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Year 5 MBChB > JB-Passmedicine > Flashcards

JB-Passmedicine Flashcards

1
Q

ABG metabolic picture in Cushings

A

Hypokalemic metabolic alkalosis (loss of h+ and Na)

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2
Q

Common organism in OE

A

Pseudomonas aeruginosa

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3
Q

What is tolterodine

A

Anti-muscarinic used for overactive bladder, increased frequency and urgency

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4
Q

Maximum recommended rate of potassium infusion via a peripheral line

A

10 mol/horu

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5
Q

Key carbimazole side effect

A

Agranulocytosis

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6
Q

Two key Gentamicin side effects

A

Ototoxicity
Nephrotoxic

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7
Q

When should HIV patients be given prophylactic co-trimoxazole

A

CD4 below 200

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8
Q

Type of CT in ?stroke

A

Non contrast

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9
Q

Biochemical changes seen in Legionella

A

Hyponatraemia
Lymphopenia
Deranged LFTs

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10
Q

How can early keloid scars be treated

A

Intra-lesional steroids

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11
Q

UTI management in men

A

7 days nitro or trimethoprim (3 for non pregnant women)

All men need a culture sending

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12
Q

ABG in cushings syndrome

A

Hypokalaemic metabolic alkalosis

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13
Q

What do anticardiolipin AB suggest

A

Anti-phospholipid syndrome
Many rheum conditions including SLE, drug induced SLE and Bechets

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14
Q

When do you measure FSH and when mis-luteal progesterone

A

FSH: menopause
Progesterone: fertility

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15
Q

Test for post h pylori eradication

A

Urea breath test

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16
Q

Does constipation or diarrhoea cause decompensation in liver failure patients

A

Constipation

(give laxatives to treat it)

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17
Q

How to differentiate Wilson’s and haemochromatosis

A

Wilson’s: sub acute neurological and liver disease
HCTs: chronic arthalgia, bronze, ED, DM

Liver disease common in both

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18
Q

What is penicillamine used for

A

Wilsons

Coper chelation agent

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19
Q

What is used to prevent vasospasm in SAH

A

Nimodipine

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20
Q

Preceding influenza predisposes to which type of pneumonia

A

Staph A

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21
Q

Loss of motor or sensory function -> dx

A

Conversion disorder

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22
Q

Inguinal hernia in infants management

A

Urgent surgery as high risk

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23
Q

ER+ve breast ca management in pre vs post menopausal

A

Pre: tamoxifen
Post: anastroazole

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24
Q

Why can methotrexate not be prescribed with co-trimoxazole

A

Contains trimethoprim

Both deplete folate

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25
Q

Paeds BLS where do you feel for pulse

A

Infants use brachial or femoral pulse

Children use femoral pulse

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26
Q

At what CR size is a foetus with no cardiac activity confirmed as a miscarriage

A

over 7mm

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27
Q

Management of thyroid storm

A

beta blockers, propylthiouracil and hydrocortisone

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28
Q

Investigation in pregnant women with a DVT with ? PE

A

None

Start LMWH

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29
Q

Most likely selective serotonin reuptake inhibitor (SSRI) to lead to QT prolongation and Torsades de pointes

A

Citalopram

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30
Q

Treatment for anterior uveitis

A

Steroid + cycloplegic (mydriatic) drops

(??Dilate as relaxes muscles)

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31
Q

What distinguishes vestibular neuronitis from labyrinthitis

A

Loss of hearing in labyrinthitis

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32
Q

2 electrolyte abnormalities of PPIs

A

Low Na, Mg

Osteoporosis

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33
Q

Drug used in prolactinoma

A

Cabergoline

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34
Q

first-line treatment for superficial thrombophlebitis

A

NSAIDs
Compression stocking

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35
Q

What is cataplexy associated with

A

Narcoplexy

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36
Q

What is cataplexy

A

Sudden loss in muscular tone

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37
Q

What can PCV progress to

A

AML

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38
Q

HB cut off for oral iron in pregnancy 1st tri

A

110

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39
Q

what does factor v liden result in

A

Protein c resistance -> pro clotting

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40
Q

Most common thrombotic disorder in UK

A

Factor V liden (protein C resistence)

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41
Q

What do protein C and S do

A

?Natural anti coagulant

Hence if deficient, increased risk of clots

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42
Q

Which lung ca causes SIADH

A

Small cell

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43
Q

Which ABX is contraindicated in GP6D deficiency

A

Quinones (Ciprofloxacin and levofloxacin)

(Haemolytic anaemia and Heinz bodies)

