Internal Med Flashcards
1
Q
Mx of provoked PE
A
E.g. long flight
Loading dose then 3 months DOAC
2
Q
What drugs given to treat oesophageal varices and then prevent it
A
Treat= terlipressin
Prevent= Propranolol
3
Q
Which drug to offload fluid in ascites
A
Spirinolactone
4
Q
Which kind of seizure is normally associated with lip/ mouth involvement
A
TempORAL lobe partial seizure
5
Q
Most common cause of endogenous Cushing
A
Pituitary adenoma (cushings’s disease)
Drugs is most common cause (steroids)
6
Q
If no asthma signs and ipratropium not working what to do
A
Stop the SAMA (ipratropium)
Start LAMA and LABA so tiotropium and formoterol
LAMA and SAMA work on the same receptors
Also add salbutamol ?
7
Q
Crypt abscesses which GI problem
A
Ulcerative colitis
Goblet cells and granulomas, villus atrophy are coeliac
8
Q
Which antihistamines are sedating and non-sedating
A
Clhlorphenamine is sedating
Cetirizine, fexofenadine and loratadine are non sedating
9
Q
Which test determines whether kidney injury is acute or chronic
A
If hypocalcaemic it is chronic
10
Q
How to manage bilateral adrenocortical hyperplasia vs adrenal adenoma
A
Hyperplasia treat with spirinolactone (aldosterone antagonist)
Adenoma treat with surgery
11
Q
How to treat trigeminal neuralgia
A
Carbemazepine is first line
Neuro referall if that doesn’t work
12
Q
How to differentiate lambert Eaton and myasthenia gravies
A
Lambert Eaton usually gets a bit better with muscle use, MG worsened
MG affects the face and arms earlier, then legs
LES affects legs
13
Q
What size of AAA requires what monitoring
A
3-4.5cm = every 12 months USS
4.5-5.5 = every 3 months USS
>5.5cm= 2ww to vascular surgery
14
Q
Breastfeeding with HIV
A
No
15
Q
What condition is carbimazole used to treat
A
Propanolol initially to help with Sx
Then if graves
Then carbimazole
16
Q
How to treat mild/ moderate UC flares vs severe
A
Mild/moderate treat at home with topical (rectal) aminosalicylate -> add oral if that doesn’t work
Severe colitis treat with IV steroids -> add IV cyclosporine if that doesn’t work
17
Q
Which cardiac abnormality occurs with high calcium
A
Short QT
Same with high k+
And the opposite is true for low of both
18
Q
Triad of budd-chiari syndrome,e
A
Sudden onset abdominal pain
Ascites
Tender hepatomegaly
19
Q
How to manage idiopathic intracranial hypertension
A
Weight loss
Carbonic anhydrase inhibitors e.g. acetazolamide
Can also use topiramate which helps with WL also
20
Q
Which seizure Types do you not give sodium valproate
A
Focal seizure (partial) give lamotrigine or levetriacetam
Absence seizures (petit mal) give ethosuximide
21
Q
How do discern between anaemia of chronic disease and IDA from iron studies
A
Total iron binding capacity (body’s ability to take in iron)
High in IDA as there’s no iron
Low/ normal in AOCD as the body is storing iron outside of the blood so no free space
22
Q
How to diagnose chronic pancreatitis
A
CT pancreas
23
Q
Which type of prostate drug is likely to cause gynaecomastia
A
GnRH agonists e.g. goserelin
Not doxazosin as much but i think it still can
24
Q
Which diabetes drug causes weight gain
A
Sulphonylureas e.g. gliclazide
25
Why could u do an ECG before starting SSRIs or TCIs
Risk of prolonged QT syndrome
So can do a baseline ECG
Seen more in higher dose
26
Severe acute alcoholic hepatitis Mx
Glucocorticoids e.g. pred in acute episode
Pentoxyphylline is also sometimes used
27
Which BP drug causes ED
Indapamide or other thiazide-like diuretics
28
Which clotting screen does warfarin affect
PT (prolongs it )
No effect on APTT
Because warfarin reduces F7 levels which is in the extrinsic pathway afffecting PT but nt the intrinsic pathway which affects APTT
29
How to differentiate between gastric and duodenal ulcer
Gastric worse on eating
Duodenal better on eating
As when eating the sphincter is closed between the stomach and duodenum so no acid in duodenum and all in stomach
30
Lyme disease Mx
If caught early then 14-21daycourse of oralodxycycline
