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MRCP > Important x2 > Flashcards

Important x2 Flashcards

1
Q

How do we group ascites

A

SAAG <11
SAAG >11

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2
Q

Causes of ascites
SAAG <11

A

Liver:
- liver cirrhosis
- acute liver failure
- liver mets

Cardiac:
- RHS heart failure
- constrictive pericarditis

Other:
- Budd-Chiari
- Myxoedema

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3
Q

Causes of ascites
SAAG >11

A
  • nephrotic syndrome
  • TB
  • pancreatitis
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4
Q

Management of ascites

A
  1. reduce dietary sodium
  2. fluid restrict if Na+ <125
  3. bacterial prophylaxis: (PO cipro - note treatment for SBP is with IV ceftriaxone)
  4. Spiro
  5. Drainage (if more than 5L will require albumin as well)
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5
Q

Warfarin
- major bleed

A

Stop warfarin
IV vitamin K 5mg
Prothrombin complex

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6
Q

Warfarin
- INR >8.0
- minor bleed

A

Stop warfarin
Give IV vitamin K 1-3mg
Repeat INR if remains high to repeat vitamin K dose
Restart warfarin when INR < 5.0

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7
Q

Warfarin
- INR >8.0
- no bleeding

A

Stop warfarin
Given IV vitamin K 5 mg in oral form
Repeat in 24 hours if INR not less than 5.0
Repeat INR and restart once INR < 5.0

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8
Q

Warfarin 5.0-8.0
- Minor bleeding

A

Stop warfarin
Give intravenous vitamin K 1-3mg
Restart when INR < 5.0

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9
Q

Warfarin 5.0-8.0
- no bleeding

A

Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose

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10
Q

When to add oral cipro for ascites

A

People with cirrhosis and ascites with an ascitic protein of 15 g/litre or less, until the ascites has resolved

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11
Q

What do you need to rule out in acute UC

A

CMV

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12
Q

Diagnostic indicator for SBP

A

neutrophils >250

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13
Q

SBP treatment and prophylaxis

A

Treatment: Oral cefotaxime
Prophylaxis: Oral cipro

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14
Q

K+ replacement

A

1mmol/kg/day

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15
Q

Type 1 renal tubular acidosis

A

low K+, renal stones

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16
Q

Type 2 renal tubular acidosis

A

low K+, osteomalacia

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17
Q

Type 3 renal tubular acidosis

A

low K+

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18
Q

Type 4 renal tubular acidosis

A

high K+

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19
Q

Tumour lysis syndrome electrolytes

A

Low Ca2+, high PO43-, high K+

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20
Q

Tumour lysis management

A

Rasburicase (uric acid to allutonin)

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21
Q

Prevention of haemorrhagic cystitis

A

Mesna

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22
Q

Sideroblastic anaemia management

A

Pyridoxine

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23
Q

Acute promyelotic leukaemia

A

DIC t(15;17)

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24
Q

Hodgkins chemo

A

ABVD

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25
Q

Non hodgkins chemo

A

RCHOP

26
Q

TIA management

A

Aspirin 300mg then aspirin 75mg for 2 weeks and then switch to clopidogrel 75mg

note if already on an anticoagulant continue this

27
Q

Brown-Sequard sx

A
  1. Ipsilateral motor loss
  2. Contralateral temperature and pain and vibration loss
28
Q

Multiple system atrophy symptoms

A

Parkinsons + cerebellar + postural hypotension

29
Q

PSP

A

Parkinsons + downward vision

30
Q

Miller Fisher Syndrome

A

Like GBS but affects the eyes
GQ1b antibodies

31
Q

PCA stroke

A

CN III palsy, ipsilateral (down and out)

32
Q

PICA stroke

A

ipsilateral facial pain and temp. loss, nystagmus and ataxia

33
Q

AICA stroke

A

Like PICA but also has facial paralysis and deafness

34
Q

Chlamydia antibiotics

A

PO doxy for 7 days (azithromycin if pregnant)

35
Q

Toxoplasmosis treatment

A

Sulfadazine and pyrimethiadone

36
Q

Falciparum malaria mx

A

artenusate

37
Q

Non-falciparum mx

A

quinine and doxy (need to check for G6PD deficiency)

38
Q

Rabies histology

A

Negri bodies

39
Q

Prostaglandin analogues

A

end in -prost

40
Q

Endothelin antagonists

A

end in -tan

41
Q

Clari moa

A

Inhibits ribosome 50s subunit

42
Q

Hep A cause

A

Seafood (hep E is pork)

43
Q

Herpes in question with pneumonia

A

Pneumococcal pneumonia

44
Q

Malaria with high parasitic count

A

Plasmodium Knowles

45
Q

Cyclical fevers with malaria
- 48 hours
- 72 hours

A

48: plasmodium vivax
72: plasmodium malariae

46
Q

Diptheria management

A

IM penicillin

47
Q

Cat scratch cause

A

Bartonella

48
Q

Dog scratch cause

A

Pasturella mucocida

49
Q

Pleural effusion transudate

A

<30g/L

50
Q

Transudate causes

A

Heart failure
Hypoalbuminaemia e.g. nephrotic
Liver disease
Meigs
Hypothyroid

51
Q

Meigs

A

Ovarian cancer +pleural effusion +ascites

52
Q

Pleural effusion exudate

A

> 30g/L

53
Q

Pleural effusion exudate causes

A

Infection - pneumonia, TB
RA, SLE
Malignancy

54
Q

Pleural effusion ix

A

PA chest XR, US, CT if exudative cause

55
Q

Pleural effusion should be sent for

A

pH, protein, lactate dehydrogenase (LDH), cytology and microbiology

56
Q

Lights criteria

A

Protein level is between 25-35 g/L

An exudate is likely if at least one of the following criteria are met:
pleural fluid protein divided by serum protein >0.5
pleural fluid LDH divided by serum LDH >0.6
pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

57
Q

When to insert a chest drain for pleural effusion

A

If septic, empyema, cloudy fluid

If clear, pH less than 7.2 then chest drain should be inserted

58
Q

MEN I

A

Parathyroid gland: hyperparathyroidism

Pancreatic: pancreatic neuroendocrine tumour

Women: breast cancer

59
Q

MEN 2a

A

95% of patients with MEN 2 have MEN 2a

  • medullary thyroid cancer
  • phaeochromocytoma
  • hyperparathyroidism
60
Q

MEN 2b

A
  • medullary thyroid cancer
  • phaeochromocytoma
  • mucosal neuroma
  • skeletal abnormalities
  • Sjogrens
61
Q

MEN 1 gene mutation

A

MEN 1

62
Q

MEN 2 gene mutation

A

RET

MRCP (28 decks)

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