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Medicine > GP > Flashcards

GP Flashcards

1
Q

CP DD

A

MI, pneumothorax, PE, pericarditis, dissecting aortic aneurysm, GORD, musculoskeletal CP, shingles, perforated peptic ulcer, Boerhaaves S, achalasia

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2
Q

MI sounding CP

A

sudden onset, heavy, central, radiating to neck/L arm, N, sweating, elderly, ? no pain in DM, CVS risk factors

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3
Q

pneumothorax sounding CP

A

asthma/Marfan’s Hx, sudden onset, SOB, pleuritic CP

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4
Q

PE sounding CP

A

sudden onset, pleuritic CP, calf pain/swelling, haemoptysis, hypoxia, ?sm pleural effusion, COCP user, ca

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5
Q

pericarditis sounding CP

A

sharp pain, relieved by siting forward, ?pleuritic

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6
Q

dissecting aortic aneurysm sounding CP

A

tearing CP, radiating through back, unequal upper limb vs lower limb BP

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7
Q

GORD sounding CP

A

burning retrosternal CP, regurgitation, dysphagia

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8
Q

musculoskeletal sounding CP

A

worse on movement/palpation, precipitated by exercise/trauma/coughing

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9
Q

shingles sounding CP

A

pain often preceeds rash

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10
Q

most common sites for aortic dissection to occur

A

ascending aorta, just distal to the L subclavian

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11
Q

demographic of aortic dissection

A

Afrocarribean, male, 50-70

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12
Q

PE ECG changes

A

tachycardia, S waves in I, Q waves in III, inverted T waves in III

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13
Q

perforated peptic ulcer sounding CP

A

sudden onset, EG pain, generalised abdo pain, worse after eating

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14
Q

Boerhaaves S sounding CP

A

sudden onset, severe retrosternal CP, worse on swallowing, recent V Hx

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15
Q

Boerhaaves S is

A

spontaneous rupture of the oesophagus as a result of repeated episodes of V

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16
Q

immediate management of suspected ACS

A

GTN, aspirin 300mg, clopidogrel, ECG, analgesia, O2 IF <94% O2 sats (MONAC)

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17
Q

typical angina is

A

all 3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

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18
Q

atypical angina is

A

2/3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

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19
Q

non-anginal CP is

A

1/3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

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20
Q

CP in pregnancy DD

A

aortic dissection, mitral stenosis, PE, any other CP causes

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21
Q

sudden onset, heavy, central, radiating to neck/L arm, N, sweating, elderly, ? no pain in DM, CVS risk factors

A

MI

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22
Q

asthma/Marfan’s Hx, sudden onset, SOB, pleuritic CP

A

pneumothorax

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23
Q

sudden onset, pleuritic CP, calf pain/swelling, haemoptysis, hypoxia, ?sm pleural effusion, COCP user, ca

A

PE

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24
Q

sharp pain, relieved by siting forward, ?pleuritic

A

pericarditis

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25
Q

tearing CP, radiating through back, unequal upper limb vs lower limb BP

A

dissecting aortic aneurysm

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26
Q

burning retrosternal CP, regurgitation, dysphagia

A

GORD

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27
Q

worse on movement/palpation, precipitated by exercise/trauma/coughing

A

musculoskeletal CP

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28
Q

pain often preceeds rash

A

shingles

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29
Q

ascending aorta, just distal to the L subclavian

A

most common sites for aortic dissection

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30
Q

tachycardia, S waves in I, Q waves in III, inverted T waves in III

A

PE ECG changes

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31
Q

sudden onset, EG pain, generalised abdo pain, worse after eating

A

peptic ulcer perforation

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32
Q

spontaneous rupture of the oesophagus as a result of repeated episodes of V

A

Boerhaaves S

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33
Q

GTN, aspirin 300mg, clopidogrel, ECG, analgesia, O2 IF <94% O2 sats is the management for

A

ACS

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34
Q

all 3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

A

typical angina

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35
Q

2/3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

A

atypical angina

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36
Q

1/3 of: constricting discomfort in the front of the chest/neck/shoulders/jaw/arms, precipitated by physical exercise, relieved by rest/GTN in ~5mins

