MCQBANK **Mistakes and Learning Points Flashcards
otitis media with effusion TM appearance
air bubbles
air fluid level
bulging
Lambert eaton myasthenic syndrome
autoimmune disease again VGCC’s
Spares lung and eyes
Worse in morning, improves with activity
** HIV and MMR vaccine
Can still have MMR in HIV as long as not poor immune function
NB// Should not have MMR with undiagnosed neurological condition however.
** Risk factors for infant respiratory distress syndrome
Male sex
Premature birth
Maternal diabetes
Multiple pregnancy
C-section rather than vaginal delivery
Haemorrhoid symptoms, precipitating factor, location, grades, management options
Painless PR bleeding
Triggered when constipated
Anal pruritis
Most common at 3,7,11 o clock
Grade 1 = inside only
Grade 2 = pops out (e.g when straining) but automatically reduces
Grade 3 = pops out and has to be manually reduced
Grade 4 = Can’t be reduced
Mx options
Non-surgical = rubber band ligation, sclerotherapy, infrared therapy
Surgical = haemorroidectomy
Meckel’s diverticulum = painless rectal bleeding in child (bowel remnant)
Complication of entamoeba histolytica GI infection
(Obviously causes bloody diarrhoea)
Can also cause amoebic liver abscess
Difference between costochondritis vs Tietze’s syndrome
Tietze’s has palpable rib cartilage swelling
Difference between otitis media with effusion vs acute otitis media
in OME, patient is systemically well
There is effusion and inflammation in middle ear, in the ABSCENCE OF INFECTION
Most common cause of hearing loss in children
OME
Most common type of shoulder dislocation and signs?
Anterior shoulder dislocation most common
Caused by fall onto abducted, outward arm (as arm pushed back, the glenoid is pushed anteriorly in shoulder capsule)
2 mechanisms of clavicle fracture usually, and which is most common?
Most common = backward and upwards force i.e. falling off horse
Less common = direct clavicular trauma
Function of 4 rotator cuff muscles? What signs on examination?
Supraspinatus = abduction first 15 degrees before deltoid takes over
Subscapularis = internal rotation, adduction
Teres minor and infraspinatus = external rotation.
Pain, weakness, crepitus due to friction as loss of stability that comes with rotator cuff muscles, tenderness at subacromial area which is area of rotator cuff insertions
Complications of nasal foreign body?
local inflammation
pressure on blood vessels can cause epistaxis
obstruction and inflammation can cause sinusitis
Investigation to diagnose COPD?
POST-bronchodilator spirometry, as you’re confirming it is not reversible
Hallmark of genitourinal TB?
Sterile pyuria (not this can be caused by many other things though)
Suspect Genitourinary TB in patient with history of repeat UTIs which do not respond to ABx
Most common cause of childhood diarrhoea?
Rotavirus
Explain Brown Squared syndrome (including in terms of where tracts cross)
corticospinal (motor) and dorsal column (light touch, proprioception, vibration) cross at medulla
spinothalamic cross at sensation level
Hemisection of spinal cord (i.e only one half injured at that level)
causes IPSILATERAL dorsal and corticospinal loss below that level (bc already crossed) and CONTRALATERAL spinothalamic loss below that level (as they have just crossed at that level)
What is the interaction between amlodipine and simvastatin?
amlodipine slightly inhibits CYP3A4 enzyme which metabolises simvastatin, so effectively doubles dose of simvastatin
Hence max dose you should prescribe of simvastatin is 20mg when with 10mg amlodipine.
When should nausea and vomiting in pregnancy usually resolve by?
16-20 weeks
What can be used to alleviate N+V in pregnancy?
Ginger
Wrist acupuncture
Antihistamines
Phenothiazines
What fractures are typical of a fall from height (i.e. axial loading injury)?
spinal compression
upper femur (pelvic)
calcaneal (NB// distally spreading bruising on plantar aspect foot = MORDOR sign)
Different types of sections??
Section 5(2) and 5(4) for patients voluntarily attending hospital (i.e ED)
5(2) is for doctors - 72hrs
5(4) for nurses - 6hs
2 = 28 days, for assessment
3 = 6 months for treatment
135 = private property extraction
136 = police in public
Most common cause of otitis media?
RSV most common overall
Most common bacterial are HMS
What is Samter’s triad?
Nasal polyps, asthma, sensitivity to aspirin
Difference in symptoms between fibroadenoma and breast cyst?
Symptoms of chronic supporative otitis media?
How long after MI can you shag again?
How long after MI can you return to work?
How long after MI can you drive if had PCI?
1 week
Normal physiological changes in pregnancy?
Increased stroke volume and HR slightly
BP falls initially
Increase in tidal volume
(A RISE IN RR IS NOT NORMAL HOWEVER)
Most common cause of perennial allergic rhinitis?
House dust mite
(perennial = all year around)
Abx if pyelonephritis treated in community (i.e. when low risk)?
Cefalexin
MRC dyspnoea scale grades 1-5
Shortness of breath
1- only on strenuous activity
2 - on walking uphill
3 - has to walk slower
4 - has to stop at 100m
5 - can’t leave house
Difference between PD and Dementia with Lewy body
PD motor then after at least a year, you get dementia issues
DLB, there isn’t this gap
Which lung cancer type releases PTHrp and causes hypercalcaemia?
Squamous cell
Symptoms of cholesteatoma?
attic crust
leaky ear discharge, smelly
as it invades can cause episodes of vertigo (inwards) and TM perforation (outwards)
Management of bronchiolitis in hospital?
Ensuring adequate oxygenation and hydration
(Pavalazimumab is prophylaxis only and not given during)
Progressive weakness whistling and sucking straw?
Fascioscapulohumeral dystrophy
E.Coli is the most common bacteria in UTIs. As a side fact, which bacteria is also common in sexually active women?
Staphylococcus saprophytic
Which pulmonary complication does methotrexate cause? How do you treat it?
Pneumonitis (dry cough, dyspnoea, bibasaliar crackles, +/- fever)
Treatment is stop methotrexate and treat with prednisolone
Which drug classes are used to treat BPH?
5 alpha reductase inhibitors (finasteride)
alpha BLOCKERS (tamsulosin - relaxes the smooth muscle around prostate, allowing better passage of urine)
Example of acne treatment safe in pregnancy?
Topical benzoyl peroxide
What is Brugada syndrome, what does ECG show and what is management?
Autosomal dominant heart condition causing defective sodium channels, which predisposes to life-threatening ventricular arrhyhthmias.
ECG shows coved ST elevation followed by T wave inversion in any of V1-3.
Management is with ICD which helps identify and cardiovert/defibrillate the tachyarrhythmias.
Most common type of childhood epilepsy?
Benign Rolandic epilepsy
Focal motor aware seizures, usually affecting face (as this corresponds to Rolandic area), that occur infrequently at night-time and usually resolve by the age of 16.
As in the name, benign, so treatment not needed.
SSRIs you can use in breastfeeding?
Sertraline or paroxetine
Treatment of nasal polyps?
Intranasal steroids for 3 months
