High Yield Revision Flashcards
What are the first line medications for focal seizures?
Carbamazepine
Lamotrigine
What are the first line medications for tonic-clonic seizures?
Sodium valproate
Lamotrigine
What are the first line medications for myoclonic seizures?
Sodium valproate
Levetiracetam
What are the first line medications for absence seizures?
Ethosuximide
Sodium valproate
Pyloric stenosis ABG results
Hypochloraemic hypokalaemic metabolic alkalosis
Define ADHD
A persistent pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development
Present before age 12 and in two or more settings
Treatment actinic keratosis
Suncream
5FU
Top diclofenac/imiquimod
Cryo
Jaundice <24 hours causes
Haemolysis eg. Rhesus, ABO, G6PD, spherocytosis
Sepsis
Features of life threatening asthma
PEFR <33% Oxygen <92% Hypotension Cyanosis Silent chest
Development smiling
6 weeks
Sit without support
6-8 months
Start to crawl
9 months
3 block tower
18 months
Painful 3rd nerve palsy ..
Posterior communicating artery aneurysm
Bacteria associated with GBS
Campylobacter
DDH tests
Ortolani - relocates
Barlow - dislocates
Laryngeal cancer is commonest is which region?
Glottic
Average age diagnosis retinoblastoma
18 months
Features of foetal alcohol syndrome
Microcephalic
Flat philtrum
Reduced IQ
Thin upper lip
Migraine triggers
Chocolate Hangovers Orgasms Cheese/caffeine Oral contraceptives Lie ins Alcohol Travel Exercise
Contents of cryoprecipitate
Factor VIII
Fibrinogen
VWF
Factor XIII
DOAC in renal impairment
Apixaban
Management Ménière’s disease
Acute - buccal/IM prochlorperazine
Prevent - betahistine
WHO performance status
0 = fully active 1 = restricted in strenuous activity 2 = ambulatory incapable of all self-care, up and about more than 50% of waking hours 3 = limited self-care, confined to bed or chair for more than 50% 4 = completely disabled, totally confined to bed and chair 5 = dead
MenB vaccine
2 months
4 months
1 year
Brief ALL mx
Multi drug chemo 2-3 years
Classic AML blood film finding
Auer Rods
Polycythaemia Vera mutation
JAK 2
Oncogene of CML
BCR-Abl
t(9;22)
Philadelphia chromosome
Treatment cml
Imatinib - TK inhibitor
Blood film finding CLL
Smudge/smear cells
Reed-Sternberg cells diagnostic for
Hodgkin
Hodgkin management
ABVD chemo
Doxorubicin, bleomycin, vinblastine, dacarbazine
Non-Hodgkin treatment
R-CHOP Rituximab Cyclophosphamide Hydroxydaunorubicin Vincristine Prednisolone
Bench jones protein?
Light chains in urine
Myeloma
Diagnostic criteria myeloma
Paraproteinaemia - serum or urine
Radiological evidence of bone lesions
Increased plasma on BM biopsy
DVLA restriction 1st seizure
6 months
Established epilepsy DVLA restriction
12 months seizure free
On meds = 5 years
Withdrawing epilepsy medication DVLA
6 months after last dose
Single, explained syncope DVLA
4 weeks off
Single, unexplained syncope DVLA
6 months off
Stroke/TIA DVLA
1 month off
Multiple TIAs over short period DVLA
3 months
Normal pressure hydrocephalus triad
Urinary incontinence
Gait abnormality
Dementia
Thrombolysis and thrombectomy windows
Lysis - 4.5 hours of sx onset
Surgery - 6 hours
Total anterior stroke classification
Unilateral hemiparesis/sensory loss
Homonymous hemianopia
Higher cognitive dysfunction
Action of 5FU
Inhibits thymidylate synthesis
Decreases DNA synthesis
Doxorubicin MoA
Inhibits topoisomerase function
Ondansetron moa
5HT3 antagonist
Prokinetic antiemetic
Metoclopramide
Domperidone
Cyclizine MoA
Antihistamine
Late radiotherapy SEs
Skin pigmentation Bone necrosis Lung fibrosis Cardiomyopathy Infertility Early menopause
Early RT SEs
Hair loss Fatigue N+V+D Lymphoedema Mucositis Erythema
CRAB for myeloma
Calcium raised
Renal insufficiency
Anaemia
Bone lesions
Immediate management acute glaucoma
IV carbonic anhydrase inhibitor eg. Mannitol
Autism questionnaire
GARS-2
ADHD questionnaire
Conners
Crawling date
9 months
Following moving objects date
6 weeks
NEC x-day findings
Distended loops of bowel
Intramural gas
Thickened wall
What type of bilirubin can be deposited in the brain?
