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4th year Passmed > Mixed > Flashcards

Mixed Flashcards

1
Q

Reduce the absorption of levothyroxine

A

Iron/calcium carbonate tablets - Should be given 4 hrs apart.

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2
Q

Klinefelter Syndrome

A

results from 2 / > X chromosome in males.
Features: infertility + small poorly functioning testicles –> LOW testosterone w/ increased FSH/LH.

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3
Q

Androgen Insensitivity

A

X-lined recessive.
End-organ resistance to testosterone –> genetically male but phenotypically female.

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4
Q

What is the treatment of galactorrhoea?

A

Bromocriptine

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5
Q

A common source of Hep A?

A

Shellfish and travelling.

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6
Q

Anterior cerebral artery

A

Contralateral hemiparesis + sensory loss.
Lower > upper (ALU)

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7
Q

Middle cerebral artery

A

Contralateral hemiparesis + sensory loss.
Upper>lower
Contralateral homonymous hemianopia.

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8
Q

Posterior cerebral artery

A

Contralateral homonymous hemianopia w/ macular sparing.
Visual agnosia

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9
Q

Weber’s syndrome –> supplies the midbrain

A

ipsilateral CN III palsy
Contralateral weakness of upper + lower.

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10
Q

PICA –> lateral medullary syndrome

A

Ipsilateral facial pain + temp loss
Contralateral: limb / torso pain + temp loss.
Ataxia, nystagmus.

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11
Q

AICA –> lateral pontine syndrome

A

Ipsilateral: facial paralysis + deafness

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12
Q

Retinal/ophthalmic artery

A

Amaurosis fagux

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13
Q

Urgent dyspepsia referral

A

all pts who’ve got dysphagia + Abdo pain.
>55 yrs + Wt loss, Dyspepsia + Reflex.

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14
Q

Non-urgent referral

A

Haematemesis.
Pts >55 yrs, treatment-resistant dyspepsia / Abdo pain w/ low Hb.

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15
Q

AS - xray findings

A

subchrondral erosions
sclerosis
squaring of lumbar vertebrae

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16
Q

Modified Glasgow score

A

PO2 <8
Age >55
Neutrophils >15
Ca2+ <2
Renal >16
Enzymes >400 / 600
Albumin <32
Sugar >10

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17
Q

SBO symptoms

A

diffused central abdo pain
n+v
constipation (before vomiting)
bloating

CT to confirm diagnosis

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18
Q

Paget’s disease

A

Similar to eczema, it starts if the nipples and spreads to the areolas.

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19
Q

Cardiogenic shock

A

Increased SVR, HR
Reduced CO + BP.

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20
Q

Hypovolemic shock

A

blood volume depletion e.g. haemorrhage, vomiting, dehydration
Increased SVR, HR
Reduced CO + BP.

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21
Q

Septic Shock

A

Reduced SVR, HR + BP
Reduced / normal CO

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22
Q

Non-haemolytic febrile

A

Reacting go WCC in the blood bag
Fever + chills
Give paracetamol + monitor.

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23
Q

Minor allergic reaction

A

itchy + urticaria
temporally stop + antihistamine + monitor

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24
Q

Anaphylaxis

A

Due to deficiency in IgA
Reduced BP, difficulty breathing + angioedema.
IM adrenaline, O2 + Fluids.

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25
Q

Holmes - Adie pupils

A

Problems w/ dilated eyes (mydriatic) indicate parasympathetic issues.
Causes: via viral infections affecting ciliary ganglion.
Use of pilocarpine - induces mitotic effects –> inducing ciliary contraction.

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26
Q

Dry macular Degeneration

A

Progressive, subacute lloss
Difficulty seeing in the dark
Distorted Lines

Initial investigation - slit lamp microscopy
Fluorescein - the presence of neovascularization.

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27
Q

Guttate P

A

To occur 2 - 4 weeks after a sore throat.
Resolves 2 - 3 months.

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28
Q

P. rosea

A

Oval lesion running parallel to the line of langer.
Resolves 6 - 12 weeks.

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29
Q

Used to calculate the volume of fluids in burns

A

Parkland

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30
Q

Most aggressive form of melanoma

A

Nodular melanoma –> grows rapidly –> deep layer.

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31
Q

Management of angina

A

GTN (acute)
Aspirin (Anti-platelet).
Atenolol (BB - prophylaxis)
Atrovastatin (statin)
Amlodapine (if used as combo)

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32
Q

Investigation for angina

A

CT angiogram and exercise intolerance test

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33
Q

Anginal Pain

A
  1. Discomfort in the chest, or in the neck, shoulders, jaw or arms.
  2. precipitated by physical exertion
  3. relieved by rest or GTN in about 5 minutes
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34
Q

Angina investigation

A

CT Angiogram –> Gold Standard.
Non-invasive functional imaging (looking for reversible myocardial ischaemia).