IV cef when there is CNS involvement
31
What should all people with peripheral artery disease be taking
Statin 80mg
Clopidogrel
32
what us Chvostek’s sign
Twitching of facial muscles on percussion
Classic indication of hypocalcaemia
E.g. after thyroid surgery, damage to PT gland
33
What rate should maintainance fluids be prescribed at
30 ml / kg / DAY
So someone who weighs 75kg needs 2250mls over 24 hours
So they need 93.75 ml/hr aka 100 ml/hr
34
What is a normal anion gap
8-14
On pass med it says 10-18
35
How do you investigate a suspected perforated duodenal ulcer
Erect CXR
As you can see pneumoperitoneum
Which is suggestive of the above
36
Which analgesic is first line in renal colic pain
IM diclofenac 75mg
In less severe pain you can do rectal or oral route
37
How to manage alcohol withdrawal in those with and without liver cirrhosis
Without cirrhosis= chlordiazepoxide (long-acting benzodiazepine)
With cirrhosis= lorazepam (metabolism less affected by liver dysfunction)
38
How to discern between IgA nephropathy and post-streptococcal glomerulonephritis
IgA nep is shorter word so comes on after 1-3 days of infection
Post-strep glom is longer so comes on 1-2 weeks after infection
39
Which t2dm meds can cause pancreatitis
DPP-4 inhibitors e.g. gliptins e.g. sitaliptin
40
UC is linked with which liver problem and how do we diagnose it
Linked with primary sclerosing cholangitis
Diagnose with ERCP or MRCP (ERCP is endoscopic and MRCP is MRI scan)
41
Which blood pressure med messes with thyroid levels
Amiodarone
Can cause hypo and hyperthyroid
42
4 drugs that cause idiopathic intracranial hypertension
Tetracyclines e.g. doxycycline
Isotretinoin
Contraceptives
Steroids
Also levothyroxine, lithium, cimetidine (for ulcers)
43
Hello how do you manage thyrotoxic storm
Beta blockers
Propylthiouracil
Hydrocortisone
44
How do you investigate hyperadrenalism vs adrenal insuficiency
Hyper e.g. Cushing = dexamethasone supression test
Hypo e.g. addisons = ACTH stimulation test (short Synacthen test)
45
Ischaemic stroke management outline
1) exclude haemorrhage with CT head
2) Aspirin 300mg OD for 2 weeks
3) if presents <4.5 hours then thrombolysis with alteplase (or <9 hours sometimes)
4) if proximal ant circ (or sometimes prox post circ) and presents <6 hours then thrombectomy, consider thrombectomy <24 hours if salvageable tissue
Secondary prevention with clopidogrel monotherapy
46
How to manage active and latent TB
Active= RIPE
Rifampicin 6/12
Isoniazid 6/12
Pyrazinamide 2/12
Ethambutol 2/12
Co prescribe vitamin B6 (Pyridoxine) as isoniazid causes peripheral neuropathy
RifamPEEcin
IsoNERVEzid
PyraLIVERmid
EYEthambutamol
47
Fatigue, positive anti mitochondrial antibodies and raised IgM diagnosis and management
Primary biliary cholangitis
Also has cholestatic LFTs
Mx with urseodeoxycholic acid
48
Return from travel with non-bloody, yellow green diarrhoea, persistent fever and abdominal pain AND rose coloured spots around the umbilicus
Typhoid fever
Which is caused by salmonella typhi
49
What makes an UC flare severe and how does that affect management
Mild= <4 stools/day, small amount of blood
Moderate= 4-6 stools/day, varying amount of blood, no systemic upset
Severe= >6 bloody stools a day, systemic upset
For mild/moderate give rectal/ oral aminosalicylate +/- oral corticosteroid
For severe give IV steroids
50
Which virus causes suppression of the bone marrow
Parvovirus
Can trigger an aplastic crisis in those with blood cell deformity e.g. spherocytosis
51
How does haemolytic uraemic syndrome present
AKI
Thrombyocytopenia (low platelets)
Microangiopathic haemolytic anaemia (normocytic)
Can also have bloody stool x
52
What is nephrogenic diabetes insipidus and thus how do you investigate it
When the kidneys are no longer sensitive to ADH meaning they have no ability to concentrate urine (polydipsia etc)
Do water deprivation test:
Urine osmalality after fluid deprivation is still low
Urine osmalality after desmopressin (synthetic ADH) is still low!
