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Pregnant patients with BMI over 40 are grade ASA what?
ASA III
If patient has brain injury and brain seems to be oedema–ing what should you do?
IV mannitol
When is the time out period in sugery?
Before first skin incision is made
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
In ALS if iV access can’t be achieved what route and where should you give drugs?
I0 interosseous (proximal tibia)
Neo-adjuvant = to dp what
SHRink Tmour before sug
Bleeding risk of anti-coags in AF scoring system?
orbit score
Patient with hyprcalciuria and renal stones, how can you treat?
Hydrochlorothiazide
Uncomplicated dissection of descending aorta?
BP control
Mitral stenosis patients, asymptomatic, what management should they have?
Regular echo every 6-12 months
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
Precocious pberty in males age?
Before 9 y/o
Moderate-severe Aortic stenosis is a CI for what Heart drug?
ACEi
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
What type of exudate in mets to lungs?
Exudative (high in protein)
Small testes in precocious puberty?
Adrenal cause of symptoms
Test for comparing the means of 2 group subjects?
Two-sample T test
If you hear tinkling sounds in a neonate what do you think? Management?
Diaphragmatic hernia
Intubation and ventilation
Murmur which becomes louder in inspiration?
Tricuspid regurg
Hypokalaemia with alkalosis causes?
Vomiting
Thiazide loop diuretics
Cushing’s syndrome
Conn’s syndrome
What classic red flag can come second to mitral stenosis?
Haemoptysis
Primary prevention of CVD using statins aim for a reduction in non-HDL cholesterol of how much?
> 40%
Occupational asthma test?
Serial peak flow measurements at work and home
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?
<8
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?
LP
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
