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1
Q

cause of BPPV

A

otoconia that become displaced into the semicircular canals

may be displaced by viral infection, head trauma, ageing or without clear cause

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2
Q

menieres diseae cause

A

excessive buildup of endolymph in the semocircular canals, causing higher pressure

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3
Q

management of BPPV

A

epley manoeuvre
prochlorperazine
antihistamines

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4
Q

meniere’s disease management

A

prophylaxis: betahistine
short term management:
Prochlorperazine
Antihistamines

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5
Q

heberden nodes

A

bony growths which suggest osteoarthritis

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6
Q

trigger finger

A

thumb locks during flexion and extension at the distal and proximal intraphalangeal joints

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7
Q

treatment of childhood obstructive sleep apnoea

A

adenotonsillectomy

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8
Q

SUFE management

A

urgent surgery to pin the femoral head to prevent further slipage

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9
Q

presentation of damage to recurrent laryngeal nerve during thyroidectomy

A

hoarseness

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10
Q

polymyositis

A

condition of chronic inflammation of muscles

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11
Q

dermatomyositis

A

connective tissue disorder where there is chronic inflammation of the skin and muscles

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12
Q

key investigation in diagnosing myositis

A

creatine kinase

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13
Q

telogen effluvium

A

condition where there is increased hair shedding due to a disruption in the normal hair cycle

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14
Q

investigation for acromegaly

A

insulin-like growth factor1
oral glucose tolerance test
MRI brain for pituitary tumour

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15
Q

treatment for acromegaly

A

trans-sphenoidal through the nose and sphenoid bone

Somatostatin analogues: Sandostatin LAR/ Lanreotide- first line

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16
Q

lateral border of the anatomical snuffbox

A

extensor pollicis brevis and the abductor pollicis longus tendons

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17
Q

presentation of cushing’s disease

A

weight gain
fatigue
presence of abdominal striae
hirsutism

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18
Q

most common endogenous cause of cushing’s syndrome

A

pituitary adenoma

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19
Q

presentation of Niacin B3 deficiency

A

dermatitis
diarrhoea
dementia

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20
Q

presentation of adrenal insufficiency

A 
fatigue 
nausea 
cramps 
abdominal pain 
reduced libido 
hyperoigmentation 
hypotension
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21
Q

test of choice for adrenal insufficiency

A

short synacthen test

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22
Q

red flags for child developement at 6 months

A

not reaching for object

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23
Q

red flags for child developement at 10 months

A

no smile or speech

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24
Q

red flags for child developement at 12 months

A

cannot sit unsupported and has preferential use of one hand (cerebral palsy)

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25
Q

red flags for child developement at 18 months

A

cannot walk

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26
Q

causes of cerebral palsy

A 
TORCH
- toxoplasmosis 
- rubella 
- CMV 
- Herpes simplex 
intrapartum- hypoxia, focal distress
post-natal
- anything that affects the brain
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27
Q

presentation of cerebral palsy

A 
spasticity
- increased tone and reflexes 
- reduced power
dyskinetic
- slow writing, convoluted movements of fingers, hands and toes
- ataxia
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28
Q

management of cerebral palsy

A

oral diazepam

oral baclofen

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29
Q

gower’s sign

A

using hands to push on legs to stand upright

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30
Q

duchene muscular dystrophy

A

X-linked recessive condition

malformation of dystrophin gene

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31
Q

presentation of duchene musclar dystrophy

A

boys aged 1-6 who are struggling to walk (waddling gait)
proximal muscle wasting
pseudohypertrophy of calves
gowers sign

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32
Q

investigation for duchene muscular dystrophy

A

CK

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33
Q

management of duchene muscular dystrophy

A

poor prognosis

usually die in 20s duee to cardiac/resp failure

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34
Q

physical examination for suspected meningitis

A

kernig’s test

brudzinski’s test

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35
Q

management of bulging fontanelle

A

mannitol

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36
Q

management of meningitis community

A

IM/IV benzylpenicillin

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37
Q

hospital management of meningitis in kids

A

LP + bloods for culture
<3 months Cefotaxime + Amoxicillin
> 3 months 1st dose Cefotaxime followed 6 hours later with once daily Ceftriaxone + dexamethasone

