GP Flashcards
1
Q
CP DD
A
MI, pneumothorax, PE, pericarditis, dissecting aortic aneurysm, GORD, musculoskeletal CP, shingles, perforated peptic ulcer, Boerhaaves S, achalasia
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
3
Q
pneumothorax sounding CP
A
asthma/Marfan’s Hx, sudden onset, SOB, pleuritic CP
4
Q
PE sounding CP
A
sudden onset, pleuritic CP, calf pain/swelling, haemoptysis, hypoxia, ?sm pleural effusion, COCP user, ca
5
Q
pericarditis sounding CP
A
sharp pain, relieved by siting forward, ?pleuritic
6
Q
dissecting aortic aneurysm sounding CP
A
tearing CP, radiating through back, unequal upper limb vs lower limb BP
7
Q
GORD sounding CP
A
burning retrosternal CP, regurgitation, dysphagia
8
Q
musculoskeletal sounding CP
A
worse on movement/palpation, precipitated by exercise/trauma/coughing
9
Q
shingles sounding CP
A
pain often preceeds rash
10
Q
most common sites for aortic dissection to occur
A
ascending aorta, just distal to the L subclavian
11
Q
demographic of aortic dissection
A
Afrocarribean, male, 50-70
12
Q
PE ECG changes
A
tachycardia, S waves in I, Q waves in III, inverted T waves in III
13
Q
perforated peptic ulcer sounding CP
A
sudden onset, EG pain, generalised abdo pain, worse after eating
14
Q
Boerhaaves S sounding CP
A
sudden onset, severe retrosternal CP, worse on swallowing, recent V Hx
15
Q
Boerhaaves S is
A
spontaneous rupture of the oesophagus as a result of repeated episodes of V
16
Q
immediate management of suspected ACS
A
GTN, aspirin 300mg, clopidogrel, ECG, analgesia, O2 IF <94% O2 sats (MONAC)
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
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
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
20
Q
CP in pregnancy DD
A
aortic dissection, mitral stenosis, PE, any other CP causes
21
Q
sudden onset, heavy, central, radiating to neck/L arm, N, sweating, elderly, ? no pain in DM, CVS risk factors
A
MI
22
Q
asthma/Marfan’s Hx, sudden onset, SOB, pleuritic CP
A
pneumothorax
23
Q
sudden onset, pleuritic CP, calf pain/swelling, haemoptysis, hypoxia, ?sm pleural effusion, COCP user, ca
A
PE
24
Q
sharp pain, relieved by siting forward, ?pleuritic
A
pericarditis
25
tearing CP, radiating through back, unequal upper limb vs lower limb BP
dissecting aortic aneurysm
26
burning retrosternal CP, regurgitation, dysphagia
GORD
27
worse on movement/palpation, precipitated by exercise/trauma/coughing
musculoskeletal CP
28
pain often preceeds rash
shingles
29
ascending aorta, just distal to the L subclavian
most common sites for aortic dissection
30
tachycardia, S waves in I, Q waves in III, inverted T waves in III
PE ECG changes
31
sudden onset, EG pain, generalised abdo pain, worse after eating
peptic ulcer perforation
32
spontaneous rupture of the oesophagus as a result of repeated episodes of V
Boerhaaves S
33
GTN, aspirin 300mg, clopidogrel, ECG, analgesia, O2 IF <94% O2 sats is the management for
ACS
34
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
typical angina
35
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
atypical angina
36
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
non-anginal CP
37
Boerhaave's S diagnosis by
CT contrast swallow
38
sudden onset, severe retrosternal CP, worse on swallowing, recent V Hx
Boerhaave's S
39
complications of Boerhaave's S
surgical emphysema, mediastinitis, shock
40
achalasia symptoms
difficulty swallowing, dysphagia to liquids + solids, sometimes CP
