Fri Flashcards
tinea unguium
nail infection
ringworm
tinea corporis
ringworm of body
patches of round red on anterior body
treatment of tinea
antifungal
clotrimazole
treatment for tinea capitis and if tinea with oncholysis
terbinafine - first line
itraconazole
systemic
both contraindicated in autoimmune diseases
vaso occlusive crisis
sickle cell disease
can be precipitated by infection, dehydration, hypoxia
shingles treatment
paracetamol, ibuprofen
gabapentin- 2nd line
amitriptyline/ duloxetine
what does wallenberg syndrome affect
lateral medulla
which artery does wallenberg syndrome occlude
posterior inferior cerebellar artery
wallenberg syndrome symptoms and why?
horners syndrome
ipsilateral loss of pain and temperature of face and contralateral of body
hoarse voice
dysphagia
change in taste sensation
cranial nerves 9 and 10
vagus and glossopharyngeal
Horner’s syndrome
partial ptosis
miosis- constricted pupils
facial anhidrosis- loss of sweating
webers syndrome which arteries
upper basilar and proximal posterior cerebral
webers syndrome symptoms
ipsilateral occulomotor palsy and contralateral hemiparesis
basilar artery occulsion symptoms
quadriparesis - locked in syndrome
eyes fine
red flag for anorexia nervosa
sit-up–squat–stand (SUSS) test
inability to stand up from a chair without using their hands
nephritic syndrome symptoms
sudden haematuria
oedema
hypertension
can be post strep throat
most common type of delusion seen in mania
grandiose
Nihilistic delusions
think they are dead or don’t exist
low mood
somatic delusion
believe something is medically /physically wrong with them
psychosis
delusions of control
believe someone else is controlling their thoughts or actions
Lactational breast abscess
mastitis but has a fluctuant mass
staph aures
Pityriasis rosea
xmas tree pattern of rash
Lactational breast abscess treatment
Incision and drainage or needle aspiration
antibiotics
breast screening
every 3 years
50-70
non binary who still have breasts
trans women taking hormones
placental abruption symptoms
painful vaginal bleeding
hard/woody, tender uterus
placental abruption
pre mature separation of placenta from uterine wall resulting in haemorrhage
placental abruption treatment
delivery- spontaneous or c section
induction of labour if no maternal or foetal comprimise
if rhesus D negative
give anti D
induction of labour
prostaglandins inserted into vagina using gel or pessary
full term
37 weeks
Placenta praevia symptom
painless bleeding
Pelvic Inflammatory Disease
organisms
STI spreads from vagina up
chlamydia trachomatis
neisseria gonorrhoeae
Pelvic Inflammatory Disease symptoms
Bilateral abdominal pain
Vaginal discharge
Post-coital bleeding
some RUQ pain - spread to liver
fitz high curtis syndrome
treatment of pelvic inflammatory disease
Ceftriaxone (given intramuscularly) + doxycycline + metronidazole
Ofloxacin + metronidazole
endometriosis
growth outside uterine cavity
endometriosis symptoms and signs
Dysmenorrhoea- painfull periods
Dyspareunia- painful sex
Subfertility
Cyclical rectal bleeding, if endometrium-like tissue grows outside the female reproductive system
palpable tender nodular masses
endometriosis management
NSAIDS, paracetamol
COCP
medroxyprogesterone acetate (progesterone)
gonadotrophin-releasing hormone agonists
surgery
which contraceptions prevent ovulation
COCP
mini pill- progesterone only
patch
implant
ring
how do IUD’s work
prevent implantation
which hormones in patch
oestrogen and progesterone
which hormone in implant
progesterone
which hormone in vaginal ring
oestrogen and progesterone
pre-labour rupture of membranes symptoms
Foul-smelling or greenish amniotic fluid
Maternal fever
Reduced foetal movements
feeling that waters have broken but no contractions
management of pre-labour rupture of membranes
induction of labour if doesn’t happen spontaneously in 24h
if infection then immediate induction