Unconjugated
Define astigmatism
Abnormal curvature of the cornea
US sign intussusception
Doughnut/target
Organism bronchiolitis
RSV
Organism whooping cough
Bordetella pertussis
Organism croup
Parainfluenza virus
Calories in 1 ounce breast milk
20
Suckling development
34-35 weeks
Coca Cola urine indicates
Post-strep glomerulonephritis
Cluster headache preventive meds
Calcium channel blockers
VSD murmur
Pan systolic left sternal edge
High risk prostate Ca
PSA >20
Gleason 8-10
T stage 2c+
Max dose codeine
60mg QDS
Codeine to morphine ratio
Codeine:morphine
10:1
Bowel obstruction anti emetics
Cyclizine
Dexamethasone
5 main sx of dying
Pain N+V SoB Restlessness Resp secretions
Superficial bladder Ca mx
TURBT
Invasive bladder Ca mx
TURBT or Radical cystectomy or radical RT
Mammogram views
Craniocaudal
Mediolateral oblique
Haemolysis screen
FBC, blood film, reticulocytes Direct Coombs Haptoglobins Bilirubin LDH
Factors in Bloom Richardson
Degree of tubule formation
Extent of nuclear variation
Number of mitoses
Cervical screening
25-49 every 3 years
50-64 every 5 years
Side effects of LHRH agonists
Hot flushes Decreased libido Impotence Weight gain Osteoporosis Gynaecomastia
Commonest hormonal therapy CaP
LHRH agonist
Risk factors colorectal Ca
Red meat High calorie diet Alcohol Smoking Obesity Sedentary lifestyle FAP/lynch
Lung cancer occurring in peripheries
Adenocarcinoma
Large cell
Li Fraumeni cancers
Breast
Lung
Colon
Central scotoma cause
Optic neuritis
Arcuate scotoma cause
Chronic glaucoma
Wernicke’s triad
Mental confusion
Ataxia
Ophthlamoplegia
Non-MS causes optic neuritis
NMO Infections Post-vaccine GBS Sarcoidosis
Argyll Robertson pupil
Bilateral, small, irregular
Absence of light reflex
Prompt accommodation
Glaucoma drugs
Prostaglandin analogues
Beta blockers
Alpha agonists
Carbonic anhydrase inhibitors
Commonest cause of blindness
Age related macular degeneration
Scabies mx
Permethrin cream
Melanoma risk factors
Type 1 skin Sunburn Multiple moles Hx of melanoma Family hx Tanning beds
H+N cancer risk factors
Tobacco
Alcohol
HPV
Triad normal pressure hydrocephalus
Urinary incontience
Gait disturbance
Dementia
OCT
Optical coherence tomography
Cross section of the retina
Define SGA
<10th centile
Causes conjugated hyperbilirubinaemia
Biliary atresia
Prolonged TPN
Hepatitis
Fluid depletion calculation
Weight kg x %fluid depleted x 10
Causes nephritic syndrome
Post-strep glomerulonephritis
HSP
IgA nephropathy
Goodpastures
Complex febrile convulsions features
> 15 mins
Recurs in same illness
Focal
Inheritance of haemophilia
X linked recessive
Cause of slapped cheek
Parvovirus
Cause of hand, foot and mouth
Coxsackie virus
Drug causes ototoxic
Loop diuretics Aminoglycosides Vancomycin Cisplatin Quinine
Acute, painless red eye causes
Episcleritis
Subconjunctival haemorrhage
