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Y4 > Misc Knowledge > Flashcards

Misc Knowledge Flashcards

1
Q

Primary pneumothorax over 2cm or with symptoms should be treated with

A

Aspiration

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2
Q

Secondary pneumothorax over 2cm should be treated with

A

Chest drain

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3
Q

Tension pneumothorax should be treated with

A

Needle decompression

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4
Q

Patient that has received adequate fluid resuscitation and antibiotics for sepsis but still extremely hypotensive. What should be given to the patient?

A

Patient needs some inotropic support

  • adrenaline infusion
  • adrenaline would vasoconstrict vessels
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5
Q

Common location for venous ulcer?

A

Medial malleolus

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6
Q

haemosyderin pigmentation

  • artial ulcer
  • venous ulcer
A

Venous ulcer

- it is a sign of venous insufficiency

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7
Q

Which investigation do you do to give you the definitive diagnosis of hodgkins lymphoma

A

Excisional biopsy of lump

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8
Q

Patient with longstanding (several years) deep hoarse voice. No other symptoms. What is the likely diagnosis?

A

Renkie’s oedema

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9
Q

IF patient taking ICS inhaler for asthma gets oral thrush, what should you change about management?

A

Get patient to use spacer device

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10
Q

35 year old woman with painless axillary lump. Should she be referred via 2 week wait pathway to breast clinic?

A

Yes

- any woman over 30 with painless axillary lump

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11
Q

Post partum thyroiditis will show

  • hypothyroid
  • hyperthyroid

What is the initial treatment?

A

Hyperthyroid

Initial treatment is propranolol for symptomatic relief

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12
Q

Endoscopic biopsy of oesophagus shows “granulation tissue with a layer of necrotic debri on surface” this makes you think

  • tumour invasion
  • candidiasis
  • oesophageal varices
  • oesophageal ulceration
A

Oesophageal ulceration

- granulation tissue is characteristic of the base of a peptic ulcer

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13
Q

MODY ahs what inheritance pattern

A

Autosomal dominant

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14
Q

Patients with bronchiectasis often have a nonproductive/productive cough?

A

Productive

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15
Q

If an anti depressant is started in a patient who is suicidal, when should the patient be followed up?

  • 1 week
  • 1 month
A

1 week

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16
Q

Exudative pleural effusion

- protein is high/low

A

High

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17
Q

Exudative pleural effusion causes

A

Caused by inflammation which makes protein leak out

  • lung cancer
  • pneumonia
  • tuberculosis
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18
Q

Transudative pleural effusion causes

A

Causes of fluid shifting

  • heart failure
  • hypoalbuminaemia (nephrotic syndrome, liver disease)
  • hypothyroidism
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19
Q

Primary pneumothorax, completely asymptomatic and under 2cm. what is the management?

A

Conservative - send home

repeat CXR in 1 month

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20
Q

First line treatment of tonic clonic seizure in woman of child bearing age

A

Lamotrigine

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21
Q

What is the first line treatment for absence seizure

A

Ethosuximide and sodium valproate

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22
Q

What is the first line treatment for focal seizure

A

Lamotrigine, carbamazepine

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23
Q

Cervical myelopathy has UMN / LMN signs?

A

UMN

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24
Q

Which imaging is best for cervical myelopathy?

A

MRI

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25
Q

Lumbar puncture findings BACTERIAL meningitis

A

Neutrophils
High protein
Low glucose (bacteria eats glucose)

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26
Q

Lumbar puncture findings VIRAL meningitis

A

Lymphocytes
High protein
Normal glucose (viruses don’t eat glucose)

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27
Q

Headache + fever + seizure + rash
+ NO NECK STIFFNESS
makes you think

A

Encephalitis

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28
Q

extradural haematoma

  • clinical feature
  • where is the bleed
  • which vessel involved
A

Clinical feature: lucid interval
Bleed: between dura and skull
Vessel: middle meningeal artery

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29
Q

Subdural haematoma

  • clinical feature
  • where is the bleed
  • which vessel is involved
A

Clinical feature: gradual decline, elderly
Bleed: between dura and arachnoid matter
Vessel: bridging veins

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30
Q

Someone with a GCS less than 8, what is the first thing you should think of

A

Intubate

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31
Q

Posterior communicating artery aneurysm causes CN? palsy?