53
Which T2DM drug causes fasciitis of the genitalia
SGLT-2 inhibitors e.g. dapagliflozin
As the glucose flows in the urine i.e excreted in the urine causing genital problems
54
Patient with HIV presenting with diarrhoea most likely organism
Cryptosporidium parvum
55
How to manage allergic bronchopulmonary aspergillosis
Prednisolone oral
Often occurs in those with existing lung pathology e.g. CF/ asthma
do RAST test to diagnose it
56
When is prasugrel indicated
In a STEMI before PCI given as dual antiplatelet therapy with aspirin
Not given if they are taking an oral anticoagulant (clopidogrel instead)
Not given in NSTEMI- ticagrelor given instead
57
Which type of sensation crosses to the contralateral side at which level
Fine touch (normal sensation) crosses at the brainstem
Pain and temperature crosses at the level that it enters the spine
Motor crosses at the brainstem also
58
What acid-base imbalance is caused by addisonian crisis
Hyperkalaemic metabolic acidosis
Addisons-> less aldosterone production-> more K+ in the blood. K+ is equivalent to H+ so it is acidic and so causes an acidosis
59
How to diagnose Graves’ disease
Thyroid autoantibodies
TRAB/ TBII - positive in 95% of graves
Also TPO - positive in 80z of graves
Can do a thyroid uptake scan if these are negative but you’re still suspicious of graves
60
4 specific signs for graves
Pretibial myxoedema
Thyroid acropachy - soft tissue swelling and periosteal bone changes
Eye problems
Thyroid bruit
Aren’t common but very specific
61
Myxoedema coma mx
Iv levothyroxine
Iv hydrocortisone until AI cause ruled out
ICU
62
What is the risk when managing SIADH
Osmotic demyelination syndrome
Due to rapid change in osmalality
Presents with non specific neuro sx diagnose with mri
63
Which cardiac problem causes notching of the inferior border of the ribs
Aortic coarctation
Aortic obstruction gives rise to the development of dilated intercostal collateral vessels which erodes the inferior margin of the ribs
64
Angina drug management options
EITHER
Rate-limiting CCB monotherapy e.g. verapamil or diltiazem
OR
Longer-acting dihydropyridine CCB e.g. amlodipine/ modified-release nifedipine WITH a beta blocker
65
What is the threshold aortic valve gradient that makes people eligible for surgery in aortic stenosis
>40mmHg
If less than than then regular outpt review
Also eligible for surgery if symptomatic with significant left ventricular dysfunction
66
Most likely causative organism for endocarditis normally and <2 months post-valve surgery
Staph. Aureus
Staph. Epidermidis if <2months post valve-surgery
67
What is fonaparinux’s role in NSTEMI management
They are an anticoagulant - it is a LMWH
Used long-term for those who have had an NSTEMI to prevent future clots and has less bleeding risk than other LMWHs
Used in those who aren’t going straight for PCI
68
How does NSTEMI drug management change if they are undergoing PCI or not
For antiplatelet therapy: still give initial aspirin loading dose AND another antiplatelet (either ticagrelor or prasugrel)
Still anticoagulate but in PCI you might give fondaparinux and unfracitonated heparin
Rest of management is the same?
69
How does NSTEMI management change if they are high bleeding risk
Still give aspirin plus another antiplatelet therapy BUT in high bleeding risk give clopidogrel instead of ticagrelor or prasugrel
Nothing else changes apart from that you might stop DAPT earlier e.g. 3-6 months instead of 12
70
How does the management of aortic dissection differ based on the type
If it is Stanford type A (ascending aorta) then do surgery while controlling BP to 100-120
Type B (descending aorta, distal to left subclavian origin, 1/3 of cases) = conservative Mx with IV labetalol and bed rest
You do a CT angiography to diagnose and classify- look for a false lumen
71
How to clinically differentiate between ascending and descending aortic dissection
New onset diastolic murmur (aortic dissection) in ascending dissection
72
Which cardiac drug can cause erectile dysfunction
Beta blockers
73
Two surgical options for severe symptomatic aortic stenosis
Surgical aortic valve replacement- done in those of low/medium operative risk
trans catheter AVR for high risk
74
Tall broad R waves and some ST depression
Posterior MI
Posterior MIs cause reciprocal changes in V1-3
horizontal ST depression
tall, broad R waves
upright T waves
dominant R wave in V2
75
Is pulseless electrical activity a shockable rhythm
No
Give adrenaline and then do chest compressions
76
What is the potassium threshold when deciding to add spironolactone or beta blocker in HTN Mx
If potassium is <4.5, add spiro
If >4.5 add BB
77
Which cardiac drugs can cause ototoxicity
Loop diuretics
E.g. bumetanide or furosemide
78
Which type of MI can be followed by third degree heart block
Right coronary artery
As this supplies the AV node
Trouble in the AV node causes third-degree heart block
79
First line management of acute pericarditis
NSAIDs and colchicine
80
Is pulseless ventricular tachycardia a shockable rhythm
Yes!
