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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
Holmes - Adie pupils
Problems w/ dilated eyes (mydriatic) indicate parasympathetic issues. Causes: via viral infections affecting ciliary ganglion. Use of pilocarpine - induces mitotic effects --> inducing ciliary contraction.
26
Dry macular Degeneration
Progressive, subacute lloss Difficulty seeing in the dark Distorted Lines Initial investigation - slit lamp microscopy Fluorescein - the presence of neovascularization.
27
Guttate P
To occur 2 - 4 weeks after a sore throat. Resolves 2 - 3 months.
28
P. rosea
Oval lesion running parallel to the line of langer. Resolves 6 - 12 weeks.
29
Used to calculate the volume of fluids in burns
Parkland
30
Most aggressive form of melanoma
Nodular melanoma --> grows rapidly --> deep layer.
31
Management of angina
GTN (acute) Aspirin (Anti-platelet). Atenolol (BB - prophylaxis) Atrovastatin (statin) Amlodapine (if used as combo)
32
Investigation for angina
CT angiogram and exercise intolerance test
33
Anginal Pain
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
34
Angina investigation
CT Angiogram --> Gold Standard. Non-invasive functional imaging (looking for reversible myocardial ischaemia).
35
S3 sound
Caused by HF --> Dilated ventricles
36
S4 sound
Caused by hypertrophic cardiomyopathy
37
Whats preserved in MND
External ocular muscle.
38
Ectopic size <35, asymptomatic, unruptured
close monitoring
39
ectopic size <35, no pain &fetal heartbeat, <1500.
medical management
40
Fetal heart detected, pain / ruptured / size >35.
surgical
41
< 6 weeks for miscarriage
Expectant
42
> 6 weeks of miscarriage
Misoprostol (Medical management)
43
Primary dysmenorrhoea
NSAIDs + COCP.
44
Termination of <9 weeks
anti-progesterone followed prostaglandin 2 days later.
45
Termination of >13weeks
Surgical dilation
46
Initial management of fibroids
Transaminic acid, NSAIDs / POP. IUS --> if the uterus is not distorted.
47
Older lady with labial lump + inguinal lymphadenopathy + itchy
Vulval cancer
48
Acute hypersensitivity pneumonitis
Caused by exposure to organic dust. Onset, 4 - 6 hrs
49
Chlamydia psittaci
Atypical pneumonia, is found in domesticated + exotic birds. Acute/chronic conjunctivitis, but presentation can range from mild flu-like illness --> multi-organ failure.
50
Why you should not mix both iron and levothyroxine tablets?
Iron tablets reduced the absorption of levothyroxine - should be given 4 hrs apart.
51
Mechanism of Desmopressin?
Vasopressin V2 receptor agonist.
52
Features of Non-haemolytic febrile reaction
Fever, chills - most likely from platelets than RBC transusion.
53
Feature of minor reactions?
Pruritis, urticaria
54
Feature of Anaphylaxis?
Hypotension, dyspnoea, wheezing, angioedema
55
Cataracts
generalised reduced acuity. Assoc. w/ advancing age + smoking.
56
Age-related macular degeneration
leads to the gradual worsening central visual field. Assoc. w/ age and smoking.
57
Post-partum contraception?
Pop can be started immediately IUD, can be inserted w/in 48hr or after 4 weeks.
58
Pemphigoid gestations
Starts periumbilical area and can cause blisters.
59
Polymorphic eruption of pregnancy?
Pruritic condition. Periumbilical area often spared.
60
CT scan within 1 hr?
>1 vomiting Signs of basil skull fracture Open/depressed skull fracture Focal deficit Post-traumatic seizures
61
Why do steroids increase blood glucose?
opposes the action of insulin + stimulates hepatic gluconeogenesis.
62
New onset of HIGH BP, retinal haemorrhages / papilloedema?
Same day specialist assessment.
63
Blood film seen in coeliac patients?
target cells + Howell-Jolly bodies --> Hyposplenism.
64
Drugs that may exacerbate haemolysis?
Antimalarials e.g. primaquine Ciprofloxacin Sulph-group drugs
65
Sister mary joseph nodes?
is periumbilical lymphadenopathy. Seen in gastric cancer/cholangiocarcinoma.
66
Treatment for acute confusion state?
haloperidol / olazapine.
67
Group for transfusion <30x10?
Significant bleeding e.g. haematemesis, melaena, prolonged epistaxis.
68
Group for transfusion <100x10?
bleeding at critical sites, such as the CNS.
69
Pre-invasive procedure w/ thrombocytopenia?
> 50×109/L for most patients
70
Likely organism in young patients with septic arthritis who is sexually active?
Neisseria gonorrhoeae
71
Patient recently undergone chemo for cancer, presenting with fever?
Neutropenic sepsis - require IV broad antibiotics.
72
Takotsubo cardiomyopathy
known as broken heart syndrome induced by severe stress can cause MI like symptoms - ST elevation
73
Airway Management - pt with stridor
oropharyngeal airway
74
Most common hepatitis in patients who have travelled and are vaccinated?
Hepatitis E
75
Common Hepatitis in the UK?
Hepatitis E
76
Epididymal cyst features?
scrotal swelling can be palpated as separate from the testicles. Found posterior to testicles.
77
horners syndrome?
Sympatheitic issue causing horners syndrome. ptosis + pupil constriction (miosis) = horners.
78
Turners syndrome
Aortic stenosis - systolic ejection murmur due to bicuspid aortic valve.
79
Most common cause of discitis?
S. aureus
80
Fever/back pain with pain on extension of the hip
iliopsoas abscess
81
Rheumatic Fever
Occurs 2 - 4 weeks after strep throat. Joint pain - larger joints Carditis Erythema Marginatim
82
Cut-off for Iron?
First trimester <110g Second Trimester <105g Pospostpartum <100g
83
Common causes of chronic pancreatitis?
Alcohol, haemochromatosis, smoking, hypercalcaemia, cystic fibrosis. CT scan - diagnostic.
84
48 hrs after MI
Pericarditis --> worse on lying flat.
85
2 - 6 weeks after MI
dresslers syndrome - treat w/ NSAIDs.
86
1 - 2 weeks after MI
Left ventricular free wall rupture --> cardiac tamponade.
87
Children's fluid management?
100m --> 50 --> 20
88
Mononeuritis multiplex presentation?
Acute/subacute loss of sensory + motor function. Usually, asymmetric --> can progress to symmetrical --> common in diabetics.
89
Pt w/ bells palsy has not improved within 3 weeks
Refer to an ENT specialist.
90
Ejection systolic
Load on expiration - aortic stenosis + HOCM Load on inspiration - pulmonary stenosis, ASD
91
Holosystolic (pan systolic)
Mitral / tricuspid regurg, VSD
92
Non-haemolytic Febrile Reaction
Fever, Chills --> slow/ stop transfusion, paracetamol.
93
Minor Allergic reactions
Pruritus, Urticaria --> Temporarily Stop Transfusion + Antihistamines.
94
Anaphylaxis
Hypotension, Dyspnoea, Wheezing + angioedema --> stop transfusion, IM adrenaline.
95
Acute Haemolytic Reactions
Fever, abdo pain + hypotension --> stop transfusion + resus.
96
Alcoholic Withdrawal -Start of symptoms?
6 - 12 hrs, tremors, sweating, tachycardia + anxiety
97
Alcoholic Withdrawl - Seizures
36hrs
98
Alcoholic Withdrawl - Delirium tremens
48 - 72hrs, coarse tremor, confusion, delusions, auditory + visual hallucinations, fever, tachycardia
99
Presentation of Herpes?
Painful ulcer, headaches, fever, malaise. Tender inguinal lymphadenopathy.
100
Investigation of choice for Genital Herpes?
NAAT
101
What is the difference between scarlet and Kawasaki?
Scarletspares palms and soles and Kawasaki does not.
102
Risk factors for prematurity?
Resp Distress Syndrome Intraventricular Haemorrgaes Necrotizing Enterocolitis Chronic lung disease Retinopathy of Prematurity Hearing Problems
103
Complications of Diverticular Disease?
Colovaginal fistula - Abnormal connection between two viscera. - Happens during an acute phase.
104
Iliotibial Band Syndrome
Lateral knee pain in runners.
105
Risk factors for pseudogout?
Haemochromatosis Hyperparathyroidism Low magnesium, low phosphate Acromegaly, Wilson's disease
106
Measles
Irritable, conjunctivitis, fever Koplik spots: white spots Rash starts in the ear and then spreads.
107
Mumps
Fever, malaise, muscular pain Ear pain on eating.
108
Down syndrome Features?
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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