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AMC MCQ > Gen Medicine > Flashcards

Gen Medicine Flashcards

1
Q

4 intsances when to Tx Paracetamol toxicity empirically

A
  1. 8 or more hours after ingestion
  2. serum level not available in 8 hrs
  3. uncertain timing
  4. unconscious pt with suspected OD
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2
Q

CPR Protocol

A

DRS ABCD
Danger
Responsive
Send for Help

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3
Q

effects of ACEI and NSAID on kidneys?

A

Decrease: 1. vasoconstriction (Efferent)

2. vasodilation (affarent)

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4
Q

MC complication of TURP?

A

UTI

Followed by bleeding

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5
Q

ejection systolic murmur radiate to carotid

A

AS …

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6
Q

first-line treatment for CMV pneumonia

A

IV foscarnet or ganciclovir

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7
Q

seizure prophylaxis med?

A

Phenobarbitone

alternatives: phenytoin or valproate

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8
Q

Tx steps of duodenal Atresia (4)

A

NPO

Nasogastric decompression

Intravenous fluids

Surgery—duodenoduodenostomy

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9
Q

1 st step in management of cyanotic spells in TOF…

A

Squatting position

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10
Q

1 st step in management of TGV…

A

PG infusion (to maintain patency of PDA)

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11
Q

1st line Tx acute pericarditis in Australia?

A

NSAIDS + Colchicine

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12
Q

1st line tx of GBS? guillain barre

A

IVIG

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13
Q

1st line tx of shigella?

A

Cipro

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14
Q

1st step in managemnt of RDS in neonates?

A

CPAP

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15
Q

1st trimester serum screening for downs?

A

PAPP —-low

BHCG……..high

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16
Q

2 hpoglycemics that can be used in pregnancy?

A
  1. Metformin

2. Insulin

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17
Q

2nd hyperparathyroidism is associated with?

A

hypocalcemia

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18
Q

2 protective and 2 detrimental effects of tamoxifen?

A

breast and bone protector

Causes DVT and endometrical CA

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19
Q

2nd complication of nephrotic syndome

A

Renal vein thrombosis (thrombophilia)

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20
Q

3 big organisms causing meningitis

A

strep pneumo
H influenza
Neisseria meningitides

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21
Q

3 day child with symptoms of HF and shock…what is wrong with his heart?

A

hypoplastic ventricle

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22
Q

3 signs need to dx lewy body dementia

A
  1. Hallucination
  2. Parkinsonism
  3. Fluctuating mental status
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23
Q

Is a CD4 count less than 350 indication to start HIV tx?

A

yes

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24
Q

viral load > 100000 indication for HIV tx?

A

yes

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25
Q

Hep B infection indication for HIV tx?

A

yes

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26
Q

Hep C infection indication for HIV tx?

A

NO

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27
Q

Neuropathy indication for HIV tx?

A

NO

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28
Q

Nephropathy indication for HIV tx?

A

yes

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29
Q

Tx of strep endocarditis?

A

beta lactam plus gent

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30
Q

Tx of staph endocarditis?

A

beta lactam, gent and rifampin

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31
Q

4 breech presentations

A
  1. complete ….completely flexed hip and knee
  2. Frank…..flexed hip extended knee
  3. kneeling….extended hip flexed knee
  4. footling…completely extended
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32
Q

5 year old with 5 day fever, skin and mouth and hand manisfestations, think?

A

Kawasaki Disease

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33
Q

5 year old, mother has FAP, when to screen?

for how long? Then what?

A

start screening at 12

screen until 35 yearly. then q 3yrs after 35

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34
Q

<5 years, wat to give for prevention of athsma?

A

SCG sodium chromoglycate

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35
Q

> 40 year old pt…solitary incidental lung nodule, wat to do? (2)

A

Previous xray

CT

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36
Q

when to use wafarin to prevent stroke

A

CHA2DS2 VASc score =>2

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37
Q

A baby is failing to thrive and has clay-coloured stools and jaundice which suggest

A

an obstructive lesion (biliary Atresia)

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38
Q

Ab for sclereoderma

A

Anti SCL70

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39
Q

Ab to detect CREST?

A

Anti Centromere

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40
Q

Abx producing similar disturbance to Botulism?

What is the disturbance?