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35
Q

S3 sound

A

Caused by HF –> Dilated ventricles

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36
Q

S4 sound

A

Caused by hypertrophic cardiomyopathy

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37
Q

Whats preserved in MND

A

External ocular muscle.

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38
Q

Ectopic size <35, asymptomatic, unruptured

A

close monitoring

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39
Q

ectopic size <35, no pain &fetal heartbeat, <1500.

A

medical management

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40
Q

Fetal heart detected, pain / ruptured / size >35.

A

surgical

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41
Q

< 6 weeks for miscarriage

A

Expectant

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42
Q

> 6 weeks of miscarriage

A

Misoprostol (Medical management)

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43
Q

Primary dysmenorrhoea

A

NSAIDs + COCP.

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44
Q

Termination of <9 weeks

A

anti-progesterone followed prostaglandin 2 days later.

45
Q

Termination of >13weeks

A

Surgical dilation

46
Q

Initial management of fibroids

A

Transaminic acid, NSAIDs / POP.
IUS –> if the uterus is not distorted.

47
Q

Older lady with labial lump + inguinal lymphadenopathy + itchy

A

Vulval cancer

48
Q

Acute hypersensitivity pneumonitis

A

Caused by exposure to organic dust.
Onset, 4 - 6 hrs

49
Q

Chlamydia psittaci

A

Atypical pneumonia, is found in domesticated + exotic birds.
Acute/chronic conjunctivitis, but presentation can range from mild flu-like illness –> multi-organ failure.

50
Q

Why you should not mix both iron and levothyroxine tablets?

A

Iron tablets reduced the absorption of levothyroxine - should be given 4 hrs apart.

51
Q

Mechanism of Desmopressin?

A

Vasopressin V2 receptor agonist.

52
Q

Features of Non-haemolytic febrile reaction

A

Fever, chills - most likely from platelets than RBC transusion.

53
Q

Feature of minor reactions?

A

Pruritis, urticaria

54
Q

Feature of Anaphylaxis?

A

Hypotension, dyspnoea, wheezing, angioedema

55
Q

Cataracts

A

generalised reduced acuity.
Assoc. w/ advancing age + smoking.

56
Q

Age-related macular degeneration

A

leads to the gradual worsening central visual field.
Assoc. w/ age and smoking.

57
Q

Post-partum contraception?

A

Pop can be started immediately
IUD, can be inserted w/in 48hr or after 4 weeks.

58
Q

Pemphigoid gestations

A

Starts periumbilical area and can cause blisters.

59
Q

Polymorphic eruption of pregnancy?

A

Pruritic condition.
Periumbilical area often spared.

60
Q

CT scan within 1 hr?

A

> 1 vomiting
Signs of basil skull fracture
Open/depressed skull fracture
Focal deficit
Post-traumatic seizures

61
Q

Why do steroids increase blood glucose?

A

opposes the action of insulin + stimulates hepatic gluconeogenesis.

62
Q

New onset of HIGH BP, retinal haemorrhages / papilloedema?

A

Same day specialist assessment.

63
Q

Blood film seen in coeliac patients?

A

target cells + Howell-Jolly bodies –> Hyposplenism.

64
Q

Drugs that may exacerbate haemolysis?

A

Antimalarials e.g. primaquine
Ciprofloxacin
Sulph-group drugs

65
Q

Sister mary joseph nodes?

A

is periumbilical lymphadenopathy.
Seen in gastric cancer/cholangiocarcinoma.

66
Q

Treatment for acute confusion state?

A

haloperidol / olazapine.

67
Q

Group for transfusion <30x10?

A

Significant bleeding e.g. haematemesis, melaena, prolonged epistaxis.

68
Q

Group for transfusion <100x10?

A

bleeding at critical sites, such as the CNS.

69
Q

Pre-invasive procedure w/ thrombocytopenia?

A

> 50×109/L for most patients

70
Q

Likely organism in young patients with septic arthritis who is sexually active?

A

Neisseria gonorrhoeae

71
Q

Patient recently undergone chemo for cancer, presenting with fever?

A

Neutropenic sepsis - require IV broad antibiotics.

72
Q

Takotsubo cardiomyopathy

A

known as broken heart syndrome
induced by severe stress
can cause MI like symptoms - ST elevation

73
Q

Airway Management - pt with stridor

A

oropharyngeal airway

74
Q

Most common hepatitis in patients who have travelled and are vaccinated?

