Medicine (including all year 4 specialities) Flashcards
1
Q
What is the gold standard investigation for bladder cancer diagnosis?
A
Cystoscopy
2
Q
Sexual intercourse is a cause of transient visible haematuria, name 3 more.
A
Vigorous exercise
Urinary tract infection
Menstruation
3
Q
Cancer and renal stones are two causes of persistent visible haematuria, name 4 more.
A
benign prostatic hyperplasia
prostatitis
urethritis e.g. Chlamydia
renal causes: IgA nephropathy, thin basement membrane disease
4
Q
Which malignancy does a H.pylori infection predispose to?
A
Gastric lymphoma (MALT)
5
Q
What is the firstline investigation for suspected leptospirosis?
A
Serology
6
Q
The patient who has a job as a sewage worker presents with fevers, myalgia, headache, conjunctival redness, jaundice and dark urine. What is the most likely diagnosis?
A
Leptospirosis
7
Q
Following an ACS what medications should all patients be offered?
A
Dual antiplatelet therapy (aspirin plus a second antiplatelet agent)
ACE inhibitor
Beta-blocker
Statin
8
Q
What is the most common cause of viral meningitis in adults?
A
Enteroviruses (Coxsackievirus B)
9
Q
What nerve conduction study result would support a diagnosis of MND?
A
Normal results.
10
Q
How long must voice hoarseness be present for, for it to be considered persistent?
A
> 3 weeks
11
Q
Fatigue is an early sign of haemochromatosis, name two more.
A
Erectile dysfunction
Arthralgia
12
Q
What is the most common cause of death for patients with CKD on haemodialysis? Why?
A
Ischaemic heart disease
This is due to several factors including hypertension, dyslipidaemia, anaemia and systemic inflammation that are common in CKD patients.
13
Q
What is the most suitable option for renal replacement therapy for a patient with Crohn’s disease? Why?
A
Haemodialysis
Insertion of the peritoneal dialysis would be complicated by the Crohn’s disease.
14
Q
Define Rapidly Progressive Glomerulonephritis.
A
Rapid loss of renal function associated with the formation of epithelial crescents in the majority of glomeruli.
15
Q
Goodpastures syndrome is a cause of Rapidly Progressive Glomerulonephritis, name 3 more.
A
Wegener’s granulomatosis
SLE
Microscopic polyarteritis
16
Q
What is the gold standard investigation for suspected optic neuritis?
A
MRI contrast of the orbits and brain (gadolinium).
17
Q
What are the features of Brocas aphasia?
A
Non-fluent
Comprehension normal
Repetition impaired
18
Q
Management of tricyclic antidepressant overdose:
- …
- Give 50 grams of charcoal if within one hour of ingestion.
- Give sodium bicarbonate (50 ml of 8.4%) if:
pH <7.1
QRS >160 ms
Arrhythmias
Hypotension
A
Consider gastric lavage only if within one hour of a potentially fatal overdose.
19
Q
Management of tricyclic antidepressant overdose:
- Consider gastric lavage only if within one hour of a potentially fatal overdose.
- …
- Give sodium bicarbonate (50 ml of 8.4%) if:
pH <7.1
QRS >160 ms
Arrhythmias
Hypotension
A
Give 50 grams of charcoal if within one hour of ingestion.
20
Q
Management of tricyclic antidepressant overdose:
- Consider gastric lavage only if within one hour of a potentially fatal overdose.
- Give 50 grams of charcoal if within one hour of ingestion.
- …
A
Give sodium bicarbonate (50 ml of 8.4%) if:
pH <7.1
QRS >160 ms
Arrhythmias
Hypotension
21
Q
How are arrhythmias managed in a TCA overdose?
A
avoid antiarrhythmics, correct hypoxia, hypotension, acidosis, hypokalaemia.
22
Q
Where is the most common location for a metatarsal stress fracture?
