General 2 Flashcards
Mx of MRSA
IV Vancomycin and rifampicin
Chronic hep C with oedema, hypoalbuniaemia, proteinuria - what is this and ix
Chronic hep C is RF for membranoproliferazive glomerulonephritis
Urine dipstick to assess for proteinuria. If there is protienura then quantify with Urinary protein: creatinine ratio
Severe hypocalcaemia mx
10-20ml calcium gluconate in 50-100ml of 5% dextrose over 10mins with cardiac monitoring (as can lead to prolongation QT interval)
A 34-year-old man presents with a two-week history of a purple coloured rash on his lower limbs. He also reports approximately 5kg weight loss in the last two months. He is otherwise well, and his only significant past medical history is of recurrent episodes of sinusitis in the past year.
On examination, there is a widespread palpable purpuric rash on the anterior aspects of both legs. Examination and observations are otherwise normal.
Diagnosis and next best step in management?
Small vessel vasculitis - granulomatoosis with polyangiitis 9GPA)
Urine dipstick to exclude significant renal complications as can manifest with protienura an dhaematuria
Widespread erythema >90% skin and dehydration - what could this be
Erythroderma - emergency - dehydration is complication
A 40-year-old man with a history of recurrent right-sided otitis media presents with a one-month history of gradually worsening hearing loss in his right ear. He denies any other symptoms, and his past medical history is otherwise unremarkable.
On examination, otoscopy reveals chalky white patches on the tympanic membrane. Rinne’s test is negative on the right, and Weber’s test lateralises to the right ear.
Which of the following is the most likely diagnosis
tympana sclerosis
Mx steroid induced diabetes
If blood glucose levels >12 on two occasions in single 24h period then once daily short acting sulphonyluria like gliclazide is best treatment
Screening test for bushings syndrome
24 hour urine collecitoon - elevated cortisol
(High dose dex suppression test is used to differentiate between pituitary and ectopic causes)
A 35-year-old lady with a history of chronic pancreatitis presents with post-prandial vomiting and abdominal pain. She denies weight loss, fevers, pruritus and any family history of malignancy.
Her blood tests are significant for a cholestatic pattern of liver function tests.
Which of the following is the most likely diagnosis?
Pancreatic pseudocyst
Common cx of chronic pancreatitis
Acute limb ischaemia mx
Unfractionatwd heparin
How many days to withhold clopidogrel before surgery
7 days
Painless genital ulceration
Then weeks later with painful, inguinal and/or femoral lymphadenopathy (buboes)
Dx + mx
Lymphogranuloma centrum (LGV)
Doxycycline 3 weeks
Meigs syndrome
Pleural effusion , ascites, fibroma (benign ovarian tumour)
If failed anticoagulant with DOAC and rec DVTs then what mx
Warfarin
Lemeirre’s syndrome
Infective thrombophlebitis that can develop as result untreated bacterial throat infections in otherwise healthy young adults. Can lead to other further systemic complications like bacteraemia and septic emboli
HBP in IgA nephropathy mx
Rmaipril 1.25mg daily once
What Ix at bedside has a significant correlation with risk reps failure and need for intubation in GBS
Bedside spirometry
A 74-year-old male is referred to the falls clinic after he suffers three mechanical falls at home within two months. He has a past medical history that includes postural hypotension, urinary incontinence, recurrent chest infections and six months ago was diagnosed with Parkinson’s disease. He currently takes tamsulosin, co-benyldopa and has just finished a course of amoxicillin. On examination, you note that he has hypomimia, rigidity and bradykinesia with a very mild tremor.
What extra examination or test might help you with your diagnosis?
Test vertical gaze - likely parkinsons plus syndrome as symptoms autonomic instability and co-benyldopa hasn’t helped.
If they have lost vertical gaze would suspect progressive supra nuclear palsy
Cranial Nevre III (occulomotor nerve palsy) one of most common medication causes
Vasculopathic ischaemia
Mx lithium toxicity -
IV fluids mainstay treatment
Indications for steroids in Sarcoidosis
Pts with CXR stage 2 or 3 disease who are symptomatic. Pts with asymptomatic and stable stage 2 or 3 disease who have only mildly abnormal lung function do not require tx.
Hypercalcaemia
Eye, heart or neuro
mx severe hypocalcaemia
IV calcium gluconate
First line Tx in ethylene glycol poisoning (antifreeze)
Fomepizole
Types renal tubular acidosis
T1 (distal) - low potassoim, cx include renal stones
T2 - low potassium, cx include osteomalacia
T3 - low potassium, v rare
T4 - high potassium, caused by diabetes
