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Gap deck MSRA > MCQbank Gap > Flashcards

MCQbank Gap Flashcards

1
Q

risk factor for endometrial cancer

A

obesity
nulliparity
late menopause
FHx of ovary, breast, colon cancer
tamoxifen
HRT
pelvic irradiation
diabetes
PCOS

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2
Q

skin swabs in angular chelitis

A

inflammation of the angles of the mouth
- candida albicans, s.aureus and h. simplex

replace poorly fitting dentures, topical antifuncal can use miconazole can potentially use a topical steroid combination product

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3
Q

seborrhoeic dermatitis

A

eczema/dermatitis affects the sebaceous gland rich regions of the scalp, face and trunk

malassezia yeast

keratolytics, topical antifungals, mild topical corticosteroids or topical calcineurin, tacrolimus

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4
Q

mx of diverticulits

A

co-amxoxiclav
pen allergic = cefalexin and met

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5
Q

meningitis mangaement

A

benpen

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6
Q

methotrexate side effects

A

methotrexate pneumonitis, pre existing lung disease is a major risk factor and based on methotrexate exposure, sx, labs and imaging findings –> methotrexate cessation and high dose steroids

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7
Q

hydroxychloroquines s/e

A

disturbances in hepatic and renal function
retinal toxicity

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8
Q

infliximab s/e

A

reactivation of hep b and TB, skin reactions such as drug induced lupus, psoriasiform skin lesions and new onset vitiligo, demyelinating CNS disorders, blood sycrasias, hepatosplenic T cell lymphoma (usually with 6 MCP)

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9
Q

sulfasalazine s/e

A

bone marrow suppressions, folate deficiency, megaloblastic anaemia, haemolytic anaemia in people with G6PD deficiency, oligospermia, orange/yellow discolouration of urine and stains contact lenses yellow

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10
Q

NHL symptoms

A

lymphadenopathy, weight loss, fatigue and night sweats, splenomegaly
Hepatomegaly occurs less than splenomegaly

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11
Q

NHL is associated with

A

EBV, hep c, kaposi sarcoma herpesvirus

sjogrens and hashimotos

h.pylori

R CHOP 21

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12
Q

lithium causes in babies

A

ebsteins anomaly

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13
Q

isotretinoin abnormality

A

craniofacial anomalies, cardiac defects, thymic development, alterations in CNS

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14
Q

warfarin abnormality

A

skeletal abnoramlities (6-9 weeks gestations)

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15
Q

deithylstilbestrol abnormality

A

clear cell adenocarcinoma of vagina

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16
Q

folic acid antagonist abnormality

A

skeletal malformations

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17
Q

carbamazpine abnormality

A

neural tube defects

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18
Q

ACEi abnormalities

A

intrauterine renal insufficiency and oligohydramnios
prematurity
intrauterine growth retardation and foetal death

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19
Q

can warfarin be given when breast feeding

A

yes

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20
Q

what is hyphaemia

A

blood in the anterior chamber secondary to trauma

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21
Q

what is the most common cause of red eye

A

conjunctivitis

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22
Q

acute angle closure glaucoma appear like

A

exacerbated by pupil dilatation so attacks are more common at night and with use of anticholinergic, sympathomimetic eyedrops

blurred vision, severe pain, nausea and vomitigng

unilateral semi dilated non reactive pupil, hazy cornea

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23
Q

acute iritis information

A

a/w systemic conditions –> ank spond, UC, reactive arthritis

PAINFUL red eye with blurred vision and photophobia
unilateral, poorly reactive irregular pupil with circumcornela readness

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24
Q

episcleritis vs scleritis

A

scelritis is more severe inflammation of episcleritis that occurs throughout the entire thickness of the scelra

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25
Q

keratitis/corneal ulcer

A

inflammation of the cornea secodnary to infective/traumatic/autoimmune
dendritic ulcer

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26
Q

risk of PCV

A

transformation to myelofibrosis and secondary acute myeloid leukaemia

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27
Q

side effect of metformin

A

low b12 levels

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28
Q

mx of whooping cough

A

prescribe clarithromycin/azithromycin if the cough is within the previous 21 days

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29
Q

management of pyelonephritis

A

cefalexin

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30
Q

CI to metformin

A

lactic and DKA / egfr <30

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31
Q

most common causes of acute gastroenteritis in kids

A

rotavirus, norovirus and adenovrius

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32
Q

central cord syndrome

A

most commonly occurs in older individuals wtih cervical spondylosis / OA in the neck
there is greater motor impairment in the upper compared to lower extremities and variable degrees of sensory loss below the level of injury alongside bladder dysfunction and urinary retention