41
achalasia cause
failure of distal oesophageal inhibitory neurones
42
achalasia is diagnosed by
pH, manometry studies, contrast swallow, endoscopy
43
achalasia management
botox, pneumatic dilation, cardiomyotomy
44
mitral stenosis in pregnancy associated with
rheumatic heart DZ, mid diastolic murmur
45
when to refer to hospital for CP
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
46
ant aortic dissection O/E changes
aortic regurgitation murmur, inf MI (II, III, aVF) ECG changes
47
surgical emphysema, mediastinitis, shock are complications of
Boerhaave's S
48
difficulty swallowing, dysphagia to liquids + solids, sometimes CP
achalasia
49
failure of distal oesophageal inhibitory neurones
achalasia
50
Hx of rheumatic heart DZ, mid diastolic murmur
mitral valve stenosis in pregnancy
51
aortic regurgitation murmur + inf MI (II, III, aVF) ECG changes
anterior aortic dissection
52
SOB DD
HF, asthma, aortic stenosis, recurent PE, L ca, pulmonary fibrosis, bronchiectasis, anaemia, obesity
53
HF Hx
Hx of IHD/HTN, orthopnea, PND
54
HF O/E
bibasal crackles, S3 (L sided failure)
| peripheral oedema, raised JVP (R sided failure)
55
asthma Hx
cough, wheeze, SOB, worse at night, precipitated by cold weather/exercise, associated with hayfever/eczema
56
aortic stenosis Hx
CP, SOB, syncope
57
aortic stenosis O/E
ESM radiating to carotids, narrow pulse P
58
recurrent PE Hx
predisopsing factors (ca), pleuritic CP, haemoptysis
59
recurrent PE O/E
tachycardia, tachopnea, symptoms of R HF if severe
60
L ca Hx
smoker, haemoptysis, chronic cough, unresolving infections, systemic symptoms (weight loss, anorexia)
61
pulmonary fibrosis Hx
progressive SOB
62
pulmonary fibrosis O/E
fine bibasal crackles, restrictive spirometry
63
bronchiectasis Hx
purulent sputum, infections Hx (TB, measles), bronchial obstruction, ciliary dyskinetic S e.g. Kartagener's S
64
anaemia Hx
GI symptoms, lethargy, SOB, palpitations
65
abdo pain DD
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
66
two types of peptic ulcer
duodenal, gastric
67
Hx difference between duodenal + gastric ulcers
duodenal: > common, EG pain relieved by eating
gastric: EG pain worsened by eating
68
appendicitis
central to RIF pain, anorexia
69
Hx of IHD/HTN, orthopnea, PND
HF
70
bibasal crackles, S3, peripheral oedema, raised JVP
HF
71
cough, wheeze, SOB, worse at night, precipitated by cold weather/exercise, associated with hayfever/eczema
asthma
72
CP, SOB, syncope
AS
73
ESM radiating to carotids, narrow pulse P
AS
74
predisopsing factors (ca), pleuritic CP, haemoptysis
recurrent PE
75
tachycardia, tachopnea, symptoms of R HF if severe
recurrent PE
76
purulent sputum, infections Hx (TB, measles), bronchial obstruction, ciliary dyskinetic S e.g. Kartagener's S
bronchiectasis
77
GI symptoms, lethargy, SOB, palpitations
anaemia
78
Rovsing's sign
> pain in RIF when palpating LIF
79
acute pancreatitis Hx
EtOH/gallstones Hx, severe EG pain, V
80
acute pancreatitis O/E
tenderness, ileus, low grade fever, Cullen's sign, Grey-Turner sign
81
appendicitis O/E
RIF tenderness, Rovsing's sign, low grade fever, tachycardia
82
Cullen's sign
periumbilical discolouration
83
Grey-Turner's sign
flank discolouration
84
biliary colic Hx
pain in RUQ, radiating to back/interscapular scapula, following fatty meal, pale stools + dark urine (obstructive), [females, forties, fat, fair]
85
acute cholecystasis Hx
Hx of gallstones, continuous RUQ pain
86
acute cholecystasis O/E
