FCM Flashcards
First and second line treatment for oral thrush
- Miconazole gel
- Nystatin
What cancer is associated with GORD?
Adenocarcinoma
SVT management if haemodynamically unstable?
DC cardioversion
Ix for suspected leukaemia?
Bone marrow aspirate
Beta thalassaemia major vs minor
Major = symptoms in infancy; failure to thrive
Minor = mild anaemia in adulthood
Complication of co-amoxiclav
Cholestatic hepatitis
10-20y/o male with proximal tibial mass, painless; XR shows pedunculate lesion on the surface of the bone
Osteochondroma
Where does amoebiasis come from and how do you treat it?
Diarrhoea; travel to LIC
Metronidazole then diloxanide
Treatment for sciatica?
Paracetamol/NSAIDS
Codeine
Treatment for bacterial meningitis GP vs. hospital
GP = IM ben pen
Hospital = IV cefotaxime
AF; rate treatment
- Beta blocker
- if HR >100bpm still, add digoxin
Treatment for STEMI
PCI
Treatment of hyperparathyroidism and complication
Parathyroidectomy; aphonia due to damage to recurrent laryngeal nerve
Treatment of venous eczema
Reduce leg swelling and potent topical steroid
Salmon herald patch and Christmas tree distribution
Pityriasis rosea
What drug can cause gynaecomastia?
Spironolactone
UTI treatment in pregnancy
Nitrofurantoin until 3rd trimester
Amoxicillin in 3rd trimester
TRIMETHOPRIM IS CONTRAINDICATED
What bacteria causes otitis externa
Staph aureus
Migraine prophylactic treatment?
Propranolol
(Topiramate if contraindicated)
Migraine attack treatment?
NSAIDs (paracetamol if pregnant)
Triptans
Cluster headache prophylaxis?
Verapamil
Cluster headache attack treatment?
O2 and sub cut triptan
Which joint does gout commonly affect?
MTP joint
Which joint does psuedogout commonly affect?
Knee
What bacteria causes UTI?
E coli
What analgesia can cause urticarial rash?
NSAIDs
Tension headache, vomiting, tachycardia, tachypnoea, seizures, reduced GCS, cherry red skin
Carbon monoxide poisoning
AF and haemodynamically unstable?
DC cardioversion
Snowstorm appearance on TVUS
Molar pregnancy
Sepsis within 48 hours of birth - cause
Group B strep
1st line for fibrocystic disease of the breast
Supportive bra and avoid caffeine
Treatment for trichomonas
Metronidazole
Treatment for gonorrhoea
IM ceftriaxone
Unilateral deafness and vertigo
Acoustic neuroma
Asymptomatic jaundice
Gilbert’s
What can EBV increase risk of?
Hodgkin’s lymphoma
What bacteria causes prostatitis
E coli
What do you do if a baby has a hernia?
Observe, repair at 2 years if it hasn’t closed spontaneously
Treatment for spinal cord compression
High dose dexamethasone
Treatment for microalbuminaemia
ACEi
Sudden onset blurry vision, reduction in visual acuity, visible drusen on fundoscopy
Macular degeneration
Treatment for CML
Oral imatinib
What CN causes down and out gaze
Occulomotor
Bleeding, bruising, organ ischaemia and failure
DIC
Treatment of essential tremor
Propranolol
White tongue, maculopapular rash on chest and back
Scarlet fever
What do you give in a intracerebral haemorrhage
Labetalol
When can you drive after a TIA
After 1 month
Treatment for apthous ulcers
Hydrocortisone Oro-mucosal tablets
What can shoulder dystocia cause?