A

Gentamicin…muscle paralysis

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41
Q

acute asthma attack, how many puffs kids? adults?

A

<6 ….6 puffs

Adults 12 puffs

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42
Q

Acute cerebral hemorrhage,how to tx pt on warfarin?

A

Give FFP,,,,vit k takes time

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43
Q

acute confusional state, is called wat?

A

delirium

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44
Q

acute gout management in pt with CKD?

A

Steroids…prednisolone

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45
Q

acute gout plus renal failure, tx?

A

Steroids

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46
Q

Acute Messenteric ischemia, what investigation to do?

A

i know it as CT Angio

Serum lactate (non specific marker seen lata)

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47
Q

Agent of choice for malignant HTN?

A

IV Nitroprusside

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48
Q

Ages of chlamydia screening?

A

15 - 29 yrs

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49
Q

Air in the biliary tree, think?

A

cholelithiasis

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50
Q

air-fluid level on radiography and the presence of foul-smelling sputum, indicates what?

A

Abscess is draining

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51
Q

All household contacts of pts with pertusis should be treated with?

A

10 day course of erythromycin

if allergic : Cotrimoxazole

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52
Q

All pts with egg anaphylactic reaction should recieve following in split doses under supervision:

A

Q fever
Yellow fever
Influenza

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53
Q

Anemia, High INR, Low ca, think

A

Celiac disease

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54
Q

Antibodies for Greaves Disease?

A

Anti TSH

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55
Q

Antibodies for Hashimotos (Hypothroid) (2)

A

Anti TPO

Anti Microsomal

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56
Q

Anticholinergic effects, think? DDRY

A

Dry, constipation retention

DRY …..Dry, Dilation Retention, constYpation

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57
Q

Antipsychotic with least side effect profile?

A

Quitapine

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58
Q

Appearance of vascular calcification in breast?

A

lines of calcification in both breasts….b9

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59
Q

Arrhythmia…….most common in Hyperthroidism is?Arrhythmia

A

Afib

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60
Q

Arterial disease with ABI<0.3?

A

CT Angio

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61
Q

Arterialdisease with ABI >= 0.5

A

Doppler US

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62
Q

At wat age do u start screening fo DM (in pts with no risk), how frequent?

A

40

q3 yrs

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63
Q

At what age do u screen for cholesterol?

A

45

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64
Q

B4 starting Azathioprine, what test should be done?

A

Thiopurine enzyme activity

low activity = good chance of side effect of azathioprine
no activity = severe reaction

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65
Q

Back pain + red eye, think?

A

Ankylosis spondylitis with Uveitis

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66
Q

Bed bound elderly with constipation and cramping pain, think?

A

Sigmoid Volvulus

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67
Q

Best diagnostic test for acromegaly

A

OGTT with serial growth hormones

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68
Q

Best dx modality for MS?

A

MRI of brain

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69
Q

best initial test for acromegaly

A

IGF 1

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70
Q

Best screening test for developmental dysplasia in the first 6 months of life?
After 6 months?

A

US

Xray

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71
Q

pt presents with acute gout, cant use NSAID or steroids, what to use?

A

Colchicine

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72
Q

best initial tx for ASpondylitis

A

NSAID

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73
Q

Major cause of erectile dysfunction? (2)

A

alcohol

smoking

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74
Q

drugs causing significant increase in HDL (2)

A

Nicotinic acid

Gemfibrozil

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75
Q

risk of dev. breast CA in old?

A

Old = Obesity = CA

OBESITY

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76
Q

Tx of vTach in stable pt?

A

amiodarone

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77
Q

Test to diagnose hemachromatosis?

A

iron studies (ferritin and transferrin sat)

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78
Q

Best test for diagnosing sliding hiatus hernia?

A

barium swallow

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79
Q

Best test to confirm aortic dissection? (3)

A

Spiral CT(angio)…MR Angio…TEE(fastest)

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80
Q

Best way to avoid HIV…………

A

condom

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81
Q

Bilatreal duct discharge, think?

A

mammary duct ectasia

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82
Q

mammary duct ectasia tx?

A

excision

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83
Q

Bilious vomiting without abdominal distention on first day of life

A

Duodena Atresia

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84
Q

Boy with anger problem, think?

TX?