A

Hepatitis E

75
Q

Common Hepatitis in the UK?

A

Hepatitis E

76
Q

Epididymal cyst features?

A

scrotal swelling can be palpated as separate from the testicles. Found posterior to testicles.

77
Q

horners syndrome?

A

Sympatheitic issue causing horners syndrome. ptosis + pupil constriction (miosis) = horners.

78
Q

Turners syndrome

A

Aortic stenosis - systolic ejection murmur due to bicuspid aortic valve.

79
Q

Most common cause of discitis?

A

S. aureus

80
Q

Fever/back pain with pain on extension of the hip

A

iliopsoas abscess

81
Q

Rheumatic Fever

A

Occurs 2 - 4 weeks after strep throat.
Joint pain - larger joints
Carditis
Erythema Marginatim

82
Q

Cut-off for Iron?

A

First trimester <110g
Second Trimester <105g
Pospostpartum <100g

83
Q

Common causes of chronic pancreatitis?

A

Alcohol, haemochromatosis, smoking, hypercalcaemia, cystic fibrosis.
CT scan - diagnostic.

84
Q

48 hrs after MI

A

Pericarditis –> worse on lying flat.

85
Q

2 - 6 weeks after MI

A

dresslers syndrome - treat w/ NSAIDs.

86
Q

1 - 2 weeks after MI

A

Left ventricular free wall rupture –> cardiac tamponade.

87
Q

Children’s fluid management?

A

100m –> 50 –> 20

88
Q

Mononeuritis multiplex presentation?

A

Acute/subacute loss of sensory + motor function.
Usually, asymmetric –> can progress to symmetrical –> common in diabetics.

89
Q

Pt w/ bells palsy has not improved within 3 weeks

A

Refer to an ENT specialist.

90
Q

Ejection systolic

A

Load on expiration - aortic stenosis + HOCM
Load on inspiration - pulmonary stenosis, ASD

91
Q

Holosystolic (pan systolic)

A

Mitral / tricuspid regurg, VSD

92
Q

Non-haemolytic Febrile Reaction

A

Fever, Chills –> slow/ stop transfusion, paracetamol.

93
Q

Minor Allergic reactions

A

Pruritus, Urticaria –> Temporarily Stop Transfusion + Antihistamines.

94
Q

Anaphylaxis

A

Hypotension, Dyspnoea, Wheezing + angioedema –> stop transfusion, IM adrenaline.

95
Q

Acute Haemolytic Reactions

A

Fever, abdo pain + hypotension –> stop transfusion + resus.

96
Q

Alcoholic Withdrawal -Start of symptoms?

A

6 - 12 hrs, tremors, sweating, tachycardia + anxiety

97
Q

Alcoholic Withdrawl - Seizures

A

36hrs

98
Q

Alcoholic Withdrawl - Delirium tremens

A

48 - 72hrs, coarse tremor, confusion, delusions, auditory + visual hallucinations, fever, tachycardia

99
Q

Presentation of Herpes?

A

Painful ulcer, headaches, fever, malaise.
Tender inguinal lymphadenopathy.

100
Q

Investigation of choice for Genital Herpes?

A

NAAT

101
Q

What is the difference between scarlet and Kawasaki?

A

Scarletspares palms and soles and Kawasaki does not.

102
Q

Risk factors for prematurity?

A

Resp Distress Syndrome
Intraventricular Haemorrgaes
Necrotizing Enterocolitis
Chronic lung disease
Retinopathy of Prematurity
Hearing Problems

103
Q

Complications of Diverticular Disease?

A

Colovaginal fistula - Abnormal connection between two viscera.
- Happens during an acute phase.

104
Q

Iliotibial Band Syndrome

A

Lateral knee pain in runners.

105
Q

Risk factors for pseudogout?

A

Haemochromatosis
Hyperparathyroidism
Low magnesium, low phosphate
Acromegaly, Wilson’s disease

106
Q

Measles

A

Irritable, conjunctivitis, fever
Koplik spots: white spots
Rash starts in the ear and then spreads.

107
Q

Mumps

A

Fever, malaise, muscular pain
Ear pain on eating.

108
Q

Down syndrome Features?

A

Face: upslanting palpebral fissures, protruding tongue, small low set ears, round face.
Flat occiput
single palmar crease
hypotonia
CHD: ASD, ASVD.
Duodenal atresia
Hirschsprung’s disease
Short stature.
Repeated Resp infection: glue ear etc.
Atlantoaxial instability

4th year Passmed (1 decks)

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