Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

yr4 FINALS > MLA > Flashcards

MLA Flashcards

1
Q

MI complications, left ventricular aneurysm

A

Persistent ST elevation
LV failure - pulm oedema
S3 sounds - LV larger
S4 sounds - LV stiffer
Anticoag as risk of thrombus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Left ventricular free wall rupture

A

1-2 weeks after
Acute HF 2ndry to cardiac tamponade, raised JVP, pulses paradox, HS muffled
Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute mitral regurg

A

More common in infero post infarction
Papillary muscle rupture
Acute hypotension, flash pulmonary oedema
Early to mid systolic murmur
Vasodilator therapy, surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MI complication, Ventricular septal defect

A

occur in 1st wk
new pan systolic murmur
Raised JVP
SOB, bibasal crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dressler’s syndrome post MI

A

pleuritic pain, left, pericardia effusion
Saddle shape st elev on ecg
After MI 2-6wks
Tx - nsaids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MI complic, bradyarrhythmia

A
  • AV block common after inferior MI -> HB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Drugs causing drug induced liver disease

A

Paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

drug induced cholestasis

A

COCP
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

P450 enzyme inducers (inc other drugs metabolism, reduce therapeutic conc)

A

Antiepileptics: phenytoin, carbamazepine
barbiturates: phenobarbitone
rifampicin
St John’s Wort
chronic alcohol intake
griseofulvin
smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

P450 enzyme inhibitors, inc therapeutic concentration

A

Ciprofloxacin, erythromycin
isoniazid
cimetidine, omeprazole
amiodarone
allopurinol
imidazoles: ketoconazole, fluconazole
SSRIs: fluoxetine, sertraline
ritonavir
sodium valproate
acute alcohol intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Palliative med, what medication is started with

A

modified release metformin or standard release
laxative co prescribed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the breakthrough dose for morphine

A

1/6 of total dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is used for metastatic bone pain

A

opioids
bisphosphonates
radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the drug conversion of oral codeine/tramadol to oral morphine

A

divide by 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

drug conversion oral morphine to oral oxycodone

A

divide by 1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what opioid is used in mild moderate renal impairment

A

oxycodone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what opioid is used in severe renal impairment

A

alfentanil,
buprenorphine,
fentanyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

conversion for oral morphine to s/c morphine

A

divide by 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

oral morphine -> subcut diamorphine

A

divide by 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

oral oxycodone -> subcut diamorphone

A

divide by 1.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mechanism of action metformin

A

Biguanide

Inc insulin sensitivity
Dec hepatic gluconeogenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

DDP-4 inhibitor

A

Increase active incretin levels
Reduce peripheral breakdowns of incretins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pioglitazone

A

inc insulin sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sulfonyurea

A

Inc insulin release from pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

GLP-1 analogues

A

Inc insulin release
inhibit glucagon secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mx of open angle glaucoma

A

360° selective laser trabeculoplasty (SLT) first-line to people with an IOP of ≥ 24 mmHg NICE

Prostaglandin analogue (PGA) eyedrops should be used next-line, Latanoprost

beta-blocker eye drops
carbonic anhydrase inhibitor eye drops
sympathomimetic eye drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Latanoprost action and SE

A

Prostaglandin analogue
increasing uveoscleral outflow

Brown pigmentation of the iris, increased eyelash length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Beta blocker timolol action

A

Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Carbonic anhydrase inhibitors (e.g. Dorzolamide) action

A

Reduces aqueous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Miotics (e.g. pilocarpine, a muscarinic receptor agonist) action

A

Increases uveoscleral outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Causes of gynaecomastia

A

syndromes with androgen deficiency: Kallman’s, Klinefelter’s
testicular failure: e.g. mumps
liver disease
testicular cancer e.g. seminoma secreting hCG
ectopic tumour secretion
hyperthyroidism
haemodialysis

drugs:
spironolactone (most common drug cause)
cimetidine
digoxin
cannabis
finasteride
GnRH agonists e.g. goserelin, buserelin
oestrogens, anabolic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what drug most commonly causes gynaecomastia

A

spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Thiazide diuretics side effects

A

hypokalaemia
hyponatraemia
hypercalcaemia
impaired glc tolerance
gout
sexual dysfunction
Dehydration
Postural hypo
digoxin toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the features of dengue fever

A

viral infection
- fever
- retro orbital headache
- facial flushing
- myalgia, bone pain
- rash
- haemorrhagic
- thrombocytopenia, raised AST
- travelling
- 7 day incubation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Features of typhoid fever