As is VF
Pulseless electrical activity and asytole are not shockable
81
Alcoholic hepatitis what is the AST:ALT ratio
2:1
82
What rate can you give potassium in mmol/hour
10mmol/hour
83
What are the physiological requirements in a day for water, Na, Cl and K+
Water= 25-30 ml/kg/day
Na= 1mmol/kg/day
Cl=1mmol/kg/day
K=1mmol/kg/day
84
How do you monitor someone on warfarin
Measure their INR regularly (frequency depends on how stable their INR is)
Target 2.5 but typically between 2-3 is accepted
85
How does aortic regurgitation present
SOB
Cardiac murmur (diastolic heard loudest on expiration)
Collapsing pulse
Quincke’s sign (nail bed pulsation)
86
How do loop diuretics and thiazide diuretics differ in their effect on electrolytes
Similar! Loop diuretics have a stronger ability to excrete Na, K, Cl and Mg
But loop diuretics also excrete calcium whereas thiazide diuretics retain calcium !
87
Which cardiac problem predisposes you to mesenteric ischaemia
AF
Clot formation in left atrium goes to superior mesenteric artery causing ischaemia of the meentery
Causes severe abdominal pain
88
When do you offer PCI in NSTEMI
NEVER!
Only joking
If GRACE score is above 3.% then offer it!
Immediately if clinically unstable, otherwise within 72 hours
Also give prasugrel/ ticagrelor and unfractionated heparin
89
How to diagnose PSC
ERCP/ MRCP
Diagnose PBC with LFTs (raised alk phos)
Autoantibodies AMA or antinuclear antibodies
90
Which liver disease is indicated if someone has positive anti-mitochondrial antibodies
Primary biliary chonlangitis
Occurs in middle aged females
Autoimmune conditions resulting in the destruction of bile ducts in the liver
High IgM also
Managed with antipruritics and ursodeoxycholic acid
91
How to manage autoimmune haemolytic anaemi
Steroids and ritixumab
Present with anaemia
High bilirubin
High reticulocytes
Blood film would show spherocytes and direct antiglobulin test is positive
92
Mainstay of treatment for haemochromatosis
Regular venesection (removing blood)
Transferring saturation should be kept below 50%
93
What type of malignancy is a complication of coeliac
T-cell lymphoma of the small intestine
94
What ABG result in Cushing’s
Hypokalaemic metabolic ALKALOSIS
Same mechanism that causes the low K+ leads to the excretion of hydrogen ions in the renal tubules and bicarbonate retained-> met alk
95
Which cardiac drug should be stopped with erythromycin/ clarithromycin
Statins !
