Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSRA > Medicine > Flashcards

Medicine Flashcards

1
Q

What is Idiopathic Pulmonary Fibrosis (IPF)?

A

A chronic lung condition characterized by progressive fibrosis of the interstitium of the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the typical age range for patients diagnosed with IPF?

A

50-70 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is IPF more common in men or women?

A

Twice as common in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the key features of IPF.

A
  • Progressive exertional dyspnea
  • Bibasal fine end-inspiratory crepitations
  • Dry cough
  • Clubbing
  • Non-smoker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does spirometry show in IPF patients?

A

Restrictive picture (normal/↓ FEV1, ↓ FVC, ↑ FEV1/FVC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does a chest X-ray (CXR) show in IPF?

A

Bilateral interstitial shadowing (small, irregular, peripheral opacities – ‘ground-glass’ – late progressing to ‘honeycombing’)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the investigation of choice for diagnosing IPF?

A

High resolution CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the average life expectancy for someone with IPF?

A

Approximately 3-4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common inherited bleeding disorder?

A

Von Willebrand’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What inheritance pattern does Von Willebrand’s Disease follow?

A

Autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What role does von Willebrand factor play in the body?

A
  • Promotes platelet adhesion to damaged endothelium
  • Carrier molecule for factor VIII
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the types of Von Willebrand’s Disease?

A
  • Type 1: Partial reduction in vWF (80% of patients)
  • Type 2: Abnormal form of vWF
  • Type 3: Total lack of vWF (autosomal recessive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List common manifestations of Von Willebrand’s Disease.

A
  • Epistaxis
  • Oral cavity bleeding
  • Excessive bleeding from minor wounds
  • Excessive post-op bleeding
  • Menorrhagia
  • Postpartum hemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a characteristic feature of autoimmune hepatitis?

A

Condition of unknown etiology commonly seen in young females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the recognized associations of autoimmune hepatitis?

A
  • Other autoimmune disorders
  • Hypergammaglobulinemia
  • HLA B8, DR3
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the types of autoimmune hepatitis based on circulating antibodies?

A
  • Type I: Anti-nuclear antibodies (ANA) and/or anti-smooth muscle antibodies (SMA)
  • Type II: Anti-liver/kidney microsomal type 1 antibodies (LKM1)
  • Type III: Soluble liver-kidney antigen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the features of autoimmune hepatitis?

A
  • Signs of chronic liver disease
  • Acute hepatitis: fever, jaundice
  • Amenorrhea
  • Deranged LFTs
  • Liver biopsy: Inflammation extending beyond limiting plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the first-line treatment for acute heart failure?

A

IV loop diuretics (furosemide, bumetanide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What should be avoided in the treatment of acute heart failure?

A

Routine use of nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is an important management step for patients with respiratory failure in acute heart failure?

A

CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Mycoplasma pneumoniae associated with?

A

Atypical pneumonia often affecting younger patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the complications of Mycoplasma pneumoniae?

A
  • Cold agglutinins (IgM)
  • Erythema multiforme
  • Meningoencephalitis
  • Bullous myringitis
  • Pericarditis/myocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the most common inherited cause of kidney disease?

A

Autosomal Dominant Polycystic Kidney Disease (ADPKD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the two disease loci identified in ADPKD?

A
  • PKD 1
  • PKD 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the screening investigation for relatives of ADPKD patients?

A

Abdominal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the first-line treatment for diabetic neuropathy?

A

Amitriptyline, duloxetine, gabapentin, pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are common features of Systemic Lupus Erythematosus (SLE)?

A
  • Fatigue
  • Fever
  • Mouth ulcers
  • Lymphadenopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is shingles caused by?

A

Reactivation of the varicella-zoster virus (VZV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the key features of shingles?

A
  • Prodromal period
  • Burning pain over the affected dermatome
  • Vesicular rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the first-line treatment for shingles?

A

Antivirals (e.g., Famciclovir, valaciclovir)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the key features of osteoarthritis of the knee?

A
  • Age > 50
  • Overweight
  • Severe pain
  • Intermittent swelling
  • Limitation of movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is Polymyalgia Rheumatica (PMR)?

A

A condition characterized by muscle stiffness and raised inflammatory markers in older people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the definitive diagnosis for sickle cell anemia?

A

Hemoglobin electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does sickle cell anemia result from?

A

Synthesis of an abnormal hemoglobin chain termed HbS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the symptoms of sickle cell anemia?

A

Symptoms typically develop at 4-6 months when HbSS molecules take over from fetal hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What causes RBCs to sickle in sickle cell disease?

A

S molecules polymerise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

At what pO2 do HbAS patients typically sickle?

A

2.5 – 4 kPa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

At what pO2 do HbSS patients typically sickle?

A

5 – 6 kPa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What complications do sickle cells cause?

A

Fragility, hemolysis, blocking small blood vessels, and causing infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the definitive diagnosis for sickle cell disease?

A

Hemoglobin electrophoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is recurrent priapism?

