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Chings Notes > HIGH yield > Flashcards

HIGH yield Flashcards

1
Q

Tx for Ankylosing Spondylitis

A

NSAIDs- 1st line
INFLAXIMAB, ETANERCEPT, ADALIMUMAB - 2nd line

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2
Q

Best initial inv for Ankylosing Spondylitis

A

Xray

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3
Q

Accurate inv for Ankylosing Spondylitis

A

MRI

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4
Q

Latest New York criteria for dx Ankylosing Spondylitis

A

Xray of Sacroilitis
Limited chest expansion - Normal chest expansion is more than 5 cm
History of inflammatory back pain
Decreased motion of Lumbar spine in both sagittal and frontal planes

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5
Q

6As of AS

A

Arthritis
Aortitis
Anterior Uveitis
Atypical Lung Fibrosis
Achilles Tenditis
Age group (Young)

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6
Q

Lung ABSCESS - INITIAL Cxr fluid level within the cavity
2wks antibiotic tx - no resolution
What’s next

A

Refer to Surgeon
- Lobectomy ( surgery is needed due to the abscess that drains poorly can cause toxic symptoms and persistent fever)

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7
Q

Rusty sputum
Multiple brownish red spot in the foot
Weight Loss

A

TB

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8
Q

In leg, ERYTHEMA NODUSUM

A

Dx Sarcoidosis

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9
Q

In leg, Erythema NODuSUM + RUSTY SPUTUM

A

Dx TB

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10
Q

Foul Smelling SPUTUM - key
thick- walled cavitary lesion

A

Lung Abscess

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11
Q

Mobitz type 2 ECG with slow HR
Ultimate treatment?
Initial Treatment

A

Pacemaker - Ultimate tx
Atropine - next or Initial TX

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12
Q

Sinus bradycardia
tx?

A

Atropine to increase the heart rate
Pacemaker - definitive treatment

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13
Q

Cause of Sinus bradycardia

A

Beta blocker or Calcium blocker excess

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14
Q

<60 bpm
lightheadness and Syncope

A

Sinus bradycardia

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15
Q

PR interval >200 msec
associated with Increased vagal tone and with B-blocker or CCB use

A

First Degree AV block

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16
Q

Drug Effects ( digoxin , B blockers , CCBs)
PR interval is increase until dropped beat ccurs

A

Second Degree AV block (Mobitz I Wenkebach)
tx: Stop the offending drug

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17
Q

Unexpected dropped beat
without a change in PR interval
Results from fibrotic disease of the conduction system from a previous septal myocardial infarct
occasionally syncope

A

Second degree AV block ( Mobitz II)
tx Pacemaker placement

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18
Q

No electrical communication between the atria and the ventricles
sycope, dizziness, acute heart failure, hypotension, cannon A waves

A

Third degrew AV block (complete)
tx: Pacemaker placement

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19
Q

7 days after prostatectomy with fever and chills
cause?

A

Wound infection

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20
Q

What to do next when CORONA virus examination is negative
and the patient has cough sometimes dry or sometimes with spit
the sputum

A

CXR

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21
Q

Man with free male partner, initial screening including HIV is negative
What to do next

A

Repeat HIV screening 3 months later

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22
Q

Menopausal woman - postcoital bleeding
inv?

A

Endometria Biopsy
Dx; Cervical carcinoma

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23
Q

Menopausal woman - sexually active
greeny brownish discharge

A

Chlamydia

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24
Q

Routine screening for Ovarian Cancer

A

CA-125 or TVS

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25
Q

What are the risk factors for Ovarian Cancer

A

Lower risk - have used the OCPS and carried a pregnancy to term
Higher risk - Presence of breast cancer susceptibility to gene 1 (BRCA1) or BRCA2

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26
Q

Mgt of Sickle Cells

A

Analgesics

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27
Q

Pain after walking some distance lower limb impulse after palpable (probably not ischaemic - coz it is usually palpable if it is ischaemic)
bext inv

A

If MRI not given - then DOPPLER first
MRI

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28
Q

Treatment of DVT

A

Heparin eg ENOXAPARIN

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29
Q

Positive Homan’s sign
Calf pain on foot dorsiflexion

A

DVT

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30
Q

NO ct
Warfarin taken
Amoxicillin taken
Massive bleeding

A

Rectus Sheath Hematoma

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31
Q

Pt on warfarin
INR 5
Rectus Sheath Haematoma
What is the initial step?

