May 13th, 2021 Flashcards

1
Q

Differential for elderly with increase of months of cognitive decline, 5 things

A
Alzheimer’s
Depression
Illicit substances
Space occupying lesion
UTI/infection
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2
Q

CCF exacerbation 6 management steps in 72M

A
commence low dose ACEi, 2.5-5mg perindopril
frusemide 40mg, PO daily
spironolactone 12.5-25mg, po, daily
low sodium diet <5g
fluid restrict 1L-1.5L
cardiac rehab
daily weights
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3
Q

4 causes of hypercholesterolaemia

A
hypothyroidism 
familial cholesterolaemia
diabetes type 2
nephrotic syndrome
CKD
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4
Q

47M hypertension 175/82, Fhx brother 60 MI: 6 examination findings

A
papilloedema on fundoscopy
neck circumference
displaced apex beat
bibasal crackles
renal angle for enlarged kidneys
goitre
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5
Q

CVD risk management SNAP?

A

smoking cessation
low sodium diet <5g per day
150-300min moderate physical city each week
maintenance of BMI 18-25
diet: 5 serves veg, 2 serves fruits per day
cease alcohol intake

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6
Q

19M struggles to get out of bed, alert later in the day. 5 ddx

A
depression
delayed sleep phase disorder
narcolepsy
caffeine use at night
chronic sleep restriction
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7
Q

19M struggles to get out of bed, alert later in the day. sleeps at 3am to 11am. 7 history

A
falling asleep during conversations?
anhedonia?
nature of insomnia, ?initiation
stimulant use?
screen time at night?
snoring?
restless limbs?
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8
Q

19M struggles to get out of bed, alert later in the day. 3 examination

A

blunted affect
hypertension
increase BMI?

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9
Q

68F seamstress, hand and back pain, phi dep, op, eGFR 40, right flank L1-5 pain, dipstick 2+haematuria. 5hx

A
dysuria?
unintentional weight loss?
recent NSAIDs use?
previous renal calculi
symptoms of diabetes: polydipsia
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10
Q

68F seamstress, hand and back pain, phi dep, op, eGFR 40, right flank L1-5 pain, dipstick 2+haematuria. 4 ddx

A
IgA nephropathy
hypertensive nephropathy
urinary tract malignancy
polycystic kidney disease
renal calculi
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11
Q

32F, first mum, 5/52 son, nipple pain R>L 5 hx

A
feeding frequency?
nipple pain onset?
history of dermatitis
fever?
use of breast pump?
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12
Q

32F, first mum, 5/52 son, nipple pain R>L 4 ddx

A

poor latch
infant factors: biting
nipple dermatitis
nipple vasospasm

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13
Q

32F, first mum, 5/52 son, nipple pain R>L

4 Mx of nipple candidiasis

A
  • commence 150mg, fluconazole every 2nd day for 3 days
  • nystatin 100 000units TDS + miconazole oral gel to nipples QID
  • commence son on miconazole oral get QID
  • keep nipples dry
  • sterilise dummy daily
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14
Q

33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 6hx

A
bile in vomit?
projectile vomiting after feeds?
blood in stool?
fever?
malodorous urine?
number of wet/soiled nappies?
mum's mental health and supports?
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15
Q

33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 2ddx

A

purple crying

cows milk protein intolerance

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16
Q

33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 3 mx

A
  • referral to lactation consultant
  • follow up in 5-7 days
  • acknowledge impact of crying baby on mental health
17
Q

26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 6hx

A
fever?
Phx of disease among employees?
mask usage at work?
rash?
wheeze?
night sweats?
18
Q

26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 4 ddx

A

occupational asthma
occupational silicosis
hypersensitivity pneumonitis
sarcoidosis

19
Q

26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 4mx

A

encourage SafeWork notification
cease exposure to silica dust
cease cigarette smoking
referral resp physician

20
Q

52M, samoan, forklift driver, 4-24SD on weekends, 20py smoking, single, ?liver disease 8 physical exam signs?

A
palmar erythema
dupytren's contracture
metabolic flap
spider naevi
caput medusae
scleral icterus
hepatomegaly
gynecomastia
increase BMI
21
Q

6F, 24/24 of severe ear pain, blocked for last 2/52, 7hx

A
fever?
rash?
otorrhea?
headache?
hx of swimming?
recent trauma?
aboriginal or torres strait?
speech delay?
coryza symptoms?
22
Q

75M L>R hearing loss, hearing aids, worsening past 5 years hearing, bilateral tinnitus, 8hx?

A
fever?
Otorrhoea 
headaches?
loud noise exposure?
prev ear surgery?
vertigo?
otalgia?
facial pain?
previous head trauma
23
Q

75M L>R hearing loss, hearing aids, worsening past 5 years hearing, bilateral tinnitus, 3ddx?

A

presbycusis
noise-induced hearing loss
acoustic neuroma

24
Q

59M, dmII new diagnosis, ACR 35, protein in urine ++, ddx?

A

diabetic nephropathy
nephrotic syndrome
hypertensive nephropathy
polycystic kidney disease

25
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker: 4hx
``` family history of bleeding disorders? recent nose trauma? heavy menstrual bleeding? bleeding from gums? NSAID use? ```
26
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker: 4 exam findings?
``` petechiae? hypotension oropharynx mucocutaneaous bleeding signs of anaemia, conjunctival pallor splenomegaly hepatomegaly ```
27
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker 4 ddx
Von Willebrand's haemophilia immune thrombocytopenia bone marrow failure
28
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker, iron oral advice 5 things
``` take on empty stomach take with vitamin C may cause nausea may cause dark stools may cause constipation ```
29
8yo boy with left leg limp past 7/7 associated cough, runny nose past 3/52 3ddx
left hip perthes disease left hip transient synovitis viral arthritis stress fracture
30
8yo boy with left leg limp past 7/7 associated cough, runny nose past 3/52 Trans Synov: 3Mx
- paracetamol 1g, po, QID, PRN - rest from aggravating activities - review in 2-7 days