A

non-anginal CP

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37
Q

Boerhaave’s S diagnosis by

A

CT contrast swallow

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38
Q

sudden onset, severe retrosternal CP, worse on swallowing, recent V Hx

A

Boerhaave’s S

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39
Q

complications of Boerhaave’s S

A

surgical emphysema, mediastinitis, shock

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40
Q

achalasia symptoms

A

difficulty swallowing, dysphagia to liquids + solids, sometimes CP

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41
Q

achalasia cause

A

failure of distal oesophageal inhibitory neurones

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42
Q

achalasia is diagnosed by

A

pH, manometry studies, contrast swallow, endoscopy

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43
Q

achalasia management

A

botox, pneumatic dilation, cardiomyotomy

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44
Q

mitral stenosis in pregnancy associated with

A

rheumatic heart DZ, mid diastolic murmur

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45
Q

when to refer to hospital for CP

A

current CP/CP w/i last 12h = emergency admission
CP 12-72hrs ago = same day assessment in hospital
CP >72hrs ago = full assessment, ECG, troponin to determine further action

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46
Q

ant aortic dissection O/E changes

A

aortic regurgitation murmur, inf MI (II, III, aVF) ECG changes

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47
Q

surgical emphysema, mediastinitis, shock are complications of

A

Boerhaave’s S

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48
Q

difficulty swallowing, dysphagia to liquids + solids, sometimes CP

A

achalasia

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49
Q

failure of distal oesophageal inhibitory neurones

A

achalasia

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50
Q

Hx of rheumatic heart DZ, mid diastolic murmur

A

mitral valve stenosis in pregnancy

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51
Q

aortic regurgitation murmur + inf MI (II, III, aVF) ECG changes

A

anterior aortic dissection

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52
Q

SOB DD

A

HF, asthma, aortic stenosis, recurent PE, L ca, pulmonary fibrosis, bronchiectasis, anaemia, obesity

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53
Q

HF Hx

A

Hx of IHD/HTN, orthopnea, PND

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54
Q

HF O/E

A

bibasal crackles, S3 (L sided failure)

peripheral oedema, raised JVP (R sided failure)

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55
Q

asthma Hx

A

cough, wheeze, SOB, worse at night, precipitated by cold weather/exercise, associated with hayfever/eczema

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56
Q

aortic stenosis Hx

A

CP, SOB, syncope

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57
Q

aortic stenosis O/E

A

ESM radiating to carotids, narrow pulse P

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58
Q

recurrent PE Hx

A

predisopsing factors (ca), pleuritic CP, haemoptysis

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59
Q

recurrent PE O/E

A

tachycardia, tachopnea, symptoms of R HF if severe

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60
Q

L ca Hx

A

smoker, haemoptysis, chronic cough, unresolving infections, systemic symptoms (weight loss, anorexia)

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61
Q

pulmonary fibrosis Hx

A

progressive SOB

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62
Q

pulmonary fibrosis O/E

A

fine bibasal crackles, restrictive spirometry

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63
Q

bronchiectasis Hx

A

purulent sputum, infections Hx (TB, measles), bronchial obstruction, ciliary dyskinetic S e.g. Kartagener’s S

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64
Q

anaemia Hx

A

GI symptoms, lethargy, SOB, palpitations

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65
Q

abdo pain DD

A

peptic ulcer DZ, appendicitis, acute pancreatitis, biliary colic, acute cholecystitis, diverticulitis, AAA, intestinal obstruction, MI, DKA, pneumonia, acute intermittant porphyria, Pb poisoning, cholangitis, renal colic, pyelonephritis, ectopic pregnancy, PID, ovarian torsion, urinary retention, UTI, testiular torsion,gastroenteritis, hepatitis, ruptured spleen, perforation, Mitleschmertz, Fitz-Hugh-Curtis S, endometriosis, IBS, urogenital prolapse

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66
Q

two types of peptic ulcer

A

duodenal, gastric

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67
Q

Hx difference between duodenal + gastric ulcers

A

duodenal: > common, EG pain relieved by eating
gastric: EG pain worsened by eating