fever, raised inflammatory markers, raised WCC, Murphy's sign +ve
87
Murphy's sign
inspiratory arrest on palpation of RUQ
88
diverticulitis Hx
colicy LLQ pain, D (?blood)
89
diverticulitis O/E
fever, raised inflammatory markers, raised WCC
90
AAA Hx
severe, central abdo pain, radiating to back, sudden collapse, shock, CVS DZ Hx
91
intestinal obstruction Hx
Hx of ca/previoous Sx, V, nil recent BO
92
intestinal obstruction O/E
tinkling BS
93
ascending cholangitis
gallstones Hx, Charcot's triad: RUQ pain, fever, jaundice
94
ascending cholangitis is often caused by
E. coli
95
peptic ulcer DZ Hx
NSAIDS/EtOH Hx, upper GI haemorrhage (haematemesis, melaena)
96
renal colic Hx
loin to groin pain, severe, intermittant pain, haematuria
97
acute pyelonephritis
loin pain, fever, rigors, V
98
urinary retention Hx
suprapubic pain, BPE Hx
99
ectopic pregnancy Hx
amenorrhoea, PV bleeding
100
Mittleschmirtz
mid cycle pain, suprapubic pain
101
abdo pain in pregnancy DD
ectopoic, miscarriage, labour, placental abruption, symphisis pubis dysfunction, pre-eclampsia, HELLP S, uterine rupture, appendicitis, UTI
102
ectopic pregnancy risk factors
damage to tubes (Sx, salpingitis), previous ectopic, IVF
103
types of miscarriage
threatened, missed, ineviatable, incomplete
104
threatened miscarriage
painless PV bleeding <24/40, os closed
105
missed miscarriage
gestation sac + dead foetus <20/40 w/o symptoms of expulsion, light PV bleeding, no symptoms of pregnancy remain
106
ineviatable miscarriage
open os, heave PV bleeding with clots
107
incomplete miscarriage
retained products of conception
108
placental abruption features
shock inconsistent with visible blood loss, pain, tenderness, tense uterus, N lie + presentation, FH distressed/absent, coagulation problems, beware preeclampsia/DIC/anuria
109
symphysis pubis dysfunction features
pain over pubic symphysis, radiation to groins + medial aspect of thighs, waddling gait
110
uterine rupture risk factors
previous c/s
111
renal colic Ix
plain CT non contrast
112
central to RIF pain, anorexia
appendicitis
113
> pain in RIF when palpating LIF
Rovsing's sign
114
EtOH/gallstones Hx, severe EG pain, V
acute pancreatitis
115
tenderness, ileus, low grade fever, Cullen's sign, Grey-Turner sign
acute pancreatitis
116
RIF tenderness, Rovsing's sign, low grade fever, tachycardia
appendicitis
117
periumbilical discolouration
Cullen's sign
118
flank discolouration
Grey-Turner's sign
119
pain in RUQ, radiating to back/interscapular scapula, following fatty meal, pale stools + dark urine (obstructive), [females, forties, fat, fair]
biliary colic
120
Hx of gallstones, continuous RUQ pain
acute cholecystitis
121
inspiratory arrest on palpation of RUQ
Murphy's sign
122
colicy LLQ pain, D (?blood)
diverticulitis
123
severe, central abdo pain, radiating to back, sudden collapse, shock, CVS DZ Hx
AAA
124
Hx of ca/previoous Sx, V, nil recent BO
intestinal obstruction
125
tinkling BS
intestinal obstruction
126
gallstones Hx, Charcot's triad: RUQ pain, fever, jaundice
ascending cholangitis
127
NSAIDS/EtOH Hx, upper GI haemorrhage (haematemesis, melaena)
peptic ulcer DZ
128
loin to groin pain, severe, intermittant pain, haematuria
renal colic
129
loin pain, fever, rigors, V
acute pyelonephritis
130
suprapubic pain, BPE Hx
urinary retention
131
painless PV bleeding <24/40, os closed
threateneed miscarriage
132
gestation sac + dead foetus <20/40 w/o symptoms of expulsion, light PV bleeding, no symptoms of pregnancy remain