A

salmonella typhi

initially, headache, fever, arthralgia
relative bradycardia
constipation, abd pain
rose spots - trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

X-ray features of rheumatoid

A
  • loss of joint space
  • peri articular erosions
  • juxta articular osteoporosis
  • soft tissue swelling
  • subluxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

X-ray fts of osteoarthritis

A

-osteophytes
-loss of joint space
-cyst formation
-subchondral sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Indications for urgent CT head (within 1 hour) in head injuries

A

GCS < 13 on initial assessment
GCS < 15 at 2 hours post-injury
suspected open or depressed skull fracture
any sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign).
post-traumatic seizure.
focal neurological deficit.
More than 1 episode of vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When should you send a urine culture for UTI in non pregnant women

A

visible or non visible haematuria
over 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Pleural effusion exudative causes

A

Protein >30

Infection
-pneumonia (most common exudate cause),
-tuberculosis
-subphrenic abscess
Connective tissue disease
-rheumatoid arthritis
-systemic lupus erythematosus
Neoplasia
-lung cancer
-mesothelioma
-metastases
pancreatitis
pulmonary embolism
Dressler’s syndrome
yellow nail syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Pleural effusion transudative cause

A

Protein <30

heart failure (most common transudate cause)
hypoalbuminaemia
liver disease
nephrotic syndrome
malabsorption
hypothyroidism
Meigs’ syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Empyema ph, glucose and LDH levels

A

pH <7.2
low glc
high LDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

features of limited systemic sclerosis

A

scleroderma of face and distal limbs (tightening and fibrosis of skin)

CREST
Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility, Sclerodactyly, Telangiectasia

anti centromere antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Diffuse cutaneous systemic sclerosis fts

A

anti scl-70 antibodies
resp involvement - interstitial lung disease
renal disease - use ACEI
hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Metformin side effects

A

GI upset
Reduced vit b12 asso
Lactic acidosis w severe liver disease or renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Sulphonyurea side effects

A

weight gain
hypoglycaemia

(siadh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

DDP-4 inhibitor side effects

A

weight neutral
pancreatitis
nausea
nasopharyngitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Thiazidolines side effects

A

weight gain
fluid retention - contraind HF
inc risk bladder cancer
inc risk fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

GLP-1 analogues side effects

A

weight loss
nausea pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

SGLT2-inhib side effect

A

inc risk UTI
weight loss
Inc risk lower limb amputation
Contraind in active foot disease - skin ulcer
Necrotising fasciitis of genitalia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what does 4AT include

A

Alertness - name and address
4AMT - age, date of birth, place, current year
Attention - state months of year backward
Acute change or fluctuating course

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the treatment for focal seizures

A

lamotrigine,
levetiractam
2nd line - carbemazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What drug is used to treat myoclonic seizures in females

A

Levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What anti epileptics are contraindicated in pregnancy

A

sodium valproate - neural tube defect
phenytoin - cleft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Causes of interstitial nephritis

A

penicillin
rifampicin
NSAIDs
allopurinol
furosemide
SLE, sarcoid
staph, hanta virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What defines an exudate in pleural effusion

A

protein >30
pleural fluid protein divided by serum protein >0.5

pleural fluid LDH divided by serum LDH >0.6

pleural fluid LDH more than two-thirds the upper limits of normal serum LDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what defines a transudate pleural effusion

A

protein <30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Causes of exudative pleural effusion

A

malignancy
pneumonia
Pulmonary embolism
Infection
Mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

causes of transudate pleural effusion

A

Heart failure
liver cirrhosis
Hypoalbuminaemia
Malabsorption
hypothyroidism
Meigs’ syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Investigations for premature rupture of membranes?

A

sterile speculum exam
for fluid, if no pooling of fluid
PAMG-1 test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Management of preterm rupture of membranes

A

Admit, observe for chorioamniotiis
oral erythromycin 10 days
antenatal steroids, reduce risk of respiratory distress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Management of post partum haemorrhage

A

ABCDE
- crystalloid infusion
- empty bladder catheterise
- masssage umbilicus
- IV oxytocin
- ergometrine (not if hypertension)
- IM carboprost (not if asthma)
- misoprostal sublingual

surgical - intrauterine balloon tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

carcinoid syndrome fts

A

flushing (earliest symptom)
Abd pain
D+
Bronchospasm
Hypotension
Cushings syndrome
Right heart valve stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

carcinoid syndrome ix and mx

A

urinary 5-HIAA

ocreotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Osteoarthritis x-ray features

