more Flashcards
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
2
Q
menieres diseae cause
A
excessive buildup of endolymph in the semocircular canals, causing higher pressure
3
Q
management of BPPV
A
epley manoeuvre
prochlorperazine
antihistamines
4
Q
meniere’s disease management
A
prophylaxis: betahistine
short term management:
Prochlorperazine
Antihistamines
5
Q
heberden nodes
A
bony growths which suggest osteoarthritis
6
Q
trigger finger
A
thumb locks during flexion and extension at the distal and proximal intraphalangeal joints
7
Q
treatment of childhood obstructive sleep apnoea
A
adenotonsillectomy
8
Q
SUFE management
A
urgent surgery to pin the femoral head to prevent further slipage
9
Q
presentation of damage to recurrent laryngeal nerve during thyroidectomy
A
hoarseness
10
Q
polymyositis
A
condition of chronic inflammation of muscles
11
Q
dermatomyositis
A
connective tissue disorder where there is chronic inflammation of the skin and muscles
12
Q
key investigation in diagnosing myositis
A
creatine kinase
13
Q
telogen effluvium
A
condition where there is increased hair shedding due to a disruption in the normal hair cycle
14
Q
investigation for acromegaly
A
insulin-like growth factor1
oral glucose tolerance test
MRI brain for pituitary tumour
15
Q
treatment for acromegaly
A
trans-sphenoidal through the nose and sphenoid bone
Somatostatin analogues: Sandostatin LAR/ Lanreotide- first line
16
Q
lateral border of the anatomical snuffbox
A
extensor pollicis brevis and the abductor pollicis longus tendons
17
Q
presentation of cushing’s disease
A
weight gain
fatigue
presence of abdominal striae
hirsutism
18
Q
most common endogenous cause of cushing’s syndrome
A
pituitary adenoma
19
Q
presentation of Niacin B3 deficiency
A
dermatitis
diarrhoea
dementia
20
Q
presentation of adrenal insufficiency
A
fatigue nausea cramps abdominal pain reduced libido hyperoigmentation hypotension
21
Q
test of choice for adrenal insufficiency
A
short synacthen test
22
Q
red flags for child developement at 6 months
A
not reaching for object
23
Q
red flags for child developement at 10 months
A
no smile or speech
24
Q
red flags for child developement at 12 months
A
cannot sit unsupported and has preferential use of one hand (cerebral palsy)
25
red flags for child developement at 18 months
cannot walk
26
causes of cerebral palsy
```
TORCH
- toxoplasmosis
- rubella
- CMV
- Herpes simplex
intrapartum- hypoxia, focal distress
post-natal
- anything that affects the brain
```
27
presentation of cerebral palsy
```
spasticity
- increased tone and reflexes
- reduced power
dyskinetic
- slow writing, convoluted movements of fingers, hands and toes
- ataxia
```
28
management of cerebral palsy
oral diazepam
| oral baclofen
29
gower's sign
using hands to push on legs to stand upright
30
duchene muscular dystrophy
X-linked recessive condition
| malformation of dystrophin gene
31
presentation of duchene musclar dystrophy
boys aged 1-6 who are struggling to walk (waddling gait)
proximal muscle wasting
pseudohypertrophy of calves
gowers sign
32
investigation for duchene muscular dystrophy
CK
33
management of duchene muscular dystrophy
poor prognosis
| usually die in 20s duee to cardiac/resp failure
34
physical examination for suspected meningitis
kernig's test
| brudzinski's test
35
management of bulging fontanelle
mannitol
36
management of meningitis community
IM/IV benzylpenicillin
37
hospital management of meningitis in kids
LP + bloods for culture
<3 months Cefotaxime + Amoxicillin
> 3 months 1st dose Cefotaxime followed 6 hours later with once daily Ceftriaxone + dexamethasone
38
cause of measles
RNA virus- paramyxovirus
39
presentation of measles
```
koplick spots (white spots on buccal mucosa)
rash starting behind the ears
```
40
management of measles
supportive and tell PH
41
most common complication of measles
otitis media
42
cause of rubella
togavirus
43
presentation of rubella
fever
rash- pink-red maculopapular rash
lymphadenopathy
44
chicken pox management
calamine lotion for the itch
45
scarlet fever presentation
strawberry tongue
| find punctuate erythema (starts on trunk)
46
presentation of open angle-glaucoma
gradual onset vision loss (beginning peripherally)
| fluctuating pain, headaches, blurred vision and halos around light
47
investigations for open angle glaucoma
visual field assessment and acuity
fundoscopy
tonometry
48
management of open angle glaucoma
latanoprost eye drops
bb- reduce aqueous production
carbonic anhydrase inhibitors
surgery
49
presentation of acute angle-closure glaucoma
rapid onset vision loss
painful, red, teary eye with semi dilated pupil
symptoms worse in dark room
halos around light
50
investigations for acute angle closure glaucoma
visual field assessment and acuity
fundoscopy
tonometry
51
management of acute closure glaucoma
urgent referral
pilocarpine eye drops
IV acetozolamide
surgery is definitive
52
symptoms of dry ARMD
gradual worsening central vision loss
reduced visual acuity
wavy appearance of line
53
investigation for dry ARMD
snellen chart
amsler grid test
fundoscopy
optical coherence tomography
54
biochem for primary hyperparathyroid
high calcium
low phosphate
PTH raised or normal
sometimes low vit d
55
bence jones proteins
in the urine with multiple myeloma
56
main features of multiple myeloma
calcium (raised)
renal failure
anaemia
bone lesions/pain
57
investigation for myeloma- BLIP
```
bence-jones proteins- urine electrophoresis
serum- free Light chain
serum Immunoglobulins
serum Protein electrophoresis
bone marrow biopsy
imaging
```
58
xray signs for multiple myeloma
punched out lesions
lytic lesions
raindrop skull
59
management of multiple myeloma
```
chemotherapy with
bortezomid
thalidomide
dexamethasone
myeloma bone disease- bisphosphonates
```
60
lichen planus management
emollients
topical steroid cream- first line ?
