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1
Q

Cauda Equina syndrome symptoms?

A

Increasing backpain
Bilateral sciatica
Sensory loss in lumbosacral distribution
Flaccid, weakened lower limbs
Reduced reflexes
Urinary symptoms

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2
Q

Presentation of
-Demyelination
-MND
-Cerebral tumour
-Syrinx
-Subacute combined cord degeneration

A

Spastic paraparesis

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3
Q

6 causes of cauda equina syndrome?

A

Bony mets
Myeloma
Epidural abscess
Disc prolapse
Epidural haematoma
Primary sacral tumour

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4
Q

Further management of cauda equina syndrome?

A

Arrange urgent spinal surgical admission that day

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5
Q

Differentiating between compression of cauda equina and cord?

A

CE: Loss of reflexes, flaccid paralysis
CC: Spastic paralysis, brisk reflexes

Both: sensory/power loss

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6
Q

S1 supplies which sensory dermatome?

A

Sole of foot

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7
Q

L2 Supplies which sensory dermatome?

A

Upper anterior thigh

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8
Q

L1 supplies which sensory dermatome?

A

Groin

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9
Q

L3 supplies which sensory dermatome?

A

Buttock

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10
Q

L4 supplies what sensory dermatome?

A

Calf

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11
Q

Someone has just been diagnosed with diabetes what is your first port of call for treatment?

A

Lifestyle advice:
- Diet
-Physical activity
Screening for diabetic complications

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12
Q

What is 1st line treatment for T2DM and why?

A

Metformin
-Weight neutral
-Good glucose lowering efficacy

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13
Q

What must be monitored before and during metformin use?

A

Renal function

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14
Q

Con of pioglitazone and gliclazide?

A

Weight gain

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15
Q

Metformin SEs?

A

Diarrhoea (GI upset)

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16
Q

Management of migraines?

A

Acute: Rizatriptan, diclofenac
Prophylaxis: Propranolol, amitriptyline, topirmate

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17
Q

Symptoms that would be seen in gastroenteritis?

A

-Streak of blood in vomit
-Intermittent abdo pain
-Blood in stool
-Mucus in stool

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18
Q

Treatment of gastroenteritis?

A

-Drink reg fluids
-Take paracetamol for abdo pains
-Observe hygiene measures like wash hands, separate towels etc

Consider supplementing fluid intake with rehydration salrs in adults at increased risk (>60 y/o, frail, comorbidities where dehyrdration would be problematic (CVS issues/thrombotic tendencies)

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19
Q

Treatment of choice for Tonsilitis?

A

Penicillin V

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20
Q

Patient wants tests as her father just died of MI aged 39, what blood test do you do?

A

Fasting lipid profile

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21
Q

Good cholesterol?

A

HDL

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22
Q

LDL is good or bad?

A

BAD cholesterol

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23
Q

Treatment of high cholesterol?

A

Statins
Ezetimibe
Fenofibrate

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24
Q

Common SE of statins?