A

LOSS
loss of joint space
osteophytes at joint margins
subchondral sclerosis
subchondral cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

signs of vitamin C deficiency

A

Follicular hyperkeratosis and perifollicular haemorrhage
Ecchymosis, easy bruising
Poor wound healing
Gingivitis with bleeding and receding gums
Sjogren’s syndrome
Arthralgia
Oedema
Impaired wound healing
Generalised symptoms such as weakness, malaise, anorexia and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Amiodarone side effects

A

thyroid dysfunction
corneal deposits
pulmonary fibrosis/pneumonitis
liver fibrosis/hepatitis
peripheral neuropathy, myopathy
photosensitivity
‘slate-grey’ appearance
thrombophlebitis and injection site reactions
bradycardia
lengths QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

beta blocker side effects

A

bronchospasms
cold peripheries
fatigue
sleep disturbances, including nightmares
erectile dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

ECG changes in trifasicular block

A

RBBB
LAD
1st degree HB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Causes od G6PD exacerbation

A

anti malarials - primaquine
ciproflox
sulphonamides
sulfonureas
infection
fava beans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

drugs causing erythema multiforme

A

penicillin
sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

causes of erythema multiforme

A

HSV
idiopathic
bacteria: Mycoplasma, Streptococcus
drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
connective tissue disease e.g. Systemic lupus erythematosus
sarcoidosis
malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

physiological abnormalities of anorexia nervosa

A

G’s and C’s raised
growth hormone, glucose, salivary glands, cortisol, cholesterol, carotinaemia

hypokalaemia
low FSH, LH, oestrogens and testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Hypercalcaemia ecg changes

A

short QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Hypocalcaemia ecg

A

prolonged QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What measurement is prolonged QT interval

A

> 450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Normal PR interval

A

120-200 (3-5 small squares)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Hypokalaemia ecg changes

A

widened P waves
Prolonged PR interval
Long QT
U waves (after T wave in V2/3)
T wave inversion, small or absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Wolf parkinson white syndrome ecg changes

A

Broad complex tachycardia

short PR interval
wide QRS complexes with a slurred upstroke - ‘delta wave’
usually LAD - affecting right accessory pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Hyperkalaemia ecg changes

A

Tall tented t waves
Loss of p waves
Broad QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Neuroleptic malignant syndrome features

A

Muscle rigidity
confusion
hypotension
hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Causes of warm haemolytic anaemic

A

CLL, lymphoma
SLE
methyldopa
idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Causes of cold haemolytic anaemia

A

mycoplasma
EBV
lymphoma
neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Most common cause of D+ in HIV

A

cryptosporidium parvum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the post exposure prophylaxis in HIV

A

up to 72hrs after exposure,
4 weeks antiretrovirals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

How should asymptomatic patients be tested for HIV

A

test 4wks after exposure
if negative repeat at 12wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

How is HIV diagnosed

A
  • HIV p24 antigen 1-4wks
  • HIV ab 4wks-3mths
    4th generation
    if positive, repeat test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How is HIV disease progress monitored

A

using CD4+ cell count and viral load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

HIV complications CD4 200-500

A

-oral thrush
-shingles
-hairy leucoplakia (EBV)
- kaposi sarcoma (HHV-8)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

HIV complications CD4 100-200

A
  • PJP pneumocystitis
  • cryptosporidiosis (D+)
  • cerebral toxoplasmosis
  • progressive leukoencephalopathy (JC virus)
  • HIV dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

HIV complications CD4 50-100

A
  • aspergillosis
  • oesophageal candidiasis
  • Cryptococcal meningitis - fungal, low glc, high protein, india ink staining
  • primary CNS lymphoma (EBV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

HIV complications CD4 <50

A
  • CMV retinitis
  • mycobac avium intracellulare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Features of PJP pneumocystitis in HIV and CD4 count

A

100-200
pneumothorax common
- exercise induced desat
- cxr bilat interstitial pulm infiltrates
- mx oral co-trimox
IV pentamidine in severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what should be given to HIV patients w CD4 count <200

A

prophylactic co-trimoxazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Fts of cerebral toxoplasmosis and CD4 count

A

100-200
headaches, double vision
CT - mult ring enhancing lesions
negative thallium spect scan

  • tx sulfadiazine, pyrimethamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Fts of cerebral progressive multifocal lekoencephalopathy and CD4 count