A 
oppositional defiant disorder.. ODD
Psychological strategies (parent management training)
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85
Q

boy with LE cyanosis, dx?

A

R to L shunt

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86
Q

Breast mass in a 20 year old is likely?

Inv of choice

A

fibroadenoma or cyst

US

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87
Q

Bronchiolitis is seen in wat age? 12 words

A

<1yr old

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88
Q

brown sequard?

A

VP on my side Vibration N propriception Ipsi

motor …ipsi

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89
Q

VP on my side Vibration N propriception Ipsi

motor …ipsi

A

Depression

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90
Q

cancer associated with High ACTH?

A

small cell ca of lungs

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91
Q

Ottawa knee rules for requesting xray?

A 
WAIT
W==weight bearing difficulty
A==age greater than 55
I==inability to flex at 90
T== tenderness at isolated patella or fibula head
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92
Q

Classic sign of ischemic hepatitis?

A

Elevated liver enzymes and normal bilirubin

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93
Q

Asthma pt resistant to initial tx, what to do?

A

Give IV Mag Sulfate

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94
Q

Canon A waves is related to what?

A

Complete heart block

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95
Q

Meds Causing angioedema? (2)

A

ACEI

Amoxicillin

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96
Q

Central lung lesions are dx by?

A

bronchoscopy

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97
Q

central vs nephrogenic DI, wat to see?

A

In central….Vasopressin cause increase in urine osmolality

In Nephrogenic…nephrons are not responsive to Vasopressin

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98
Q

child sexual abuse should be reported to?

A

Child protection agency

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99
Q

Child protection agency

A

report to child protection services

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100
Q

child’s frequent vomiting and microcytic anaemia suggest?

A

hiatus hernia with reflux

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101
Q

Cholinergic (organophosphate) poisoning results in?

A 
DUMBELS
Diarrhea
Urination
Miosis
Bradycardia
Emesis
Lacrimation
Salivation
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102
Q

classes of hypovolaemic shock

A 
NAC_L
Normal =1
Anxious = 2
Confused =3
Lethargic = 4
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103
Q

classic enzyme sign of ischemic hepatitis?

A

elevated liver enzymes with normal bilirubin

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104
Q

Common cause of unilateral tumor?

A

Graves Disease(thyrotoxicosis)

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105
Q

Compression stockings are contraindicated in 2 instances…

A
  1. diabetics

2. ABI< 0.8

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106
Q

Confirmatory test for SLE

A

dsDNA

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107
Q

Contributing factors for Dupuytrens contracture (3)

A

Family Hx
DM
Epilepsy

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108
Q

cranial nerves

A

OOOTTAFVGVAH

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109
Q

CURB 65 ….3/5

A 
Confusion
Urea >7
Resp >30
BP<90/60
age > 65     need admission and tx if >3 points
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110
Q

Cyanosis since birth (at 1 st day of life)…

A

TOGVs

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111
Q

Cyanotic spells in pt with TOF occur when (age)

A

childhood (not directly after birth)

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112
Q

How long before warfarin becomes active?

A

at least 5 days

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113
Q

Tx of GBS Buillean Barre ==1st line

== 2nd line

A

IVIG

Plasmapheresis

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114
Q

Blood volume lost in Motor vehicle accident determined as?

A

Pulse <100 = 15%
Pulse 100 - 120 = 15-30%
pulse 120 - 140 = 30 -40%
pulse >140 = >40%

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115
Q

Ursodeoxycholic acid will relieve symptoms of?

A

PBC (primary Biliary cirrohsis

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116
Q

Ab predicitive for poor clinincal outcome in Auto immune hepatitis?

A

Anti LKM

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117
Q

Ab present in Chronic auto immune hepatitis?

A

Anti Smooth muscle

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118
Q

Ab present in PBC

A

Anti Mitochondrial

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119
Q

Ab present in Churg Strauss?

A

PANCA

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120
Q

Cyst with cholesterol crystals, think?

A

Dermoid cyst

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121
Q

Diabetic Drug associated with increased risk of cancer

A

Pioglitazone

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122
Q

Diagnose polyarteritis Nodosa with?

A

Muscle biopsy

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123
Q

Diagnosis of herpes zoster?

A

Tzanck prep or viral culture

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124
Q

Diagnosis of Pyloric stenosis with?

A

US

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125
Q

MCC of ACS?