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33
Q

anterior cord syndrome

A

motor paralysis and loss of pain, temperature and autonomic function –> caused by anterior spinal artery ischaemia

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34
Q

MCC of bacterial meningitis in adults

A

strep pneumoniae

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35
Q

seborrhoeic dermatitis and acne rosacea nasolabial folds

A

seborhhoeic dermatiis affects the nasolabial folds but acne rosacea does not

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36
Q

mycoplasma pneumoniae is associated with

A

bullous myringitis

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37
Q

plantar fasciitis causes pain where

A

causes pain beneath the heel - associated with tissue overload, breakdown and incomplete repair

bilateral plantar fasciitis –> raise suspicion of psoriatic / reactive arthritis

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38
Q

light criteria

A

pleural fluid to serum protein ratio >0.5

pleural fluid to serum LDH ratio >0.6

pleural fluid LDH concentrtation >2/3 upper limit of normal for serum LDH

= exudate

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39
Q

what is wet AMD characterised by

A

choroidal neovascularisation

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40
Q

what is diabetic retinopathy characterised by

A

microaneurysms, dot and blot and flame haemorrhages

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41
Q

what is HTN retinopathy seen in

A

AV nicking

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42
Q

what is a side effect of sildanafil

A

visual disturbnaces can go blue, non arteritic anteior ischaemic optic neuropathy

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43
Q

contraindication of sildenafil

A

nitrates, non anterior ischaemic optic neuropathy, hypotension (avoid if SBP <90), recent stroke/MI, unstable angina

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44
Q

first episode of tonic clonic seizure, risk of another episode

A

30-50%

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45
Q

ANA

A

SLE

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46
Q

antiro/la

A

sjogren’s syndrome

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47
Q

anti centromere

A

CREST

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48
Q

antimitochondrial

A

PBC

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49
Q

which antidepressants are sedating

A

mirtazapine, trazodone, lofepramine

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50
Q

what can precipitate gout

A

alcohol, diuretics, salicylates, pyrazinamide, ethamnbutol, nicotinic acid, cytotoxic agents

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51
Q

what would you prescribe between attacks of menieres disease

A

betahistine - relieves pressure from xs fluid

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52
Q

background of menieres

A

vertigo, tinnitus, hearing loss
sensorineural deafness and loss of lower frequencies is moer pronounced
nystagmus away from affected ear

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53
Q

causes of bleeding in 1st trimester

A

spontaneous abortion
ectopic pregnancy
hydatidiform mole

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54
Q

causes of bleeding in second trimester

A

spontaneous abortion
hydatiform mole
placental abrotpion

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55
Q

causes of third trimester

A

bloody shows
placental abruption
placental praevia
vasa praevia

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56
Q

where is most commonly affected in costochodnritis

A

2-5 costochondral junctions

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57
Q

difference between costochondritis and tietze’s syndrome

A

tietze’s syndrome is characterised by swelling of the costal cartilages, while in costochondritis there is no swelling

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58
Q

causes of CN III palsy

A

DM very common cause
aneurysm (compression)
leukaemia (infiltrative)
toxic (chemo)

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59
Q

what is a holmes adie pupil

A

parasympathetic denervation of the affected pupil - the affected pupil appears dilated at rest. there is poor or sluggish pupillary constriction in bright light. Constriction is more notable with the near reaction and remains constricted with slow re-dilation. Patients may also have decreased deep tendon reflexes in the full holmes adie pupil.

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60
Q

Margus gunn pupil

A

RAPD

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61
Q

pupil damage

A
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62
Q

where is damaged in RAPD

A

optic nerve or retina

there is a unilateral lesion in afferent visual pathway anterior to the chiasm

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63
Q

CN III lesion in diabetes

A

usually the pupil is spared

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64
Q

Argyll Robertson pupils

A

Accomodation reflex pupil, pupillary reflex absent

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65
Q

what causes a holmes adies pupil

A

large and irregular pupil that is slow to constrict to light but constricts normally with accommodation - once pupil has constricted it remains small for an abnormally long time

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66
Q

causes of holmes adie upil

A

efferent parasympathetic pathway damage, most cases are idiopathic

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67
Q

how much paracetamol do you need to take to OD

A

> 150mg/kg body weight

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68
Q

risk factors for bladder cancer

A

nitrosamines
aromatic amines, polycylic aromatic hydrocarbons, rubber, dyes, paints, solvents, cyclophopshamide, pioglitazone