A

100-200

  • neuro symptoms, demyelination on MRI
  • JC virus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Fts of CNS Lymphoma and CD4 count

A

50-100
EBV
- CT single enhancing lesions, SPECT positive
- tx steroids, chemo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Fts of cyptococcal meningitis and CD4 count

A

50-100
fungal, low glc, high protein, india ink staining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

When is the combined test for downs syndrome and what does it include

A

11 - 13+6 weeks

nuchal translucency measurement + serum B-HCG + pregnancy-associated plasma protein A (PAPP-A)

thickened nuchal
inc bcg
dec papp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

When is the quadruple test done

A

15-20wks
quadruple test: alpha-fetoprotein, unconjugated oestriol, human chorionic gonadotrophin and inhibin A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

quadruple test positive results for downs

A

afp down
oestriol down
bhcg up
inhibin a up

102
Q

renal cell carcinoma triad of fts

A

Flank pain,
Palpable abdominal mass,
Haematuria

103
Q

Henoch Schloein Purpura or IgA vasculitis fts

A

palpable non blanching purpura on buttocks, lower limbs
abd pain
renal involvement
haematuria
polyarthritis

104
Q

Alpha 1 antitrypsin deficiency fts

A

young p’s non smokers
panacinar emphysema, lower lobes
obstructive spirometry

105
Q

Cerebral palsy dyskinetic fts

A

athetoid movements and oro-motor problems
- damage to basal ganglia and substantia nigra

106
Q

Cerebral palsy spastic fts

A

most common
- damage to upper motor neurons in periventricular white matter,
hemiplegia, hypertonia

107
Q

cerebral palsy ataxic fts

A

nystagmus, ataxia

108
Q

Newborn screening hearing test

A

Otoacoustic emission test

109
Q

newborn hearing test 2nd line

A

Auditory Brainstem Response test

110
Q

hearing test at >3years old

A

Pure tone audiometry

111
Q

features of posterior hip dislocation

A

90% of hip dislocations. The affected leg is shortened,
adducted, and internally rotated.

112
Q

fts of anterior hip dislocation

A

abducted and externally rotated. No leg shortening.

113
Q

Alport syndrome fts

A

X linked dominant

microscropic haematuria
sensorineural deafness
occular defects
progressive CKD
retinitis pigementosa

114
Q

Causes of raised prolactin

A

prolactinoma
pregnancy
oestrogens
physiological: stress, exercise, sleep
acromegaly: 1/3 of patients
polycystic ovarian syndrome
primary hypothyroidism
metoclopramide, domperidone
phenothiazines
haloperidol

115
Q

myxedema coma fts

A
  • undiagnosed hypothy or poor compliance
    hypothermia
    Hypotension
    Bradycardia
    Confusion
116
Q

myxedema coma management

A

IV thyroxine and hydrocortisone

117
Q

Thyrotoxic storm management

A

IV propanolol, anti thyroid drugs, methimazole, hydrocortisone

118
Q

Edward syndrome fts

A

trisomy 18
dysmorphic fts
rocker bottom feet
overlapping fingers
low set ears
microgathnia - small jaw

119
Q

Patau syndrome fts

A

trisomy 13
microcephalic, small eyes
polydactyly
cleft lip/palate

120
Q

Noonan syndrome features

A

autosomal dominant
short stature
broad forehead
downward sloping eyes
webbed neck
pectus excavatum
low set ears
pulmonary stenosis
wide set eyes

121
Q

Prader willi syndrome fts

A

deletion of 15q11-q13
infantile hypotonia/ feeding problems
hyperphagia/ obesity
short stature
hypogonadism
developmental delay

122
Q

Fragile X fts

A

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism

123
Q

Klinefelter syndrome fts

A

Males XXY
low testosterine
High FSH and LH
tall, infertility, gynaecomastia

124
Q

lateral stemi ecg changes and artery affected

A

I, aVL +/- V5-6

left circumflex

125
Q

Medications for focal seizure

A

Lamotrigine
Leviteraciteam
Carbemazepine

126
Q

Medication for myoclonic seizure in females

A

Levitiracetam

127
Q

Antiphospholipid syndrome antibody and blood results

A

anti-cardiolipin AB

prolonged APTT
thrombocytopaenia

127
Q

Antiphospholipid syndrome fts

A

Clots, venous arterial thrombosis
Livedo reticularis (mottled skin)
Obstetric loss

