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PLABABLE 2.0 > Mock 11 > Flashcards

Mock 11 Flashcards

1
Q

40-year old man + feeling weak and tired + complains of headache + hypertensive at 210/100 + not on any medications + normal serum sodium + hypokalemia at 2.9

Most likely diagnosis?

A

PRIMARY HYPERALDOSTERONISM

Hypokalemia and hypertension = Think of primary hyperaldosteronism

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2
Q

Differentiate Conn from Addison

A

Addison’s Disease = ALL DROP - drop in aldosterone, drop in sodium, drop in BP, drop in weight, drop in energy. ONLY POTASSIUM IS INCREASED

Conn’s is exact opposite of Addison - hypertension, hypernatremia (or high of normal), HYPOKALEMIA

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3
Q

How do you manage Conn’s?

A

Medical: Spironolactone (aldosterone antagonists)
Surgical: definitive - adrenalectomy

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4
Q

When do you think of Conn’s syndrome?

A
  1. HTN + hypokalemia
  2. Refractory hypertension despite more than 3 antihypertensive drugs
  3. Hypertension occurring before age 40
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5
Q

Lymphatic drainage: skin (scrotum, vulva, perineum)

A

Superficial inguinal LN

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6
Q

Lymphatic drainage: all below umbilicus except gonad and lateral foot

A

Superficial inguinal LN

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7
Q

Lymphatic drainage: testes and ovaries

A

Para-aortic LN

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8
Q

Lymphatic drainage: lateral foot

A

Popliteal LN (then to the SILN)

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9
Q

Lymphatic drainage: lateral foot

A

Popliteal LN (then to the SILN)

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10
Q

Lymphatic drainage: deep lymphatic of glans and clitoris

A

External iliac LN

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11
Q

Superficial inguinal LN drains all structures below the umbilicus except for these structures:

A

Gonads (ovaries and testes) - para-aortic LN
Lateral foot - popliteal lymph nodes (then later drains into the inguinal LN)
*Deep lymphatics of glans and clitoris - external iliac LN

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12
Q

What is (Arya) Fregoli delusions?

A

Delusion of doubles - various persons are indeed one person in disguise or changes in apperance

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13
Q

What is the difference between Fregoli and Capgras?

A

Fregoli (as in Arya Fregoli) is the delusion wherein a person is just in disguise (think of Arya Stark in disguise as other persons) while Capgras is similar identical to the person YOU KNOW but he is not the real person.

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14
Q

What is the difference between Fregoli and Capgras?

A

Fregoli (as in Arya Fregoli) is the delusion wherein a person is just in disguise (think of Arya Stark in disguise as other persons) while Capgras is similar identical to the person YOU KNOW but he is not the real person.

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15
Q

Ganser syndrome?

A

Prison psychosis in an attempt to gain leniency from prison

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16
Q

Breastfeeding advice for mother with mastitis

A

Continue breastfeeding

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17
Q

Breastfeeding advice for mother with breast abscess

A

Continue

18
Q

Breastfeeding advice for mother with nipple candidiasis

A

Continue breastfeeding

19
Q

Breastfeeding advice for mother with maternal HIV

A

Avoid breastfeeding

20
Q

Breastfeeding advice for mother with maternal hepatitis B

A

Continue (Breastfeeding safe but make sure baby has received HBV prophylaxis)

21
Q

Management of recurrent UTI with identified trigger

A

Single-dose antibiotic prophylaxis

22
Q

Management of recurrent UTI with no identifiable triggers

A

Low-dose antibiotic prophylaxis daily (TMP, Nitrofurantoin or Cefalexin)

23
Q

Management of recurrent URI in post-menopausal women

A

Oestrogen replacement

24
Q

Management of recurrent UTI with residual urine present

A

Optimize bladder emptying by intermittent catheterization

25
Q

Breastfeeding advice for mother with maternal hepatitis C

A

Continue (BF safe unless mother has cracked or bleeding nipple)

26
Q

PLABABLE’s 3 never-forget points for DKA

A
  1. NSS
  2. Insulin and KCl
  3. If glucose falls below 14 mmol/L, started 10% glucose + saline
27
Q

Other name for RItter’s disease

A

Staphylococcal Scalded Skin Syndrome

28
Q

2 y/o boy + irritable and lethargic for the past two days with rash and fever + rash started as red patches which developed into blisters + painful and distressing + fever preceded the rash + no significant PMH + not on any meds + Nikolsky sign positive

A

SSSS

29
Q

Common causes of CN XII injury

A
  1. LMN Lesions - polio, syringomyelia
  2. Stroke
  3. Bulbar palsy
  4. Neck trauma
  5. Carotid endarterectomy
30
Q

Pseudohypoparathyroidism vs. Fanconi syndrome vs. Vit D deficiency vs. Primary hyperparathyroidism

A

Pseudohyparathyroidism - associated with congenital syndrome; hypocalcemia + elevated PTH and phosphate

Vit D deficiency - reduced Ca absorption from GIT; increased PTH

Fanconi syndrome - Type II RTA where there is defect of the proximal renal tubule; hypocalcemia + hypophosphatemia + hypomagnesemia + metabolic acidosis

31
Q

Management for neutropenic sepsis

A

Piperacillin-Tazobactam

32
Q

When would you suspect neutropenic sepsis?

A
  1. Fever more than 38.5ºC or two occasions of high temp two hours apart
  2. ANC ≤ 0.5 x 10^9/L
  3. Recipients of chemotherapy within the last 4 weeks
  4. Recipients of bone marrow transplant
33
Q

What is the caveat regarding laboratory parameters in DIC?

A

Everything is elevated except for fibrinogen and platelet.

In DIC, platelet may be decreased or normal. aPTT is elevated. Fibrin products (including D-dimer) are elevated. Protime is elevated. Fibrinogen is decreased.

34
Q

Laboratory findings in a patient with subclinical hypothyroidism

A

Elevated TSH

Normal T4

35
Q

TIA and DVLA

A

For group 1 driver - do not drive for 1 month. No need to notify DVLA if suffered from 1 TIA only. (Notify DVLA if suffered multiple TIA)

For group 2 driver - Notify DVLA

36
Q

Which type of antihypertensive medications should be omitted prior to surgery? And how many hours should they be omitted?

A

Omit ACE inihibitors as well as ARBs 24 hours prior to surgery.

***These medications can result in severe hypotension after induction of general anesthesia.

37
Q

Treatment for Dressler syndrome

A

NSAIDs

38
Q

Maintenance fluid for diarrhea in children

A

PNSS + 5% dextrose

39
Q

Painless bilateral swelling of the face + mild-grade fever + dry mouth + CXR finding of bilateral perihilar lymphadenopathy

A

Mikulicz’s syndrome

40
Q

Most preferred treatment for trigeminal neuralgia

A

CARBAMAZEPINE > lamotrigine/ phenytoin/ gabapentin

41
Q

Presence of Paul-Bunnell would prompt you into this diagnosis + sore throat + palatal petechiae

A

Glandular fever

42
Q

When would you consider using Clozapine?

A

After two failed attempts of antipsychotics

PLABABLE 2.0 (33 decks)

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