A

Painful prolonged erection of the penis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What defines traveller’s diarrhea?

A

At least 3 loose to watery stools in 24 hours with or without abdominal cramps, fever, nausea, vomiting, or blood in the stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the most common cause of traveller’s diarrhea?

A

Escherichia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What describes acute food poisoning?

A

Sudden onset of nausea, vomiting, and diarrhea after ingestion of a toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which bacteria typically cause acute food poisoning?

A
  • Staphylococcus aureus
  • Bacillus cereus
  • Clostridium perfringens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the incubation period for Staphylococcus aureus and Bacillus cereus?

A

1-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the typical presentation of Escherichia coli in gastroenteritis?

A

Watery stools, abdominal cramps, nausea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What symptoms are associated with cholera?

A

Profuse, watery diarrhea and severe dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the key symptoms of Shigella infection?

A

Bloody diarrhea, vomiting, abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the incubation period for Shigella and Campylobacter?

A

48-72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the symptoms of tuberculosis?

A

Fever, night sweats, anorexia, weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the symptoms of pulmonary embolism?

A

Pleuritic chest pain, tachycardia, tachypnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the typical history associated with aspergilloma?

A

Past history of tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is gout?

A

A form of inflammatory arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the typical duration of acute gout episodes?

A

Lasting several days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the main feature of gout?

A
  • Pain
  • Swelling
  • Erythema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What uric acid level supports a diagnosis of gout?

A

≥ 360 umol/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What does synovial fluid analysis reveal in gout?

A

Needle shaped negatively birefringent monosodium urate crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the first line management for acute gout?

A

NSAIDs or colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the first line urate-lowering therapy for gout?

A

Allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What lifestyle modifications are recommended for gout?

A
  • Reduce alcohol intake
  • Lose weight if obese
  • Avoid high purine foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What does ROME stand for in arterial blood gas interpretation?

A

Respiratory = Opposite, Metabolic = Equal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the first line treatment for chronic plaque psoriasis?

A

Potent corticosteroid + vitamin D analogue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is hyperhidrosis?

A

Excessive production of sweat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the first line management for hyperhidrosis?

A

Topical aluminium chloride preparations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is urinary incontinence (UI)?

A

A common problem affecting 4-5% of the population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the risk factors for urinary incontinence?

A
  • Advancing age
  • Previous pregnancy and childbirth
  • High BMI
  • Hysterectomy
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the types of urinary incontinence?

A
  • Overactive bladder (OAB)/ Urge incontinence
  • Stress incontinence
  • Mixed incontinence
  • Overflow incontinence
  • Functional incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the initial investigation for urinary incontinence?

A

Bladder diaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the management approach for urge incontinence?

A

Bladder retraining, antimuscarinics, pelvic floor muscle training, surgical options

Antimuscarinics include Oxybutynin and Tolterodine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the first-line medications for urge incontinence?

A

Antimuscarinics: Oxybutynin, Tolterodine, Darifenacin

Mirabegron may be used in frail elderly patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the recommended duration for pelvic floor muscle training?

A

At least 3 months, with contractions performed 3 times per day

Minimum of 8 contractions each session.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the first-line treatment for chronic heart failure?

A

An ACE inhibitor and a beta blocker

One drug should be started at a time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Which medications are considered second-line for chronic heart failure?

A

Aldosterone antagonists: Spironolactone, Eplerenone

Potassium levels should be monitored due to the risk of hyperkalemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What are the criteria for using Ivabradine in heart failure management?

A

Sinus rhythm > 75/min and LVEF < 35%

LVEF stands for Left Ventricular Ejection Fraction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the main feature of temporal arteritis?

A

Vasculitis affecting medium and large-sized vessels

Also known as giant cell arteritis (GCA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the first-line treatment for temporal arteritis?

A

High-dose prednisolone

Treatment should start promptly upon suspicion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What are the common symptoms of sarcoidosis?

A

Dyspnea, non-productive cough, malaise, weight loss

Acute features include erythema nodosum and bilateral hilar lymphadenopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What antibodies are associated with limited cutaneous systemic sclerosis?

A

Anti-centromere antibodies

CREST syndrome is a subtype of limited cutaneous systemic sclerosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are the key features of Bell’s palsy?

A

Acute unilateral facial nerve paralysis, post-auricular pain, altered taste

More common in pregnant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is the typical treatment for Bell’s palsy?

A

Prednisolone within 72 hours of onset

Antivirals may be added for severe cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What are the clinical features of aortic stenosis?

A

Chest pain, dyspnea, syncope, ejection systolic murmur

Murmur radiates to the carotids and decreases with Valsalva maneuver.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is the most common cause of aortic stenosis in patients over 65?

A

Degenerative calcification

Bicuspid aortic valve is common in younger patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is the hallmark rash of Lyme disease?

A

Erythema migrans, a ‘bulls-eye’ rash

Typically appears 1-4 weeks after a tick bite.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the first-line test for suspected Lyme disease?