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69
Q

suspected bladder cancer 2WW

A

over 45 and unexplained visible haematuria without UTI

aged > 60 and unexplained non visible haematuria and either dysuria / raised WCC on bloods

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70
Q

ottowa knee rules

A

age over 55
isolated tenderness of patella
tendereness at head of fibula
inability to bear weight immediately and in the ED

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71
Q

side effects of hydroxychloroquine

A

disturbances in hepatic/renal function

retinal toxicitiy and deposition of the drug in the cornea

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72
Q

infliximab s/e

A

reactivation of hepatitis B and TB
drug induced lupus, psoriasiform skin lesions
demyelinating CNS disorders
blood dyscrasias
hepatosplenic T cell lymphoma

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73
Q

sulfasalazine s/e

A
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74
Q

prednisolone s/e

A
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75
Q

Lyme disease sx

A
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76
Q

when to suspect early lyme disease

A
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77
Q

when to consider late lyme disease

A
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78
Q

testing of lyme disease

A
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79
Q

Mx of lyme disease

A
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80
Q

High risk cholecystectomy

A

In this case –> do an ERCP and sphincterotomy

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81
Q

which conditions are erythema abigne seen in

A

hypothyroidism and lymphoedema

mx with topical tretinoin or laser

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82
Q

hereditary spherocytosis

A
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83
Q

sideroblastic anaemia

A
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84
Q

accessory inspiratory muscles

A

SCM
scalene muscles
external intercostal muscles
pectoralis major and minor
serratus anterior and posterior
latissimus dorsi

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85
Q

accessory expiratory muscle

A

abdominal muscles
internal intercostal muscles

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86
Q

pyridostigmine MOA

A
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87
Q

congenital bleeding disorders

A
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88
Q

acquired bleeding disorders

A
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89
Q

what does APTT measure and what activates it

A

negative charge

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90
Q

what does PT measure and what activates it

A

tissue factor

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91
Q

Fanconi syndrome

A
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92
Q

most sensitive test for vesicoutreteric fistula

A

CT SCAN

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93
Q

8 - 12 weeks gestation

A
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94
Q

10-13 weeks gestation

A
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95
Q

11-13+6 weeks

A
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96
Q

16 weeks

A
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97
Q

18-20+6 weeks

A

anomaly scan

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98
Q

25 weeks if primip

A
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99
Q

28 weeks

A
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100
Q

31 weeks (if primip)

A

routine care: BP, urine dipstick and SFH

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101
Q

34 weeks

A
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102
Q

36 weeks

A
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103
Q

38 weeks

A

routine care - BP, SFH and urine dipstick

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104
Q

40 weeks (only if primip)

A

routine care - BP, SFH and urine dipstick
discussion about options for prolonged pregnancy

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105
Q

41 weeks

A

routine care - BP, SFH and urine dipstick
dsicuss labour plans and possibility of induction

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106
Q

Autosomal dominant inhertied conditions

A

structural

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107
Q

amantadine used in

A

PD, post herpetic neuralgia and influenza A

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107
Q

autosomal recessive conditions

A

metabolic/enzyme defects

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108
Q

anaemia in pregnancy

A

dilutional anaemia
blood volume increases to a greater extent than red cell mass –> reduced blood viscocity