Conjunctivitis
Acute, painful, red eye causes
Acute glaucoma Anterior uveitis Corneal abrasion/trauma Keratitis/ulcer Scleritis Orbital cellulitis
Risk factors acute glaucoma
Hypermetropia
Family hx
Female 50-60s
Acute, painful loss of vision
Acute glaucoma Anterior uveitis/iritis GCA Optic neuritis Keratitis/corneal ulcer
Acute painless loss of vision
Central retinal artery occlusion
Central retinal vein occlusion
Retinal detachment
Vitreous haemorrhage
Define grades HTN retinopathy
1 - tortuous arterioles, silver and copper wiring
2 - AV nipping
3 - cotton wool spots, dot and flame haemorrhages
4 - papilloedema
Psoriatic nails
Pitting
Ringing
Onycholysis
Steroid ladder
Hydrocortisone
Eumovate
Betnovate
Dermovate
Acne mx
Advice
Topical abx/retinoids and benzoyl peroxide
Oral abx
Oral isotretinoin
Special - laser resurfacing and chemical peels
Melanoma margins
Stage 1 - 1cm
2 - 2cm
3 - 2cm +/- LN
4 - 2cm + immuno/chemo
SCC margin
2-4 mm
Bcc margin
3-5 mm
Weber’s syndrome
Ipsilateral CN3 palsy
Contralateral weakness
(PCA branch)
Wallenberg syndrome
Ipsilateral facial pain and temp loss
Contralateral limb pain and temp loss
Ataxia, nystagmus
(Post, inf cerebellar)
VG sodium channel blockers
Carbamazepine
Phenytoin
Lamotrigine
GABA agonist
Benzos
Sodium valproate
Cataracts risk factors
Increase age UV exposure Diabetes Steroids Smoking/alcohol
Test for metamorphopsia
Amsler Grid
Mx acute glaucoma
IV acetazolamide
Pilocarpine
Laser iridotomy
Example 2 dilator drops
Atropine
Tropicamide
Define glaucoma
Disease of optic nerve due to raised IOP
Define diabetic retinopathy stages
Background - microanuerysms, haemorrhages, hard exudates
Pre-proliferative - cotton wool spots
Proliferative - fragile new vessels
Heparin reversal
Protamine
Benzodiazepine overdose
Flumazenil
Tear drop RBCs suggest
Myelofibrosis
Triple test down’s date and constituents
11 - 13+6 weeks
Nuchal
PAPP-A
HCG
Quadruple test down’s time and constituents
15 - 20 weeks HCG - increased Alpha FP - decreased Oestriol - decreased Inhibin A -increased
Parts of APGAR
Appearance Pulse Grimace (reflex irritability) Activity / muscle tone Respiration
Bloods at booking
FBC
Blood group and rhesus
Haemoglobinopathies
HepB, rubella, HIV, syphilis
Booking visit time
8 - 12 weeks (ideal <10)
Dating US scan date
10 + 13+6 weeks
CV sampling dates
11 - 13+6 weeks
Amniocentesis dates
> 15 weeks
Hyperemesis triad
> 5% weight loss
Dehydration
Electrolyte imbalance
Causes of Pseudobulbar palsy
UMN - MS, vascular disease, tumour
Types of MND and upper or lower signs
ALS - U+L Progressive muscular palsy - L Progressive bulbar - L Pseudobulbar - U Primary lateral sclerosis - U
Multiple systems atrophy triad
Parkinsonism + cerebellar signs + autonomic signs
Progressive supranuclear palsy features
Parkinsonism
Vertical gaze palsy (ophthalmoplegia)