A

Vitamin K - IV

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32
Q

Man with chronic constipation
What will you lead to dx?

A

Colonoscopy

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33
Q

Child with mass on his umbilicus
No tender3

A

Hernia

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34
Q

Narrow QRS complex
HR: 150

A

SVT
mgt: Vagal maneuver or carotid sinus massage
child mgt: immersion his face on the cold water
DOC: IV Verapamil or Adenosine - if there is asthma - you cannot give ADENOSINE, prefer VERAPAMIL
If unstable case - Mgt will be DC shock or cardioversion - vital stats such as BP very low

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35
Q

SOB, 35M, cannot stop his hear from pounding
No other medical problems
Afebrile
HR 214 / min
Dx?

A

Paroxysmal Supraventicular TAchycardia

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36
Q

palpitation + thyroid problem
Ecg shows

A

Dx: AF
tx: Metoprolol

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37
Q

Bilateral hilar lymph nodes - this shows that CXR is done
high ca level

A

Check ACE level
dx: Sarcoidosis

Other inv:
Xray - Initial
ACEI - next
CT - next
Biopsy - to confirm

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38
Q

Heavy smoker, cough and blood streal ,
night sweats, weight loss, CXR was given that upper RIght lobe

A

Carcinoma
_ if no fever

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39
Q

A man with CKD poor GFR, sydpnea + tachycardia + chest pain
Xray - showed wedge shaped opacity
INv?

A

Dx: Pulmonary Embolism
Inv: V/Q Scan

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40
Q

CHF and MI patient die
Primary cause of dead?

A

Cardiac Arrest

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41
Q

pt with hypoglycemia and driving
when can drive again?

A

ONly drive back 6 wks later

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42
Q

Driving Restrictions
cannot go back within 2 wks

A

AMI
Insertion of Defib
DVT

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43
Q

Driving Restrictions
cannot go back within 4 wks

A

AAA
CABG

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44
Q

Driving Restrictions
cannot go back within 2 days if complication free

A

Angioplasty

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45
Q

Driving Restrictions
cannot go back within 6 wks

A

PE

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46
Q

Driving Restrictions
cannot go back within 2 yrs

A

Chronic Epilepsy

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47
Q

Driving Restrictions
cannot go back within 3-6 months

A

Isolated Seizure
Recently diagnosed Epilepsy
Recurrent seizure

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48
Q

Driving Restrictions
cannot go back within 1 yr

A

Seizure causing accident

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49
Q

Driving Restrictions
cannot go back not less than 6-12 months

A

Visual acuity

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50
Q

Huntingtons screening

A

Bring her back when she turns 16

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51
Q

Huntington treatment with depression

A

Paroxetine

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52
Q

Prostate ca
underwent prostatectomy
PSA double rising too quick

A

Abd CT

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53
Q

if patient is less than 50
grandmother has ovarian Ca
what to do?

A

Nothing

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54
Q

60M, history of cirrhosis
DIstended abdomen

A

Dx: Hepatic Encephalopathy
inv: ammonia

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55
Q

Ascitic fluid - polymorphs present

A

Ceftriaxone

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56
Q

Severe UTI
chills, high fever and pain
GFR is low (20ml/min)

A

Trimethoprim - used in adjusted dose in Renal impairment
in GFR up to 15

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57
Q

Jelly fish sting , and has resp distress
What to do next?

