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Mollie's P2a > Ix + Tx > Flashcards

Ix + Tx Flashcards

1
Q

Cushing’s syndrome/disease: 1st-line Ix?

A

raised plasma/urine cortisol
overnight dexamethasone suppression test

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2
Q

Cushing’s syndrome: 1st-line Tx?

A

Metyrapone/Fluconazole (inhibit cortisol synthesis)

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3
Q

Cushing’s disease: Gold Ix?

A

CRH test (cortisol increases)

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4
Q

Cushing’s disease: 1st-line Tx?

A

trans-sphenoidal surgery
Metyrapone/Fluconazole (inhibit cortisol synthesis)

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5
Q

Acromegaly: Gold Ix?

A

OGTT (no suppression)
raised IGF-1

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6
Q

Acromegaly: 1st-line Tx?

A

transsphenoidal surgery
octreotide (SST analogue)

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7
Q

Prolactinoma: 1st-line Tx?

A

cabergoline (dopamine agonist)

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8
Q

NFPA: 1st-line Tx?

A

cabergoline (dopamine agonist)

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9
Q

Carcinoid tumour: Gold Ix?

A

raised 24hr urinary 5-HIAA (serotonin metabolite)

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10
Q

Carcinoid tumour: 1st-line Tx?

A

surgical resection

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11
Q

Carcinoid crisis: 1st-line Tx?

A

octreotide (somatostatin analogue)

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12
Q

Conn’s syndrome: 1st-line Ix?

A

aldosterone:renin ratio (raised aldosterone)

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13
Q

K+ in Conn’s syndrome?

A

low

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14
Q

Conn’s syndrome: Gold Ix?

A

raised aldosterone, which is not suppressed with 0.9% saline or fludrocortisone)

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15
Q

Conn’s syndrome: 1st-line Tx?

A

laparoscopic adrenalectomy

(spironolactone 4 weeks pre-op)

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16
Q

K+ in Addison’s?

A

high

(sodium + cortisol are both low)

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17
Q

Addison’s: 1st-line Ix?

A

morning serum cortisol

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18
Q

Addison’s: Gold Ix?

A

synacthen test

(cortisol 30 mins after IM tetracosactide <550 nmol/L)

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19
Q

Addison’s: 1st-line Tx?

A

hydrocortisone + fludrocortisone

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20
Q

Secondary adrenal insufficiency: 1st-line Ix?

A

low ACTH

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21
Q

Secondary adrenal insufficiency: 1st-line Tx?

A

hydrocortisone

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22
Q

SIADH: 1st-line Ix?

A

low serum Na, high urine Na

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23
Q

SIADH: Gold Ix?

A

no response to 1-2L 0.9% saline

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24
Q

SIADH: 1st-line Tx?

A

restrict fluid
acute: IV hypertonic saline + furosemide
long-term: tolvaptan/demeclocycline

