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MSRA > Mixed practice 3 > Flashcards

Mixed practice 3 Flashcards

1
Q

Which type of pneumonia can cause hyponatraemia

A

Legionella pneumonia

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2
Q

Symptoms associated with:
Posterior vitreous detachment

A

Flashes of light (photopsia) - in the peripheral field of vision
Floaters, often on the temporal side of the central vision

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3
Q

Symptoms associated with:
Retinal detachment

A

Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Straight lines appear curved
Central visual loss

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4
Q

Symptoms associated with:
Vitreous haemorrhage

A

Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters

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5
Q

Acne vulgaris in pregnancy treatment:

A

Erythromycin

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6
Q

Chvostek sign and trousseau sign are positive in which electrolyte disturbance

Eye problem associated:

A

HYPOcalcaemia

Cataracts

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7
Q

Diagnostic criteria for AKI:

In young adults/children

A

Absolute rise of creatine >26mmol/l in 48 hours

Absolute increase in creatinine >50% in 7 days

Urine output <0.5ml/kg/hour for more than 6 hours

> = 25% fall in eGFR in children / young adults in 7 days

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8
Q

Which two commonly prescribed medications/supplements can cause malabsorption of thyroxine?

A

Iron
Calcium carbonate

Should be given 4 hours apart

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9
Q

Which common anti-hypertensive may exacerbate gout and thus, is contraindicated

A

Bendroflumethiazide

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10
Q

Which drugs may trigger an exacerbation of psoriasis

A

drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids
Alcohol

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11
Q

Suspected orbital cellulitis: Order of treatment

A

IV antibiotics
THEN arrange for urgent CT head

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12
Q

What will arterial gas show in pulmonary embolism?

A

RESPIRATORY ALKALOSIS

Secondary to hyperventilation

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13
Q

When should ACEis be stopped before surgery:

A

1 day usually. Is sometimes continued up until surgery

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14
Q

Anal fissure treatment step up:

A

soften stool
dietary advice: high-fibre diet with high fluid intake
bulk-forming laxatives are first-line - if not tolerated then lactulose should be tried

lubricants such as petroleum jelly may be tried before defecation

topical anaesthetics,analgesia

GTN

Botoxm sphincterotomy last line - if GTN not effective after 8 weeks

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15
Q

Normal lithium level:

Which drugs may precipitate toxicity:

A

0.4-1.0
toxicity occurs when >1.5

Diuretics (especially thiazides)

ACE inhibitors/angiotensin II receptor blockers

NSAIDs and metronidazole.

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16
Q

What type of urinary incontinence may Amitriptyline precipitate:

A

Overflow incontinence

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17
Q

Management of acute flares of rheumatoid arthritis

A

IM or oral corticosteroids

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18
Q

Peripheral neuropathy secondary to diabetes:

1) Management:

2) What can be used as rescue therapy

A

1) Amitriptyline, duloxetine, gabapentin or pregabalin

2) Tramadol

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19
Q

Symptomatic aortic stenosis management:

Older person

Younger person

patients who are too high-risk for surgical intervention or as a bridge to definitive treatment

A

Bioprosthetic valve

Mechanical valve (tends to last longer)

Balloon valvuloplasty

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20
Q

Most common cause of primary headache in children:

A

Migraines

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21
Q

Decreasing vision over months with metamorphopsia, well-demarcated red patches on the retina and a central scotoma should cause high suspicion of

A

wet age-related macular degeneration

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22
Q

Main investigation required prior to starting herceptin:

A

Echocardiogram

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23
Q

Which disease is associated with Anti-jo1 antibodies:

What disease is associated with

Anti-scl antbodies:

Anti-centromere:

A

Polymyositis

Diffuse systemic sclerosis

Limited systemic sclerosis

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24
Q

Neuropathic drug to avoid in BPH:

A

Amitriptyline - increased risk of retention

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25
Q

Define syringomyelia

M/C cause:

Investigation:

A

Collection of fluid within spinal cord.

Results in spinothalmic loss in cape-like distribution - > loss of pain reception but preserved light touch, proprioception and vibration

Chiari formation

MRI spine - may need brain too to investigate Chiari formations

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26
Q

What is irradiated blood requested for:

A

Usually in states of immunocompromise -> lymphoma

Reduces incidence of graft versus host disease

27
Q

Pain 4-6 cm down from lateral epicondyle:
symptoms may be worsened by extending the elbow and pronating the forearm

A

Radial tunnel syndrome

28
Q

Other name for chondromalacia patellae:

Pattern of pain:

A

Runner’s knee

Anterior knee pain in adolescents and young adults. -> cartilage on the underside of the patella (kneecap) becomes softened and irritated, often due to overuse or poor alignment of the patella.

The pain worsens with activities that involve bending the knee.

29
Q

Likely disease process for these symptoms:
Pruritis
history of peptic ulcer
Gout
‘Ruddy’ complexion

A

Polycythaemia

30
Q

Which cancer is BRCA mutation also associated with in men:

A

Prostate cancer

31
Q

Most common haemophilia

Factors affected in Haem A and Haem B

A

Haemophillia A

A = VIII (8)
B = IX (9)

32
Q

Which anti-depressant should NOT be prescribed with warfarin

A

SSRIs

Can have Mirtazapine

33
Q

When should SUs be stopped prior to surgery.

A

Omitted on day of surgery prior to op -> can have after

If afternoon operation and SU is taken twice per day, omit both doses

34
Q

If a woman has a ‘higher chance’ results regarding Down-syndrome on her 11-13+6 week tests (combined test - NT, PAPPA, BCG etc.) , what are the further investigations?

A

Offered a second screening test (NIPT) or a diagnostic test (e.g. amniocentesis or chorionic villus sampling (CVS).

35
Q

Dose of rectal diazepam in adults for refractory seizure:

A

10 mg

36
Q

Common causes of drug induced lupus:

A

Hydralazine
Procainamide

37
Q

Herpes causing cold-sores
Herpes causing genital herpes

A

HSV-1 (cold sores - 1 mouth)

HSV-2 (genital herpes - 2 balls)

38
Q

If presenting with pre-eclampsia and greater 37 weeks gestation, what should be done ->

A

Plan for emergency delivery

39
Q

Drugs causing acute interstitial nephritis

A

Penicillin
Rifampicin
NSAIDs
allopurinol
furosemide

40
Q

What is there increased risk of when prescribing SSRI with a triptan

A

Serotonin syndrome

41
Q

What term defines maternal mortality

A

Any death in pregnancy, during labour till, till 6 weeks post-partum

42
Q

COPD severity scale:

FEV/FVC1 threshold

A

Mild - FEV1 > 80% (symptoms must be present to diagnose)
Moderate - FEV1 = 50-79%
Severe = FEV1 30-49%
Very severe = < 30%

<0.7 post-bronchodilator

43
Q

Any person being considered for the BCG vaccine must first be given what ?

At what age is BCG vaccine given up till

A

Tuberculin skin test- > The only exceptions are children < 6 years old who have had no contact with tuberculosis

35 years - no evidence that it works past this age group

44
Q

What investigation is important to start during phenytoin infusion

A

cardiac monitoring - arrhythmogenic

45
Q

Further investigation to order in the diagnosis of staph aureus discitis

A

Echocardiogram -> Looking for endocarditis as primary disease process

46
Q

Duct dependent congenital heart disease: what should be given prior to corrective surgery

A

Prostaglandin E2 (or 1) to maintain duct patency

47
Q

Ophthalmia neonatorum:
What is it?

Infective organisms:
Management:

A

Conjunctivitis type symptoms at LESS THAN 30 days old.

Chlamydia
Gonorrhoea

Should be seen same day by Ophthalmology

48
Q

MODY:
Define ->]
C-peptide?
Inherited?

A

Diagnosis of T2DM in a person <25 years
Normal C-peptide

Autosomal dominant inheritance

49
Q

Describe discharge and cervix in trichomonas vaginalis

A

offensive yellow/green discharge, strawberry cervix

50
Q

Flexural psoriasis management:

A

Differs to normal plaque psoriasis ->

Mild or moderate potency corticosteroid applied once or twice daily for a maximum of 2 weeks

51
Q

Acute otitis media:
When should antibiotics be prescribed?

Which antibiotic?

A

If unwell for more than 4 days

Systemically unwell but not requiring admission

Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease

Younger than 2 years with bilateral otitis media

Otitis media with perforation and/or discharge in the canal

Amoxicillin

52
Q

Osteosarcoma: appearance on XR

Ewing’s sarcoma: appearance on XR

A

most common primary malignant bone tumour: sunburst pattern

Onion-skin

53
Q

When is Men B vaccine given:

A

2, 4 12 months

54
Q

What is in 6 in 1 vaccine

A

Diptheria, tetnus, whooping, polio, HiB, Hepatitis B

55
Q

When is oral rotavirus vaccine given:

A

Months 2 and 3

56
Q

SSRI of choice post myocardial infarction ->

A

Sertraline

57
Q

Gestation to refer if fetal movements have not been felt

A

24 weeks

58
Q

Components of Bishop score

Bishop score meaning labour is unlikely to start without induction

NICE guidelines when to induce:

Score greater than X suggests high chance of spontaneous labour

A

Cervical position
Cervical consistency
Cervical effacement
Cervical dilation
Fetal station

<5
<6

> 8

59
Q

Methods of inducing labour

NICE guidelines for inducing labour

Complication of inducing labour

A

Membrane sweep

Vaginal or oral Prostaglandins E1
Maternal oxytocin infusion
Amniotomy
Cervical ripening balloon

If <6 -> PO/PV PGLs or oral misoprostol
If > 6 -> Oxytocin infusion or amniotomy

Hyperstimulation -> remove any PGLs

60
Q

Medical management of miscarriage

A

Mifepristone followed by misoprostol 48 hours later

61
Q

2 common drugs contraindicated with sildenafil

A

Nicorandil and nitrates

62
Q

Scarlet fever organism:
M/C complication:

Treatment:

A

Group A strep - Strep pyogenes

Otitis media

Penicillin V for 10 days

63
Q

Difference between paroxysmal and persistent AF:

A

Paroxysmal self temrinates typically after 1-2 days -> persistent AF requires flecainide

64
Q

Treatment for non-gonococcal urethritis

A

azithromycin or doxycycline

MSRA (15 decks)

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