managements Flashcards

1
Q

IgA nephropathy

A

optimise BP

- ACEi

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2
Q

management of scabies

A

permethrin 5%

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3
Q

management of actinic keratosis

A

5% fluorouracil cream

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4
Q

Minimal change disease management

A

fluid restriction and reduced salt
corticosteroid therapy- prednisolone
human albumin and furosemide

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5
Q

management of pagets disease

A

bisphosphonates
NSAIDs for bone pain
vitD and calcium supplements

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6
Q

examples of bisphosphonates

A
Risedronate 
Alendronate
Ibandronate 
Zoledronic Acid 
Pamidronate
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7
Q

management of otitis externa

A

Provide information on aural care.
Mild – do not swab. Acetic acid 2% continuing for 2 days after resolution (max 7 days).
Moderate – do not swab. Sofradex® or Otomize® tds. (antibiotic and steroid combo)
ENT for severe

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8
Q

fracture T4 or above suggests?

A

malignancy

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9
Q

management of kidney stones

A

NSAIDs for pain- IM diclofenac
watchful waiting
tamsulosin
surgical intervention

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10
Q

raised urinary:creatinine ratio with proteinuria in patient with diabetes

A

signs of end organ complications- diabetic neuropathy

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11
Q

what is seen on renal biopsy in patients with diabetic neuropathy

A

Kimmelstein-Wilson nodules

- regions of pink hyaline material that can be found in the glomerular capillary loops

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12
Q

glomerular crescents on renal biopsy

A

rapidly progressive glomerulonephritis

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13
Q

diagnostic features of glomerulonephritis

A

haematuria, oedema, hypertension and presence of risk factors

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14
Q

management of post-streptococcal glomerulonephritis

A

supportive

antihypertensive medications and diuretics if complication develop

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15
Q

diagnosis of post-streptococcal glomerulonephritis

A

history of tonsilitis- either positive throat swab results

and anti-streptolysin antibody titres

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16
Q

acute kidney failure and haemoptysis

A

good-pastures (associated with anti-GBM)

granulomatosis with polyangiits (ANCA)

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17
Q

Key to diagnosing IgA nephropathy

A

renal biopsy

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18
Q

what is seen on renal biopsy in IgA nephropathy

A

IgA deposits and glomerular mesangial proliferations

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19
Q

management of IgA nephropathy

A

monitoring

optimise BP- ACEi

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20
Q

management of minimal change disease

A

fluid restriction and reduced salt
corticosteroid therapy
human albumin and furosemide

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21
Q

management of BPH

A

alpha blockers- tamsulosin (relax smooth muscle, rapid improvement in symptoms)
5-alpha reductase inhibitors (finasteride)

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22
Q

diagnosis of varicocele

A

ultrasound with doppler

if left sided- could suggest renal cell carcinoma so US KUB

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23
Q

loin pain, haematuria, palpable mass

A

renal cell carcinoma

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24
Q

management of anti-phospholipid syndrome

A

low dose aspirin if they have no had a thrombosis yet

patients who experience venous or arterial thrombosis: life long warfarin

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25
Q

raynauds treatment of choice

A

Daily nifedipine

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26
Q

presentation of anti-phospholipid syndrome

A
CLOTS
clots 
livedo reticularis 
obstetric complications
thrombocytopenia- platelet deficiency
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27
Q

livedo reticularis

A

net-like mottling of the skin

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28
Q

Monteggia fracture

A

dislocation of the proximal radioulnar joint in association with an ulnar fracture

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29
Q

Galeazzi fracture

A

fracture of the distal radius with an associated dislocation of the distal radioulnar joint.

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30
Q

investigation for spinal stenosis

A

MRI

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31
Q

joint aspirate in rheumatoid arthritis

A

high WBC

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32
Q

management of SLE

A
Depends on manifestations
For skin disease and arthralgia: 
	- Hydroxychloroquine
	- Topical steroids 
	- NSAIDs
Inflammatory arthritis or evidence of organ involvement:
	- Immunosuppression: azathioprine
Severe organ disease:
	- IV steroids and cyclophosphamide 

Monitor anti-dsDNA and complement levels
Check urinalysis for blood or protein

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33
Q

management of septic arthritis

A

prolonged antibiotics 4-6weeks (fluxo?

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34
Q

pain exacerbated by walking on toes

A

plantar fasciitis

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35
Q

most common site of metatarsal stress fracture

A

2nd metatarsal shaft

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36
Q

treatment of hypoparathyroid

A

alfacalcidol

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37
Q

management of blepharitis

A

hot compress and gentle cleaning first line

lubricating eye drops

38
Q

presentation of seborrhoeic keratosis

A
  • Stuck on appearance
  • Benign proliferation of epidermal keratinocytes
  • Common in ageing skin
    basically big crusty mole
39
Q

management of seborrhoeic keratosis

A
  • Reassure

- Cryotherapy if troublesome

40
Q

management of nasal septal haematoma

A

urgent ENT referral
surgical drainage
intravenous antibiotics

41
Q

Ptosis + dilated pupil

A

3rd nerve palsy

42
Q

ptosis + constricted pupil

A

horners syndrome

43
Q

In a child with an asymptomatic, fluctuant swelling behind the knee

A

Bakers cyst

44
Q

Ankylosing spondylitis xray findings

A

subchondral erosions, sclerosis

and squaring of lumbar vertebrae

45
Q

Oral ulcers + genital ulcers + anterior uveitis

A

Behcet’s

46
Q

management of blepharitis

A

hot compress and cleaning of eyelids

47
Q

argyll and roberston pupil

A

bilaterally small pupils that reduce in size on a near object, but do not constrict when exposed to bright light

48
Q

what is vestibular neuronitis

A

inflammation of the vestibular nerve. This is usually attributed to a viral infection.

49
Q

presentation of vestibular neuronitis

A

acute onset of vertigo
associated with nausea and vomiting (may be severe) and balance problems
history of viral upper respiratory tract infection

50
Q

management of vestibular neuritis

A

Prochlorperazine for symptoms

Antihistamines

51
Q

management of scarlet fever

A

oral penicillin

notify ph

52
Q

cause of mumps

A

paramyxovirus

53
Q

slapped cheek syndrome

A

erythema infectiosum

caused by parvovirus

54
Q

management of croup

A

steroid dose ?

- dexamethasone

55
Q

epiglottitis management

A

immediate ent help

Ceftriaxone IV

56
Q

bronchiolitis management

A

supportive
oxygen
NG tube

57
Q

whooping cough management

A

diagnosed by nasal swab

oral macrolide

58
Q

hanging rope sign on xray

A

perthe’s disease

59
Q

displaced klein lines on xray

A

slipped upper femoral epiphysis

60
Q

management of DDH

A

mild: serial examinations + US
moderate: pavlik harness
severe/ >18 months: surgical open reduction/osteotomy

61
Q

hearing loss, tinnitus, family history of early hearing loss

A

otosclerosis

62
Q

management of ramsay hunt syndrome

A

aciclovir

prednisolone

63
Q

first line treatment in treating pain from peripheral neuropathy

A

amitriptyline, duloxetine, gabapentin or pregabalin

64
Q

management of renal complications in systemic sclerosis

A

ACEi

65
Q

management of acute closed angle glaucoma

A

Intravenous acetazolamide and topical pilocarpine, beta-blockers, and steroids are used initially- NICE

1st- prostaglandin analogue (PGA) eyedrop (latanoprost)- PASSMED

66
Q

bilateral conjunctivitis management

A

Chloramphenicol or fuscidic acid eye

67
Q

positive straight leg raise test

A

sciatic pain

68
Q

which Ig is found in mucosa

A

IgA

69
Q

What produces endotoxin

A

gram negative

70
Q

enzyme affected in PCT

A

uroporphyrinogen decarboxylase causing buildup of coproporphyrinogen iii

71
Q

presentation of PCT

A

blisters, skin fragility, hyperpigmentation, hypertrichosis, solar urticaria and morphoea
sun exposed sites
red urine

72
Q

type 1 PCT

A

acquired

liver damage

73
Q

type 2 PCT

A

genetic

74
Q

investigations for PCT

A

porphyrin plasma levels

examine under wood lamps- pink fluorescence

75
Q

management of PCT

A

avoid iron, alcohol and oestrogen
sun cream
treat underlying
if still symptomatic- chloroquine, venesection

76
Q

enzyme affected in Erythropoietic protoporphyria

A

ferrochelatase causing buildup of protoporphyin ix

77
Q

presentation of EP

A

early- vesicles, blisters, skin fragility, pain and itch in sun
late- pitted scars, keratinised crusty skin

78
Q

investigations for EP

A

fluorocytes, quantitative RBC porphyrins

monitor for liver disease

79
Q

enzyme affected in acute intermittent porphyrias

A

PBG deaminase causing buildup of hydroxymethylbilane

80
Q

complications of colles fractre

A

median nerve compression
EPL rupture
CRPS
loss of grip strength

81
Q

What rheumatoid drug is nephrotoxic?

A

Gold, penicillamie

82
Q

Which insulin do you give once a day

A

basal

83
Q

management of anterior uevitis

A

urgent referral to ophthalmology
steroids- eye drops, topical or oral
Cycloplegic-mydriatic medications such as cyclopentolate or atropine eye drops- relieve the pain

84
Q

enlarged blind spot
Pain on eye movement
Impaired colour vision
Relative afferent pupillary defect

A

optic neuritis

85
Q

management of optic neuritis

A

urgent referral to ophthalmology

steroids

86
Q

Haemolytic anaemia
Acute kidney injury
Low platelet count (thrombocytopenia)

A

HUS

87
Q

most common cause of HUS

A

shiga toxin produced by e.coli

88
Q

management of HUS

A

Antihypertensives
Blood transfusions
Dialysis

89
Q

extra renal presentation of ADPKD

A

Hepatic cysts- appears later
SOB, pain, ankle swelling
Intracranial aneurysms- seen in clusters of family members, screen patients
Cardiac disease: mitral/aortic valve prolapse
Diverticular disease

90
Q

management of ADPKD

A

tolvaptan- slow development of cysts

plus management of complications

91
Q

SGLT2 mechanism of action

A

Increase renal loss > resulting in glucose reduction and weight loss