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Finals > Mixture > Flashcards

Mixture Flashcards

1
Q

Occlusion of which cerebral artery would cause personality changes

A

Anterior

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2
Q

Symtpoms of MCA stroke

A

Aphasiaheadachehemiplegiaweakness+others

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3
Q

DEXA scan results for osteoporosis

A

Normal >-1Osteopenia -1-2.5osteoporosis < -2.5

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4
Q

Polypharmacy definition

A

the concurrent use of multiple medications by a patient (~5)

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5
Q

What is overflow incontinence

A

Inability to completely empty bladder

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6
Q

rf for overactive bladder

A

high caffeinealcoholsome medicines

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7
Q

What is a total anterior circulation stroke

A

affects parts of brain supplied by anterior and middle cerebral arteries

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8
Q

Presentation of total anterior circulation stroke

A

unilateral weakness of face arm and leghigh cerebral dysfunctionhomonymous hemianopia

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9
Q

Horner’s syndrome presentation

A

unilateral anhidrosis (abscnece of sweating on face)enophthalmos (inset eye)miosis (constricted pupil)and ptosisAlways remember lung apical (Pancoast) tumour compressing the sympathetic chain

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10
Q

What is mydriasis

A

dilated pupil

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11
Q

What is the medication for MND

A

riluzole (only one)

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12
Q

what is the first-line drug for Alzheimers

A

donezepil (acetylcholinesterase inhibitor) or rivastigmine

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13
Q

What is the drug of choice for severe ALzheimers

A

memantine

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14
Q

What is the treatment of choice for trigeminal neuralgia

A

carbamazepine(else - lamotrigine, gabapentin, phenytoin)

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15
Q

triggers of migraine

A

ChocolateHangoverOrgasmCheeseOral contraceptieLie insAlcoholTumultExerciseOthers: periods, injury, bright lights/boises, huger, smoking

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16
Q

First line prevention of migraine

A

topiramate OR propranolollook for contraindications in stemtopiramate = teratogenicpropranolol = x asthma

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17
Q

What s corticobasal degenereation

A

Parkinson plus syndromeHas alien hand syndrome (limbs moving on own)+apraxia +aphasia

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18
Q

What is progressive supranuclear palsy

A

Parkinson plus syndromesupranucear opthalmoplegia (initially cant look down, then cant look left and right)neck dystonia, balance issues and cognitive impairment

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19
Q

Action of ropinirole

A

Activates dopamine receptors to mimic the action of dopamine (alternative to L-dopa)

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20
Q

What can be used for meningitis close contact prophylaxis

A

oral ciprofloxacin or rifampicin.

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21
Q

Criteria for orthostatic hypotension

A

A drop in blood pressure of at least 20 systolic or 10 diastolic within 3 minutes of standing

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22
Q

aortic dissection presentation

A

10/10 pain in centre of chest or back, radiating to neck/jaw and spreading caudally. Receding pain. Sweaty, weak left sided pulse

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23
Q

Features of PE o ECG

A

ST depression or sinus tachycaria

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24
Q

Signs of PE on CXR

A

Fleischner sign (dilated central pulmonary vessel)Westermark sign (collapse of vasculature distal to PE)Hampton’s hump (wedge shaped infarct

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25
Q

Treatment for pericarditis

A

NSAIDs first linecolchicine

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26
Q

What is the mechanism of action of N-acetylcysteine in the treatment of paracetamol overdose

A

Replenishes stores of glutathione in hepatocytes. This binds to NAPQI which is the toxic product from paracetamol

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27
Q

What can be used to reverse heparin

A

protamine

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28
Q

what can be used to reverse warfarin

A

beriplexvitamin k

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29
Q

What drugs should be given to MI patients on arrival to hospital

A

bisoprolol, clopidogrel and LMWH

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30
Q

which crystals are seen in gout

A

negatively birefringent needles

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31
Q

which crystals are seen in pseudogout

A

positively birefringent crystals

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32
Q

what is aspirin

A

cox 1 inhibitor

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33
Q

what is clopidogrel

A

p2y12 inhibitor

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34
Q

What is tamsulosin and what are its side effects

A

an alpha blocker used for benign prostatic hyperplasia. common side effects are dizziness and sexual dysfunction

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35
Q

What should be done in HELLP syndrome

A

deliver baby!