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109
Q

management of recurrent apthous ulceration

A

topical corticosteroids

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110
Q

classic typhoid symptoms

A
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111
Q

placental abruption

A
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112
Q

placenta praevia

A
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113
Q

vasa praevia

A
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114
Q

z deformity

A
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115
Q

boutonniere deformity

A
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116
Q

what causes headaches in the morning that are improved by standing

A
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117
Q

LA doses

A
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118
Q

achilles tendon rupture

A
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119
Q

PMR

A
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120
Q

absence seizures

A
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121
Q

malignant melanoma

A
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122
Q

abx management of respiratory tract infections

A
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123
Q

urinary tract infections abx

A
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124
Q

GI tract infections management

A
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125
Q

genital tract infections abx

A
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126
Q

skin and soft tissue infections abx

A
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127
Q

when in hcg detectable

A

positive 9 days post conception until 20 weeks of pregnancy

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128
Q

patient presents with PPIs in the absence of alarm sx what is the management

A

full dose PPI for one month then review

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129
Q

if there is no improvement following addition of PPI for dyspepsia

A

test for h.pylori with a 13C breath testh

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130
Q

how long to abstain from abx / ppis with urea breath test

A

4 weeks abx
2 weeks PPIs/H2 antagonists

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131
Q

uninvestigated dispesia

A
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132
Q

schneider’s first rank symptoms of schizophrenia

A
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133
Q

cervical ripeness assessement

A
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134
Q

management for newly diagnosed generalised tonic clonic seizures

A

sodium valproate

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135
Q

hand foot and mouth disease

A
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136
Q

keratoancanthoma

A
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137
Q

difference between PD and dementia with lewy bodies

A
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138
Q

amiodarone side effects

A
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139
Q

dosage of amlodipine with simvastatin

A

when amlodipine is used with simvastatin the max. dose of simvastatin should only be 20mg

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140
Q

risk factors for hyperemisis gravidarum

A
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141
Q

causes of gingival hyperplasia

A

phenytoin
ciclosporin
nifedipine and other CCBs

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142
Q

urinary changes and their causative factors

A
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143
Q

side effects of ethambutol

A
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144
Q

side effects of isoniazid

A
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145
Q

side effects of pyrazinamide

A

hyperuricaemia
hepatitis

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146
Q

side effcts of rifampicin

A
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147
Q

acute sinusitis

A
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148
Q

syringomyelia

A
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149
Q

pseudobulbar palsy

A
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150
Q

classification of haemorrhoids

A
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151
Q

MCC of SBO

A

postoperative adhesions
malignancy
crohns disease
hernias

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152
Q

what to do if someone presents with raised bilirubin

A
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153
Q

what does TB look like on a CT scan

A

tuberculomas appear as a low or high density round / lobulated mass

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154
Q

lupus vulgaris

A
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155
Q

TB meningitis explained

A

the TBM bacilli seed to the meninges resulting in the formation of small foci called rich foci

rich foci increase in size until ruptures into the Sub arachnoid space

there are focal neurological deficits
visual symptoms
tremor

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156
Q

turners syndrome

A

45 XO
short stature
gonadal dysgenesis
lymphoedema

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157
Q

what colour sputum in strep pneumoniae

A

blood tinged - looks rusty

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158
Q

steroid cream ladder strength

A
159
Q

what happens if you have a blephorplasty and they take excess skin and then you cant close eyelids properly

A

lagopthalmos

160
Q

pinguecula

A

common degenerative nodule of the conjunctiva

161
Q

what can cause substance induced psychosis

A
162
Q

primary biliary cirrhosis

A
163
Q

pseudohypoparathyroidism

A
164
Q

cushingoid symptoms

A

what is there is undetectable ACTH –> suggests adrenal adenoma

165
Q

risk of smoking in pregnancy

A
166
Q

tetanus vaccination guidelines

A
167
Q
A
168
Q

mortons neuroma

A
169
Q

where is pain felt in plantar fasciitis

A

beneath the heel

170
Q

freiberg’s disease

A
171
Q

EEG findings in tonic clonic seizure

A

bisynchronous epileptiform activity in both cerebral hemispheres

172
Q

tonic seizures

A

impair consciousness and stiffening

173
Q

clonic seizures

A

cause jerking and impairment of consciousness

174
Q

tonic clonic seizures

A

cause stiffening and jerking and impairment of consciousness

175
Q

typical absence seizures

A

begin in childhood
there is sharp onset and offset with no residual symptoms
normal acitivity is interrupted and the child stares for a few seconds
there may be eyelid twitch and some small jerking movements of the fingers
absence seizures may occur 100s of times

176
Q
A
177
Q

myoclonic seizures

A

brief, shock like contraction of the limbs, without LOC

178
Q

atonic seizures

A

sudden brief attacks of loss of tone, a/w falls and LOC

179
Q

focal onset seizures

A

start in one area of the brain

focal motor –> jerking movement (face or hand and spread to involve the limbs)

focal sensory –> temporal lobe seizures (sensory, automatic, emotional, cognitive)

secondarily generalised seizures –> focal seizure before spreading to generalised

180
Q

trigeminal neuralgia

A
181
Q

difference between myelodsyplasia and aplastic anaemia

A

aplastic anaemia occurs in younger people
bone marrow is hypocellular in aplastic anaemia but hypercellular in myelodysplastic syndrome

aplastic anaemia - marrow stops making enough stem cells but in MDS the marrow produced abnormal cells