A

Because there is resp distress
- then give O2

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58
Q

Used in the ED rescucitation room to assess the chest and abdomen of acutely injured patients
esp those with shock

esp GUNSHOT Wounds with abdominal distenntion with low BP even with GCS is good

A

FAST scan
- can be done in 2 - 3 min
- non invasive
- - disav: does not defined the injured organ., only the presence of bloos or fluid in the abdomen or pericardium

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59
Q

OCP used for 10 years
BMI > 30
Whats the increase risk of what cancer

A

Breast Ca

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60
Q
A
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61
Q
A
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62
Q
A
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63
Q
A
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64
Q
A
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65
Q

Small smooth lump in the vaginal opening
Painful but not discharge
no itchiness
Mgt?

A

Marsupialization

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66
Q

It involves the opening of the Bartholin cyst or abscess and then suturing the edges forming
a permanent open poket or pouch and allowing continued drainage
Performed under General or Local Anestheia
Typically reserved for recurrent cysts or abscesses

A

Marsupialization

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67
Q

INR < 5

A

Lower warfarin dose

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68
Q

INR > 5-9

A

Administer 1-2.5 mg oral Vitamin K

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69
Q

INR > 9

A

5=10 mg Vitamin K
and hold Warfarin

70
Q

INR > 2o

A

Hold Warfarin
and administer Vitamin K 10mg

71
Q

It is more sensitive for early Covid - 19 diagnosis than CXR

72
Q

Head Injury has low sodium low potassium
What is the cause?

73
Q

Excessive water retention
hyponatremia with continued Urinary Excretion
Urine Osmolarity > serum osmolarity

74
Q

What is the treatment for SIADH

A

Fluid restriction
IV saline
Conivaptan, Tolvaptan and Demeclocyline

75
Q

What is the treatment for DI

A

Desmopressin
given twice intranasally

76
Q

What are the causes of SIADH

A

Cancer (lung, lymphomas, kidney, pancreas)
drugs (Carbamazepine and Antipsychotic agents)

77
Q

Polyuria
Nocturia
Compensatory polydipsia
passage of 33-20 L of dilute urine per day

A

Diabetes Insipidus

78
Q

What is the best initial test for Sarcoidosis

A

Chest Xray

79
Q

What is the most accurate test for Sarcoidosis

A

Lymph Node biopsy

80
Q

Drug of choice for Sarcoidosis

A

Prednisone

81
Q

Had scarred history of appendectomy 10 yrs ago - key

82
Q

Acute limb ischemia, what will you do?

A

Embolectomy

83
Q

Sickle cells, anemia crisis
What will you give to him?

A

Analgesics

84
Q

Traumatic Vulvar hematoma
Fall from the bath tub
inv?

A

CT of pelvis

85
Q

Pedia with jelly fish sting
Screaming in pain
tentacles across both legs
before remooving the tentacles

86
Q

Menopausal symptoms with personal hx of BRCA , HER-2 is negative
What to give

A

Estrogen only

87
Q

30M, presents with Right Scrotal swelling, Spermatic cord palpated
Firm Mass upper pole of Right Testis
Inv?

88
Q

What are the painful scrotal mass

A

Testicular torsion
Epididymitis
Inguinal hernia
testicular tumor
trauma

89
Q

Painless scrotal mass

A

Testicular tumor
Hydrocele
Inguinal hernia
Spermatocele
Varicocele
Paratesticular tumors

90
Q

63F, driblling, urinary frequency x 12 mons, PE with mild rectocele,
cystocele, moderate uterine Prolapse
Next step?

91
Q

Pic of gynecomastia in Adolescence 19 yo
football player asthmatic on salbutamol and fluticasone
What is the cause of Presentation?

A

Steroids = GYNECOMASTIA SE

Gynecomastia in
15 yo = Physiologica
17 years = Idiopathic
21 + athlete = STEROIDS

92
Q

Abdominal CT dx history of ntermittent abdominal pain which resolves spontaneously
No other remarkable findings?