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68
Q

appendicitis

A

central to RIF pain, anorexia

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69
Q

Hx of IHD/HTN, orthopnea, PND

A

HF

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70
Q

bibasal crackles, S3, peripheral oedema, raised JVP

A

HF

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71
Q

cough, wheeze, SOB, worse at night, precipitated by cold weather/exercise, associated with hayfever/eczema

A

asthma

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72
Q

CP, SOB, syncope

A

AS

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73
Q

ESM radiating to carotids, narrow pulse P

A

AS

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74
Q

predisopsing factors (ca), pleuritic CP, haemoptysis

A

recurrent PE

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75
Q

tachycardia, tachopnea, symptoms of R HF if severe

A

recurrent PE

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76
Q

purulent sputum, infections Hx (TB, measles), bronchial obstruction, ciliary dyskinetic S e.g. Kartagener’s S

A

bronchiectasis

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77
Q

GI symptoms, lethargy, SOB, palpitations

A

anaemia

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78
Q

Rovsing’s sign

A

> pain in RIF when palpating LIF

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79
Q

acute pancreatitis Hx

A

EtOH/gallstones Hx, severe EG pain, V

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80
Q

acute pancreatitis O/E

A

tenderness, ileus, low grade fever, Cullen’s sign, Grey-Turner sign

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81
Q

appendicitis O/E

A

RIF tenderness, Rovsing’s sign, low grade fever, tachycardia

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82
Q

Cullen’s sign

A

periumbilical discolouration

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83
Q

Grey-Turner’s sign

A

flank discolouration

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84
Q

biliary colic Hx

A

pain in RUQ, radiating to back/interscapular scapula, following fatty meal, pale stools + dark urine (obstructive), [females, forties, fat, fair]

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85
Q

acute cholecystasis Hx

A

Hx of gallstones, continuous RUQ pain

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86
Q

acute cholecystasis O/E

A

fever, raised inflammatory markers, raised WCC, Murphy’s sign +ve

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87
Q

Murphy’s sign

A

inspiratory arrest on palpation of RUQ

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88
Q

diverticulitis Hx

A

colicy LLQ pain, D (?blood)

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89
Q

diverticulitis O/E

A

fever, raised inflammatory markers, raised WCC

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90
Q

AAA Hx

A

severe, central abdo pain, radiating to back, sudden collapse, shock, CVS DZ Hx

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91
Q

intestinal obstruction Hx

A

Hx of ca/previoous Sx, V, nil recent BO

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92
Q

intestinal obstruction O/E

A

tinkling BS

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93
Q

ascending cholangitis

A

gallstones Hx, Charcot’s triad: RUQ pain, fever, jaundice

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94
Q

ascending cholangitis is often caused by

A

E. coli

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95
Q

peptic ulcer DZ Hx

A

NSAIDS/EtOH Hx, upper GI haemorrhage (haematemesis, melaena)

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96
Q

renal colic Hx

A

loin to groin pain, severe, intermittant pain, haematuria

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97
Q

acute pyelonephritis

A

loin pain, fever, rigors, V

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98
Q

urinary retention Hx

A

suprapubic pain, BPE Hx

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99
Q

ectopic pregnancy Hx

A

amenorrhoea, PV bleeding

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100
Q

Mittleschmirtz

A

mid cycle pain, suprapubic pain

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101
Q

abdo pain in pregnancy DD

A

ectopoic, miscarriage, labour, placental abruption, symphisis pubis dysfunction, pre-eclampsia, HELLP S, uterine rupture, appendicitis, UTI

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102
Q

ectopic pregnancy risk factors

A

damage to tubes (Sx, salpingitis), previous ectopic, IVF

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103
Q

types of miscarriage

A

threatened, missed, ineviatable, incomplete

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104
Q

threatened miscarriage

A

painless PV bleeding <24/40, os closed

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105
Q

missed miscarriage

A

gestation sac + dead foetus <20/40 w/o symptoms of expulsion, light PV bleeding, no symptoms of pregnancy remain

