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Year 4 > Intensive Revision Period > Flashcards

Intensive Revision Period Flashcards

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1
Q

What does the DEXA score relate to?

A

Compares the bone density compared to that of a healthy young adult

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2
Q

Key differences between psoriatic and rheumatoid arthritis

A

Psoriatic arthritis = results in DIP swelling, dactylitis

Both have a pattern of inflammatory arthritis

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3
Q

What is Scheurmann’s Disease?

A

Usually seen in pubertal females

See abnormal ossification of the thoracic vertebrae

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4
Q

Sudeck’s Atrophy =

A

= complex regional pain syndrome

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5
Q

Sulphasalazine can result in… (males)

A

= oligospermia

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6
Q

If on long term steroids need…

A

Need bisphosphonates e.g. alendronic acid

Make sure that they are not calcium or vitamin D deficient

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7
Q

What does the Weber classification relate to?

A

Used to assess ankle fractures

Relates to the syndesmosis (made of anterior and posterior inferior tibiofibular ligament)

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8
Q

Sunburst appearance =

A

= osteosarcoma

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9
Q

Blood test changes associated with Lupus (4)

Flare VS Infection

A 
Haemolytic anaemia 
Leucopaenia 
Lymphopaenia 
Thrombocytopaenia 
ESR = raised in a flare 
CRP = raised in an infection
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10
Q

Difference in blood tests:

Primary vs Secondary Hyperparathryoidism

A

= calcium

Will be high in primary, low in secondary (appropriate response to hypocalcaemia)

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11
Q

Difference in blood tests:

Osteomalacia VS Paget’s

A

= calcium
Both will have high ALP and may present with pain
Calcium will be normal in osteomalacia and raised in Paget’s disease

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12
Q

Epidural abscess VS discitis

A

Discitis pain will be a prominent feature

In an abscess there may not be focal pain

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13
Q

Behcet’s Disease =

A

= a vasculitis, classically see oral and genital ulcers and uveitis
May also see a polyarteritis, arterial thrombosis or DVT

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14
Q

PCI - deciding on anti-platelets

A

= dual antiplatelets e.g. aspirin + another agent
Aspirin + Prasugrel/Ticagrelor = if not on anti-coagulants
Aspirin + Clopidogrel = on anti-coagulants

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15
Q

What is osteochondritis dissecans?

A

= loss of blood supply to part of bone, part of bone breaks off and causes pain and locking symptoms

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16
Q

How long are people with shingles infectious for?

A

Until the vesicles have crusted

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17
Q

What formulation is the chicken pox vaccine in?

A

2 doses

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18
Q

What is the pathophysiology of seborrhoeic dermatitis?

A

It is a reaction to malassezia (type of fungus)

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19
Q

Features of hereditary haemorrhagic telangiectasia (4)

A

Epistaxis
Telangiectases
Visceral lesions
Family history

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20
Q

Investigation of suspected contact dermatitis

A

Patch testing

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21
Q

PUVA

  • Uses
  • Risk
A

Used in management of psoriasis

Associated with SSC

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22
Q

Prescribing courses of topical steroids in psoriasis

A

Need to have a gap of 4 weeks between courses

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23
Q

Dot haemorrhages diagnostic of

A

Diabetic retinopathy

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24
Q

Which cells in the body rely on glycolysis?

A

Erythrocytes

They don’t have any mitochondria

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25
Q

What causes erysipelas?

A

Strep pyogenes

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26
Q

Association of thrombophelbitis migrans

What is it?

A

Pancreatic cancer

= Trosseau syndrome: phelbitis with a thrombus

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27
Q

Unusual presentation of hyperglycaemic hyperosmolar state

A

Focal neurology

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28
Q

Lateral medullary vs Weber’s Syndrome

A

Lateral medullary = sensory
Contralateral sensory loss body
Ipsilateral sensory loss face

Weber’s = motor
Contralateral hemiplegia
Ipsilateral CN III palsy

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29
Q

CMV eye disease in HIV

A

Use ganciclovir

Wait to start HAART until they have recovered - may cause a deterioration

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30
Q

Lichen planus VS sclerosus

A 
Planus = purple 
Sclerosus = white, itchy, vulva
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31
Q