128
Q

primary thromboprophylaxis in antiphospholipid syndrome

A

low dose aspirin

129
Q

Behcet’s triad

A

oral ulcers
genital ulcers
anterior uveitis

130
Q

Rheumatic fever organism

A

strep pyogenes

131
Q

Rheumatic fever

A

erythema marginatum
Sydenham’s chorea: this is often a late feature
polyarthritis
carditis and valvulitis
subcut nodules

132
Q

what is Sydenham’s chorea

A

late complication of rheumatic fever
abrupt involuntary movements, muscle weakness

133
Q

drug induced lupus antibodies and causes

A

procainamide
- hydralazine
- isoniazid
- phenytoin
- anti-histone antibodies
- ANA

134
Q

Vitamin B12 deficiency, subacute degen of spinal cord symptoms

A

hyperreflexia
loss of proprioception, vibration

135
Q

ankylosing spondylitis features, A’s

A

Reduced lateral and forward flexion of spine
Limitations of chest expansion
morning stiffness
back pain
Bilateral sacroiliitis

Apical fibrosis (lungs)
Anterior Uveitis
Aortic regurg
Achilles tendonitis
AV node block
Amyloidosis
Arthritis peripheral
And cauda equina

136
Q

Type 1 hypersensitivity reaction

A

Anaphylactic
- IgE
- anaphylaxis
- atopy

136
Q

Type 2 hypersensitivity reaction

A

Cell Bound
- IgG or IgM to antigen on cell surface
- autoimmune haemolytic anaemia
- ITP
- good pastures
- Pernicious
- Rheumatic fever

137
Q

Type 3 hypersensitivity reaction

A

Immune complex
- free antigen and antibody combine IgG or IgA
- SLE
- post strep glomerulonephritis

138
Q

Type 4 hypersensitivity reaction

A

Type 4
Delayed
- t cell mediated
- TB
- graft vs host disease
- allergic contact derm
- MS
- GBS

139
Q

Post splenectomy infectious organisms

A

strep pneumoniae
haem influenza
meningococci

Capnocytophaga (dog bite)

140
Q

Rivaroxaban + apixiban reversal agent

A

Andecanet alfa

141
Q

Heparin reversal agent

A

protamine sulphate

142
Q

How do u monitor unfractioned heparin

A

APTT

143
Q

Lithium side effects

A

benign leucocytosis
- hyperparathyroidism -> hypercalc
- fine tremor
- N, V+
- nephrotoxicity
- polyuria
- IIH
- weight gain
- thyroid enlarge, hypothyroidism

144
Q

Lithium toxicity precipitants

A

dehydration, renal failure, diuretics esp thiazides, ACEI, NSAIDs, metronidazole

145
Q

Lithium toxicity mx if >3.5

A

haemodialysis

146
Q

Palliative med for visceral/serosal (constipation) N+ and V+

A

cyclizine, levomeprozine

147
Q

Palliative med for chemically mediated N+ and V+

A
  • ondanestron
  • haloperidol
148
Q

Typical antipsychotics

A

haloperidol
chlorpromazine

149
Q

Side effects of atypical antipsychotics

A

weight gain (most common)
hyperprolactinaemia
DM
dyslipidaemia

150
Q

reed sternberg cells description

A

large B cells, multinucleated.

large cells with a bilobed nucleus and prominent eosinophilic inclusion-like nucleoli.

151
Q

Acute myeloid leukaemia fts

A

anaemia, pallor, breathlessness
- thrombocytopenia, bruising, petechiae
purpura and mucosal membrane bleeding
-recurrent infection because of neutropenia
hepatomegaly
splenomegaly
gum hyperplasia

myeloid blast cells
Aur rods

152
Q

Chronic myeloid leukaemia fts

A

Philadelphia chromosome 9:22
thrombocytosis
inc granulocytes at dif stages of maturation
high WCC

massive splenomegaly
anemia
weight loss
sweating
hyperleukocytosis - fundal haemorrhage and venous congestion

tx - imatinib

153
Q

Acute lymphoblastic leukaemia fts

A

75% cases occur in children <6years
B-cell lineage

2-3 week history of bone marrow failure +/- rasied wcc
bone/joint pain
infection
night sweats
neutropenia
anaemia, soft systolic murmur and SOB
thrombocytopenia, easy bruising, petechiae
lead to DIC

splenomegaly
hepatomegaly

Blast cells

154
Q

Chronic Lymphocytic Leukaemia fts on blood film

A

smudge cells

155
Q

CLL fts

A

asymptomatic at presentation

  • bone marrow failure - anaemia, thrombocytopenia
  • lymphadenopathy
  • splenomegaly
  • fever and sweats

warm haemolytic anaemia

inc wbc
inc lymphocytes

156
Q

PRV gene and pathophysiology

A

JAK2 V617F gene

too many red cells, blood thick, raised haematocrit, red cell count and Hb conc

157
Q

PRV presentation

A

fatigue
headache
itch
ruddy complexion
gout
vas occlussion
TIA, stroke
splenomegaly