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106
Q

ineviatable miscarriage

A

open os, heave PV bleeding with clots

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107
Q

incomplete miscarriage

A

retained products of conception

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108
Q

placental abruption features

A

shock inconsistent with visible blood loss, pain, tenderness, tense uterus, N lie + presentation, FH distressed/absent, coagulation problems, beware preeclampsia/DIC/anuria

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109
Q

symphysis pubis dysfunction features

A

pain over pubic symphysis, radiation to groins + medial aspect of thighs, waddling gait

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110
Q

uterine rupture risk factors

A

previous c/s

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111
Q

renal colic Ix

A

plain CT non contrast

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112
Q

central to RIF pain, anorexia

A

appendicitis

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113
Q

> pain in RIF when palpating LIF

A

Rovsing’s sign

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114
Q

EtOH/gallstones Hx, severe EG pain, V

A

acute pancreatitis

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115
Q

tenderness, ileus, low grade fever, Cullen’s sign, Grey-Turner sign

A

acute pancreatitis

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116
Q

RIF tenderness, Rovsing’s sign, low grade fever, tachycardia

A

appendicitis

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117
Q

periumbilical discolouration

A

Cullen’s sign

118
Q

flank discolouration

A

Grey-Turner’s sign

119
Q

pain in RUQ, radiating to back/interscapular scapula, following fatty meal, pale stools + dark urine (obstructive), [females, forties, fat, fair]

A

biliary colic

120
Q

Hx of gallstones, continuous RUQ pain

A

acute cholecystitis

121
Q

inspiratory arrest on palpation of RUQ

A

Murphy’s sign

122
Q

colicy LLQ pain, D (?blood)

A

diverticulitis

123
Q

severe, central abdo pain, radiating to back, sudden collapse, shock, CVS DZ Hx

A

AAA

124
Q

Hx of ca/previoous Sx, V, nil recent BO

A

intestinal obstruction

125
Q

tinkling BS

A

intestinal obstruction

126
Q

gallstones Hx, Charcot’s triad: RUQ pain, fever, jaundice

A

ascending cholangitis

127
Q

NSAIDS/EtOH Hx, upper GI haemorrhage (haematemesis, melaena)

A

peptic ulcer DZ

128
Q

loin to groin pain, severe, intermittant pain, haematuria

A

renal colic

129
Q

loin pain, fever, rigors, V

A

acute pyelonephritis

130
Q

suprapubic pain, BPE Hx

A

urinary retention

131
Q

painless PV bleeding <24/40, os closed

A

threateneed miscarriage

132
Q

gestation sac + dead foetus <20/40 w/o symptoms of expulsion, light PV bleeding, no symptoms of pregnancy remain

A

missed miscarriage

133
Q

open os, heave PV bleeding with clots

A

ineviatable miscarriage

134
Q

retained products of conception

A

incomplete miscarriage

135
Q

shock inconsistent with visible blood loss, pain, tenderness, tense uterus, N lie + presentation, FH distressed/absent, coagulation problems, beware preeclampsia/DIC/anuria

A

placental abruption

136
Q

pain over pubic symphysis, radiation to groins + medial aspect of thighs, waddling gait

A

symphisis pubis dysfunction

137
Q

Strep pneumo

A

most common pneumonia pathogen, fever, rapid onset, herpes labialis, vaccine available

138
Q

H. influenzae

A

common cause of pneumonia in COPD

139
Q

Staph aureus

A

cause of pneumonia following flu vaccine

140
Q

M. pneumoniae

A

atypical pneumonia, hyponatraemia, lymphopaenia

141
Q

Klebsiella pneumo

A

pneumonmia in alcoholics

142
Q

Pneumocystis jiroveci

A

pneumonia seen in immunocompromised, dry cough, exercise induced desaturations, absence of chest signs

143
Q

most common pneumonia pathogen, fever, rapid onset, herpes labialis, vaccine available

A

Strep pneumo

144
Q

common cause of pneumonia in COPD

A

H. influenzae

145
Q

cause of pneumonia following flu vaccine

A

Staph aureus

146
Q

atypical pneumonia, hyponatraemia, lymphopaenia

A

M. pneumoniae

147
Q

pneumonmia in alcoholics

A

Klebsiella pneumo

148
Q

pneumonia seen in immunocompromised, dry cough, exercise induced desaturations, absence of chest signs