A
The most common site of metatarsal stress fractures is the 2nd metatarsal shaft
23
Q
In pregnant woman who develop hyperthyroidism in the first trimester, …… is preferred over carbimazole due to lower risk of …..
A
propylthiouracil
foetal malformation
24
Q
Polycythaemia rubra vera - around …… progress to myelofibrosis or AML
A
5-15%
25
Creutzfeldt-Jakob disease is characterised by rapid onset dementia and what other feature?
Myoclonus
26
Polymalgia Rheumatica features:
typically patient .... years old
usually rapid onset (e.g. < 1 month)
aching, ..... stiffness in proximal limb muscles
What are the other features that can be present in patients?
>60
morning
mild polyarthralgia, lethargy, depression, low-grade fever, anorexia, night sweats
27
How to differentiate between solar lentigo and lentigo maligna?
SL - symmetrical
LM - asymmetrical
28
The most common organism causing infective exacerbations of COPD is .......
Haemophilus influenzae
29
Lacunar strokes can present with...
unilateral motor disturbance affecting the face, arm or leg or all 3.
complete one sided sensory loss.
ataxia hemiparesis.
30
How would hyperkalaemia present on an ECG?
Tall tented T waves, a lack of P waves and broad QRS complexes,
31
What are the three possible diagnoses suggested by ST depression in V1-2?
How would you differentiate between them?
Non-ST-elevated myocardial infarction (NSTEMI), unstable angina and posterior ST-elevated myocardial infarction (STEMI).
Differentiate between the untable angina and STEMI/NSTEMI with the rise in troponin levels.
Differentiate between NSTEMI and posterior STEMI with artery - LAD would rule out posterior STEMI.
32
What features are associated with bulbar palsy?
slurred speech and swallowing difficulties
33
Intrahepatic cholestasis of pregnancy increases the risk of ......; therefore induction of labour is generally offered at ...... weeks gestation.
stillbirth
37-38
34
Name the 5 types of thyroid cancer from most common to least common.
Papillary, follicular, medullary, anaplastic, and lymphoma.
35
Medullary thyroid cancer is associated with high ....
Calcitonin
36
What is the most appropriate treatment for recurrent UTIs in females following sexual intercourse?
Single dose of nitrofurantoin after each time sexual intercourse occurs.
37
Haemorrhage following Tonsillectomy:
Primary, or reactionary haemorrhage most commonly occurs in the first ....... following surgery. It is managed by ......
Secondary haemorrhage occurs between ....... days after surgery and is often associated with ......... Treatment is usually with ............ Severe bleeding may require surgery.
6-8 hours
immediate return to theatre
5 and 10
a wound infection.
admission and antibiotics.
38
More than 90% of colorectal cancers are .......
Adenocarcinomas
39
What is the investigation of choice to look for renal scarring in a child with vesicoureteric reflux?
Radionuclide scan using dimercaptosuccinic acid (DMSA)
48%.
40
What visual field defect is most associated with optic neuritis?
Central scotoma
41
Herpes simplex keratitis most commonly presents with a ........... ulcer.
Dendritic corneal
42
When would a urethral catheter be contraindicated?
Suspected urethral injury (e.g. pelvic fracture)
43
High-dose dexamethasone suppression test with a pituitary adenoma
Cortisol: .........
ACTH: ...........
suppressed
suppressed
44
High-dose dexamethasone suppression test with adrenal adenomas
Cortisol: .........
ACTH: ...........
not suppressed
suppressed
45
What are the components of parenteral nutrition?
Water
Electrolytes
Amino acids
Lipid Glucose
Vitamins
Trace elements
46
What are the two options for administration of parenteral nutrition?
PICC
Hickman Line
47
What problem can arise from the over administration of normal saline?
Hyperchloraemic acidosis
48
What abnormality with calcium can be seen in acute pancreatitis?
Hypocalcaemia (often used to assess whether a person is at risk of adverse outcomes).
49
What is the antidote for methotrexate toxicity?
