mock corrections Flashcards
failed medical management of acute pulmonary oedema?
CPAP airway
vitreous detachment , RF’s and presentation
RF’s include diabetes, bleeding disorders
presentation can be with numerous dark spots or floaters in vision if the bleed is smaller
mnemonic for Wernicke’s
Confusion
Ataxia
Nystagmus
Ophthamoplegia
PEripheral
Neuropathy
trans-tentorial herniation
fixed and dilated pupil with down and out gaze
decreasing consciousness level and intercranial mass
Cerebellar tonsillar herniation
Cerebellar tonsillar herniation affects the medulla oblongata and is often a terminal event in an unconscious patient resulting in asystolic cardio-respiratory arrest
when is elective endovascular aneurysm repair recommended for AAA
asymptomatic > 5.5
enlarging by > 1cm/ year
loop ileostomy
used in the defunctioning of the colon e.g. following rectal cancer surgery in RIF
loop colostomy
to defunction distal segment of colon
most easily reversible stoma
loop ileostomy
complications of cholecystectomy
gallstones
common bile duct injury which presents within the first few days after surgery due to inflammation and scarring
neurogenic shock
following spinal cord transection interrupting the autonomic nervous system resulting in either decreased/ increased parasympathetic tone
presents with low hr, flushed peripheries
_____________ is a contraindication to circumcision in infancy as the foreskin is used in the repair
hypospadias
. A confirmed miscarriage can be diagnosed on ultrasound if there is no cardiac activity and:
The crown-rump length is greater than 7mm OR
The gestational sack is greater than 25mm
prophylaxis of sinusitis
intranasal decongestants
________can be used to assess the presence of fluid in the abdomen and thorax
FAST scan
Thyrotoxic storm is treated with
beta blockers, propylthiouracil and hydrocortisone
Suspected PE in pregnant women with a confirmed DVT:
treat with LMWH first then investigate to rule in/out
The following drugs may cause urinary retention:
tricyclic antidepressants e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide
8 reversible causes of cardiac arrest
Hypothermia
Hypoxia
Hypovolaemia
Hypokalaemia / hyperkalaemia / hypoglycaemia
Tension pneumothorax
Toxins
Tamponade
Thrombosis
investigations for erectile dysfunction
free testosterone in the morning between 9-11 am
Patient >= 60 years old with new iron-deficiency anaemia →
FIT testing before colonoscopy
clinical signs is most strongly suggestive of a diagnosis of acute compartment syndrome
pain on passive ankle dorsiflexion
s the intervention of choice in patients with malignant distal obstructive jaundice due to unresectable pancreatic carcinoma
biliary stenting
anterior uveitis management
steroid eye drops with mydriatic eye drops
complication of rapid hyponatraemia correction
central pontine myelinosis
complication of rapid hypernatraemia correction
cerebral oedema
investigation required before starting anti TNF’s
CXR
side effects of PPI’s
hyponatraemia, hypomagnasaemia
osteoporosis → increased risk of fractures
microscopic colitis
increased risk of C. difficile infections
how should human bites and animal bites betreated
co-amoxiclav
Whilst a patient is receiving PCA opioids what other medications should be stopped
all other opioids
what supplements should be prescribed to the mums of babies with CMPI
calcium and vitamin D
management of massive PE
IV heparin
life expectancy currently
82 years
suspected septic arthritis - negative gram stain
start iv abx
what is recommended in the work up for inflammatory bowel disease
stool culture
when should activated charcoal be considered in an overdose
1st one hour
best investigation to assess acute abdomen post surgery
CT abdomen
how to confirm norovirus
viral PCR
What is the aim of the cervical cancer screening programme?
screen for HPV-
abnormal cells indicative of pre-invasive dyskaryosis
Name three blood tests that would be requested as part of confusion screen
FBC
- CRP/ESR
- Folate
- B12
- U&Es
- HbA1c
- Calcium
- LFTs
- TFTs
why is a repeat CXR recommended in mx of pneumonia in older persons
check for malignancy
genetic mutation of the Philadelphia
chromosome?
Translocation of chromosomes 9 and 22
Apart from the Philadelphia chromosome, what other chromosomal
abnormality predisposes children to this form of leukaemia?
Trisomy 21
Name 2 options that can be offered for definitive management of hyperthyroidism
Radioiodine therapy
Thyroidectomy
Which zone of the prostate is primarily affected in prostate cancer?
Peripheral zone
What imaging is used as the first-line investigation for suspected prostate
cancer?
Multiparametric MRI
Prostate cancer is diagnosed through biopsies of prostatic tissue, which are
used to calculate a ‘Gleason score’. How is the Gleason score calculated?
The two most common tumour patterns across all samples are graded based on their
differentiation
The sum of the two grades is the Gleason score
role of tolvaptan in PKD
reduces the growth rate of cysts
cause of low Hb in CKD
Anaemia of chronic disease due to reduced EPO production
Name the most common cause of chronic kidney disease in the UK
T2DM
Parkland formula for burns
4ml x body weight (kg) x total body surface area affected (%)
What effect does carbon monoxide have on the oxyhaemoglobin dissociation
curve and how does this cause symptoms of carbon monoxide poisoning?
carbon dioxide = greater affinity for Hb than O2 so it binds to O2
curve shifts from right to left, which makes Hb hold on to oxygen more causing hypoxia
direct inguinal hernia
bowel enters the inguinal canal directly through weakness in posterior wall
indirect hernia
bowel enters inguinal canal through the deep inguinal ring
which hernia is most commonly seen in infants and why
indirect inguinal hernia due to a patent processus vaginalis
which nerve is damaged intra-operatively in hernia surgery
ilioinguinal
What is the difference between the terms ‘oligoarthritis’ and ‘polyarthritis’?
Oligoarthritis affects 4 or fewer / affects 2-4 joints
In polyarthritis, more than 4 joints are involved
which serological markers are used in hep B screening
HBsAg and anti HBc
which marker gives a count of viral load
hepatitis B virus DNA
what is injected in hep B vaccine
HBsAg - hep B surface antigen
which hep B serological marker indicates immunity post vaccination
Anti HBs - hepatitis B surface antibody
what forms of hepatitis can be vaccinated against -
Hep A
dog bite prophylaxis
co-amoxiclav
trachea pulled towards the white out
pneumonectomy
complete lung collapse
pulmonary hypoplasia
class of drugs useful in overactive bladder
antimuscarinics
no jaundice - bile stones which duct
cystic duct
PPROM which steroid
dexamethasone
symptoms of mania in primary care
refer urgently to primary care
indications for thoracotomy in haemothorax
> 1.5 L blood loss
losses of > 200 ml / hour for 2 hours
agonal breathing
can occur in the first few minutes after a cardiac arrest
woman with bone metastases- origin
breast
Most common tumour causing bone metastases
prostate
breast
lung
side effects of heparins
heparin induced thrombocytopenia
which medications can precipitate digoxin toxicity
thiazide diuretics
Patients with long saphenous vein superficial thrombophlebitis should have
ultrasound to exclude DVT
_________is usually indicated in patients with acute, severe, symptomatic hyponatraemia (< 120 mmol/L)
Hypertonic
codeine to morphine
divide by 10
hpw is hydrocortisone given in Addisons
split with majority in 1st half of the day