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44
Q

2 steps in management of PCV

A

Aspirin and venesection

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45
Q

3 biochemical abnormality of thiazides

A

Hypercalcemia (low ca urine)
Hyponatremia
Hypokalaemia

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46
Q

Strangulated vs incarcerated hernias

A

Strangulated = blocked and dying
Incarcerated = irreducible

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47
Q

Scan of choice in MS

A

MRI with contrast

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48
Q

Treatment if man has severe voiding symptoms and enlarged prostate

A

Double (tamsulosin and finasteride)

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49
Q

Main SE of oral Mg

A

Diarrhoea

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50
Q

What does Phrens sign (ease pain when lifted) suggest

A

Eppidimitis not torsion

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51
Q

Treatment of pyelonephritis

A

Cipro or cefalexin

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52
Q

Pneumonia in ETOH with caveatting lesions

A

Klebsiela

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53
Q

What contrast is used in stroke CTs

A

None

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54
Q

When is halliperidol used in PD

A

Never

Benzos/ new gen antipsychotics in acute confusion

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55
Q

Management of TCA OD

A

IV sodium bicarb

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56
Q

Lithium level testing

A

12 hours after dose
Every 7 days till stable
3 monthly

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57
Q

What resp rate is a red flag at all ages in feverish illness

A

> 60

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58
Q

Diplopia looking down

A

CN4 (trochlea) issue

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59
Q

Of all the clotting factors warfarin blocks, what has shortest half life

A

Protein C and S (anti coagulants)

2 has longest

Need LMWH first 2 days

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60
Q

What clotting test does warfarin prolong

A

PT (part of INR)

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61
Q

Most common cause of viral meningitis

A

Enterococcus virus (coxsackie)

Herpes is second most common

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62
Q

What two things should be monitored in kids with HSP

A

BP and Urinalysis to check for renal involvement

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63
Q

Difference between lichen planus and lichen sclerosis

A

Lichen planus: PURPLE skin colour lesions
Lichen sclerosis: itchy white areas on vulva of older women

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64
Q

Who is Sulfasalazine contraindicated in

A

Aspirin allergy
Other sulph- drugs
G6PD

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65
Q

What needs to be tested for in patients who have a blood products allergic reaction

A

IgA deficiency

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66
Q

Criteria to diagnose endocarditis

A

Duke

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67
Q

2nd line treatment in resistant hyperlipidemia

A

ezetimibe (stops GI inscription)

PKS9 inhibitors (-mab)

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68
Q

Only PAD vasodilator recommended by NICE

A

naftidrofuryl oxalate

(should only be used in those with poor quality of life)

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69
Q

Wilson’s disease effect on serum caeruloplasmin

A

Decreased
Transport protein

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70
Q

Critical limb ischaemia management by location

A

Above IL -> PTA/ stent
CFA -> endartectomy
Below IL ->
Short -> stent
Long -> bypass

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71
Q

Management of mild/ moderate claudication (3)

A

statin
clopidogrel
exercise training

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72
Q

What CURB-65 needs admission

A

2 or above

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73
Q

Ranges for CURB-65

A

Confused
Urea >7
RR>30
SBP<90
65 or older

74
Q

What is type 2 Necrotising fasciitis caused by

A

Streptococcus pyogenes

Type 1 is caused by mixed anaerobes and aerobes, is the most common and mainly found in diabetics post surgery

75
Q

What is blood stained breast discharge most likely to be associated with

A

Papiloma

76
Q

Management of MG

A

Pyridostigmine
long-acting acetylcholinesterase inhibitors

77
Q

What type of drug is doepezil

A

Anticholinesterase inhibitor

78
Q

How does a pontine haemorrhage commonly presents with

A

reduced GCS, paralysis and bilateral pin point pupils

79
Q

3 common causes of infective endocarditis

A

MOST COMMON: Staphylococcus aureus (in intravenous drugs uses or prosthetic valves)

Streptococcus viridans

Staphylococcus epidermidis (in prosthetic valves)

80
Q

Key SE of Hydroxychloroquine

A

bull’s eye retinopathy - may result in severe and permanent visual loss

81
Q

Two ABX unusable in CKD

A

tetracycline, nitrofurantoin

82
Q

Key difference in psoriasis management by site

A

If face, flexor or genital:

mild or moderate corticosteroid applied once or twice daily for a maximum of 2 weeks

83
Q

Psoriasis management (1,2,3)

A

Steroid + Vit D (separate creams for 4 weeks)
Vit D BD (4 weeks)
Potent steroid or coal tar (4 weeks)

