high yield Q's Flashcards
reed sternberg cells
hodgkins lymphoma
smudge cells
CLL
auer rod
AML
rouleux formation
myeloma
lytic bone lesions
myeloma
muddy brown casts
acute tubular necrosis
what is the most common cause of pancreatitis
gallstones
alcohol
how is cancer definitively diagnosed
biopsy
what type of laxative is laxido
osmotic
stimulant
osmotic laxative
when is a FIT test used
when there is suspicion of bowel cancer but pt does not meet 2ww
what is the most common cause of diarrhoea
rotavirus
what organism is responsible for causing diarrhoea with vomiting
nora virus
what medication might you give a pt with diarrhoea
loperamide
give an eg of an abx that can cause c.diff infection
co amoxicillin
ciproflaxacin
what abx is given to treat c.diff
metronidazole
which sided pain does constipation usually cause
left sided pain
what is the diagnosis:
generalised abdominal pain then moves to RIF
appendicitis
what is the 1st line treatment for GORD and how long
PPI e.g. omeprazole for 4 weeks if not better then h.pylori stool sample
what is site should be used in acute poisoning
TOXBASE
what is the most diagnostic test for inflammatory bowel disease
facecal calprotectin
what is used to monitor colon cancer
CA
what’s the diagnosis
40 yr old female, RUQ pain, murphy positive
cholcystitis
what is the most common cause of varies
alcohol
which hernia is most palpable in the scrotum
indirect hernia
which hernia is more common in women
femoral hernia
which hernia has increased risk of strangulation
femoral hernia
what is the name of the hernia that can occur anywhere in the abdominal wall
ventral hernia
what is 1st line treatment for anal fissures
topical steroids and analgesia
what is 2nd line treatment for anal fissures
topical GTN
what side effect must you warn the pt about when using topical GTN for anal fissures
headaches
what’s the diagnosis
2 yr old boy, distended abdo, red jelly stools
intussusception
what’s the diagnosis
child, projectile vominting, olive mass
pyloric stenosis
what is a serious complication of UC
toxic megacolon
which type of bowel obstruction is most common
small bowel obstruction
in what condition should you measure intrinsic factor
pernicious anaemia
when can acylovir be used to treat shingles
with 72 hrs of onset
up to 5 days of onset
what is the function of acyclovir is the management of shingles
reduced risk of post neuropathic neuralgia
what is 1st line and 2nd line treatment for cluster headache
1st line: nasal/IM triptan
2nd line: short burst o2 therapy
list 2 conditions that can cause glove and stocking syndrome
diabetes
gillian barre syndrome
how does glove and socking syndrome differ in gillian barre syndrome to diabetic
in GBS it develops acutely over a few days
what scoring system is used for TIA
ABCD2:
age blood pressure clinical features diabetes duration
what medication i used in the community to manage a tonic status epileptics
buccal midozalam
what test is used to carpal tunnel syndrome
tinnels test
what are 2 initial management for carpal tunnel syndrome
wrist splints
physiotherapy
in GP when should you give benzylpenicillin to manage suspected meningitis
meningitis with a rash
what is the most common underlying cause in this presentation
loss of power + personality changes
space occupying lesion
what is the most common cause of cerebral palsy
birth trauma
what is the cause/carrier of lyme disease
ticks
what causes a foot drop
damage to common perinea nerve
what nerve would be damaged in a fracture of the surgical neck of humerus and what sign would you get
axillary nerve
patch sign
what nerve would be damaged in a spiral fracture of the humerus
Radial nerve
what nerve would be damaged in a fracture of the medial epicondyle of the humerus
ulnar nerve
what type of dementia is associated with Parkinson’s
lewy body dementia
what type of dementia presents with language disorder and personalty changes
front temporal lobe dementia
what signs might suggest vascular dementia (RFx)
HTN
diabetes
signs of arteriopathy
what type of sarcoma is present in those with HIV
karposki sarcoma
what does pappiloedema suggest
inflammation of optic nerve
raised ICP
what is the diagnosis
drooping eye lid, double vision and chest muscle weakness
MG
what is the inheritance pattern for Huntington’s
autosomal dominant
what type of neuropathy can be present in B12 deficiency but can be easily reversed
glove and stocking syndrome
when would you prescribe prednisolone in bells palsy
if presenting within 72 hrs of onset of symptoms
what are the 4 types of dementia
alzihmers
lewy body
vascular
front temporal lobe
what is the cause of korskoff psychosis
acute alcohol withdrawal due to thiamine deficiency
what is the cause of wernikes encephalopathy
chronic thiamine deficiency
list 3 conditions that might initially present with ‘clumsiness’
MND MS parkinson's muscular dystrophy MG
what is the 1st line treatment for Parkinsons
levadopa
what is important to ask in a pt your suspecting id med overuse headache
over the counter meds
e.g. codeine
how long does a typical cluster head last
15mins to 3 hrs
what’s 1st line treatment in a migraine
‘NSAIDs e.g. naproxen
give an example of a med that can be used to manage Trigeminal nerve neuralgia