A

Acute thrombosis

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126
Q

Discharge pt with acute asthma on?

A

oral steroids……tapered down

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127
Q

DKA pt, first thing to check?

A

ABG

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128
Q

Drug of choice for essential tremor?

A

propanolol

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129
Q

drug of choice for opiate overdose?

A

Naloxone

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130
Q

Drug of choice for partial seizures

A

Carbamazepine

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131
Q

drugs to stop 1 week prior to suregery (4) WAAN

A
  1. WArfarin
  2. Amitryptilline
  3. Antiplalets
  4. NSAIDS
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132
Q

Glasgow Coma Scale Memory

https://www.youtube.com/watch?v=gE5gSU_8oHs

A

EVM (4, 5, 6)

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133
Q

Glasgow Coma Scale Memory - EYE

A 
EYES (4)= ESPN
EYE OPENS SPONTANEOUSLY =4
SOUND=3
PAIN = 2
NOTHING = 1
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134
Q

Glasgow Coma Scale Memory - VOICE

A 
VOICE (5) = Our Country WIN
O= Oriented (5)
C= Confused (4)
W = Words inappropriate (3)
I= inappropriate sound (2)
N = Nothing
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135
Q

Glasgow Coma Scale Memory- MOTOR

A 
Cant Live Without FANs
C = commands obeyed
L = localizes pain
W = Withdrawal to pain
F=Flexion abnormal (decorticate)
A= Abnormal extension (decelebrate)
N = Nothing
136
Q

Diabetic pt controlled on diet, what driving restriction?

A

None

137
Q

Diabetic pt controlled on insulin, what driving restriction?

A

condition, reviewed 2 yearly

138
Q

MCC allergy in kids in Australia?

A

food

139
Q

Major side effect of Sulfasalazine? (2)

A

Thrombocytopenia and Agranulocytosis

140
Q

screening and monitor of hepatoma (liver Cancer), use?

A

Alpha Fetoprotein

141
Q

Testicular cancer screening with whcih 3?

A

AFP, BHCG, LD…Lactate dehydrogenase… all elevated

142
Q

DA is related to what disease?

A

Downs Syndrome

143
Q

Dx of adenocarcinoma and Large cell Ca (peripheral Lesion) is by?

A

Fine Needle aspiration

144
Q

dysphagia b4 hoarsness, think?

A

Esophageal

145
Q

Earliest sign of carbamazepine toxicity?

A

Diplopia

146
Q

early dumping u find ?

A

hypovolemia

147
Q

Early sign of snake bite envenomation

A

Nausea and vomiting

148
Q

Ecg presentation of acute pericaditis?

A

Diffuse ST segment elevation

149
Q

Ekg changes in Hyperkalemia? (3)

A

Tall T waves
Short qt interval
Increased PR interval

150
Q

epiglotitis and croup age range?

A

6mths - 6 years

151
Q

Erythema multiforme is often associated with which pnuemonia?

A

Mycoplasma pneumoniae infection.

152
Q

Factor for chronic pain syndrome

A

Being a woman

153
Q

Pt with rheumatic heart disease and Afib, what to give?

A

WARFARIN…..important CHADSVASC does not APPLY

to valvular afib

154
Q

How long does Vit K take to reverse Warfarin?

A

6 - 12hrs

use FFP in that case of quick reversal

155
Q

Hypercarbia or Hypocarbia, which causes ICP

A

Hyper…increased…Cabia

156
Q

Factors predisposing to central sleep apnea? (2)

A

CHF

Neurologic condition ….stroke

157
Q

First indication of Pagets Disease?

A

Elevated Serum Alk Phos

158
Q

First investigation to any patient with AF…..

A

thyroid functions

159
Q

first line tx of bipolar

A

Antipsychotics

160
Q

first line of inv of scrotum mass

A

USG

then AFP

161
Q

First line tx for AS? 2nd line

A

NSAIDs

Infliximab (biologicals)

162
Q

First line Tx of trigeminal Neuralgia?

A

Carbamazepine

163
Q

First test for salmonella? Best

A

Stool culture

Blood culture

164
Q

First time seizure, isolated…advice to pt?

A

Do not drive for 6 months

165
Q

formula fed white first born male with family hx and maternal smoke hx is at risk of?