A

Enzyme-linked immunosorbent assay (ELISA)

If negative, repeat ELISA after 4-6 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What should be done for suspected bacterial meningitis in a pre-hospital setting?

A

Administer IM benzylpenicillin if meningococcal disease is suspected

This should not delay transit to the hospital.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What investigations should be performed in suspected bacterial meningitis?

A

FBC, U&E, CRP, glucose, lactate, clotting profile

If lumbar puncture is performed, test CSF for glucose, protein, and cultures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What are the signs that indicate severe sepsis or rapidly evolving rash?

A

Sepsis or rapidly evolving rash, severe respiratory or cardiac compromise, significant bleeding risk, signs of raised intracranial pressure, focal neurological signs, papilledema, continuous or uncontrolled seizures, GCS ≤ 12

GCS refers to the Glasgow Coma Scale, a neurological scale that aims to provide a reliable, objective way of recording the conscious state of a person.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What investigations should be performed if a lumbar puncture (LP) has been performed?

A

CSF should be tested for:
* Glucose
* Protein
* Microscopy and culture
* Lactate
* Meningococcal and pneumococcal PCR
* Enteroviral, herpes simplex and varicella-zoster PCR
* Consider investigation for TB meningitis

These tests help in diagnosing various types of meningitis and other CNS infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the initial empirical therapy for patients aged < 3 months with suspected bacterial meningitis?

A

IV cefotaxime + amoxicillin (or ampicillin)

This combination is used to cover a broad range of potential pathogens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the management strategy for patients with signs of raised ICP?

A

IV access for bloods and blood cultures, LP if cannot be done within 1st hour, IV antibiotics, IV dexamethasone, CT scan not normally indicated, critical care input, secure airway + high flow oxygen, IV fluid resuscitation

Management may vary based on the severity and specific circumstances of the patient’s condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the common causes of primary hypothyroidism?

A

Hashimoto’s thyroiditis, subacute thyroiditis, Riedel thyroiditis, drug therapy (lithium, amiodarone, anti-thyroid: carbimazole), dietary iodine deficiency

Hashimoto’s thyroiditis is the most common cause and is an autoimmune condition.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are the key features of acute pericarditis?

A

Pleuritic chest pain relieved by sitting forwards, non-productive cough, dyspnea, flu-like symptoms, pericardial rub

Symptoms may mimic those of myocardial infarction but differ in nature and response to position.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Which ECG changes are most specific for pericarditis?

A

PR depression

This is considered the most specific ECG marker for pericarditis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the first-line treatment for acute idiopathic or viral pericarditis?

A

NSAIDs + Colchicine

This treatment is aimed at reducing inflammation and managing pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What defines the diagnosis of trigeminal neuralgia according to the International Headache Society?

A

A unilateral disorder characterized by brief electric shock-like pains, abrupt in onset and termination, limited to one or more divisions of the trigeminal nerve

Pain is often triggered by light touch and can remit for variable periods.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What are the red flag symptoms for trigeminal neuralgia?

A

Sensory changes, deafness or other ear problems, history of skin or oral lesions, pain only in the ophthalmic division, optic neuritis, family history of multiple sclerosis, age of onset < 40

These symptoms may suggest an underlying serious condition requiring further investigation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the management for patients with dyspepsia suspected of having cancer?

A

Urgent referral for endoscopy within 2 weeks for patients with dysphagia, upper abdominal mass consistent with stomach cancer, and patients > 55 y/o with weight loss and other symptoms

Early detection of gastrointestinal cancers can significantly improve prognosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What tests are used for the initial diagnosis of H. pylori infection?

A

Carbon-13 urea breath test, stool Helicobacter antigen test, laboratory-based serology

These tests help in confirming the presence of H. pylori, which is linked to peptic ulcers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What is the first-line treatment regimen for H. pylori in patients without penicillin allergy?

A

PPI + amoxicillin + clarithromycin/metronidazole for 7 days

This combination targets the bacteria effectively and helps in reducing gastric acid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What are the key features for diagnosing Irritable Bowel Syndrome (IBS)?

A

Abdominal pain AND/OR bloating AND/OR change in bowel habit

Positive diagnosis requires abdominal pain relieved by defecation or associated with altered bowel frequency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What red flag features may indicate a more serious condition in patients with IBS?

A

Rectal bleeding, unexplained/unintentional weight loss, family history of bowel or ovarian cancer, onset after 60 y/o

These features warrant further investigation to rule out serious pathology.

103
Q

What are the diagnostic criteria for Type 2 Diabetes Mellitus using plasma glucose?

A

Fasting glucose ≥ 7.0 mmol/l, random glucose ≥ 11.1 mmol/l (or after 75g OGTT)

Diagnosis must be confirmed on two separate occasions in asymptomatic patients.

104
Q

What lifestyle changes are recommended for managing Type 2 Diabetes Mellitus?

A

High fibre diet, low glycemic index carbohydrates, low-fat dairy products, oily fish, control of saturated fats, target weight loss of 5-10%

These changes play a crucial role in managing blood glucose levels.