Folinic acid (allows for some normal DNA replication to take place)
50
What area of the heart does the left circumflex artery supply and what are the corresponding leads in which you would see ischaemic changes?
Lateral
I, aVL, V5-6
51
Where is the QT interval measured from? What is the normal length of the QT interval?
The start of the Q wave to the end of the T wave
A normal corrected QT interval is less than 430 ms in males and 450 ms in females.
52
What should counselling for alpha anti-trypsin deficiency include?
Absolute tobacco abstinence, avoidance of noxious inhalants, as well as the risk of liver disease.
53
What is the correct management for men presenting with a UTI?
Send urine culture and then start on 7 day course of trimethoprim
54
Yellow Fever: The incubation period is short at .......... following a mosquito bite. The first stage classically causes a non-specific illness which is often described as 'flu-like' with ................................... and headache. This stage is due to the circulating virus in the bloodstream (viraemic stage). There is then a recovery stage when the viraemia clears. Most patients recover completely following this stage and do not progress to the third stage. Around ....... of patients progress after about ............. after the onset of symptoms which presents with ..................................
3-6 days
fever, malaise, nausea, myalgia
15%
3-7 days
fever, nausea and vomiting, acute kidney injury, hepatitis with jaundice, and haemorrhage.
55
What is the key investigation for a person presenting with suspected septic arthritis?
Synovial fluid analysis
56
What are the typical thyroid function test results for a patient with subclinical hyperthyroidism? What complications are patients with this condition at risk of?
Often thyroid function tests will show a low TSH, with normal free T3 and T4 levels.
Atrial fibrilliation and Osteoporosis
57
What is the most appropriate investigation to test for suspected legionella pneumonia?
Urine test (urinary antigen)
58
Lights Criteria:
if the protein level is between 25-35 g/L, Light's criteria should be applied. An exudate is likely if at least one of the following criteria are met:
pleural fluid protein divided by serum protein .....
pleural fluid LDH divided by serum LDH ........
pleural fluid LDH more than ............ the upper limits of normal serum LDH
>0.5
>0.6
two-thirds
59
What is the most common cause of stridor in children?
Laryngomalacia
60
In relation to labour, when do most amniotic fluid embolisms occur? What are some key signs?
30 mins post labour
Respiratory distress, hypoxia, and hypotension are also clear signs of an amniotic fluid embolism.
61
What blood results can be indicative of an upper GI bleed?
A drop in Hb and a significant rise (out of proportion) in the urea.
62
What is the timeframe for the development of a Post-MI VSD? How does it present? What is seen on ECHO?
1-2 days
Breathlessness, new pan-systolic murmur.
Left-to-right shunt.
63
Patients with schizoid personality disorder are not in touch with reality and often have magical thoughts and hallucinations.
True or False?
False
Patients with schizoid personality disorders are in touch with reality. (display the negative sx of schizophrenia).
Patients with schizotypal personality disorders often have magical beliefs and hallucinations.
64
For a patient presenting with suggested TIAs what are the two most important investigations that should be carried out when referred to the stroke specialists?
Duplex carotid dopplers.
MRI head (diffusion-weighted)
65
....................... is a hallmark feature of necrotising enterocolitison on AXR
Pneumatosis intestinalis
66
What sx would be suggestive of an ANCA associated vasculitis?
Renal impairment, respiratory symptoms, joint pain, systemic features.
67
What are the three patterns of disease in systemic sclerosis?
Limited cutaneous systemic sclerosis
Diffuse cutaneous systemic sclerosis
Scleroderma
68
What does CREST Syndrome stand for?
Calcinosis, Raynaud's phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia
69
In the investigation of a DVT, if the scan is negative, but the D-dimer is positive what is the next step in treatment?
Stop any anticoagulation and repeat the USS in 1 week.
70
What is Beck's Triad? What does this indicate?
Beck's triad, characterised by hypotension, raised jugular venous pressure (JVP), and heart sounds that are difficult to auscultate (often described as muffled), which suggests a diagnosis of cardiac tamponade.