Definition of orthostatic hypotension

A

Drop of 20 SBP after three minutes of standing

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32
Q

Fluconazole and warfarin

A

= p450 inhibitor

Greater availability of warfarin, INR increases

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33
Q

Previous fracture + discharging sinus

A

Consider osteomyelitis

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34
Q

1y hyperaldosteronism VS renal cell tumour

A 
1y = high aldosterone and low renin 
RCC = high aldosterone and high renin
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35
Q

ECG signs in digoxin toxicity (3)

A

T wave inversion
ST depression
Short QT

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36
Q

Widespread T wave inversion on ECG…

A

Think non-cardiac cause e.g. head injury

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37
Q

Indication for stopping a statin

A

Liver enzymes 3x the upper limit of normal

Below that, keep them on the statin and monitor

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38
Q

Add in management for hypertension but potassium is high

A

Avoid spirinolactone

Use alpha or beta blocker instead

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39
Q

What is cortical blindess?

A

= blindness without an ophthalmological cause

e.g. occipital lesion

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40
Q

What is reverse cholesterol transport?

A

Transport of cholesterol from peripheral tissues to the liver
Done by HDL - need HDL to process cholesterol

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41
Q

Ascending cholangitis VS acute cholecystitis

A 
Cholecystitis = normal bilirubin 
Cholangitis = abnormal bilirubin, may be jaundiced
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42
Q

Management of acute sinusitis

A

Pain management
Symptoms for 2 weeks = intranasal steroid
Symptoms for 4 weeks or severe = phenoxymethylpenicillin

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43
Q

Causes of gradual visual loss (4)

A

ARMD
Cataract
Diabetic retinopathy
Open angle glaucoma

44
Q

Risks of Plasma Exchange (2)

A

Bleeding (lose clotting factors)

Hypocalcaemia

45
Q

What is a Jacksonian Seizure?

A

= type of simple partial seizure

Usually starts in the mouth and the spreads to that side of the body

46
Q

Management of orbital fracture

A

Delay surgical repair

Allows oedema and diplopia to improve

47
Q

Investigation of recurrent UTIs

A
  1. Urinary USS

2. Flexible cystoscopy

48
Q

Management of alcoholic hepatitis

A

Steroids

49
Q

Infection in kids associated with lymphocytosis

A

Whooping cough

50
Q

Proximal myopathy

- Associated gait

A

Waddling gait = can be associated with osteomalacia

51
Q

Investigation of acute limb ischaemia

A

Doppler of pulses

Then want to determine whether is a thrombus or embolus

52
Q

Investigation of Oesophageal Rupture

A

CT contrast

53
Q

Investigation of suspected cervical spine #

A

CT neck

54
Q

Proctitis + Lymphadenopathy

A

Lymphogranuloma venerum

55
Q

Management of acute gout in CKD 4

A

Use steroids

NSAIDs contra-indicated

56
Q

Confirmation of rotator cuff tendinopathy

A

Don’t need to investigate, clinical diagnosis

Manage using physiotherapy

57
Q

Management of ‘terminal restlessness’

A

Midazolam

58
Q

Where do you see the first changes in Alzheimer’s Disease?

A

Temporal lobe

59
Q

Epidural VS Spinal Anaesthesia as Post-Operative Pain Management

A

Epidural can be topped up/titrated, spinal cannot be

60
Q

Presentation of delirium tremens (4)

A

Confusion
Visual hallucinations
Tachycardia
Pyrexia

61
Q

How long do you continue anti-coagulation in DVT?

A 
Provoked = 3 months 
Unprovoked = 6 months
62
Q

Anti-smooth muscle Ab associated with

A

Autoimmune hepatitis

63
Q

Acute limb ischaemia + embolus suspected

A

= embolectomy

64
Q

Management of Peripheral Arterial Disease (2)

A

Atorvostatin

Clopidogrel

65
Q

H. pylori erradication

A

PPI + Amoxicillin + Clarithromycin OR Metronidazole

66
Q

Surgical management of anal fissure

Why?

A

Sphincterotomy

= relaxes the muscle and gives the fissure time to heal

67
Q

Aortic abnormality associated with Marfan’s Syndrom

A

Dilated aortic root

68
Q

An oliguric crisis is an example of what?

