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UKMLA > flash cards for wrong questions > Flashcards

flash cards for wrong questions

1
Q

When should amiodarone 300mg be administered for shockable rhythms?

A

After delivery of 3rd shock

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2
Q

What is seen on the ECG in wolf parkinson white?

A

Delta wave

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3
Q

What causes wolf Parkinson white?

A

Pre-excitation of an accessory pathway between atria and ventricles

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4
Q

What is first-line medication for rhythm control?

A

Bisoprolol or CCB - diltiazem

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5
Q

What is first line for papulopustular rosacea?

A

Topical ivermectin

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6
Q

What is first line for rosacea without the pustules?

A

Topical brimonidine

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7
Q

What are the obvious features of dermatomyositis?

A

Heliotrope rash and gottron’s papules

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8
Q

What is the most sensitive indicator for dermatomyositis?

A

Creatinine kinase

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9
Q

What is the muscle weakness conditions caused by Small cell cancer?

A

Lambert eaton syndrome

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10
Q

What is pathophysiology of labert eaton syndrome?

A

Anti VGCC antibodies

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11
Q

What is first-line drug for bed wetting in kids and what is the mechanism of action?

A

Desmopressin - it’s an AVP analogue

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12
Q

What measure is enough for diagnosing diabetes?

A

One random blood glucose measure 11.1 or more in a symptomatic patient
One fasting blood glucose 7 or more in symptomatic patient
One 2 hour glucose 11.1 or more in symptomatic patient
Hba11c more than 48
If asymptomatic two results are required from different days

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13
Q

Which brain tumour shows psamomma bodies?

A

Meningioma

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14
Q

What do meningiomas look like on T1 MRI?

A

Hypointense

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15
Q

In patients where adenosine is contraindicated - eg. asthmatics what drug should be used?

A

Verapamil

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16
Q

What are 3 side effects of bisoprolol?

A

Tiredness
Peripheral coldness
Bronchospasm

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17
Q

What are 4 side effects of CCB’s?

A

Ankle swelling
Headache
Flushing
In patients with reflux - can increase it as it relaxes the lower oesophageal sphincter

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18
Q

What is definitive treatment for brugada syndrome?

A

Implanatable cardiac defib

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19
Q

What UTI drug is okay in 1st and second trimester?

A

Nitrofurantoin

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20
Q

What drug is okay for third trimester UTI?

A

Trimethoprim

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21
Q

Why can’t nitrofurantoin be used in third trimester?

A

Risk of neonatal haemolytic anaemia

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22
Q

Which UTI drug is contraindicated with methotrexate?

A

Trimethoprim

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23
Q

Which UTI drug is contraindicated with G6PD deficiency?

A

Nitrofurantoin

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24
Q

Which pathogens are culture negative?

A

Kingella, cardiobacterium, Eikenella

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25
Q

For non sexual epididymo-orchitis what is first line?

A

Oral ofloxacin - as they cover e.coli

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26
Q

What is treatment for severe malaria?

A

IV artesunate

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27
Q

When should liraglutide be discontinued?

A

If within 12 weeks the patient has not lost 5% or more of their body weight

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28
Q

When should bariatric surgery be recommended and what type?

A

BMI 40 or over or 35 or over with significant obesity co-morbidities. And a rout y gastric bypass

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29
Q

What are the symptoms of systemic sclerosis (scleroderma)

A

CREST
Calcinosis
Raynauds
Eosophageal dysfunction
Sclerodactyl
Telengiectasia

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30
Q

What antibodies are found in dermatomyosists?

A

Anti-m2

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31
Q

Which pathogen is involved in food poisoning within 1-2 hours esp after eating dairy products?

A

Staph aureus

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32
Q

Can campylobacter cause bloody diarrhea?

A

Yes - 2-5 days after exposure

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33
Q

Which pathogen is involved in diarrhea for HIV and immunocompromised patients?

A

Cryptosporidium parvum

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34
Q

When is a CABG more advantageous than a PCI?

A

Over 65
T2DM
Complex 3 vessel disease

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35
Q

What is a serious side effect of azathioprine?

A

Neutropenia due to bone marrow suppression

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36
Q

What is a relative contraindication to thrombolytic therapy?

A

Systolic BP over 180 , diastolic over 110

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37
Q

What is the function of alpha 1 trypsin?

A

Protease inhibitor - it inhibits neutrophil elastase in lung

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38
Q

What is the pathophysiology of alpha 1 trypsin deficiency?

A

Deficiency of alpha 1 trypsin which is a protease inhibitor

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39
Q

What is the treatment for PBC?

