High-yield Flashcards
What is the common cause of nephrotic syndrome in children/young adults?
Minimal change glomerulonephritis
What are the common presentations of primary hyperaldosteronism?
Hypertension, hypernatraemia, hypokalemia
What does NICE recommend for vascular dementia?
Tight control of vascular risk factors
What are the absolute contraindications for combined oral contraceptive pills (COCP)?
More than 35 years old, smoking more than 15 cigarettes/day
When should aciclovir be started in suspected encephalitis cases?
In all cases of suspected encephalitis
What is the management for herpes zoster ophthalmicus?
Urgent ophthalmological review, 7-10 days of oral antivirals
What can sepsis cause in terms of acid-base balance?
Profound lactic acidosis
What should be assessed prior to induction of labor?
The Bishop Score
How is mastoiditis typically diagnosed?
Clinically
What is the preferred way to support nutrition in patients with motor neuron disease?
Percutaneous gastrostomy tube (PEG)
What are the increased risks associated with the combined oral contraceptive pill?
Breast cancer, cervical cancer
What is the first-line treatment for eclampsia?
Magnesium sulphate
Should compression stockings be routinely offered to all patients with deep vein thrombosis?
No
What is transient synovitis often associated with?
A mild fever
What is a risk factor for ectopic pregnancy?
Endometriosis
What are the classic symptoms of scarlet fever?
Sore throat, fever, headache, bright red tongue, coarse red rash
What is the first step to consider if a patient has a urine output of < 0.5ml/kg/hr postoperatively?
Fluid challenge, if no contraindications
Why are inhaled corticosteroids used in COPD?
To reduce exacerbations
What virus accounts for the majority of cases of croup?
Parainfluenza virus
What must be done if a person’s death occurs while under the mental health act?
Reported to the coroner
What is the first line of treatment for blepharitis?
Hot compresses
What is the recommended duration of DOAC treatment for cancer patients with VTE?
6 months
What should be screened for with an echocardiogram in Kawasaki disease?
Coronary artery aneurysms
What is caput succedaneum?
A puffy swelling over the presenting part that crosses suture lines
What may a chest x-ray show in transient tachypnoea of the newborn?
Hyperinflation, fluid in the horizontal fissure
When should breech babies at or after 36 weeks gestation have USS for DDH screening?
At 6 weeks regardless of mode of delivery
What can circumstantiality be a sign of?
Anxiety disorders, hypomania
What is the only option for hyperacute transplant rejection?
Removal of the graft
What is the first-line treatment for nocturnal enuresis if general advice has not helped?
Enuresis alarm
Where is an inguinal hernia located in relation to the pubic tubercle?
Superior and medial
What should be offered if HbA1c has risen to 58 mmol/mol in a patient with T2DM on metformin?
DPP-4 inhibitor, pioglitazone, sulfonylurea, SGLT-2 inhibitor
What is the first step when there is chickenpox exposure in pregnancy?
Check antibodies
What is the acute treatment for migraine?
Triptan + NSAID or triptan + paracetamol
What is the prophylactic treatment for migraine?
Topiramate or propranolol
What condition is Mycoplasma associated with?
Erythema multiforme
What are the metabolic abnormalities in tumor lysis syndrome?
High potassium, high phosphate, low calcium
What is the cause of sudden painless loss of vision characterized by a dense shadow starting peripherally?
Retinal detachment
What should patients with ascites secondary to liver cirrhosis be given?
An aldosterone antagonist
What are the symptoms of acute haemolytic reaction during a blood transfusion?
Fever, abdominal pain, hypotension
What are the symptoms of Roseola infantum?
Fever followed later by rash
What condition is made worse when arms are outstretched?
Essential tremor
What should you think of when CT head shows temporal lobe changes?
Herpes simplex encephalitis
What is a common side effect of atypical antipsychotics?
Weight gain
What is the first-line antibiotic for tonsillitis?
Phenoxymethylpenicillin
What movement is impaired in adhesive capsulitis?
External rotation
What is a missed miscarriage?
Gestational sac containing a dead fetus before 20 weeks without symptoms of expulsion
When should persistent oral ulceration of more than 3 weeks be referred to oral surgery?
Under the two-week wait
What heart condition is Turner’s syndrome associated with?
Ejection systolic murmur due to bicuspid aortic valve
What symptom may duct papilloma present with?
Blood-stained discharge
What is the initial management for duct-dependent congenital heart disease?
Maintenance of the ductus arteriosus with prostaglandins
What is the next step in treating haemodynamically stable SVT patients unresponsive to vagal manoeuvres?