105
Q

What is the first-line drug therapy for Type 2 Diabetes Mellitus?

A

Metformin

Metformin is preferred for its efficacy in lowering blood sugar levels and favorable safety profile.

106
Q

What factors indicate the need for SGLT-2 inhibitors in Type 2 Diabetes Mellitus management?

A

High risk of developing CVD (QRISK ≥ 10%), established CVD, CHF

SGLT-2 inhibitors are beneficial in patients with cardiovascular risks.

107
Q

What are the NICE criteria for using SGLT-2 inhibitors?

A

SGLT-2 inhibitors may be used if the patient has:
* High risk of developing CVD (QRISK ≥ 10%)
* Established CVD
* CHF

Metformin should be established and titrated up before introducing the SGLT-2 inhibitor.

108
Q

When should further drug therapy be considered for HbA1c?

A

Further treatment is indicated if HbA1c rises to 58 mmol/mol (7.5%)

109
Q

What are the options for 2nd line therapy in diabetes management?

A

Dual therapy options include:
* Metformin + DPP-4 inhibitor
* Metformin + pioglitazone
* Metformin + sulfonylurea
* Metformin + SGLT-2 inhibitor

110
Q

What are the options for 3rd line therapy in diabetes management?

A

Options include:
* Metformin + DPP-4 inhibitor + sulfonylurea
* Metformin + pioglitazone + sulfonylurea
* Metformin + (pioglitazone/sulfonylurea/DPP-4 inhibitor) + SGLT-2
* Insulin-based treatment

111
Q

What criteria must be met to consider GLP-1 mimetics in diabetes management?

A

Criteria include:
* BMI ≥ 35 with specific medical problems associated with obesity
* BMI < 35 where insulin therapy has significant implications

Only continue if there is a reduction of ≥ 11 mmol/mol (1.0%) in HbA1c and a weight loss of ≥ 3% of initial body weight in 6 months.

112
Q

What are the classifications of blood product transfusion complications?

A

Transfusion complications may be classified into:
* Immunological
* Infective
* Transfusion-related acute lung injury (TRALI)
* Transfusion-associated circulatory overload (TACO)
* Other (e.g., hyperkalemia, iron overload, clotting)

113
Q

What are the features and management of non-hemolytic febrile reactions?

A

Features: Fever, chills
Management: Slow or stop transfusion, administer paracetamol, monitor

114
Q

What is the cause and management of anaphylaxis during a transfusion?

A

Cause: Patients with IgA deficiency who have anti-IgA antibodies
Management: Stop transfusion, administer IM adrenaline, provide ABC support (oxygen, fluids)

115
Q

What are the characteristics of sick euthyroid syndrome?

A

Sick euthyroid syndrome is characterized by:
* Low T3/T4
* Normal TSH
* Changes are reversible upon recovery from systemic illness

116
Q

How is obesity classified using BMI?

A

Classification of obesity based on BMI:
* Underweight: < 18.49
* Normal: 18.5 – 25
* Overweight: 25 – 30
* Obese class 1: 30 – 35
* Obese class 2: 35 – 40
* Obese class 3: > 40

117
Q

What is the management approach for obesity?

A

Management consists of a stepwise approach:
* Conservative: Diet, exercise
* Medical: Orlistat, Liraglutide
* Surgical

118
Q

What is Marfan’s syndrome and its genetic cause?

A

Marfan’s syndrome is an autosomal dominant connective tissue disorder caused by a defect in the FBN1 gene on chromosome 15.

119
Q

What are the features of Marfan’s syndrome?

A

Features include:
* Tall stature
* High arched palate
* Arachnodactyly
* Pectus excavatum
* Scoliosis of > 20 degrees
* Aortic dilatation
* Mitral valve prolapse
* Upwards lens dislocation

120
Q

What are the components of alcoholic liver disease?

A

Alcoholic liver disease includes:
* Alcoholic fatty liver disease
* Alcoholic hepatitis
* Cirrhosis

121
Q

What are common symptoms of Guillain-Barre syndrome?

A

Symptoms include:
* Progressive, symmetrical weakness of limbs
* Ascending weakness
* Diminished reflexes
* Normal sensation

122
Q

What is the main feature of a common peroneal nerve lesion?

A

The most characteristic feature is foot drop.

123
Q

What are the components of the CHA2DS2-VASc scoring system?

A

CHA2DS2-VASc is used to determine the need for anticoagulation in AF based on:
* Congestive heart failure
* Hypertension
* Age
* Diabetes
* Stroke
* Vascular disease
* Sex category

124
Q

What ECG features are associated with hypokalemia?

A

ECG features include:
* U waves
* Small or absent T waves
* Prolonged PR interval
* ST depression

125
Q

What is the management for severe hypokalemia?

A

Management includes IV replacement (3 x 1L 0.9% NaCl + 40mmol KCl)

126
Q

What is the management for Addison’s disease?

