Full Send Shuffle Passmed Flashcards by Charis Gibson

Pregnant patients with BMI over 40 are grade ASA what?

ASA III

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If patient has brain injury and brain seems to be oedema–ing what should you do?

IV mannitol

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When is the time out period in sugery?

Before first skin incision is made

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30 y/o man. asthma, 5 day cough and wheeze. Takes salbutamol and beclametasone. Peak flow 70% of normal what you want to give him?

Prednisolone days

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In ALS if iV access can’t be achieved what route and where should you give drugs?

I0 interosseous (proximal tibia)

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Neo-adjuvant = to dp what

SHRink Tmour before sug

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Bleeding risk of anti-coags in AF scoring system?

orbit score

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Patient with hyprcalciuria and renal stones, how can you treat?

Hydrochlorothiazide

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Uncomplicated dissection of descending aorta?

BP control

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Mitral stenosis patients, asymptomatic, what management should they have?

Regular echo every 6-12 months

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ROGUE but passmed:
Famer, found with empty bottle, found unconscious, GCS 11 in hospital, eyes/nose watering, bradycardia, dried vomitus around mouth, RR: 9, muscle fasics.

What happened here?

CLEARLY
Oganophosphate insecticide poisoning

Farmer> access o insecticides

These inhibit action of ACh ase

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Precocious pberty in males age?

Before 9 y/o

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Moderate-severe Aortic stenosis is a CI for what Heart drug?

ACEi

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If 2 pills missed between days 8-14 of menstrual cycle and sex be had, whats the emergency contraception situ?

None
2 pills that day, continue as normal

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What type of exudate in mets to lungs?

Exudative (high in protein)

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Small testes in precocious puberty?

Adrenal cause of symptoms

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Test for comparing the means of 2 group subjects?

Two-sample T test

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If you hear tinkling sounds in a neonate what do you think? Management?

Diaphragmatic hernia

Intubation and ventilation

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Murmur which becomes louder in inspiration?

Tricuspid regurg

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Hypokalaemia with alkalosis causes?

Vomiting
Thiazide loop diuretics
Cushing’s syndrome
Conn’s syndrome

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What classic red flag can come second to mitral stenosis?

Haemoptysis

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Primary prevention of CVD using statins aim for a reduction in non-HDL cholesterol of how much?

> 40%

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Occupational asthma test?

Serial peak flow measurements at work and home

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Recent sore throat + rash + arthritis + murmur =?

Rheumatic fever

RFs for ectopics?

Anything slowing ovum's passage uterus -Damaged tubes - Previous ectopic -Endometriosis -IUCD -POP -IVF

Initial management of heart failure with reduced ejection fraction?

B blocke ACEi

Type of diuretic in HF?

Loop (furosemide)

Tetralogy of fallot?

Pulmonary stenosis RVH Ventricular septal defect Overriding aorta

What invgX should all TIA patients recieve?

Carotid artery doppler

What ABG does hyperventilation cause?

Respiratory alkalosis O2 normal because no problems with gas exchange, no metabolic comp as panic attack resolves rapidly

Most common site affected by ischaemic colitis?

Splenic flexure or Rectosigmoid junction

What artery does amaurosis fugax affect?

Central retinal Artery

How long after giving birth can you not take contraception?

21 days

Patient, 21 days post-partum, majority breast feeding what contraception shall you give her?

POP UKMEC1

COCP and post-partum?

CI during breast feeding for first 6 weeks post-partum (potential transfer of hormones to child, + elevated VTE risk)

Copper coil and post-partum?

Discouraged (UKMEC3) FROM 48 HOURS UP TO 4 WEEKS POST-CHILDBIRTH DUE TO LIKELIHOOD OF EXPULSION

First line management of acute pericarditis?

Combination NSAIDs + colchicine

Most common organism in YA with septic arthritis?

Neisseria gonnorhoeae

Time frame to classify a death as neonatal?

Within 0-28 days of birth

Diabetic patients who have reasonable glycaemic control + are having minor surgery...what you do with their insulin?

Reduce morning dose by 50% and leave evening unchanged If on SGLT2 inhibitor omit for 2 days pre-surgically

Management for woman with breast cancer + no obvious lymphadenopathy?

Sentinel node biopsy to assess nodal burden

What does high SAAG gradient (>11g/L) indicae?

Portal HT

Treatment for ingestion of ethylene glycol toxicity?

Fomepizole

IECOPD prophylaxis in patients who meet criteria?

Azithromycin

What AB can cause torsades de pointes?

Clarithromycin

Rose spots on abdo organism?

Salmonella typhi

Wide based gait with loss of heel-toe walking is called what?

Ataxic

What level of magnesium would result in the patient being treated for hypomagnesia?

IV mg if <0.4mmol/L or Tetany Arrhythmias Seizures

V1-4 Changes ECG?

LAD Anteroseptal

II, III, aVF changes ECG?