A

CN 3

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32
Q

Cavernous sinus thrombosis causes CN? palsy

A

CN 6

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33
Q

GBS

  • CNS or PNS
  • which type of cells
  • UMN / LMN
A

PNS
Schwann cells
LMN signs

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34
Q

MS

  • CNS or PNS
  • which type of cells
  • UMN / LMN
A

CNS
Oligodendrocytes
UMN

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35
Q

Diagnostic test for myaesthenia gravis

A

Repetitive muscle stimulation test

- muscles are fatiguable

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36
Q

Name 2 eye pathologies that can occur with MS

A

Optic neuritis

Internuclear ophthalmaplaegia

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37
Q

Patient has a stroke that affects legs. Which is likely artery

A

Anterior cerebral artery

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38
Q

Patient has a stroke that affects arms and face. Which is the likely artery

A

Midddle cerebral artery

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39
Q

What is the treatment of haemorrhagic stroke

A

Good BP control

- control the bleeding

40
Q

What is the treatment of ischeamic stroke

A

Aspirin

Thrombolysis within 4.5 hours

41
Q

CN3 palsy - dilated/constricted pupils

A

DILATED

42
Q

On ophthalmoscopy you see flame shaped haemorrhages in all 4 quadrants. What does this make you think?

A

CRVO

43
Q

Conjunctival injection
DIlated pupil
hazy cornea
these make yu think of which diagnosis

A

Acute angle closure glaucoma

44
Q

Which acute angle closure glaucoma treatment reduces aqueous production

A

TImolol

45
Q

elderly patient with unilateral ptosis and miosis. They also have cough, weight loss and change in voice. What is the most likely cause of this pateint’s horners syndrome?

A

Pancoast tumour

46
Q

Young male with unilateral ptosis and miosis. He has a severe headache and neck pain. What is the most likely cause of this patient’s horners syndrome?

A

Carotid dissection

47
Q

Bilateral dilated pupils

A

Holmes adie pupil

48
Q

Bilateral constricted pupils

A

Argyll Robertson pupil

49
Q

Patient with CKD needs IV contrast for an investigation. What is the most appropriate treatment to be given before the IV contrast?

A

0.9% sodium chloride infusion

50
Q

Patient with rhabdomyolysis and hypovolaemia after long lie on floor. Which is most likely to cause an AKI?

A

Hypovolaemia

51
Q

Best investigation for a ?C spine fracture

A

CT neck

52
Q

nuclear enlargement, hyperchromasia and pleomorphism are features that suggest

A

cancer

53
Q

Investigations for infective endocarditis

A

TOE

Blood cultures

54
Q

Who tends to get primary hyperparathyroidism

  • elderly / young
  • female / male
A

Elderly female patients

55
Q

Hypercalcaemia, High PTH, hypercalciuria, abnormal renal function. What is most likely

  • primary hyperparathyroidism
  • secondary hyperparathyroidism
  • tertiary hyperparathyroidism
A

Tertiary hyperparathyroidism

56
Q

If someone post op develops paralytic ileus, what should you do?

A

NG tube

57
Q 
painful swelling in groin and pain when opening bowels. Unprotected anal sex with a new male partner 4 weeks ago. perianal ulcer and tender inguinal lymphadenopathy.
What is the likely diagnosis? 
Genital herpes 
HIV seroconversion 
Lymphogranuloma venereum 
Secondary syphilis
A

Lymphogranuloma venereum

58
Q

WHich artery may be a source of major haemorrhage in peptic ulcer disease

A

gastroduodenal artery

59
Q

Management of spinal cord compression in a frail elderly patient

A

External beam radiotherapy

60
Q

Which condition characteristically causes haematuria A FEW DAYS after URTI

  • post infectious glomerulonephritis
  • IgA nephropathy
A

IgA nephropathy

61
Q

At which time period after URTI does post infectious glomerulonephritis happen

A

A few weeks after URTI

62
Q

Tend to put weight on / lose weight in duodenal ulcer

A

Put on weight

- as it is associated with releif with eating

63
Q

In which part of the brain are changes most likely to be found in early alzheimers disease?

A

Temporal lobe - this is where the hippocampus is located

64
Q

Tri-cyclic antidepressant overdose. Which drugs is used to reverse?

A

Sodium bicarbonate

65
Q

If patient receiving blood transfusion has a TACO, how is this managed?

A

IV furosemide

66
Q

56 year old diabetic patient with hypertension. What is first line management

A

ACE inhibitor

67
Q

Which investigation is used to diagnose idiopathic pulmonary fibrosis?

A

High resolution CT scan

68
Q

confusion, visual hallucinations, tachycardia and pyrexia on the background of heavy alcohol use.

  • wernickes encephalopathy
  • korsakoff syndrome
  • delerium tremens
A

Delerium tremens

69
Q

Which nerve is affected here:

Sensation lost below the knee, except for the medial leg.

A

Sciatic nerve

70
Q

Painful red swelling on face with characteristically well defined edge. What is the likely diagnosis and management?

A

Diagnosis: erysipelas
Management: IV antibiotics

71
Q

What is the recommended treatment for asystole

A

Adrenaline

- defibrillation wont work as it is non shockable rhythm

72
Q

patient with an unprovoked DVT, which investigation should they be offered?

A

CT abdo pelvis

- look for malignancy

73
Q

All patient with mechanical heart valves require treatment with which 2 medications

A

Aspirin

Warfarin

74
Q

If blood tests and urine/serum osmolality suggests cranial diabetes insipidus….what is the next investigation?

A

MRI pituitary

75
Q 
Which airway device provides protection for the lungs from regurgitated stomach contents? 
A. Guedel (oral) airway 
B. i-gel (supraglottic) airway 
C. Laryngeal mask airway 
D. Nasopharyngeal airway 
E. Tracheal tube
A

E - tracheal tube

76
Q

What is the screening test for haemochromatosis?

A

Transferrin saturatin

77
Q

Hx suggestive of PE.
Which is the most appropriate next investigation?
A. Chest X-ray
B. CT pulmonary angiography
C. D dimers
D. Echocardiography
E. Ventilation/perfusion isotope lung scan

A

A - chest X ray
- If a patient presents with signs or symptoms of pulmonary embolism (PE), carry out an assessment of their general medical history, a physical examination and a chest X ray to exclude other causes before definitive investigations

78
Q

Calculate wells score and this is low. Which investigation is done
B. CT pulmonary angiography
C. D dimers
D. Echocardiography
E. Ventilation/perfusion isotope lung scan

A

C - d-dimers

79
Q

Calculate wells score and this is high, which investigation is done
A. Chest X-ray
B. CT pulmonary angiography
C. D dimers
D. Echocardiography
E. Ventilation/perfusion isotope lung scan

A

B. CT pulmonary angiography

80
Q

well-defined, non-tender spherical 1 cm mass on the right side of the scrotum. It is superior to the testis and transilluminates.
Is this
- A - epididymal cyst
- B - hydrocele

A

Epididymal cyst
- Separate and can get above mass which is cystic is an epididymal cyst (spermatocele) which is benign and usually asymptomatic and managed conservatively. Although a hydrocele trans illuminates it would surround the testis.

81
Q

Aside from staph aureus, what is the most common organism causing cellulitis in the leg?

A

Strep pyogenes

82
Q

What is the first line treatment for superficial thrombophlebitis?

A

NSAID

83
Q

Patient with T2DM. Due to go to surgery.
Which is the most appropriate plan for managing her diabetic medication?
A. Continue both drugs and start a variable-rate insulin infusion
B. No change to usual medication
C. Omit both drugs and start a variable-rate insulin infusion
D. Omit gliclazide and continue metformin
E. Omit metformin and continue gliclazide

A

D - omit gliclazide and continue metformin

- no need for insulin since patient can take metformin after op at lunch

84
Q

Patient with SVC obstruction. What is the initial management

A

IV Dexamethasone

- this reduces tumour swelling

85
Q

Nephrotic syndrome in adults requires which investigation?

A

Renal biopsy

86
Q

If someone has malrotation, will vomit be bilous or not?

A

Bilous

87
Q

Investigation for pyloric stenosis

A

US

88
Q

Short duration acute low back pain in fit person.
Which is the most appropriate advice?
A. Avoid work until the pain has completely settled
B. Back strengthening exercises
C. Bed rest until pain improves, then gradual mobilisation
D. Continue usual activity
E. Self referral for physiotherapy

A

D

89
Q

What is the first line medication for neuropathic pain

A

Amitryptiline

- also pregablin, gabapentin, duloxetine

90
Q 
If a patient has had a massive PE and is also at risk of acute haemorrhage, which medication should be adminitered initially? 
A. Insertion of vena cava filter 
B. Intravenous alteplase
C. Intravenous heparin
D. Apixaban
A

C

91
Q

What is the recommended first line investigation for renal stones

A

CT KUB

92
Q 
Patient with painful swollen wrist. Joint aspiration carried out and reveals 
- no organisms on gram stain 
- no crystals 
- very high WCC 
What is the management? 
A. Inject steroid into the joint
B. No further treatment pending culture results 
C. Start IV fluclox
D. Start oral colchicine
E. Start oral prednisolone
A

C
- The gram stain is positive in about 50% of cases, so a negative gram stain does not mean there is no infection. Intravenous antibiotics should be started pending culture results.

93
Q 
SOB 2 hours after removal of chest drain. 
Which is the most likely diagnosis?
A. Aspiration pneumonia 
B. Pneumothorax
C. Pulmonary embolism 
D. Pulmonary oedema
E. Recurrence of effusion
A

B

94
Q

What is the best investigation of an acute abdoment following surgery?

A

CT scan (with contrast)

95
Q

A 27 year old male with polycystic kidney disease presents with sudden onset headache and collapse. On admission to emergency department his blood pressure 190/105 mmHg, tachycardic with a Glasgow Coma Score of 7/15. He is intubated and transferred for a CT scan. The scan reveals a subarachnoid haemorrhage. He is transferred to the critical care unit for monitoring.
Which medication should be prescribed to reduce the chance of any acute complications?

	A.	Labetalol
	B.	Mannitol
	C.	Ramipril
	D.	Furosemide
	E.	Nimodipine
A

E - nimodipine

- this is used to prevent vasospasm

Y4 (23 decks)

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