Treating with adenosine
In suspected digoxin toxicity, when is the digoxin level monitored?
Routinely not monitored, except in suspected toxicity
What can precipitate lithium toxicity?
NSAIDs
What is the likely condition when a patient experiences episodic, intense, unilateral eye pain?
Cluster headache
What does ptosis and a dilated pupil indicate?
Third nerve palsy
What does ptosis and a constricted pupil indicate?
Horner’s syndrome
What is the initial investigation for palpitations?
Holter monitor
What is an important adverse effect of aminoglycosides?
Ototoxicity
What should be the insulin management in the acute management of DKA?
Fixed rate insulin while continuing regular long-acting insulin
According to NICE 2017, what should be added first in asthma patients not controlled with SABA + ICS?
LTRA (Leukotriene receptor antagonist)
What is the recommended immediate treatment for croup?
Single dose of oral dexamethasone (0.15 mg/kg)
For vestibular neuronitis, when should prochlorperazine be stopped?
After a few days
What are the indicative symptoms of Kawasaki disease?
High fever lasting >5 days, red palms with desquamation, strawberry tongue
What is the most common cause of discitis?
Staphylococcus aureus
What causes acute epiglottitis?
Haemophilus influenzae type B
What usually causes mucoid white vaginal discharge in newborn girls?
Normal hormonal changes
When should a referral to secondary care be considered for a family history of breast and ovarian cancer?
When there is a family history of breast and ovarian cancer
What can be used to reduce pyrexia in cases of non-haemolytic febrile transfusion reaction?
Paracetamol
What medications are used to promote duct closure in patent ductus arteriosus?
Indomethacin or ibuprofen
What are the common features of rosacea?
Nose, cheeks, forehead; flushing, erythema, telangiectasia; papules and pustules
What should be tried if analgesia doesn’t help with endometriosis?
Combined oral contraceptive pill or a progestogen
What do the risk factors for ovarian cancer relate to?
Increased number of ovulations
What can amoxicillin lead to in the presence of URTI symptoms?
Rash or glandular fever
What should a person with Addisons’ who vomits do?
Take IM hydrocortisone until vomiting stops
What is given for stabilization of the cardiac membrane in the presence of hyperkalaemia?
IV calcium gluconate
What can be given to slow the deterioration of visual loss in dry AMD?
High dose of beta-carotene, vitamins C and E, zinc
What is the investigation of choice for reflux nephropathy?
Micturating cystography
What does the ABG triad for chronic CO2 retention consist of?
Respiratory acidosis, hypoxemia, normal or increased pH
What are the characteristics of a strong suspicion of PE?
Normal pH, High pCO2, High HCO3
What symptoms are associated with acute viral labyrinthitis?
Sudden onset horizontal nystagmus, hearing disturbances, nausea, vomiting, vertigo
What potential side effect may be caused by sulphonylureas?
Cholestasis
Why is whole breast radiotherapy recommended after a wide-local excision?
To reduce the risk of recurrence by around two-thirds
How are most intracranial aneurysms treated following a subarachnoid haemorrhage?
With a coil by an interventional neuroradiologist
What deficits does Alzheimer’s Dementia produce on the Addenbrookes Cognitive Exam?
Global deficits
What may arise in a lung cavity developed secondary to previous tuberculosis?
An aspergilloma
What treatment is first-line for trigeminal neuralgia?
Carbamazepine
What is the first-line treatment for hypertension in diabetics?
ACE inhibitors/A2RBs
What is a common cause of speech and language delay in young children?
Glue ear
What is the classic presentation of episcleritis?
A red eye that is not painful
How does a meibomian cyst present?
As a firm painless lump in the eyelid
What are the symptoms of anterior uveitis?
Acute pain, red eye, photophobia, small pupil, reduced visual acuity
Why is prescribing anaesthetic eye drops not advisable for patients with corneal ulcer?
It may cause more harm and delay healing of the ulcer
What is the recommended action for acute sensorineural hearing loss?
Urgent referral to ENT for audiology assessment and brain MRI
How can ovulation be confirmed?
Take the serum progesterone level 7 days prior to the expected next period
What potential side effect may aromatase inhibitors cause?
Osteoporosis
What is the empirical antibiotic of choice for neutropenic sepsis?
Piperacillin with tazobactam (Tazocin)
What potential side effect may macrolides cause?
Prolongation of the QT interval
At what age does atopic eczema typically present in children?
Before the age of 2 years
What is the typical duration for Finasteride treatment of BPH before results are seen?
6 months
What is the risk associated with unopposed oestrogen in HRT?
