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MSRA passmed > Gen Med > Flashcards

Gen Med Flashcards

1
Q

Multiple myeloma features (CRABBI)

A

Calcium: hypercalcaemia
Renal: light chain deposition within the renal tubules
Anaemia
Bleeding
Bones (pain)
Infection

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2
Q

Falsely low HbA1C reading causes

A

Sickle cell anaemia
G6PD
Beta thalassemia

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3
Q

Falsely high HbA1C reading causes

A

Splenectomy, iron-deficiency anaemia, B12 deficiency and alcoholism

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4
Q

Eradication of h pylori test

A

Urea breath test

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5
Q

Lhermitte’s sign

A

Tingling of fingers when neck is flexed
Indicates disease near the dorsal column nuclei of the cervical cord

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6
Q

Treatment of broad complex tachycardia

A

IV amiodarone

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7
Q

Enzyme inducers (CRAP GPs)

A

CRAP GPs :*

Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

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8
Q

Enzyme inhibitors

A

SICKFACES.COM

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole

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9
Q

Torsades de pointes causes

A

Hypothermia
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia

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10
Q

Bacterial otitis media most common cause

A

H. Influenzae

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11
Q

Dermatomyositis cause

A

Malignancy

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12
Q

What artery is affected in amarousis fugax

A

Opthalmic/retinal artery

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13
Q

Management of HF

A

1st line: ACEi/BB(Bisoprolol, Carvedilol)
2nd line Aldosterone antagonist(Spironolactone, Eplerenone), reduced EF= SGLT-2 inhibitor
3rd line: involve a specialist for
-Ivabradine(SR, HR>75+ EF<35%)
-Sacubitril-valsartan( EF <35%+ Symptoms despite ACEi/ARB)
-Digoxin( if coexistent AF)
- Hydralazine+Nitrate( in Afro-Caribbean)
-Cardiac resynchronization therapy( Widened QRS e.g. LBBB)

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14
Q

Trigeminal neuralgia management

A

Carbamezapine

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15
Q

Management of acute seizures

A

Buccal midazolam
Rectal diazepam

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16
Q

Cushing reflex

A

Bradycardia and hypertension with a wide pulse pressure

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17
Q

Bell’s palsy management

A

Oral steroids within 72hrs of onset

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18
Q

Posterior stroke signs

A

5Ds: dizziness, diplopia, dysarthria, dysphagia, dystaxia

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19
Q

Ulcerative colitis management

A

Mild/moderate
Proctitis: topical (rectal) aminosalicylate

proctosigmoiditis and left-sided ulcerative colitis: topical aminosalicylate -4 wks later-> add a high-dose oral aminosalicylate OR switch to a high-dose oral aminosalicylate and a topical corticosteroid —> oral aminosalicylate and an oral corticosteroid
Extensive disease: topical (rectal) aminosalicylate and a high-dose oral aminosalicylate

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20
Q

ACS take home meds

A

STAAB
Statin
Ticagrelor (or Clopidogrel)
Aspirin
ACEi
Beta blocker

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21
Q

Long term prophylaxis of cluster headaches

A

verpamil

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22
Q

Fundoscopy signs of acut angle closure glaucoma

A
  1. Optic disc cupping - cup-to-disc ratio >0.7 (normal = 0.4-0.7), occurs as loss of disc substance makes optic cup widen and deepen
  2. Optic disc pallor - indicating optic atrophy
  3. Bayonetting of vessels - vessels have breaks as they disappear into the deep cup and re-appear at the base
  4. Additional features - Cup notching (usually inferior where vessels enter disc), Disc haemorrhages
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23
Q

RA vs OA XR findings

A

OA (LOSS): Loss of joint space, Osteophytes, Subchondral cysts, Sclerosis
RA (LESS): Loss of joint space, Erosions, Subluxation, Extra-articular
Ostroporosis

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24
Q

Complications of MIs

A

1st 48 hours: Pericarditis
1-2wks: L ventricular free wall rupture (acute heart failure secondary to cardiac tamponade), VSD (acute heart failure associated with a pan-systolic murmur)
2-6wks: Dressler’s syndrome: fever, pain, pericardial effusion, raised ESR

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25
Q

Anti-platelets advice for ACS and PCI

A

Aspirin (lifelong) & ticagrelor (12 months)

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26
Q

Generalized tonic-clonic management

A

males: sodium valproate
females: lamotrigine or levetiracetam

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27
Q

Focal seizures management

A

first line: lamotrigine or levetiracetam
second line: carbamazepine, oxcarbazepine or zonisamide

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28
Q

Absence seizures management

A

first line: ethosuximide
second line:
male: sodium valproate
female: lamotrigine or levetiracetam

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29
Q

Myoclonic seizures management

A

males: sodium valproate
females: levetiracetam

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30
Q

Tonic or atonic seizures management

A

males: sodium valproate
females: lamotrigine

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31
Q

Features of anti-phospholipid syndrome

A

Clots - veno/ arterial thrombus
L - livido reticularis
O - obstetric miscarriage
T - thrombocytopenia