71
A 25-year-old man presents to the Emergency Department with a spontaneous pneumothorax, confirmed on a chest X-ray. He reports no significant pain or breathlessness, and his vital signs are stable; however, the chest X-ray shows a 3 cm gap between the lung edge and the chest wall at the level of the hilum.
What is the most appropriate management for this patient?
Conservative management
As the patient is minimally symptomatic, regardless of the size of the pneumothorax if there is no physical compromise then they should be treated conservatively.
72
While an essential tremor is classically associated with a tremor present with sustained muscle tone (i.e. postural tremor) in the hands, it can also affect the ..........
vocal cords
73
What are the sx of cholestasis? What is seen on blood results (LFTs)?
jaundice, pruritus
raised bilirubin + ALP
74
What are the features of an aspirate taken from an empyema?
pH less than 7.2
glucose low
LDH high
75
Which type of lymphoma are Reed-Sternberg cells indicative of?
Hodgkins
76
What are the most common complications of strawberry naevi?
Potential complications
mechanical e.g. Obstructing visual fields or airway
bleeding
ulceration
thrombocytopaenia
77
What are some of the signs of negative fluid balance?
Hypotension
Oliguria
Sunken eyes and reduced skin turgor
Tachycardia
78
Post MI which medications should a patient be offered?
All patients should be offered the following drugs:
dual antiplatelet therapy (aspirin plus a second antiplatelet agent)
ACE inhibitor
beta-blocker
statin
79
STEMI management: if patient is having PCI then .......... is given in addition to aspirin. If patient is on an anticoagulant then ............. used instead
prasugrel
clopidogrel
80
What is the causative organism for syphilis?
Treponema pallidum
81
The most common organism causing infective exacerbations of COPD is ..........................
Haemophilus influenzae
82
What do all of these vaccinations have in common?
BCG
MMR
oral polio
yellow fever
oral typhoid
They are live attenuated vaccines
83
What antibodies are associated with Hashimoto's Thyroiditis?
Anti-thyroid peroxidase antibodies
84
Which lung cancer is most commonly associated with gynaecomastia?
Adenocarcinoma
85
What is the most common causative organism for prostatitis? What test should be done for younger men presenting with prostatitis and why?
E.coli
STI screen, prostatitis can be caused by Neisseria Gonnorhoea and Chlamydia.
86
Other than recent UTI what are 3 other risk factors for prostatitis?
Urogenital instrumentation, intermittent bladder catheterisation and recent prostate biopsy.
87
What are the sx of an acute chest syndrome (on a background of sickle cell anaemia)?
dyspnoea, chest pain, cough, hypoxia and new pulmonary infiltrates seen on chest x-ray
88
Swallowing difficulties and Impaired consciousness are two risk factors for aspiration pneumonia, what are 3 other risk factors?
Poor dental hygiene
Prolonged hospitalization or surgical procedures
Impaired mucociliary clearance
89
What medication is used to treat tardive dyskinesia?
Tetrabenazine
90
Therapeutic ....................... is an absolute contraindication to the use of regional anaesthesia.
anticoagulation (e.g warfarin)
91
Indications for thoracotomy in haemothorax include ................ blood initially or losses of ....... per hour for ...........
>1.5L
>200ml
>2 hours
92
What is the treatment for antiphospholipid syndrome after the first presentation for VTE?
Lifelong Warfarin (or LMWH)
93
What results would be seen on CSF in a patient with bacterial meningitis?
Low glucose
High Protein
Polymorphs
94
How to tell the difference between gout and pseudogout?
The presence of chrondocalcinosis (seen as linear calcifications) in pseudogout and not in gout.
95
What is the treatment of proctitis (mild-to-moderate ulcerative colitis)?
Rectal aminosalicylate -> Add oral aminosalicylate -> add topical/oral corticosteroid
96
What is the firstline treatment of an open-angle glaucoma in a patient with a hx of heart block?
Latanoprost
97
What is the typical presentation of a patient with polymyositis?
It typically presents in male patients >40 years with symmetrical proximal muscle weakness, raised creatine kinase as a result of muscle breakdown, and the absence of rash.
98
How to differentiate polymyositis and dermatomyositis?
Poly - no rash
Dermato - rash
99
What are the red flag sx for gastric cancer?
Red flag symptoms for gastric cancer includes
new-onset dyspepsia in a patient aged >55 years
unexplained persistent vomiting
unexplained weight-loss
progressively worsening dysphagia/
odynophagia
epigastric pain
100
What is typically seen on the lab results of a patient with ALL?
anaemia, neutropaenia, leukocytosis, and thrombocytopaenia
101
What vaccination should be offered to patients with heart failure annually?
Influenza vaccination
102
All patients with acute asthma should receive oral ............. rather than IV hydrocortisone (unless vomiting etc)
prednisolone
103
What is the recommended length of time between blood culture samples for a suspected infective endocarditis?
30 minutes
104
What is the treatment of gonorrhoea?
IM ceftriaxone
OR
oral cefixime + oral azithromycin
105
Other than intracranial berry aneurysms what are some other common extra-renal manifestations of Autosomal Dominant Polycystic Kidney Disease?
Formation of hepatic and pancreatic cysts, mitral valve prolapse, colonic diverticula, and abdominal wall hernias.
106
New onset AF is considered for electrical cardioversion if it presents within ................. of presentation
48 hours
107
A 60-year-old man presents to the Emergency Department with a three-month history of a progressively worsening cough with sputum production. He reports dyspnoea on exertion and fatigue. His medical history includes recurrent respiratory infections, and he has a 40-pack-year smoking history.
Clinical examination reveals coarse crackles auscultated bilaterally, predominantly in the lower lung fields. A chest X-ray shows bilateral bronchial dilatation with a tram-line appearance.
What is the most likely diagnosis and causative organism?
Bronchiectasis
Haemophilus influenzae
108
What is the vaccination schedule for babies who are born to mothers who are hepatitis B surface antigen positive, or are known to be high risk of hepatitis B?
Should receive the first dose of hepatitis B vaccine soon after birth and those born to mother's who are surface antigen positive should also receive 0.5 millilitres of hepatitis B immunoglobulin within 12 hours of birth.
The baby should then further receive a second dose of hepatitis B vaccine at 1-2 months and at 6 months.
109
What is the investigation of choice for an infant with suspected necrotising enterocolitis?
Abdo Xray
110
What are the expected levels of calcium and phosphate if there are high levels of parathyroid hormone?
Calcium high
Phosphate low
111
When can antiepileptic medications be under consideration to be stopped?
After the patient has been seizure free for at least two years and the medications should be reduced slowly over 2-3 months
112
In hypothermia, rapid re-warming can lead to ................... and .....................
peripheral vasodilation and shock
113
Arnold-Chiari malformation involves the ............. herniating through the ........................
Cerebellum
Foramen magnum.
114
What is the treatment for Wolf-Parkinson-White syndrome?
Radiofrequency Ablation.
115
What cancer does coeliac disease increase the risk of?
Enteropathy-associated T cell lymphoma
116
What is the firstline treatment for lichen planus?
Topical corticosteroids e.g. Topical clobetasone butyrate
117
When is fibrinolysis indicated for a STEMI and what drug should be given before this takes place?
When percutaneous coronary intervention (PCI) cannot be given within 120 minutes.
An anti-thrombin medication e.g. Fondaparinux
118
What is a characteristic finding that can be seen on an x-ray of a patient with ankylosing spondylitis?
Syndesmophytes - calcification of the ligaments that can cause fusion of the bone.
119
When is brimonidine gel not the firstline treatment for Acne Rosacea?
When there is the presence of papules, pustules or rhinophyma.
120
How can you clinically differentiate between post-streptococcal glomerulonephritis and IgA nephropathy?
PSG - 1-2 weeks after infection
IgA - 1-2 days after infection
121
serum ACE is raised in approximately 60% of ................. patients at diagnosis and is the most specific autoantibody used in diagnosis.
sarcoid
122
Contraceptives - time until effective (if not first day period):
instant: .....
2 days: .....
7 days: ......., ........, ......., ........
instant: IUD
2 days: POP
7 days: COC, injection, implant, IUS
123
Which organism is associated with cavitating lesions when it causes pneumonia?
Staphylococcus aureus
124
When should neonates be given 10% dextrose for neonatal hypoglycaemia?
If they have a very low blood sugar or they are symptomatic.
125
When should antiviral therapy be initiated for a patient with a diagnosis of HIV?
Immediately after diagnosis.
126
What should be done for a patient presenting with severe cellulitis accompanied by systemic features?
IV co-amoxiclav/cefuroxime/clindamycin/ceftriaxone
Urgent surgical consultation to evaluate the potential for debridement.
127
What appearance on light microscopy is suggestive of a chronic Hep B infection?
Ground-glass appearance of the cytoplasm of hepatocytes.
128
For a patient who is experiencing an anaphylactic reaction to a blood transfusion what is the treatment?
The transfusion should be permanently stopped and IM adrenaline immediately administered.
Antihistamines should be given to reduce the allergic symptoms, bronchodilators to alleviate bronchospasm and corticosteroids to mitigate protracted anaphylaxis.
Supportive care will also be required as in any case of anaphylaxis.
129
What is the firstline medication for inducing remission in a patient with Crohn's?
What is the firstline medication for maintaining remission in Crohn's?
Prednisolone
Azathioprine
130
In the investigation of acromegaly, if a patient is shown to have raised IGF-1 levels, what is suggested to confirm the diagnosis?
an oral glucose tolerance test (OGTT) with serial GH measurements is suggested to confirm the diagnosis
131
Why does primary adrenal failure cause hyperpigmentation, but secondary adrenal insufficiency does not?
Primary -> lack of cortisol, increased secretion of ACTH, this increases the production of melanocytes.
Secondary -> hypopituitarism, lack of ACTH, melanocytes not stimulated.
132
Low serum calcium, raised serum phosphate, raised ALP and raised PTH - what are these blood results suggestive of?
chronic kidney disease leading to secondary hyperparathyroidism
133
Limited systemic sclerosis is associated with .................. antibodies.
anti-centromere
134
Latent tuberculosis treatment options:
3 months of isoniazid (with pyridoxine) and rifampicin, or
6 months of isoniazid (with pyridoxine)
135
What does hypergonadotrophic hypogonadism mean?
FSH and LH concentrations are elevated and serum testosterone concentrations are low.
136
Acute haemolytic transfusion reactions are usually the result of RBC destruction by ................ antibodies
IgM-type
137
What is the most appropriate adjuvant treatment for a 62 year old female with an oestrogen receptor positive breast cancer?
Aromatase inhibitor e.g. Anastrozole
138
What drugs can be given to reduce the number of relapses in patients with MS?
natalizumab - firstline IV
ocrelizumab - IV
fingolimod - oral formulations available
beta-interferon - not as effective given SC
glatiramer acetate - SC
along with beta-interferon considered an 'older drug' with less effectiveness compared to monoclonal antibodies and S1P) receptor modulators
139
What is the firstline treatment for a relapse of MS? What is the purpose of giving steroids?
5 day course of Methylprednisolone (oral or IV)
Alter the length of the relapse not the degree of recovery.
140
What needs to be done prior to giving the BCG vaccination?
Tuberculin skin test
141
What is the most specific antibody that is associated with RA?
anti-cyclic citrullinated peptide antibodies
142
Borrelia burgdorferi is the causative organism in ..............
What symptoms are suggestive of this disease?
Lyme disease
Joint pains, facial nerve palsy, palpitations, headaches and fever.
143
In diabetic retinopathy, cotton wool spots represent areas of ...................
retinal infarction
144
Raised serum calcium, low serum phosphate, raised ALP and raised PTH - ............................... hyperparathyroidism
primary
145
What is the firstline treatment for benign prostatic hyperplasia in a patient with troublesome sx?
Alpha-1 Antagonist (e.g. tamulosin) - relax the smooth muscle in the bladder neck.
146
What is the firstline antibiotic for a patient with neutropenic sepsis?
Tazocin
147
What difference is seen in the results of a combined test done for down's syndrome and those done for trisomy 18 and 13?
Down's syndrome combined screening: trisomy 18 (Edward syndrome) and 13 (Patau syndrome) give similar results but the **hCG** tends to be *lower*, whereas in Down's it is *raised*
148
What is the recommended prescription for a patient that has suffered a TIA?
Dual antiplatelet therapy - aspirin and clopidogrel
149
There is often the loss of rotation ................. of the leg in ................ in slipped capital femoral epiphysis
internal
flexion
150
Why should NSAIDs be avoided in patients with chickenpox?
NSAIDs increase the risk of developing necrotising fasciitis when used for chickenpox.
151
Patients with type I diabetes and a BMI ............ should be considered for metformin in addition to insulin
> 25
152
Confusion, gait ataxia, nystagmus + ophthalmoplegia are features of ....................... ..........................
Wernicke's encephalopathy
153
What is the typical triad of Wernicke's encephalopathy?
Confusion, gait ataxia, nystagmus + ophthalmoplegia
154
Turner's syndrome is associated with an .................................... murmur due to bicuspid aortic valve
ejection systolic
155
Turner's syndrome is associated with an ejection systolic murmur due to ....................................
bicuspid aortic valve
156
What is the RR for the different paediatric ages?
Infant 0-12 months ....... per minute
Toddler 1-3 years ........... per minute
Preschooler 4-5 years ........... per minute
School age 6-12 years ............. per minute
Age Category Age Range Normal Respiratory Rate
Infant 0-12 months 30-60 per minute
Toddler 1-3 years 24-40 per minute
Preschooler 4-5 years 22-34 per minute
School age 6-12 years 18-30 per minute
157
Ascites: a high SAAG gradient (> ....g/L) indicates portal hypertension
11
158
What chest sound is characteristic of a patient with pulmonary fibrosis?
Fine end-inspiratory creptiations
159
What is the most common cause of death following an MI?
Ventricular fibrillation
160
What are the three common sx associated with Reactive Arthritis?
Urethritis
Arthritis
Conjunctivitis
## Footnote
Can't see, can't pee, can't climb a tree
161
What investigations are done for suspected reactive arthritis?
Joint aspiration
Testing for previous STIs
162
What are the mx options for a patient with reactive arthritis?
Symptomatic relief: Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used.
Corticosteroids: Intra-articular injections may help in severe cases.
Disease-modifying agents: Sulfasalazine or methotrexate may be considered for persistent symptoms.
163
In Vestibular neuronitis:
Prochlorperazine is used for ........................
Betahistine is used for ......................
Symptomatic relief
To prevent symptoms
164
What is given for ischaemic stroke prevention?
Clopidogrel or aspirin + dipyramidole
165
What are some of the main causes of gingival hyperplasia?
Gingival hyperplasia: phenytoin, ciclosporin, calcium channel blockers and AML
166
What is the treatment for temporal arteritis (GCA)?
Visual sx -> high-dose IV methylprednisolone
No visual sx -> high-dose oral prednisolone (40-60mg per day)
(Same day ophthalmology assessment)
167
Selective serotonin reuptake inhibitor discontinuation syndrome can present with a wide variety of symptoms including d....................., v.................. and abdominal pain.
Diarrhoea
Vomiting
168
What is the firstline medication for treatment of a focal seizure?
Lamotrigene or Levitaracetam
