Finals Flashcards

1
Q

Acute pancreatitis Investigations

A

USS abdo for cause
then CT Abdo with contrast

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2
Q

Which nerves are affected by vestibular schwannoma

A

CN V VII VIII

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3
Q

Vomiting ABG

A

High Cl, Low K, Metabolic alkalosis, raised anion gap

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4
Q

Difference between Fe def anaemia and chronic disease anaemia

A

TIBC high in Fe def, TIBC low in chronic disease

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5
Q

CNIII Palsy

A

Surgical mx if pupil unreactive –> CT head
Medical if reactive pupil

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6
Q

When is a GLP-1 mimetic used

A

T2DM when pt is obese and on dual/triple therapy
Pre-diabetic and obese

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7
Q

eGFR that Metformin is CI

A

<30, use sulfonylurea instead

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8
Q

Mx of inguinal hernia in infant

A

Surgery ASAP

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9
Q

Crohn’s Mx

A

Acute - Pred, Biologics 2nd
Maintenance - Azathioprine or Mercaptopurine

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10
Q

Anorexia Changes

A

Everything low except G and C
High GH, Glucose, Saliva Glands
High Cortisol, CHolesterol, Carotinaemia

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11
Q

CKD Dx

A

Urinary ACR –> need early morning sample

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12
Q

Elevating the testis - Torsion vs Epidimitis

A

Torsion - pain NOT relieved
Epididimitis - pain RELIEVED

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13
Q

Most common cause of Viral Encephalitis

A

HSV

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14
Q

Htn + ACR > 30

A

Ramipril / ACEi

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15
Q

Cirpofloxacin s/e

A

Lowers seizure threshold

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16
Q

AAA presentation

A

Abdo pain, ? mimic renal colic
Hypotension and shocked, + abdo guarding

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17
Q

Pericarditis 1st line Mx

A

Ibuprofen + colchicene

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18
Q

OGT in pregnancy

A

24 - 28 wks

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19
Q

Mesenteric Adenitis

A

Inflamed lymph nodes in mesentery. Similar sx to appendicitis but follows viral infection. ?enlarged lymph nodes

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20
Q

Neuroleptic Malignant Syndrome

A

Sx - Pyrexia, muscle rigidity, autonomic lability (htn, tachy HR and RR)
Raised CK
Mx: sop antipsychotic, give IV fluid and dantrolene

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21
Q

Trastuzumab use

A

HER2 positive
Monoclonal Ab targets HER2 receptors

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22
Q

Tamoxifen

A

ER/PR positive disease
SERM - 1st line in men or pre-menopausal women
Risk: clot, endometrial Ca, osteoporosis

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23
Q

Anastrozole / Letrozole

A

ER/PR positive
Aromatase Inhibitor - used 1st line in post-menopausal women
S/E - menopausal sx, osteoporosis, MSK pain

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24
Q

AML

A

Dx >75yr

Film - Auer rods, myeloid blast cells

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25
Q

ALL

A

Dx - 2-5yr

Film - Blast cells
Philadelphia chromosome

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26
Q

CML

A

Dx >65 yr

Philadelphia Chromosome
Splenomegaly

3 phases -
Chronic (last 5yrs, asymptomatic),
Accelerated (abnormal blast cells take up high proportion of blood = anaemia + thrombocytopenia),
Blast = V high proportion of blast cells = severe pancytopenia

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27
Q

CLL

A

Dx >55yr

Film - smear or smudge cells

Richter’s transformation - CLL progresses to high-grade lymphoma

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28
Q

Temporal lobe focal seizure

A

Aura, racing feeling in stomach, writhing movements

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29
Q

Cataplexy

A

Transient loss of tone / collapse with strong emotion

30
Q

Extradural Haematoma bleed in which vessel

A

Middle Meningeal Artery

31
Q

Lymphogranuloma Vereneum

A

MSM
Proctitis
Lymphadenopathy

32
Q

Cellulitis commonest organism

A

Strep Pyogenes

33
Q

Thrombophlebitis Mx

A

NSAID

34
Q

Gilbert’s

A

Isolated high Bili in response to physiological stress

35
Q

Anal Fissure Mx

A

Stool softener, diltiazem topical, botox, GTN

36
Q

Total Anterior Circulation Stroke

A

Unilateral weakness or sensory defecit in face +/- arm +/- leg
AND homonomous hemianopia
AND higher cerebral dysfunction

37
Q

Lacunar stroke

A

Pure motor hemiparesis or pure sensory hemiparesis or ataxic hemiparesis or dysarthria-clumsy hand, sensorimotor