steroid mouthwash
oral prednisolone- for flare ups
61
behcet disease presentation
oral ulcers, genital ulcers and uveitis
62
management of trigger finger
steroid injection
finger splint
surgery
63
presentation of trigger finger
thumb, middle or ring finger
initially stiffness and snapping when extending a flexed digit
nodule may be felt
64
anterior uveitis presentation
```
unilateral
dull, achy painful red eye
ciliary flush
floaters and flash
pain on movement
photophobia
hypopyon
```
65
management of anterior uveitis
same day referral to ophthalmology
steroids
cyclopegic-mydriatics
immunosuppressants: DMARDs, TNF inhibitors
66
Weakness of hip abduction and foot drop, no specific reflex lost
L5 radiculopathy
67
herald patch
singular, large plaque that appears several days before general rash
pityriasis rosea
68
management of pityriasis rosea
self-limiting disease
| symptomatic relief- aqueous cream, antihistamines
69
sudden sensorineural hearing loss management
immediate referral
| high dose oral steroids
70
Retinitis pigmentosa
congenital inherited condition where there is degeneration of the rods and cones in the retina
71
presentation of retinitis pigmentosa
night blindness
| loss of peripheral vision first- tunneling vision
72
management of otitis media that has lasted >3-4 days
amoxicillin
| clarithromycin- if allergic
73
management for recurrent epistaxis (not acute management)
prescribe naseptin nasal cream- contains PEANUTS
74
lump which is anterior to the sternocleidomastoid muscle, round, soft and non-tender
branchial cyst
75
first line investigation in suspected primary hyperaldosteronism
aldosterone/renin ratio
76
first line investigation for secondary hypothyroidism
MRI pituitary gland
77
normal hyperparathyroid by high calcium
parathyroid is the cause- most likely adenoma
| raised calcium means the PTH should be suppressed
78
child crying in direct sunlight
erythropoietic protoporphyria
79
build up of what occurs in porphyria cutanea tarda
Urophorphinogen
80
first line treatment for acne rosacea
topical metronidazole
81
first line treatment for acne vulgaris
benzoly peroxide
82
what is epidermolysis bullosa?
breakdown of anchoring between epidermis & dermis
83
which diabetic drug is weight neutral
DPP4 Inhibitors
84
Pagets electrolytes
normal calcium, phosphate and PTH
| increased ALP
85
osteomalacia results
decreased calcium and phosphate
| increased alp and PTH
86
what can aggravate psoriasis
BB
87
primary hyperparathyroid results
increased calcium
decreased phosphate
increased ALP
normal or increased PTH
88
CKD causing secondary hyperparathyroid
decreased calcium
| increased phosphate, ALP, PTH
89
hormone to test for pregnancy
HCG
90
hormone peaks before ovulation
LH
91
hormone to test for fertility
progesterone
92
osteomalacia treatment
vit D therapy with calcium and phosphate supplements
93
waddling gait
osteomalacia (rickets in kids)
94
DMARD that can cause interstitial pneumonitis
methotrexate
95
Visual loss, mouth ulcers and genital ulcers
Behcets syndrome
96
vertigo seconds to minutes
BPPV
97
diagnosis of BPPV??
Hallpike
98
treatment of BPPV
epley manoeuvre
99
compression of CNVII causes
Bells palsy
100
ramsay hunt syndrome
reactivation of varicella zoster virus in geniculate ganglion of CN7
101
third nerve palsy (eye)
looking down and out
fixed pupil
proptosis and ptosis
102
fourth nerve palsy
eyes look upwards
vertical diplopia
cannot look down and in
103
sixth nerve palsy
horizontal diplopia
| eyes medially deviated and cannot move laterally from midline
104
first line treatment for BPH
alpha blocker- tamsulosin
| second line- 5 alpha reductase- finestride
105
first line investigation for hydrocele
doppler us with colour
106
first line investigation for osteomyelitis
MRI
107
achilles tendon rupture investigation
US
108
Propylthiouracil side effects
agranulocytosis
109
drugs that may be used to control the symptoms and signs of Cushing’s Syndrome?
Metyrapone [blocks cortisol synthesis]
110
urinary tract obstruction management
nephrostomy
111
investigation for bullous pemphigoid
immunofluorescence- show IgG and C3 at dermoepidermal junction
linear IgG deposits
112
management of bullous pemphigoid
oral corticosteroids
tetracycline antibiotics
topical corticosteroids, immunosuppressants
113
investigation for pemphigus vulgaris
immunofluroscence- intra-epidermal deposition of IgG and C3 (Chicken wire)
biopsy- loss of intercellular adhesion sites
114
management of pemphigus vulgaris
steroids- prednisolone
| immunosuppressants
115
large vessel vasculitis
takaysau arteritis and GCA
116
vasculitis associated with resp tract and kidneys
GPA
117
young woman with absent pulses?
takaysau
118
male baldness with positive family history
androgenic alopecia
119
venous ulcer infection
strep pyogenes?
120
first line in back pain with red flag
Xray
121
haematuria
flank pain
palpable mass
renal cell carcinoma
122
non-tender painless lumb in testicles
hard
irregular
testicular cancer