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25
Hyperparathyroidism: 1st-line Ix?
24hr urine (high Ca), MRI
26
Primary hyperparathyroidism: 1st-line Tx?
resection
27
Secondary hyperparathyroidism: 1st-line Tx?
vit D, cinacalcet (calcimimetic)
28
Hypoparathyroidism: 1st-line Tx?
calcium, calcitriol (active vit D)
29
Pheochromocytoma: 1st-line Ix?
raised plasma metanephrines
30
Pheochromocytoma: Gold Ix?
MIBG scan
31
Pheochromocytoma: 1st-line Tx?
phenoxybenzamine then resection
32
Hypercalcemia: 1st-line Tx?
IV fluids, bisphosphonate, calcitonin
33
Hypocalcemia: 1st-line Tx?
Acute: IV calcium gluconate Chronic: colecalciferol, adcal
34
Hyperkalemia: 1st-line Tx?
Mild: polysytrene sulfonate resin Severe: IV calcium gluconate + insulin + glucose
35
Hypokalemia: 1st-line Tx?
Mild: SANDO-K Severe: IV K
36
Cellulitis: 1st-line Ix?
serology (e.g. Strep pyogenes)
37
Cellulitis: 1st-line Tx?
penicillin, flucloxacillin
38
Necrotising fasciitis: 1st-line Tx?
debridement, IV benzylpenicllin + clindamycin
39
HF: Gold Ix?
echo
40
AAA + TAA: Gold Ix?
CTA
41
Aortic dissection: Gold Ix?
CTA
42
ACS: Gold Ix?
coronary angiography (/catheterisation), SPECT
43
AF: 1st-line Tx?
CCB, beta-blocker, anticoagulant (if 2+ CHA2DS2 VASC)
44
AFL: 1st-line Tx?
anticoagulant (e.g. dalteparin) then DC cardioversion
45
Unstable AVRT/AVNRT: 1st-line Tx?
DC cardioversion
46
Stable AVRT/AVNRT: 1st-line Tx?
IV adenosine
47
Long QT: 1st-line Tx?
IV isoprenaline
48
VF: Acute Tx?
DC cardioversion
49
VF: Long-term Tx?
ICD
50
Complete heart block: 1st-line Tx?
IV atropine, pacemaker
51
AVRT/AVNRT: Gold Tx?
catheter ablation
52
Sympomatic BBB: 1st-line Tx?
beta-blocker
53
PVD: 1st-line Ix?
ankle-brachial pressure index, doppler USS
54
PVD: Gold Ix?
CTA
55
PVD: 1st-line Tx?
clopidogrel (P2Y12i)
56
Pericarditis: 1st-line Tx?
NSAID for 2 wks, colchicine for 2 wks
57
Pericardial effusion: 1st-line Tx?
pericardiocentesis
58
IE: Tx if NOT staph?
benzylpenicillin, gentamicin
59
IE: Tx if S.aureus?
flucloxacillin
60
IE: Tx if MRSA?
vancomycin
61
ANY valve pathology: Gold Ix?
TOE (EXCEPT pulmonary stenosis = TTE)
62
Mitral stenosis: Gold Tx?
percutaneous mitral balloon valvotomy
63
Cardiomyopathy: Gold Ix?
echo
64
Rheumatic fever: 1st-line Tx?
benzylpenicllin, analgesia, diazepam (for chorea)
65
TGA: 1st-line Tx?
atrial switch operation
66
PDA: 1st-line Tx?
closed surgically, indomethacin (prostaglandin inhibitor)
67
Spondyloarthropathy: 1st-line Tx?
DMARD (e.g. methotrexate)
68
Volvulus: 1st-line Tx?
Ladd's procedure, GI decompression (with NG tube)
69
Thalassaemia: 1st-line Tx?
blood transfusions every 2-4 wks
70
Sideroblastic anaemia: Gold Ix?
bone marrow smear (ring sideroblasts with Perl's stain)
71
Sideroblastic anaemia: 1st-line Tx?
pyridoxine
72
Sickle cell: Gold Ix?
Hb electrophoresis (80-95% HbS + absent HbA)
73
Sickle cell: Acute Tx?
IV fluids, analgesia, O2
74
Sickle cell: Preventative Tx?
hydroxycarbamide
75
Hereditary spherocytosis: Gold Ix?
EMA binding test (low fluorescent intensity)
76
Hereditary spherocytosis: 1st-line Tx?
