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Y3 Clinical Case Revision > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

indications for nutritional support

A

BMI < 18.5 kg/m^2
unintentional weight loss of > 10% in 3-6 months
BMI of < 20 kg/m^2 + unintentional weight loss of greater than 5% in 3-6 months

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2
Q

refeeding syndrome definition

A

potentially fatal shifts in electrolytes following feeding in malnourished individuals (^ protein intake than before)

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3
Q

refeeding syndrome predispositions

A 
low energy diet
obese + sudden, profound weight loss
stress
malabsoptive syndrome (IBD / pancreatitis)
anorexia
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4
Q

how can refeeding syndrome be prevented?

A

prophylactic vitamin B + thiamine

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5
Q

complications of blood transfusions

A

clotting abnormalities
electrolyte abnormalities
acute haemolytic reaction
transfusion associated circulatory overload
transfusion related acute lung injury (acute respiratory distress syndrome)

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6
Q

what are respiratory and physiological post-operative complications

A 
DVT / PE
pressure ulcers
XS fluid production (mediastinal surgeries) > acute respiratory distress syndrome 
inflammation
infection 
compartment syndrome
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7
Q

vitamin B12 anaemia picture

A

microcytic anaemia

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8
Q

erythromycin effect on other drugs

A

potent hepatic enzyme inhibitor > drug toxicity

eg. digoxin, phenytoin, lithium, warfarin and theophylline

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9
Q

warfarin route of administration

A

oral

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10
Q

warfarin moa

A

vitamin K antagonist

acts on extrinsic clotting pathway

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11
Q

warfarin effect on renal function

A

no effect

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12
Q

warfarin indications

A

DVT / PE treatment
stroke prevention in AF
prevention of recurrent TIA / stroke
VTE prevention post prosthetic heart valve

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13
Q

assessment of pancreatic function

A

clinical judgement

faecal elastase

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14
Q

raised faecal calprotein

A

gastrointestinal inflammation

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15
Q

perforations causing retroperitoneal free air

A

3rd part of duodenum
ascending colon
descending colon

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16
Q

sepsis definition

A

life threatening organ dysfunction caused by abnormal and uncontrolled host response to an infection

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17
Q

septic shock definition

A

sepsis with hypotension despite aggressive fluid resuscitation

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18
Q

first line antibiotic in MRSA infection

A

vacomycin

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19
Q

first line antibiotic in ? sepsis

A

meropenem

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20
Q

first line antibiotic in acute bacterial prostatitis

A

ciprofloxacin

penetrates prostate well

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21
Q

causes of post operative fever

A 
wind 
water
wound 
walking 
wonder drugs
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22
Q

first line antibiotics for large anastomotic leak

A

meropenem

tazocin

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23
Q

first line antibiotic for staph aureus wound infection post operatively

A

flucloxacillin PO 500mg QDS for 5 days

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24
Q

red flags of back pain

A 
TUNAA FISH 
trauma
unexplained weight loss
neurological sx
age > 50 
fever
intravenous drug use
steroid use
hx of ca
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25
Q

first line antibiotic for osteomyelitis

A

IV flucloxacillin

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26
Q

complications of osteomyelitis

A

sepsis
recurrent infection
chronic osteomyelitis
growth disturbances in children

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27
Q

first line antibiotics in patient with septic arthiritis

A

flucloxacillin IV

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28
Q

first line antibiotics in patient with septic arthritis and first line contraindication

A

ie. penicillin allergy

= clindamycin

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29
Q

urinary tract tubercolosis presentation

A 
travel history
flank pain
dysuria
polyuria
haematuria
X renal calculi on XR KUB 
X pregnancy
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30
Q

risk factors of Forier’s gangrene

A 
= necrotising fasciitis of scrotum and perineal area
DM
alcohol XS
poor nutrition
steroid use
malignancies
trauma
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31
Q

most common organism in lactational mastitis

A

staphylococcus aureus

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32
Q

RFs of pilonidal sinus

A

sedentary
poor hygeine
obesity
male

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33
Q

haemophilia A inheritance pattern

A

X linked recessive

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34
Q

haemophilia A diagnosis

A

Factor VIII assay

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35
Q

haemophilia A management

A

minor bleeds - desmopressin

major bleeds - recombinant factor VIII

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36
Q

haemophilia B inheritance pattern

A

X lined recessive

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37
Q

haemophilia B diagnosis

A

factor IX assay

38
Q

reversal agent for DOAC (dabigatran)

A

idarucizumab

39
Q

reversal agent for warfarin

40
Q

reversal agent for heparin

A

protamine sulfate

41
Q

most diagnostic test for ACL injury

A

Lachman’s

42
Q

ASA score of pt with uncontrolled HTN

43
Q

BMI of pt with ASA score of 4

44
Q

management of intracapsular #: independent / poorly mobilising

A 
independent = total hip replacement 
immobile = hemiarthroplasty
45
Q

nephropathic ulcer presentation

A 
history of DM
punched out appearache
poor healing
granulated base
painless
46
Q

venous ulcer management

A

ABPI (<0.8 not indicated for multilayer compression bandaging)
Multilayer compression bandaging

47
Q

Ductal papilloma presentation

A

UL blood stained discharge

= harmless growth behind nipple, malignant potential (tx: surgical excision)