Increased risk of endometrial cancer
What adverse effect may result from the concurrent use of methotrexate and trimethoprim containing antibiotics?
Bone marrow suppression and severe or fatal pancytopenia
What is the high-risk association of Clindamycin treatment?
C. difficile infection
What condition should be considered if a newborn lacks red reflex?
Retinoblastoma
What should be done if 2 pills are missed in week 3 of COCP?
Finish the pills in the current pack and start a new pack immediately
By what age should children be able to combine two words?
2 years
When must Levonorgestrel be taken?
Within 72 hours of UPSI
What are the characteristics of Scleritis?
Classically painful, may be associated with reduced visual acuity and blurred vision
Is Trimethoprim considered safe to use during breastfeeding?
Yes
What is a red flag symptom related to polyps?
Unilateral polyps
How long are ‘unprovoked’ pulmonary embolisms typically treated for?
6 months
What medication may be used to treat bile-acid malabsorption?
Cholestyramine
Is Campylobacter infection often self-limiting?
Yes
What may be indicated if Campylobacter infection is severe?
Treatment with clarithromycin
What is the most common feature of carbon monoxide poisoning?
Headache
What is the recommended age for achieving sitting without support?
7-8 months, refer if not achieved by 12 months
What is the best first line management for NAFLD?
Weight loss
What is an important complication of femoral hernias?
Strangulation
What are the red flags for endophthalmitis following intraocular surgery?
Red eye, pain, visual loss
What is the recommended treatment for bacterial conjunctivitis in pregnant women?
Topical fusidic acid
What potential side effect may loop diuretics cause?
Ototoxicity
What action should be taken if a 2-level DVT Wells score is ≥ 2 points?
Arrange a proximal leg vein ultrasound scan within 4 hours
What is the first line radiological investigation for suspected stroke?
Non-contrast CT head scan
How can local anesthetic toxicity be treated?
With IV 20% lipid emulsion
In which patients is azithromycin prophylaxis recommended for COPD?
Patients who meet certain criteria and continue to have exacerbations
What investigation is required for adult patients with a hydrocele to exclude underlying causes?
Ultrasound
What is the antiplatelet choice for managing NSTEMI conservatively?
Not specified
What is the recommended medication combination for a patient with aspirin and high bleeding risk?
Clopidogrel
What is the first-line treatment for polycythaemia vera to maintain normal haemoglobin levels?
Venesection
What is the recommended treatment for acute presentation of atrial fibrillation with signs of haemodynamic instability?
Electrical cardioversion
What condition is indicated by fluctuating confusion/consciousness?
Subdural haematoma
What is the likely diagnosis for thyrotoxicosis with a tender goitre?
Subacute (De Quervain’s) thyroiditis
What is the cause of cubital tunnel syndrome?
Compression of the ulnar nerve
What should be considered in the differential diagnosis for women presenting with a breast lump and a history of trauma?
Fat necrosis
What type of hearing loss does presbycusis present with?
Bilateral high-frequency hearing loss
What may cause painless, monocular loss of vision in Marfan’s syndrome?
Lens dislocation
What requires an immediate CT scan to assess for raised ICP and tentorial herniation?
A unilaterally dilated pupil that responds sluggishly to light
What can erythromycin cause in terms of cardiac function?
Prolonged QT interval
What is a risk factor for developmental dysplasia of the hip?
Breech presentation
What should be added if blood glucose targets are not met with diet/metformin in gestational diabetes?
Insulin
What are the treatment options for latent tuberculosis?
3 months of isoniazid with pyridoxine and rifampicin, or 6 months of isoniazid with pyridoxine
What is refractory anaphylaxis defined as?
Respiratory and/or cardiovascular problems persisting despite 2 doses of IM adrenaline
What should be added for COPD patients still breathless despite using SABA/SAMA?
LABA + ICS
What are the symptoms of delirium?
Impairment of conscious level, often involves psychotic symptoms
What is the transfusion threshold for patients with ACS?
80 g/L
What should be considered in Raynaud’s phenomenon with extremity ischaemia?
Buerger’s disease
What are the symptoms of acute angle closure glaucoma?
Ocular pain, decreased visual acuity, worse with mydriasis
What should be added for COPD patients still breathless despite using SABA/SAMA and having asthma/steroid responsive features?
LABA + ICS
What are the symptoms of delirium?
Impairment of conscious level and often involves psychotic symptoms
What are the symptoms of acute angle closure glaucoma?
Ocular pain, decreased visual acuity, worse with mydriasis, haloes around lights
What is the differential for raised paraproteins in the blood?