182
Q

causes of bloody diarrhoea

A
183
Q

FIT testing criteria

A
184
Q

most common childhood epilepsy

A

benign rolandic epilepsy

185
Q

pterygium

A

benign growth of the conjunctiva commonly growing from the nasal side of the sclera

a/w UV light and foind in people who work outdoors in hot dusty places

186
Q

difference between pterygium and pinguecula

A

pterygia grow over the edge of the cornea and pingueculae don’t

187
Q

endocrine system changes during pregnancy

A
188
Q

pregnancy cardiovascular changes

A
189
Q

pregnancy respiratory changes

A
190
Q

pregnancy GIT changes

A
191
Q

pregnancy urinary tract changes

A
192
Q

pregnancy haematological changes

A
193
Q

pregnancy metabolic, skin, MSK changes

A
194
Q

blood results in pregnancy

A
195
Q

patients with carcinoid tumours may be deficient in…

A

niacin –> pellagra

196
Q

characteristics of diabetic retinopathy

A
197
Q
A
198
Q

Gell and coombs hypersensitivity

A
199
Q

stress and urge incontinece mx

A
200
Q

drug induced seizures causes

A
201
Q

stage 1, 2, 3 HTN

A
202
Q

koplik spots

A

spots on the buccal mucosa (opposite the lower 1st and 2nd molars) are pathognomic for measles

203
Q

azathioprine reaction ACEi

A

anaemia and severe leukopeniar

204
Q

eyrthema toxicum neonatorum

A
205
Q

side effect of atenolol

A

ED

206
Q

causes of ED medications

A
207
Q

HSP

A
208
Q

what can be used to treat gynaecomastia

A

tamoxifen

209
Q

most common site of colorectal

A

rectum

210
Q

management of transient synovitis

A

rest and NSAIDs

211
Q

central retinal artery occlusion

A
212
Q

mechanisms of adminsitration of theophylline

A

oral or injectable preparations

213
Q

most common bacetial cause of cellulitis

A

strep pyogenes / s aureus

214
Q

description of basal cell caricinoma

A

non healing ulcer on the tip of nose
enlarging
rolled edges

215
Q

friable exophytic lesion

A

squamous cell carcinoma

216
Q

MAOI and SSRI

A

avoid together can cause seroronin syndrome

217
Q

light criteria

A
218
Q

PMB is

A

endometrial cancer until proven otherwise

219
Q

pinworm mx

A

enterobius

220
Q

medullary thyroid cancer

A
221
Q

p450 enzyme inducers and inhibitors

A

The mnemonic CRAP GPs can be used to easily remember common CYP450 inducers.

Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

The mnemonic SICKFACES.COM can be used to easily remember common CYP450 inhibitors.

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole

222
Q

diagnosis of myasthenia gravis

A
223
Q

how to manage children at home with clinical features of diarrhoea

A
224
Q

MOA streptokinase

A
225
Q

CXR findings bronchiectasis

A

tram tracking appearance with dilated lower lobe

226
Q

is turners a/w hypothyroidism

A

yes

227
Q

progesterone only pill rules for missed pill

A

if you forget a pill take it as soon as you remember. if more than 3 hours overdue you are not protected –> use a condom over the next 2 days

228
Q

UKMEC 3 POP

A
229
Q

starting the POP

A
230
Q

missed pill rule POP

A
231
Q

pulsus paradoxus

A
232
Q

which antibodies with systemic scleroderma

A

anti-scl70

233
Q

sectioning

A
234
Q

most common cause of IE overall

A

s.aureus

235
Q

UC monitoring

A

colonoscopy with multiple biopsies

236
Q

tonsillectomy indications

A
237
Q

anticardiolipin antibodies are found in

A
238
Q

difference between provoked and unprovoked DVT

A
239
Q

how many days post conception do you get a positive BHCG

A

9 days

240
Q

rusty coloured sputum

A

strep pneumoniae

241
Q

downs syndrome risks

A
242
Q

atypical UTI in paeds

A
243
Q

what is nitrofurantoin c/i in

A

G6PD and acute porphyria

244
Q

duration of abx for UTI

A
245
Q

DEXA scan indication

A
246
Q

roseola infantum

A
247
Q

cat scratch disease

A
248
Q

which SSRIs are of choice during breastfeeding

A

paroxetine and sertrlaine

249
Q

when to screen for post natal depression

A

4-6 weeks and 3-4 months

250
Q

urinary sodium <20mmol means what

A

pre-renal –> therefore hypovolaemic

251
Q

what causes post-TURP colicky abdo pain and anuria

palpable bladder

A

clot retnetion

252
Q

chlamydia psittaci

A
253
Q

hallux valgus

A
254
Q

indications of ECMO in paeds

A
255
Q

what is the best early indicator for diabetic nephropathy

A

microalbuminuria

256
Q

what do you use for fungal nail infection

A

amorolfine (topical) and terbinafine

257
Q

tx for lice

A

dimerticone - permethrin no longer indicated

258
Q

rash on cheek sparing nasolabial folds - preceeding episode of feeding generally unwell with a sore throat and fever.