84
Q

Where must a lesion be for autonomic dysreflexia to occur

A

Above T6

85
Q

Where must a lesion be for autonomic dysreflexia to occur

A

Firs Above T6

86
Q

First line in achalasia

A

pneumatic (balloon) dilation

87
Q

Angina drug which can cause ulceration of GI tract

A

Nicorandil

88
Q

What is Churg-Strauss syndrome

A

Sub type of granulomatosis with polyangiitis (esonophilic)

Associated with asthma, sinusitis and nasal polyps

pANCA positive and esonopbillia

89
Q

Which is port wine and salmon patches resolves

A

Salmon

Dont drink port till older

90
Q

When should anal fissures be referred to colorectal surgeons

A

If fissures do not occur on the posterior midline

91
Q

What is Parklands formula

A

4ml x % burns x weight (kg)

50% in first 8 hours
50% in next 16 hours

92
Q

How to dx asthma

A

Spirometry with reversal
(all adults and under 17s only with uncertainty) FeNo2

93
Q

When should anti coagulation be started in stroke patients with AF

A

2 weeks

94
Q

EVG changes in SAH

A

Tdp

95
Q

Acute haemolytic transfusion reactions are usually the result of RBC destruction by what

A

IgM-type antibodies

96
Q

‘anchovy sauce’ liver access

A

Entamoeba histolytica

97
Q

Most common type of non-hodgkin lymphoma

A

Diffuse large B cell lymphoma

98
Q

What electrolyte abnormality predisposes to digoxin toxicity

A

Hypokalaemia

99
Q

ITP haematology

A

Only platelets low

100
Q

Mutation in familial hypercholesterolaemia

A

low-density lipoprotein

101
Q

How to measure disease in Haemachromatosis

A

Ferritin and transferrin saturation

102
Q

What is lateral medullary syndrome

A

Caused by PICA

ipsilateral: dysphagia, facial numbness, cranial nerve palsy e.g. Horner’s
contralateral: limb sensory loss

103
Q

How many weeks pregnant until you can be admitted to EPAU

A

6 weeks (manage at home and do PT after 7 days)

104
Q

Treatment for Hepatitis A

A

None

105
Q

Management of exomthalmos

A

Exomphalos (covered in peritoneum outside abdomen) should have a gradual repair

106
Q

Antibiotic contraindicated in G6PD deficiency

A

Ciprofloxacin

107
Q

How often can IM adrenaline be given in anaphylaxis

A

5 min

108
Q

Dose of IM adrenaline

A

1 in 1000
500mcg 11+
300mcg (6-11)
150 (0.5-5)

109
Q

Regular screening in patients with cirrhosis

A

MELD score 6/12
AFP and USS 6/12
Endoscopy 3 yearly

110
Q

Why should blood transplants be limited in CKD

A

Risk of allosensitisation -> renal transplant reject

111
Q

Bleeding pattern with POP

A

20% of women will be amenorrhoeic
40% will bleed regularly
40% will have erratic bleeding.

112
Q

5 ECG changes in low K

A

U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT

113
Q

Post H Pylori erradication therapy test

A

Urea breath test

114
Q

What is hydrogen breath test for

A

SBBO

115
Q

How many weeks until cannot have medical abortion

A

9-13

115
Q

How many weeks until cannot have medical abortion

A

9-13

116
Q

Which medication is associated with the highest chance of inhibition disorders out of the antiparkinsonian medications

A

Dopamine receptor agonist

117
Q

What is the antibiotic of choice for GBS prophylaxis

A

Benzylpenicillin

118
Q

If a patient is on warfarin/a DOAC/ or has a bleeding disorder and they are suspected of having a TIA what is the next step in their management

A

CT head

(even if resolved)

119
Q

Cushing’s syndrome ABG

A

hypokalaemic metabolic alkalosis

120
Q

Why must blood products be irradiated in Hodgkins lymphoma

A

Risk of G v H disease

Immunocompromised, bone marrow transplants, neonates

121
Q

First line If CBT or EMDR therapy are ineffective in PTSD,

A

Venlafaxine (then SSRI)