32
Q

Conditions that precipitate lithium toxicity

A

Hypomagnesaemia
Hypercalcaemia
Hypernatraemia
Hypokalaemia

33
Q

Scleritis vs episcleritis

A

Scleritis is painful
Episcleritis is Pain free

34
Q

Inferio-posterior infarct complications

A

Acute mitral regurg (acute hypotension and pulmonary oedema)
AV block

35
Q

Most common cause of death following an MI

A

V fib

36
Q

Anti-emetic for intracranial causes of N+V

A

Cyclizine -> dex

37
Q

UC vs Crohn’s

A

UC: ileocaecal valve -> rectum continuous disease, no inflammation past submucosa, crypt abscesses, bloody diarrhoea, uveitis, CR cancer, Primary sclorsing cholangitis, pseudopolyps, LLQ tenderness

Crohn’s: Episcleritis, weight loss, mouth -> anus skip lesions, indlammation of all cells, goblet cells, bowel obstruction, non-bloody diarrhoea

38
Q

Addison’s + vomiting

A

Im hydrocortisone until vomiting stops

39
Q

Lacunar stroke site

A

Basal ganglia, thalamus, internal capsule

40
Q

Good prognosis in RA

A

RF -ve

41
Q

1st line treatment of Lyme’s disease

A

21 day course of doxycycline

42
Q

Acute haemolytic reaction sx

A

Fever, abdo pain and hypotension post transfusion

43
Q

Fever, abdo pain and hypotension post transfusion

A

Acute haemolytic reaction sx

44
Q

Murmur man

A

Draw murmur man

45
Q

Pre-endoscopy variceal haemorrhage meds

A

Terlipressin and Abx

46
Q

Angina management

A

ABCD
Aspirin+GTN
Beta-blockers
Ca channel blocker
Nicorandil

47
Q

Prophylaxis for contacts of patients with meningococcal meningitis

A

Oral cipro or rifampicin

48
Q

Most likely cause of death in CK on haemodialysis

A

IHD

49
Q

IgA nephropathy vs minimal change disease

A

Minimal change disease: nephrotic syndrome
IgA nephropathy: nephritic syndrome

50
Q

Management of minimal change disease

A

Oral corticosteroids

51
Q

Renal transplant increases the risk of which cancers

A

SCC, cervical cancer, lymphoma

52
Q

Discharge advice post-penuothorax

A

No sea diving for life
Stop smoking
No flying until 1 week post check x-ray

53
Q

Antii-CCP

A

RA

54
Q

ANCA

A

Vasculitides

55
Q

Anti-Jo1

A

Poly/Dermatomyositis

56
Q

Anti-dsDNA
ANA

A

SLE

57
Q

AntiRo/Anti-LA

A

Sjorgen’s

58
Q

Treatment for wilson’s

A

Penicillamine

59
Q

Monitoring tests for haemochormatosis

A

Ferritin and transferrin

60
Q

Causes of raised prolactin

A

pregnancy
prolactinoma
physiological
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines, metoclopramide, domperidone

61
Q

EGFR variables

A

CAGE
Creatinine
Age
Gender
Ethncity

62
Q

AF electrical cardioversion, when to do

A

Haemodynamically unstable
Elective

63
Q

Elective cardioversion, onset <48 hrs ago

A

Rhythm OR rate control
Rate control (Beta blockers or Ca channel blockers)
Heparinize + rhythm control

64
Q

Anticoag in AF if onset <48 hrs, post cardioversion

A

No anti coag if no risk of stroke (CHADVASC)

65
Q

Elective cardioversion, onset >48hrs ago

A

Anticoag for 3/52 OR TOE to exclude thrombus -> cardiovert immediately
Heparinize + cardiovert (electrical preferred_
Anticoag post electical cardioversion for 4 wks, then rv

66
Q

AF pharmacological vcardioversion options

A

Amiodarone if structural heart disease
Flecainide if no structural heart disease

67
Q

What medication should be avoided in HOCM

A

ACE i

68
Q

Tumour lysis syndrome electrolytes

A

Hyperkalaemia
Hyperphosphatemia
Hypocalcaemia

69
Q

Prophylaxis for TLS

A

allopurinol /rasburicase

70
Q

Hodgkin’s lymphoma signs of poor prognosis

A

B symptoms
Increasing age
Male sex
IV disease
Lymphocyte depleted subtype

71
Q

Sickle cell crises

A

Big spleen - mostly always sequestration crisis
Limb pain - mostly haemolytic/ischaemic/vaso-occlusive crisis
Hip pain - haemolytic/ischaemic/vaso-occlusive crisis (plus possible avascular necrosis head of femur)
Parvovirus infection should result in an aplastic anaemia (with pancytopenia of all cell lines)

72
Q

How soon can you re-administer adrenaline in anaphylaxis

A

5 minutes

73
Q

Cushing’s triad

A

Bradycardia
Irregular breathing
Hypertension + widening pulse pressure

74
Q

Migraine acute management

A

triptain+NSAID/triptan+paracetamol

75
Q
A
76
Q

Causes of digoxin toxicity

A

Low: hypoK, hypoMg, hypoalbumin? Hypothermia/thyroidism
Potassium: drugs that cause hypoK (thiazides/loop diuretics)
Can: hyperCa, acidosis, hyperNa
Hurt/Heart: common heart drugs: amiodatone, diltiazem, verapamil, spiro

MSRA passmed (7 decks)

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