Raised Hb and haematocrit

158
Q

PRV mx

A

venesection
aspirin

159
Q

Idiopathic thrombocytosis presentation

A

raised platelet count
- asymp
- burning hands
- arterial venous thromboses
- bleeding
- digital ischaemia
- gout
- headache
- mild splenomegaly

160
Q

Idiopathic thrombocytosis mx

A

aspirin and hydroxycarbamide or anagrelide

161
Q

Myelofibrosis features

A

fatigue
massive splenomegaly
weight loss, night sweats

tear drop poikolocytes

162
Q

testicular cancer teratoma blood marker

A

AFP and BHCG

non seminoma

163
Q

Clozapine side effects

A

agranulocytosis, neutropenia
reduce seizure threshold
constipation
myocarditis, do baseline ecg
hypersalivation

164
Q

Pityriasis Rosea organism and features

A

HHV 7

Herald patch, rash on trunk, first singular
raised erythematous, oval, scaly
fir-tree appearance

165
Q

Pityriasis versicolour organism, fts, tx

A

Malassezia furfur

trunk
patches vary in colour, hyperpigmentation, pink, brown
scaling

sun make it more evident

topical ketoconazole

166
Q

What is Trousseau’s sign

A

carpal spasm if the brachial artery occluded by inflating the blood pressure cuff and maintaining pressure above systolic
wrist flexion and fingers are drawn together

in hypocal

167
Q

what is Chvostek’s sign

A

tapping over parotid causes facial muscles to twitch

in hypocal

168
Q

Anal fissure mx if <1wk

A

Soften stool, dietary advice, bulk forming laxative
Lubricant bfr defecation
Topical anaesthetic

169
Q

Anal fissure mx if >6wks

A

topical GTN
If not effective >8wks, sphincterotomy or botulinum toxin

170
Q

What is budd chiari syndrome, symptoms?

A

hepatic vein thrombosis
- abd pain
- ascites
- hepatomegaly tender

171
Q

what types of shock causes warm peripheries

A

Neurogenic
Anaphylactic
Septic

171
Q

what types of shock causes cool peripheries

A

cardiogenic
haemorrhagic

171
Q

HIV toxoplasmosis tx

A

sulfadiazine, pyrimethamine

172
Q

Metronidazole side effects/ interactions

A

disulfiram-like reaction with alcohol
increases the anticoagulant effect of warfarin

173
Q

genital wart tx if keratinised

A

crypotherapy

174
Q

ascites SAAG >11 indicates?
causes

A

portal hypertension

Budd-Chiari
liver cirrhosis
Right HF

175
Q

ascites SAAG <11 causes

A

Malignancy
Hypoalbuminaemia, nephrotic syndrome
Tuberculosis peritonitis
Pancreatitis
Biliary ascites

176
Q

tetracyclines SE

A

discolouration of teeth: therefore should not be used in children < 12 years of age
photosensitivity - sunburn
angioedema
black hairy tongue

177
Q

tx for telangiectasia in acne rosacea

A

laser therapy

178
Q

tx for flushing in rosacea

A

topical brimonidine

179
Q

cause of pseudohponatraemia

A

hyperlipidaemia (increase in serum volume)

180
Q

Hepatitis E

A

RNA virus
undercooked pork
Shellfish
Signify mortality during pregnancy

181
Q

Hepatitis A features

A

benign, self-limiting disease

flu-like prodrome
abdominal pain: typically right upper quadrant
tender hepatomegaly
jaundice
deranged liver function tests

182
Q

which hepatitis has signif mortality in preg

A

hep E

183
Q

who should be vaccinated for hep A

A

people travelling to or going to reside in areas of high or intermediate prevalence, if aged > 1 year old
people with chronic liver disease
patients with haemophilia
men who have sex with men
injecting drug users
individuals at occupational risk: laboratory worker; staff of large residential institutions; sewage workers; people who work with primates