A

Ursodeoxycholic acid and supplementation of fat soluble vitamins - A,D, E and K

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40
Q

Which heart defects are associated with carcinoid syndrome?

A

Pulmonary stenosis
Tricuspid regurg

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41
Q

Which drug is used to treat influenza in high risk people?

A

Oseltamivir

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42
Q

Which tumours are present in MEN1?

A

Pancreas
Parathyroid
Pituitary adenoma

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43
Q

Which gene is implicated in MEN1 vs MEN2?

A

Men 1 - men 1 gene
Men 2- RET-proto-oncogene

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44
Q

Which tumours are associated with MEN2?

A

Parathyroid
Medullary thyroid
Phaechromacytoma

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45
Q

What drug is long term prophylaxis against further leeds in variceal patients?

A

Propranalol

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46
Q

Which drug is used in acute treatment of variceal bleeds?

A

Terlipressin

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47
Q

Which antibodies are positive in patient with autoimmune hepatitis type 1?

A

Anti smooth muscle antibodies

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48
Q

What are the symptoms of pellagra and which vitamin deficiency causes it?

A

DDD
Diarrhea
Dementia
Dermatitis - photosensitive rash
Lack of vitamin B3- niacin

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49
Q

If P waves are inverted in V2 - what is most likely cause of this ECG abnormality?

A

Rarm and LA electrodes have been reversed

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50
Q

What is treatment for children with cradle cap - seborrhaeic dermatitis that doesn’t go away with cleaning?

A

Topical clomitrazole 1%

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51
Q

Which wall is affected in wellen’s syndrome?

A

Anterior wall

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52
Q

Where is fibrosis usually caused in TB?

A

Upper lobes

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53
Q

What are the two drugs for BPH and which is used first? what is their mechanism and when would u use finasteride over tamsulosin?

A

Tamsulosin - alpha blocker (anatgonist)
Finasteride - 5-alpha -reductase inhibitor
Use finasteride first if there is history of orthostatis hypotension and falls

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54
Q

What does 5-alpha reductase actually mean?

A

Block the conversion of testosterone to dihydrotestosterone and therefore slow progression of BPH

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55
Q

Which medication can be used for reducing secretions from tumour sites?

A

Glycopyrronium

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56
Q

What is treatment for torsades de point?

A

IV magnesium sulfate

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57
Q

What are the symptoms of bacterial prostitis?

A

Boggy prostate
Fever
Tender prostate
Urgency
Fever
Dysuria

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58
Q

What is first line management of bacterial prostitis?

A

Ciprofloxacin 500mg BD

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59
Q

What is the mechanism of action of sulfonyurea?

A

Increased insulin secretion from beta cells

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60
Q

What is mechanism of thiazolidinediones?

A

Increased peripheral glucose uptake

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61
Q

What time definition is QT elongation in men and women?

A

Over 460ms i women
over 440 in men

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62
Q

What are the symptoms of whipple’s disease?

A

Large joint arthropathy
Gi features - malabsorption
Diarrhea
Weight loss
Hyperpigmentation

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63
Q

What is gold standard diagnosis for whipples disease?

A

Jejunal biopsy shows deposition of macrophages in lamina propria staining positive for acid-schiff

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64
Q

Treatment for whipple’s?

A

Co-trimoxazole

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65
Q

What drugs cause steven johnson syndrome?

A

Co-trimoxazole
Beta lactams like penicillin
Anti-convulsants

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66
Q

What is pattern of inheritance of charcot marie tooth?

A

Autosomal dominant

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67
Q

What are symptoms of charcot marie tooth?

A

Genetic peripheral neuropathy - distal motor and sensory deficits

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68
Q

Which pathogen causes rice water like stool?

A

Cholera

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69
Q

What are symptoms of giardia lamblia?

A

Contaminated water access, uncooked fruit , 1-3 week incubation

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70
Q

Treatment for giardia lamblia?

A

Metronidazole

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71
Q

Which diabetes drug cause lactic acidosis?

A

Metformin

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72
Q

What’s the genotype of androgen insensitivity

A

46XY - so resistance to testosterone - so phenotypically female - regression of mullerian duct structures

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73
Q

What is ovulatory dysfunctional uterine bleeding?

A

Excessive production of vasoconstrictive prostaglandins in endometrium during menstrual period leading to painful uterine contractions and prolonged bleeding.

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74
Q

What is management of genital herpes in expectant mothers?