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36
Q

what can small cell carcinoma of the lung secrete

A

ADH or ACTH

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37
Q

what can squamous cell carcinoma of the lung secrete

A

PTH and hence cause hypercalcaemia

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38
Q

what is Conn’s syndrome

A

primary hyperaldosteronism

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39
Q

features and treatment of Conn’s syndrome

A

Hypernatraemia and hypokalaemiatreatment is potassium sparing diuretic - spironolactone

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40
Q

treatment of h.pylori infection

A

PPI + clarithromycin + metronidazole

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41
Q

Stages of CKD

A
  1. >
    1. 60-893A. 45-593B. 30-444. 15-29
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42
Q

should you treat a second seizure

A

yes if there hasnt been sufficient time to recover, administer a benxodiazepine

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43
Q

what is the first medical treatment for COPD

A
  1. SABA or SAMA2. LABA + LAMA3. +ICS
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44
Q

aki stage 1

A

creatinine <2x baseline/ urine output <0.5ml/kf for >6 consecutive hours

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45
Q

aki stage 2

A

creatinine 2-3x baseline/urine output <0.5ml/kg for >12 consecutive hours

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46
Q

aki stage 3

A

creatinine >3x baseline/urine output <0.5ml/kg >24 hours

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47
Q

some drugs that cause aki

A

NSAIDACEiARBsCCBsa-blockersb-blockersopiodsdiureticsacyclovirtrimethoprimlithium

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48
Q

what is a static risk factor

A

one that cant be changed

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49
Q

what is error of inheriting thinking

A

when a working diagnosis is handed over and accepted without consideration

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50
Q

what is error of ignorance

A

unconscious incompetence

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51
Q

Which nerve lesion spares the forehead

A

UMN lesion! think stroke

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52
Q

which nerve involves the forehead

A

LMN! remember a LMN should be ipsilateral as it is after the decussation

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53
Q

What is the treatment of temporal arteritis

A

prednisolone high dose!risk of amaurosis fugax

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54
Q

What is diagnostic of temporal arteritis

A

temporal artery biopsy

55
Q

what else are those with temporal arteritis at risk of

A

AAA so would want to do a CT abdomen

56
Q

Wernicke Korsakoff syndrome presentation

A

encephalopathyophthalmoplegiaataxiaamnesiaconfabulation

57
Q

first line treatment for guillain barre

A

IV immunoglobulins

58
Q

treatment of kawasaki disease

A

aspirin and IVIG!

59
Q

What does temporal arteritis have a strong association with

A

polymyalgia rheumatica ~50%

60
Q

what causes a convergent squint (esotropia)

A

hypermetropia (long sightedness) causes image to focus behind the retina.myopia = short sightedness

61
Q

What receptors do beta agonists act on

A

G protein-coupled receptors - cause smooth muscle relaxation and hence bronchodilation

62
Q

how might gastric cancer resent

A

palpable mass, ascites, dysphagia

63
Q

what might you see on the xray of someone with heart failure

A

A- alveolar oedema (bat wing opacities)B - Kerley B linesC - cardiomegalyD - dilated upper lobe veinsE - pleural effusion

64
Q

what is measured to assess managment of heart failure

A

serum natriuretic peptide-pro BNP

65
Q

when to do an audit score

A

to establish history of drinking problems, do this first if insufficient info in the stem!