Brachial plexus palsy
Treatment for angular stomatitis
Topical miconazole and hydrocortisone
Bipolar symptoms but psychotic in manic phase
Schizoaffective disorder
Fixed, split second hard sound
Atrial septal defect
Weak femoral pulses, systolic murmur below left scapula, tachypnoea, poor feeding, grey floppy baby
Coarctation of the aorta
Machine like murmur, SOB, poor feeding, recurrent LRTIs
Patent ductus arteriosus
First line treatment for menorrhagia
IUS
Haematuria, flank pain and palpable mass
Renal cell carcinoma
What is ketatitis and what can cause it
Infection of the cornea; often caused by contact lenses
12 year old, leg pain when exercising, limping, pain is dull and deep, feeling tired
Osteosarcoma
Treatment for PTSD
EMDR or trauma based CBT
SSRI
Treatment for onychomycosis
- Topical amorolfine
- Oral terbinafine (if symptomatic or >2 nails)
Analgesia for renal colic
Diclofenac
Treatment for PCOS
COCP
Diarrhoea from crowded area e.g. prison
Shigella
Diarrhoea from contaminated water
Cholera
55y/o woman, progressive muscle weakness, frequent falls, difficulty standing up from seated, hand weakness
Polymyositis
Murmur with Marfan’s
Mitral valve prolapse
Pink and brown papules
Kaposi’s
Long term steroid use and exposure to lots of UV can cause…
Cataracts
Sharp tearing pain on defecation and fresh PR bleeding
Anal fissure
Treatments for anal fissure
- Soften stool with IH
- GTN ointment
Treatment for pityriasis rosea
Emolients
Medications following TIA
Aspirin for 2 weeks then clopidogrel
Treatment of PPH
IV syntocinon
Demithicone
For head lice
Slow growing, soft lump, non-tender, doughy consistency
Lipoma
Central punctum
Epidermoid cyst
Treatment given in PPROM
Corticosteroids and erythromycin
Pregnant woman, sudden back pain, regular contractions, painful bright red bleeding, pelvic tenderness, closed cervix
Abruptio placenta
Pregnant woman, painless vaginal bleeding
Placenta praevia
Treatment for acute delirium
Haloperidol
Lorazepam if Parkinson’s
Bronchiolitis causative organism
RSV
Croup causative organism
Parainfluenza virus
Epiglottitis causative organism
HiB
Treatment for vitiligo
Topical betnovate
Treatment for mastoiditis
IV broad spec ABx and admission
Treatment for tension PTX
Needle decompression
Treatment for spontaneous PTX
Needle aspiration
Medical management for OCD
SSRI
What can indapamide cause
Gout
Painful red eye, N&V, blurry vision, abnormal pupils, reduction in acuity
Acute closed-angle glaucoma
Crampy leg pain, worse when walking uphill; what is it and what can it cause
Claudication; arterial ulcers
Menieres disease attack and prevention
Attack = prochlorperazine
Prevention = betahistine
Menieres Sx
Vertigo, tinnitus, hearing loss and pressure feeling
ABx given for sickle cell
Lifelong pen V
(Erythromycin if allergic)
Vibrio cholerae - what food
Caused by oysters
Treatment for acute migraine in pregnancy
Paracetamol
AVOID NSAIDS IN PREGNANCY
Treatment for pneumocystis
Co-trimoxazole
Treatment for molluscum
Self-limiting
Skin lesion, Hx of sun exposure, feels like sandpaper - what is it and how do you treat it
Actinic ketatosis; fluorouracil
Second line HTN treatment in Afro-Caribbeans
CCB+ARB
Causative organisms in septic arthritis
1. Normally
2. Young, unvaccinated child
3. Sexually active
- Staph aureus
- HiB
- N. gonorrhoeae
Treatment for septic arthritis
IV clindamycin for 1 week then 4-6W of oral ABx
What treatment are you giving if DEXA scan results are <T-2.5?
Bisphosphonates
Analgesia for OA
Paracetamol
Bacteria that causes osteomyelitis
Staph aureus
6 year old boy, painless limp, XR shows frog leg
Perthe’s disease; cast brace
Fat 14 year old boy, painful limp, O/E external rotation of leg - what is it and how do you treat it?
SUFE; surgical fixation
Loss of vision like a curtain closing over the eye
TIA - GIVE 300mg ASPIRIN
Recurrent unilateral electric shock pain lasting a few seconds, triggered by brushing teeth, smoking and talking - what is it and how do you treat it?