Can increase the risk of hepatotoxcitiy and rhabdomyolysis
96
What is the mechanism for why nephrotic syndrome makes you in a hypercoagulable state
Loss of antithrombin III and plasminogen
Antithrombin III inhibitors coagulation by inhibiting the action of thrombin
plasminogen is involved in fibrinolysis
These are both lost via the kidneys in nephrotic syndrome
97
How to diagnose idiopathic pulmonary fibrosis
High-resolution CT chest
98
Which organism causing pneumonia causes cavitating lesions
Staph aureus
99
Which type of pneumonia is more common in people with CF
Pseudomonas aeruginosa
100
How to differentiate between spider naevi and telangiectasia
Spider naevi when pressed on fill from the centre
Telangiectasia from the edge
101
How to distinguish between the causes of RUQ pain
RUQ pain only --> biliary colic
RUQ pain + fever --> acute cholecystitis
RUQ pain + fever + jaundice --> ascending cholangitis (Charcot's triad)
Charcot's triad + confusion + hypotension = Reynold's pentad (more severe ascending cholangitis)
102
Which anti-emetic causes galactorrhoea
Metoclopramide
103
Which vaccine is given yearly to those with heart failure
Influenza vaccine
104
Which type of pneumonia occurs in alcoholics
Klebsiella
105
What drug is given to treat idiopathic intracranial hypertension and what is its mechanism of action
Acetazolamide
Carbonic anhydrase inhibitor - reduces CSF production
106
First line Tx of essential temor
Propanolol
107
How do you manage anti-phospholipid syndrome in pregnancy
Aspirin and LMWH
Due to increased chance of VTE
108
Which type of leukaemia affects kids most commonly
ALL
Associated with Down’s syndrome
109
Which leukaemia is associated with Philadelphia chromosome
CML
Translocation t(9:22)
Seen in 95% of CML pts
Also seen in 25% of adult ALL
110
Which finding on blood film is associated with myelofibrosis
Tear-drop poikilocytes
Often high urate and LDH
111
How to differentiate between aplastic and sequestration crises of sickle cell anaemia
Aplastic is caused by parvovirus infection. Sudden fall in Hb and low reticulocytes due to bone marrow suppression
Sequestration is pooling of blood due to sickling within organs. Associated with increased reticulocyte count
112
What drug do you give to prevent sickle cell crises
Hydroxyurea
This increases the foetal haemoglobin levels so reduces the amount of sickling (?)
So prevents crises
113
What is the mechanism of Factor V Leiden mutation
Resistance to action of protein C
Protein C controls the coagulation systems and so a lack thereof leads to more coagulation
114
Tremor cause if worse on arm extension
Benign essential tremor
PD tremor is worse when they are resting, able to control it with movement
Treat BET with propanolol
115
Which test to diagnose acromegaly
Serum IGF-1 levels
Correlates well with GH levels - highly sensitive
116
Which test to diagnose acromegaly
Serum IGF-1 levels
Correlates well with GH levels - highly sensitive
117
What kind of vision change does pituitary adenoma cause
Bitemporal hemionopia
118
Is goitre tender or non tender is hashimotos and subacute thyroiditis
Tender in subacute (De Quervain’s) thyroiditis
Non tender in hashimotos Thyroid goes from hyper to hypo then back to euthyroid
119
Management of hyperprolactinaemia
Dopamine agonists e.g. cabergoline or bromocriptine
120
How to diagnose Guillain-Barre
LP
Presents with acute onset symmetrical weakness in lower limbs first. Usually preceded by gastroenteritis
121
Vaccinations for heart failure patients
Annual flu
One off pneumococcal
122
6 causes of transdative exudate protein under 30
Heart failure!
Liver disease
Nephrotic sx
Malabsorption
Hypothyroid
Meig’s syndrome
123
Achalasia management
Pneumatic (balloon) dilation is increasingly the preferred first line option
Surgical intervention with Heller cardiomyotomy is considered if persistent Sx
Drug therapy with nitrates and CCBs also have a role
124
Wilsons disease Mx
Penicillamine
It is a copper chelating agent
Wilson’s has increased copper accumulation in liver and brain
125
What fasting glucose is pre diabetes
6.1-6.9
126
Imaging in suspected renal colic
non contrast CT-KUB
127
What imaging to investigate alcoholic liver disease
Transient elastography (Fibroscan)- type of USS
Measures how stiff the liver is which is a reflection of cirrhosis
NICE also recommend doing an upper endoscopy to check for varies in patients with new diagnosis of cirrhosis , and 6 monthly LUSS for cancer
128
what is second line Tx in HF when ACEi and BB havent worked
aldosterone antagonist aka mineralocorticoid receptor antagonists e.g. spirinolactone and eplerenone
(potassium-sparing diuretic)- consider risk of high K+ with ACEi
also consider SGLT-2 inhibitors
129
what type of diastolic murmur is caused by aortic regurgitation
early diastolic murmur
not low-pitched diastolic
worse when making a fist (ARthur meme)
130
131
Which type of atypical pneumonia causes SIADH
Legionella pneumophila (Legionnaire’s disease)
Often got from infected water e.g. air con
Screen using a urine antigen test
132
Which atypical pneumonia causes neurological symptoms in young patients
Mycoplasma pneumoniae
Can cause erythema multiforme (target lesions)
133
Which type of lung cancer presents with cavitating lesions
Squamous cell carcinoma
Also associated with clubbing
134
how to discern between ileostomy and colostomy stoma bags
ileostomy in the right iliac fossa, spouted appearance with liquid output
Colostomy variable location, flushed appearance and solid output
135
prophylaxis of cluster headaches
verapamil
136
pH cut off for NG tube
<5.5 is ok
137
how does goodpastures present
haemoptysis
AKI
proteinuria
haematuria
it is a small vessel vasculitis hence AKA anti-glomerular basement membrane disease
causes pulmonary haemorrhage and rapidly progressing nephritis
think lungs and kidneys
138
which kidney problem presetns with allergic type picture with leukocytes in urine and rasied eosinophils
acute interstitial nephritis
typically triggered by meds e.g. penecillins.