A

fifth disease

259
Q

what makes acne worse

A
260
Q

genitourinary TB

A
261
Q

examples of pupil dilators

A
262
Q

what is rheumatoid factor

A

IgM antibody

263
Q

IgM antibodies

A
264
Q

IgA antibodies

A
265
Q

IgG antibodies

A
266
Q

IgD antibodies

A
267
Q

diagnosis of TB

A

throat swab

268
Q

management of shingles

A
269
Q

ESR and LH levels in anorexia

A

ESR normal
LH depressed

270
Q

causes of macrocytic anaemia

A
271
Q

which bacteria causes UTIs in young sexually active women / abnormalities of urinary tract

A

staph saprophyticus / pseudomonas and staph epidermidis

272
Q

most common valve and causative pathogen of IE

A

s.aureus and affetcs the tricuspid valve

273
Q

difference between location of aorta dissection

A
274
Q

s/e of chloramphenicol

A
275
Q

encapsulated baccyy

A
276
Q

exposure to UV light causes

A
277
Q

causes of brown urine

A
278
Q

causes of brown/black urine

A
279
Q

causes of green/blue urine

A
280
Q

cause of orange urine

A
281
Q

cause of red urine

A
282
Q

cause of yellow urine

A
283
Q

what is lichen simplex

A
284
Q

COCP MOA

A
285
Q

extraperitoneal urine extravasation management

A
286
Q

urethral injuries

A
287
Q

post-campylobacter sequelae

A
288
Q

5HT3 receptor antagonist indications

A

post operative and cytotoxic drug related nausea and vomiting

289
Q

dopamine antagonist

A
290
Q

antihistamine anti emetics

A
291
Q

metoclopramide indication

A

gastritis, gastric stasis, functional bowel obstruction

292
Q

cylizine indication

A

mechanical bowel osbtruction, raised ICP, motion sickness

293
Q

haloperidol indication

A

metabolic causes of vomtiing –> hypercalcaemia / renal failure

294
Q

symptoms of TCA OD

A

dilated pupils, dry mouth, drowsiness, sinus tachycardia, urinary retention, increased tendon reflexes and extensor plantar responses

295
Q

what to do if CCB are not tolerated

A

thiazide like diuretic

296
Q

HSP

A

purpuric rash, GI symptoms, joint pain and renal invovlement

297
Q

complications of HSP

A
298
Q

fibromyalgia criteria for diagnosis

A

widespread pain for at least 3 months and multiple localised tender areas

299
Q

oesophageal spasm symptoms

A

central crushing chest pain, intermittent dysphagia and globus

corkscrew oesophagus

300
Q

secondary prevention of atherothrombotic events

A
301
Q

MEN 1 symptoms

A
302
Q

MEN 2

A
303
Q

X linked dominant conditions

A

alports syndrome
rett syndrome
vitamin d resistant rickets
fragile x

304
Q

X linked recessive conditions

A

androgen insensitivity
becked muscular dystrophy
colour blidnness
duchenne
fabry’s disease
G6PD deficiency
haemophilia A and B
Hunters disease
lesch nyhan syndrome
nephrogenic diabetus insipidus
ocular albinism
retinitis pigmentosa
wiskott aldrich syndrome

305
Q

bloods in hyperPTH

A
306
Q

bloods in hypoPTH

A
307
Q

active TB vs latent TB management

A
308
Q

patau syndrome features

A
309
Q

HPV screening

A
310
Q

first line management for TB meningitis

A

isoniazid

311
Q

BPPV

A
312
Q

shoulder impingement syndrome vs subacromial bursitis

A

shoulder impingement - when rotator cuff tendons intermittently catch during shulder movements
causes injury to the shoulder tendos and bursa resulting in pain and often weakness when raising the arm