Trigeminal neuralgia; carbemazapine
If a pt has a migraine and asthma AND PREGNANT, what drug do you give for prophylaxis
Amitriptyline
Treatment for status epilepticus GP vs hospital
GP = buccal midazolam/rectal diazepam
Hospital = IV lorazepam
Time frame to treat Bell’s palsy and what do you give
Prednisolone; within 72 hours - for 10 days
Treatment for tonic clonic seizures? What if they’re pregnant?
Sodium valproate; lamotrigine
Overweight female, generalised headache that’s worse in the mornings and when coughing - what is it and how do you treat it?
Idiopathic intracranial hypertension; LP and weight loss
Patient has a fall, temporary loss of consciousness, fluctuating changes in cognition, CT scan shows crescent-shape - what is it?
Subdural haematoma
Treatment for myasthenia gravis
Steroids + anti cholinesterase inhibitors (e.g. pyridostigmine)
What kind of seizure - sudden jerking of limb, trunk or face
Myoclonic
EtOH drinker, nystagmus, confusion and ataxia - what is it and how do you treat it?
Wernicke’s encephalopathy; IV pabrinex
Treatment for Alzheimer’s:
- Mild-moderate?
- Moderate-severe?
- Donepazil
- Memantine
Treatment of hyperparathyroidism if not eligible for surgery
Alendronate and cinacalet
Obese man, chronic cough and constipation - what type of hernia?
Direct inguinal hernia
6 month old baby, bulge into scrotum - what type of hernia?
Indirect inguinal hernia
Treatment of hepatic encephalopathy
Lactulose
Cherry red spot on fundoscopy
Central retinal vein occlusion
Morning headaches, vomiting, raised intracranial pressure
Glioblastoma
Management of cardiac tamponade
Pericardiocentesis
Adult female, low Hb, schistocytes on blood film
TTP
Child, recent viral illness normal blood smear
ITP
Pearly papule with rolled edge
Basal cell carcinoma
Clawing of the hand with sensory loss of 5th and half of 4th finger
Ulnar nerve compression
Enlarged scaly pink plaque that’s friable and bleeds easily
Squamous cell carcinoma
Recent infection that causes red lumps on legs - what is it and what bacteria causes it?
Erythema nodosum; strep pyogenes
Retinitis in immunocompromised patient; what causes it and what is seen on fundoscopy?
CMV; cottage cheese with ketchup
What rash can doxycycline cause
Erythema multiforme
What is slapped cheek (2)
Erythema infectiosum / parvovirus B19
Rash from exposure to infrared
Erythema ab igne
Rash caused by Lyme disease
Erythema migrans
Treatment of hypercalcaemia
IV fluids and IV furosemide
Patient with Hx of sickle cell, sudden onset floaters in eyes, painful vision loss, can only see hazy red out of affected eye; fundoscopy reveals a poor view of the fundus
Vitreous haemorrhage
Cradle cap - what is it and how do you treat it?
Sebhorraeic dermatitis;
1. Olive oil and brush out the flakes
2. Topical miconazole 1%
Treatment of bowel obstruction
Insert an NG tube
Treatment of Kawasaki disease
IVIG and high dose aspirin
Painful arc 60-120 degrees
Rotator cuff injury
Treatment for cat/dog/human bites
Co-amoxiclav
Treatment for impetigo
5 days fusidic acid and good hygiene
Dysuria, pain at base of penis, tender and boggy prostate - what is it and how do you treat it?
Prostatitis; ciprofloxacin
Menopausal woman with no uterus?
Oestrogen only
Menopausal woman with only urogenital Sx?
Low dose vaginal oestrogen
What Sx can hypomagnesia cause
Seizures, muscle cramps and tremors
Patient with metabolic acidosis and tinnitus - what did they overdose on?
Aspirin
Treatment of blepharitis
- Chloramphenicol
- Fusidic acid
1st line treatment of trigger finger
Splinting
When do you review an undescended testes in newborn
6 months
PMS treatment
Lifestyle changes and COCP
Pregnant woman with a well-defined hyperpigmentation in a symmetrical pattern on the face
Melasma
Pt bitten by dog abroad, unable to swallow water and has parasthesia around the wound - what is it?
Rabies
What antihypertensive can cause ankle swelling?