A

Treat primary infection then oral aciclovir from 36 weeks and expectant delivery

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75
Q

What is the dose mother with HSV from 1st or second trimester should be offered?

A

400mg three times a day from 36 weeks onwards

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76
Q

If a pathogen is methicillin sensitive which antibiotic should be given?

A

Flucloxacillin

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77
Q

What is a positive Mc-Murrays test and what does it indicate?

A

Clunk when flexing knee up to chest - indicates a meniscal tear

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78
Q

Which line is safest to administer adrenaline through?

A

Central venous line

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79
Q

When does uterine rupture usually occur?

A

During labour more common in women with previous uterine surgery

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80
Q

What is management of uterine rupture?

A

Emergency exploratory laparotomy with C section and fluid recuss

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81
Q

Which disorder contains Barr bodies on histopathology?

A

Klienfelter’s syndrome

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82
Q

What is the genotype of klinefelter’s?

A

47 XXY

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83
Q

What is a barr body?

A

In activated and condensed X chromosome

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84
Q

Which drugs causes erythema nodusm?

A

COCP
Penicillin
Sulfonamides

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85
Q

What pathogen causes a chancroid?

A

Haemophilus ducreyi

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86
Q

What is antidote to lidocaine toxicity?

A

Intralipid

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87
Q

When is it abnormal for kids to develop a hand preference?

A

Before 12 months

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88
Q

What is a red flag when it comes to walking age for kids?

A

Not walking by 18 months

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89
Q

Where does the origin of the tear in lateral epicondylitis begin?

A

Extensor carpi radialis brevis - ERCB

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90
Q

Which fractures is the radial nerve more likely to be injured?

A

Mid shaft fractures

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91
Q

Which artery is in danger in supracondylar fractures?

A

Brachial artery

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92
Q

Which drug can be used for trigeminal neuralgia?

A

Carbamezapine

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93
Q

Which function tests do you need to do before beginning carbamezapine?

A

Liver function tests

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94
Q

What does aldosterone do to blood pressure and renin and potassium?

A

Aldosterone causes a reduction of potassium in blood and an increase of sodium. It increases BP by causing renin release and vasoconstriction and sodium reabsorption into blood

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95
Q

What is mechanism of action of spironolactone?

A

Aldosterone antagonist

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96
Q

What is mechanism of action of loop diuretics?

A

Inhibits co-transport of Na , potassium and chloride

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97
Q

What is the most common side effect of ondansteron?

A

Constipation

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98
Q

What can ondansteron do to the QT ?

A

Prolong it

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99
Q

In females who have high blood pressure what should be done for discharge?

A

Community midwife check their BP every other day until BP is below 150/100.

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100
Q

When can BP meds be stopped in women who had pre-eclampsia?

A

When BP drops below 130/80

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101
Q

Which rare congenital malformation is associated with primary ciliary dyskinesia?

A

Kartagener’s syndrome

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102
Q

What are the features of kartagener’s syndrome?

A

Subfertility
Recurrent sinus infection
Situs inversus - heart on right side of chest

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103
Q

What is the level of bifurcation of carina?

A

t4-t5

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104
Q

What is bartter syndrome?

A

Metabolic hypokalaemia
Alkalosis
Hypercalcueria
Normal BP

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105
Q

Which gene mutation causes achondroplasia - dwarfism?

A

Activation of fibroblast growth factor 3 receptor

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106
Q

Which genetic mutation causes marfan syndrome?

A

Fibrillin mutation

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107
Q

What is pleurodesis and when is it used?

A

Induces pleural inflammation to promote fibrosis and obliteration of pleural space - talc pleurodesis is popular - Can be used in malignant pleural effusions

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108
Q

If BP is not increasing in sepsis despite fluid bolus what should be given?

A

IV noradrenaline/ norepinephrine infusion - vasopressor support

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109
Q

Which biochemical marker is super raised in tumour lysis syndrome?

A

Urate - uric acid

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110
Q

What are the characteristics of perthes disease?

A

Insidious onset of limp with or without pain
In boys 4-6

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111
Q

What is diagnostic test for myeloma?

A

Serum light chains - look for bence jone sproteins

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112
Q

What drug is used to oppose a neuromuscular blockade?

A

Neostigmine

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113
Q

What hormone surges just before ovulation

A

LH

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114
Q

Which virus is indicated in SCC of oropharynx?

A

HPV

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115
Q

What is the meaning of continuous data?

A

On a scale eg. numbers

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116
Q

What is a nominal variable?

A

No ranking order - categories like hair colour, occupation

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117
Q

Which two drugs are okay with renal impairement?