subacromial burisitis - pain over a 60 degree arc when the arm is abducted

313
Q

papillary muscle rupture

A

they usually occur in the first 24-72 hours

314
Q

when does left ventricular aneurysm occur

A

usually a late complication

315
Q

hypersensitivity to egg w/ previous anaphylaxis

A

cant have influenza vaccines, tick borne encephalitis and yellow fever vaccine

316
Q

what to do when 2 live virus vaccinations are needed

A

simultaneously at different sites / separated by an interval of at least 4 weeks

317
Q

live vaccines and neurological issues

A

no refer to specialists

318
Q

hartnup disease

A
319
Q

what vaccines contain egg protein

A

MMR and influenza

320
Q

testicular torsion sympoms

A

absent cremasteric reflex, tender, high riding testicle with transverse lie

321
Q

most common type of kidney stone

A

calcium oxalate

322
Q

management of tinea of the scalp

A

oral griseofulvin and keotconazole shampoo

323
Q

ameobiasis management

A

metrondiazole

324
Q

goodpastures syndrome

A

diffuse pulmonary haemorrhage, glomeulonephritis and circualting anit-glomerular basement membrane antibodies

  • there is pulmonary and renal disease
325
Q

causes of high PSA levels

A

old age
acute urinary retnetion
urinary catheterisation
prostatitis
prostate carcinoma
TURP
BPH

326
Q

different types of portal HTN

A
327
Q

what type of virus is influenza

A

orthomyxovirus (RNA virus

328
Q

what does adenovirus cause

A

conjunctivitis

329
Q

different types of viruses

A
330
Q

gamekeepers thumb

A

injury to the UCL of the htumb (avulsion fracture ) at the ulna corner of the base of the proximal phalanx

331
Q

boxers fracture

A

minimally comminuted transvers fractures of the 5th metacarpal neck

332
Q

rolando fracture

A

three part / comminuted intra articular fracture dislocation of the proximal first metacarpal - comminuted bennett fracture

333
Q

which conditions must sriving be ceased post

A

angioplasty
STEMI and angioplasty
pacemaker implantation

334
Q

which conditions must cease for 4 weeks - driving

A

CABG STEMI
NSTEMI

335
Q

driving should cease if

A

patietn has angina at rest

336
Q

when should DVLA be informed for driving

A

AAA >6 and artythmia

337
Q

post MI how long to avoid sex

A

1 month

338
Q

how long to take off work post MI

A

2 months

339
Q

listeria abx

A

amox and gentamicin

340
Q

toxoplasmosis drug management

A

spiramycin

341
Q

what is the difference between pinna cellulitis and perichondritis

A

in perichondritis the ear lobe is spared

342
Q

what is pinna cellulitis vs perichondiritis

A

can occur as a complication of acute otitis externa - complciation of eczema or psoriasis

pinna perichondritis is a result of penetrating including ear piercing
- it can lead to necrosis and cauliflower ear or cause nec fasc

343
Q

MCC of pinna cellulitis and perichondritis

A

pinna cellulitis = s.aureus
pinna perichondritis = pseudomonas

344
Q

exacerbation of COPD abx

A

amoxicillin 500mg TDS
doxycycline 200mg on day 1 then 100mg OD or clarithromycin 500 BD

alternative choice
co-trimoxazole
levofloxacin

345
Q

post streptococcal glomerulonephritis info

A
346
Q

what is duodenal atresia

A

failure of recanalisation of the bowel lumen - it makes it into a solid tube

vomiting within the first 24 hours

scaphoid abdomen with absent bowel sounds

double bubble sign - the first bubble is due to the gas filled distended stomach and the second to the postpyloric and prestentonic dilated duodenal loop

347
Q

what is bergers disease

A

most common type of glomerulonephritis in adults worldwide that presents as nephritis syndrome 24-48 hours post URTI.w

348
Q

what is the difference between bergers disease and post-streptococcal glomerulonephritis

A

the timing. bergers occurs 24-28 hours post URTI. while poststrep glomerulonephritis occurs 2 weeks post.

349
Q

where are subhyaloid haemorrhages seen

A

in SAH

350
Q

management of an acute attack of cluster headache

A

sumatriptan and oxygen.
prophylaxis - prednisolone and verapamil

351
Q

what do you use to screen for depression and anxiety in hospital

A

HADS scale - used in hospital

14 questions for anxiety and seven for depression

352
Q

what symptoms are usually related to colitis and what aren’t

A
353
Q

glucagonoma symptoms

A

diabetes dermatosis DVT depression
- necrolytic migratory erythema

354
Q

what is erythema toxic neponatorum

A

idiopathic transient rash that occurs in the newborn period

355
Q

what is the difference between otitis media and OM with effusion

A

AOM there is bulging opacified tympanic membrane with an attenuated light reflex. membrane may be white, yellow, pink or red.