A

Management includes:
* Hydrocortisone for cortisol replacement
* Fludrocortisone for aldosterone replacement
* Doubling glucocorticoid dose during intercurrent illness

127
Q

What are the first-line treatments for acute migraine?

A

First-line treatments include:
* PO triptan + NSAID
* PO triptan + paracetamol
* Nasal triptan for 12-17 year-olds

128
Q

What is the Ranson criteria used for?

A

To assess the severity of acute pancreatitis

The Ranson criteria includes various clinical and laboratory parameters to predict mortality.

129
Q

What are common ECG features of hypokalemia?

A
  • U waves
  • Small or absent T waves/T wave flattening
  • Prolonged PR interval
  • ST depression

Hypokalemia can predispose patients to digoxin toxicity, especially if on diuretics.

130
Q

What is cataplexy?

A

A sudden and transient loss of muscular tone caused by strong emotion

It is commonly seen in patients with narcolepsy.

131
Q

What disease is caused by Hemophilus ducreyi?

A

Chancroid

It presents with painful genital ulcers and unilateral inguinal lymph node enlargement.

132
Q

What is the classic presentation of primary biliary cholangitis?

A

Itching in a middle-aged woman

It is a chronic liver disorder commonly associated with Sjogren’s syndrome.

133
Q

What are the immunological markers for primary biliary cholangitis?

A
  • Anti-mitochondrial antibodies (AMA) M2 subtype in 98% of patients
  • Smooth muscle antibodies in 30% of patients
  • Raised serum IgM

AMA is highly specific for this condition.

134
Q

What is a common cause of atypical pneumonia?

A

Mycoplasma pneumoniae

It often affects younger patients and is associated with erythema multiforme.

135
Q

What is the first-line management for essential tremor?

A

Propranolol

Primidone may also be used in some cases.

136
Q

How is cerebral perfusion pressure (CPP) calculated?

A

CPP = Mean arterial pressure (MAP) – Intracranial pressure (ICP)

A rise in ICP can lead to a fall in CPP, resulting in cerebral ischemia.

137
Q

What are the features of Henoch-Schonlein purpura (HSP)?

A
  • Palpable purpuric rash over buttocks and extensor surfaces
  • Abdominal pain
  • Polyarthritis

HSP is an IgA mediated small vessel vasculitis often seen in children.

138
Q

What is Section 2 of the Mental Health Act?

A

Admission for assessment for up to 28 days, not renewable

Requires an application by an Approved Mental Health Professional and two doctors.

139
Q

What is the initial treatment for active tuberculosis?

A
  • Rifampicin
  • Isoniazid
  • Pyrazinamide
  • Ethambutol

This is part of the initial phase treatment lasting the first 2 months.

140
Q

What characterizes alcoholic ketoacidosis?

A

A non-diabetic form of ketoacidosis occurring in malnourished alcoholics

It presents with metabolic acidosis and normal or low glucose concentration.

141
Q

What are the features of anaphylaxis?

A
  • Sudden onset of symptoms
  • Airway problems (throat swelling)
  • Breathing problems (wheeze, dyspnea)
  • Circulation problems (hypotension, tachycardia)

Skin changes like generalized pruritus and rash are also common.

142
Q

What is the first-line acute management for supraventricular tachycardia (SVT)?

A
  • Vagal maneuvers
  • Intravenous adenosine

Adenosine is given as a rapid IV bolus, increasing the dose if necessary.

143
Q

What does the Glasgow Coma Scale (GCS) assess?

A

The level of consciousness in a patient

It evaluates eye opening, verbal response, and motor response.

144
Q

What distinguishes obstructive lung disease from restrictive lung disease in pulmonary function tests?

A

Obstructive: FEV1 significantly reduced, FVC reduced or normal
Restrictive: FEV1 and FVC both reduced, FEV1% normal or increased

Common obstructive diseases include asthma and COPD; restrictive diseases include pulmonary fibrosis.

145
Q

What is the main management for Clostridioides difficile infection?

A

1st line: PO vancomycin for 10 days

Other options include fidaxomicin and metronidazole for recurrent cases.

146
Q

What is the classic triad of infectious mononucleosis?

A
  • Sore throat
  • Pyrexia
  • Lymphadenopathy

It is caused by the Epstein-Barr virus (EBV).

147
Q

What is the management for major bleeding in a patient on warfarin?

A
  • Stop warfarin
  • IV vitamin K 5mg
  • Prothrombin complex concentrate

Fresh frozen plasma (FFP) is an alternative but takes time to prepare.

148
Q

What should be considered in case of intracranial hemorrhage?

A

Prothrombin complex concentrate

This is due to the risk of significant bleeding associated with intracranial hemorrhage.

149
Q

What is the management for INR levels between 5.0 and 8.0 with no bleeding?

A

Withhold 1 or 2 doses of warfarin and reduce subsequent maintenance dose

This is to prevent further increases in INR.

150
Q

What is the management for INR levels between 5.0 and 8.0 with minor bleeding?