A

Oxycodone and fentanyl

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118
Q

Why is warfarin used in valular heart failure for anticoagulation instead of DOACs?

A

DOACs are contraindicated in valvular heart disease

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119
Q

Where is broca’s area ?

A

Frontal lobe - left hemisphere

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120
Q

Where is wernicke’s area?

A

Left hemisphere temporal lobe

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121
Q

What is medical management for toxoplasmosis?

A

Administer sulfadiazine and pyrimethamine

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122
Q

Which anti-depressant is okay in children?

A

Fluoxetine

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123
Q

What is treatment for scarlet fever?

A

Phenoxymethylpenicillin

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124
Q

What is treatment for kawasaki?

A

IVIG and aspirin

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125
Q

What are the symptoms of Kawasaki?

A

CRASH
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hands and feet burn

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126
Q

When nitrofurantoin and trimethoprim is contraindicated for UTI was is given?

A

Pivmecillinam 400mg initial dose then 200mg TDS for three days

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127
Q

Which drug is common to cause drug induced lupus?

A

Isonizaid
Minocylcine
Phenytoin
Hydralazine

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128
Q

Which markers should be tested for in anti-phospholipid

A

Anti-cardiolipin
Lupus anticoagulant
Beta-2-glycoprotein

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129
Q

What is the most common viral cause of croup?

A

Parainfluenza

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130
Q

Which vaccine should be given to children who are at risk of RSV and bad RSV?

A

Palivizumab

131
Q

Which function tests do you have to do before starting lithium therapy?

A

Renal and thyroid function tests

132
Q

What is acceptable limit for sperm morphology?

A

4% or more

133
Q

What non pharma therapies can be used to treat palliative care?

A

CBT

134
Q

Which mutation are associated with a poorer outcomes in AML ?

A

FLT3 internal tandem duplication.

135
Q

Which mutation is associated with better outcomes in AML?

A

NPM1 mutation without concurrent FLT3 internal tnadem duplication

136
Q

What is the best initial management for autism?

A

Applied behaviour analysis

137
Q

What is appropriate treatment for complex facial fractures?

A

Open reduction and internal fixation

138
Q

Is cervical os closed in threatened miscarriage?

A

Yes

139
Q

What age can HPV vaccine be given till?

A

45 years old

140
Q

When is chronic villus sampling done?

A

10-13 weeks - used for high risk pregnancies when NIV tests shown a high risk

141
Q

When is quadrouple test done?

A

15-20 weeks

142
Q

When is amniocentisis done?

A

15-20 weeks gestation

143
Q

What is management of stable osetoprotic wedge compression fracture? + when do you refer?

A

Conservative management- refer if neuro symptoms , instability or persistant pain despite conservative measures

144
Q

What colour is discharge with trichomonas?

A

Yellow-green frothy

145
Q

At which mmol is giving biscuits okay to a diabetic with low blood sugar?

A

Over 4mmol

146
Q

What is 1st line management of hypoglycaemic conscious patient?

A

Oral glucose gel

147
Q

What is treatment for hypoglycaemia if oral glucose gel fails after 3 treatment cycles?

A

IM glucagon

148
Q

What is the management of oral hairy leukoplakia

A

Refer to secondary care

149
Q

How many days of treatment is recommended in men for UTI vs woman?

A

7 days in men and 3 days in women

150
Q

In a near term pregnant woman with UTI what can yougive her?

A

Amoxcillin or cefalexin

151
Q

Medication for bacterial meningitis?

A

Ceftriaxone

152
Q

What is prophylactic for meningitis for contacts?

A

Ciprofloxacin single oral dose

153
Q

What medication is used in pen allergic patients for meningitis?

A

Chloramphenicol is second line in patients with severe penicillin allergy

154
Q

Which BP drug is contraindicated in heart failure?

A

CCB except amlodipine

155
Q

Why is beta blockers and verapamil an issue together ?

A

Can cause severe brady

156
Q

What type of CCB is amlodopine?

A

Dihydropyridine

157
Q

Give an example of non dihydropyridine CCB?

A

Ditiazem
Verampamil

158
Q

What is target INR for aortic valve replacement vs mitral?

A

Aortic - 3
Mitral 3.5

159
Q

What is the dose of adrenaline to be used in cardiac arrest?

A

1mg-10ml 1:10000 IV or 1ml

160
Q

What reaction is commonly known about for metronidazole?

A

Reaction with alcohol

161
Q

Which antibiotic lowers seizure threshold?

A

Ciprofloxacin

162
Q

Which collagen is affected in osteogenesis imperfecta?