MGUS
What is cavernosal blood gas analysis useful for?
Investigation for priapism
What is the difference between affect and mood?
Affect is the current, observed emotional state, whereas mood is the more pervasive, predominant state over a longer period
What does the ‘M rule’ stand for in primary biliary cholangitis?
IgM, anti-Mitochondrial antibodies (M2 subtype), Middle aged females
Is antibiotic prophylaxis routinely recommended in the UK for dental and other procedures to prevent infective endocarditis?
No
What is recommended for the acute management of renal colic?
Use of IM diclofenac
What are the characteristics of Broca’s dysphasia?
Speech non-fluent, comprehension normal, repetition impaired
What can rifampicin cause?
Orange tears/urine
What is the first-line treatment for lichen planus?
Potent topical steroids
What is a contraindication to statin therapy?
Pregnancy
Is sickle cell anemia an autosomal recessive condition?
Yes
What can precipitate thrombotic crises in sickle cell?
Infection, dehydration, or deoxygenation
What does tangentiality refer to?
Wandering from a topic without returning to it
Is new LBBB always pathological?
Yes, it is always pathological and never normal
What is a potential consequence of obesity with abnormal LFTs?
Non-alcoholic fatty liver disease
What may Methotrexate cause as a side effect?
Lung fibrosis
What can lead to complete heart block following a myocardial infarction?
Right coronary artery lesion
What is a life-threatening side effect of clozapine?
Agranulocytosis/neutropenia
What should be given to all patients with Bell’s palsy within 72 hours of onset?
Oral prednisolone
How should otitis externa in diabetics be treated to cover Pseudomonas?
With ciprofloxacin
Do pleural plaques undergo malignant change and require follow-up?
No, they are benign and do not undergo malignant change
What does a pizza pie appearance on fundoscopy indicate?
Chorioretinitis
What commonly causes an itchy rash affecting the face and scalp distribution?
Seborrhoeic dermatitis
What should be done if the cervical cancer screening sample is hrHPV positive and cytologically normal?
Repeat smear at 12 months
What should be assessed following ocular trauma to determine the need for immediate decompression?
Orbital compartment syndrome
How long should the symptoms be present to make a diagnosis of chronic fatigue syndrome?
3 months
When should stages 1 & 2 of chronic kidney disease be diagnosed?
If supporting evidence accompanies eGFR
At what age does bow legs in a child under 3 usually resolve?
By the age of 4 years
What may topical corticosteroids cause in patients with darker skin?
Patchy depigmentation
How can the risk of peripheral neuropathy with isoniazid be reduced?
By prescribing pyridoxine
What can cause blurring of vision years after cataract surgery?
Posterior capsule opacification
When is pure tone audiometry typically done in most areas of the UK?
At school entry
What may cause pelvic pain in women around ovulation with no PV bleeding?
Mittelschmerz
What does an ACE inhibitor cause?
Hyperkalaemia
What does allopurinol increase the risk of?
Azathioprine toxicity
What is the association of SSRIs?
Hyponatremia
What should be added for an adult with uncontrolled asthma by SABA?
Low-dose ICS
What is Kocher’s criteria used for in children?
Assessing the probability of septic arthritis
What should be tried if metformin is not tolerated due to GI side-effects?
Modified-release formulation
How should oral bisphosphonates be taken?
With plenty of water while sitting or standing on an empty stomach at least 30 minutes before breakfast (or another oral medication); the patient should stand or sit upright for at least 30 minutes after taking
What is recommended for symptom control in non-CF bronchiectasis?
Inspiratory muscle training + postural drainage
What is the increased risk associated with antipsychotics in the elderly?
Stroke and VTE (Venous Thromboembolism)
What are PDE 5 inhibitors contraindicated by?
Nitrates and nicorandil
What is caput succedaneum?
Scalp edema that crosses suture lines
What is the Barlow manoeuvre used for?
Attempted dislocation of a newborn’s femoral head
What are the characteristics of acute epiglottitis?
Rapid onset fever, stridor, and drooling
What testing is recommended in patients with non-alcoholic fatty liver disease to aid diagnosis of liver fibrosis?
Enhanced liver fibrosis (ELF) testing
What does amaurosis fugax affect?
The retinal/ophthalmic artery
What are typically raised in iron-deficiency anaemia?
Total iron-binding capacity (TIBC) + transferrin levels
What are topical aluminium chloride preparations first-line for?
Hyperhidrosis
What is prominent and severe in Stevens-Johnson syndrome?
Mucosal involvement