folic acid
77
G6PD deficiency: Gold Ix?
G6PD enzyme assay
78
Complicated malaria: 1st-line Tx?
IV artesunate
79
Uncomplicated malaria: 1st-line Tx?
riamet/quinine
80
Autoimmune haemolytic anaemia: Gold Ix?
DAT/Coombs (+ve)
81
Autoimmune haemolytic anaemia: 1st-line Tx?
corticosteroids
82
Anaemia of chronic disease: 1st-line Ix?
EPO injections
83
Aplastic anaemia: Gold Ix?
bone marrow biopsy
84
Aplastic anaemia: 1st-line Tx?
bone marrow transplant (from HLA identical sibling donor) OR immunosuppression with ATG + cyclosporine
85
B12 deficiency: 1st-line Tx?
IM hydroxycobalamin
86
CML: 1st-line Tx?
Imatinib (tyrosine kinase inhibitor)
87
CLL: Gold Ix?
peripheral blood flow cytometry
88
CLL: 1st-line Tx?
chemo + IV Ig
89
Hodgkin's lymphoma: 1st-line Tx?
ABVD (adriamycin, bleomycin, vinblastine, decarbazine)
90
Non-Hodgkin's lymphoma: 1st-line Tx?
R-CHOP (rituximab, cyclophosphamide, hydroxy-daunorubicin, vincristine/oncovin, prednisolone)
91
MM: 1st-line Tx?
VAD (vincristine, adriamycin, dexamethasone)
92
ITP: 1st-line Tx?
IV Ig, prednisolone
93
TTP: 1st-line Tx?
plasma exchange (provide ADAMTS-13) with IV methyprednisolone
94
Heparin induced thrombocytopenia: 1st-line Tx?
stop heparin, lepirudin/danaparoid (thrombin inhibitor)
95
VWD: Gold Ix?
VWF:RCo assay
96
Minor bleed in VWD: 1st-line Tx?
desmopressin
97
Major bleed in VWD: 1st-line Tx?
VWF + factor VIII
98
Haemophilia: Gold Ix?
factor assay
99
Minor bleed in haemophilia A: 1st-line Tx?
desmopressin
100
Major bleed in haemophilia A: 1st-line Tx?
factor VIII
101
Haemophilia B: 1st-line Tx?
factor IX
102
DIC: 1st-line Tx?
blood transfusion
103
Tumour lysis syndrome: 1st-line Tx?
allopurinol or rasburicase
104
Hyperviscosity syndrome: 1st-line Tx?
plasmapharesis
105
Crohn's: Mild/mod Tx?
prednisolone
106
Crohn's: Severe Tx?
IV hydrocortisone + metronidazole
107
Crohn's: Preventative Tx?
azathioprine
108
UC: Tx?
5-ASA (e.g. mesalazine)
109
UC: Preventative Tx?
azathioprine
110
UC: Preventative Tx?
azathioprine
111
IBS: 1st-line Tx?
FODMAP diet, mebeverine (antispasmodic)
112
PUD without H.pylori: 1st-line Tx?
ranitidine (H2 antagonist)
113
Perianal abscess: Gold Ix?
endoanal USS
114
Haemorrhoids: 1st-line drug Tx?
docusate (stool softner)
115
Pseudomembranous colitis: 1st-line Tx?
amoxicillin
116
Pseudo-obstruction: 1st-line Tx?
IV neostigmine
117
Achalasia: 1st-line Tx?
Heller's myotomy, CCB/nitrates
118
Achalasia: Gold Ix?
manometry
119
Appendicits: Gold Ix?
CT
120
Appendicitis: 1st-line Tx?
IV metronidazole then laparoscopic appendectomy
121
Bowel obstruction: 1st-line Tx?
bowel decompression, fluids, analgesia, antiemetic, Abx
122
Gastritis: 1st-line Tx?
ranitidine (H2 antagonist), H.pylori eradication (if needed)
123
H.pylori infection: 1st-line Ix?
serology (IgG) C-urea breath test faecal antigen test (uses MAb)
124
H.pylori: 1st-line Tx?
triple therapy of 2 Abx + 1 PPI for 7-14 days (e.g. clarithromycin, amoxicillin, omeprazole) "CAP"
125
Cocaine overdose: 1st-line Tx?
IV diazepam
126
Insecticide overdose: Gold Ix?
low RBC acetylcholinesterase activity