122
Q

Otitis externa in diabetics

A

treat with ciprofloxacin to cover Pseudomonas

123
Q

Microscopy of trichomonas shows ->

A

microscopy of a wet mount shows motile trophozoites

124
Q

Prevention of Menieres disease

A

Betahistine

125
Q

How long can lochia go on for before USS

A

6 weeks

126
Q

What is Peutz-Jeghers syndrome associated with

A

Hamartomas (bowel polyps)
Pigmented lesions

127
Q

ABX class that causes TdP

A

Macrolide

128
Q

Drug that stimulates release of ADH

A

vasopressin

129
Q

When should warfarin be stopped before surgery

A

5 days

130
Q

APTT in antiphopholipid syndrome

A

prolonged

131
Q

In 3rd nerve palsy, is the consensual response in tact

A

Yes as CN2 senses

132
Q

Criteria for thrombectomy

A

Must be proximal anterior
<6 hours
OR
6-24 hours AND salvageable tissue on CT

133
Q

Oligocloanal bands

A

MS LP

134
Q

management of MS relapses

A

500mg methyl pred

135
Q

Is MND upper or lower

A

Both

136
Q

Only drug licenced for MND

A

Riluzole

137
Q

What Parkinsons medications are impulse disorders most common in

A

Dopamine agonist

138
Q

What is adenoma sebaceum associated with

A

Tuberous sclerosis

Lots of small angiomas

139
Q

First line in absence seizures

A

ethosuximide

140
Q

Where is speech centre in brain

A

Opposite side to which side handed

141
Q

Hearing loss/ vertigo + absent corneal reflex -> dx

A

Acoustic neuroma (schwannoma)

142
Q

How many hours after UPSI can levongeosterole be used

A

72

(UA 120 hrs)

143
Q

Most common pathogen to cause bronchiectasis

A

Haemophilus influenzae

144
Q

Recommend escalating adenosine doses of

A

6mg → 12mg → 18 mg

145
Q

Sight prescription which increases risk of open angle glaucoma

A

Myopia

146
Q

How long after inhaler use can it be re used

A

30 seconds

147
Q

Bone cancer associated with FAP

A

Osteoma

148
Q

Most common malignant bone tumour

A

Osteosarcoma

149
Q

First line anti thyroid drug

A

Carbimazole

(Propylthiouracil has risk of liver failure)

150
Q

two central lung cancers

A

Squamous
Small cell

151
Q

When is clopidogrel used in STEMI

A

Bleeding risk
Already on an anticoagulant

152
Q

What dementia can haloperidol not be used

A

PD
DLB

153
Q

Patients using methotrexate require effective contraception during and for at least ? months after treatment in men or women

A

6

154
Q

Valvular disease associated with polycystic kidney disease

A

Mitral valve prolapse

155
Q

A recurrent episode of C. difficile within 12 weeks of symptom resolution should be treated with

A

findoxamicin oral

156
Q

FAP + bone cancer ->

A

Gardeners syndrome

157
Q

Whooping cough management

A

azithromycin or clarithromycin

158
Q

Breast fibroadenoma: surgical excision is usual if….

A

3cm plus

159
Q

In what common condition can you not use cyclazine

A

Heart failure (severe)

160
Q

What is Peutz-Jeghers syndrome

A

AD
Hamartomatous polyps in GI tract
Can cause obstruction
Hyperpigemented lesions on lips, palms, soles

161
Q

Raised HbA2

A

Beta thalassemia

162
Q

Appearance of papules in guttate pspriasis

A

Teardrop

Management is emollients and conservative (normal psoriasis mx if no improvement)

163
Q

Why increased risk of VTE in nephrotic syndrome

A

Piss out antithrombin 3

164
Q

Inheritance of HCT

A

AR

165
Q

When should cyclizine be prescribed in palliative care?

A

Intercranial courses

166
Q

Pseudogout crystals

A

Rhomboid positive

167
Q

Gout crystals

A

Needle negative

168
Q

4 drugs that cause tinnitus

A

Aspirin
Nsaids
Loop diuretics
Quinne
Gent

169
Q

Electrolyte abnormality which shows key risk of refeeding

A

Hypophosphataemia

(hypokalaemia, magnesia)

170
Q

Anorexia features on bloods

A

All low except G and C’s

171
Q

How to treat bile acid malabsorption

A

cholestyramine

172
Q

Where do stones get stuck in submandibular gland

A

Wharton’s duct

173
Q

Mx of severe urticaria

A

Oral pred

174
Q

Where are seizures with automatisms (lip smacking, grabbing, plucking)

A

Temporal

Most strange actions are temporal

175
Q

Common drug risk factor for osteonecrosis

A

Steroids
(chemo and ETOH)

176
Q

Medication to prevent attacks of Menieres

A

Betahistine

177
Q

Haemophillia bloods

A

prolonged APTT
bleeding time, thrombin time, prothrombin time normal

178
Q

HbA2 is raised in what condition

A

Beta-thalassemia

179
Q

What drug can be used to stimulated VwF

A

Desmopressin

Year 5 MBChB (17 decks)

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