CCB - amlodipine
What bacteria causes folliculitis? And what about if the pt. has been in a hot tub recently?
- Staph aureus
- Pseudomonas aeruginosa
What is a side-effect of azithromycin?
LQTS
Treatment of DKA (which fluids)
0.9% saline
What bacteria can cause schistocytes on blood smear
E coli
Treatment for acute cholecystitis?
IV co-amoxiclav
Treatment of hyperparathyroidism if not eligible for surgery
Alendronate and cinacalet
Treatment for agoraphobia?
CBT with graded exposure therapy
Young boy, facial swelling then whole body swelling
Minimal change
Old man, urinary incontinence, abnormal gait, dementia
Normal pressure hydrocephalus
Patient with recurrent sinus infections now has fever, sudden onset headache, peri-orbital swelling and diplopia
Cavernous sinus thrombosis
Treatment of giant cell arteritis
Prednisolone
Photosensitive malar rash in the shape of a butterfly, fatigue, fevers, muscle pain - what is it and how do you treat it?
SLE, do anti-dsDNA, give NSAIDs and prednisolone
What electrolyte abnormality can be caused by losartan?
Hyperkalaemia
Postpartum woman, new pain at the base of thumb
De Quervain’s tenosynovitis
15 year old, intermittent high fevers, rashes, hepatosplenomegaly, lymphadenopathy, anaemia, leukocytosis
Juvenile rheumatoid arthritis
Hyperpigmentation, fatigue, weakness, hypotension
Addison’s
Unvaccinated child, fever, sore throat, grey-white membrane in oropharynx that bleeds when scraped
Diphtheria
Elderly patient dehydrated, has hypernatraemia - how do you treat it, and what happens if you don’t do it slowly?
5% dextrose; too quickly may cause cerebral oedema, then seizure/coma/death
Patient with previous head trauma, now has polydipsia, polyuria and hypernatraemia - what is the condition?
Diabetes insipidus
Treatment for Addisonian crisis?
IV hydrocortisone and IV normal saline
What electrolyte imbalance can be caused by PPIs?
Hyponatraemia and hypomagnesia
What 3 results will you see in tertiary hyperparathyroidism?
Raised calcium
Raised PTH
Raised phosphate (or CKD)
9 year old, palpable non-tender, mobile, fluid-filled lump on the midline of the neck; moves upwards on swallowing and protrusion of the tongue
Thyroglossal cyst
Patient with magical thinking and dressing oddly
Schizotypal PD
Treatment for OCD
CBT+ERP (+SSRI)
Patient is on statin and you’re prescribing a macrolide - what do you do?
Withhold the statin
Treatment for intermittent claudication
- Lifestyle advice and exercise programme
- Naftidrofuyl
What murmur can occur after an inferior MI?
Mitral regurgitation
Treatment for asystole
Adrenaline
(It’s non-shockable!)
Young ish female, smoker, CP on rest and at night - ECG shows ST elevation when she has the chest pain - what is it and how do you treat it?
Prinzmetal angina; CCB
Which bacteria in infective endocarditis?
Staph aureus
Sudden onset tearing chest pain, mediastinal widening - what is it and how do you treat it?
Aortic dissection; morphine+beta blockers -> surgery asap
What bacteria causes Scarlet fever?
Strep A
Flu-like Sx, sandpaper rash, strawberry tongue
Scarlet fever
Painless red eyes, swollen hands and feet, cracked lips, strawberry tongue
Kawasaki disease
Anaemia, hand/feet swelling, delayed puberty, frequent infections
Sickle cell anaemia
Frothy urine, oedema, proteinuria and haematuria
Glomerulonephritis
Microaneuyrisms, blot haemorrhages, neovascularisation
Diabetic retinopathy
Retinal haemorrhage, papilloedema
Hypertensive retinopathy
Peripheral loss of vision, ‘halos’ around lights
Glaucoma
Treatment of open angle glaucoma
Prostaglandin analogue eye drops
If patient is B12 deficient and folate deficient, which do you treat first
B12
What causes Cushings disease
Pituitary tumour
Rash from face to trunk, lymphadenopathy and red petechiae in mouth
Rubella
Recent LRTI, swinging fevers, night sweats, weight loss and chest pain
Empyema
Normocytic anaemia and raised bilirubin
Haemolytic anaemia
Which nerve can get damaged by shoulder dislocation
Axillary nerve
What needs to be given for life after gastric bypass
B12
Bilateral thigh pain, better when stooping or sitting
Spinal stenosis
Patient with active cancer, undergoing chemotherapy, temperature 38’C - what will their neutrophil count be? What do you treat them with?