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38
Q

cause of measles

A

RNA virus- paramyxovirus

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39
Q

presentation of measles

A 
koplick spots (white spots on buccal mucosa)
rash starting behind the ears
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40
Q

management of measles

A

supportive and tell PH

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41
Q

most common complication of measles

A

otitis media

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42
Q

cause of rubella

A

togavirus

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43
Q

presentation of rubella

A

fever
rash- pink-red maculopapular rash
lymphadenopathy

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44
Q

chicken pox management

A

calamine lotion for the itch

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45
Q

scarlet fever presentation

A

strawberry tongue

find punctuate erythema (starts on trunk)

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46
Q

presentation of open angle-glaucoma

A

gradual onset vision loss (beginning peripherally)

fluctuating pain, headaches, blurred vision and halos around light

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47
Q

investigations for open angle glaucoma

A

visual field assessment and acuity
fundoscopy
tonometry

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48
Q

management of open angle glaucoma

A

latanoprost eye drops
bb- reduce aqueous production
carbonic anhydrase inhibitors
surgery

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49
Q

presentation of acute angle-closure glaucoma

A

rapid onset vision loss
painful, red, teary eye with semi dilated pupil
symptoms worse in dark room
halos around light

50
Q

investigations for acute angle closure glaucoma

A

visual field assessment and acuity
fundoscopy
tonometry

51
Q

management of acute closure glaucoma

A

urgent referral
pilocarpine eye drops
IV acetozolamide
surgery is definitive

52
Q

symptoms of dry ARMD

A

gradual worsening central vision loss
reduced visual acuity
wavy appearance of line

53
Q

investigation for dry ARMD

A

snellen chart
amsler grid test
fundoscopy
optical coherence tomography

54
Q

biochem for primary hyperparathyroid

A

high calcium
low phosphate
PTH raised or normal
sometimes low vit d

55
Q

bence jones proteins

A

in the urine with multiple myeloma

56
Q

main features of multiple myeloma

A

calcium (raised)
renal failure
anaemia
bone lesions/pain

57
Q

investigation for myeloma- BLIP

A 
bence-jones proteins- urine electrophoresis
serum- free Light chain 
serum Immunoglobulins 
serum Protein electrophoresis
bone marrow biopsy
imaging
58
Q

xray signs for multiple myeloma

A

punched out lesions
lytic lesions
raindrop skull

59
Q

management of multiple myeloma

A 
chemotherapy with 
bortezomid 
thalidomide 
dexamethasone
myeloma bone disease- bisphosphonates
60
Q

lichen planus management

A

emollients
topical steroid cream- first line ?
steroid mouthwash
oral prednisolone- for flare ups

61
Q

behcet disease presentation

A

oral ulcers, genital ulcers and uveitis

62
Q

management of trigger finger

A

steroid injection
finger splint
surgery

63
Q

presentation of trigger finger

A

thumb, middle or ring finger
initially stiffness and snapping when extending a flexed digit
nodule may be felt

64
Q

anterior uveitis presentation

A 
unilateral 
dull, achy painful red eye 
ciliary flush 
floaters and flash 
pain on movement 
photophobia 
hypopyon
65
Q

management of anterior uveitis

A

same day referral to ophthalmology
steroids
cyclopegic-mydriatics
immunosuppressants: DMARDs, TNF inhibitors

66
Q

Weakness of hip abduction and foot drop, no specific reflex lost

A

L5 radiculopathy

67
Q

herald patch

A

singular, large plaque that appears several days before general rash
pityriasis rosea

68
Q

management of pityriasis rosea

A

self-limiting disease

symptomatic relief- aqueous cream, antihistamines

69
Q

sudden sensorineural hearing loss management

A

immediate referral

high dose oral steroids

70
Q

Retinitis pigmentosa

A

congenital inherited condition where there is degeneration of the rods and cones in the retina

71
Q

presentation of retinitis pigmentosa

A

night blindness

loss of peripheral vision first- tunneling vision

72
Q

management of otitis media that has lasted >3-4 days

A

amoxicillin

clarithromycin- if allergic

73
Q

management for recurrent epistaxis (not acute management)