127
Insecticide overdose: 1st-line Tx?
IV atropine every 10 mins
128
Insecticide overdose: 1st-line Tx?
IV atropine every 10 mins
129
Hep A: 1st-line Tx?
Sx, vaccinate close contacts
130
Chronic Hep B: 1st-line Tx?
tenofovir (nucleoside analogue)
131
Hep B + Hep D: Gold Tx?
SC pegylated IF-alpha 2A
132
Hep C: 1st-line Tx?
triple therapy with DAA (NS5Ai - e.g. ledipasvir/ritonavir, NS5Bi - e.g. sofosbuvir/dasabuvir)
133
Hep C: 1st-line Tx?
vaccinate close contacts
134
Autoimmune hepatitis: 1st-line Tx?
prednisolone +/- azathioprine
135
HIV: 1st-line Ix?
sexual Hx, anti-p24
136
HIV: Gold Ix?
IgG to envelope contents
137
HIV: 1st-line Tx?
HAART (2 NRTI + 1 NNRTI or 2 NRTI + 1 PI)
138
Amyloidosis: Gold Ix?
biopsy (red-green with congo red)
139
Lymphoedema: 1st-line Ix?
stemmer's sign, measure leg size
140
Lymphoedema: Gold Ix?
lymphoscintigraphy
141
CO poisoning: Gold Ix?
ABG (>3% in non-smokers + >10% in smokers)
142
CO poisoning: 1st-line Tx?
100% O2 (until COHb <10%)
143
Opioid overdose: 1st-line Tx?
IV naloxone (opioid antagonist) every 2 mins
144
Paracetamol overdose: 1st-line Tx?
IV N-acetylcysteine
145
Hepatic encephalopathy: Gold Ix?
PHES test
146
Hepatic encephalopathy: 1st-line Tx?
lactulose (laxative)
147
Inguinal hernia: 1st-line Tx?
truss
148
Femoral/umbilical/incisional/epigastric hernia: 1st-line Tx?
hernioplasty
149
Hiatal hernia: Gold Ix?
barium swallow
150
Portal HTN: Gold Ix?
HPVG (hepatic portal venous gas) measurement
151
Gastro-oesophageal varices: 1st-line Tx?
endoscopic banding
152
Haemochromatosis: 1st-line Tx?
lifelong venesection (3-4x per year)
153
Wilson's disease: 1st-line Tx?
penicillamine (chelating agent)
154
COPD: 1st-line Ix?
spirometry (FEV <80% PV, FEV1/FVC <0.7)
155
COPD: 1st-line Tx?
SABA + LAMA (e.g. tiotropium bromide)
156
TB: Gold Ix?
mantoux tuberculin skin test, IGRA (IF-gamma release assays)
157
Pneumonia: Gold Ix?
CXR (consolidation)
158
Mild pneumonia: 1st-line Tx?
amoxicillin 5-7 days
159
Severe pneumonia: 1st-line Tx?
IV co-amoxiclav/clarithromycin 7-10 days
160
CF: 1st-line Tx?
nebulised dornase alfa (mucolytic)
161
Pleural effusion: Gold Ix?
thoracentesis
162
Pleural effusion: 1st-line Tx?
chest drain
163
Pleural effusion: 1st-line Ix?
CXR (reduced costophrenic angles)
164
Pneumothorax: 1st-line Ix?
CXR (area of no lung markings)
165
Pneumothorax: 1st-line Tx?
needle aspiration then chest drain
166
Empyema: Gold Ix?
thoracocentesis (yellow, turbid, pH <7.2, low glucose)
167
Empyema: 1st-line Tx?
chest drain Abx: co-amoxiclav, piperacillin-tazobactam, meropenem
168
Pulmonary fibrosis: Gold Ix?
HRCT (or lung biopsy)
169
Pulmonary fibrosis: 1st-line Tx?
pirfenidone (antifibrotic)
170
Sarcoidosis: 1st-line Ix?
bloods (↑ACE/Ca) CXR (hilar lymphadenopathy)
171
Sarcoidosis: Gold Ix?
tissue biopsy (non-caseating granuloma)
172
Sarcoidosis: 1st-line Tx?
prednisolone
173
Pulmonary HTN: Gold Ix?
right heart catheterisation (mPAP >25 mmHg)
174
Pulmonary HTN: 1st-line Tx?
ilorprost (prostanoid) bosentan (endothelin receptor antagonist) sildenafil (PDE5i)