Neutropenic sepsis - <0.5, initiate sepsis 6 (give BS ABx e.g. tazocin) and then filgastrim
Treatment of acute pancreatitis
Fluids, analgesics and antiemetics
Soft stool and going a few times a day, but only passing small amounts - which laxative do you prescribe?
Senna
Old patient with dementia, chronic constipation - what GI can it cause and how do you treat this?
Sigmoid volvulus; flatus tube
What is the cause of 70% of small bowel obstructions?
Previous abdominal surgery
What GI condition can co-amoxiclav cause?
Cholestasis
Treatment for tension PTX
Needle decompression
What can the scarring from GORD cause?
Benign oesophageal stricture
Most common cause of raised Virchow’s node
Gastric cancer
RUQ pain after ERCP, relieved by leaning forward
Acute pancreatitis
Positive RPR test
Syphilis
What is the timeframe for adjustment disorder
Within 3 months of a stressful life event
Drugs to stop in AKI
Diuretics
ACEi and ARB
Metformin
NSAIDs
Friable cervix with cobblestone appearance, dyspareunia and post coital bleeding
Chlamydia
Slit lamp: shallow anterior chambers and corneal epithelial oedema
Acute closed-angle glaucoma
Treatment for tension PTX
Needle decompression
Patient with spontaneous PTX (primary and secondary)
- Tall young male
- Middle aged pt with COPD
Patient with tension PTX (x3)
Ventilated, trauma or Marfan’s
What type of cancer in colorectal cancer
Adenocarcinoma
When do you assess a pt for LTOT
Patient is stable and has <92% ORA
Smoker, clubbing - which lung cancer
Squamous cell
Smoker, SIADH - which lung cancer
Small cell
Non-smoker, gynaecomastia - which lung cancer
Adenocarcinoma
What causes stoney dullness
Pleural effusion
Cerumen impaction - treatment algorithm (3)
- Ear drops e.g. oil
- Ear irrigation
- Microsuction
Test for peripheral vertigo
Head impulse test
What can leukoplakia become
Squamous cell carcinoma
Which TB med causes orange secretions
Rifampacin
Which TB med causes peripheral neuropathy
Isoniazid
Os closed, mild bleeding, little pain - what type of miscarriage?
Threatened (often 6-9 weeks)
Os open, heavy bleeding, painful - what type of miscarriage?
Inevitable
Os closed, pain and bleeding with clots, empty uterus - what type of miscarriage?
Complete
Os open, pain, bleeding, products of conception are partially expelled - what type of miscarriage?
Incomplete
Os closed, gestational sac with dead foetus without clinical features
Missed (silent)
Crohn’s treatment 1 and 2
- Oral prednisolone
- Mesalazine
Complications of Crohn’s
Fissures, fistulas and strictures
Most common location for Crohn’s
Terminal ileum
Most common location for UC
Rectum
Complications of UC
Toxic megacolon and strictures
Treatment of UC
Topical ASA (mesalazine)
Pregnant woman, painless bright red blood
Placenta praevia
Pregnant woman, painful dark red blood
Placental abruption
What is a pterygium
White, wing-shaped growth across the eye, caused by exposure to UV and being in a dry, dusty environment
Blood tests in menopause
High FSH, high LH and low oestrogen
Floaters, flashers, painless vision loss starting in the periphery , blurred vision
Retinal detachment
Hx of HTN, sudden painless loss of vision in one eye, cherry red spot
Central retinal artery occlusion
Central loss of vision
Macular degeneration
Peripheral loss of vision and halos around lights
Glaucoma
Which bronchus would an inhaled foreign object go down
Right
Drug that is positively inotropic, negatively chronotropic
Digoxin
New York HF scale 1-4
- no symptoms
- mild sx
- symptomatic except at rest
- sx at rest
Which CCBs are non-dihydropyridines
Verapamil and diltiazem
H pylori and allergic to amoxicillin - what do you give!
Metronidazole, clarithomycin and omeprazole
Diverticular disease vs. diverticulosis
DD - pain, blood, bowel changes
D - incidental finding of outpouches, no inflammation
HELLP syndrome
H - haemolysis
EL - elevated liver enzymes
LP - low platelets
What drug can’t be taken if having cataract surgery
Tamsulosin
What drug should a pregnant woman not touch
Finasteride
How long until POP works
48 hours
BP target after a stroke
130/80mmHg
What can sodium valproate do to INR
Raise it
When can you drive after your first seizure
6 months
What can lithium do to thyroid
Hypothyroidism
What would histology from thyroid cancer show?
Papillary
Male, >60, wakes up at night with back pain regularly
Multiple myeloma
Intrinsic factor is involved in the transportation and absorption of what?
B12
Lack of dopamine, starts with bradykinesia
Parkinsons
Which drug - modulates cellular keratinisation and inflammatory procresses
Adapalene
Worst skin change to have on mole
Irregular shape
A 39-year-old female teacher presents with a burning sensation affecting her arms and legs. She thinks she is becoming colour blind, as she can no longer discern the colour of the red pen she uses for marking.
MS
A 28-year-old white woman who has smoked 1 pack per day for the last 10 years presents with subacute onset of cloudy vision in one eye, with pain on movement of that eye. She also notes difficulty with colour discrimination, particularly of reds. She was treated for a sinus infection 2 weeks ago and, on further history, recalls that she had a 3-week history of unilateral hemibody paraesthesias during examination week in university 6 years ago. She occasionally has some tingling on that side if she is overly tired, stressed, or hot.
MS
Baby, ejection systolic murmur, low oxygen sats, cyanosed
Tetralogy of Fallot
Which leads do you see LBBB/RBBB in?
V1 and V6
Haemophilia A&B = which factors? And which is more common?
A = 8
B = 9
(A = more common)
CT chest shows honeycombing
Asbestosis and IPF
Two drugs that can cause pulmonary fibrosis
Methotrexate and nitrofurantoin
SIADH values
High urine osmolality, low serum osmolality, low Na
Treatment for nephrotic syndrome (+minimal change)
Prednisolone
Gold standard Ix for bronchiectasis
High resolution CT chest
How much protein = pre-eclapsia
More than or qual to 0.3g in 24 hours
Treatment for aortic dissection
IV labetolol
Ix for phaeochromocytoma
24hr catecholamine collection
Ix for Cushing’s
1 = 24hr urinary free cortisol
GOLD = overnight dexamethasone suppression test
Ix for Addison’s
GP - 8-9am cortisol
GOLD = ACTH stimulation test
Ix for Conn’s
Renin:aldosterone
Ix for SLE (sensitive vs specific)
Sensitive = ANA
Specific - Anti-dsDNA
Ix for Sjogren’s
Anti-Ro and Anti-La antibodies
GCA treatment
Prednisolone
Trigeminal neuralgia = electric shocks on face, what is the treatment
Carbemazepine
Ix for Osgood Schlatters
Knee XR
Tumour marker for colon cancer
CEA
T2DM + heart failure/ACS
Metformin + SGLT-2 inhibitor (flozin)
2nd line and 3rd line for T2DM
Gliptin (DPP4)
Gliclazide
Three drugs that can cause agranulocytosis
Clozapine
Carbimazole
Methotrexate
Treatment for Addisonian crisis
IV hydrocortisone
Other name for Conn’s
Primary hyperaldosteronism
Other name for Addison’s
Primary adrenal insufficiency
Cardiac drug that can cause thyroid issues
Amiodarone
First-line for PCOS
COCP
Treatment for eclamptic seizure
IV magnesium sulphate
At how many weeks can gestational HTN be diagnosed?
20 weeks