A

Type 1 collagen

163
Q

How often is screening done for HPV?

A

Every 3 years for women aged 25-49 with negative results. 50-64 it’s every 5 years

164
Q

What is surgery for tumours located more than 8cm away from anal margin?

A

anterior resection

165
Q

What is surgery for tumour located less than 8cm away from anal margin?

A

Abdomino-perineal resection

166
Q

What is management for traumatic tension pneumothorax?

A

Wide bore cannula into 5th intercoastal space in mid axillary line

167
Q

If there is dorsal displacementof distal fragment of radius what fracture is this?

A

Colles

168
Q

What is bolam test?

A

Standard of care should be judged based on that of ordinary doctor not specialist

169
Q

Who mainly gets chondrosarcoma’s?

A

Over 40 with pain and lump

170
Q

What does ewing sarcoma look like on x-ray?

A

Onion peel

171
Q

What does osteosarcoma look like on xray?

A

Sunburst

172
Q

Where does ewing sarcoma usually occur?

A

Along long bone diaphysis

173
Q

If fluffy popcorn appearance is seen on Xray which bone pathology is that?

A

Chondrosarcoma

174
Q

Which pole (distal or proximal) is avascular necrosis due to scaphoid fracture associated with?

A

Proximal pole

175
Q

What is most common type of carpal bone fracture?

A

Scaphoid

176
Q

If ABG in COPD patient shows normal co2 what are the oxygen saturation targets?

A

94-98%

177
Q

What is the antidote to benzo overdose?

A

Flumazenil

178
Q

How can a benzo overdose present?

A

Slurred speech
Ataxia
Drowsy

179
Q

What’s the difference in how long an OCD vs depressed person needs to continue on SSRI after they start feeling better?

A

Depression: 6 months
OC: 12 months

180
Q

What is first line management for a symptomatic large (more than 2cm ) pneumothorax?

A

Aspiration

181
Q

What is diagnostic test for hirshprung disease?

A

Rectal biopsy at least 1.5cm above the pectinate line

182
Q

What pH after paracetamol ingestion is grounds for a transplant?

A

pH less than 7.3 24 hours after overdose

183
Q

What are 4 grounds for liver transplant except pH after paracetamol overdose?

A
  1. Prothrombin time over 100 secs
  2. Creatinine over 300 umol
  3. grade 3 or 4 encephalopathy
184
Q

On blood test what is serum copper like in Wilson’s?

A

It’s low - because all copper is in tissues rather then blood

185
Q

What side effect does amitriptyline have when it comes to urine?

A

Urinary retention

186
Q

For a person with a AA 3-4.4 cm what is management?

A

12 monthly US

187
Q

For a person with 4.5- 5.4 cm AA what is management?

A

3 Monthly US

188
Q

What is first line medication for giardiasis?

A

Metronidazole

189
Q

What is characteristic findings of giardisis?

A

Rose petals on stool microscopy
diarhhea and cramps

190
Q

What are the signs and symptoms of boerhaave syndrome?

A

Subcut emphysema
Pleural effusion - usually left sided
Severe chest pain and vomiting
Hamman sign

191
Q

What is hamman sign?

A

Hamman sign is the sound of crunching or popping due to air trapped in the chest cavity (outside the lungs). can be between s1 and s2

192
Q

What milk should be used in baby with potential cow milk intolerance?

A

Hydrolysed milk

193
Q

What are the symptoms of toddlers diarhhea?

A

6 months to 5 years of age
No growth loss
Usually in daytime after high amounts of fruit juice and high fibre
Non bloody, chronic and watery.
Should self resolve by 5

194
Q

What is most appropriate diagnostic test for neuroleptic malignant syndrome?

A

Creatinine kinase

195
Q

When is abortion allowed in the uk for normal baby vs defect baby?

A

Normal - under 24 weeks
Defect - anytime

196
Q

What feature of c. diff makes it hard to destroy?

A

Spore formation

197
Q

What is management of someone with MS who has neuropathic bladder?

A

Intermittent self catheter

198
Q

Which anti hypertensive is known to cause ankle swelling?

A

Amlodipine

199
Q

Which anti hypertensive is known to cause a cough?

A

ACE inhibitors

200
Q

What is most common nephrotic syndrome?

A

Membranous nephropathy

201
Q

What would biopsy show with membranous nephropathy?

A

Subepithelial immune complex deposits

202
Q

What is the most common nephrotic syndrome in children?

A

Minimal change disease

203
Q

What indicates pseudohypoparathyroidism?

