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MRCP > Misc > Flashcards

Misc Flashcards

1
Q

antibiotic treatment for an animal bite

A

co-amoxiclav

doxycycline and metronidazole if pen allergic

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2
Q

indications for haemodialysis in salicylate OD

A 
conc >700mg/dL
coma
seizures
metabolic acidosis resistant to treatment
pulmonary oedema
AKI
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3
Q

features of a salicylate (aspirin) OD

A

> 2.5mmol/l (350mg/dl) indicates significant poisoning, >5.1 (700) is associated with death

pyrexia
hyperventilation (centrally acting)
tinnitus
lethargy
n&v
seizures and coma
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4
Q

Rheumatoid arthritis HLA association

A

HLA DR4

  • rheumatoid arthritis
  • type 1 DM
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5
Q

HLA B27 associations

A

reiter’s syndrome (can’t see can’t pee can’t stand on 1 knee)
acute anterior uveitis
ank spond

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6
Q

cyclophosphamide:
mode of action
SEs - and how to prevent them

A 
alkylating agent- causes crosslinking in DNA
haemorrhagic cystitis (mesna binds urotoxic metabolites) myelosuppression, transitional cell carcinoma
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7
Q

methotrexate
mode of action
SEs

A

inhibits dihydrofolate reductase

myelosuppression, liver and lung fibrosis, mucositis

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8
Q

Vincristine
action
SEs

A 
inhibits microtubule formation
peripheral neuropathy (reversible), paralytic ileus
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9
Q

Features of Wegener’s Granulomatosis

A

upper resp: epistaxis, sinusitis, nasal crusting
lower resp: SOB, haemoptysis
renal: rapidly progressive glomerulonephritis
vasculitic rash

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10
Q

Ix for wegener’s granulomatosis

A

cANCA >90% positive

renal biopsy: epithelial crescents in bowman’s capsule

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11
Q

what is the most common infection in solid organ transplant patients?
Rx?

A

cytomegalovirus (CMV) - inclusion bodies seen

Rx with ganciclovir

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12
Q

Features of lead poisoning

A 
abdominal pain
peripheral neuropathy (mainly motor)
constipation
blue lines in gums (in 20%)
fatigue
microcytic anaemia
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13
Q

What is the cause of pellagra and what are the features?

A

B3 (niacin) deficiency
3 Ds: dementia, dermatitis, diarrhoea
can also be due to isoniazid Rx (stops conversion of tryptophan to niacin)

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14
Q

which complement levels are low in SLE?

A

C3 and C4

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15
Q

which SLE antibody is associated with congenital heart block?

A

anti-ro

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16
Q

Treatment of accidental adrenaline injection

A

Phentolamine (alpha 1 blocker) injection

Vasodilates the affected area

17
Q

What is the indication for starting treatment for osteoporosis?

A

T score < -2.5 in post menopausal women or steroid induced

or woman >75 with clinical suspicion (DEXA not necessarily needed)

18
Q

What is the treatment for osteoporosis?

A

bisphosphonate - alendronate 1st line, risedronate 2nd line

calcium and vit D supplements

19
Q

features of severe pre-eclampsia

A 
headache
RUQ/epigastric pain
papilloedema
visual disturbance
hyper-reflexia/clonus
hypertension >170/110
platelets <100, abnormal LFTs or HELLP syn (Haemolysis, Elevated Lfts, Low Platelets)
20
Q

What is the therapeutic range for lithium and when do you take bloods for monitoring?

A

0.4-1

take 12 hours post dose

21
Q

What is the target range for digoxin and when do you take bloods for monitoring?

A

0.5-1

6 hours post dose

22
Q

Indications for plasma exchange

A

neuro: acute guillian barre, MG, chronic inflam demyelinating polyneuropathy
haem: TTP, cyroglobinaemias, hyperviscosity syndromes, post transfusion purpura
renal: Goodpastures, ANCA positive nephritis
metabolic: hypercholesterolaemia, Refsum’s disease

23
Q

reason for azathioprine toxicity in a patient

A

thiopurine methyltransferase deficiency
1 in 200 people
leads to pancytopenia

24
Q

Features and pathology of Botulism

A

toxinogenic strains of Clostridium botulinum
usually caught from improperly tinned foods, meats seafoods and injecting abscesses.

Sx: diplopia, blurred vision, photophobia, bulbar palsy, ataxia, sudden cardioresp failure. No GI symptoms.

25
Q

Dx and Mx of botulism

A

Dx: stool culture, blood test to identify toxin.

Mx: early intubation and Mx on ITU.
Give antitoxin asap to avoid cardiac arrest

26
Q

Risk stratification for aspirin (salicylate) poisoning

A

> 125mg/kg - likely no effect
125-250mg/kg - mild
350 - 500 - moderate
500mg/kg - severe (eg 35g in 70kg man)

27
Q

features of digoxin toxicity

A

arrhythmias - ventricular bi/trigeminy, atrial tachycardia with CHB
n&v and diarrhoea
confusion
yellowing of vision (xanthopsia), blurred vision and photophobia

28
Q

Mx of digoxin toxicity

A

activated charcoal (within 6-8 hours of acute ingestion)
cholestyramine (binding resin, prevents enterohepatic circulation. Better for chronic toxicity)
If high K+, insulin/dextrose. AVOID calcium (as can precipitate VT/VF)
digibind (digoxin immune Fab)
Phenytoin (or lidocaine) for VT if digibind unavailable/ineffective

MRCP (15 decks)

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