A

Infant Hyperthropic Pyloric stenosis

166
Q

MCC of death 24 hrs after MI in prehospital setting?

A

Vfib…..fibrillating heart cant do NOTHING

167
Q

Drug class that commonly causes HYPONATREMIA

A

Thiazides

168
Q

Condition not commonly associated with clubbing?

A

COPD

169
Q

Management of superficial Thrombophlembitis?

A

NSAIDs

170
Q

What is elevated in Pagets disease

A

Alk Phos

171
Q

What to measure in PCOS plus results ?

A

LH/FSH ratio 2:1
LH Increased
FSH normal/low
Testotsterone Increased

172
Q

1st line tx of BVaginosis

2nd line?

A

Clindamycin

Metronidazole

173
Q

Major risk factor for Ovarian cancer?

A

Obesity (increaded BMI)

174
Q

tx choice for adhesive capsulitis (frozen shouder)

A

Oral presdisone

175
Q

what to do in a case of accidental additional paracetamol dosing? (2)

A
  1. Take blood sample within 30 mins

2. Contact poison center for advise

176
Q

initial treatment of complete heart block?

A

Atropine

177
Q

treatment of choice for complete heart block?

A

Transcutaneous pacing

178
Q

tx of moderate to severe allergic rhinitis?

A

Intranasal steroids

179
Q

what would cause syncope, carotid sinus hyper or hypo sensitivity?

A

hypersensitivity

180
Q

how do you link SVT to diagnosis and tx?

A

sVt …..A..narrow complex with v upside down
V for vagal maneuver
A for adenosine

181
Q

Unproven risk factors for PUD?

A

DACa –Diet
Alcohol
Corticosteroids

182
Q

Initial presentation of myocarditis?

A

Dyspnea

183
Q

When does risk of cardiac arrest increase with hypothermia?

A

temp <32

184
Q

Frozen shoulder is? what to do?

A

progressive loss of active and passive ROM of shoulder.
1 st line ….NSAIDS
2nd line..Intra-articular steroids

185
Q

ROSC, check?

A

Pulse and Pupil

Carotid pulse
Femoral Pulse
Pupils size and reaction to light

186
Q

Goodpasture syndrome. wat organs are involved?

A

Lungs + Kidneys

187
Q

hallmarks of BCS. hepatic vein thrombosis (Budd-Chiari syndrome [BCS])

A

Tender hepatomegaly

188
Q

Health risk for obesity?

A

Waist Hip ratio

189
Q

Heart failure symptoms few days after birth…

A

hypo-plastic left heart $

190
Q

Heavy drinker + smoker with confusion post surgery, what to check?

A

ABG

191
Q

Hematuria, inc urea and creatine, arthralgia and foot drop, think?
do?

A

Vaculitis

biopsy

192
Q

Hemianopia is due to damage of?

A

optic tract

193
Q

hoarsness b4 dysphagia, think?

A

Larynx

194
Q

HOCM is associated with what arrythmias?

A

Vtach

VFib

195
Q

How do u detect pheochromocytoma?

A

24 hr urine cathecolamines and metanephrines

196
Q

how do u determine if it is viral meningitis?

A

look for monocytes

197
Q

how do u prevent Hyperuricemia in tumor lysis syndrome? (2)

A

Hydration and allopurinol

198
Q

How do u test for Legionella

A

The urinary antigen test for Legionella

199
Q

how do you confirm pagets disease?

A

Punch biopsy

200
Q

How do you know pt has aspergillosis?

A

positive Galactomannan

201
Q

how long do u give clopidogrel for in STEMI?

A

4 weeks

202
Q

how long do u give clopidogrel for in NSTEMI?

A

12 months

203
Q

How long to be on Clopridogrel after MI?

A

4 weeks

204
Q

How long to keep pt on HRT for?

A

5 years, then stop

but continue if osteoporosis

205
Q

How to follow Pt with DKA?

A

HbA1c

206
Q

How to monitor respiratory function in any neurological disorders that can affect the respiratory muscles (e.g. GBS, myasthenia gravis).

A

FVC

207
Q

HTN and unilateral renal tenosis, use wat?

HTN and bilateral renal stenosis, use what?

A

ACEI or ARBS

CCB or BB

208
Q

Hx of DVT and Hyterectomy,use wat HRT?