A

High parathyroid
Low calcium
With no renal issues

204
Q

What classification system is used to stage cellulitis?

A

Erons classification

205
Q

What are the 4 levels of eron’s classification?

A

class 1: no signs of systemic issues and no uncontrolled comorbidities
class 2: Systemically unwell or systemically well but there is a comorbidity
Class 3: significant systemic unwell and unstable comorbidities
Class 4: life threatening / necrotising fascitis

206
Q

Other than urine output dropping below 0.5 ml/kg an hour what else is a sign of AKI?

A

Creatinine rise 1.5x baseline

207
Q

When should patients treated for h.pylori be followed up?

A

4-8weeks re tests. At least 4 weeks after antibiotics used and 2 weeks after PPI use

208
Q

What causes waterhouse-friderichson syndrome

A

Neisseria meningitidis (usually) cause disseminated intravascular coagulation (DIC), leading to widespread clotting and bleeding, including in the adrenal glands.

209
Q

which levels are elevated in sarcoidosis?

A

Serum ACE and hypercalcaemia

210
Q

What is genotype of turner syndrome?

A

45XO

211
Q

What is virchows triad?

A

Hypercoagulability
stasis
vessel wall injury

212
Q

Can topical chloramphenicol be used in pregnant women?

A

No - can cause neonatal grey baby syndrome

213
Q

Which nerve is implicated in carpal tunnel?

A

Median nerve

214
Q

If median nerve implicated what area of body sensation is altered?

A

lateral 3.5 digits

215
Q

What is the most common cause of viral myocarditis?

A

Coxackie B virus

216
Q

What is gold standard test for CF?

A

Sweat test

217
Q

What is sweat test/

A

Pilocarpine put on part of skin then sweat is used to measure chloride in there. More chloride in sweat = CF likely

218
Q

Which nerve supplies the superior oblique?

A

Fourth nerve - trochlear

219
Q

Which nerve supplies the lateral rectus?

A

6th nerve - abducens

220
Q

Which tumour markers are elevated in testicular teratoma?

A

AFP
HCG

221
Q

When can metformin be taken vs not taken?

A

If taken 1/2 times a day then can take. If taken 3 or more then lunchtime dose should be omitted. If minor surgery its fine. Major surgery withold it

222
Q

What is the most effective way to reduce contrast induced nephropathy?

A

Saline before and after the surgery

223
Q

What is investigation pathway for kids with recurrent UTI?

A

An ultrasound is typically the first imaging test.
DMSA may be performed later to assess for scarring, particularly in children with recurrent or atypical UTIs.
MCUG is used selectively, especially in infants or if VUR or structural abnormalities are strongly suspected.

224
Q

What is hallmark on cytology of brachial cyst?

A

Presence of cholesterol crystals

225
Q

Difference in location of thyroglossal vs bracial cyst?

A

Brachial:lateral
Thyroglossal : midline

226
Q

What is correct site for epidural?

A

L2-L3 or L3-4

227
Q

What is treatment of hypotension due to epidural?

A

1L hartmanns over 20 mins

228
Q

When is fibrinolysis indicated in MI patients?

A

If PCI over 120 mins

229
Q

What is vitamin B3?

A

Niacin

230
Q

What is deficiency of niacin called?

A

Pellagra

231
Q

What are symptoms of pellagra?

A

4 D’s :
Diarrhea
Dementia
Dermatitis
Death

232
Q

If a patient comes in with hyperpigmented band around neck what is it called and indicates?

A

Casals necklace: chronic alcohol excess

233
Q

What creatinine kinase is used for MI?

A

CK-MB - myocardium one

234
Q

What Creatinine kinaseis for skeletal muscle?

A

CK-MM

235
Q

Why is CK-MB useful to detect for re-infarct?

A

It clears earlier than troponin so if a CK-MB is 3 times normal usually indicates re-infarcts

236
Q

What vein inabdomen can cause variocele?

A

left renal vein or left testicular vein - issues can be due to a renal tumour so if there is isolated varicocele left kidney must be imaged using ultrasound

237
Q

What is first line treatment for focal seziure?

A

Lamotrigine
Leviteractam

238
Q

Which is the main lymphatic drainage of the ovary?

A

Para aortic nodes

239
Q

What is the most common pathogen involved in cellulitis?

A

Streptococcus

240
Q

In someone with cardiac disease what is fluid maintence rules?

A

20-25ML/kg

241
Q

How many hours does a person have to present in to get a PCI?