A

Asthenis
GI disturbance
Headache

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25
Other possible causes of hypercholesterolaemia?
-Obesity -Chronic renal failure -Alcohol XS -Anorexia nervosa -Uncontrolled hypothyroidism If not these: familial
26
Mechanism of statins?
HMG CoA reductase inhibitors
27
Statins and pregnancy?
Avoid Discontinue 3 months before attempting conception
28
2 things which increase exposure to statins?
-Grapefruit juice -Clarithromycin (monitor rhabdomyolysis if on)
29
Definition of septicaemia?
Multiplication of bacteria in the bloodstream
30
Definition of bacteraemia?
Presence of bacteria in bloodstream
31
Treatment of meningococcal septicaemia patient while waiting for an ambulance?
Lying them down + high flow O2 IV/IM benzylpenicillin
32
Reporting and meningococcal diseases?
Always report
33
Differential diagnoses for maculo-papular rash?
-Parovirus B19 -Drug hypersensitivity -Measles -EBV
34
What is a maculopapular rash, beginning behind ears and spreading to the trunk pathognomonic of?
Measles
35
Symptoms of measles?
-High fever -Incubation period 10-12 days -Koplik spots -Maculopapular rash -Cough -Coryza -Irritabililty -Red eyes
36
Incubation period of measles?
10-12 days
37
When are measles patients infectious from?
4 days before onset of rash to 5 days after it appears
38
Complications of measles for a pregnant woman?
Encephalitis Subacute sclerosing panencephalitis Bronchopneumonia Stillbirth
39
What disease has the complication of infective endocarditis?
Rheumatic fever
40
Dukes criteria A-D?
A: Bowel wall B: Through wall but not nodes C: Regional nodes D: Distant mets present
41
Chlamydia infection treatment?
Doxycycline orally
42
Signs of RA in hands?
Swan neck deformity Swelling of MCPs Synovial swelling Boutonniere''s deformity Ulnar deviation
43
Hand deformities seen in OA?
Heberden's nodes (DIPs) Bouchard nodes (PIPs)
44
Serological investigations for RA?
Anti-CCP (80% of people with RA) ANA- Non-specific for AI conditions RF- 60-70% of people with Rheumatoid arthritis
45
Examples of DMARDs?
Methotrexate Hydroxychloroquine Sulphasalazine
46
Extra-articular presentations of RA?
Scleritis Pulmonary Fibrosis CVD Amyloidosis (chronic inflammatory connective tissue disorder so extra manifestations are along that vibe too)
47
First line for uncomplicated lower UTI?
Trimethoprim 200g BD 3 days OR Nuturofurantoin 100mg MR BD 3 days (GFR <40)
48
Causes of recurrent UTIs?
Renal stones Diabetes Sexual intercourse
49
Drugs assoc with dyspepsia?
Calcium antagonists Nitrates Theiphylines Bisphosphonates Corticosteroids NSAIDs
50
Normal Hb levels?
120-155
51
Normal WCC?
4-11 X 10>9
52
Normal Na+?
136-145
53
Normal K+?
3.5-5.1
54
Normal Urea?
1.7-8.3
55
Tennis elbow AKA?
Lateral epicondylitis
56
What muscle does tennis elbow affect?
Extensor muscle attachment into lateral epicondyle of humerus
57
Clinical presentation of tennis elbow?
-Localised point tenderness on palpation over and/or distal to lateral epicondyle -Painful Resisted Middle Finger Extension muscle test -Weakened grip strength -Full active and Passive Elbow ROM
58
Phalen's test diagnoses what?
Carpal Tunnel Syndrome
59
4 dying meds?
Midazolam: agitation Morphine Sulfate: Pain Cyclizine: N/V Glycopyrronium: resp secretions
60
Treatment of mastitis?
10-14 days flucloxacillin
61
Infected insect bite treatment?
Fluclox 500-1000mg x2 daily 5-7 days Clarothromycin 500mg twice daily 5-7 days Doxycycline 200mg 1st day, 100mg once daily 5-7 days total Erythro (pregnant) 500mg x4 daily for 5-7 days
62
Platelet normal values?
150-450
63
MCV normal?
76-100
64
HHV - 8 is what virus?
Kaposi Sarcoma- neoplastic skin lesions
65
HHV-5 is commonly called?
Cytomegalovirus
66
HHV-4 called?
Epstein Barr Mononucleosis
67
HHV-3 called?
Varicella Zoster - Chicken Pox
68
hhv-1 called?
Herpes simplex- cold sore
69
HHV-2 called?
Herpes Simplex Virus coldsore
70
Prescribe for paediatric meningitis possibility?
BENPENTEN Benzylpenicillan 1-9 years: 600mg >10 : 1200mg <1: 300mg
71
Normal bilirubin values?
0-21
72
Normal ALP?
40-129
73
Normal AST?
0-40
74
Normal GGT?
10-71
75
Normal CRP?
<5
76
Normal ESR?
0-15
77
Treatment of Scabies?
Permethrin 5% cream Whole body, not scalp and face.
78
Pathophysiology of venous ulcer formation?
Chronic venous insufficiency (CVI) Venous HT Poor oxygen diffusion Retrograde Flow
79
What is keratoacanthoma?
Rapidly growing skin lesion Distinguishable from manvasive squamous cell carcinoma histologically Doesn't invade or metastatsize Grow rapidly (6 weeks)
80
Chronic gout treatment?
Urate Lowering Treatment: Allopurinol 100mg OD Requires regular blood testing to chec urate levels, initial LFT, U&E check
81
Diagnostic features of pseudogout?
-Joint aspiration would show calcium pyrophosphate dihydrate (CPPD) crystals -Knee x-ray would show calcification of articular cartilage
82
Colchicine treatment for acute gout?
500 ug QDS 2-3 days
83
Licensed prophylactic dose for chronic gout when starting allopurinol?
500 ug of colchicine BD up to 6 months as prophylaxis whilst starting allopurinol
84
Treatment of lice?
Dimeticone 4% Malathion is 2nd line
84
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84
85
Pneumonic for remembering sick day drugs?
those DAMN Drugs -Diuretics -ACE Inhibitors -Metformin -NSAIDs
86

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