A

Acute dystonic reaction

69
Q

Acute Dystonia
Tardive Dyskinesia
Akathisia

A

Acute Dystonia = sustained contraction: use procyclidine
Tardive Dyskinesia = involuntary movements: use tetrabenazine
Akathisia = severe restlessness: switch anti-psychotic or consider a beta-blocker

70
Q

What is hemiballismus?

A

A type of chorea = involves the arms

71
Q

Management of:

  • Achalasia
  • Pyloric stenosis
A

Achalasia = Heller myotomy

Pyloric stenosis = Ramstedt pyloromyotomy

72
Q

P mitrale is what?

A

Suggests left atrial hypertrophy, commonly in response to mitral stenosis

73
Q

Presentation of biliary atresia (4)

- Management

A 
Prolonged neonatal jaundice 
Hepatosplenomegaly 
Abnormal growth 
Cardiac murmurs
Management = surgical intervention
74
Q

SNRIs e.g. venlafaxine

Monitoring requirement

A

Need to check blood pressure

75
Q

Anal reflex =

A

S4, 5

76
Q

Sudden onset headache
Pituitary tumour
Visual field defect
Hypotension

A

Pituitary apoplexy

= haemorrhage or infarction of the pituitary

77
Q

How does CN VII cause hyperacusis?

A

Get paralysis of the stapedius muscle

78
Q

Management of HIV +VE and suspected LATENT TB

A

Isoniazid for 9 months

79
Q

ST elevation classification =

A

Chest leads = 2mm

Limb leads = 1mm

80
Q

PR Interval =

A

Start of the P wave to the start of the QRS complex

81
Q

Cause of haemolytic anaemia + pneumonia + maculopapular rash =

A

= mycoplasma

82
Q

Sertoli cell

  • Responds to
  • Produces
A 
Responds = FSH 
Produces = sperm
83
Q

Leydig cell

  • Responds to
  • Produces
A 
Responds = LH 
Produces = testosterone
84
Q

Difference between moderate and severe asthma

A

RR < or > 25

HR < or >110bpm

85
Q

Most common cause of infective exacerbation of COPD

A

H. influenzae

86
Q

Initial investigation of Cushing’s

A

24 urinary free cortisol

87
Q

NSTEMI + Unstable

A

Immediate PCI

88
Q

Investigation

Unprovoked DVT + No symptoms

A

Still consider CT abdomen and pelvis

89
Q

Ferritin high + screening for haemochromatosis

A

Need a transferrin

Will be elevated

90
Q

Management of superficial thrombophlebitis + no DVT

A

NSAIDs for pain management

91
Q

1st line management of SVC due to tumour

A

Dexamethasone to reduce swelling

92
Q

Most common cause of leg cellulitis

A

Strep pyogenes

93
Q

Bronchitis

  • Presentation?
  • How do you decide about antibiotics?
A

Presentation = cough, rhinorrhoea, wheeze, sore throat
Cough may or may not be productive
Use the CRP to decide whether to prescribe antibiotics
- Can offer either delayed prescription or immediate depending on level

94
Q

What is used to reverse NOACs?

A

Andexanet alfa

95
Q

What is used to reverse heparin?

A

Protamine

96
Q

Ejection systolic murmur LOUDER on inspiration

A

= pulmonary stenosis

Remember during inspiration the venous return increases

97
Q

Which bisphosphonate is only available IV?

A

Zoledronate

98
Q

What does cricoid pressure do when intubating?

A

Compresses and seals off the oesophagus, prevents the passage of gastric contents into the airway

99
Q

Painful eye and loss of visual acuity =

A

= ophthalmology assessment

100
Q

Pressure of CSF in bacterial meningitis

A

= high pressure

101
Q

Diffuse VS Limited Systemic Sclerosis

A 
Diffuse = anti-Scl-70 antibodies, includes the chest and upper arms 
Limited = anti-centromere, doesn't involve the chest and upper arms
102
Q

Difference between CML and CLL

A

CML is more likely to be symptomatic, CLL is likely to be an asymptomatic finding

103
Q

Test that can be helpful in determining whether early labour

A

fFN

= foetal fibronectin

104
Q

Management of mycoplasma pneumonia

A

Erythromycin

105
Q

Keratoconjunctivitis sicca =

A

Sjogrens

Year 4 (27 decks)

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