A

Stop warfarin and administer IV vitamin K 1 – 3mg

Restart warfarin when INR < 5.0.

151
Q

What is the management for INR levels greater than 8.0 with no bleeding?

A

Stop warfarin and give vitamin K 1 – 5 mg PO

Repeat dose of vitamin K if INR still too high after 24 hours.

152
Q

What are the commonest causes of an anterior mediastinum mass?

A

4Ts:
* Teratoma
* Terrible lymphadenopathy
* Thymic mass
* Thyroid mass

These four conditions encompass the majority of anterior mediastinal masses.

153
Q

What is the standard management for patients following a myocardial infarction (MI)?

A

Dual antiplatelet therapy (aspirin + 2nd antiplatelet), ACE inhibitor, Beta-blocker, Statin

This combination helps in reducing the risk of future cardiovascular events.

154
Q

What should be initiated within 3-14 days of an MI in patients with symptoms of heart failure and LV systolic dysfunction?

A

Aldosterone antagonist (eplerenone)

This treatment should preferably begin after ACE inhibitor therapy.

155
Q

Which organism is classically associated with pneumonia in alcoholics?

A

Klebsiella pneumoniae

This bacterium is commonly found in patients with a history of alcohol use.

156
Q

What is the commonest cause of community-acquired pneumonia (CAP)?

A

Streptococcus pneumoniae

This organism is frequently responsible for CAP cases.

157
Q

What should be done for patients allergic to aspirin regarding sulfasalazine?

A

Patients may also react to sulfasalazine

Caution is advised as cross-reactivity can occur.

158
Q

What is the commonest cause of sporadic encephalitis?

A

Herpes simplex encephalitis (HSE)

HSE typically presents with a prodrome of fever, headache, and malaise.

159
Q

What should be considered during CPR if a pulmonary embolism (PE) is suspected?

A

Thrombolytic drugs (alteplase)

This is a critical intervention for suspected PE during resuscitation.

160
Q

What are the secondary prevention options for stroke?

A

Clopidogrel, Aspirin + MR dipyridamole lifelong, MR dipyridamole lifelong

The choice depends on patient tolerance and contraindications.

161
Q

What is the driving restriction duration after successful catheter ablation for arrhythmia?

A

2 days off driving

This is a precautionary measure post-procedure.

162
Q

What is the driving restriction duration after angioplasty?

A

1 week

Patients should be advised on this timeline for safety.

163
Q

What are the first-line antibiotics for acute prostatitis?

A

Quinolone antibiotics (ciprofloxacin 500mg BD or ofloxacin 200mg BD)

Trimethoprim is an alternative if quinolones cannot be taken.

164
Q

What distinguishes bullous pemphigoid from pemphigus vulgaris?

A

No mucosal involvement in bullous pemphigoid; mucosal involvement in pemphigus vulgaris

This is crucial for diagnosis.

165
Q

What are common features of anorexia?

A

Reduced BMI, bradycardia, hypotension, hypokalemia, low FSH/LH/estrogen/testosterone, low T3

Growth hormone, glucose, cortisol, and cholesterol are typically raised.

166
Q

True or False: The use of steroids in sepsis is recommended.

A

False

Steroids are not recommended in the management of sepsis.

167
Q

What is sick euthyroid syndrome characterized by?

A

Low T3/T4 and normal TSH with acute illness

This condition reflects thyroid function during illness.

168
Q

What should be done for all patients with peripheral vascular disease (PVD)?

A

Take clopidogrel and atorvastatin

This is essential for secondary prevention.

169
Q

What is the maximum recommended alcohol intake for men and women per week?

A

14 units

It is advisable to spread this intake over 3 days or more.

170
Q

What condition is associated with infrapatellar bursitis?

A

Kneeling

Commonly seen in occupations such as clergy.

171
Q

What is acute chest syndrome a complication of?

A

Sickle-cell disease

Symptoms include dyspnea, chest pain, cough, and hypoxia.

172
Q

Why is ECG required at baseline for patients on antipsychotic medications?

A

To monitor for potential cardiac side effects

This is important for patient safety.

173
Q

What are common complications of seborrheic dermatitis?

A

Otitis externa and blepharitis

These conditions can arise due to skin inflammation.

174
Q

What is the commonest cause of hepatocellular carcinoma worldwide?

A

Hepatitis B

In Europe, Hepatitis C is more common.

175
Q

What can precipitate lithium toxicity?

A

NSAIDs, thiazide diuretics, ACEi, ARB, metronidazole

These medications can increase lithium levels.

176
Q

What is the only effective treatment for degenerative cervical myelopathy?

A

Cervical decompressive surgery

This procedure alleviates spinal cord compression.

177
Q

What should be given in case of beta-blocker overdose presenting with bradycardia?

A

Atropine

This helps to counteract the bradycardic effects.

178
Q

What can capnography detect?

A

Accidental esophageal intubation

This is a valuable tool in emergency settings.

179
Q

What is the first-line antibiotic for campylobacter infection?