amytriptylline
what vessels are the cause of a extradualr bleed
middle meningeal artery
what vessels are the cause of a subdural bleed
bridging veins
what is the most common cause of SAH
congenital aneurysms
what type of intcracrainla haemorrhage presents with a lucid interval
extradural bleed
what antipsychotic is tetrogenic
sodium valproate
what can be a differential for stroke
prodrome migraine
what is QRISK used to assess
assessing risk of having a cardiovascular event in the next 10 yrs
what is the treatment for an acute MI <120mins
PCI
what is the treatment for acute MI >120 mins
thrombolysis
what blood test is used if suspecting HF
BNP
what blood marker is used if you are suspecting MI
troponins
serial troponin
what medication used in AF helps to improve mortality
beta blocker
what test should be carried out before staring an AF on medication
baseline kidney function
what is small vessel disease
when small vessels of the heart become damaged
what is the cause of prinzmetal angina
occlusion or coronary artery spams
coronary artery spasm
what medication should a pas with raynauds be started on
calcium channel blocker
what range of ABPI would indicate peripheral vascular disease
<0.7
list 3 RFx for developing PE/DVT
recent travel COCP HT cancer immobilisation trauma obesity ] preganancy
when is it preferred to use apixaban over rivaroxaban
in venous thromboembolism t reduce risk of reoccurrence
which is a VERY common feature of PE
- chest pain
- haemoptyisis
3, cough - tachycarida
tachycardia
what’s the diagnostic investigation for PE
CT pulmonary angiogram
which type of heart block is common in athletes
morbitz type 1
which types of heart block require pacemaker
morbitz type 2
type 3
what is important to warn pt about with adenosine
feel like they are dying
what medication is used to treat SVT
adenosine
what non pharm treatments are there for SVT
vasovagal manoeuvres
carotid sinus massage
what is the dosage for adenosine in SVT
6
12
12
what is present in ECG in pericarditis
saddle shaped ST elevation
where is a pacemaker typically placed
left hand side
under the clavicle
what is a common side effect associated with ACEi use
dry cough
list 2 common side effects associated with CCB use
peripheral oedema
flushing
what is a common side effect associated with statin
myopathy
what difference in BP would suggest aortic dissection
radio radio delay
when would sugary be indicated as treatment for AAA
> 5.5cm
what criteria i used for endocarditis
dukes criteria
how should blood culture be collected for a patient with suspected infective endocarditis
3 separate occasions from 3 different areas
what are the 3 types of pneumathoracies
tensions
spontaneous
traumatic
what is the most common cause of croup
parainfluenza
3 features present in croup
barking cough
fever
stridor
how can you tell resp distress in someone/child
use of accessory muscles intercostal recession tracheal tug cyanosis reduced feeding and wet nappies
what is the treatment for croup
single dose dexamethasone
what is the cause of bronchiectasis
widening of the alveoli
what scaring system is used for pneumonia
CURB65 confusion urea RR BP >65yrs
what is a prolonged complication of viral pneumonia
pleurisy
does pneumonia usually present
unilateral or bilateral
unilateral
what vaccine are important in old pts with underlying lung disease
pneumococcal
influenza
what should you think about investigating if a pt has fungal pneumonia
HIV/immunocomprimised
when should you do a repeats chest X-ray for pt who has pneumonia
after 6 weeks
what is the typical presentation of a pneumothorax
young
tall
male
smoker
what are the 2 findings of pneumothorax
hyperessonance on percussion
reduced/no breath sounds
what is the most common cause for bronchitis
RSV
what is a common complication for lung cancer
pleural effusion
which type of lung cancer is less common
small cell lung cancer
which type of lung cancer is after spreading and not associated with smoking
small cell lung cancer
list 2 types of lung cancer
squamous cell lung cancer
adenocarcinoma
small cell lung cancer
what condition would cause a bilateral pleural effusion
heart failure
what do you test for when looking at the pleural effusion
PH
protein
what type of pleural effusion is more commonly associated with bacterial pneumonia
exudative pleural effusion
what is used to manage COPD with non-asthmatic features
LABA/LAMA
what is the diagnostic test for COPD
spirometry
what are the 3 vaccinations we want COPD its to of had
pneumococcal
influenza
covid
what medications are used to treat exacerbations of COPD
abx
nebulisers
steroids
what scoring system is used for PE/DVT
wells score
what blood test can be carried out if suspecting PE/DVT
d-dimer
what is the treatment for COPD with asthmatic features
LABA/ICS
what is cor pulmonale
right sided HF due to increased pressure in lungs
list 3 features of cor pulmomale
peripheral oedema
raised JVP
hepatomegaly
ascites
what is the treatment for PE
anticoagulation/DOAC
apixaban
list 3 occupations that can cause pulmonary fibrosis
miners
builders
roofers
asbestos exposure
name one drug that can cause pulmonary fibrosis
amiradone
methotrexate
nitrofurantoin
name one condition that can cause pulmonary fibrosis
autoimmune conditions e.g. RA
SLE
systemic sclerosis
alpha 1 antitrypsin deficiency
what type of tumours secrets hormones
carcinoid tumours
list 3 features that a carcinoid tumour might present with
facial flushing
diarrhoea
tachycardia
list 3 causes for the formation of a pulmonary nodule
cancer
calcification
underlying lung disease
what type of lung disease is sarcoidosis
restrictive lung disease
what med can be used to treat pulmonary HTN
sildenafil
what are 2 RFx for developing emphysema
pneumonia
immunocompromised
what does inhalation of asbestosis cause
mesothelioma
what is the APGAR score used for
newborn babies
according to NICE what is the diagnostic test for asthma
FENO
when can serial peak flows be used in asthma
monitor progression
what vaccine is given to prevent epiglottis
haem influenza
diagnosis:
obese, male, day time somnolence, poor concentration, snoring, fatigue
sleep apnoea
what is pertussis
whooping cough
what is the most common feature of pertussis
prolonged coughing making it difficult to breath
what is the treatment for pertussis
clarithromycin/erythromycin
what is the 1st line abx for pneumonia
amoxicillin
what is the abx of choice for COPD exacerbation
doxycycline
what is present on ABG of a pt with an exacerbation of COPD
rest acidosis
what is the treatment for c.diff infection
metronidazole
what is the appropriate immediate intervention for tension pneumothorax
needle aspiration
what blood maker is always raised in cancer
platelets
most common cause of transudative pleural effusion
heart failure
most common cause for exudative pleural effusion
pneumonia/bacterial infection
diagnosis:
male, homeless, 6m cough, night sweats, weight loss, pyrxia
TB
what is the most common cause pulmonary fibrosis
idiopathic
what is the most appropriate investigation for bronchiestasis
CT scan
what non invasive test can be used to test for pulmonary HTN
echocardiogram
what type of imaging can be used to diagnose interstitial lung disease
high resolution CT
how will the CT scan appear in interstitial lung disease
ground glass appearance
what other investigation can be used when the diagnosis of interstitial lung disease is unclear following CT scan
lung biopsy
is interstitial lung disease:
- reversible
- irreversible
- irreversible
how does idiopathic pulmonary fibrosis present
insidious onset
SOB and dry cough
bibasal fine inspiratory crackles
finger clubbing
what are the 2 consequences of working with asbestosis
causes fibrosis of the lung
can cause cancer
what 4 problems can asbestosis inhalation cause
lung fibrosis
pleural thickening and plaques
adenocarcinoma
mesothelioma
what is the most common interstitial lung disease
idiopathic pulmonary fibrosis
what zone of the lung is most affected in cystic fibrosis
- upper zone
- lower zone
upper zone of the lung
what zone of the lung is most commonly affected on idiopathic lung fibrosis
- upper zone
- lower zone
lower zone
what is pneumoconiosis
inertial fibrosis secondary to occupational exposure
give 2 types of pneumoconiosis
coal miners lung
asbestosis
list 2 complications associated with pneumoconiosis
lung cancer
cor pulmonale
what type of pattern is seen in spirometry on a pt with interstitial lung disease
restrictive pattern
give an example of a medication that can be used to treat idiopathic pulmonary fibrosis
pirfenidone
nintedanib
what is the primary cause of mesothelioma
asbestosis exposure
name the condition
presence of non caseating granulomas
sarcoidosis
what organs are predominant affected in sarcoidosis
the lungs
what 3 ways can the lungs react in an exacerbation of asthma
bronchoconstriction
inflammation
excess mucus secretion
what immune cells are responsible for the immune reaction seen in asthma
TH2 cells
what are the 3 main treatments given in an exacerbation of asthma
oxygen
nebulised bronchodilators
corticosteroids
what is the inhertance pattern for cystic fibrosis
autosomal recessive
what test can be used to diagnose cystic fibrosis
sweat test
how many g/L in transudative effusion
<30g/L
how many g/L in exudative effusion
> 30g/L
2 causes of transudative effusion
heart failure
cirrhosis
2 causes of exudative effusions
pneumonia
malignancy
what criteria is used to distinguish between transudative and exudative effusions
lights criteria
what is the most common cause of bronchiolitis
respiratory syntactical virus
what are the 3 management methods for bronchiolitis
nasal suctioning
oxygen if required
fluids
what age does bronchiolitis usually present
<1 yrs old
3-6 months
how can children with respiratory distress present
subcostal/intercostal recession tracheal tug nasal flaring reduced feeding reduced wet nappies cyanosis
what does bronchiolitis usually affect:
- upper airways
- lower airways
2.lower airways
where dies croup usually affect:
- upper airways
- lower airways
- upper airways
what is the most common cause of croup
parainfluenza virus
which has typical onset of 6months - 3yrs
- bronchiolitis
- croup
croup
which condition is treated with a single dose of dexamethasone
- bronchiolitis
- croup
- epiglotitis
- whooping cough
croup
what position will a children with is having epiglotitis and why
tripod position
optimises airflow through narrowed airway
what finding will be seen on lateral neck radiography in a pt with epiglotitis
thumb print sign –> enlarged epiglottis
what is another name for pertussis
whooping cough
what finding in the Hx might suggest whooping cough
no/incomplete vaccinations
what does NICE reccomend and 1st line treatment for a child with whooping cough
clarithromycin
what is the most important thing to correct in a child presenting with respiratory distress
correct the temperature
what is the typical age onset for bronchiolitis
3-6 months
what are the 2 classical finding of auscultation of the chest in a child with bronchiolitis
wheeze and crackles
what is the most common cause of a viral induced wheeze
RSV
what is 1st line treatment in child with a wheeze who is hypoxic
nebuliser salbutamol
what is the 1st thing to do in a child who is a RR of 0
5 rescue breaths
how many rescue breaths do you give in a child
5
what is pads basil life support
5 rescue breaths
15:2 compressions
give 3 viral examples of respiratory distress in a child
croup
asthma exacerbation
VIW
bronchiolitis
pneumonia
what is 1st line treatment for T2DM
metformin
what is the MOA of metformin
increases insulin sensitivity
what is a pro of metformin
does not cause hypoglycaemia
does not cause weight gain
what are 2 side effects of metformin
causes GI upset
can increase risk of lactic acidosis
give an example of a drug that is used 2nd line to treat T2DM
gliclazide (sulfonylurease)
what medication (group) is used 3rd line to treat T2DM
DPP4 inhibitor (gliptens) stitagliptin
what medication is used 4th line to treat T2DM
SGLT2
dapagliflozin
what is the tareget HbA1C
<48mmol
what annual monitoring is offered to patients with T2DM
annual eye check
annual foot checks
how can diabetic foot disease progress in patients with recurrent ulcers
move into bone –> osteomyelitis
what is the range of HbA1C for pre diabetes
42-47mmol
what is the most common cause of hyperthyroidism
Graves disease
what is the most prominent autoantibody present in graves `
TSH auto antibodies
what is the diagnosis
tender goitre + symptoms of hyperthyroidism
sucbacute hyperthyroidism
what can trigger subacute hyperthyroidism
starts following a viral infection that causes inflammation of the thyroid gland
what is the diagnostic test for diagnosing thyroid cancer
biopsy
what is usually 1st line investigation in a patient presenting with a thyroid lump/mass
ultrasound scan of thyroid
what will the TFT blood show in hyperthyroidism
Low TSH high T4
what will the TFT blood show in hypothyroidism
high TSH low/normal T4
how long should you wait when thinking of adjusting the dose of meds in hypothyroidism
give at least 1 month to adjust the dose
what are 2 blood findings suggestive of cancer
raised platelet
hypercalcaemia
what is the cause of addisons disease
low cortisol and aldosterone
what are the Na and K+ findings in additions disease
hyponatreamia and hyperkalaemia
list 3 features of addisons disease
hyperpigmentation
postural hypotension
dizziness
vomitign
what is the cause of cushing disease
excess cortisol
what is the mots common cause of Cushing disease
iatrogenic –> corticosteroid use
apart from insulin and autoantibodies what other marker in the blood can be used to detect T1DM
cleaved C peptide
what are the 3 types of insulins
long acting
short acting
intermediate acting
what type of acid base disorder is present in DKA
metabolic acidosis
along with insulin and fluids what else might a patient receive when trying to treat DKA
K+
what are 3 symptoms of phaeachromocytoma
severe HTN sweating palpitations headaches hot flushes
what is the most appropriate imaging for diagnosing phaeachromocytoma
CT abdomen and pelvis
what is the cause of gynacomastia and erectile dysfunction
low testosterone
what hormones are secreted by the pituitary gland
FSH, LH, ADH, prolactin, GH, TSH
what is given in hyperkalaemia to stabilise the heart
calcium gluconate
what will the ECG in hyperkalaemia show
tall t waves
broad QRS
what meds can be given to treat hyperkalaemia
calcium gluconate
insulin
nebulise salbutamol
calcium resonium
What hormones are responsible for regulating calcium
PTH and calcitonin
what is the pneumonic for hypercalaemia
moans
groans
stones
psychiatric tones
what electrolyte should always be checked when there is abnormalities in Ph
Mg
where is Mg absorbed in the gut
small bowel
what is one adverse feature of hyponatraemia you should be worried about
seizures
what are the 2 most common causes of metabolic acidosis
DKA
sepsis
when does NICE recommend starting treatment for hypothyroidism
TSH >10
list 3 causes of hypercalaemia
dehydration (elderly)
drugs
cancer
hypophosphataemia
what is the cause of conn syndrome
high aldosterone
which bone condition is associated with hyperparathyroidism
osteoperosis
what is 1st line treatment in T1DM pt who collapses and is unconscious
IV 10% dextrose
what is the diagnosis
acute onset thyroid pain, fever, post viral infection, T4 raised
subacute thyroiditis
how does a thyroid storm present
arrythmias, HTN, very unwell, very high thyroid levels
medical emergency
what is the most common cause of hypoparathyrodisim
surgical resection of the parathyroid glands
what is the diagnosis:
BP: 210/110, HR: 120, sweating, pallor, dyspnoea
phaeochromocytoma
what hormone is responsible for acromegaly/gigantism
GH
what is the most appropriate way of calculating the need for statin
QRISK2
lack of what hormone causes diabetes insupidus
ADH
what is the diagnosis
previous bowel resection, muscle weakness, tremor, palpitations
hypo magnesia
small bowel reabsorbs Mg
what is the diagnosis:
Baby bottle fed, eczema, colic, loose frequent stool, GORD, poor growth:
lactose intolerance
what is the diagnosis:
Painful bones, renal stones, abdo groans, moans:
hypercalaemia
when should a statin not be used to treat hyperlipidaemia
in patients with hep B
what medication use can be associated with galactorrhea
antipsychotics
what is the diagnosis:
fatigue, weight loss, hypeorpigmentation
addisons
what would indicate prostitis on examination using DRE
painful during DRE
what is 1st line medication for BPH
tamsulosin
what type of medication is tamsulosin
alpha blocker
what is 2nd line management in BPH after tamsulosin
finasteride
what pathogen is the most common cause for balantitis `
candida albicans
what spinal roots are involved in a spinal cord injury presenting with incontinance
sacral 2,3,4,
what would you inspect in a patient presenting with bowel incontinance
antler tone and sphincter tone
what is the diagnosis
testicular mass that transluminates on examination
hydrocele
what is the next best step:
85yr old female, +nitrites
obtain a hx
would you urine dip test on a 80 yr old female presenting with UTI symptoms
nope
bacterial would be present anyway
what organism is the most likely cause for prostitis
e.coli
what investigations would you do 1st line in
unprotected sex, new partner + penile discharge
1st line void urine sample
what should you look for in
unprotected sex, new partner + penile discharge
gonorrhoea
what is the most appropriate 1st line investigation in:
present female, loin to groin pain and microscopic haematruria
USS because she is pregnant
what imaging would you perform in a female suspecting kidney stones
CT KUB
what is the most common cause for urethral injury
surgical trauma
what is phimosis
swelling of the of the foreskin and is not retractable
what is the most appropriate treatment for phimosis
hydrocortisone
list 3 features of nephrotic syndrome
facial oedema
lipiduria
low serum albumin
what is the most common genetic inheritance pattern for polycystic kidney disease
autosomal dominant
what can affect the result of a PSA test
rectal exam, UTI and sexual intercourse
what is the diagnosis
left loin pain + microscopic haemoturia
pylonephritis
what is 1st line treatment in pyelonephritis
ciprofloxacin
what is the diagnosis
14 yr old sudden onset severe scrotal pain, no traum
testicular torsion
what is epididomocytis
infection of the epidiyomsos and testicle
what is the diagnosis
7 yr old, painless palpable mass in the loin
wilms tumour
list 3 Rfx for renal cell carcinoma
age, obesity and HTN
how does a posts abscess present
deep abdo pain
what is the most common cause of anaemia in CKD
reduced erythropoietin synthesis
how would an abscess present on USS
it would look dense and think on USS
list 3 occupational RFx for bladder cancer
working with paint/dyes
what imaging would you use if you see a soft tissue mass/hydrocele and why
USS to determine the density
what is a common symptoms of bladder cancer
unexplained painless haematuria
what imaging technique should you use to look for bladder cancer
cystoscopy
give 2 hygiene advises you would give to prevent UTI
seeing after sex
wipe from front to back
when should you consider referrals in UTI
recurrent UTI >3 in year
what should you do if patient has not responded to abx given for UTI
urine sample and culture
if need to change abx or for resistance
how would you diagnose a hydronephrosis
USS
what is hydronephrosis
build up of fluid in the kidney commonly due to obstruction
list 3 causes of pre-renal AKI
hypovolaemia
blood loss
dehydration
HF
what are the common causes of renal AKI
glomerularnephritis
nephrotic syndrome
nephritis syndrome
list 3 causes of post renal AKI
stones
cancer
tumour
what is present ninth urine in nephritic syndrome
blood
what is present in the urine on nephrotic syndrome
protein
what symptoms will be present with a loss of protein in the urine
oedema
what will be high in the blood in pts with nephrotic syndrome and why
high cholesterol because the liver is trying to compensate
how would you diagnose nephrotic/npehritic syndrome
biopsy
what number of GFR would make you consider dialysis
GFR <10
what are the 2 most common causes of renal problems
HTN and diabetes
list 2 causes that increase the risk of developing stones
dialysis
dehydration
what is a stag horn calculi
large renal stones
what size of renal stone would make you refer to renal
> 5mm
what is management options for balantitis
hydrocortisone and hygiene
clean properly
retract the foreskin
what medication is used to treat prostitis
2 weeks of ciprofloxacin
what is the diagnosis
difficulty starting stream of urine, dribbling and nocturnal urination
BPH
list 2 alpha blockers that can be used to treat BPH
tamsulosin
doxazosin
list 2 SE that are common with the use of alpha blockers
postural hypotension
dizziness
what type of medication is finasteride
alpha educate inhibitor
what levels will be high in rhabdomyolysis
CK
what is the cause of rhabdomyolysis
breakdown of skeletal muscle
what are elderly people who have had a fall and found on the floor over a long period of time at risk of developing
rhabdomyolysis
what causes AKI in rhabdomyolysis
myoglobin released and deposits in the kidney
what is the most common cause of urinary retention
urethral strictures
list 3 obstructive causes of urinary retention
stones
masses
post surgery
medication
what investigation would you consider in patients with urinary retention
bladder scan
does caudal equine present with urinary incontinance or urinary retention
urinary retention
what investigation should you consider in pt with testicualr cancer and why
MRI spine to look for mets
what is a major complication of testicular torsion if left untreated
infertility
what meds are used to treat vasculitis
steroids
what are the 2 common STI that present with penile discharge
gonorrhoea
chlymidia
what is 1st line medication for chlymidia
doxycycline
what other blood would you consider in its with STI
HIV screen
where do you refer pts too if diagnosed with an STI
sexual health screen
what is the diagnosis and what is the other name of the presentation
single painless genital ulcer
syphillis
shanks
what is crytochidism
undescended testes can be unilateral
does cryptorchidism present
unilateral or bilateral
can be both
what can increase the risk of cryptorchidism
alcohol use during pregnancy
how would you manage cryptochidism
refer to urology
what is 1st line treatment for depression
SSRI
citalopram
centreline
fluoxetine
what does NICE recommended as 1st line treatment for depression
SSRIs
when is fluoxetine given to a pt with depression
<18 yrs old
what SSRI will be prescribed to an 18yr old with depression
fluoxetine
given an example of a sedation antidepressant
lofepramine
mirtazepine
when would grief reaction be considered abnormal
> 6 months
what is 1st line management for grief reaction
CBT
give an exmaple of a mood stabiliser
lithium
what medication can be used bipolar to stabilise mood
lithium
how often do pts on lithium get their blood monitored
every 6 months
what must pts on lithium be informed about when on it
lithium toxicity
what anti-psychotics has a risk of agranulocytosis
clozapine
what med is used 1st line treatment in alzhimes
donepezil
what is the moa of donepezil in treating alzheimer’s
slowing down cognitive decline
list 2 antipsychotics
Rispiradone
olazapine
what is 1st line treatment for anxiety
CBT
what med can be used to manage SOB and palpitations in anxiety
propranolol
what medication would be used in someone who presents with anxiety and low mood
sertraline
what BMI does NICE suggest considering bariatric surgery
> 35 BMI
give an example of a medication that can be used to help with weight loss
orlistat
what is given in acute alcohol withdrawal to prevent psychiatric complications
thiamine
what does NICE reccomened as 1st line treatment for smoking cessation
NRT
who should you contract when there is a suspicion of child abuse
child safeguarding lead and safeguarding officer
what is 1st line treatment for OCD
CBT
fluoxetine
what is 1st line treatment in for a child with ADHD
methylpenidate
what is the best way to treat panic disorder
CBT
what is the diagnosis:
17 yr old girl, thinks shes fat, BMI 16.5, poor eating, uses weight loss pills
anorexia nervosa
what is the most appropriate adjunct for generalised anxiety
sertraline
what is 1st line treatment for new schizophrenia
quetapine
what is dysthymic disorder
chronic long term mild depressive mood
what is 1st line treatment for dysthymic disorder
CBT
what is the diagnosis:
Mixed low mood, disinhibition, poor concentration, flight of idea
bipolar disorder
how bipolar disorder characterised
episodes of depressive mood and mania
what is the best treatment for PTSD
CBT
what test should be done initially in a female present with menorrhagia
STI screen
what is the 1st line treatment for menorrhagia
COCP
tranexamic acid
what is the diagnosis:
discharge from cervix, infection and inflammation
cervicitis
what is the most common cause of cervicitis
STI
what symptoms does fibroids present with
pain
menorrhagia
dysmenorrhoea
what is the most common complication of gestational diabetes
oversized baby
what is hypothyroidism associated with in pregnancy
mental retardation
what happens to thyroid medication in hypothyroidism during pregnancy
increased due to an increase in demand
what is the diagnosis:
43 yr old, breast pain, redness, tenderness and nipple discharge
mastitis
what does the management of a cystocele involve
ring pessary
what is the diagnosis
white cream discharge + vaginal soreness and irritation
thrush
what is the management for vaginla thrush
clotrimazole cream
what is an alternative that can be used to manage vaginal thrush if clotrimazole cream does not work
single dose fluconazole
would you refer this pt for the 2ww
33 yrs old + unexplained axially lump
yes
would you refer this pt for the 2ww
50 yrs + nipple retraction
yes
how would you be able to differentiate between mastitis and milk mastitis
milk mastitis improves after feeding the baby
what is a cystocele
when the bladder drops into the vagina due to weakness in the walls
what is placenta preveria
low lying placenta that partially/completely covers the cervix
how would you manage dysmenorrhoea in a female who is not sexually active and has no PMH
- COCP
- IUD
- mefenamic acid
Mefenamic acid
how would you manage dysmenorrhoea in a female who is sexually active and has no PMH
COCP/IUD
what is the treatment for chlamydia
doxycycline for 7 days
what is the treatment for chlamydia if doxycycline is contraindicated
azithromycin
where do you refer someone to if they have tested + for UTI
GUM clinic
how would you manage this pt
severe premenstural symptoms, taking time off work, PMH migraine with aura
SSRI during the leutal phase
what scan is used in pregnancy to look at the thickness of a the neck in helping to diagnose downs syndrome
nuchal translucency scan
what are you at risk of developing if you forget to take your tampon out
toxic shock syndrome
at what age are women sent for cervical screening and how often
25-64
every 3 years till 50
what is the diagnosis
infertility, cyclic pelvic pain, deep dysparenuina, heavy bleeding, not responding to NSAID
Endometriosis
what is the 1st investigation to carry out in a female presenting with RIF pain
pregnancy test
what is the possible diagnosis
pregnant female + proteinuria
pre-eclampsia
what medication would you give to a pregnant female with HTN and proteinuria
labetalol
how would you manage a lady on antidepressants who is trying to conceive
adjust the medication according to the risks/benefits
what is the diagnosis
28 yr old, irregular periods, hirtirism, acne
PCOS
after how long should you consider referral in those unable to conceive
> 12 months
what should you check in females who are unable to conceive
day 21 progesterone (28 day cycle)
what should you check in males who are unable to conceive
check sperm count
what is the priamry risk of rhesus incompatibility in pregnancy
newborn haemolytic anaemia
what are the 2 emergency contraceptions that can be given
ella one
IUD
what is the diagnosis
snowstorm appearance on USS
molar pregnancy
what signs might indicate a molar pregnancy
dark vaginal bleeding
pain
how would you manage this patient
52 yr old, sweats, irritable vaginla dryness
combined HRT
what is the medical management for ectopic pregnancy
methotrexate
what could be the possible diagnosis:
52 yr old abdo pain, distention and pelvic pain
ovarian cancer
what is the cancer marker for ovarian cancer
ca125
what is the diagnosis
27 yr old struggling to have sex due to vaginal muscle spasms
vaginismus
what is the 1st line treatment for vaginismus
psychosexual counselling
what is second line treatment for vaginismus
vaginal dilators
what joint does gout present on
usually 1st metatarsal
what is 1st line medication for gout
NSAIDs
what is 2nd line medication for gout
colchicine
what is 3rd line medication for gout
prednisolone
what is prophylaxisis treatment for gout
allopurinol
what is important to mention to the patient when initially starting them on allopurinol for gout
initially causes a flare in gout
what is 1st line treatment for sprain/strains
RICE
rest
ice
compression
elevation
what is the diagnosis:
70 yr old, proximal muscle weakness no meds
poly myalgia rheumatica
what blood marker would you look for in poly myalgia rheumatica
ESR
what is medical treatment for poly myalgia rheumatic
trial prednisolone
what are the 4 features present on X-ray in osteoporosis
loss of joint space
osteophytes
subchondral cysts
sclerosis
what is the characteristic presentation of pagets disease
bow legs
whihc is the most common direction of dislocation of the shoulder joint
anterior
what nerve is at greatest risk of damage in shoulder dislocation
axially nerve
what sign will be present in axially nerve damages
payers patch
what assessment tool is used in the diagnosis of osteoporosis without RFx
qfax
name a bisphosphanate used in the treatment for oesteoperosi
alendrenic acid
what is the initial treatment for a score of -2.5
calcium
vit d
alendronic acid
what is osgood scatters disease
inflammation and swelling on the the tibial tuberosity
what is the most common group to develop osgood shatters disease
common in teens who are very active
what is the most appropriate 1st line medication for tennis elbow
topical NSAIDS
apart from NSAID what are the other management options for tennis elbow
physio
steroid injection
how is carpal tunnel treated initially
splint
what is the clinical test used for the diagnosis of carpal tunnel
tinnels test
what is the most common cause of caudal equine
disc herniation
what are 3 features of caudal equine
sandal paraesthesia
faecal incontinance
urinary retention
what is the diagnosis:
tenderness on the 5th metacarpal
boxers fracture
what is the name of the fracture that is a result of a fall on a outstretched hand
collies fracture
what is the name of the deformity seen in a collies fracture
dinner fork deformity
what is the displacement send in a collies fracture
posterior displacement of the radius and ulna
what is the diagnosis:
24 yr old, 3 month recurrent back pain, fatgiue, stiffness that disturbs sleep
ankylosing spondylosis
does ankylosing spondylosis improve with expertise or worsen with exercise
improves with exercise
what is the name of the maker specific to ankylosing spondylosis
HLA B27
what does the management for ankylosing spondylosis involve
physio
analgesia
what is the diagnosis:
reactive arthritis, conjunctivitis, urethritis
Reiters syndrome
what is the most common cause of reiters syndrome
STIs
what is the diagnosis:
joint pain, butterfly rash, mouth ulcers, fatigue, lymphadenopathy
SLE
how is SLE treated
DMARDs
what age group is osteosarcoma commonly seen in
young
what is the most specific antibody see in RA
ACCP
what is polyarertitis nodosum
chronic vasculitis presenting with skin manifestations
what is the diagnosis
dry eyes
dry mouth
joint pain
sjogren syndrome
what is the diagnosis
fibrous thickening of the skin due to excess collagen formation
scleorderma
what is a consequence of bit d deficiency
osteomalacia
deficiency in what vitamin with cause night blindness
vit a
deficiency in what vitamin causes survey
vit c
deficiency in vitamin b1 causes what condition
beriberi
what is the diagnosis
progressive pain, restricted movement in shoulder over few months
adhesive capsulitis
what is the treatment for adhesive capsulitis
physio
analgesia
what is the classic sign seen in suprasinatus tendonitis
painful arch
what is the classic sign seen in biceps rupture
popeye sign
what is the diagnosis:
unilateral swollen joints, red, inflamed, pain on movement, pyrexia
septic arthritis
what happens in a pulled elbow
partial dislocation of elbow
what is the main risk of an open fracture
osteomyelitis
what is the most common sign present in meniscus injury
locking of the joint
what is the most common sign on examination with a cruciate ligament injury
giving way
what spinal vertebrae is injured in a hangman’s fracture
c2
what is the diagnosis:
12 yr old boy, overweight, pain in left hip and limp
slipped upper femoral epiphysis
what is perthes disease
stopped blood flow to the head of the thigh bone which causes avascular necrosis
what age group does perthes disease commonly affect
young
children aged 3-11
what is the pathophys of irritable hip
inflammation of the synovial membrane usually following viral infection
what imaging technique is used to diagnose irritable hip
USS
what medications group show poor management in MSK pain
opioids
what is the diagnosis
2 yr old, seal like barking cough, coryza symptoms, mild intercostal recession
croup
what is the management of croup
single dose dex
what finding in the hx would indicate epiglottitis
unvaccinated child
where would a forge in body commonly get stuck in hinhalation
right lobe
what is the diagnosis:
child, lethargy, unconscious, sweet smelling breath
DKA
what is the diagnostic test in DKA
capillary blood glucose
what is the cause of cerebral palsy development
hypoxia during birth
what is the treatment for worms
mebendazole
list 3 childhood vaccines
MMR
HPV
pertussis
what is the diagnosis
Adult exertional dyspnoea, congestive HF congenital cardiac abnormality
atrial septal defect
what heart defect present with a machinery murmur
patent dutose arteriosus
which heart defects present early as a child
VSD
PDA
what are the 4 heart defects in tetralogy of fallot
VSD
right ventricular hypetropy
pulmonary stenosis
correction of the aorta
what congenital conditon is associated with tetralogy of fallot
downs syndrome
what is the diagnosis
7 yr old, repetitive speech, abnormal emotional response, low social interest:
autism spectrum disorder
how should asthma be diagnosed in a child
clinical judgement
what is the management of ?asthma in a child <5 yrs old
trial steroid inhaler
what is the recommended asthma management in teens and why
MART
combined maintenance and deliver due to less compliance
what is the diagnosis:
Episodic abdo pin, vomiting, drawing knees to chest, blood/mucus in stool:
intersusception
what is the diagnosis:
Previous bacterial throat infection, 4 wk later swollen joints, chest pain, dyspnoea, rash
rheumatic fever
what is the most common cause of rheumatic fever
streptococcus
what age should you refer a child 2ww a child to beads with undescended testes
> 8 weeks
what is the diagnosis
African refugee, initial bone pain, acute abdo pain, anaemia on FBC
sickle cell anaemia
what is the diagnosis:
5m child, 2 day coryza, tachypnoea, crackles on chest
bronchiolitis
list 2 reps conditions that cane arise from an unvaccinated child
epiglottis
whooping cough
what vessel is at risk of injury in a distal fracture of humerus with anterior displacement
brachial artery
what is the diagnosis
Adolescent boy, anterior knee pain during exercise,, settles with rest
osgood scalpers disease
what is the diagnosis
6yr old child, 4 day limp, viral URTI, otherwise well
transient syvonitis
what medication can help with bed wetting
desmopressin
what conservative management can help with bed wetting
enuresis alarm
what what age would you be worried about a child bedwetting
> 5 yrs
what xlinked condition can cause haemolytic crisis in children
G6PD deficiency
what is the diagnosis
Unvaccinated child, headache, joint pain, fever, parotid swelling:
mumps
notifiable disease
what is the diagnosis
sudden severe abdo pain
strangulated hernia
