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Misc Flashcards

1
Q

How do you work out average glucose from A1c?

A

1.59 x A1c – 2.59

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2
Q

Describe Kallman syndrome

A

GnRH deficiency – low oestrogen
Hypogonadism
Failure to produce secondary sexual characteristics
Test FSH + LH = if low; hypogonadotrophic hypogonadism

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3
Q

What is dehydroepiandrosterone sulphate used for?

A

Evaluate adrenal function

Can distinguish between adrenal or ovarian/ testes causes of androgen conditions

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4
Q

What is medroxyprogesterone used for?

A

Induces a withdrawal bleed – can be used in evaluation of secondary amenorrhea

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5
Q

What screening test is best for T2DM in asymptomatic pts?

A

Fasting glucose

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6
Q

Describe the presentation of an epidermoid cyst

A

Painless cyst, slow growing

Produces foul discharge

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7
Q

What is Favre-Racouchot syndrome?

A

Skin disease with multiple open + closed comedones in presence of actinically damaged skin. UV + smoking = risk factors

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8
Q

Management of epidermoid cysts

A

Asymptomatic – no treatment

Intralesional triamcinolone – speeds up recovery

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9
Q

What is lichenification?

A

Thickening + hardening of skin where it is constantly scratched
Causes accentuation of skin lines

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10
Q

What abx to use for dental infection?

A

Clindamycin or amox/ clavulanate

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11
Q

What is a perilymphatic fistula?

A

Between middle + inner ear; can be caused by barotrauma, trauma or straining

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12
Q

Management of endometriosis

A 
Conservative – NSAIDs 
COCP
Danozol 
GnRH analogues eg Leuprolide acetate goserelin 
Surgery
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13
Q

How to screen for gestational DM?

A

1 hour glucose challenge test

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14
Q

How does a mitral valve prolapse present + what is it associated with?

A

Palpitations, fatigue, migraine, cough
Mid-systolic click + late systolic murmur
Linked with Marfans

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15
Q

What bacteria is present in a human bite?

A

Mixed anaerobes + aerobes

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16
Q

Management of cluster headaches

A

Oxygen via face mask

Can be treated with hypothalamic stimulation if refractory to medical therapy

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17
Q

What are the RF for cluster headaches?

A 
Sleep apnea 
Fam hx 
Excess heat 
Shift work
Gasoline + oil smells
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18
Q

Management of gestational HTN

A

Alpha methyldopa

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19
Q

What is Von Recklinghausen disease?

A 
AKA neurofibromatosis 1 
Needs 2 of 7: 
>6 café au lait spots 
Neurofibromas 
Lische nodules 
Axillary + lymph freckes 
Optic nerve glioma 
Sphenoid dysplasia 
First degree fam hx
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20
Q

What is Mathe’s sign?

A

Kidney doesn’t move during respiration

Sign of perinephric abscess

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21
Q

What is Murphy’s sign?

A

Positive in cholecystitis

Pain during inspiration when liver edge is caught

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22
Q

What is Litten’s sign?

A

Paralysed hemidiaphragm

Loss of movement seen on inspiration

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23
Q

What is Hoover’s sign?

A

Inward movement of lower rib cage during inspiration

Means there is a flat diaphragm; associated with emphysema

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24
Q

What is Dock’s sign?

A

Bilateral rib notching due to collateral circulation of internal mammary arteries
Linked to coarctation of the aorta

