Medicine Block Formatives Flashcards
What is erythema nodosum? What infections and systemic conditions can it be associated with?
tender, erythematous, nodular lesions usually on the shins
infections:
strep, TB, brucellosis
systemic:
sarcoidosis, IBD, Behcet’s
What is the first line tx for meningococcal sepsis?
IV Benzylpenicillin
What drug (and at what dose) should be given to patients in anaphylaxis?
Intramuscular Adrenaline (epinephrine) 1:1000 500 micrograms
Give some key clinical findings on examination of AF
Hypotension
Signs of Valvular heart disease
Signs of hyperthyroidism
Signs of Heart failure
Signs of infection
What 3 drugs should be given in hyperthyroidism?
Propranolol: rate control in hyperthyroidism
Carbimazole: treatment for hyperthyroidism
LMWH: VTE prophylaxis
Would you electrically cardiovert someone who collapses due to AF who has hyperthyroidism?
No, they need to be euthyroid first
What chronic conditions can cause CKD?
Diabetes Mellitus
Hypertension
Renal vascular disease
Adult polycystic kidney disease
Glomerular Nephritis
Causes of hyperkalaemia in CKD?
Impaired GFR plus a frequently high dietary potassium intake
Extracellular shift of potassium caused by the metabolic
acidosis
Treatment with K+ sparing drugs e.g. ACEi/ARBs
What are the major potential complications of haemodialysis?
Line infection
Failed AV graft/Fistula
SVC stenosis
Give the main causes of eosinophilia
Asthma / Airway inflammation (COPD)
Hayfever
Allergic Bronchopulmonary Aspergillosis
Eosinophilic granulomatosis with polyangiitis / vasculitis
Eosinophilic Pneumonia
Hypereosinophilic syndrome
Parasites
Lymphoma
SLE
What IV medication should be given immediately in suspected sepsis?
Broad spectrum antibiotic e.g. meropenem
A 22 year old man presents with 3 days of malaise,
abdo discomfort, diarrhoea and dry cough. He has recently returned from a camping trip in South America.
On examination he has a fever, tachycardia and low bp. Examination reveals hepatosplenomegaly.
What intravenous treatment should be commenced immediately?
IV Ceftriaxone
Clinical presentation suggests Typhoid Fever. Will need blood and stool cultures to diagnose but treatment should not be delayed.
What is the management of suspected severe C Diff before stool sample results get back?
Metronidazole in the meantime
Common drug prescribed in the elderly that may cause dyspepsia and vomiting?
alendronic acid
Major complication of nephrotic syndrome?
VTE - especially DVT
An 81 year old man presents with new sudden onset of proximal limb pain and stiffness in his neck and shoulders. He also has difficulty rising from a chair. The pain is also present at night and he has felt more fatigued recently.
What is the most likely diagnosis?
Polymyalgia rheumatica
DEXA scan reveals osteopenia. What is the first treatment offered after lifestyle advice?
Vitamin D
Risk factors for infective endocarditis?
rheumatic heart disease
mitral valve prolapse
prosthetic valves or patches
degenerative and bicuspid aortic valve disease
an intravascular device
IV drug user
2 key investigations for infective endocarditis?
Blood Cultures - at least 3 sets from different sites
TOE ideally or Transthoracic Echo
Complications of infective endocarditis?
Haematuria
Splenomegaly
Septic emboli
Splinter haemorrhages
Skin manifestations
Cardiac valve damage
Valvular abscess/ Aortic root abscess
Neurological effects
What is the single gold standard diagnostic investigation for bronchiectasis and describe the findings of this investigation that would support the diagnosis?
High Resolution CT
Signet ring sign
Dilated bronchi with diameter bigger than adjacent blood vessel, with bronchial wall thickening
What are the key components of a continence exam?
Review of bladder and bowel diary
Urine dipstick and MSU
A post micturition bladder scan
Abdominal examination and PR exam
External genitalia review particularly looking for atrophic vaginitis in females