if low foetal heart beat then c section
what confirms diagnosis of pre-labour rupture of membranes
actim PROM vaginal swab
detects insulin-like growth factor binding protein-1 (IGFBP-1) which is highter in amniotic fluid then blood
narcoplexy
excessive sleepiness during the day
DVLA and epilepsy 1 seizure
car/motorbike
6 months
bus/lorry
5 years
DVLA and epilepsy 1+seizure
car/motorbike
1 year
bus/lorry
10 year
bad prognosis in hodgkins
ESR >50 mm/Hr without B symptoms
ESR > 30 mm/Hr with B symptoms
Age >50
ovarian cancer marker
ca - 125
menupause
when no period for a year
perimenupausal medication
Oral sequential combined hormone replacement therapy
breast lump found over 30
urgent referral
Monozygotic twins
identical
fertilisation of one egg and one sperm
Dichorionic and diamniotic
identical twins
2 different sacs
Monochorionic and diamniotic
same outer sac, two inner sacs
identical twins
Monochorionic and monoamniotic
same sacs
identical twins
highest risk
Dizygotic twins
non identical twins
fertilisation of two different eggs with two different sperms
two separate outer and inner sacs
ovarian cyst
cyst on ovary
most women get it once during lifetime
ovarian cyst symptoms
asymptomatic
acute unilateral pain that starts during exercise
bleeding in peritoneum
Ovarian torsion
sudden, severe pain
unilateral
nausea and vomiting.
appendicitis
gradual pain
diagnostic test for ovarian test
laparoscopy
management for ovarian cyst
pain management
laporoscopy/laporotomy
risk factors for c diff
being in hospital
older
antibiotics
treatment for covid
dexamethasone adn remdesivir
Lambert-Eaton myasthenic syndrome (LEMS).
rare autoimmune disorder
autoantibodies that target pre-synaptic voltage-gated calcium channels
affecting neurotransmission
half related to small cell lung cancer
Lambert-Eaton myasthenic syndrome (LEMS) signs and symptoms
Limb weakness
proximal and symmetrical
orthostatic hypotension
impotence
dry mouth
no tendon reflexes
Lambert-Eaton myasthenic syndrome (LEMS) investigations
test for autoantibodies
nerve conduction studies- doubles muscle action potential after exercise
CXR - cancer
Lambert-Eaton myasthenic syndrome (LEMS) management
Amifampridine
does meningitis cause confusion
no
what is encephalitis caused by
herpes simplex t1
fibrocystic disease of breast
most common benign
bilateral breast lumps and pain
cyclic and worse before period
supportive
what to test for when got tb
HIV
miscarriage
before 24 weeks
Threatened miscarriage
cervix closed
painless bleeding
foetus heart beat present
early pregnancy
inevitable misscarriage
heavy bleeding and pain
cervix open (inevitable as foetus will be lost)
complete misscarrage
uterus empty
missed miscarriage
foetus there but dead
doesn’t realise happened
management of miscarriage
conservartive- wait to come out
misoprostol
dilation and curettage
risk for breast cancer
late menopause and early periods
what drugs worsen myasthenia gravis
beta blockers, antimalarials, lithium
pyridostigmine
myasthenia gravis
anticholinesterase inhibitor
depression management once symptoms better with meds
continue for another 6 months
Creutzfeldt-Jakob disease (CJD)
prion disease
neuronal loss
Creutzfeldt-Jakob disease (CJD) symptoms
fast dementia
visual, ataxia
weakness
psych symptoms
limb jerks
Creutzfeldt-Jakob disease (CJD) diagnosis
tonsil or olfactory biopsy
EEG-sharp complexes
MRI
lewy body dementia
third most common
parkinsonism
visual hallucinations
alpha synuclein/lewy bodies
second most common dementia
vascular
lewy body vs parkinsons
lewy body- if dementia and mov disorder within a year of each other
parkinsons- if a year apart
Fronto-temporal dementia
behaviour change - repetitive checking behaviour
dementia
speech affected
Fronto-temporal dementia causes/RF
repetitive head injury
picks bodies (TAU protein stain silver that don’t stain silver in alzheimer)
