what is the mechanism of action of disulfiram?

A

it causes a build up of acetaldehyde when alcohol is consumed which causes unpleasant symptoms such as flushing, headache and anxiety

80
Q

ALCOHOL DEPENDENCE
what is the mechanism of action of naltrexone?

A

acts as an opioid antagonist to reduce the pleasurable effect of alcohol

81
Q

EPILEPSY IN PREGNANCY
which is the most common congenital abnormality from sodium valproate use in pregnancy?

A

hypospadias

82
Q
A

C TO REVISE - PHASE 3A (11 decks)

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