66
Q

treatment of cluster headache

A

high flow oxygen and sumatriptan (unless contraindicated by IHD)

67
Q

prophylaxis of cluster headaches

A

verapamil

68
Q

what mass can myasthenia gravis present with

A

thyoma in 15% shown as a large anterior mediastinal mass on CT

69
Q

how can myasthenia gravis be diagnosed

A

ice test or Tensilon test

70
Q

Symptoms of normal pressure hydrocephalus

A

urinary incontinencedementiagait disturbance

71
Q

what might a myoclonic seizure encompass

A

brief, involuntary jerking movements in limbs or facial muscles, without loss of consciousness

72
Q

what is a common cause of isolated seizures

A

head trauma

73
Q

what connects the lateral ventricles to the third ventricle

A

foramen of monro

74
Q

what connects the third and fourth ventricles

A

cerebral aqueduct

75
Q

what is the temperature phenomenon in MS called

A

Uhthoff’s phenomenon

76
Q

presentation of primary biliary cholangitis

A

fatiguejaundicepruritis

77
Q

associations of PBC

A

Anti-mitochondrial antibodies!!!!!also look for associated autoimmune conditions

78
Q

signs of nephrotic syndrome

A

pitting oedemaheavy preoteinuriahyperlipidaemia

79
Q

complications of nephrotic syndrome

A

DVT (hypercoaguable state)pleural effusionsincreased risk of infection (loss of IG in urine)

80
Q

thyrotoxicosis signs

A

very fast heart beatirregularly irregular pulseweight lossstressfine tremor

81
Q

what organism causes syphillis

A

Treponema Pallidum - spirochaete.Think painless sore presentation

82
Q

what organism is candida

A

pseudohyphae

83
Q

what blood markers indicate PCOS

A

Low FSH raised LHmay also have raised testosteronecheck for impaired glucose tolerance!!!!

84
Q

management for those with primary adrenal insufficiency with febrile illness/broken bone/diarrhoea or cold

A

must double the dose orf corticosteroid!!!(hydrocortisone)dont need to double e.g. fludrocortisone

85
Q

risk factors for SAH

A

Elhers Danlossmokingalcoholcocainepolycystic kidneyscoarctation of the aorta

86
Q

SAH on CT

A

white star shape

87
Q

where might biliary colic pain refer to

A

between the scapulae

88
Q

what is charcots triad

A

fever, RUQ, jaundice

89
Q

what is charcots triad indicative of

A

cholangitis

90
Q

Signs of basal skull fracture

A

panda eyesBattle’s sign (bruising behind ear)CSF from noseURGENT CT needed

91
Q

How to tell if chronic subdural haematoma

A

commonly in elderly or alcoholicsold blood is DARK on a CT

92
Q

how to tell acute subdural haematoma

A

blood will be lighter than brain tissue = acute bleed

93
Q

Treatment of frontotemporal dementia

A

DO NOT OFFER memantine or acetyl cholinesterase inhibitors.SSRIs may provide symptomatic relief, other than that no treatment!!!!

94
Q

what antibodies are present in guillain barre syndrome

A

anti-gangliside

95
Q

what would temporal arteritis show on a temporal artery biopsy

A

granulomatous inflammation(note has skip lesions so a negative biopsy does not exclude)

96
Q

What is Ramsay Hunt syndrome

A

caused when singles occurs in the facial nerve.Associated with a painful herpetic rash in the ear canal

97
Q

How is Ramsay Hunt syndrome managed

A

oral aciclovir or corticosteroidsto manage the pain give pregabalin as it is neuropathic pain

98
Q

Test results for Myasthenia Gravis

A

Anti-MuSK antibodies in serumincreased jitter with single-fibre EMG

99
Q

triad of normal pressure hydrocephalus

A

dementiaataxiaurinary incontinence

100
Q

what is the definitive treatment for normal pressure hydrocephalus

A

ventriculoperitoneal shunt

101
Q

acute management of cluster headache

A

high flow O2 and subcutaneous sumatriptan

102
Q

What is Lambert-Eaton myasthenic syndrome

A

condition caused by neuroendocrine small cell lung cancer (paraneoplastic - a condition that arrises from cancer elsewhere in body).auto-immune antibodies against sodium voltage-gated ion channels

103
Q

symptoms of Lambert-Eaton myasthenic syndrome

A

muscle weakness which improves with usehyporeflexiahistory of smoking/lung cancer risk

104
Q

extradural haemorrhage on CT

A

biconvex (lemon shape) collection of blood that does not cross the suture lines

105
Q

how would NPH present on CT

A

dilated ventricles

106
Q

how would subdural haematoma present on CT

A

crescent shape that crosses the suture linesdark = old bloodlight = new

107
Q

complication of SAH

A

blood in basal cisterns can lead to vasospasm as there is blood surrounding the cerebral arteries

108
Q

how can vasospasm be prevented in SAH

A

nimodipine (CCB)

109
Q

presentation of posterior inferior cerebellar artery stroke PICA

A

ipsilateral loss of pain and temperature on the faceipsilateral Horner’scontralateral loss of pain and temperature sensation on the body

110
Q

Presentation of anterior inferior cerebellar artery AICA stroke

A

Same as PICA+ ipsilateral facial paralysis and hearing loss

111
Q

presentation of progressive bulbar palsy

A

quiet nasal speech, flaccid, fasciculating tongue, absent gag reflex

112
Q

presentation of pseudobulbar palsy

A

spastic tongue, hot-potato speech and drisk jaw jerk

113
Q

B12 deficiency neurological presentation

A

can cause subacute combined degeneration of the spinal cord:loss of vibration and proprioceptionspasticityataxia

114
Q

what is internuclear ophthalmoplegia

A

impaired adduction of eye on SAME side as lesionhorizontal nystagmus of the abducting eye on the contralateral side

115
Q

cause of internuclear ophthalmoplegia

A

lesion in the medial longitudinal fasciculus (controls horizontal eye movements by interconnecting the III, IV and VI CN)located in the midbrain/ponsCAUSES:Multiple sclerosisvascular

116
Q

what is syringomyelia

A

collection of csf within the spinal cord

117
Q

presentation of syringomyelia

A

cape-like loss of sensation to temperature but preservation of other sensories.Classic example is patient who burns their hands and doesnt realisealso spastic weakness, paraesthesia, neuropathic pain, bowel and bladder dysfunction

118
Q

investigation and management of syringomyelia

A

full spine MRIbrain MRI as STRONGLY ASSOCIATED WITH ARNOLD CHIARI MALFORMATIONtreatment - shunt/treat cause

119
Q

what is arnold chiari malformation

A

downward displacement of cerebellar tonsils through foramen magnum. congenital/traumaFeatures:non-communicating hydrocephalusheadachesyringomyelia

120
Q

what is used in acute MS relapse

A

methylprednisolone IV or oral to shorten lengthBaclofen for MS spasms

121
Q

common cause of neuroleptic malignant syndrome

A

hospitalisation of someone and not giving them parkinson meds

122
Q

difference between bacteria, tb and fungi on LP

A

bacteria = high lymphocytesfungi and tb low lymphocytestb cloudy with fibrin web appearancefungi/bacteria cloudy

123
Q

how long until someone can drive withdrawing/changing epilepsy medication

A

6 months when AEDs withdrawn/changed

124
Q

when can you drive a car with epilepsy

A

1 year seizure free

125
Q

when can you drive a car after having a single seizure

A

6 months

126
Q

how long until can drive a bus/lorry with one off seizure

A

5 years

127
Q

how long until drive bus or lorry with multiple seizure

A

10 years

128
Q

presentation of acoustic neuroma (scwanomma)

A

gradual onset unilateral hearing loss +/- vertigo.neurofibromatosis type 2 is associated with bilateral schwanommas

129
Q

how to take alendronic acid

A

once a week on the same day, firsth thing in the morning. Stand upright for the first 30 minutes and don’t eat anything for 30 minutes

130
Q

how to take vitamin D when on alendronic acid

A

take same time everyday but not within 4 hours of alendronic acid

131
Q

features of Huntington’s disease

A

develop after 35 years if age (but shows anticipation)choreapersonality change (irritable, apathy, depression)intellectual impairmentdystoniasaccadic eye movements (jerky)typically live for 20 years after development

132
Q

osgood schlatter disease

A

seen in sporty teenagerspain, tenderness and swelling over the tibial tubercle (knee)supportive management

133
Q

osteochondritis dissecans

A

pain after exerciseintermittend swelling and locking

Finals (15 decks)

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