A

Transdermal estrogen
with hysterectomy no need for progesterone
with DVT, use transdermal

209
Q

Hx of hyperthyroid and AFib, use?

A

Carbimazole

210
Q

Hx of recent MI, acute abd pain and metabolic acisosis, think?

A

Mesenteric Iscaemia

211
Q

chronic cough and sputum production is classic symptoms of?

A

bronchioectsis

212
Q

Anterior dislocation of shoulder damages which nerve?

A

Axillary “anterior–Axillary”

213
Q

Drug of choice to reduce ICP?

A

steroids

Dexa

214
Q

primary phenomenon in aspirin toxicity?

A

primary respiratory alkalosis

215
Q

HTN in PKD is caused by?

A

increased activity in Renin angiotensin sytem

216
Q

Vit A def is not seen in?

A

IBS

217
Q

Ostenecrosis of jaw is commonly seen in?

A

IV Bisphosphonate. (not oral)

218
Q

Most common presentation of arthritis in SLE?

A

Symmetric arthritis of hand joints

219
Q

relationship of FSH/LF to testosterone?

A

LH Increases Testosterone

220
Q

Long term use of SSRI can lead to?

A

Hyponatremia

221
Q

Hypercalcemia is primarily seen in which Ca

A

Squamous cell Ca

222
Q

Hypoalbuminemia equals ascites, give what?

A

spironolactone

223
Q

Hypocellular or Empty fatty bone marrow, think?

A

Aplastic aneamia

224
Q

Hypochondriasis vs somatization

A

Hypo believe he has serious illness

somatization is merely symptoms

225
Q

immediate relief for a pt with depression

A

ECT

226
Q

Important indication for obstructive jaundice?

A

ERCP

227
Q

important risk factor for obesity?

A

waist circumference

228
Q

In essential tremor which medication is better, primidone vs propanolol?

A

propanolol….less side effects

229
Q

In cough due to bronchitis, expect what?

A

Productive cough

230
Q

In esophagitis, Alendronate vs Zolendronic acid?

A

Zolendronic Acid

231
Q

In MM best Investigation

A

Bone marrow exam

232
Q

In MM, next investigation

A

X ray

233
Q

In symptomatic bradycardia, wat to do? And if that fails?

A

Give Atropine

Then Transcutaneous pacing

234
Q

In which disorder would you find concrete thinking?

A

Schizophrenia

235
Q

Increased TSH , think also

A

Pituitary Adenoma

236
Q

Indication for CT in acute pancreatitis?

A

Evidence of clinical deterioration
or
complications

237
Q

The best initial tests in acute pancreatitis?

A

amylase and lipase.

238
Q

The most specific test in Acute pancreatitis is?

A

CT scan.

239
Q

Initial choice of investigation for Hemachromatosis is?

A

Serum Transferrin Saturation

240
Q

Initial investigation in Myasthenia gravis?

A 
Serum Antibodies (anti acetylcholine)
AChR antibody test (most specific test)
241
Q

initial investigation of DKA

A

urine ketones

242
Q

Initial mechanism of hypokalemia in DKA?

A

K loss due to osmotic diuresis

243
Q

Initial test for SLE?

A

ANA

244
Q

Initial test of choice for asthma pt?

A

Siprometry (PFT)

245
Q

Meds of choice to prophylax contacts of meningitis?

A

Rifampicin (contraindicated in pregnancy, liver disease,alcoholism)
Cipro (avoid in under 12yrs and pregnancy)

246
Q

clean wound cant remember doses of vaccination, give

A

Toxoid

247
Q

Dirty wound, cant remember or incomplete vaccination, give

A

IVIG, Toxoid and abx

248
Q

Investigation Acute Leukemia

A

Bone marrow apiration

249
Q

Investigation for Obstructive sleep Apnea?

A

Sleep study

250
Q

Investigation of stress incontinence?

A

Urodynamic studies

251
Q

Iraqi pt with sytolic murmur, Think?

A

Rheumatic fever

252
Q

Ischemic rest pain vs Muscular cramping

A

IRP—felt on foot and toes…burning&throbing

Muscular cramping—-calfs

253
Q

Joints involved in OA?

A

Carpometacarpal joint

254
Q

Joints involved in RA?