missed miscarriage
133
open os, heave PV bleeding with clots
ineviatable miscarriage
134
retained products of conception
incomplete miscarriage
135
shock inconsistent with visible blood loss, pain, tenderness, tense uterus, N lie + presentation, FH distressed/absent, coagulation problems, beware preeclampsia/DIC/anuria
placental abruption
136
pain over pubic symphysis, radiation to groins + medial aspect of thighs, waddling gait
symphisis pubis dysfunction
137
Strep pneumo
most common pneumonia pathogen, fever, rapid onset, herpes labialis, vaccine available
138
H. influenzae
common cause of pneumonia in COPD
139
Staph aureus
cause of pneumonia following flu vaccine
140
M. pneumoniae
atypical pneumonia, hyponatraemia, lymphopaenia
141
Klebsiella pneumo
pneumonmia in alcoholics
142
Pneumocystis jiroveci
pneumonia seen in immunocompromised, dry cough, exercise induced desaturations, absence of chest signs
143
most common pneumonia pathogen, fever, rapid onset, herpes labialis, vaccine available
Strep pneumo
144
common cause of pneumonia in COPD
H. influenzae
145
cause of pneumonia following flu vaccine
Staph aureus
146
atypical pneumonia, hyponatraemia, lymphopaenia
M. pneumoniae
147
pneumonmia in alcoholics
Klebsiella pneumo
148
pneumonia seen in immunocompromised, dry cough, exercise induced desaturations, absence of chest signs
Pneumocystis jioveci
149
croup peak incidence
6/12 - 3 years
150
causative agent for croup
parainfluenza
151
features of croup
stridor, barking cough, fever, coryzal symptoms
152
classification of severity of croup
```
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
admission advised for
moderate + severe croup, <6/12, known upper airway abnormality
154
croup management
ABCDE assessment, PO dexamethasone 0.15mg/kg regardless of severity, high flow O2, nebulised adrenaline (if severe 5mL 1:1000)
155
whooping cough cause
Bordetella pertussis
156
whooping cough immunisation
2, 3, 4/12, 3-5 years
157
features of whooping cough
2-3/7 coryza, coughing bouts (worse at night + after feeding), V, central cyanosis, inspiratory whoop, anoxia
158
whooping cough diagnosis
PN swab culture, PCR + serology
159
whooping cough management
PO macrolide if onset w/i previous 21/7, school exclusion for 2/7 after commencing ABx
160
complications of whooping cough
subconjunctival haemorrhage, pneumonia, bronchiectasis, seizures
161
Bordetella pertussis causes
whooping cough/pertussis
162
2-3/7 coryza, coughing bouts (worse at night + after feeding), V, central cyanosis, inspiratory whoop, anoxia
features fo whooping cough
163
PO macrolide if onset w/i previous 21/7, school exclusion for 2/7 after commencing ABx
management of whooping cough
164
Caplan S is used to describe
L nodules in context of RA
165
in COPD the emphysema is seem in the
upper lobes
166
in a1AT deficiency the emphysema is seen in the
lower lobes
167
features of a1AT deficiency
panacinar emphysema lower > upper lobes, liver cirrhosis, HCC (adults), cholestasis (children)
168
a1AT management
stop smoking, bronchodilators, PT, IV a1AT, Sx
169
live attenuated vaccines
BCG, MMR, influenza, PO rotovirus, PO polio, yellow fever, PO typhoid
170
L nodules in context of RA
Caplan S
171
upper lobes emphysema
COPD
172
lower lobes emphysema
a1AT deficiency
173
panacinar emphysema lower > upper lobes, liver cirrhosis, HCC (adults), cholestasis (children) features of
a1AT deficiency
174