Can form complications of otitis media with effusion

OME is fluid in the middle ear without an acute infection. Most common presentation is conductive hearing loss.

356
Q

what is bullous myringitis

A
357
Q

scarlet fever diagnosis

A

clinic but antistreptolysin O titres can be helpful

358
Q

infusion of glucose without thiamine in a patient with chronic thiamine deficiency can…

A

precipitate wernickes encephalopathy

359
Q

what is wernickes encephalopathy

A

acute mental confusion
ataxia
opthalmoplegia

360
Q

what is menieres disease

A

vertigo tinnitus and hearing loss

361
Q

difference between BPPV menieres and vestibular neuronitis

A
362
Q

what happens in chronic renal failure with ingestion of normal protein

A

fixed acids will be produced from protein catabolism
leads to metabolic acidosis with respiratory compensation

363
Q

blood changes during pregnancy

A

WCC increased
platelets fall

364
Q

endocrine changes during pregnancy

A
365
Q

CV changes during pregnancy

A
366
Q

respiratory system changes during pregnancy

A
367
Q

overall blood changes during pregnancy

A
368
Q

interactions of COCP

A

rifampicin, St johns wort, anticonvulsatns and antiretrovirals and meds that cause diarrhoea and vomiting

369
Q

what to give during an acute attack of menieres disease

A

prochloperazine or cinnarazine

370
Q

fregoli syndrome vs capgras

A

fregoli - familiar person is falsely identified in strangers
capgras - familiar person is supplanted by a stranger

371
Q

furosemide with renal failure

A

higher doses needed

372
Q

HHS fixed rate

A

0.05 units/kg/hr

373
Q

caplans syndrome

A

pulmonary fibrosis in coal miners who have RA

374
Q

what is the most common cause of pleural effusion

A

malignancy then heart failurewh

375
Q

what does optic atrophy look like on fundoscopy

A

pale optic disc

376
Q

what is the hallmark of diabetes insipidus

A

urine specific gravity of 1.005 or less and a urine osmolality less than 200

377
Q

different types of diabetes insipidus

A
378
Q

what causes increased specific gravity

A
379
Q

what causes decreased specific gravity

A

excessive fluid intake
renal failure
pyelonephritis
central and nephrogenic diabetes insipidus

380
Q

management of hyperthyroid during pregnancy

A

PTU and carbimazole

PTU is used in the 1st trimester instead of carbimazole

381
Q

posterior urethral injuries are located where

A

in the membranous and prostatic urethra
they are most commonly related to major blunt trauma such as RTA and falls and pelvic fractures

382
Q

anterior urethral injuries are located

A

distal to the membranous urethra
come from blunt trauma to the perineum (straddle injuries), appearing years later as a stricture

383
Q

does atropine constrict or dialte pupils

A

dilate pupils

384
Q

what does pilocarpine do to pipils

A

causes constriction

385
Q

retroperitoneal fibrosis

A

involves proliferation of fibrous tissue in the retroperitoneum over the anterior surface of L4-L5
leads to entrapment of retroperitoneal structures, notably the ureters

a/w ankylosing spond, SLE, scleroderma, systemic vasculitis, wegeners, polyarteritis nodosa, raynaud’s disease, RA, riedels and immune complex membranous glomerunoephritis

metastatic malignancy

b blockers, methysergide and methyldopa

386
Q

riboflavin deficiency causes

A

cracked red lips, inflammation of the lining of the mouth and tongue, mouth ulcers, cracks at the corners of the mouth and sore throat

387
Q

what is the unhappy triad

A

ACL, MCL and medial meniscus tear
valgus stress to the knee from a cotnact injury / high velocity trauma

388
Q

what drugs cause dry mouth

A
389
Q

what drugs increase salivary production

A

clozapine, neostigmine

390
Q

what drugs decrease taste acuity / alteration in taste sensation

A
391
Q

duchenne muscle dystrophy

A

x linked recessive condition in which there is progressive proximal muscular dystrophy and pseudohypetrophy at the calves

392
Q

facioscapulohumeral muscular dystrophy

A

difficulty sucking through straw
- starts in the face and then progresses to the shoulder girdle, humeral muscles and abdominal muscles and then the anterolateral compartment of the leg

winging of the scapular is the most characteristic sign

393
Q

management of ED

A
394
Q

urine collection in young child mechanism

A

clean catch urine

Gap deck MSRA (2 decks)

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