A

Hemangioma - correct

93
Q

Weight loss
Cough x 2 wks
Night sweats
Bilateral CLAD
dx?

94
Q

best nonpharmacologic treatment for someone who couldnt sleep at night or has less sleep

A

Stress Management

95
Q

Volvulus + abdominal Pain + Constipation

A

Sigmoid volvulus

96
Q

Football sign
premature, bloody stool, pneumatosis intestinalis + feed intolerance

A

Necrotizing enterocolitis

97
Q

Epigastric hernia sign
best way to evaluate

A

Cough impulse - Standing position

98
Q

Type of study
best possible evidence
Efficacy

99
Q

Type of study
Time involvement -
prevalence, Risk FActors, study between, adverse effects

A

CROSS Sectional

100
Q

Type of study
Incidence
two group exposure

101
Q

The type of fracture typically occurs after falling down
on an outstrecthed arm and laning on the back side of the wrist

A

Smith Fracture

102
Q

Scaphoid Fracture:
in a highly suspected normal Xray of wrist

A

Scaphoid plaster for 10 days

103
Q

Sphaoid Fracture for undisplaced and stable fractures

A

6-8 wks in a below - elbow scaphoid cast

104
Q

Scaphoid Fractures
Displaced fractures - required reduction either open or closed
If unstable?

A

Internal Fixation

105
Q

Variable CTF, 39 wks
no fetal movement
nxt?

A

Amniotomy - if fetus is dead then extablished labor

106
Q

Abnormal CTG sinusoidal pattern, prolonged bradycardia

107
Q

Normal and Variable CTG

A

Reassurance

108
Q

In dead fetus
try CTG and to confirm the findings

A

Try NVD if possible

109
Q

If no detal movements is felt 24 hrs after a normal CTG
nxt?

A

Induction of labor esp if near term and cervix is favourable

110
Q

Fetal hypoxia, fetal distress
mgt?

111
Q

Uterus bleeding, tender uterus
No fetal heart sound

A

Amniotomy - because it is a dead fetus

112
Q

weakness of the left arm
Key - axillary lymph nodes are enlarged but not tender
pet cat is unwell
dx?

A

Cellulitis

113
Q

ECG shortening of QT intervals
tx?

A

Hydration
biphosphonates
in Refactory situation - Calcitonin
In Volume overload - Loop Diuretics
In comlplex - Streoids

114
Q

What will help in the diagnosis of bell’s palsy

A

Cannot raise eyebrow in the Left side

115
Q

What lobe is responsible for personality and behavioral changes

A

Frontal Lobe

116
Q

Anterior Drawer Positive

A

ACL RUPTURE - with a Popping sound

117
Q

5cm mass in the kidney
What will you do?

A

Nephrectomy

118
Q

> 7cm paracentral, central
stage 4 disease
Ipsilateral Adrenal Gland

119
Q

If solitary kidney along with above condition

A

Nephron Sparing

120
Q

Stone in the kidney 0.5 cm
Mgt?

A

Observation

121
Q

Ischemic leg warning sign

122
Q

Indication of Urgent Embolectomy

123
Q

Chlamydia, urethral dischrge, dysuria, frequeny
inv?

A

Urine Culture

124
Q

Breast lump
her2 n poitive
more than 2 places,
Bony metastasis

A

Radiotherapy

125
Q

low Na
Low BP
High K

126
Q

normal Ca, raised ALP

A

Paget disease

127
Q

hyperthyroidism
anti TSH

A

grave Disease

128
Q

Secondary gain

A

Malingering

129
Q

Splitting phenomenon

A

Borderline Personality

130
Q

Depressed , low mood > 2 years

131
Q

SIGECAP 2 wks

132
Q

Alcoholic, agitated

A

IV Diazepam

133
Q

Eye dischage

A

Day 1 - Chemical Conjunctivitis
1st week - Gonorrjea
>7-21 - Chlamydia
> 21 - HSV