A

Clarithromycin

This antibiotic is indicated for severe cases.

180
Q

What are the side effects associated with SSRIs?

A

Hyponatremia

This can occur due to inappropriate secretion of antidiuretic hormone (SIADH).

181
Q

What fetal abnormalities can lithium cause?

A

Cardiac abnormalities, tremor

This highlights the teratogenic potential of lithium.

182
Q

What should be done if one COCP pill is missed?

A

Take the last pill ASAP, no further action needed

This is the recommended immediate response.

183
Q

What may be one of the earliest symptoms of aspirin overdose?

A

Tinnitus

This symptom can help in early identification of overdose.

184
Q

What is the timeframe for diagnosing chronic fatigue syndrome?

A

Symptoms should be present for 3 months

This duration is necessary for diagnosis.

185
Q

When should anticoagulation for atrial fibrillation start after a TIA?

A

Immediately once imaging has excluded hemorrhage

Timely intervention is crucial in preventing further strokes.

186
Q

When should anticoagulation for atrial fibrillation start after an acute stroke?

A

After 2 weeks

This is to ensure patient safety post-stroke.

187
Q

When should COCP or HRT be stopped before surgery?

A

4 weeks before surgery

This reduces the risk of thromboembolic events.

188
Q

What should be trialed in infants with GORD who do not respond to initial treatments?

A

PPI

This is considered if there are feeding difficulties or faltering growth.

189
Q

What is the dosing schedule for Depo Provera injectable contraceptive?

A

Every 12 weeks (3 months)

Contraindicated in patients with breast cancer.

190
Q

What are some ototoxic medicines?

A

Gentamicin, Quinine, Furosemide, Aspirin, some chemotherapy agents

These drugs can cause hearing loss.

191
Q

What are the side effects of quinine?

A

Tinnitus, sweating, low platelets, increased sweating

These effects can vary in severity.

192
Q

What is bow legs in a child under 3 years old considered?

A

A normal variant

Usually resolves by age 4.

193
Q

What condition is pioglitazone contraindicated in?

A

Heart failure

This medication can cause fluid retention.

194
Q

What condition should be suspected with metabolic ketoacidosis and normal or low glucose?

A

Alcohol use

This metabolic state is often seen in chronic alcoholics.

195
Q

What is the standard for diagnosing and screening HIV?

A

Combination tests (HIV p24 antigen and HIV antibody)

These tests enhance accuracy.

196
Q

What should women take during the first 12 weeks of pregnancy?

A

Folic acid 400mcg

This is important for fetal neural tube development.

197
Q

What should pregnant women avoid in multivitamins?

A

Vitamin A (retinol)

It is teratogenic in high doses.

198
Q

What condition is suggested by fasciculations?

A

Motor neuron disease

This symptom is characteristic of this disease.

199
Q

What is a key feature of motor neuron disease regarding eye movements?

A

Typically spared

This helps differentiate it from other neurological disorders.

200
Q

What type of inhibitor is aspirin?

A

Non-reversible COX 1 and 2 inhibitor

This mechanism is crucial for its antiplatelet effects.

201
Q

What should be avoided when prescribing methotrexate?

A

Trimethoprim or co-trimoxazole concurrently

This increases the risk of marrow aplasia.

202
Q

What is the management for methotrexate toxicity?

A

Folinic acid

This helps to mitigate the effects of toxicity.

203
Q

What is the SSRI of choice post-MI?

A

Sertraline

This medication is preferred for its safety profile.

204
Q

What should be done for women on COCP who present with migraines + aura?

A

Stop the COCP and start POP

This is to reduce the risk of stroke.

205
Q

What is the risk for a child under 3 months with a fever > 38.0?

A

High risk of serious illness

Such cases require urgent assessment.

206
Q

What condition is indicated by fluctuating confusion or consciousness?

A

Subdural hematoma

This can occur due to head trauma.

207
Q

What is the most common cause of death following a myocardial infarction?

A

Ventricular fibrillation

This arrhythmia can lead to sudden cardiac death.

208
Q

What should be done for pneumonia cases after clinical resolution?

A

Repeat CXR at 6 weeks

This ensures consolidation has resolved.

209
Q

What is contraindicated in patients with Parkinsonism?

A

Metoclopramide

This medication can exacerbate symptoms.

210
Q

What is erythema multiforme a known complication of?

A

Carbamazepine use

This skin condition can arise as an adverse effect.

211
Q

What is the most common organism causing exacerbations of COPD?

A

H. influenza

This bacterium frequently contributes to acute exacerbations.

212
Q

What is the distinction between inguinal and femoral hernias?

A

Inguinal hernia: superior and medial to pubic tubercle; Femoral hernia: inferolateral to pubic tubercle

This anatomical knowledge is vital for diagnosis.

213
Q

What does myxedema coma present with?

A

Confusion + hypothermia

This is a medical emergency requiring immediate intervention.

214
Q

What effect does phenylephrine have on conjunctival and episcleral vessels?

