Key concepts part 4 Flashcards
what are the key features of optic neurtis?
- painful eye movements
- reduced visual acuity
- poor colour discrimination (red saturation)
- central scotoma
- RAPD
Describe the syphilis testing system
Consists of both non-treponemal test (not specific for syphilis) and treponemal test.
A positive non-treponemal test (VDRL) + positive treponemal test (TPHA) = active syphilis
A positive VDRL + negative TPHA = false positive (due to pregnancy, SLE, HIV etc)
A negative VDRL + positive TPHA = treated syphilis (as VDRL eventually goes away)
what are examples of things that can result in false positive VDRL
pregnancy, SLE, TB, HIV, malaria, leprosy
what condition can cause a false negative mantoux test
sarcoidosis
what is the most common cause of endocarditis <2 months post prosthetic valve replacement? and >2 months?
<2 months = staph epi
> 2 months = staph aureus
what drug causes colourful visual hallucinations, depersonalisation, psychosis and paranoia
LSD (lysergic acid diethylamine)
how do you treat pneumocystis jirovecci
co-trimox
what is a suitable screening tool for childhood squints?
corneal light reflection test
what can be used to monitor LMWH (if needed)
anti-factor Xa
what can be used to monitor unfractioned heparin
APTT
what is an example of a poor prognosis factor for liver cirrhosis
ascites
what thyroid function tests would be demonstrated in sick euthyroid?
normal TSH, low T3/T4
what is the most common site of metatarsal stress fractures?
2nd metatarsal
what are contraindications to lung cancer surgery?
- SVC obstruction
- FEV <1.5
- malignant plural effusion
- vocal cord paralysis
which haem cancer is associated with massive splenomegaly
CML
in which patient population is malignant otitis externa most common?
diabetics
which nerve is most likely to be injured in a mid shaft humeral fracture and what will that present as?
radial nerve - wrist drop, loss of finger extension
what is the management of myasthenic crisis?
IVIG + plasmapheresis
what investigation findings are seen in renal TB
persistent pyuria and negative urine culture
what can trigger liver decompensation in cirrhosis
constipation
what condition is pigmented gallstones associated with
sickle cell
what investigation should be done in patients with symptoms suggestive of colorectal cancer but who do not fit 2 week wait criteria?
faecal immunochemical test (FIT)
what is the preferred drug for pain relief in a palliative patient with mild/mod renal failure?
oxycodone
when should you start allopurinol following a gout attack?
immediately after the inflammation has settled/patient is no longer in pain
what antibodies are present in dermatositis?
Anti-Jo, anti Mi2, ANA (80% of patients are +ve)
what are the Wells score cut offs?
PE likely = >4 points
PE unlikely = 4 or less
what is required once a diagnosis of dermatomyositis is made?
a malignancy screen (ovarian, breast, lungs)
what is lupus pernio?
a manifestation of sarcoid presenting with a purple plaque that involves the tip of the nose and the skin around the nostrils
what is a pfannensteils incision used for?
C/S
what is a Kocher’s incision used for?
open cholecystectomy
what is a rooftop/midline incision used for?
whipples
what is a key risk of over replacement with thyroid?
osteoporosis
Is trimethoprim safe in breastfeeding?
yes