A

MCP

PIP

255
Q

Key clinical feature of orbital floor fracture?

A

Diplopia

256
Q

Late dumping u find ?

A

Hypoglycemia

257
Q

Leukotriene inhibitor use is associated with an increased incidence of which disease?

A

Churg-Strauss syndrome

258
Q

Long term management of cluster headache is (2)?

A

CCB

Lithium

259
Q

Long term management of SLE

A

Hydrochloroquin

260
Q

Long term use of what medication causes Gynaecomastia?

A

Cimetidine

261
Q

Low TSH and normal T3?T4 is called what?

Associated with what?

A

Subclinical Hyperthroidism

Afib

262
Q

Main ttt of prolonged itching after scabies……..

A

steroid

263
Q

Malaria prophylaxis to regions? CDM

A

Chloroquin …….Central America
Doxycycline…….Thai
Mefloquin…….S America and Africa
Primaquine if allergic to Mefloquine

264
Q

Malignant HTN in pregnancy , use?

A

Hydralazine

265
Q

Man afraid of prostate cancer but symptomatic 1st 3 steps?

A

1 st step……….DRE
2 nd step………PSA
3 rd step……..US and biopsy

266
Q

Man afraid of prostate cancer but

asymptomatic what to do?

A

reassure even if (+) family history

267
Q

Management of Acute Pulmonary Oedema?

A

MONa_D

Morphine O2 Nitrates and Diuretics

268
Q

MC cardiac defect in turners syndrome is?$

A

Bicuspid aortic valve
then
Coarctation

269
Q

Mc cause of death in hemachromatosis…

A

Liver

270
Q

MC complication of GERD

A

esophagitis

271
Q

what increases risk of pseudogout?

A

hypothyroidism

272
Q

what is the aim of initial treating NSTEMI?

A

prevent new thrombus from forming?

273
Q

what is the aim of treating STEMI?

A

Break formed Thrombus

274
Q

Initial Tx of NSTEMI

A

CAH…..clopidogriel 600mg
Aspirin 300mg
Heparin (therapeutic dose)

275
Q

MC symptom of pagets?

A

Bone pain

276
Q

botulism binds where? b4?

A

presynapse

277
Q

long standing GERD, what to do?

A

scope pt

278
Q

Initial diagnosis of GERD?

A

24 Hr PH monitoring

279
Q

confirmation of Graves disease, do?

A

Anti TSH Recepto Ab

280
Q

Elevated BNP is found in what organs?

A

Heart and Kidney diseases

281
Q

what is the target HBA1C for persons with recurrent hypogylcemic episodes?

A

<8 (not <7 as with everyone else)

282
Q

first line tx of diabetic Neuropathy

A

Amitrptyline

283
Q

MCC of anaphylaxis in Australia?

A

Drugs

284
Q

Pt started on antisychotics, start recurrent fainting what to think?

A

Long QT syndrome

285
Q

pt with positive screening for pheochromocytoma( serum or urine), what to do next?

A

CT to localize tumor

MIBG next

286
Q

which drug most commonly induces hirsutism?

A

Sodium Valproate

287
Q

Pt with Hypercalcemia, not responding to fluids, what to give?

A 
IV Bisphosphonate (ZeePee) not Alendronate which is oral
Zelendronate or pamidronate
288
Q

After an episode of MI, a systolic murmur develops, think?

A

Papillary muscle Dysfunction»Mitral Regurgitation (NOT RUPTURE)
MR ___MI

289
Q

Most reliable screening test for Hemachromatosis?

A

Transferrin saturation (serum)

290
Q

pt with glicazide induced hypogycemia was stabilized, what to do next?

A

iv dextrose for 24-48 hrs

291
Q

tx of acidemia in cardiac arrest?

A

chest compression

292
Q

How do you assess severity of chronic airway disease in a stable pt

A

Hx and bedside spirometry

293
Q

How long wouls asplenic pt without other comorbid conditions take abx for?

A

6 months

294
Q

Pts with leukemia and thrombocytosis are prone to what kind of bleeding? Remeber girl with Leukemia at GPHC

A

Mucocutaneous

295
Q

when do we use new oral anticoagulants? (2)

A
  1. Non valvular afib

2. elective hip and knee surgery prophylaxis

296
Q

Tx of meningitis caused by Listeria Monocytogens

A

Amp And Gent (always add amp in Listeria)

297
Q

what to check for in hereditary angioedema

A

c1 and c4 low

298
Q

what to check for in acquired angioedema

A

c1q low ( q for aQuired)

299
Q

Contraindication to use of Thiazolinedione?

A

Heart and liver

Liver is relative contra

300
Q

mode of action of sulphonyureas?

A

stimulate insulin secretion

301
Q

Pt on levodopa, later develops xs involutary movement, what to do?

A

Decrease dose of drug

302
Q

what vessel is affected in left lateral meduallary syndrome (wallenberg)

A

PICA

303
Q

Difference between lateral and medial medullary syndrome?

A

Medial = medium = preserved Pain and Temperature/facial sensation

304
Q

Drug that does not cause SLE

A

Nitrofurintoin

305
Q

Mechanism of action of exenatide?

A

release insulin from pancreas…..glucose dependent

306
Q

What do u find in euthyroid sick syndrome?

A

everything normal…T3 LOW

307
Q

First step in DKA

A

Fluids fluids fluids

308
Q

Ptosis and miosis?

A

Horners syndrome

309
Q

Ptosis and dilated pupil?

A

3rd cranial nerve….down and out

310
Q

Ptosis and diplopia?

A

Myasthenia Gravis

311
Q

Adult with pyloric stenosis when does he vomit?

A

within 1 hour

312
Q

tx of HTN in pheochromocytoma?

A

Phenoxybenzamine

313
Q

Tx of Salmonella

A

Cipro or zmax

314
Q

Vit A toxicity leads to hepato or Nephro toxicity?

A

Hepato……stored in the liver

315
Q

pagets disease most commony affects?

A

pelvis ppp pagets pelvis palmindronate

316
Q

prognosis of systolic chf

A

jvp

s3 (presence or absence

317
Q

Lab Presentation of Legionnaires?

A

Hyponatremia and deranged liver function

318
Q

Analogue of Niacin?

A

ISoniazide

Iso suppresses endogenous niacin and B3 should be given to prevent Pellagra (DDDD) dementia, diarrhea, dermatitis death

319
Q

What condition increases risk of acute renal failure?

A

Advanced Liver cirrhosis

320
Q

Mnemonic for stroke…Stroke is a TA BEFAST

A

TX: TA Thrombolytics Antiplatelets
BEFAST: Balance Eye Face Arms Speech Time to call

321
Q

How do u remember exudate fluids?

A

executives think high of themselves –High levels

They are toxic – Acidic fluid

322
Q

Causes of exudative fluids?

A

Caused by infection and cancer

323
Q

Causes of transudate Fluid

A

cirrhosis, CHF , Nephrotic, Hypoalbumin

324
Q

mc symptom of addisons disease?

A

weakness

325
Q

Vertigo and dizziness, think all 4 and distinguish

A

Mean LGBTnooooo LVBT

Meniere Disease chronic similar to Lab.
Labrynitis –with hearing loss
Vestibular neuritis (post inf similar to BPPV but negative Dix Hallpike test…NO HEARING LOSS)
BPPV- Positive Dix Hallpike

326
Q

Pt presents 3 weeks post MI fever and pericardial rub, what is it?
Tx?

A

Dresslers syndrome

Aspirin

327
Q

Pt <30 years , positive TB skin test , what to do?

A

INH for 12 months (chemoprophylaxis with isoniazide for 12 months)

328
Q

Pt with poor response to Levodopa, think?

A

Parkinson plus syndrome

329
Q

when does pt need OGTT (2)

A

Fasting blood glucose 5.5 - 6.9
Random glucose 5.5 - 11.0
>7.0 = Diabetes
>11.1= Diabetes

330
Q

First step in diabetic obese patient….

A

lose weight and diet

331
Q

First step in diabetic thin patient……

A

metformin

332
Q

Type of carbohydrate……

A

complex not simple

333
Q

Never give K to DKA patient except

A

after passing urine

334
Q

First step in DKA…..

A

normal saline not insulin

335
Q

Most imp inv in DKA……

A

…ABG

336
Q

Most common complication during ttt of DKA…..

A

hypoglycemia

337
Q

Most serious complication during ttt of DKA….

A

.cerebral edema

AMC MCQ (14 decks)

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