38
Q

Posterior Stroke

A

Brainstem or cerebellar syndrome, LOC, isolated HH

39
Q

Weber’s Syndrome

A

Midbrain Stroke, Ipsilateral CN III palsy + contralateral hemiparesis

40
Q

Posterior Inferior Cerebellar Artery
(Wallenburg / Lateral Medullary Syndrome)

A

Ipsilateral facial pain and temperature loss
Contralateral limb / torso pain and temp loss
Ataxia and nystagmus

41
Q

Anterior Inferior Cerebella Artery

A

Ipsilateral facial paralysis and deafness

Plus
Ipsilateral facial pain and temperature loss
Contralateral limb / torso pain and temp loss
Ataxia and nystagmus

42
Q

Wellen’s

A

Resolved CP
Deep T wave inversion in V2-V3
Critical LAD stenosis

43
Q

Bifasicular block

A

RBBB with L Axis deviation

44
Q

Trifasicular block

A

RBBB + L axis deviation + 1st degree heart block (prolonged PR)

45
Q

Pneumothorax

A

Primary - >2cm or sx then needle aspirate, <2cm or no sx d/c
Secondary - >2cm drain, 1-2cm aspirate, <1cm O2 and admit 24hr

46
Q

Granulomatous Polyangitis

A

Kidney, Respiratory and ENT problems
cANCA positive

47
Q

Transudate vs Exudate effusion

A

Transudate <30g/L protein
Exudate >30g/L protein

48
Q

Antibodies in hepatitis - acute or chronic infection

A

IgM = Acute, IgG = chronic

49
Q

Sister Mary Joseph Nodule

A

Gastric ca. metastasises to the peri-umbilical LN

50
Q

HNPCC and FAP genes

A

HNPCC - MSH2 MLH1
FAP - APC

51
Q

MALT

A

H.Pylori and Lymphoma

52
Q

EATL

A

Enteropathy associated T-cell lymphoma –> associated with coealic

53
Q

Difference between Haemolytic crisis, Aplastic crisis, Sequestrian crisis SickleCell

A

Aplastic - reduced reticulocytes, high WBC, low RBC, Parvovirus infection
Sequestrian - increased reticulocytes, Blood pools in organs due to sickling, high reticulocytes compensate for RBC loss
Haemolytic - rare, jaundice, pain, low RBC, splenomegaly

54
Q

Alcoholic Hepatitis Bloods

A

High CRP, High WCC
High Bilirubin, AST > ALT

55
Q

Massive PE and hypotension management

A

THrombolysis

56
Q

Hereditary Spherocytosis

A

AD condition
Neonatal jaundice, chronic sx, gallstones, splenomegaly

57
Q

Electrical Alternans

A

ALternation of QRS amplitude associated with cardiac tamponade

58
Q

Hypocalcaemia

A

Muscle cramps and paraesthesia
Trousseau sign (flex of wrist on BP monitoring)
QT prolonged

59
Q

Peripheral Arterial disease Meds

A

Atorvastatin and Clopidogrel

60
Q

Achalasia Mx

A

Heller Cardiomyotomy

61
Q

Bladder Cancer Mx

A

TURBT
Intravesical treatment - BCG or mitomycin C

62
Q

Rotator Cuff Muscles

A

Supraspinatus - abduction
Infraspinatus - ext rotation
Teres minor - ext rotation + adduction
Subscapularis - int rotation + adduction

63
Q

DKA resolution

A

pH >7.3
Ketones <0.6
Bicarb >15

64
Q

Kleinefelter and Kallman

A

Klinefelter (47XXY)= High LH low testosterone

Kallman (failed migration of GnRH neurons)- anosmia, low-norm LH & FSH, low testosterone

65
Q

Phaechromocytoma

A

Give Phenoxybenzamine before B-Blocker

Sx: palpitations, tremor, headache
Ix: Htn ++, high urinary metanephrines

66
Q

Quadrantopia

A

PITS - parietal inferior, temporal superior

67
Q

COCP and cancer

A

Protective against ovarian and endometrial
Increased risk cervical and breast cancer

68
Q

SIADH

A

hyponatraemia, hypo-osmolar serum, hyperosmolar urine, high urinary sodium

69
Q

ASpirin OD

A

Resp alkalosis
then metabolic acidosis

70
Q

Ix to Diagnose and monitor liver cirrhosis

A

Transient Elastography

71
Q

Acute Interstitial Nephritis

A

Allergic picture
Fever, rash, arthralgia
Sterile pyuria, White cell casts in urine, Eosinophila

72
Q

Autoimmune haemolytic anaemia

A

Raised unconj. bilirubin
Raised LDH
Mycoplasma pneumonia infection with anaemia