184
Q

what is TURP syndrome

A

Glycine toxicity
results in hyponatremia

185
Q

Cisplatin side effects

A

otoxicity
- hypomagnesia
- peripheral neuropathy

186
Q

Cyclophosphamide side effects

A
  • myelosuppression
  • haemorrhagic cystitis
  • transitional cell carcinoma
187
Q

Anthracyclines, Doxorubicin side effect

A

cardiomyopathy

188
Q

Bleomycin side effect

A

lung fibrosis

189
Q

Vincristine side effect

A

peripheral neuropathy, paralytic ileus

190
Q

what is Brudzinski’s sign

A

hip and knee flex on passive flexion of neck

meningitis

191
Q

what is kernig’s sign

A

pain on passive extension of knee

meningitis

192
Q

Organism for meningitis <3mths

A
  • group b strep
  • e. coli
  • listeria monocytogenes
193
Q

Down’s quadruple test results

A
  • low AFP
  • low oestriol
  • high hcg
  • high inhibin A
194
Q

Edwards quadruple test results

A

low afp
low oestriol
low hcg
inhibin normal

195
Q

neural tube defect quadruple test results

A

high afp
normal oestriol
normal hcg
normal inhibin A

196
Q

cephalhaematoma description

A

Develop after birth and do not cross the suture lines of the skull as the blood is confined between the skull and periosteum

197
Q

neiseria gonorrhoea tx for needle phobic p’s

A

oral cefixime + oral azithromycin

198
Q

Metoclopramide side effects

A

EPS - acute dystonia
D+
hyperprolactinaemia
tardive dyskinesia
parkisonism

avoid in bowel obstruction

199
Q

levodopa side effects

A

dry mouth
anorexia
palpitations
postural hypotension
psychosis

dyskinesia at peak dose, dystonia, chorea, athetosis

200
Q

dopamine receptor agonist side effects

A

impulse control disorders
excessive daytime somnolence

201
Q

Amantadine side effects

A

ataxia, slurred speech, confusion, livedo reticularis

202
Q

horners central lesion features and causes

A

anhidrosis of face, arm trunk
Stroke,
syringomyelia, MS, tumour,
encephalitis

203
Q

Horner’s pre ganglionic lesion fts and causes

A

Anhidrosis of face
pan coast tumour
Thyroidectomy
Cervical rib

204
Q

Horner’s post ganglionic lesion fts and causes

A

No anhidrosis
Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache

205
Q

Criteria for long term oxygen therapy in COPD p’s

A

2 ABG pO2 < 7.3

or
7.3 - 8 +
2ndry polycythaemia, peripheral oedema, pulmonary hypertension

206
Q

organs that metastasise to Brain

A

lung (most common)
breast
bowel
skin
kidney

207
Q

adrenaline induced ischaemia reversal agent

A

phentolamine

208
Q

safe triangle borders

A

Latissimus dorsi,
pectoralis major,
line superior to the nipple
apex at the axilla

209
Q

what conditions cause lower than expected Hba1c levels, (reduced rbc lifespan)

A

G6pd
sickle cell
hereditary spherocytosis
haemodialysis

210
Q

what conditions cause higher than expected Hba1c levels, (increased rbc lifespan)

A

Vitamin B12/folic acid deficiency
Iron-deficiency anaemia
Splenectomy

211
Q

when doing PSA how long musy you wait after
- biopsy
- uti etc

A

6wks prostate biopsy
4wks UTI
1wk DRE
48hrs vigorous exercise or ejaculation

212
Q

Opiate withdrawal symptoms

A

insomnia
- yawning
- dilated pupils
- muscle pain and cramps
- agitation
- anxiety, D+

213
Q

MDMA (ecstasy) overdose signs

A

neurological: agitation, anxiety, confusion, ataxia

tachycardia, hypertension
hyperthermia
rhabdomyolysis

hyponatraemia
this may result from either syndrome of inappropriate ADH secretion or excessive water consumption whilst taking MDMA

214
Q

Cocaine side effects

A

hypertension n HR
- euphoria
- hyperthermia
- seizures
- coronary artery spasm

215
Q

Ciprofloxacin side effects

A

QT prolong
reduce seizure threshold
tendon, cartilage damage

216
Q

Renal tubular acidosis ABG effect

A

hyperchloraemic metabolic acidosis, normal anion gap

217
Q

Type 1 renal tubular acidosis

A

distal
hypokalaemia
nephrocalcinosis, renal stones

causes
- idiopathic
- RA - SLE
- sjogrens

218
Q

Type 1 renal tubular acidosis causes

A
  • idiopathic
  • RA - SLE
  • sjogrens
219
Q

Type 2 renal tubular acidosis

A

proximal
hypokalaemic
- osteomalacia

causes
- idiopathic
- fanconi
- wilsons disease
- carbonic anhydrase inhib

220
Q

Type 2 renal tubular acidosis causes

A
  • idiopathic
  • fanconi
  • wilsons disease
  • carbonic anhydrase inhib
221
Q