A

Phenylephrine blanches the conjunctival and episcleral vessels but not the scleral vessels

215
Q

What is a painful condition associated with scleritis?

A

Scleritis is a painful condition

216
Q

What are the ocular manifestations of rheumatoid arthritis?

A
  • Keratoconjunctivitis sicca (commonest)
  • Episcleritis
  • Scleritis
  • Corneal ulceration
  • Keratitis
217
Q

What are the symptoms of necrotizing enterocolitis?

A
  • Feeding intolerance
  • Abdominal distension
  • Bloody stools
218
Q

Where is an inguinal hernia located?

A

Superior and medial to the pubic tubercle

219
Q

Where is a femoral hernia located?

A

Inferolateral to the pubic tubercle

220
Q

What are the key features of myxedema coma?

A
  • Confusion
  • Hypothermia
221
Q

What medical interventions are required for myxedema coma?

A
  • IV thyroid replacement
  • IVF
  • IV corticosteroids
  • Electrolyte imbalance management
222
Q

When is azithromycin prophylaxis recommended?

A

In COPD patients who meet certain criteria and who continue to have exacerbations

223
Q

What are the symptoms of Paget’s disease of the bone?

A
  • Frontal bossing
  • Bowing of the legs
224
Q

How is Paget’s disease of the bone treated?

A

With bisphosphonates (alendronate, risedronate, zoledronate)

225
Q

What is a protective factor for endometrial cancer?

A

Combined oral contraceptive pill (COCP)

226
Q

What condition is caused by radial nerve palsy?

A

Saturday night palsy

227
Q

What medications should be avoided in breastfeeding?

A
  • Aspirin
  • Amiodarone
  • Lithium
  • Benzodiazepines
  • Carbimazole
  • Methotrexate
  • Sulfonylureas
  • Clozapine
  • Antibiotics (ciprofloxacin, tetracycline, chloramphenicol, sulphonamides)
228
Q

What appearance does chorioretinitis have on fundoscopy?

A

Pizza pie appearance (mixture of red and white retinal lesions)

229
Q

What is a common symptom of psoriatic arthritis?

A

Dactylitis (sausage finger)

230
Q

What stimulant can be used in newborns to aid weaning off a ventilator?

A

Caffeine

231
Q

Which antiepileptic medication has the smallest effect on the developing fetus?

A
  • Lamotrigine
  • Carbamazepine
  • Levetiracetam
232
Q

What may be required during pregnancy for women with epilepsy prescribed lamotrigine?

A

A dose increase

233
Q

Is breastfeeding considered safe for mothers taking antiepileptics?

A

Yes, generally safe

234
Q

What life-threatening side effects are associated with clozapine?

A

Agranulocytosis/neutropenia

235
Q

What should be monitored in patients taking clozapine?

A

Full blood count (FBC)

236
Q

What is a key side effect of mirtazapine at lower doses?

A

Sedation and increased appetite

237
Q

How does caput succedaneum present?

A

Crosses the suture line and resolves within days

238
Q

How does cephalohematoma present?

A

Does not cross the suture line and resolves within months

239
Q

What is the treatment for impetigo if hydrogen peroxide is not suitable?

A

Topical fusidic acid

240
Q

What is a clinical sign of a scaphoid fracture?

A

Persisting pain in the anatomical snuffbox

241
Q

When is jaundice in the first 24 hours post delivery considered pathological?

A

Always pathological

242
Q

What medication may be used as ‘rescue therapy’ for neuropathic pain exacerbation?

A

Tramadol

243
Q

What should be checked before treating ulcerative colitis with azathioprine?

A

Thiopurine methyltransferase deficiency (TPMT)

244
Q

What happens to clotting factors in liver failure?

A

All are low except for factor VIII which is supra-normal

245
Q

What is the treatment for Ramsay Hunt syndrome?

A

Oral aciclovir + prednisolone

246
Q

What is the treatment for chlamydia?

A

Doxycycline for 7 days; if pregnant, use azithromycin, erythromycin, or amoxicillin

247
Q

Which medications are known to cause cholestasis?

A
  • Sulphonylureas (gliclazide)
  • Co-amoxiclav
  • Erythromycin
  • COCP
248
Q

When must methotrexate be stopped before conception?

A

At least 6 months before conception in both men and women

249
Q

What neurotransmitter balance changes occur during alcohol withdrawal?

A

Decreased inhibitory GABA and increased NMDA glutamate transmission

250
Q

What are the components of Beck’s triad in cardiac tamponade?

A
  • Falling BP
  • Raised JVP
  • Muffled heart sound
251
Q

What is the first line investigation for suspected clinically localized prostate cancer?

A

Multiparametric MRI

252
Q

What are the first line treatments for spasticity in multiple sclerosis?

A
  • Baclofen
  • Gabapentin
253
Q

Which organism commonly causes LRTI in cystic fibrosis patients?

A

Pseudomonas aeruginosa

254
Q

How long should children be excluded from school after mumps onset?

A

5 days from the onset of swollen glands

MSRA (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions