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second year!! > managements > Flashcards

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
raynauds treatment of choice
Daily nifedipine
26
presentation of anti-phospholipid syndrome
``` CLOTS clots livedo reticularis obstetric complications thrombocytopenia- platelet deficiency ```
27
livedo reticularis
net-like mottling of the skin
28
Monteggia fracture
dislocation of the proximal radioulnar joint in association with an ulnar fracture
29
Galeazzi fracture
fracture of the distal radius with an associated dislocation of the distal radioulnar joint.
30
investigation for spinal stenosis
MRI
31
joint aspirate in rheumatoid arthritis
high WBC
32
management of SLE
``` 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
33
management of septic arthritis
prolonged antibiotics 4-6weeks (fluxo?
34
pain exacerbated by walking on toes
plantar fasciitis
35
most common site of metatarsal stress fracture
2nd metatarsal shaft
36
treatment of hypoparathyroid
alfacalcidol
37
management of blepharitis
hot compress and gentle cleaning first line | lubricating eye drops
38
presentation of seborrhoeic keratosis
- Stuck on appearance - Benign proliferation of epidermal keratinocytes - Common in ageing skin basically big crusty mole
39
management of seborrhoeic keratosis
- Reassure | - Cryotherapy if troublesome
40
management of nasal septal haematoma
urgent ENT referral surgical drainage intravenous antibiotics
41
Ptosis + dilated pupil
3rd nerve palsy
42
ptosis + constricted pupil
horners syndrome
43
In a child with an asymptomatic, fluctuant swelling behind the knee
Bakers cyst
44
Ankylosing spondylitis xray findings
subchondral erosions, sclerosis | and squaring of lumbar vertebrae
45
Oral ulcers + genital ulcers + anterior uveitis
Behcet's
46
management of blepharitis
hot compress and cleaning of eyelids
47
argyll and roberston pupil
bilaterally small pupils that reduce in size on a near object, but do not constrict when exposed to bright light
48
what is vestibular neuronitis
inflammation of the vestibular nerve. This is usually attributed to a viral infection.
49
presentation of vestibular neuronitis
acute onset of vertigo associated with nausea and vomiting (may be severe) and balance problems history of viral upper respiratory tract infection
50
management of vestibular neuritis
Prochlorperazine for symptoms | Antihistamines
51
management of scarlet fever
oral penicillin | notify ph
52
cause of mumps
paramyxovirus
53
slapped cheek syndrome
erythema infectiosum | caused by parvovirus
54
management of croup
steroid dose ? | - dexamethasone
55
epiglottitis management
immediate ent help | Ceftriaxone IV
56
bronchiolitis management
supportive oxygen NG tube
57
whooping cough management
diagnosed by nasal swab | oral macrolide
58
hanging rope sign on xray
perthe's disease
59
displaced klein lines on xray
slipped upper femoral epiphysis
60
management of DDH
mild: serial examinations + US moderate: pavlik harness severe/ >18 months: surgical open reduction/osteotomy
61
hearing loss, tinnitus, family history of early hearing loss
otosclerosis
62
management of ramsay hunt syndrome
aciclovir | prednisolone
63
first line treatment in treating pain from peripheral neuropathy
amitriptyline, duloxetine, gabapentin or pregabalin
64
management of renal complications in systemic sclerosis
ACEi
65
management of acute closed angle glaucoma
Intravenous acetazolamide and topical pilocarpine, beta-blockers, and steroids are used initially- NICE 1st- prostaglandin analogue (PGA) eyedrop (latanoprost)- PASSMED
66
bilateral conjunctivitis management
Chloramphenicol or fuscidic acid eye
67
positive straight leg raise test
sciatic pain
68
which Ig is found in mucosa
IgA
69
What produces endotoxin
gram negative
70
enzyme affected in PCT
uroporphyrinogen decarboxylase causing buildup of coproporphyrinogen iii
71
presentation of PCT
blisters, skin fragility, hyperpigmentation, hypertrichosis, solar urticaria and morphoea sun exposed sites red urine
72
type 1 PCT
acquired | liver damage
73
type 2 PCT
genetic
74
investigations for PCT
porphyrin plasma levels | examine under wood lamps- pink fluorescence
75
management of PCT
avoid iron, alcohol and oestrogen sun cream treat underlying if still symptomatic- chloroquine, venesection
76
enzyme affected in Erythropoietic protoporphyria
ferrochelatase causing buildup of protoporphyin ix
77
presentation of EP
early- vesicles, blisters, skin fragility, pain and itch in sun late- pitted scars, keratinised crusty skin
78
investigations for EP
fluorocytes, quantitative RBC porphyrins | monitor for liver disease
79
enzyme affected in acute intermittent porphyrias
PBG deaminase causing buildup of hydroxymethylbilane
80
complications of colles fractre
median nerve compression EPL rupture CRPS loss of grip strength
81
What rheumatoid drug is nephrotoxic?
Gold, penicillamie
82
Which insulin do you give once a day
basal
83
management of anterior uevitis
urgent referral to ophthalmology steroids- eye drops, topical or oral Cycloplegic-mydriatic medications such as cyclopentolate or atropine eye drops- relieve the pain
84
enlarged blind spot Pain on eye movement Impaired colour vision Relative afferent pupillary defect
optic neuritis
85
management of optic neuritis
urgent referral to ophthalmology | steroids
86
Haemolytic anaemia Acute kidney injury Low platelet count (thrombocytopenia)
HUS
87
most common cause of HUS
shiga toxin produced by e.coli
88
management of HUS
Antihypertensives Blood transfusions Dialysis
89
extra renal presentation of ADPKD
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
management of ADPKD
tolvaptan- slow development of cysts | plus management of complications
91
SGLT2 mechanism of action
Increase renal loss > resulting in glucose reduction and weight loss

second year!! (7 decks)

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