A

Present within 12 hours but PCI has to be available within 2 hours

242
Q

Which epilepsy drug causes warfarin to be broken down more vs inhibits its breakdown vs being a cytochrome p450 iducer or inhibitor?

A

Carbamezapine is an inducer - leading to decrease in INR
Sodium valproate is an inhibitor - so can lead to increased INR

243
Q

What action of trazadone means it causes priapism

A

a adrenergic blocking activity

244
Q

What is peri op advice for aspirin and clopidogrel?

A

Stop 7 days before surgery

245
Q

What is peri op advice for bisoprolol?

A

Take even on day of surgery

246
Q

What score is used to calculate risk of major bleeds in patient with anticoag?

A

ORBIT

247
Q

What is hasbled score?

A

assess the risk of major bleeding in patients with atrial fibrillation (AF) who are being considered for anticoagulation therapy

248
Q

What is cullens sign?

A

Bruising in perumbilical region

249
Q

What is pneumonic to remember pancreatitis severity?

A

PANCREAS
PaO2
Age over 55
Neutrophils
Calcium over2
Renal function - urea over 16
Enzymes LDH over 600
Albumin over 32
Sugar blood glucose over 10.
3 or more points = severe and need HDU

250
Q

If a patient takes more than 20mg of pred a day what is operative strategy?

A

IV hydrocortisone during induction and usual morning dose

251
Q

When is Electrocardioversion used in AF management?

A

If the AF onset is within 48 hours.

252
Q

Following electrocardioversion for AF how long should person be on anticoag?

A

3 weeks prior and 4 weeks after

253
Q

What is first line medication for acute prostatitis?

A

Oral ciprofloxacin

254
Q

Which BP medication can cause hyperkalaemia and why?

A

ACEs as they block action of aldosterone

255
Q

What is gold standard for diagnosing coeliac?

A

Endoscopy with duodenal biopsy

256
Q

What is treatment for staph scalded skin syndrome?

A

IV flucloxacillin and topical fusidic acid

257
Q

What is medical treatment for toxic shock syndrome?

A

IV clindamycin and meropenem

258
Q

What is management of a patient with Angina still experiencing angina after beta blocker or CCB?

A

Switch to the other vice versa

259
Q

Which ECG sign is most specific for pericarditis?

A

PR depression

260
Q

What mustthe serum osmolality be in HHS?

A

Greater than 320/kg

261
Q

What is diagnostic test for carcinoid tumour?

A

Urinary 5-HIAA

262
Q

Diagnostic test of phaeochromacytoma?

A

Urinary VMA - VMA is breakdown of catecholamines

263
Q

What is treatment of severe crohns?

A

Infliximab

264
Q

What is treatment for severe UC?

A

Ciclosporin

265
Q

For an aortic anyeurysm what is the rate of growth that would warrant a 2 week referral to vascular surgeons?

A

1cm per year and is larger than 4cm

266
Q

What is diagnostic test for hereditary spherocytosis?

A

Eosin - 5 - maleimide binding test

267
Q

What are fibrinogen levels like in DIC?

A

Low

268
Q

What is the treatment for oculogyric crisis?

A

Procyclidine

269
Q

What is first line management for achlasia then second line if surgery not okay?

A

Surgical myotomy
Botulinum toxin

270
Q

What scan is used to detect meckels diverticulum ?

A

Technetium scan 99

271
Q

What is the symptoms of meckels diverticulum?

A

Abdo pain + rectal bleeding

272
Q

Which chromosome is involved in digeorge?

A

22q11.2 deletion

273
Q

Is electrocution a recognised cause of posterior shoulder dislocation?

A

Yes

274
Q

What is staining for amyloidosis?

A

Apple green birefringence when stained with congo red under polarised light

275
Q

What collagen is affected in ALport syndrome?

A

Type 4

276
Q

What is symptoms of alport syndrome?

A

Kidney disease
Visual issues
Hearing loss

277
Q

Which drug overdose presents with resp alkalosis ?

A

Aspirin

278
Q

Where is there a swelling is osgood schlatter disease?

A

Tibial tuberosity

279
Q

When should COCP be stopped before surgery? and when can it be restarted

A

4-6 weeks before due to increased risk of VTE can be restarted at least 2 weeks after surgery

280
Q

What pathogen causes hand foot and mouth?

A

Coxackie virus 16

281
Q

Which pathogen causes scarlet fever?

A

Strep pyogenes

282
Q

What are the symptoms of intussusception?

A

Severe colick pain
Vomit
Passage of blood stained mucus
Target sign on ultrasound
Palpable mass on abdomen

283
Q

What is management of intussussepsion?