bronchiolitis vs asthma vs croup
```
bronchiolitis = wheeze, <1 y.o., RSV
asthma = >5y.o., exersice/cold induced, bronchodilators
croup = stridor, 6/12 - 3 years, parainfluenza
```
175
laryngomalacia suspect in
otherwise well, noisy breathing infant
176
otherwise well, noisy breathing infant
laryngomalacia
177
haemoptysis DD
L ca, pulmonary oedema, TB, PE, LRTI, bronchiectasis, mitral stenosis, aspergilloma, GPA, Goodpasture's S
178
L ca features
smoking Hx, weight loss, anorexia
179
pulmonary oedema features
dyspnoea, bibasal crackles, S3
180
TB features
fever, night sweats, anorexia, weight loss
181
PE features
pleuritic CP, tachycardia, tachopnea
182
LRTI features
acute Hx of purulent cough
183
bronchiectasis features
long Hx of cough, daily purulent sputum production
184
mitral stenosis features
dyspnoea, AF, malar flush on cheeks, mid-diastolic murmur
185
aspergilloma features
TB PMH, severe haemoptysis, CXR round opacity
186
GPA features
URT: epistaxis, sinusitis, nasal crusting
LRT: dyspnoea, haemoptysis
GN, saddle shaped nose deformity
187
Goodpasture's S features
haemoptysis, fever, N, GN
188
smoking Hx, weight loss, anorexia, haemoptysis
L ca
189
dyspnoea, bibasal crackles, S3, haemoptysis
pulmonary oedema
190
fever, night sweats, anorexia, weight loss, haemoptysis
TB
191
pleuritic CP, tachycardia, tachopnea, haemoptysis
PE
192
acute Hx of purulent cough, haemoptysis
LRTI
193
long Hx of cough, daily purulent sputum production, haemoptysis
bronchiectasis
194
dyspnoea, AF, malar flush on cheeks, mid-diastolic murmur, haemoptysis
mitral stenosis
195
TB PMH, severe haemoptysis, CXR round opacity
aspergilloma
196
epistaxis, sinusitis, nasal crusting, dyspnoea, haemoptysis, GN, saddle shaped nose deformity
GPA
197
haemoptysis, fever, N, GN
Goodpasture's S
198
diarrhoea DD
gastroenteritis, diverticulitis, ABx therapy, overflow, IBS, UC, Crohn's, CRC, coeliac DZ, thyrotoxicosis, laxative abuse, appendicitis, radiation enteritis, HIV
199
gastroenteritis features
accompanied by abdo pain, V, N
200
diverticulitis features
LLQ pain, diarrhoea, fever
201
ABx therapy features
> common with BS ABx
202
overflow diarrhoea
constipation Hx, incontinence
203
IBS features
abdo pain, bloating, change in bowel habits, lethargy, N, backache, bladder symptoms
204
UC features
bloody diarrhoea, crampy abdo pain, weight loss, faecal urgency, tenesmus
205
Crohn's DZ features
crampy abdo pain, diarrhoea, malabsorption, mouth ulcers, perianal DZ, intestinal obstruciton
206
CRC features
diarrhoea, PR bleeding, anaemia, weight loss, anorexia
207
coeliac DZ
failure to thrive, diarrhoea, abdo distension, lethargy, anaemia, weight loss
208
diarrhoea definition
>3 loose stools/d
209
acute diarrhoea duration
<14/7
210
chronic diarrhoea duration
>14/7
211
diarrhoea in infants
gastroenteritis, cows' milk intollerance, coeliac DZ, post-gastroenteritis lactose intollerance, toddler's diarrhoea
212
HIV diarrhoea opportunistic infections
cryptosporidium + protozoa, CMV, M avium intracellulare (CD4 < 50), giardia
213
stain for cryptosporidium in stool sample
modified Ziehl-Neelsen
214
E. coli diarrhoea features
travellers, watery stools, abdo cramps, N
215
giardiasis diarrhoea features
prolonged, non-bloody
216
cholera diarrhoea features
profuse, watery, severe dehydration
217
Shigella diarrhoea features
bloody, V, abdo pain
218
Staph aureus diarrhoea features
severe V, short incubation
219
Campylobacter diarrhoea features