potentially presents with fever and rash and arthralgia
139
how to treat nephrogenic diabetes insipidus
thiazides!
low salt/protein diet
treat cranial with desmopressin
140
141
How to differentiate between primary and secondary hyperaldosteronism using renin levels
If renin levels are high then it is likely secondary cause e.g. renal artery stenosis
Because when blood flow to the kidneys is low it thinks the BP is low so increases renin production
In primary hyperaldosterone the RAAS system works normally so everything would be normal
142
Which clotting factor is affected in haemophilia A and B
A = 8 (a-te)
B= 9
143
Early presentation of haemochromatosis
Fatigue
Erectie dysfunction
Arthralgia (often hands)
Then can have bronze skin, liver problems, heart problems, diabetes
144
How to differentiate between aplastic and haemolytic crises
Aplastic would have recent illness then significant pancytopenia including Hb
Haemolytic presents with jaundice and increased bilirubin
145
How to diagnose legionella pneumonia
Urinary antigen test
CXR is non specific but often finds mid to lower patchy consolidation
146
When doing paracentesis for large-volume ascites, what do you have to given during
IV human albumin solution
To prevent paracentesis-induced circulatory dysfunction
147
When doing paracentesis for large-volume ascites, what do you have to given during
IV human albumin solution
To prevent paracentesis-induced circulatory dysfunction
148
How to treat kidney stones of different sizes and symptoms
<0.5 cm = conservative
<2 cm= shock wave lithotripsy or uteroscopy if pregnant
>2 cm = nephrolithiotomy
Associated hydronephrosis/ infection= nephrostomy
149
When would you use VQ scan over CTPA to diagnose PE
In pregnancy or renal failure as CTPA uses contrast
150
What is the ABPI threshold for managing venous ulcers surgically and not compression
When ABPI >1.3 refer to vascular surgery
If less treat with compression bandages and then stockings to prevent future episodes
151
First line VWD management mild bleeding
Desmopressin
152
How to diagnose dermatomyositis
Muscle biopsy
Presents with muscle weakness, gottrons Papules, heliotrope rash
153
VBG result for profuse diarrhoea with electrolyte imbalance
Metabolic acidosis with hypokalaemia
154
What 4 things can cause a false positive syphillis test result
SomeTimes Mistaks Happen
SLE
TB
Malaria
HIV
The test is the VDRL/RPR test
155
Pleural plaques on CXR likely diagnosis
Asbestosis
156
Pneumonia but history of alcoholism and redcurrant sputum which organism
Klebsiella
Gram negative anaerobic rod
157
Bilateral hilar lymphadenopathy which lung condition
Sarcoidosis
Formation of non-caseating granulomas
TB is normally unilateral
Could also be other things e.g. mono, neoplasm
158
How to manage a pediatric inguinal hernia
If <6 weeks old= correct in 2 days
If <6 months old= correct in 2 weeks
If <6 years=correct in 2 months
Umbilical hernias rarely require surgical correction and resolve by 3 years
Also femoral hernias corrected asap ?
159
How to manage prostatitis
If well enough to be treated in the community then 14 day course of quinolone e.g. ciprofloxacin
Also send urine for culture
If unwell/ septic/ retaining then refer urgently to secondary care
160
Which TB medication causes hepatotoxictiy
Pyrazinamide
161
Which type of bacterial gastroenteritis is associated with the shortest incubation time
Staph aureus = 1-6 hours
Often caused by milk products / pre-prepared food
162
How to treat goodpastures
Aka antiglomerular basement membrane disease
Treat with plasma exchange aka plasmapheresis
