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high yield Q's > high yield Q's > Flashcards

high yield Q's Flashcards

1
Q

reed sternberg cells

A

hodgkins lymphoma

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2
Q

smudge cells

A

CLL

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3
Q

auer rod

A

AML

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4
Q

rouleux formation

A

myeloma

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5
Q

lytic bone lesions

A

myeloma

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6
Q

muddy brown casts

A

acute tubular necrosis

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7
Q

what is the most common cause of pancreatitis

A

gallstones

alcohol

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8
Q

how is cancer definitively diagnosed

A

biopsy

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9
Q

what type of laxative is laxido

osmotic
stimulant

A

osmotic laxative

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10
Q

when is a FIT test used

A

when there is suspicion of bowel cancer but pt does not meet 2ww

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11
Q

what is the most common cause of diarrhoea

A

rotavirus

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12
Q

what organism is responsible for causing diarrhoea with vomiting

A

nora virus

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13
Q

what medication might you give a pt with diarrhoea

A

loperamide

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14
Q

give an eg of an abx that can cause c.diff infection

A

co amoxicillin

ciproflaxacin

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15
Q

what abx is given to treat c.diff

A

metronidazole

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16
Q

which sided pain does constipation usually cause

A

left sided pain

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17
Q

what is the diagnosis:

generalised abdominal pain then moves to RIF

A

appendicitis

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18
Q

what is the 1st line treatment for GORD and how long

A

PPI e.g. omeprazole for 4 weeks if not better then h.pylori stool sample

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19
Q

what is site should be used in acute poisoning

A

TOXBASE

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20
Q

what is the most diagnostic test for inflammatory bowel disease

A

facecal calprotectin

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21
Q

what is used to monitor colon cancer

A

CA

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22
Q

what’s the diagnosis

40 yr old female, RUQ pain, murphy positive

A

cholcystitis

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23
Q

what is the most common cause of varies

A

alcohol

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24
Q

which hernia is most palpable in the scrotum

A

indirect hernia

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25
Q

which hernia is more common in women

A

femoral hernia

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26
Q

which hernia has increased risk of strangulation

A

femoral hernia

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27
Q

what is the name of the hernia that can occur anywhere in the abdominal wall

A

ventral hernia

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28
Q

what is 1st line treatment for anal fissures

A

topical steroids and analgesia

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29
Q

what is 2nd line treatment for anal fissures

A

topical GTN

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30
Q

what side effect must you warn the pt about when using topical GTN for anal fissures

A

headaches

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31
Q

what’s the diagnosis

2 yr old boy, distended abdo, red jelly stools

A

intussusception

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32
Q

what’s the diagnosis

child, projectile vominting, olive mass

A

pyloric stenosis

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33
Q

what is a serious complication of UC

A

toxic megacolon

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34
Q

which type of bowel obstruction is most common

A

small bowel obstruction

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35
Q

in what condition should you measure intrinsic factor

A

pernicious anaemia

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36
Q

when can acylovir be used to treat shingles

A

with 72 hrs of onset

up to 5 days of onset

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37
Q

what is the function of acyclovir is the management of shingles

A

reduced risk of post neuropathic neuralgia

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38
Q

what is 1st line and 2nd line treatment for cluster headache

A

1st line: nasal/IM triptan

2nd line: short burst o2 therapy

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39
Q

list 2 conditions that can cause glove and stocking syndrome

A

diabetes

gillian barre syndrome

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40
Q

how does glove and socking syndrome differ in gillian barre syndrome to diabetic

A

in GBS it develops acutely over a few days

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41
Q

what scoring system is used for TIA

A

ABCD2:

age 
blood pressure 
clinical features 
diabetes 
duration
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42
Q

what medication i used in the community to manage a tonic status epileptics

A

buccal midozalam

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43
Q

what test is used to carpal tunnel syndrome

A

tinnels test

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44
Q

what are 2 initial management for carpal tunnel syndrome

A

wrist splints

physiotherapy

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45
Q

in GP when should you give benzylpenicillin to manage suspected meningitis

A

meningitis with a rash

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46
Q

what is the most common underlying cause in this presentation

loss of power + personality changes

A

space occupying lesion

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47
Q

what is the most common cause of cerebral palsy

A

birth trauma

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48
Q

what is the cause/carrier of lyme disease

A

ticks

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49
Q

what causes a foot drop

A

damage to common perinea nerve

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50
Q

what nerve would be damaged in a fracture of the surgical neck of humerus and what sign would you get

A

axillary nerve

patch sign

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51
Q

what nerve would be damaged in a spiral fracture of the humerus

A

Radial nerve

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52
Q

what nerve would be damaged in a fracture of the medial epicondyle of the humerus

A

ulnar nerve

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53
Q

what type of dementia is associated with Parkinson’s

A

lewy body dementia

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54
Q

what type of dementia presents with language disorder and personalty changes

A

front temporal lobe dementia

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55
Q

what signs might suggest vascular dementia (RFx)

A

HTN
diabetes
signs of arteriopathy

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56
Q

what type of sarcoma is present in those with HIV

A

karposki sarcoma

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57
Q

what does pappiloedema suggest

A

inflammation of optic nerve

raised ICP

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58
Q

what is the diagnosis

drooping eye lid, double vision and chest muscle weakness

A

MG

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59
Q

what is the inheritance pattern for Huntington’s

A

autosomal dominant

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60
Q

what type of neuropathy can be present in B12 deficiency but can be easily reversed

A

glove and stocking syndrome

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61
Q

when would you prescribe prednisolone in bells palsy

A

if presenting within 72 hrs of onset of symptoms

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62
Q

what are the 4 types of dementia

A

alzihmers
lewy body
vascular
front temporal lobe

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63
Q

what is the cause of korskoff psychosis

A

acute alcohol withdrawal due to thiamine deficiency

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64
Q

what is the cause of wernikes encephalopathy

A

chronic thiamine deficiency

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65
Q

list 3 conditions that might initially present with ‘clumsiness’

A 
MND
MS
parkinson's 
muscular dystrophy 
MG
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66
Q

what is the 1st line treatment for Parkinsons

A

levadopa

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67
Q

what is important to ask in a pt your suspecting id med overuse headache

A

over the counter meds

e.g. codeine

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68
Q

how long does a typical cluster head last

A

15mins to 3 hrs

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69
Q

what’s 1st line treatment in a migraine

A

‘NSAIDs e.g. naproxen

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70
Q

give an example of a med that can be used to manage Trigeminal nerve neuralgia

A

amytriptylline

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71
Q

what vessels are the cause of a extradualr bleed

A

middle meningeal artery

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72
Q

what vessels are the cause of a subdural bleed

A

bridging veins

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73
Q

what is the most common cause of SAH

A

congenital aneurysms

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74
Q

what type of intcracrainla haemorrhage presents with a lucid interval

A

extradural bleed

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75
Q

what antipsychotic is tetrogenic

A

sodium valproate

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76
Q

what can be a differential for stroke

A

prodrome migraine

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77
Q

what is QRISK used to assess

A

assessing risk of having a cardiovascular event in the next 10 yrs

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78
Q

what is the treatment for an acute MI <120mins

A

PCI

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79
Q

what is the treatment for acute MI >120 mins

A

thrombolysis

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80
Q

what blood test is used if suspecting HF

A

BNP

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81
Q

what blood marker is used if you are suspecting MI

A

troponins

serial troponin

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82
Q

what medication used in AF helps to improve mortality

A

beta blocker

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83
Q

what test should be carried out before staring an AF on medication

A

baseline kidney function

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84
Q

what is small vessel disease

A

when small vessels of the heart become damaged

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85
Q

what is the cause of prinzmetal angina

occlusion or coronary artery spams

A

coronary artery spasm

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86
Q

what medication should a pas with raynauds be started on

A

calcium channel blocker

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87
Q

what range of ABPI would indicate peripheral vascular disease

A

<0.7

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88
Q

list 3 RFx for developing PE/DVT

A 
recent travel 
COCP
HT
cancer 
immobilisation 
trauma 
obesity ]
preganancy
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89
Q

when is it preferred to use apixaban over rivaroxaban

A

in venous thromboembolism t reduce risk of reoccurrence

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90
Q

which is a VERY common feature of PE

  1. chest pain
  2. haemoptyisis
    3, cough
  3. tachycarida
A

tachycardia

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91
Q

what’s the diagnostic investigation for PE

A

CT pulmonary angiogram

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92
Q

which type of heart block is common in athletes

A

morbitz type 1

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93
Q

which types of heart block require pacemaker

A

morbitz type 2

type 3

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94
Q

what is important to warn pt about with adenosine

A

feel like they are dying

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95
Q

what medication is used to treat SVT

A

adenosine

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96
Q

what non pharm treatments are there for SVT

A

vasovagal manoeuvres

carotid sinus massage

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97
Q

what is the dosage for adenosine in SVT

A

6
12
12

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98
Q

what is present in ECG in pericarditis

A

saddle shaped ST elevation

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99
Q

where is a pacemaker typically placed

A

left hand side

under the clavicle

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100
Q

what is a common side effect associated with ACEi use

A

dry cough

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101
Q

list 2 common side effects associated with CCB use

A

peripheral oedema

flushing

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102
Q

what is a common side effect associated with statin

A

myopathy

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103
Q

what difference in BP would suggest aortic dissection

A

radio radio delay

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104
Q

when would sugary be indicated as treatment for AAA

A

> 5.5cm

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105
Q

what criteria i used for endocarditis

A

dukes criteria

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106
Q

how should blood culture be collected for a patient with suspected infective endocarditis

A

3 separate occasions from 3 different areas

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107
Q

what are the 3 types of pneumathoracies

A

tensions
spontaneous
traumatic

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108
Q

what is the most common cause of croup

A

parainfluenza

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109
Q

3 features present in croup

A

barking cough
fever
stridor

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110
Q

how can you tell resp distress in someone/child

A 
use of accessory muscles
intercostal recession 
tracheal tug 
cyanosis 
reduced feeding and wet nappies
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111
Q

what is the treatment for croup

A

single dose dexamethasone

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112
Q

what is the cause of bronchiectasis

A

widening of the alveoli

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113
Q

what scaring system is used for pneumonia

A 
CURB65
confusion 
urea 
RR
BP
>65yrs
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114
Q

what is a prolonged complication of viral pneumonia

A

pleurisy

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115
Q

does pneumonia usually present

unilateral or bilateral

A

unilateral

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116
Q

what vaccine are important in old pts with underlying lung disease

A

pneumococcal

influenza

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117
Q

what should you think about investigating if a pt has fungal pneumonia

A

HIV/immunocomprimised

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118
Q

when should you do a repeats chest X-ray for pt who has pneumonia

A

after 6 weeks

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119
Q

what is the typical presentation of a pneumothorax

A

young
tall
male
smoker

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120
Q

what are the 2 findings of pneumothorax

A

hyperessonance on percussion

reduced/no breath sounds

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121
Q

what is the most common cause for bronchitis

A

RSV

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122
Q

what is a common complication for lung cancer

A

pleural effusion

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123
Q

which type of lung cancer is less common

A

small cell lung cancer

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124
Q

which type of lung cancer is after spreading and not associated with smoking

A

small cell lung cancer

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125
Q

list 2 types of lung cancer

A

squamous cell lung cancer
adenocarcinoma
small cell lung cancer

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126
Q

what condition would cause a bilateral pleural effusion

A

heart failure

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127
Q

what do you test for when looking at the pleural effusion

A

PH

protein

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128
Q

what type of pleural effusion is more commonly associated with bacterial pneumonia

A

exudative pleural effusion

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129
Q

what is used to manage COPD with non-asthmatic features

A

LABA/LAMA

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130
Q

what is the diagnostic test for COPD

A

spirometry

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131
Q

what are the 3 vaccinations we want COPD its to of had

A

pneumococcal
influenza
covid

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132
Q

what medications are used to treat exacerbations of COPD

A

abx
nebulisers
steroids

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133
Q

what scoring system is used for PE/DVT

A

wells score

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134
Q

what blood test can be carried out if suspecting PE/DVT

A

d-dimer

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135
Q

what is the treatment for COPD with asthmatic features

A

LABA/ICS

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136
Q

what is cor pulmonale

A

right sided HF due to increased pressure in lungs

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137
Q

list 3 features of cor pulmomale

A

peripheral oedema
raised JVP
hepatomegaly
ascites

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138
Q

what is the treatment for PE

A

anticoagulation/DOAC

apixaban

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139
Q

list 3 occupations that can cause pulmonary fibrosis

A

miners
builders
roofers
asbestos exposure

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140
Q

name one drug that can cause pulmonary fibrosis

A

amiradone
methotrexate
nitrofurantoin

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141
Q

name one condition that can cause pulmonary fibrosis

A

autoimmune conditions e.g. RA
SLE
systemic sclerosis
alpha 1 antitrypsin deficiency

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142
Q

what type of tumours secrets hormones

A

carcinoid tumours

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143
Q

list 3 features that a carcinoid tumour might present with

A

facial flushing
diarrhoea
tachycardia

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144
Q

list 3 causes for the formation of a pulmonary nodule

A

cancer
calcification
underlying lung disease

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145
Q

what type of lung disease is sarcoidosis

A

restrictive lung disease

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146
Q

what med can be used to treat pulmonary HTN

A

sildenafil

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147
Q

what are 2 RFx for developing emphysema

A

pneumonia

immunocompromised

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148
Q

what does inhalation of asbestosis cause

A

mesothelioma

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149
Q

what is the APGAR score used for

A

newborn babies

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150
Q

according to NICE what is the diagnostic test for asthma

A

FENO

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151
Q

when can serial peak flows be used in asthma

A

monitor progression

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152
Q

what vaccine is given to prevent epiglottis

A

haem influenza

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153
Q

diagnosis:

obese, male, day time somnolence, poor concentration, snoring, fatigue

A

sleep apnoea

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154
Q

what is pertussis

A

whooping cough

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155
Q

what is the most common feature of pertussis

A

prolonged coughing making it difficult to breath

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156
Q

what is the treatment for pertussis

A

clarithromycin/erythromycin

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157
Q

what is the 1st line abx for pneumonia

A

amoxicillin

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158
Q

what is the abx of choice for COPD exacerbation

A

doxycycline

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159
Q

what is present on ABG of a pt with an exacerbation of COPD

A

rest acidosis

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160
Q

what is the treatment for c.diff infection

A

metronidazole

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161
Q

what is the appropriate immediate intervention for tension pneumothorax

A

needle aspiration

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162
Q

what blood maker is always raised in cancer

A

platelets

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163
Q

most common cause of transudative pleural effusion

A

heart failure

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164
Q

most common cause for exudative pleural effusion

A

pneumonia/bacterial infection

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165
Q

diagnosis:

male, homeless, 6m cough, night sweats, weight loss, pyrxia

A

TB

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166
Q

what is the most common cause pulmonary fibrosis

A

idiopathic

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167
Q

what is the most appropriate investigation for bronchiestasis

A

CT scan

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168
Q

what non invasive test can be used to test for pulmonary HTN

A

echocardiogram

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169
Q

what type of imaging can be used to diagnose interstitial lung disease

A

high resolution CT

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170
Q

how will the CT scan appear in interstitial lung disease

A

ground glass appearance

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171
Q

what other investigation can be used when the diagnosis of interstitial lung disease is unclear following CT scan

A

lung biopsy

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172
Q

is interstitial lung disease:

  1. reversible
  2. irreversible
A
  1. irreversible
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173
Q

how does idiopathic pulmonary fibrosis present

A

insidious onset
SOB and dry cough
bibasal fine inspiratory crackles
finger clubbing

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174
Q

what are the 2 consequences of working with asbestosis

A

causes fibrosis of the lung

can cause cancer

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175
Q

what 4 problems can asbestosis inhalation cause

A

lung fibrosis
pleural thickening and plaques
adenocarcinoma
mesothelioma

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176
Q

what is the most common interstitial lung disease

A

idiopathic pulmonary fibrosis

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177
Q

what zone of the lung is most affected in cystic fibrosis

  1. upper zone
  2. lower zone
A

upper zone of the lung

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178
Q

what zone of the lung is most commonly affected on idiopathic lung fibrosis

  1. upper zone
  2. lower zone
A

lower zone

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179
Q

what is pneumoconiosis

A

inertial fibrosis secondary to occupational exposure

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180
Q

give 2 types of pneumoconiosis

A

coal miners lung

asbestosis

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181
Q

list 2 complications associated with pneumoconiosis

A

lung cancer

cor pulmonale

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182
Q

what type of pattern is seen in spirometry on a pt with interstitial lung disease

A

restrictive pattern

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183
Q

give an example of a medication that can be used to treat idiopathic pulmonary fibrosis

A

pirfenidone

nintedanib

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184
Q

what is the primary cause of mesothelioma

A

asbestosis exposure

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185
Q

name the condition

presence of non caseating granulomas

A

sarcoidosis

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186
Q

what organs are predominant affected in sarcoidosis

A

the lungs

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187
Q

what 3 ways can the lungs react in an exacerbation of asthma

A

bronchoconstriction
inflammation
excess mucus secretion

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188
Q

what immune cells are responsible for the immune reaction seen in asthma

A

TH2 cells

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189
Q

what are the 3 main treatments given in an exacerbation of asthma

A

oxygen

nebulised bronchodilators

corticosteroids

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190
Q

what is the inhertance pattern for cystic fibrosis

A

autosomal recessive

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191
Q

what test can be used to diagnose cystic fibrosis

A

sweat test

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192
Q

how many g/L in transudative effusion

A

<30g/L

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193
Q

how many g/L in exudative effusion

A

> 30g/L

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194
Q

2 causes of transudative effusion

A

heart failure

cirrhosis

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195
Q

2 causes of exudative effusions

A

pneumonia

malignancy

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196
Q

what criteria is used to distinguish between transudative and exudative effusions

A

lights criteria

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197
Q

what is the most common cause of bronchiolitis

A

respiratory syntactical virus

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198
Q

what are the 3 management methods for bronchiolitis

A

nasal suctioning
oxygen if required
fluids

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199
Q

what age does bronchiolitis usually present

A

<1 yrs old

3-6 months

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200
Q

how can children with respiratory distress present

A 
subcostal/intercostal recession 
tracheal tug
nasal flaring 
reduced feeding 
reduced wet nappies 
cyanosis
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201
Q

what does bronchiolitis usually affect:

  1. upper airways
  2. lower airways
A

2.lower airways

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202
Q

where dies croup usually affect:

  1. upper airways
  2. lower airways
A
  1. upper airways
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203
Q

what is the most common cause of croup

A

parainfluenza virus

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204
Q

which has typical onset of 6months - 3yrs

  1. bronchiolitis
  2. croup
A

croup

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205
Q

which condition is treated with a single dose of dexamethasone

  1. bronchiolitis
  2. croup
  3. epiglotitis
  4. whooping cough
A

croup

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206
Q

what position will a children with is having epiglotitis and why

A

tripod position

optimises airflow through narrowed airway

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207
Q

what finding will be seen on lateral neck radiography in a pt with epiglotitis

A

thumb print sign –> enlarged epiglottis

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208
Q

what is another name for pertussis

A

whooping cough

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209
Q

what finding in the Hx might suggest whooping cough

A

no/incomplete vaccinations

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210
Q

what does NICE reccomend and 1st line treatment for a child with whooping cough

A

clarithromycin

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211
Q

what is the most important thing to correct in a child presenting with respiratory distress

A

correct the temperature

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212
Q

what is the typical age onset for bronchiolitis

A

3-6 months

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213
Q

what are the 2 classical finding of auscultation of the chest in a child with bronchiolitis

A

wheeze and crackles

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214
Q

what is the most common cause of a viral induced wheeze

A

RSV

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215
Q

what is 1st line treatment in child with a wheeze who is hypoxic

A

nebuliser salbutamol

216
Q

what is the 1st thing to do in a child who is a RR of 0

A

5 rescue breaths

217
Q

how many rescue breaths do you give in a child

A

5

218
Q

what is pads basil life support

A

5 rescue breaths

15:2 compressions

219
Q

give 3 viral examples of respiratory distress in a child

A

croup

asthma exacerbation

VIW

bronchiolitis

pneumonia

220
Q

what is 1st line treatment for T2DM

A

metformin

221
Q

what is the MOA of metformin

A

increases insulin sensitivity

222
Q

what is a pro of metformin

A

does not cause hypoglycaemia

does not cause weight gain

223
Q

what are 2 side effects of metformin

A

causes GI upset

can increase risk of lactic acidosis

224
Q

give an example of a drug that is used 2nd line to treat T2DM

A

gliclazide (sulfonylurease)

225
Q

what medication (group) is used 3rd line to treat T2DM

A 
DPP4 inhibitor (gliptens)
stitagliptin
226
Q

what medication is used 4th line to treat T2DM

A

SGLT2

dapagliflozin

227
Q

what is the tareget HbA1C

A

<48mmol

228
Q

what annual monitoring is offered to patients with T2DM

A

annual eye check

annual foot checks

229
Q

how can diabetic foot disease progress in patients with recurrent ulcers

A

move into bone –> osteomyelitis

230
Q

what is the range of HbA1C for pre diabetes

A

42-47mmol

231
Q

what is the most common cause of hyperthyroidism

A

Graves disease

232
Q

what is the most prominent autoantibody present in graves `

A

TSH auto antibodies

233
Q

what is the diagnosis

tender goitre + symptoms of hyperthyroidism

A

sucbacute hyperthyroidism

234
Q

what can trigger subacute hyperthyroidism

A

starts following a viral infection that causes inflammation of the thyroid gland

235
Q

what is the diagnostic test for diagnosing thyroid cancer

A

biopsy

236
Q

what is usually 1st line investigation in a patient presenting with a thyroid lump/mass

A

ultrasound scan of thyroid

237
Q

what will the TFT blood show in hyperthyroidism

A

Low TSH high T4

238
Q

what will the TFT blood show in hypothyroidism

A

high TSH low/normal T4

239
Q

how long should you wait when thinking of adjusting the dose of meds in hypothyroidism

A

give at least 1 month to adjust the dose

240
Q

what are 2 blood findings suggestive of cancer

A

raised platelet

hypercalcaemia

241
Q

what is the cause of addisons disease

A

low cortisol and aldosterone

242
Q

what are the Na and K+ findings in additions disease

A

hyponatreamia and hyperkalaemia

243
Q

list 3 features of addisons disease

A

hyperpigmentation
postural hypotension
dizziness
vomitign

244
Q

what is the cause of cushing disease

A

excess cortisol

245
Q

what is the mots common cause of Cushing disease

A

iatrogenic –> corticosteroid use

246
Q

apart from insulin and autoantibodies what other marker in the blood can be used to detect T1DM

A

cleaved C peptide

247
Q

what are the 3 types of insulins

A

long acting
short acting
intermediate acting

248
Q

what type of acid base disorder is present in DKA

A

metabolic acidosis

249
Q

along with insulin and fluids what else might a patient receive when trying to treat DKA

A

K+

250
Q

what are 3 symptoms of phaeachromocytoma

A 
severe HTN 
sweating 
palpitations 
headaches
hot flushes
251
Q

what is the most appropriate imaging for diagnosing phaeachromocytoma

A

CT abdomen and pelvis

252
Q

what is the cause of gynacomastia and erectile dysfunction

A

low testosterone

253
Q

what hormones are secreted by the pituitary gland

A

FSH, LH, ADH, prolactin, GH, TSH

254
Q

what is given in hyperkalaemia to stabilise the heart

A

calcium gluconate

255
Q

what will the ECG in hyperkalaemia show

A

tall t waves

broad QRS

256
Q

what meds can be given to treat hyperkalaemia

A

calcium gluconate
insulin
nebulise salbutamol
calcium resonium

257
Q

What hormones are responsible for regulating calcium

A

PTH and calcitonin

258
Q

what is the pneumonic for hypercalaemia

A

moans
groans
stones
psychiatric tones

259
Q

what electrolyte should always be checked when there is abnormalities in Ph

A

Mg

260
Q

where is Mg absorbed in the gut

A

small bowel

261
Q

what is one adverse feature of hyponatraemia you should be worried about

A

seizures

262
Q

what are the 2 most common causes of metabolic acidosis

A

DKA

sepsis

263
Q

when does NICE recommend starting treatment for hypothyroidism

A

TSH >10

264
Q

list 3 causes of hypercalaemia

A

dehydration (elderly)
drugs
cancer
hypophosphataemia

265
Q

what is the cause of conn syndrome

A

high aldosterone

266
Q

which bone condition is associated with hyperparathyroidism

A

osteoperosis

267
Q

what is 1st line treatment in T1DM pt who collapses and is unconscious

A

IV 10% dextrose

268
Q

what is the diagnosis

acute onset thyroid pain, fever, post viral infection, T4 raised

A

subacute thyroiditis

269
Q

how does a thyroid storm present

A

arrythmias, HTN, very unwell, very high thyroid levels

medical emergency

270
Q

what is the most common cause of hypoparathyrodisim

A

surgical resection of the parathyroid glands

271
Q

what is the diagnosis:

BP: 210/110, HR: 120, sweating, pallor, dyspnoea

A

phaeochromocytoma

272
Q

what hormone is responsible for acromegaly/gigantism

A

GH

273
Q

what is the most appropriate way of calculating the need for statin

A

QRISK2

274
Q

lack of what hormone causes diabetes insupidus

A

ADH

275
Q

what is the diagnosis

previous bowel resection, muscle weakness, tremor, palpitations

A

hypo magnesia

small bowel reabsorbs Mg

276
Q

what is the diagnosis:

Baby bottle fed, eczema, colic, loose frequent stool, GORD, poor growth:

A

lactose intolerance

277
Q

what is the diagnosis:

Painful bones, renal stones, abdo groans, moans:

A

hypercalaemia

278
Q

when should a statin not be used to treat hyperlipidaemia

A

in patients with hep B

279
Q

what medication use can be associated with galactorrhea

A

antipsychotics

280
Q

what is the diagnosis:

fatigue, weight loss, hypeorpigmentation

A

addisons

281
Q

what would indicate prostitis on examination using DRE

A

painful during DRE

282
Q

what is 1st line medication for BPH

A

tamsulosin

283
Q

what type of medication is tamsulosin

A

alpha blocker

284
Q

what is 2nd line management in BPH after tamsulosin

A

finasteride

285
Q

what pathogen is the most common cause for balantitis `

A

candida albicans

286
Q

what spinal roots are involved in a spinal cord injury presenting with incontinance

A

sacral 2,3,4,

287
Q

what would you inspect in a patient presenting with bowel incontinance

A

antler tone and sphincter tone

288
Q

what is the diagnosis

testicular mass that transluminates on examination

A

hydrocele

289
Q

what is the next best step:

85yr old female, +nitrites

A

obtain a hx

290
Q

would you urine dip test on a 80 yr old female presenting with UTI symptoms

A

nope

bacterial would be present anyway

291
Q

what organism is the most likely cause for prostitis

A

e.coli

292
Q

what investigations would you do 1st line in

unprotected sex, new partner + penile discharge

A

1st line void urine sample

293
Q

what should you look for in

unprotected sex, new partner + penile discharge

A

gonorrhoea

294
Q

what is the most appropriate 1st line investigation in:

present female, loin to groin pain and microscopic haematruria

A

USS because she is pregnant

295
Q

what imaging would you perform in a female suspecting kidney stones

A

CT KUB

296
Q

what is the most common cause for urethral injury

A

surgical trauma

297
Q

what is phimosis

A

swelling of the of the foreskin and is not retractable

298
Q

what is the most appropriate treatment for phimosis

A

hydrocortisone

299
Q

list 3 features of nephrotic syndrome

A

facial oedema
lipiduria
low serum albumin

300
Q

what is the most common genetic inheritance pattern for polycystic kidney disease

A

autosomal dominant

301
Q

what can affect the result of a PSA test

A

rectal exam, UTI and sexual intercourse

302
Q

what is the diagnosis

left loin pain + microscopic haemoturia

A

pylonephritis

303
Q

what is 1st line treatment in pyelonephritis

A

ciprofloxacin

304
Q

what is the diagnosis

14 yr old sudden onset severe scrotal pain, no traum

A

testicular torsion

305
Q

what is epididomocytis

A

infection of the epidiyomsos and testicle

306
Q

what is the diagnosis

7 yr old, painless palpable mass in the loin

A

wilms tumour

307
Q

list 3 Rfx for renal cell carcinoma

A

age, obesity and HTN

308
Q

how does a posts abscess present

A

deep abdo pain

309
Q

what is the most common cause of anaemia in CKD

A

reduced erythropoietin synthesis

310
Q

how would an abscess present on USS

A

it would look dense and think on USS

311
Q

list 3 occupational RFx for bladder cancer

A

working with paint/dyes

312
Q

what imaging would you use if you see a soft tissue mass/hydrocele and why

A

USS to determine the density

313
Q

what is a common symptoms of bladder cancer

A

unexplained painless haematuria

314
Q

what imaging technique should you use to look for bladder cancer

A

cystoscopy

315
Q

give 2 hygiene advises you would give to prevent UTI

A

seeing after sex

wipe from front to back

316
Q

when should you consider referrals in UTI

A

recurrent UTI >3 in year

317
Q

what should you do if patient has not responded to abx given for UTI

A

urine sample and culture

if need to change abx or for resistance

318
Q

how would you diagnose a hydronephrosis

A

USS

319
Q

what is hydronephrosis

A

build up of fluid in the kidney commonly due to obstruction

320
Q

list 3 causes of pre-renal AKI

A

hypovolaemia
blood loss
dehydration
HF

321
Q

what are the common causes of renal AKI

A

glomerularnephritis
nephrotic syndrome
nephritis syndrome

322
Q

list 3 causes of post renal AKI

A

stones
cancer
tumour

323
Q

what is present ninth urine in nephritic syndrome

A

blood

324
Q

what is present in the urine on nephrotic syndrome

A

protein

325
Q

what symptoms will be present with a loss of protein in the urine

A

oedema

326
Q

what will be high in the blood in pts with nephrotic syndrome and why

A

high cholesterol because the liver is trying to compensate

327
Q

how would you diagnose nephrotic/npehritic syndrome

A

biopsy

328
Q

what number of GFR would make you consider dialysis

A

GFR <10

329
Q

what are the 2 most common causes of renal problems

A

HTN and diabetes

330
Q

list 2 causes that increase the risk of developing stones

A

dialysis

dehydration

331
Q

what is a stag horn calculi

A

large renal stones

332
Q

what size of renal stone would make you refer to renal

A

> 5mm

333
Q

what is management options for balantitis

A

hydrocortisone and hygiene
clean properly
retract the foreskin

334
Q

what medication is used to treat prostitis

A

2 weeks of ciprofloxacin

335
Q

what is the diagnosis

difficulty starting stream of urine, dribbling and nocturnal urination

A

BPH

336
Q

list 2 alpha blockers that can be used to treat BPH

A

tamsulosin

doxazosin

337
Q

list 2 SE that are common with the use of alpha blockers

A

postural hypotension

dizziness

338
Q

what type of medication is finasteride

A

alpha educate inhibitor

339
Q

what levels will be high in rhabdomyolysis

A

CK

340
Q

what is the cause of rhabdomyolysis

A

breakdown of skeletal muscle

341
Q

what are elderly people who have had a fall and found on the floor over a long period of time at risk of developing

A

rhabdomyolysis

342
Q

what causes AKI in rhabdomyolysis

A

myoglobin released and deposits in the kidney

343
Q

what is the most common cause of urinary retention

A

urethral strictures

344
Q

list 3 obstructive causes of urinary retention

A

stones
masses
post surgery
medication

345
Q

what investigation would you consider in patients with urinary retention

A

bladder scan

346
Q

does caudal equine present with urinary incontinance or urinary retention

A

urinary retention

347
Q

what investigation should you consider in pt with testicualr cancer and why

A

MRI spine to look for mets

348
Q

what is a major complication of testicular torsion if left untreated

A

infertility

349
Q

what meds are used to treat vasculitis

A

steroids

350
Q

what are the 2 common STI that present with penile discharge

A

gonorrhoea

chlymidia

351
Q

what is 1st line medication for chlymidia

A

doxycycline

352
Q

what other blood would you consider in its with STI

A

HIV screen

353
Q

where do you refer pts too if diagnosed with an STI

A

sexual health screen

354
Q

what is the diagnosis and what is the other name of the presentation

single painless genital ulcer

A

syphillis

shanks

355
Q

what is crytochidism

A

undescended testes can be unilateral

356
Q

does cryptorchidism present

unilateral or bilateral

A

can be both

357
Q

what can increase the risk of cryptorchidism

A

alcohol use during pregnancy

358
Q

how would you manage cryptochidism

A

refer to urology

359
Q

what is 1st line treatment for depression

A

SSRI
citalopram
centreline
fluoxetine

360
Q

what does NICE recommended as 1st line treatment for depression

A

SSRIs

361
Q

when is fluoxetine given to a pt with depression

A

<18 yrs old

362
Q

what SSRI will be prescribed to an 18yr old with depression

A

fluoxetine

363
Q

given an example of a sedation antidepressant

A

lofepramine

mirtazepine

364
Q

when would grief reaction be considered abnormal

A

> 6 months

365
Q

what is 1st line management for grief reaction

A

CBT

366
Q

give an exmaple of a mood stabiliser

A

lithium

367
Q

what medication can be used bipolar to stabilise mood

A

lithium

368
Q

how often do pts on lithium get their blood monitored

A

every 6 months

369
Q

what must pts on lithium be informed about when on it

A

lithium toxicity

370
Q

what anti-psychotics has a risk of agranulocytosis

A

clozapine

371
Q

what med is used 1st line treatment in alzhimes

A

donepezil

372
Q

what is the moa of donepezil in treating alzheimer’s

A

slowing down cognitive decline

373
Q

list 2 antipsychotics

A

Rispiradone

olazapine

374
Q

what is 1st line treatment for anxiety

A

CBT

375
Q

what med can be used to manage SOB and palpitations in anxiety

A

propranolol

376
Q

what medication would be used in someone who presents with anxiety and low mood

A

sertraline

377
Q

what BMI does NICE suggest considering bariatric surgery

A

> 35 BMI

378
Q

give an example of a medication that can be used to help with weight loss

A

orlistat

379
Q

what is given in acute alcohol withdrawal to prevent psychiatric complications

A

thiamine

380
Q

what does NICE reccomened as 1st line treatment for smoking cessation

A

NRT

381
Q

who should you contract when there is a suspicion of child abuse

A

child safeguarding lead and safeguarding officer

382
Q

what is 1st line treatment for OCD

A

CBT

fluoxetine

383
Q

what is 1st line treatment in for a child with ADHD

A

methylpenidate

384
Q

what is the best way to treat panic disorder

A

CBT

385
Q

what is the diagnosis:

17 yr old girl, thinks shes fat, BMI 16.5, poor eating, uses weight loss pills

A

anorexia nervosa

386
Q

what is the most appropriate adjunct for generalised anxiety

A

sertraline

387
Q

what is 1st line treatment for new schizophrenia

A

quetapine

388
Q

what is dysthymic disorder

A

chronic long term mild depressive mood

389
Q

what is 1st line treatment for dysthymic disorder

A

CBT

390
Q

what is the diagnosis:

Mixed low mood, disinhibition, poor concentration, flight of idea

A

bipolar disorder

391
Q

how bipolar disorder characterised

A

episodes of depressive mood and mania

392
Q

what is the best treatment for PTSD

A

CBT

393
Q

what test should be done initially in a female present with menorrhagia

A

STI screen

394
Q

what is the 1st line treatment for menorrhagia

A

COCP

tranexamic acid

395
Q

what is the diagnosis:

discharge from cervix, infection and inflammation

A

cervicitis

396
Q

what is the most common cause of cervicitis

A

STI

397
Q

what symptoms does fibroids present with

A

pain
menorrhagia
dysmenorrhoea

398
Q

what is the most common complication of gestational diabetes

A

oversized baby

399
Q

what is hypothyroidism associated with in pregnancy

A

mental retardation

400
Q

what happens to thyroid medication in hypothyroidism during pregnancy

A

increased due to an increase in demand

401
Q

what is the diagnosis:

43 yr old, breast pain, redness, tenderness and nipple discharge

A

mastitis

402
Q

what does the management of a cystocele involve

A

ring pessary

403
Q

what is the diagnosis

white cream discharge + vaginal soreness and irritation

A

thrush

404
Q

what is the management for vaginla thrush

A

clotrimazole cream

405
Q

what is an alternative that can be used to manage vaginal thrush if clotrimazole cream does not work

A

single dose fluconazole

406
Q

would you refer this pt for the 2ww

33 yrs old + unexplained axially lump

A

yes

407
Q

would you refer this pt for the 2ww

50 yrs + nipple retraction

A

yes

408
Q

how would you be able to differentiate between mastitis and milk mastitis

A

milk mastitis improves after feeding the baby

409
Q

what is a cystocele

A

when the bladder drops into the vagina due to weakness in the walls

410
Q

what is placenta preveria

A

low lying placenta that partially/completely covers the cervix

411
Q

how would you manage dysmenorrhoea in a female who is not sexually active and has no PMH

  1. COCP
  2. IUD
  3. mefenamic acid
A

Mefenamic acid

412
Q

how would you manage dysmenorrhoea in a female who is sexually active and has no PMH

A

COCP/IUD

413
Q

what is the treatment for chlamydia

A

doxycycline for 7 days

414
Q

what is the treatment for chlamydia if doxycycline is contraindicated

A

azithromycin

415
Q

where do you refer someone to if they have tested + for UTI

A

GUM clinic

416
Q

how would you manage this pt

severe premenstural symptoms, taking time off work, PMH migraine with aura

A

SSRI during the leutal phase

417
Q

what scan is used in pregnancy to look at the thickness of a the neck in helping to diagnose downs syndrome

A

nuchal translucency scan

418
Q

what are you at risk of developing if you forget to take your tampon out

A

toxic shock syndrome

419
Q

at what age are women sent for cervical screening and how often

A

25-64

every 3 years till 50

420
Q

what is the diagnosis

infertility, cyclic pelvic pain, deep dysparenuina, heavy bleeding, not responding to NSAID

A

Endometriosis

421
Q

what is the 1st investigation to carry out in a female presenting with RIF pain

A

pregnancy test

422
Q

what is the possible diagnosis

pregnant female + proteinuria

A

pre-eclampsia

423
Q

what medication would you give to a pregnant female with HTN and proteinuria

A

labetalol

424
Q

how would you manage a lady on antidepressants who is trying to conceive

A

adjust the medication according to the risks/benefits

425
Q

what is the diagnosis

28 yr old, irregular periods, hirtirism, acne

A

PCOS

426
Q

after how long should you consider referral in those unable to conceive

A

> 12 months

427
Q

what should you check in females who are unable to conceive

A

day 21 progesterone (28 day cycle)

428
Q

what should you check in males who are unable to conceive

A

check sperm count

429
Q

what is the priamry risk of rhesus incompatibility in pregnancy

A

newborn haemolytic anaemia

430
Q

what are the 2 emergency contraceptions that can be given

A

ella one

IUD

431
Q

what is the diagnosis

snowstorm appearance on USS

A

molar pregnancy

432
Q

what signs might indicate a molar pregnancy

A

dark vaginal bleeding

pain

433
Q

how would you manage this patient

52 yr old, sweats, irritable vaginla dryness

A

combined HRT

434
Q

what is the medical management for ectopic pregnancy

A

methotrexate

435
Q

what could be the possible diagnosis:

52 yr old abdo pain, distention and pelvic pain

A

ovarian cancer

436
Q

what is the cancer marker for ovarian cancer

A

ca125

437
Q

what is the diagnosis

27 yr old struggling to have sex due to vaginal muscle spasms

A

vaginismus

438
Q

what is the 1st line treatment for vaginismus

A

psychosexual counselling

439
Q

what is second line treatment for vaginismus

A

vaginal dilators

440
Q

what joint does gout present on

A

usually 1st metatarsal

441
Q

what is 1st line medication for gout

A

NSAIDs

442
Q

what is 2nd line medication for gout

A

colchicine

443
Q

what is 3rd line medication for gout

A

prednisolone

444
Q

what is prophylaxisis treatment for gout

A

allopurinol

445
Q

what is important to mention to the patient when initially starting them on allopurinol for gout

A

initially causes a flare in gout

446
Q

what is 1st line treatment for sprain/strains

A

RICE

rest
ice
compression
elevation

447
Q

what is the diagnosis:

70 yr old, proximal muscle weakness no meds

A

poly myalgia rheumatica

448
Q

what blood marker would you look for in poly myalgia rheumatica

A

ESR

449
Q

what is medical treatment for poly myalgia rheumatic

A

trial prednisolone

450
Q

what are the 4 features present on X-ray in osteoporosis

A

loss of joint space
osteophytes
subchondral cysts
sclerosis

451
Q

what is the characteristic presentation of pagets disease

A

bow legs

452
Q

whihc is the most common direction of dislocation of the shoulder joint

A

anterior

453
Q

what nerve is at greatest risk of damage in shoulder dislocation

A

axially nerve

454
Q

what sign will be present in axially nerve damages

A

payers patch

455
Q

what assessment tool is used in the diagnosis of osteoporosis without RFx

A

qfax

456
Q

name a bisphosphanate used in the treatment for oesteoperosi

A

alendrenic acid

457
Q

what is the initial treatment for a score of -2.5

A

calcium
vit d
alendronic acid

458
Q

what is osgood scatters disease

A

inflammation and swelling on the the tibial tuberosity

459
Q

what is the most common group to develop osgood shatters disease

A

common in teens who are very active

460
Q

what is the most appropriate 1st line medication for tennis elbow

A

topical NSAIDS

461
Q

apart from NSAID what are the other management options for tennis elbow

A

physio

steroid injection

462
Q

how is carpal tunnel treated initially

A

splint

463
Q

what is the clinical test used for the diagnosis of carpal tunnel

A

tinnels test

464
Q

what is the most common cause of caudal equine

A

disc herniation

465
Q

what are 3 features of caudal equine

A

sandal paraesthesia
faecal incontinance
urinary retention

466
Q

what is the diagnosis:

tenderness on the 5th metacarpal

A

boxers fracture

467
Q

what is the name of the fracture that is a result of a fall on a outstretched hand

A

collies fracture

468
Q

what is the name of the deformity seen in a collies fracture

A

dinner fork deformity

469
Q

what is the displacement send in a collies fracture

A

posterior displacement of the radius and ulna

470
Q

what is the diagnosis:

24 yr old, 3 month recurrent back pain, fatgiue, stiffness that disturbs sleep

A

ankylosing spondylosis

471
Q

does ankylosing spondylosis improve with expertise or worsen with exercise

A

improves with exercise

472
Q

what is the name of the maker specific to ankylosing spondylosis

A

HLA B27

473
Q

what does the management for ankylosing spondylosis involve

A

physio

analgesia

474
Q

what is the diagnosis:

reactive arthritis, conjunctivitis, urethritis

A

Reiters syndrome

475
Q

what is the most common cause of reiters syndrome

A

STIs

476
Q

what is the diagnosis:

joint pain, butterfly rash, mouth ulcers, fatigue, lymphadenopathy

A

SLE

477
Q

how is SLE treated

A

DMARDs

478
Q

what age group is osteosarcoma commonly seen in

A

young

479
Q

what is the most specific antibody see in RA

A

ACCP

480
Q

what is polyarertitis nodosum

A

chronic vasculitis presenting with skin manifestations

481
Q

what is the diagnosis

dry eyes
dry mouth
joint pain

A

sjogren syndrome

482
Q

what is the diagnosis

fibrous thickening of the skin due to excess collagen formation

A

scleorderma

483
Q

what is a consequence of bit d deficiency

A

osteomalacia

484
Q

deficiency in what vitamin with cause night blindness

A

vit a

485
Q

deficiency in what vitamin causes survey

A

vit c

486
Q

deficiency in vitamin b1 causes what condition

A

beriberi

487
Q

what is the diagnosis

progressive pain, restricted movement in shoulder over few months

A

adhesive capsulitis

488
Q

what is the treatment for adhesive capsulitis

A

physio

analgesia

489
Q

what is the classic sign seen in suprasinatus tendonitis

A

painful arch

490
Q

what is the classic sign seen in biceps rupture

A

popeye sign

491
Q

what is the diagnosis:

unilateral swollen joints, red, inflamed, pain on movement, pyrexia

A

septic arthritis

492
Q

what happens in a pulled elbow

A

partial dislocation of elbow

493
Q

what is the main risk of an open fracture

A

osteomyelitis

494
Q

what is the most common sign present in meniscus injury

A

locking of the joint

495
Q

what is the most common sign on examination with a cruciate ligament injury

A

giving way

496
Q

what spinal vertebrae is injured in a hangman’s fracture

A

c2

497
Q

what is the diagnosis:

12 yr old boy, overweight, pain in left hip and limp

A

slipped upper femoral epiphysis

498
Q

what is perthes disease

A

stopped blood flow to the head of the thigh bone which causes avascular necrosis

499
Q

what age group does perthes disease commonly affect

A

young

children aged 3-11

500
Q

what is the pathophys of irritable hip

A

inflammation of the synovial membrane usually following viral infection

501
Q

what imaging technique is used to diagnose irritable hip

A

USS

502
Q

what medications group show poor management in MSK pain

A

opioids

503
Q

what is the diagnosis

2 yr old, seal like barking cough, coryza symptoms, mild intercostal recession

A

croup

504
Q

what is the management of croup

A

single dose dex

505
Q

what finding in the hx would indicate epiglottitis

A

unvaccinated child

506
Q

where would a forge in body commonly get stuck in hinhalation

A

right lobe

507
Q

what is the diagnosis:

child, lethargy, unconscious, sweet smelling breath

A

DKA

508
Q

what is the diagnostic test in DKA

A

capillary blood glucose

509
Q

what is the cause of cerebral palsy development

A

hypoxia during birth

510
Q

what is the treatment for worms

A

mebendazole

511
Q

list 3 childhood vaccines

A

MMR
HPV
pertussis

512
Q

what is the diagnosis

Adult exertional dyspnoea, congestive HF congenital cardiac abnormality

A

atrial septal defect

513
Q

what heart defect present with a machinery murmur

A

patent dutose arteriosus

514
Q

which heart defects present early as a child

A

VSD

PDA

515
Q

what are the 4 heart defects in tetralogy of fallot

A

VSD
right ventricular hypetropy
pulmonary stenosis
correction of the aorta

516
Q

what congenital conditon is associated with tetralogy of fallot

A

downs syndrome

517
Q

what is the diagnosis

7 yr old, repetitive speech, abnormal emotional response, low social interest:

A

autism spectrum disorder

518
Q

how should asthma be diagnosed in a child

A

clinical judgement

519
Q

what is the management of ?asthma in a child <5 yrs old

A

trial steroid inhaler

520
Q

what is the recommended asthma management in teens and why

A

MART

combined maintenance and deliver due to less compliance

521
Q

what is the diagnosis:

Episodic abdo pin, vomiting, drawing knees to chest, blood/mucus in stool:

A

intersusception

522
Q

what is the diagnosis:

Previous bacterial throat infection, 4 wk later swollen joints, chest pain, dyspnoea, rash

A

rheumatic fever

523
Q

what is the most common cause of rheumatic fever

A

streptococcus

524
Q

what age should you refer a child 2ww a child to beads with undescended testes

A

> 8 weeks

525
Q

what is the diagnosis

African refugee, initial bone pain, acute abdo pain, anaemia on FBC

A

sickle cell anaemia

526
Q

what is the diagnosis:

5m child, 2 day coryza, tachypnoea, crackles on chest

A

bronchiolitis

527
Q

list 2 reps conditions that cane arise from an unvaccinated child

A

epiglottis

whooping cough

528
Q

what vessel is at risk of injury in a distal fracture of humerus with anterior displacement

A

brachial artery

529
Q

what is the diagnosis

Adolescent boy, anterior knee pain during exercise,, settles with rest

A

osgood scalpers disease

530
Q

what is the diagnosis

6yr old child, 4 day limp, viral URTI, otherwise well

A

transient syvonitis

531
Q

what medication can help with bed wetting

A

desmopressin

532
Q

what conservative management can help with bed wetting

A

enuresis alarm

533
Q

what what age would you be worried about a child bedwetting

A

> 5 yrs

534
Q

what xlinked condition can cause haemolytic crisis in children

A

G6PD deficiency

535
Q

what is the diagnosis

Unvaccinated child, headache, joint pain, fever, parotid swelling:

A

mumps

notifiable disease

536
Q

what is the diagnosis

sudden severe abdo pain

A

strangulated hernia

high yield Q's (2 decks)

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