175
SCLC or NSCLC: Gold Ix?
bronchoscopy with EBUS (for histology)
176
Mesothelioma: Gold Ix?
pleural biopsy
177
Goodpasture's: Gold Ix?
kidney biopsy (crescent glomerulus)
178
Goodpasture's: 1st-line Tx?
cyclophosphamide, prednisolone
179
Otitis media: Gold Ix?
otoscope (red + bulging TM)
180
Sinusitis: 1st-line Tx?
nasal decongestant (e.g. xylometazoline) co-amoxiclav
181
Acute epiglottitis: 1st-line Tx?
endotracheal intubation, then IV ceftriaxone
182
Croup: 1st-line Tx?
steroids (e.g. dexamethasone) with O2
183
Whooping cough: 1st-line Tx?
clarithromycin
184
Bronchiolitis: 1st-line Tx?
NG tube/IV fluids, O2
185
OA: 1st-line Tx?
NSAID
186
Mild RA: 1st-line Tx?
NSAID + corticosteroids
187
Severe RA: 1st-line Tx?
methotrexate (DMARD)
188
Gout: 1st-line Tx (acute)?
colchicine + prednisolone
189
Gout: 1st-line Tx (prevent)?
allopurinol + febuxostat
190
Pseudogout: 1st-line Tx?
methotrexate (DMARD)
191
Osteoporosis: Gold Ix?
DEXA scan for T-score (< -2.5)
192
Fibromyalgia: 1st-line Tx?
antidepressants (e.g. amitriptyline), anticonvulsants (e.g. pregabalin)
193
Sjogren's: 1st-line Ix?
Schirmer tear test (<10 mm in 5 mins), salivary gland biopsy
194
Wegener's granulomatosis: 1st-line Ix?
urinalysis (proteinuria, haematuria)
195
Wegener's granulomatosis: Gold Ix?
renal biopsy
196
Polyarteritis nodosa: 1st-line Ix?
bloods (anaemia, ↑WCC/ESR) angiography (micro-aneurysms)
197
Polyarteritis nodosa: Gold Ix?
renal biopsy
198
Paget's disease: 1st-line Ix?
bloods (↑ALP), ↑urinary hydroxyproline
199
Septic arthritis: 1st-line Tx?
urgent aspiration then Abx for 2 wks
200
Osteomyelitis: Gold Ix?
bone biopsy + culture
201
SLE: 1st-line Tx?
prednisolone, chloroquine
202
aPL syndrome: Gold Ix?
anticardiolipin test lupus anticoagulant test anti-B2-glycoprotein test (persistent +ve in 1 of these)
203
aPL syndrome? 1st-line Tx?
aspirin/clopidogrel
204
DM/PM: Gold Ix?
muscle biopsy
205
DM/PM: 1st-line Tx?
prednisolone, methotrexate, chloroquine
206
Scleroderma: 1st-line Ix?
bloods (anaemia) urine (proteinuria) hand X-ray (Ca deposits) barium swallow (esophageal dysmotility)
207
Scleroderma: 1st-line Tx?
CCB, ACEi, methotrexate
208
Osteomalacia: 1st-line Tx?
calcium D3 forte, calcitriol
209
Depression: 1st-line Ix?
PHQ-9 questionnaire
210
Depression: 1st-line Tx?
psychological therapy (e.g. CBT), SSRi (e.g. sertraline)
211
Wrist drop: Gold Ix?
EMG (radial)
212
Claw hand: Gold Ix?
EMG (ulnar)
213
Foot drop: Gold Ix?
EMG (common peroneal branch of sciatic)
214
Brown-Sequard: 1st-line Ix?
clinical, MRI
215
Brain tumour: Gold Ix?
biopsy (via burr hole)
216
UMN + LMN lesions: 1st-line Tx?
baclofen/botox (muscle relaxant), physio
217
Myasthenia gravis: Gold Ix?
EMG, Edrophonium/Tensilon test
218
Myasthenia gravis: 1st-line Tx?
pyridostigmine (anti-cholinesterase)
219
MND: 1st-line Ix?
clinical, NCS/EMG
220
MND: 1st-line Tx?
riluzole (Na channel blocker which inhibits glutamate)
221
Guillain-Barre syndrome: Gold Ix?
NCS
222
Guillain-Barre syndrome: 1st-line Tx?
IV Ig (5 days)
223
PD: Gold Ix?
MRI head (atrophy)
224