134
Q

3rd day discharge from eye baby

A

Diplococci…. Gonorrhea

135
Q

Hoarseness, reflux, infection resolved

A

Pancoast Tumor

136
Q

term

A

Transient Tachypnea of the Newborn

137
Q

RDS or Hyaline Membrane

138
Q

Post term

A

Meconium aspiration

139
Q

Subclavian tube insertion
BP drops
Tracheal deviation
DX

A

tension Pneumothorax
mgt: Needle throacentesis

140
Q

After hip surgery how will you give the Warfarin

A

Ideally it should be 12 -24hrs

141
Q

Patient done with hip surgery, post op 38 days heparin taking

A

Stop drug as it is > 35 days now
if mobilised - stop drug immediately
If no mention of physio - check blood - APTT

142
Q

CCB + metformin

A

Hypoglycemia

143
Q

SSRI + SIADH

A

Hyponatremia

144
Q

SSRI + CCB

A

Hypotension with Tachycardia

145
Q

Fever , elevated enzymes
Vital unstable, encephalopathy , rigidity of muscles
tx?

A

Dantrolene

146
Q

Dripping poor urine stream on exam bilateral enlarged prostate
inv?

147
Q

Pneumonia
with fever and agitatio = Moderate Pneumonia

A

tx
Benzylpenicillin only if vomiting otherwise Amoxicillin
Mild = Amox
mod = Oral Amo = Iv B pen if oral is issue
Severe = Ceftriaxone and Flucloxacillin - Erythromycin/ Vancomycin

148
Q

Tx for Bronchiectasis with superimposed Lobar pneumonia

A

IV Ticarcillin

149
Q

man dizziness , hearing good, nystagmus

150
Q

Accident, chest injury , morphine, conscious

A

Intubate and ventilate

151
Q

1st stage of labour < 2 cm Os dilatation and -1 station

A

reassurance

152
Q

Uterine rupture can’t appreciate FHR

153
Q

Psych patient treated with Olanzapine

A

Aripiprazole

154
Q

Nursing home patient. thinking nurse is putting worms in food
Dx

A

Brief Pyschotic Disorder

155
Q

Man in ED with drug overdose, he was in the Garden
Wake upwith agitation
hx of divorce
wants to die

A

Involuntary admission

156
Q

Suicidal patient

A

needs to be seen alone by the GP

157
Q

TOnic clonic seizure in hospital with 02 Mask
next?

A

Lateral Position

158
Q

3cm breast mass with ER +ve
no LV enlargement
Next?

159
Q

Tonic clonic seizure at hospital, recurrent on going seizure O2 and mask given

A

IV diazepam

160
Q

Breast Cancer all receptors present - 3 cm mass, estrogen receptor positive
initial mgt

161
Q

Vertigo 3 days, no tinnitus
Nystagmus positive nausea
Noviral condition

162
Q

rubbery LN

163
Q

You are a Register, anesthetist always sleepiing

A

Notify the head of the surgery

164
Q

Old female, epigastric pain, no lipase
no abnormality in US

A

Esophagitis

165
Q

Female, INR, wrfarin overdose
No bleeding, no bruising
mgt

A

Cease Warfarin and Observation

166
Q

Low Na+ pnly
all other normal
Urine osmolarity also normal
Dx?

A

Delusional Hyponatremia

167
Q

Protei +1
Male middle age
next?

A

Early morning urine sample

168
Q

Stiffness of the hand
GFR not good
cause?

A

Methotrexate - used in RA

169
Q

Female , ANA +, Antirho +
la +
What will you give

A

Oral Prenisolone followed by monoclonal antibodies

170
Q

Dry eye

171
Q

3 kids, fishclip, 5 days flooding
fresh bleeding
tx?

A

Mirena / IUD

Chings Notes (39 decks)

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