flu-like prodrome, crampy abdo pain, fever, ?bloody, GBS = complication
220
Bacillus cereus diarrhoea features
V w/i 6hrs (rice), or D after 6hrs
221
amoebiasis diarrhoea features
gradual onset, bloody, abdo pain, tenderness, weeks
222
diarrhoea accompanied by abdo pain, V, N
gastroenteritis
223
LLQ pain, diarrhoea, fever
diverticulitis
224
constipation Hx, incontinence, diarrhoea
overflow
225
diarrhoea > common with BS ABx
ABx diarrhoea
226
abdo pain, bloating, change in bowel habits, lethargy, N, backache, bladder symptoms, diarrhoea
IBS
227
bloody diarrhoea, crampy abdo pain, weight loss, faecal urgency, tenesmus
UC
228
crampy abdo pain, diarrhoea, malabsorption, mouth ulcers, perianal DZ, intestinal obstruciton
Crohn's
229
diarrhoea, PR bleeding, anaemia, weight loss, anorexia
CRC
230
failure to thrive, diarrhoea, abdo distension, lethargy, anaemia, weight loss
coeliac's DZ
231
modified Ziehl-Neelsen
cryptosporidium
232
travellers diarrhoea, watery stools, abdo cramps, N causative agent
E. coli
233
prolonged, non-bloody diarrhoea causative agent
giardiasis
234
profuse, watery diarrhoea, severe dehydration causative agent
cholera
235
bloody diarrhoea, V, abdo pain causative agent
Shigella
236
severe V, short incubation, diarrhoea causative agent
Staph aureus
237
flu-like prodrome, crampy abdo pain, fever, ?bloody diarrhoea, GBS = complication causative agent
Campylobacter
238
V w/i 6hrs (rice), or D after 6hrs causative agent
Bacillus cereus
239
gradual onset, bloody diarrhoea, abdo pain, tenderness, weeks causative agent
Amoebiasis
240
bilious V in neonates DD
duodenal atresia, malrotation with volvulus, jejunal/ileal atresia, mec ileus, NEC
241
duodenal atresia features
bilious V, hours post natal, AXR double bubble
242
malrotation with vulvulus features
bilious V, 3-7/7 post natal, peritoneal signs, HD instability
243
jejunal/ileal atresia features
bilious V, w/i 24h, AXR = air-fluid levels
244
mec ileus features
abdo distension, bilious V, 24-48hrs post natal, AXR = air-fluid level, ?cf (seat test)
245
NEC features
2/52 post natal, bilious V, prematurity, intercurrent illness, AXR = dialted bowel loops, pneumatosis, portal venous air
246
cyclical V S presentation
severe N, sudden V, hrs - days, sweating prodrome, weight loss, LOA, abdo pain, diarrhoea, dizziness, photophobia, headache, well between episodes
247
bilious V, hours post natal, AXR double bubble
duodenal atresia
248
bilious V, 3-7/7 post natal, peritoneal signs, HD instability
mal rotation + volvulus
249
bilious V, w/i 24h, AXR = air-fluid levels
jejunal/ileal atresia
250
abdo distension, bilious V, 24-48hrs post natal, AXR = air-fluid level, ?cf (seat test)
mec ileus
251
2/52 post natal, bilious V, prematurity, intercurrent illness, AXR = dialted bowel loops, pneumatosis, portal venous air
NEC
252
severe N, sudden V, hrs - days, sweating prodrome, weight loss, LOA, abdo pain, diarrhoea, dizziness, photophobia, headache, well between episodes
cyclical V S
253
pyloric stenosis features
non-bilious V, projectile
254
severity index used to score UC flares
Truelove and Witt's
255
Truelove and Witt's criteria
severe = blood in stools, >6 stools/d plus 1 of: T'c > 37.8, HR > 90 bpm, anaemia Hb < 105, ESR > 30
256
hyperemesis gravidarum criteria
5% pre-pregnancy weight, dehydration, electrolyte imbalance
257
non-bilious V, projectile
pyloric stenosis
258
Truelove and Witt's used to score
severity of UC
259
