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D 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
PARACETAMOL OVERDOSE what is the definition of a staggered paracetamol overdose?
first and last paracetamol more than 1 hour apart
26
OCD what class of medication is clomipramine?
tricyclic antidepressant
27
OCD what is the medical management of OCD?
1st line = SSRI 2nd line = clomipramine
28
ANTIPSYCHOTICS what is the treatment for tardive dyskinesia?
tetrabenazine
29
ANTIPSYCHOTICS what is the medical management of neuroleptic malignant syndrome
bromocriptine or dantrolene
30
ANTIPSYCHOTICS what is the medical management of acute dystonia?
procyclidine or benzatropine
31
OPIOID USE what is the definition of opioid use disorder?
a harmful pattern of use is evident over a 12 month period or at least 1 month if use is continuous
32
THE BLACK REPORT What did The Black Report show?
Confirmed social class health inequalities in overall mortality and that health inequalities were widening
33
THE BLACK REPORT What were the recommendations from The Black Report?
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
THEORIES OF CAUSATION Name 3 theories of causation
Psychosocial Neo-material Life-course
35
THEORIES OF CAUSATION What is the psychosocial theory of causation?
Effect of poverty on us psychosocially Stressors are mainly social Stress --> BP, cortisol levels
36
THEORIES OF CAUSATION What is the neo-material theory of causation?
Poverty exposes people to health hazards Hierarchy to public good Money = goods
37
THEORIES OF CAUSATION Explain the life-course theory of causation
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
ETHICAL ANALYSIS Name 2 approaches to ethical analysis
1. Seedhouse's ethical grid | 2. The four quadrant approach
39
ETHICAL ANALYSIS Describe the inner layer of Seedhouse's ethical grid
Asks the question of whether the intervention is going to create autonomy, respect autonomy and treat all equally
40
ETHICAL ANALYSIS Describe the second layer of Seedhouse's ethical grid
Duties and motives Is the intervention consistent with moral duties - keeping promises, telling the truth, minimising harm and maximising benefit
41
ETHICAL ANALYSIS Describe the third layer of Seedhouse's ethical grid
Consequentialist layer Is the intervention going to provide the greatest benefit for the greatest number? Who will benefit, society, individuals, a group?
42
ETHICAL ANALYSIS Describe the outer layer of Seedhouse's ethical grid
Is the intervention likely to be affected by external considerations e.g. risk, law, use of resources?
43
ETHICAL ANALYSIS What are the advantages of Seedhouse's ethical grid?
It provides structure and function for analysing ethical problems Based on moral theory
44
ETHICAL ANALYSIS What are the heading which make up the four quadrants approach?
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
DDH what are the risk factors for developmental dysplasia of the hip?
female FHx - 1st degree relative breech after 36 weeks multiple pregnancy firstborn child oligohydramnios macrosomic baby
46
PYLORIC STENOSIS what is the pathophysiology?
hypertrophy of the pyloric sphincter resulting in narrowing of the pyloric canal
47
CAH what is the management of a salt-losing crisis?
IV fluids dextrose hydrocortisone
48
TETRALOGY OF FALLOT what are the symptoms?
- blue tinge to lips, tongue and skin - recurrent chest infections - poor feeding - breathlessness
49
who should be notified about notifiable diseases?
local health protection team
50
DUCHENE MUSCULAR DYSTROPHYY what is the pathophysiology?
gene mutation of Xp21 dystrophin is absent so muscle is lost and replaced by adipose tissue
51
DUCHENE MUSCULAR DYSTROPHY what are the investigations?
serum creatine kinase electromyogram (EMG) muscle biopsy genetic testing muscle MRI
52
DUCHENE MUSCULAR DYSTROPHY what is the MDT management?
medical - corticosteroids surgical - correct contractures respiratory ventilation physiotherapy exercise education counselling palliative care
53
at what point in time does physiological jaundice typically resolve in a preterm neonate and a term neonate?
- preterm = 21 days - term = 14 days
54
what are the causes of jaundice in newborns within first 24 hours?
rhesus disease of newborn sepsis congenital infections (TORCH)
55
what are the two main treatments for jaundice in neonates?
phototherapy exchange transfusion
56
CHRONIC OTITIS MEDIA WITH EFFUSION why is it important for there to be middle ear ventilation?
crucial for equalising pressure, preventing fluid build-up and maintaining optimal hearing
57
CHRONIC OTITIS MEDIA WITH EFFUSION what is the conservative management?
nasal irrigation antibiotics for acute exacerbations
58
NOONAN SYNDROME what are the cardiovascular complications?
pulmonary valve stenosis hypertrophic cardiomyopathy ASD
59
NOONAN SYNDROME what cancers are individuals at risk of getting?
leukaemia neuroblastoma
60
what are the symptoms of neuroblastoma?
palpable abdominal mass blueberry muffin rash dark circles around eyes (racoon eyes) proptosis weight loss bone pain constipation lymphadenopathy
61
what type of fracture is a "toddlers fracture" and where is it most commonly found?
spiral fracture tibia
62
after treatment for nephrotic syndrome, what is the chance of recurrence?
20%
63
which is the most common heart defect in trisomy 21?
AVSD
64
SCHIZOPHRENIA What features of voices would indicate a diagnosis of schizophrenia?
- hearing her own thoughts spoken aloud - auditory third person hallucinations - running commentary - not command
65
what features of a mental state exam would support a diagnosis of bipolar disorder?
- 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
what psychological therapies are considered in first episode psychosis?
CBT psychoeducation psychoanalytical therapy
67
IUGR what are the risk factors for IUGR?
- booking BMI - pre-existing HTN - history of pre-eclampsia - smoking - substance abuse
68
what is the role of magnesium sulfate in premature births?
it provides neuroprotection
69
what causes low Hb in a person with suspected cancer?
- poor intake of folic acid/Fe - anaemia of chronic disease - presence of tumour
70
GUILLAIN BARRE what are the findings of a lumbar puncture?
- raised protein - normal WCC - normal RBC - raised opening pressure - normal glucose
71
GUILLAIN BARRE SYNDROME why should ABG not be used to monitor respiratory function?
Changes in ABG would occur after the onset of respiratory compromise and would be late in identifying the problem.
72
GUILLAIN BARRE what is the management whilst in hospital?
IV immunoglobulins (IVIG) prophylactic anticoagulation (dalteparin) physiotherapy ventilator support
73
ALCOHOL DEPENDENCE name two blood tests to screen for alcohol dependence and how it is affected
GGT MCV CDT they are all raised
74
MENINGITIS describe the appearance of meningococcal bacteria on microscopy
gram negative diplococci
75
what is the first line treatment for morning sickness?
promethazine
76
what are the first line treatments for spasticity in multiple sclerosis?
baclofen or gabapentin
77
VARICOCELE what is the most common presentation of a varicocele?
asymptomatic
78
ALCOHOL DEPENDENCE what is the mechanism of action of acamprosate?
reduces cravings by activating GABA transmission
79
ALCOHOL DEPENDENCE what is the mechanism of action of disulfiram?
it causes a build up of acetaldehyde when alcohol is consumed which causes unpleasant symptoms such as flushing, headache and anxiety
80
ALCOHOL DEPENDENCE what is the mechanism of action of naltrexone?
acts as an opioid antagonist to reduce the pleasurable effect of alcohol
81
EPILEPSY IN PREGNANCY which is the most common congenital abnormality from sodium valproate use in pregnancy?
hypospadias
82

D TO REVISE - PHASE 3A (9 decks)

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