Inferior Right coronary

Antero lateral leads and artery ECG?

v1-6, I, aVL Proximal LAD

Leads and artery for lateral ECG?

I aVL V5-6 Left circumflex

Cardiac catheterisation results show you a jump in O2 sats from right atrium to right ventricle...what do you think it is?

VSD

Aims of acute glaucoma treament?

Reducing Aq secretion + inducing pupillary constriction This helps to open up the drainage angle and promote outflow

Wat do you want to give a lil baby who has patent ductus arteriosus?

Indomethacin or ibuprofen to promote duct closure This blocks Prostaglandin production which keep the duct open

What cancer marker can be seen in cholangiocarcinoma?

Ca 19-9

What GCS do you intubate at?

In renal colic what do you give if NSAIDs are CI?

IV Paracetamol

What surgery would you do for distal transvese or descending colon cancer?

Left hemicolectomy

What anti-psychotic is CIed in Parkison's patients?

Haloperidol

Mechanism of lidocaine?

Blockage of sodium channels

What eye condition is red desaturation affected in?

Optic neuritis

Treatment of acute dystonia secondary to antipsychotics?

Procyclidine

Management of patient with sigmoid volvulus who have Bowel obstruction with symptoms of peritonitis

Skip flexible sigmoidoscopy and perform urgent midline laparotomy

Gram negative rod, non-lactose fermenting, oxidase positive?

Pseudomonas aeruginosa

What does Wilcoxon signed-rank test look at?

Before and after data of same population

When should metformin be stopped?

Patient who is septic or critically ill (assoc risk of lactic acidosis)

Initial management of acute angle closure glaucoma?

IV acetazolamide Eye drops

Epigastric pain several hours after eating?

Duodenal

New onset flashers and floaters in eyes management?

Referred urgently for assessment by an ophthalmologist within 24 hours

Common SE of ciclosporin?

Nephrotoxicity

WHat type of vein should TPN be given through?

Central vein (strongly phlebitic)

VTE prophylaxis for hip replacements?

TED stockings Dalteparin sodium at least 6 hours post operation

Hyaline casts seen in patient taking what?

furosemide

Non-fluent speech, comprehension normal, repetition impaired...what area of the brain?

Broca's dysphagia

Displaced hip fracture treatment?

Hemiarthroplasty THR

Management of inter trochanteric proximal femoral fractures?

Dynamic hip screws

Likely site of early rupture of ectopic pregnancy?

Isthmus

Treatment of chlamydia in pregnancy?

Erythromycin Azythromycin Amoxicillin

PID can progress to what?

Perihepatitis (Fitz-Hugh Curtis syndrome)

Erythromycin + what = BAD INTERACTION?

Atorvastatin

Methotrexate and looking to conceive?

Use contraception and wait for 6 months after stopping treatment for either parents

HIV + diarrhoea + ziejl-Neelsen stain showing protozoa?

Cryptosprodium parvum

Prescribe what to women with high risk of pre-eclampsia?

Los dose aspirin should be prescribed from 12 weeks

Human bit etreatment?

Co-amoxiclav

Oral to SC morphine transfer?

divide by 2

Rectal cancer on anal verge treatment>

Abdominal perineal excision of rectum

Describe meaning of forrest plots?

Sze of square = weight of study in meta-analysis Line running through square = confidence interval

What electrolyte abnormality predisposes patients to digoxin toxicity?

Hypokalaemia

If an anal fissure hasn't responded to initial treatments what do you want to do?

Sphincterotomy

If an anal fistula wasn't healing with treatment what would you like to do?

Seton insertion

Best stoma if you are defunctioning the colon to protect an ileostomy?

Loop ileostomy

Potassium requirement per mmol/kg/day?

1mmol/Kg/day

Guillain-Barre diagnostic invgX?

Triangle of safety?

Base of axilla Lateral pectoralis major 5TH ICS Anterior latissimus dorsi

High anterior resection is for?

Upper rectal tumours

Left hemicolectomy is used to excise tumours where?

Distal 2/3rds of transverse colon and descending colon + sigmoid colon

Low anterior resection is for tumours where?

Less than 5cm from anus Involves excision of distal colon rectum and anal sphincters

Right hemicolectomy is for surgical removal of tumours in what locations?

Caecum Ascending or proximal third of transverse colon

DKA management of insulin?

FIXED-RATE IV INSULIN + Injectable long acting insulin only

Upper GI bleed score used to predict rebleeding and mortality?

Rockall score

Most common cause of peritonitis secondary tp peritoneal dialysis?

Staph epidermis

What can corticosteroids do to the blood count

Neutrophilia

How long does finasteride take to work?

6 months

What type of renal cancer is polycythaemia associated with?

Renal adenocarcinoma

Svereity of C Difficicile is measured how?

WBC count

Hyaline casts on urine?

Loop diuretic cause