Type 4 renal tubular acidosis

A

hyperkalaemic

causes - hypoaldosteronism, DM

222
Q

drug causes of pancytopenia

A

Cytotoxics
Trimethoprim, chloramphenicol
Gold, penicillamine
Carbimazole*
Carbamazepine
sulphonylureas: tolbutamide

223
Q

Parkinson’s plus syndrome
Multiple system atrophy fts

A

autonomic CF
Postural hypotension
Incontinence
Erectile dysfunction
Cerebellar signs

224
Q

Cortico basal degenerations fts
Parkinson plus

A
  • spontaneous activity of limb or akinetic rigidity
225
Q

cystic fibrosis diagnosis and value

A

sweat chloride test
>60

226
Q

when are cleft lips repaired

A

first week of life to 3mths

227
Q

when are cleft palates repaired

A

6-12mths

228
Q

drugs causing IIH

A

combined oral contraceptive pill
steroids
tetracyclines
retinoids (isotretinoin, tretinoin) / vitamin A
lithium

229
Q

causes of hypokalaemia w alkalosis

A

vomiting
thiazide and loop diuretics
Cushing’s syndrome
Conn’s syndrome

230
Q

causes of hypokalaemia w acidosis

A

diarrhoea
renal tubular acidosis
acetazolamide
partially treated diabetic ketoacidosis

231
Q

causes of hyperkalaemia

A

acute kidney injury
drugs: potassium sparing diuretics, ACE inhibitors, angiotensin 2 receptor blockers, spironolactone, ciclosporin, heparin
metabolic acidosis
Addison’s disease
rhabdomyolysis
massive blood transfusion

231
Q

causes of hypercalcaemia

A

primary hyperparathryoidism
malignancy

sarcoid
vitamin D intoxication
acromegaly
thyrotoxicosis
thiazide diuretics
dehydration
addisons

232
Q

how is severe hypocalcaemia managed

A

IV calcium gluconate 10%

233
Q

treatment for severe hyponatraemia <120

A

Hypertonic saline (typically 3% NaCl)

234
Q

statins contraindications

A

pregnancy

on course of macrolides

235
Q

Levodopa side effects

A

dyskinesia at peak dose, dystonia, chorea, athetosis
Dry mouth,
end of dose wearing
palpitations,
N+ V+
Psychosis
Postural hypotension

236
Q

dopamine agonist side effects

A

impulse control disorders, gambling, hyper sexuality, shopping, binge eating
Excessive daytime somnolence

237
Q

drug treatment for N+ and V+ in parkinsons

A

Domperidone
Doesn’t cross blood Brain barrier

238
Q

MAO-B inhibitor drug examples

A

selegiline, rasagiline, safinamide

239
Q

when should pregnant women take folic acid

A

until 12th week of pregnancy

240
Q

when do pregnant women require 5mg folic acid

A

partner has a NTD,
they have had a previous pregnancy affected by a NTD,
family history of a NTD
antiepileptic drugs
coeliac disease,
diabetes
thalassaemia trait
BMI >30

241
Q

what causes false positive syphilis test

A

negative TPHA and positive VDRL

pregnancy,
HIV,
SLE,
TB
malaria

242
Q

MEN1 features

A

hypercalcaemia

Parathyroid hyperplasia and adenomas

Pancreatic insulinoma, gastronoma, peptic ulceration

Pituitary adenoma

243
Q

MEN 2 type 2a fts

A

RET oncogene

Parathyroid
Phaemochromocytoma

Medullary thyroid carcinoma

244
Q

MEN 2 type 2b fts

A

Phaemochromocytoma

Marfanoid body
Neuromas

245
Q

antibiotics used in brain abscess

A

IV 3rd-generation cephalosporin + metronidazole

246
Q

common causes of meningitis <3mths

A

Group b strep
e.coli
listeria

247
Q

common causes of meningitis

A

Neisseria meningitidis - gram neg diploc
Streptococcus pneumoniae

yr4 FINALS (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions