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Progress Test > Hints + Tips > Flashcards

Hints + Tips Flashcards

1
Q

What are the results for primary hyperparathyroidism?

A
  • Increased PTH + Ca (kidney stones)
  • Decreased phosphate
  • Some indication the kidneys are fine
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2
Q

What are results for secondary hyperparathyroidism?

A
  • Increased PTH + phosphate
  • Decreased or normal Ca
  • Decreased Vit D
  • Kidney disease leads to decreased Ca so parathyroid gland becomes hyperactive to compensate
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3
Q

What is tertiary hyperparathyroidism?

A
  • Increased or normal Ca
  • Increased PTH
  • Decreased or normal phosphate + Vit D
  • Increased ALP
  • Kidneys correct, parathyroid overactive
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4
Q

What medications are used for gout flare-up?

A

NSAIDs or colchine

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5
Q

What is slipped upper femoral epiphysis (SUFE)?

A
  • Early adolescence, usually obese
  • Limp
  • Hip, knee or groin pain (hip held in abduction and external rotation)
  • Treatment: non-weight bearing + surgery
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6
Q

What is the investigations for GCA?

A

Scan of temple and temporal artery biopsy

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7
Q

What is osteoarthritis?

A
  • Wear + tear
  • Worse with exercise
  • Not swollen and hot
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8
Q

What is rheumatoid arthritis?

A
  • Improves with exercise
  • Morning stiffness
  • Hot + swollen
  • Might have systemic sx
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9
Q

What is HLA-B27?

A
  • Psoriatic arthritis and ankolysing spondylitis
  • Young man, back stiffness, improves with exercise
  • 1st line - x-ray
  • 1st line - NSAIDs
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10
Q

What do haematological results mean?

A
  • ALWAYS replace B12 before folate
  • Increased reticulocytes - blood loss
  • Increased LDH - haemolysis
  • If blood loss + increased urea - GI bleed
  • In sickle cell disease always admit especially if >38°c or chest symptoms
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11
Q

What are the pathological RBCs?

A
  • Howell-jolly bodies (hyposplenism) - coeliac or sickle cell
  • Target cells - sickle cell/thalassaemia, IDA, hyposplenism, liver disease
  • Heinz bodies + bite cells - G6PH deficiency
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12
Q

What are the signs and symptoms of multiple myeloma?

A

CRAB (calcium, renal, anaemia, bones)

  • Bone pain, osteoporosis + pathological features, osteolytic lesions
  • Lethargy
  • Hypercalcaemia
  • Renal failure
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13
Q

What are investigations for multiple myeloma?

A
  • X-ray - rain drop skull
  • Monoclonal (serum paraprotein), urine paraprotein (Bence Jones)
  • Increased plasma cells in bone marrow
  • Bone lesions (MRI)
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14
Q

Describe the acute leukaemias

A
  • Anaemic, bleeding, infections
  • BLAST cells: take over bone marrow
  • ALL: hepatosplenomegaly
  • AML: Downs
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15
Q

Describe lymphoma

A
  • Palpable LN, night sweats, weight loss
  • Hodgkin’s: Reid steinberg cells
  • Diagnosis biopsy LN
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16
Q

What is psoriasis?

A
  • Well defined areas of scale at sites of minor skin injuries - red, scaly
  • Treatment: emollient 1st line, topical steroids + Vit D analogues
17
Q

What is melanoma?

A
  • Increased UV
  • Asymmetrical, borders are irregular, colour variations, diameter (>6mm), evolving (changing)
  • Breslin stage (how deep it goes into skin 0-IV)
18
Q

What is SLE (lupus)?

A
  • Anti-dsDNA antibody

- Butterfly rash, photosensitive, spares nose

19
Q

What are the investigations for TB?

A
  • Active: sputum culture + smear, CXR, NAAT test

- Latent: Mantoux test/interferon gamma blood test

20
Q

What is the treatment for TB?

A

Rifampicin (orange body fluids)
Isoniazid (peripheral neuropathy, agranulocytosis)
Pyrazinamide (hyperuricaemia - gout, muscle pain)
Ethambutol (optic neuritis)
- Active: 2 months RIPE, 4 months RI
- Latent: 3 months RI or 6 months I

21
Q

What are common things to know about IE?

A
  • Sepsis + prosthetic heart valves
  • Common in IVDUs
  • 3 blood cultures + echo
  • Tricuspid valve most common
  • Staph aureus most common
22
Q

What are management options for tachy/bradycardia?

A
  • Regular narrow tachycardia (SVT) = vasovagal manoeuvre then adenosine
  • VT (broad) = amiodarone
  • Bradycardia = atropine (sometimes)
23
Q

What are the results for thyrotoxicosis?

A
  • TSH receptor antibodies present 90-100% of Graves’ disease
  • Decreased TSH
  • Increased T4
24
Q

What are the results for primary hypothyroidism?

A

e. g. hashimotos
- Anti-TPO antibodies
- Increased TSH
- Decreased T4

25
Q

What are the results for euthyroid syndrome?

A
  • Decreased TSH
  • Decreased T4
  • Thyroid goes off when patient is ill
26
Q

What are common hip pain pathologies in children?

A
  • Irritable hip peaking at 3-8 yrs, treatment: rest and analgesia
  • Septic arthritis (any age - peaking at 0-6yrs): systemically unwell, febrile, unable to weight bear, hot, swollen joint. Emergency: aspirate to confirm, surgical debridement and washout under GA, IV abx
  • Perthes disease (3-12 yrs peaking at 5-7 yrs) - limited and painful rotation and abduction of ipsilateral hip. Treatment: rest, pain relief, orthoses or surgery may be required
27
Q

What is the management for major bleeding?

A
  • Stop warfarin
  • Give IV Vit K 5mg
  • Prothrombin complex concentrate - if not available give FFP
28
Q

What is the management for minor bleeding + INR >8.0?

A
  • Stop warfarin
  • Give IV Vit K 1-3mg
  • Repeat dose of VitK if INR still too high after 24 hrs
  • Restart warfarin when INR <5.0
29
Q

What is the management for no bleeding + INR >8.0?

A
  • Stop warfarin
  • Give Vit K 1-5mg by mouth, using the IV preparation orally
  • Repeat dose of Vit K if INR is still too high after 24 hrs
  • Restart when INR <5.0
30
Q

What is the treatment for minor bleeding + INR 5.0-8.0?

A
  • Stop warfarin
  • Give IV Vit K 1-3mg
  • Restart when INR <5.0
31
Q

What is the treatment for no bleeding + INR 5.0-8.0?

A
  • Withhold 1 or 2 doses of warfarin

- Reduce subsequent maintenance dose

32
Q

What are the ECG changes in pericarditis?

A
  • PR depression
  • Saddle shaped concave ST elevation
  • ST + PR depression in aVR + V1
33
Q

What parts of the heart do the ECG leads show?

A
  • Anteroseptal (V1-V4) - LAD
  • Inferior (II, III, aVF) - right coronary
  • Anterolateral (V4-6, I + aVL) - LAD or left circumflex
  • Lateral (I, aVL +/- V5-6) - left circumflex
  • Posterior (tall R waves V1-2) - usually left circumflex, also right coronary
34
Q

What are the signs and symptoms of Myasthenia Gravis?

A
  • Antibodies against ACh receptors
  • Symptoms worsen with muscle activity + lessen with rest - ptosis, diplopia, dysphagia, proximal muscle weakness
  • Crisis: severe generalised quadraparesis or life-threatening respiratory muscle weakness, measure FVC, manage with plasmapheresis/immunoglobulins
35
Q

What is the investigations + management for myasthenia gravis?

A
  • 1st line: single fibre electromyography, autoantibody levels
  • CT scan for thymoma
  • Management: pyridostigmine + immunosuppression (prednisolone&raquo_space; azathioprine etc)
36
Q

What is Guillain-Barré syndrome?

A
  • Rapidly progressing, but self-limiting polyneuropathy + muscle weakness
  • Usually following a recent infection
  • Most common type is ascending, affecting legs and then arms
  • 5-10% suffer from respiratory paralysis, requiring FVC measurements
37
Q

What are the investigations + treatment for Guillain-Barré syndrome?

A
  • Anti-GMI (anti-ganglioside) antibodies
  • LP + nerve conduction studies
  • Treatment: IVIGI plasma exchange
38
Q

How is neuropathic pain treated?

A
  • Burning + tingling pain, out of proportion with tissue injury
  • Monotherapy one of: amitriptyline, duloxetine, gabapentin or pregabalin
39
Q

What are the features of multiple endocrine neoplasia type 1?

A
  • Peptic ulceration
  • Galactorrhoea
  • Hypercalcaemia
  • Parathyroid, pituitary, pancreas

Progress Test (5 decks)

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