A

Rectail air or contrast enema

284
Q

What does thiazide diuretics do to sodium and chloride?

A

Reduce active reabsorption in distal tubules

285
Q

What is diagnostic investigation for thalassaemia?

A

Haemoglobin electrophoresis

286
Q

What haemoglobin is found to be increased in thalassaemia?

A

HbF or HbA2

287
Q

What genetic mutation is involved in fragile X syndrome?

A

CGG trinucleotide repeat expansion in FMR1 gene

288
Q

What can a mass superiour to ischium on rectal exam indicate?

A

Obturator hernia

289
Q

What abnormality in pregnancy is created with lithium use?

A

Ebstein anomaly

290
Q

How long does it take for transient tachypnoea of newborn to dissapear?

A

72 hours

291
Q

What can help prevent air emboli whe inserting a central line?

A

Trendelenburg position - lie 15 degrees down

292
Q

What is despopressins role on factor 8 the clotting factor?

A

Desmopressin stimulates release of vWF from storage sites in endothelial cells therefore improving stability of factor 8 . Therefore desmopressin can be given immediately before surgery or after trauma to reduce excessive bleeds

293
Q

What is investigation of hydrocephalus?

A

MRI or CT head

294
Q

If there is a young patient with paroxysmal AF what is treatment?

A

Oral flecainide or sotalol

295
Q

When is a carotid endarterectomy needed?

A

If carotid artery stenosis is 70-99% with symptoms such as stroke or TIA in corresponding areas

296
Q

What is the most common cause of HAP?

A

Pseudomonas aerginosa

297
Q

In patients with sjorgens disease which tubuar acidosis is common?

A

Renal tubular acidosis type 1 : hypokalaemic, hyperchloraemic, with a normal anion gap

298
Q

How often should patients with low grade dysplasia due to barrett’s have endoscopy?

A

Every 6 months

299
Q

When is a 3 way catheter used vs a 2 way foley?

A

3 way if there is haematuria or debris to be irrigated. 2 way just for acute urinary retention

300
Q

Which cancer is increased if you have PBC?

A

Hepatocellular carcinoma

301
Q

Which antibodies are present in PBC?

A

Anti-mitochondrial

302
Q

What cancer is increased risk of having if you have PSC?

A

Cholangiocarcinoma

303
Q

What antibodies are seen in PSC?

A

Anti nuclear - ANA

304
Q

What is the most common cause of renal cell cancer?

A

Renal clear cell carcinoma

305
Q

Which renal cell cancer is usually seen in young men with sickle cell?

A

Renal medullary carcinoma

306
Q

Which scoring system is used to assess patients risk of developing a pressure ulcer?

A

Waterlow score

307
Q

Which mental health medication can cause SIADH?

A

Citalopram - SSRI’s!!!

308
Q

What is first line pharma treatment for idiopathic intracranial hypertension?

A

Acetazolamide it reduces the CSF

309
Q

What is phosphate, calcium and ALP like in paget?

A

ALP is raised. everything else is normal

310
Q

In osteomalacia what is calcium, alp and phosphate like?

A

High ALP, low calcium, low phosphate

311
Q

In osteoporosis what is the bone profile?

A

Normal

312
Q

What metabolic disorder does vomiting and diarrhea cause?

A

Vomiting - alkalosis
Diarrhea - acidosis

313
Q

What is first line treatment of atrial flutter?

A

Bisoprolol

314
Q

First line medication for toxoplasmosis?

A

IV pyrimethamine and sulphadiazine

314
Q

If HIV patient has single ring enhancing lesion what is this ?

A

Brain abscess

315
Q

What is treatment for brain abscess?

A

IV ceftriaxone and metronidazole

316
Q

What sign is most apparent for babies to know they have congestive heart failure?

A

Hepatomegaly

317
Q

Which antibody test is first line in coeliac then second line?

A

First line anti-ttg -IGA then the IGG ones

318
Q

What is treatment of guttate psoriasis?

A

Topical emollient and reassurance

319
Q

What is mechanism of action of tamsulosin?

A

Alpha blocker - relaxes protastatic smooth muscle

320
Q

What is mechanism of action of finasteride?

A

5-alpha reductase inhibitor that shrinks prostate

321
Q

What are symptoms of potter’s syndrome?

A

Twisted posture baby
Dysplastic kidneys
Bbay is squashed due to oligohydramnios

322
Q

What measure is used to confirm that tube for anaesthetics is in right place?

A

End tital CO2

UKMLA (13 decks)

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