PD: 1st-line Tx?
ropinirole (dopamine agonist)
225
PD: Gold Tx?
levodopa
226
HD: Gold Ix?
genetic test (>35 CAG repeats)
227
HD: 1st-line Tx?
SSRI Benzodiazepine (chorea) Haloperidol (antipsychotic)
228
Migraine: 1st-line Tx?
sumatriptan
229
Tension headache: 1st-line Tx?
aspirin
230
Cluster headache: Acute Tx?
100% 15L O2 via non-rebreathable mask + SC sumatriptan
231
Cluster headache: Preventative Tx?
CCB
232
Trigeminal neuralgia: 1st-line Tx?
carbamazepine (anticonvulsant)
233
Epilepsy: 1st-line Ix?
CT head (look for space-occupying lesion)
234
Epilepsy: Gold Ix?
EEG
235
Generalised seizures: 1st-line Tx?
sodium valproate (teratogenic; 2nd line = carbamazepine/lamotrigine)
236
Focal seizures: 1st-line Tx?
carbamazepine (2nd = lamotrigine)
237
Dementia: 1st-line Ix?
MMSE (mini mental state examination)
238
Alzheimer's: 1st-line Tx?
rivastigmine/donepezil (acetylcholinesterase inhibitors)
239
Renal colic: 1st-line Ix?
KUB-XR
240
Renal colic: Gold Ix?
NCCT-KUB
241
Renal colic: 1st-line Tx?
analgesia, antiemetic, CCB/alpha-blocker
242
AKI: Gold Ix?
KDIGO, renal biopsy (if intrarenal)
243
AKI: Common 1st-line Tx?
furosemide (loop diuretic)
244
SAH: Gold Ix?
CT head (white, star-shape)
245
SAH: 1st-line Tx?
nimodipine (CCB) + IV fluids, endovascular coiling
246
EDH: Gold Ix?
CT head (bright white, lemon-shape)
247
EDH: 1st-line Tx?
IV mannitol, thrombectomy
248
SDH: Gold Ix?
CT head (dark, sickle shape)
249
SDH: 1st-line Tx?
IV mannitol, burr hole craniotomy
250
Amaurois fugax: 1st-line Tx?
aspirin/warfarin
251
Meningitis: Tx in GP?
IM benzylpenicillin
252
Meningitis: Tx in hospital?
IV cefotaxime/ceftriaxone
253
Encephalitis: 1st-line Tx?
IV acyclovir
254
Intracerebral haemorrhage: Gold Ix?
CT head (bright white, roughly spherical area)
255
Intracerebral haemorrhage: 1st-line Tx?
IV mannitol, burr hole craniotomy or stereotactic clot aspiration
256
TIA: 1st-line Tx?
aspirin then lifelong clopidogrel (P2Y12i)
257
Ischaemic stroke: 1st-line Tx?
IV alteplase (thrombolysis) within 4.5 hrs, then lifelong clopidogrel (P2Y12i)
258
MS: Gold Ix?
2+ CNS lesions disseminated in time + space
259
MS: Tx (acute)?
IV benzylpenicillin
260
MS: Tx (frequent relapse)?
SC interferon-1A/B
261
MS: Tx (symptomatic)?
baclofen (muscle relaxant)
262
Lambert-Eaton: Gold Ix?
EMG (amplitude greatly↑post-exercise)
263
Lambert-Eaton: 1st-line Tx?
prednisolone, IV Ig, amifampridine (K channel blocker)
264
CTS: 1st-line Ix?
phalen’s test (only flex wrist for 1 min) tinel’s test (tap median nerve → tingling)
265
CTS: Gold Ix?
EMG (median)
266
Charcot-Marie-Tooth: 1st-line Ix?
FHx, clinical (e.g. high arch)
267
Charcot-Marie-Tooth: Gold Ix?
genetic test (nerve biopsy from calf if inconclusive)
268
Charcot-Marie-Tooth: 1st-line Tx?
physio
269
DMD: 1st-line Ix?
FHx, bloods (↑creatinine)
270
DMD: Gold Ix?
genetic test (nerve biopsy from calf if inconclusive)
271
DMD: 1st-line Tx?
physio, oral steroids
272
Testicular cancer: Gold Ix?
scrotal USS
273
Testicular cancer: 1st-line Tx?
inguinal orchiectomy
274
BPH: 1st-line Tx?
tamsulosin (alpha-1 blocker)