A

Pneumocystis jioveci

149
Q

croup peak incidence

A

6/12 - 3 years

150
Q

causative agent for croup

A

parainfluenza

151
Q

features of croup

A

stridor, barking cough, fever, coryzal symptoms

152
Q

classification of severity of croup

A 
mild = occasional cough, no stridor, mild effort of breathing, well child
moderate = frequent cough, stridor at rest, recession, mildly stressed child
severe = frequent cough, prominant stridor, marked recession, significant distress, tachycardia, hypoxia
153
Q

admission advised for

A

moderate + severe croup, <6/12, known upper airway abnormality

154
Q

croup management

A

ABCDE assessment, PO dexamethasone 0.15mg/kg regardless of severity, high flow O2, nebulised adrenaline (if severe 5mL 1:1000)

155
Q

whooping cough cause

A

Bordetella pertussis

156
Q

whooping cough immunisation

A

2, 3, 4/12, 3-5 years

157
Q

features of whooping cough

A

2-3/7 coryza, coughing bouts (worse at night + after feeding), V, central cyanosis, inspiratory whoop, anoxia

158
Q

whooping cough diagnosis

A

PN swab culture, PCR + serology

159
Q

whooping cough management

A

PO macrolide if onset w/i previous 21/7, school exclusion for 2/7 after commencing ABx

160
Q

complications of whooping cough

A

subconjunctival haemorrhage, pneumonia, bronchiectasis, seizures

161
Q

Bordetella pertussis causes

A

whooping cough/pertussis

162
Q

2-3/7 coryza, coughing bouts (worse at night + after feeding), V, central cyanosis, inspiratory whoop, anoxia

A

features fo whooping cough

163
Q

PO macrolide if onset w/i previous 21/7, school exclusion for 2/7 after commencing ABx

A

management of whooping cough

164
Q

Caplan S is used to describe

A

L nodules in context of RA

165
Q

in COPD the emphysema is seem in the

A

upper lobes

166
Q

in a1AT deficiency the emphysema is seen in the

A

lower lobes

167
Q

features of a1AT deficiency

A

panacinar emphysema lower > upper lobes, liver cirrhosis, HCC (adults), cholestasis (children)

168
Q

a1AT management

A

stop smoking, bronchodilators, PT, IV a1AT, Sx

169
Q

live attenuated vaccines

A

BCG, MMR, influenza, PO rotovirus, PO polio, yellow fever, PO typhoid

170
Q

L nodules in context of RA

A

Caplan S

171
Q

upper lobes emphysema

A

COPD

172
Q

lower lobes emphysema

A

a1AT deficiency

173
Q

panacinar emphysema lower > upper lobes, liver cirrhosis, HCC (adults), cholestasis (children) features of

A

a1AT deficiency

174
Q

bronchiolitis vs asthma vs croup

A 
bronchiolitis = wheeze, <1 y.o., RSV
asthma = >5y.o., exersice/cold induced, bronchodilators
croup = stridor, 6/12 - 3 years, parainfluenza
175
Q

laryngomalacia suspect in

A

otherwise well, noisy breathing infant

176
Q

otherwise well, noisy breathing infant

A

laryngomalacia

177
Q

haemoptysis DD

A

L ca, pulmonary oedema, TB, PE, LRTI, bronchiectasis, mitral stenosis, aspergilloma, GPA, Goodpasture’s S

178
Q

L ca features

A

smoking Hx, weight loss, anorexia

179
Q

pulmonary oedema features

A

dyspnoea, bibasal crackles, S3

180
Q

TB features

A

fever, night sweats, anorexia, weight loss

181
Q

PE features

A

pleuritic CP, tachycardia, tachopnea

182
Q

LRTI features

A

acute Hx of purulent cough

183
Q

bronchiectasis features

A

long Hx of cough, daily purulent sputum production

184
Q

mitral stenosis features

A

dyspnoea, AF, malar flush on cheeks, mid-diastolic murmur

185
Q

aspergilloma features

A

TB PMH, severe haemoptysis, CXR round opacity

186
Q

GPA features

A

URT: epistaxis, sinusitis, nasal crusting
LRT: dyspnoea, haemoptysis
GN, saddle shaped nose deformity

187
Q

Goodpasture’s S features

A

haemoptysis, fever, N, GN

188
Q

smoking Hx, weight loss, anorexia, haemoptysis

A

L ca

189
Q

dyspnoea, bibasal crackles, S3, haemoptysis

A

pulmonary oedema

190
Q

fever, night sweats, anorexia, weight loss, haemoptysis

A

TB

191
Q

pleuritic CP, tachycardia, tachopnea, haemoptysis

A

PE

192
Q

acute Hx of purulent cough, haemoptysis

A

LRTI

193
Q

long Hx of cough, daily purulent sputum production, haemoptysis

A

bronchiectasis

194
Q

dyspnoea, AF, malar flush on cheeks, mid-diastolic murmur, haemoptysis

A

mitral stenosis

195
Q

TB PMH, severe haemoptysis, CXR round opacity

A

aspergilloma

196
Q

epistaxis, sinusitis, nasal crusting, dyspnoea, haemoptysis, GN, saddle shaped nose deformity

A

GPA

197
Q

haemoptysis, fever, N, GN

A

Goodpasture’s S

198
Q

diarrhoea DD

A

gastroenteritis, diverticulitis, ABx therapy, overflow, IBS, UC, Crohn’s, CRC, coeliac DZ, thyrotoxicosis, laxative abuse, appendicitis, radiation enteritis, HIV

199
Q

gastroenteritis features

A

accompanied by abdo pain, V, N

200
Q

diverticulitis features

A

LLQ pain, diarrhoea, fever

201
Q

ABx therapy features

A

> common with BS ABx

202
Q

overflow diarrhoea

A

constipation Hx, incontinence

203
Q

IBS features

A

abdo pain, bloating, change in bowel habits, lethargy, N, backache, bladder symptoms

204
Q

UC features

A

bloody diarrhoea, crampy abdo pain, weight loss, faecal urgency, tenesmus

205
Q

Crohn’s DZ features

A

crampy abdo pain, diarrhoea, malabsorption, mouth ulcers, perianal DZ, intestinal obstruciton

206
Q

CRC features

A

diarrhoea, PR bleeding, anaemia, weight loss, anorexia

207
Q

coeliac DZ

A

failure to thrive, diarrhoea, abdo distension, lethargy, anaemia, weight loss

208
Q

diarrhoea definition

A

> 3 loose stools/d

209
Q

acute diarrhoea duration

A

<14/7

210
Q

chronic diarrhoea duration

A

> 14/7

211
Q

diarrhoea in infants

A

gastroenteritis, cows’ milk intollerance, coeliac DZ, post-gastroenteritis lactose intollerance, toddler’s diarrhoea

212
Q

HIV diarrhoea opportunistic infections

A

cryptosporidium + protozoa, CMV, M avium intracellulare (CD4 < 50), giardia

213
Q

stain for cryptosporidium in stool sample

A

modified Ziehl-Neelsen

214
Q

E. coli diarrhoea features

A

travellers, watery stools, abdo cramps, N

215
Q

giardiasis diarrhoea features

A

prolonged, non-bloody

216
Q

cholera diarrhoea features

A

profuse, watery, severe dehydration

217
Q

Shigella diarrhoea features

A

bloody, V, abdo pain

218
Q

Staph aureus diarrhoea features

A

severe V, short incubation

219
Q

Campylobacter diarrhoea features

A

flu-like prodrome, crampy abdo pain, fever, ?bloody, GBS = complication

220
Q

Bacillus cereus diarrhoea features

A

V w/i 6hrs (rice), or D after 6hrs

221
Q

amoebiasis diarrhoea features

A

gradual onset, bloody, abdo pain, tenderness, weeks

222
Q

diarrhoea accompanied by abdo pain, V, N

A

gastroenteritis

223
Q

LLQ pain, diarrhoea, fever

A

diverticulitis

224
Q

constipation Hx, incontinence, diarrhoea

A

overflow

225
Q

diarrhoea > common with BS ABx

A

ABx diarrhoea

226
Q

abdo pain, bloating, change in bowel habits, lethargy, N, backache, bladder symptoms, diarrhoea

A

IBS

227
Q

bloody diarrhoea, crampy abdo pain, weight loss, faecal urgency, tenesmus

A

UC

228
Q

crampy abdo pain, diarrhoea, malabsorption, mouth ulcers, perianal DZ, intestinal obstruciton

A

Crohn’s

229
Q

diarrhoea, PR bleeding, anaemia, weight loss, anorexia

A

CRC

230
Q

failure to thrive, diarrhoea, abdo distension, lethargy, anaemia, weight loss

A

coeliac’s DZ

231
Q

modified Ziehl-Neelsen

A

cryptosporidium

232
Q

travellers diarrhoea, watery stools, abdo cramps, N causative agent

A

E. coli

233
Q

prolonged, non-bloody diarrhoea causative agent

A

giardiasis

234
Q

profuse, watery diarrhoea, severe dehydration causative agent

A

cholera

235
Q

bloody diarrhoea, V, abdo pain causative agent

A

Shigella

236
Q

severe V, short incubation, diarrhoea causative agent

A

Staph aureus

237
Q

flu-like prodrome, crampy abdo pain, fever, ?bloody diarrhoea, GBS = complication causative agent

A

Campylobacter

238
Q

V w/i 6hrs (rice), or D after 6hrs causative agent

A

Bacillus cereus

239
Q

gradual onset, bloody diarrhoea, abdo pain, tenderness, weeks causative agent

A

Amoebiasis

240
Q

bilious V in neonates DD

A

duodenal atresia, malrotation with volvulus, jejunal/ileal atresia, mec ileus, NEC

241
Q

duodenal atresia features

A

bilious V, hours post natal, AXR double bubble

242
Q

malrotation with vulvulus features

A

bilious V, 3-7/7 post natal, peritoneal signs, HD instability

243
Q

jejunal/ileal atresia features

A

bilious V, w/i 24h, AXR = air-fluid levels

244
Q

mec ileus features

A

abdo distension, bilious V, 24-48hrs post natal, AXR = air-fluid level, ?cf (seat test)

245
Q

NEC features

A

2/52 post natal, bilious V, prematurity, intercurrent illness, AXR = dialted bowel loops, pneumatosis, portal venous air

246
Q

cyclical V S presentation

A

severe N, sudden V, hrs - days, sweating prodrome, weight loss, LOA, abdo pain, diarrhoea, dizziness, photophobia, headache, well between episodes

247
Q

bilious V, hours post natal, AXR double bubble

A

duodenal atresia

248
Q

bilious V, 3-7/7 post natal, peritoneal signs, HD instability

A

mal rotation + volvulus

249
Q

bilious V, w/i 24h, AXR = air-fluid levels

A

jejunal/ileal atresia

250
Q

abdo distension, bilious V, 24-48hrs post natal, AXR = air-fluid level, ?cf (seat test)

A

mec ileus

251
Q

2/52 post natal, bilious V, prematurity, intercurrent illness, AXR = dialted bowel loops, pneumatosis, portal venous air

A

NEC

252
Q

severe N, sudden V, hrs - days, sweating prodrome, weight loss, LOA, abdo pain, diarrhoea, dizziness, photophobia, headache, well between episodes

A

cyclical V S

253
Q

pyloric stenosis features

A

non-bilious V, projectile

254
Q

severity index used to score UC flares

A

Truelove and Witt’s

255
Q

Truelove and Witt’s criteria

A

severe = blood in stools, >6 stools/d plus 1 of: T’c > 37.8, HR > 90 bpm, anaemia Hb < 105, ESR > 30

256
Q

hyperemesis gravidarum criteria

A

5% pre-pregnancy weight, dehydration, electrolyte imbalance

257
Q

non-bilious V, projectile

A

pyloric stenosis

258
Q

Truelove and Witt’s used to score

A

severity of UC

259
Q

UTI management in non-pregnant women

A

nitrofurantoin/trimethoprim for 3/7

260
Q

management of pregnant women UTI

A

culture, ABx 7/7, culure afterwards to confirm cleared

261
Q

UTI presentaiton in children

A

poor feeding, V, irritability, abdo pain, fever, dysuria, f, haematuria

262
Q

UTI management in children

A

<3/12 paeds referral

>3/12 PO ABx 3/7: trimethoprim, nitrofurantoin, cephalosporin, amoxacillin

263
Q

risk factors for urinary incontinence

A

age, previous pregnancy, childbirth, high BMI, hysterectomy, FH

264
Q

types of urinary incontinence

A

urge = OAB, detrusor overactivity
stress = weak pelvic floor, triggers = coughing, laughing
mixed
overflow = due to BOO

265
Q

urge incontinence management

A

bladder retraining, antimuscarinics (oxybutynin)

266
Q

stress incontinence management

A

pelvic floor exercises, Sx

267
Q

LUTS symptoms classification

A

voiding: hesitancy, poor/intermittant stream, strainig, incomplete emptying, terminal dribbling
storing: urgency, f, nocturia, incontinence
post-micturition: dribbling, sensation of incomplete emptying

268
Q

LUTS Mx voiding symptoms

A

pelvic floor exercises, bladder training, fluid intake control, a-blocker, 5a-reductase i

269
Q

LUTS Mx OAB symptoms

A

fluid intake control, bladder retraining, antimuscarininc (oxybutynin)

270
Q

LUTS Mx nocturia symptoms

A

fluid intake control, furosemide PM, desmopressin

271
Q

nitrofurantoin/trimethoprim for 3/7

A

uncomplicated UTI

272
Q

culture, ABx 7/7, culure afterwards to confirm cleared

A

UTI in pregnancy

273
Q

poor feeding, V, irritability, abdo pain, fever, dysuria, f, haematuria

A

UTI presentation in children

274
Q

urethral injury types

A

bulbar + membraneous rupture

275
Q

bulbar urethral rupture features

A

more common, straddle injury, triad = urinary retention, perianal haematoma, blood at meatus

276
Q

membraneous urethral rupture features

A

extra vs intraperitoneal, pelvic #, penile/perineal oedema/haematoma, PR = prostate displaced upwards

277
Q

bladder injury features

A

intra ve extraperitoneal, haematuria, suprapubic pain, Hx of pelvic #, inability to void

278
Q

caues of transient/spurious microscopic haematuria

A

UTI, menstruation, vigorous exercise, sex

279
Q

caues of persistent microscopic haematuria

A

ca (bladder, renal, prostate), stones, BPH, prostatitis, urethritis (Chlamydia), renal (IgA nephropathy, thin BM DZ)

280
Q

spurious causes of haematuria

A

beetroot, rhubarb, rifampicin, doxorubicin

281
Q

2/52 week wait pathway for haematuria

A

> 45 + unexplained macroscopic haematuria
45 + macroscopic haematuria that persists/recurs after UTI Rx
60 + unexplained microscopic haematuria + dysuria/raised WCCcharcot

282
Q

more common, straddle injury, triad = urinary retention, perianal haematoma, blood at meatus

A

bulbar urethral rupture

283
Q

extra vs intraperitoneal, pelvic #, penile/perineal oedema/haematoma, PR = prostate displaced upwards

A

mmbraneous urethral rupture

284
Q

intra ve extraperitoneal, haematuria, suprapubic pain, Hx of pelvic #, inability to void

A

bladder injury

285
Q

Charcot joint features

A

swollen, red, warm, DM Hx

286
Q

features of aplastic anaemia

A

normocytic anaemia, lymphopaenia (lymphocytes relatively spared), thrombocytopaenia, hypoplastic BM

287
Q

medications that can cause an aplastic anaemia

A

phenytoin,cytotoxic agents, chloramphenicol, sulphonamides, gold

288
Q

causes of aplastic anaemia

A

isiopathic, congenital (Fanconi, dyskeratosis congenita), drugs, toxins (benzene), infections (parvovirus, hepatitis), radiation

289
Q

coeliac blood test

A

anti-TTG

290
Q

anti-TTG is test for

A

coeliac DZ

Medicine (30 decks)

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