UTI management in non-pregnant women
nitrofurantoin/trimethoprim for 3/7
260
management of pregnant women UTI
culture, ABx 7/7, culure afterwards to confirm cleared
261
UTI presentaiton in children
poor feeding, V, irritability, abdo pain, fever, dysuria, f, haematuria
262
UTI management in children
<3/12 paeds referral
| >3/12 PO ABx 3/7: trimethoprim, nitrofurantoin, cephalosporin, amoxacillin
263
risk factors for urinary incontinence
age, previous pregnancy, childbirth, high BMI, hysterectomy, FH
264
types of urinary incontinence
urge = OAB, detrusor overactivity
stress = weak pelvic floor, triggers = coughing, laughing
mixed
overflow = due to BOO
265
urge incontinence management
bladder retraining, antimuscarinics (oxybutynin)
266
stress incontinence management
pelvic floor exercises, Sx
267
LUTS symptoms classification
voiding: hesitancy, poor/intermittant stream, strainig, incomplete emptying, terminal dribbling
storing: urgency, f, nocturia, incontinence
post-micturition: dribbling, sensation of incomplete emptying
268
LUTS Mx voiding symptoms
pelvic floor exercises, bladder training, fluid intake control, a-blocker, 5a-reductase i
269
LUTS Mx OAB symptoms
fluid intake control, bladder retraining, antimuscarininc (oxybutynin)
270
LUTS Mx nocturia symptoms
fluid intake control, furosemide PM, desmopressin
271
nitrofurantoin/trimethoprim for 3/7
uncomplicated UTI
272
culture, ABx 7/7, culure afterwards to confirm cleared
UTI in pregnancy
273
poor feeding, V, irritability, abdo pain, fever, dysuria, f, haematuria
UTI presentation in children
274
urethral injury types
bulbar + membraneous rupture
275
bulbar urethral rupture features
more common, straddle injury, triad = urinary retention, perianal haematoma, blood at meatus
276
membraneous urethral rupture features
extra vs intraperitoneal, pelvic #, penile/perineal oedema/haematoma, PR = prostate displaced upwards
277
bladder injury features
intra ve extraperitoneal, haematuria, suprapubic pain, Hx of pelvic #, inability to void
278
caues of transient/spurious microscopic haematuria
UTI, menstruation, vigorous exercise, sex
279
caues of persistent microscopic haematuria
ca (bladder, renal, prostate), stones, BPH, prostatitis, urethritis (Chlamydia), renal (IgA nephropathy, thin BM DZ)
280
spurious causes of haematuria
beetroot, rhubarb, rifampicin, doxorubicin
281
2/52 week wait pathway for haematuria
>45 + unexplained macroscopic haematuria
>45 + macroscopic haematuria that persists/recurs after UTI Rx
>60 + unexplained microscopic haematuria + dysuria/raised WCCcharcot
282
more common, straddle injury, triad = urinary retention, perianal haematoma, blood at meatus
bulbar urethral rupture
283
extra vs intraperitoneal, pelvic #, penile/perineal oedema/haematoma, PR = prostate displaced upwards
mmbraneous urethral rupture
284
intra ve extraperitoneal, haematuria, suprapubic pain, Hx of pelvic #, inability to void
bladder injury
285
Charcot joint features
swollen, red, warm, DM Hx
286
features of aplastic anaemia
normocytic anaemia, lymphopaenia (lymphocytes relatively spared), thrombocytopaenia, hypoplastic BM
287
medications that can cause an aplastic anaemia
phenytoin,cytotoxic agents, chloramphenicol, sulphonamides, gold
288
causes of aplastic anaemia
isiopathic, congenital (Fanconi, dyskeratosis congenita), drugs, toxins (benzene), infections (parvovirus, hepatitis), radiation
289
coeliac blood test
anti-TTG
290
anti-TTG is test for
coeliac DZ