275
BPH: Gold Tx?
TURP (transurethral resection of the prostate)
276
Diffuse proliferative + memranoproliferative glomerulonephritis: 1st-line Tx?
ACEi/ARB
277
Nephrotic syndrome: 1st-line Ix? (minimal change, focal segmental glomerulosclerosis, membranous nephropathy)
urinalysis (protein >3.5g/day), bloods (low albumin), oedema
278
Nephrotic syndrome: 1st-line Tx? (minimal change, focal segmental glomerulosclerosis, membranous nephropathy)
prednisolone
279
Varicocele + testicular torsion: Gold Ix?
venography or doppler USS
280
Epididymal cyst + hydrocele: Gold Ix?
scrotal USS
281
Ovarian torsion: 1st-line Ix?
pelvic USS (whilpool sign)
282
Ovarian torsion: 1st-line Tx?
laparoscopic detorsion or oophorectomy
283
Wilm's tumour: Gold Ix?
renal biopsy
284
Wilm's tumour: 1st-line Tx?
nephrectomy
285
ADPKD: Gold Ix?
USS (cysts)
286
ADPKD: 1st-line Tx?
ACEi
287
ARPKD: Gold Ix?
antenatal/neonatal USS (cysts)
288
APKD: 1st-line Tx?
ACEi, mechanical ventilation
289
Chlamydia + gonorrhea: Gold Ix?
NAAT (vulvovaginal swab in females, first-pass urine in males)
290
Syphilis: Gold Ix?
SEROLOGY - specific = T.pallidum antigen - non-specific = RPR (rapid plasma reagin), VDRL (veneral disease research lab)
291
Ectopic pregnancy: Gold Ix?
transvaginal USS
292
Ectopic pregnancy: 1st-line Tx?
laparoscopic salpingectomy (/methotrexate)
293
RCC: Gold Ix?
CT with contrast, renal biopsy
294
RCC: 1st-line Tx?
nephrectomy advanced: temsirolimus (mTOR inhibitor)
295
UTI: Gold Ix?
MSU (microscopy, culture, sensitivity)
296
UTI: 1st-line Tx?
Uncomplicated: trimethoprim/nitrofurantoin for 3 days Complicated: trimethoprim/nitrofurantoin for 7 days (N.B. Trimethoprim is TERATOGENIC)
297
Prostate cancer: Gold Ix?
TRUS (transrectal ultrasound) + biopsy
298
Prostate cancer: 1st-line Tx?
Non-metastatic: prostatectomy Metastatic: androgen receptor blocker (e.g. bicalutamide)
299
Prolapse: 1st-line Ix?
examination using a sim’s speculum
300
Prolapse: 1st-line Tx?
vaginal pessary
301
Bladder cancer: Gold Ix?
cystoscopy with biopsy, CT urogram
302
Bladder cancer: 1st-line Tx?
Non-muscle invasive: TURBT (transurethral resection of bladder tumour) Muscle invasive: radical cystectomy
303
CKD: 1st-line Ix?
bloods (anaemia, ↓Ca, ↑phosphate/SCr) USS (small kidneys)
304
CKD: Gold Ix?
GFR <60ml/min/1.63m3 for >3 months
305
CKD: 1st-line Tx?
furosemide, ACEi/ARB
306
CKD: Gold Tx?
kidney transplant
307
Nephritic syndrome: 1st-line Ix? (IgA/Berger's, post-strep, Goodpasture's, SLE nephropathy)
urinalysis (<2 g/day), haematuria
308
IgA nephropathy / Berger's: Gold Ix?
renal biopsy (mesangial proliferation, IgA + C3 deposits)
309
IgA nephropathy / Berger's: 1st-line Tx?
ACEi
310
Post-strep glomerulonephritis: 1st-line Tx?
Abx
311
Goodpasture's syndrome: 1st-line Tx?
plasmapheresis (remove Ab), immunosuppression
312
SLE nephropathy: 1st-line Tx?
immunosuppression (steroids, cyclophosphamide, rituximab)
313
Myasthenia gravis: Gold Ix?
EMG, Tensilon/Edrophonium test

Mollie's P2a (18 decks)

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