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25
What is Friedreich’s ataxia?
Most common autosomal recessive ataxia Occurs during puberty Progressive ataxia with loss of deep tendon reflexes Presence of Babinski’s sign (extensor plantar responses)
26
What is thrombophlebitis migrans?
Pain in lower limbs that travels from one leg to another Erythematous nodule on superficial leg vein Can be due to malignancy
27
What is the Trousseau sign of malignancy?
Thrombophlebitis migrans
28
What is the Neer sign?
Used to test for impingement, can be positive in frozen shoulder Arm placed in forced flexion with arm fully pronated = pain = positive
29
What is Spurling’s sign?
Turn head to affected side with downward pressure on top of head Pain = impingement due to cervical radiculopathy
30
How often should barrett’s oesophagus be monitored with endoscopy?
3-5 years if no dysplasia present Low grade dysplasia = 6-12 mths High grade = 3 months
31
What do non-caseating granulomas suggest?
Sarcoidosis
32
What blood tests indicate sarcoidosis?
Hypercalcaemia High liver enzymes High ACE
33
What is the most common finding in patients with sarcoidosis?
Bilateral hilar lymphadenopathy
34
Dx of sarcoidosis
Biopsy of skin lesions | Biopsy of lymph nodes
35
H pylori eradication
Omeprazole Amoxicillin Metronidazole Clarithromycin
36
Tx of urethritis due to STI
IM ceftriaxone + doxycycline for 10 days
37
What does a Courvoisier sign indicate?
Presence of enlarged gallbladder that is non-tender + jaundiced Sign of pancreatic cancer
38
What is the triple screen for chromosomal abnormalities?
AFP, HCG + Ue3
39
What does a low AFP at screening suggest?
Trisomy 18 or 21
40
What do CD15 + CD30 positive multinucleated cells indicate?
Reed Sternburg cells = Hogkins lymphoma
41
What happens when amiodarone is combined with quinidine?
Arrhythmias due to elevated quinidine
42
What do granulocytes with multisegmented nuclei indicate?
Vit B12 or folate deficiency
43
When should colon cancer screening begin + what with?
>50 with FOB every 2 yeasr or sigmoidoscopy every 10 years
44
What will be seen in CSF of HSV encephalitis?
Normal glucose Pleocytosis High protein
45
What is the difference in presentation between meningitis + encephalitis?
Encephalitis presents with altered cerebral function
46
What is pre-diabetes?
Plasma glucose above normal (>6)
47
What is the recommended drinking limit for men + women?
15 for men, 10 for women
48
What treatment should be given with no active TB but a positive PPD?
Isoniazid for 9 months
49
Management of gasoline poisoning
Supportive
50
When should a shingles vaccine be given?
Anyone aged >60 regardless of prior shingles infection
51
How is GBS diagnosed?
CSF analysis + nerve conduction/ electromyography
52
What is GBS?
Rapidly progressing muscle weakness Comes on after infection/ surgery/ vaccine Tingling + loss of sensation in legs What is a urethral caruncle? Benign, urethral lesions found most commonly post-menopause Red, fleshy appearance
53
What is the most common complication of cataract surgery?
Decreased vision due to cystoid macular edema | Improves with time
54
What are the contraindications to MMR?
Anaphylaxis to gelatine or neomycin Immunosuppression Pregnancy
55
What antidote is used for anticholinesterase pesticides/ organophosphates?
Pralidoxime
56
What is the leading cause of death in Canada + what is its pattern?
Lung cancer | Increasing in women, decreasing in men
57
What are people with factitious disorder at risk of?
Alcohol + drug abuse | Depression
58
Where will you get the strongest evidence for treatment, screening or prevention strategies?
Meta-analyses RCTs Systematic reviews
59
What is the antidote for cyanide?
Sodium thiosulphate
60
What is the antidotes for copper overload?
Penicillamine
61
What does H influenza b cause?
Pneumonia Meningitis Epiglottitis
62
What does unencapsulated H influenza cause?
Otitis media Cojunctivitis Sinusitis
63
What is the recommended therapy for schizoid personality disorder?
