Final Flashcards Flashcards by Adam Moorcroft

Features of severe asthma (4)

PEFR 33 - 50% best or predicted
Can’t complete sentences
RR > 25/min
Pulse > 110 bpm

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Features of life threatening asthma? (5)

PEFR < 33% best or predicted

Oxygen sats < 92%
‘Normal’ pC02 (4.6-6.0 kPa)

Silent chest, cyanosis or feeble respiratory effort

Bradycardia, dysrhythmia or hypotension

Exhaustion, confusion or coma

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Where does Weber’s test lateralise to in conductive and sensorineural hearing loss

Conductive - lateralises to affected ear
Sensorineural - lateralises to unaffected ear

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What causes ST-segment elevation >2mm in >1 of V1-V3 followed by a negative T wave

Outline Mx

Brugada syndrome

Mx: implantable cardioverter-defibrillator

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Mx of infectious mononucleosis

Reasurrance - self limiting

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What is breakthrough morphine dose

1/6th of daily morphine dose

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What is another name for Chrug-Strauss
What antibodies are associated

Eosinophilic granulomatosis with polyangiitis

pANCA

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COPD with no asthma Fx, not controlled on SABA, what do you give?

LABA + LAMA

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At what HbA1c should you add a second oral drug to metformin

> 58

(target is then 53)

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Mx of undisplaced intracapsular hip fracture

Internal fixation, or hemiarthroplasty if unfit.

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What zones of the lungs are affected in idiopathic pulmonary fibrosis

Lower zones

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What to give if angina present despite max dose beta blocker

Give amlodipine

(Verapamil & Beta blocker contraindicated due to risk of severe bradycardia and heart failure)

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Difference between aplastic and sequestration crises in sickle cell disease

Aplastic - reduced reticulocytes

Sequestration - increased reticulocytes
(pooling of blood in spleen or lungs)

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What can cause drug-induced pancreatitis

Mesalazine

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Difference between dry and wet macular degeneration

Dry much more common (90%)
Drusen present

Wet has choroidal neovascularisation

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56 y/o woman has 2 readings of 145/90 what do you do

ambulatory blood pressure monitoring

(treat if over 135/85)

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Tx of Chlamydia

Doxycycline

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Difference between tetralogy of fallot and transposition of great arteries

ToF: 1-6 months, ejection systolic murmur

TGA: at birth, no murmur, loud single S2

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What type of stroke causes complete one sided sensory loss

Lacunar stroke

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Most specific and sensitive Ix of pancreatitis

Serum lipase (>serum amylase)

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BPPV Ix and Tx

Dix-Hallpike manoeuvre is diagnostic
Epley manoeuvre is for treatment

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Ix of choice for suspected aortic dissection

CT angiography

(TOE if unstable)

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What is Tx of a displaced intracapsular fracture in mobile/immobile people

Immobile - hemiarthroplasty
Mobile - total hip replacement

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Which UTI Tx is contraindicated by use of methotrexate

Trimethoprim

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When would you avoid metoclopramide (2)

Parkinson's Bowel Obstruction

Outline MEN1

hyperparathyroidism, pituitary disease and pancreatic disease

Outline Men 2a and 2b

Both: Medullary thyroid cancer, phaeochromocytoma 2a Parathyroid 2b: Marfanoid body habitus, Neuromas

Mx of orbital cellulitis

IV cefotaxime

Difference between incarcerated and strangulated hernia

Strangulated is painful

What confirms a diagnosis of post-streptococcal glomerulonephritis

raised anti-streptolysin O titres

Target oxygen saturations in COPD

94-98% 88-92 if CO2 retainer

Mx of roascea

Topical brimonidine

Thyrotoxicosis with tender goitre

subacute (De Quervain's) thyroiditis

COPD & steroid responsive treatment after SABA

LABA + ICS

Which pansystolic murmur becomes louder during inspirtation

Tricuspid regurg Mitral regurg louder on expiration

What nerve is damaged in RAPD

Optic nerve

What causes deeply inverted T-waves in leads V2-V3 (which may extend to V1-V6) with no or minimal ST-elevation

Wellens syndrome

COCP links to cancer

increased risk of breast and cervical cancer protective against ovarian and endometrial cancer

What to do with normal insulin treatment during DKA?

Continue long-acting insulin and stop short-acting insulin

Mx of Kawasaki disease

Aspirin

What aggravates pain in medial epicondylitis

Wrist flexion and pronation

Tx of reactive arthritis

NSAIDs

Mx of Rosacea

Predominant erythema/flushing - topical brimonidine Mild-moderate - topical ivermectin Moderate-severe - topical ivermectin + doxycycline

Visual field defect caused by pituitary mass?

Bi-temporal superior quadrantanopia

Visual field defect caused by lesion at the optic chiasm

Bi-temporal inferior quadrantanopia

Spironalactone effect on K

Hyperkalaemia

When does dressler's syndrome occur

4-6 weeks after MI Sx straight away is pericarditis

What is suggested by ST elevation in leads II, III, aVF and an AR murmur?

Aortic dissection

When do you give Tamoxifen or Anastrazole

ER positive give aunties anastrazole (post-menopause) give teens tamoxifen

Blood stained nipple discharge

Intraductal papilloma

Curtain falling down on vision

Retinal detachment

How should insulin be commenced in treatment of DKA

Fixed rate insulin infusion

1st line Mx of constipation in IBS

Ispaghula husk

Acute Tx of Vestibular neuronitis

Oral Prochlorperazine

Differences between serotonin syndrome and neuroleptic malignant syndrome?

Serotonin syndrome comes on fast (hours), Neuroleptic Malignant Syndrome comes on slow (days) NMS - lead pipe muscle rigidity, decreased reflexes Serotonin syndrome - clonus, increased reflexes

What exacerbates pain in lateral epicondylitis

Wrist extension/supination

Mx of Toxoplasmosis

No Tx Unless immunosuppressed/HIV = pyrimethamine plus sulphadiazine

Cause of a transudate pleural effusion

<0.5 fluid protein/serum protein ratio Cirrhosis Heart failure Nephrotic syndrome

Which antidiabetic should you always give if there is CVD, or chronic heart failure

SGLT-2 inhibitors Glifozins

Tx of cocaine toxicity

Diazepam (benzodiazepines)

RR in Curb-65

RR > 30

Tx of whooping cough

Erythromycin

Surgical resection procedure if bowel has perforated

Hartmann's procedure - end colostomy

Most common cause of septic arthritis, 29 y/o?

Neisseria Gonnorhoea

1st line Tx of otitis externa

Topical antibiotics with or without steroid

1st line to induce remission of Crohn's

Glucocorticoids

Antidiabetic given to all diabetics with CVD (heart failure)

SGLT2 inhibitor

When can you drive after TIA

Start driving if symptom-free for 1 month and there is no need for them to inform the DVLA