48
Q

duct ectasia presentation

A

green brown discharge
access with puss discharging
red swollen warm
= due to duct dilation

49
Q

menopausal breast manifestation

A

BL clear-white nipple discharge

due to hormonal changes

50
Q

breast access presentation

A

temperature
unwell
red swollen sore breast

51
Q

galactocele presentation

A

UL milky creamy discharge

= due to a clogged duct

52
Q

most likely hernia in women

53
Q

first line investigation for biliary pathology

A

transabdominal USS

CT = gold standard but not first line

54
Q

venous ulcer presentation

A 
gaiter region 
localised swelling
erythema
shallow 
irregular borders
55
Q

arterial ulcer presentation

A 
small lesion
well defined border
necrotic base
located at pressure area
RFs = smokers, HTN, DM
56
Q

RFs for varicose veins

A

prolonged standing
obestiy
Fx
pregnancy

57
Q

TCC haematuria

A

painless (without secondary infections)

58
Q

malaria diagnosis

A

THREE blood films (before it can be excluded)

59
Q

Drug induced lupus causes

A 
CHIMP
Carbamazepine / chlorpromazine
Hydralazine
Inflizimab / isoniazid 
Minocycline / Minoxidil
Penicillamine / Procainamide / Pyrazinamide
60
Q

RCC biopsy findings

A

clear cells (+hx of mass on L kidney)

61
Q

immune suppression suitable in pregnancy

A

azathioprine
hydroxychloroquine
steroids

62
Q

testing found on individuals with hepatitis vaccine

63
Q

testing found on individuals with previous hepatitis infection

A

Anti-HBc

Anti-HBs

64
Q

testing found on individuals with acute hepatitis

A

HBsAg
Anti-HBs
IgM Anti-HBc

65
Q

testing found on individual with chronic hepatitis

A

HBsAg

IgG Anti-HBc

66
Q

COPD step up management

A

SABA / SAMA

+ LABA + ICS + LAMA

67
Q

C diff antibiotic

A

ORAL vancomycin QDS 125mg for 10 days

68
Q

how many classes of NYHA

69
Q

macroprolacinoma presentations

A 
M > F
visual field defect (enlarged pituitary gland pressing on optic chasm)
decreased libido
brest enlargement 
milky discharge from nipples
70
Q

microprolacinoma presentation

A

F > M
F: menstural disturbances, galactorrhea, infertility
M: v libido, gynaecomastia, milky nipple discharge, hypogonadism

71
Q

otitis externa most likely organism

A

pseudomonas aerginosa
staphylococcus aureus
FUNGAL = over treatment of topical Abx

72
Q

otitis medial most likely organism

A

streptococcus pneumonia
moraxella catarrhalis
haemophillus influenzae

73
Q

most common heart defect

74
Q

most common heart defect associated with Down’s syndrome

75
Q

first line contraceptive used for heavy periods

76
Q

core sx of depression

A

severe low mood
lack of enjoyment in any activities for the last 4 weeks
lack of energy

77
Q

criteria for referral to specialist assessment for a pt with HTN

A

Clinic HTN 180/120 and higher
with signs of retinal haemorrhage / papilloedema OR life threatening sx (new onset confusion, chest pain, HF signs, AKI)
same day specialist assessment

78
Q

What should guide decisions regarding contraceptive prescribing

A

Fraser guidelines

Gillick competence

79
Q

HbA1c target in diabetic patients

A

Standard: 48 mmol/mol
On 1 medication that is associated with hypOglycaemia: 53 mmol/mol
Nb. add second drug if it rises to 58 mmol/mol

80
Q

Acute Gout management

A

NSAIDS (contraindicated in PUD)

colchicine

81
Q

management of meningitis in primary care

A

IM benzylpenicillin

82
Q

what drug commonly causes ankle oedema

A

amlodipine (CCB)

83
Q

Shingles management

A

Sx < 3 days: aciclovir

Sx >3 days: amitriptyline

84
Q

paracetamol overdose management

A

ingestion <1 hr ago AND dose > 150 mg/kg = PO charcoal
OR
N-acetylcysteine

85
Q

how does a paracetamol overdose affect the liver

A

paracetamol undergoes hepatic sulfaten and glucuronidatoin > non-toxic metabolites being excreted in the urine > ALF

^^^ paracetamol > saturation of pathways > ^ NAPQI formation (hepatotoxic - > mitochondrial injury / hepatocyte death)

v liver stores of GSH (glutathione - normally prevent ROS damage by combining with NAPQI and is renally excreted)

86
Q

most likely organism in quinsy

A

strep pyogenes

87
Q

drugs to stop pre surgery

A 
CHOW
clopidogrel 7 days before
hypoglycaemic agents - insulins night before, metformin day of
OCP 4 weeks before 
Warfarin 5 days before
88
Q

drugs to alter pre surgery

A

SC insulin - to VRII

LT steroids - switch to IV hydrocortisone

89
Q

drugs to start pre surgery

A 
fluids if NBM
prophylactic Abx (if breast, prosthetics ie. ortho, GI, vasc)
VTE prophylaxis (TEDs, LMWH)
90
Q

management of malignant hyperthermia

A

dantrolene

reaction to induction of anaesthetic agent

Y3 Clinical Case Revision (17 decks)

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