Individual visits, short, with written instructions to minimise face to face contact
64
Describe hereditary spherocytosis
Autosomal dominant Presents with haemolytic anemia, jaundice, gallstones, splenomegaly Fam hx of anemia Due to mutation in gene for ankyrin + spectrin proteins What is a common cause of overflow tearing? Epiphora = commonest cause is nasolacrimal duct obstruction
65
What are the most common complications of H influenza in children?
OM + meningitis
66
What infections in kids lead to myocarditis?
Viral; commonly adenovirus or coxsackie
67
What infection is pulmonary haemorrhage a complication of?
Avian flu
68
How long should a mother wait before breastfeeding after drinking alcohol?
2-3 hours
69
What happens to TFTs during pregnancy?
T4 increased FT4I normal T3RU decreased
70
What migraine meds are contraindicated in pregnancy?
Ergotamines – cause vasoconstriction of uterine vessels
71
When is prophylactic cerclage carried out?
Between 12-14 wks gestation
72
What is the management of an asymptomatic cyst <5cm?
Re-assess with US in 8-12 weeks
73
What test is diagnostic for malignant hyperthermia?
Caffeine halothane contracture test (requires muscle biopsy)
74
What blood results would you expect with malignant hyperthermia?
High LDH + CPK
75
What neurovascular complication is most common following a proximal humerus fracture?
Axillary nerve damage – reduced sensation in shoulder patch over deltoid
76
What part of COPD management shows a reduction in mortality?
Home O2 >15 hrs a day
77
Management of massive PE
``` Fibrinolytic agent (streptokinase) unless risk of bleeding 2nd line = embolectomy ```
78
What is a green field filter?
IVC filter placed when patient has recurrent DVTs or if heparin is contraindicated
79
Causes of upper lobe fibrosis
``` CHARTS Coal workers pneumoconiosis Histiocytosis Ankylosing spondylitis Radiation TB Silicosis + sarcoidosis ```
80
What bacteria cause ventilator associated pneumonia?
Pseudomonas, Klebsiella
81
What abx are best for HAP/ ventilator associated?
Tazocin
82
Causes of respiratory acidosis
Opiates, asthma, GBS, COPD
83
Causes of respiratory alkalosis
Pain, PE, panic attack, pneumothorax
84
Causes of increased anion gap metabolic acidosis
DKA, lactic acidosis, aspirin OD
85
Causes of decreased anion gap metabolic acidosis
Diarrhea, Addisons, renal tubular necrosis
86
Causes of metabolic alkalosis
D/V, diuretics, Conns syndrome
87
Chest drain safe triangle borders
Anterior edge of lat dorsi Lateral border of pec major Line superior to horizontal level of nipple Apex below the axilla
88
Which lobe is most likely to be affected by aspiration pneumonia?
Right lower lobe
89
Describe mycoplasma pneumonia presentation
Prolonged, gradual onset Flu like symptoms + dry cough Erythema multiforme
90
Ix results for mycoplasma pneumonia
Bilateral consolidation on CXR | Thrombocytopenia, low Hb
91
Management of mycoplasma pneumonia
Erythromycin
92
When do you see coxiella burnetti?
Q fever (farm animals)
93
Typical presentation of SCC
Most present as obstructive lesions of bronchus leading to infection
94
What are the common causes of bronchiectasis?
``` TB, pneumonias, flu Childhood infections HIV CTD Congenital: CF, Kartageners ```
95
Sarcoidosis presentation
SOB, cough Skin lesions around nose; indurated plaques Joint pain Eye problems
96
TB management; how long for each abx?
Rifampicin + isoniazid = 6 months | Pyrazinimide + ethambutol = 2 months
97
What pneumonia is associated with herpes + pleuritic chest pain?
Strep pneumonia
98
Describe what Auer rods look like, and what they are linked with.
Needle shaped bodies on blood smear | Associated with AML
99
Types of megaloblastic anemia
B12 deficiency | Folate deficiency
100
Types of normocytic anemia
Haemorrhage Anemia of chronic disease Aplastic anemia Haemolytic anemia
101
Which cytokine is involved in anemia of chronic disease?
IL-6
102
Causes of aplastic anemia
Idiopathic Fanconi’s Post viral (hepatitis) Drugs (NSAIDs, penicillamine)
103
Tx of sickle cell other than supportive (+ its main SE)
Hydroxycarbamide – SE is WBC suppression
104
What is the presentation of, and cause, of subacute degeneration of spinal cord?
``` Due to B12 deficiency Triad: Upgoing plantars Loss of knee jerk Loss of ankle jerk ```
105
What do hypersegmented neutrophils on a blood smear indicate
B12 or folate deficiency
106
What are tear drop cells on a blood film associated with?
Myelofibrosis, thalassemia + megaloblastic anemia
107
When do you give cryoprecipitate?
When there is a low fibrinogen level | Eg in DIC or liver failure
108
When is prothrombin complex used?
Emergency reversal of anticoagulation
109
When do you give FFP?
Most suited for significant but not major bleeds PT or APTT increased Can be given prophylactically if there is a high risk of bleeding in surgery
110
What is the universal donor of FFP?
AB blood because there are no anti-A or anti-B abs
111
What does cryoprecipitate contain?
Factor 8, vWF, fibrinogen, factor 13 + fibronectin
112
Management of multiple myeloma
Proteasome inhibitors (Bortezomib)
113
What does pain in lymph nodes when drinking indicate?
Hodgkins lymphoma
114
Apart from HF, what else can cause increased levels of BNP?
CKD
115
What does this help you remember: MicroSoft is the Operating System?
MS has an Opening Snap
116
What does this help you remember: AR you early?
Aortic regurg is early diastolic
117
What does this help you remember: People with AS are old and SAD
Happens in older people (calcification) | SAD = Syncope, Angina, Dyspnoea
118
What bacteria causing endocarditis is likely following a dental procedure?
Strep viridans
119
What bacteria causing endocarditis is likely in IVDU?
sTAPH
120
What bacteria causing endocarditis is likely with a prosthetic heart valve?
Staph epidermitis
121
What bacteria causing endocarditis is likely in the context of an elderly patient with colon cancer/ immunocompromised?
Strep bovis/ gallolyticus
122
What is Libman Sacks endocarditis?
Non bacterial endocarditis | Heart manifestation of lupus
123
What ECG changes do you get with hypercalcaemia?
Shortening of QT interval
124
What is a globular heart associated with
Atrial septal defect
125
What is rib notching associated with?
Coarctation of the aorta
126
What does an inferior MI + AR murmur indicate?
Ascending aorta dissection (proximal)
127
What is multiple endocrine neoplasia 1?
Autosomal dominant, causes tumours in pituitary, pancreas + parathyroid Causes hyperparathyroidism and hypercalcaemia
128
What is multiple endocrine neoplasia 2?
Autosomal dominant, causes tumours | Medullary thyroid cancer, parathyroid cancer + phaeochromocytoma
129
What does macrocytosis + a raised GGT indicate?
Alcohol use
130
How do you calculate anion gap?
(sodium + potassium) 0 (bicarb + chloride)
131
What is a normal anion gap?
8-14
132
What LFT results does a paracetamol OD cause?
High ALT Normal ALP ALT/ ALP ratio high
133
What are the causes of straw coloured ascetic fluid?
Serous effusion Clear = transudate Cloudy = exudate
134
What are the causes of bloody ascetic fluid?
Trauma, malignancy, pancreatitis, perforated ulcer
135
What are the causes of turbid ascetic fluid?
SBP, perf
136
What are the causes of chylous ascetic fluid?
Malignancy, lymphoma, TB, parasitic
137
What is the SAAG?
Serum ascites albumin gradient Measures portal pressure Serum albumin – ascetic fluid albumin
138
What causes a high SAAG?
Portal HTN is cause of ascites | Portal vein thrombosis, cirrhosis, hepatitis, RHF, pericarditis
139
What causes a low SAAG
Peritoneal disease: malignancy Nephrotic syndrome, malnutrition Pancreatitis, myxoedema
140
Describe the dysphagia associated with oesophageal cancer
Associated with weight loss, anorexia, vomiting | PMH of Barrett’s, GORD, alcohol or smoking
141
Describe the dysphagia associated with oesophagitis
Dysphagia but systemically well
142
Describe the dysphagia associated with oesophageal candidiasis
Hx of HIV or steroid inhaler use
143
Describe the dysphagia associated with achalasia
Dysphagia of solids + liquids from the starts | Regurg of food leading to cough, aspiration pneumonia
144
Describe the dysphagia associated with a pharyngeal pouch
Regurg, aspiration, chronic cough Typically older men Halitosis
145
Describe the dysphagia associated with systemic sclerosis
Other features of CREST | LES pressure is decreased
146
Describe the dysphagia associated with myasthenia gravis
Extraocular muscle weakness Ptosis Dysphagia with liquids + solids
147
Causes of raised ALP with low calcium
Osteomalacia | Renal failure
148
Causes of raised ALP with high calcium
Bone mets | Hyperparathyroidism
149
Causes of raised ALP
Pregnancy Cholestasis, hepatitis, fatty liver, neoplasia Paget’s
150
How do you test for c diff?
Test stool for GDH – if positive, test for toxins
151
Management of Wilsons disease
Penicillamine
152
What is Peutz Jeghers syndrome?
Autsomal dominant Numerous polyps in GI tract – can cause intusseception Associated with freckles on lips, face, palms + soles
153
How does Budd-Chiari syndrome present?
Sudden onset abdo pain, tender hepatomegaly + ascites | Raised SAAG = portal HTN is cause
154
What does a raised ALP + normal LFTs indicate
Malignancy, particularly bone cancer/ mets
155
What is achalasia?
Failure of oesophageal peristalsis + relaxation of sphincter due to degenerative loss of ganglia from Auerbach’s plexus Causes dysphagia of both liquids + solids
156
What is pellagra + how does it present?
Deficiency of B3 (niacin) | Causes dermatitis, diarrhea, demention, death
157
What is Kantor’s string sign?
String like configuration on barium study | Indicative of Crohns
158
Difference between duodenal + gastric ulcer presentation
``` Duodenal = relieved by eating Gastric = worse with eating ```
159
What is the mackler triad?
For Boerhaave syndrome: vomiting, thoracic pain, subcutaneous emphysema
160
What is the Truelove + Witt’s criteria?
Used to assess severity of UC flare up | Looks at bowel motions, rectal bleeding, systemic symptoms, bloods
161
UC management
Topical aminosalicylates 2nd: oral aminosalicylates 3rd: oral steroids 4th: ciclosporin
162
What causes toxic megacolon?
UC + anti-diarrhea + codeine agents
163
Management of toxic megacolon
Decompression | Surgery if not improved in 24hrs
164
Management of Crohns
Corticosteroids Azathioprine IV steroids Infliximab
165
Management of variceal bleed post endoscopy
Terlipressin Ciprofloxacin Propranolol
166
Signs of hepatic failure
``` Jaundice Hepatic encephalopathy Coagulopathy SBP Hypoalbuminaemia ```
167
What is hepatic encephalopathy caused by?
Build up of ammonia
168
Management of hepatic encephalopathy
Lactulose | Rifaximin long term
169
What is the lifelong management of SBP?
Ciprofloxacin
170
What is hepatorenal syndrome + what is the management?
AKI in someone with liver disease | Treat with HAS + terlipressin
171
What cancers is EBV associated with?
Burkitt’s lymphoma Hodgkin’s lymphoma Nasopharyngeal cancer
172
Descibe typhoid fever
Abdo pain, fever, altered mental status Positive Widal test (blood test) Describe the presentation + background of Entamoeba infection Gradual onset over 1-2 weeks Diarrhea (+/- blood), abdo pain, weight loss
173
Describe the presentation + background of cryptosporidium infection
Diarrhea, sometimes with mucus
174
Abx for COPD exacerbation
Amoxicillin, tetracycline or clarithromycin
175
Abx for pyelonephritis
Cephalosporin or quinolone
176
HIV seroconversion S+S
``` Flu like symptoms Lymphadenopathy Myalgia, arthralgia Maculopapular rash Mouth ulcers Diarrhea ```
177
What bacteria is associated with Guillain Barre?
Campylobacter jejuni
178
What is the most common viral infection following solid organ transplants?
Cytomegalovirus
179
Which treatment for TB causes optic neuritis
Ethambutol
180
What bacteria is typically found on domestic/ exotic birds?
Chlamydia psittaci | Causes URTI + conjunctivitis
181
What are the features of a blood film post splenectomy?
Howell- Jolly bodies Pappenheimer bodies Target cells Irregular contracted erythrocytes

Family Medicine (10 decks)

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