A

prescribe naseptin nasal cream- contains PEANUTS

74
Q

lump which is anterior to the sternocleidomastoid muscle, round, soft and non-tender

A

branchial cyst

75
Q

first line investigation in suspected primary hyperaldosteronism

A

aldosterone/renin ratio

76
Q

first line investigation for secondary hypothyroidism

A

MRI pituitary gland

77
Q

normal hyperparathyroid by high calcium

A

parathyroid is the cause- most likely adenoma

raised calcium means the PTH should be suppressed

78
Q

child crying in direct sunlight

A

erythropoietic protoporphyria

79
Q

build up of what occurs in porphyria cutanea tarda

A

Urophorphinogen

80
Q

first line treatment for acne rosacea

A

topical metronidazole

81
Q

first line treatment for acne vulgaris

A

benzoly peroxide

82
Q

what is epidermolysis bullosa?

A

breakdown of anchoring between epidermis & dermis

83
Q

which diabetic drug is weight neutral

A

DPP4 Inhibitors

84
Q

Pagets electrolytes

A

normal calcium, phosphate and PTH

increased ALP

85
Q

osteomalacia results

A

decreased calcium and phosphate

increased alp and PTH

86
Q

what can aggravate psoriasis

87
Q

primary hyperparathyroid results

A

increased calcium
decreased phosphate
increased ALP
normal or increased PTH

88
Q

CKD causing secondary hyperparathyroid

A

decreased calcium

increased phosphate, ALP, PTH

89
Q

hormone to test for pregnancy

90
Q

hormone peaks before ovulation

91
Q

hormone to test for fertility

A

progesterone

92
Q

osteomalacia treatment

A

vit D therapy with calcium and phosphate supplements

93
Q

waddling gait

A

osteomalacia (rickets in kids)

94
Q

DMARD that can cause interstitial pneumonitis

A

methotrexate

95
Q

Visual loss, mouth ulcers and genital ulcers

A

Behcets syndrome

96
Q

vertigo seconds to minutes

97
Q

diagnosis of BPPV??

98
Q

treatment of BPPV

A

epley manoeuvre

99
Q

compression of CNVII causes

A

Bells palsy

100
Q

ramsay hunt syndrome

A

reactivation of varicella zoster virus in geniculate ganglion of CN7

101
Q

third nerve palsy (eye)

A

looking down and out
fixed pupil
proptosis and ptosis

102
Q

fourth nerve palsy

A

eyes look upwards
vertical diplopia
cannot look down and in

103
Q

sixth nerve palsy

A

horizontal diplopia

eyes medially deviated and cannot move laterally from midline

104
Q

first line treatment for BPH

A

alpha blocker- tamsulosin

second line- 5 alpha reductase- finestride

105
Q

first line investigation for hydrocele

A

doppler us with colour

106
Q

first line investigation for osteomyelitis

107
Q

achilles tendon rupture investigation

108
Q

Propylthiouracil side effects

A

agranulocytosis

109
Q

drugs that may be used to control the symptoms and signs of Cushing’s Syndrome?

A

Metyrapone [blocks cortisol synthesis]

110
Q

urinary tract obstruction management

A

nephrostomy

111
Q

investigation for bullous pemphigoid

A

immunofluorescence- show IgG and C3 at dermoepidermal junction
linear IgG deposits

112
Q

management of bullous pemphigoid

A

oral corticosteroids
tetracycline antibiotics
topical corticosteroids, immunosuppressants

113
Q

investigation for pemphigus vulgaris

A

immunofluroscence- intra-epidermal deposition of IgG and C3 (Chicken wire)
biopsy- loss of intercellular adhesion sites

114
Q

management of pemphigus vulgaris

A

steroids- prednisolone

immunosuppressants

115
Q

large vessel vasculitis

A

takaysau arteritis and GCA

116
Q

vasculitis associated with resp tract and kidneys

117
Q

young woman with absent pulses?

118
Q

male baldness with positive family history

A

androgenic alopecia

119
Q

venous ulcer infection

A

strep pyogenes?

120
Q

first line in back pain with red flag

121
Q

haematuria
flank pain
palpable mass

A

renal cell carcinoma

122
Q

non-tender painless lumb in testicles
hard
irregular

A

testicular cancer

second year!! (7 decks)

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