Brainscape's Knowledge GenomeTM

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


See full index

Alice > MRSA > Flashcards

MRSA Flashcards

1
Q

which drugs is

  • small s/e risk of breast ca
  • have have sexual dysfun within 1yr (less than1%)
A

Finsateride/Dutasteride

- 5 alpha rectase inhib for BPH

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

Example of atypical and typical antipsychotics

A

Atypical = Clozapine (agranulo, prolact), Olanzipine (dyslip + obesity). rispiderdone

Typical = haloperidol, chlopromazine (good sedaiv if agitated)
- EP S/Es, hyperprolac

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

tx of mild/mod C.Diff

A

metro 400mg TDS 10-14days

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

1st lines

  • GTC
  • absence
A
  • SV, alternative is lamotrigene

- ethosuximide

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

35 - 40 BMI

A

Obesity 2

> 40 = 3 (morbid)
- could get surgery

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

post partum complications for SGA babdies

Rx to get it

A 
hypoglycaemia 
nec enteri 
polycytheamia - chronic intraurtine hypoxia 
thrombocytopenia - BM/hepatic comprise 
hypocalcamia

maternal substance abuse, con infection (rubella), >40 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q 
verbal fluency 
estimation
response inhibition (copy tapping)
clock drawing 
abstract thinking
A

frontal lobe function - executive thinking

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

what is MOE + treatment

A

temporal bone oestisis, caused by pseudo.ergo

–> IV Abx (ciprflox)

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

14yr old - asthma not controlled

- currentlly on SBA + low dose ICS + LTRA

A

stop LTRA, used LABA in combo with low dose ICS

still not working - change to MART regime

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

ix of tinea capitits

A

woods lamp –> bright green fluoscrence of hairs, tx oral antifundal

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

Painful arc is a sign of ?

A

Rotator cuff issue - supraspinatous

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

copd test to differenitae between bacterial and non-bacterial exacerbation

A

procalcitonin - CRP, ESR< WBC will go up in both

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

example of 20g short acting carbs

A

3 tablets, 5 jelly beans, small carton of juice

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

example of low GI foods

A

fruit, veg, peanuts

white rice etc high

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

rosacea

- tx

A

topical metero or azelaic acid or ivermeticn cream
brimonidine (mirvaso) topicl gel good for flushing
2nd line = oral tetracycline or eryhtomycin (for 3mo)

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

where are heinz seen

where are burr seen

tear drop cells (dacrocyte)

A

splenomeg, g6pd def, suplhonamides

burr - uraemia

myelofibrosis

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

paeds ALS - Ratio and shock

A

5 breaths, 15:2, 4j/kg

vs adults 30:2, mon 360j shock
150-360 biphasic

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

Tx line for CML

A

Young for for BMTx

Or imatimb

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

viterous haem
vs post viterous haemorrhage
vs ret detach

A

Posterior vitreous detachment

  • Flashes of light (photopsia) - in the peripheral field of vision
  • Floaters, often on the temporal side of the central vision

Retinal detachment
= Dense shadow that starts peripherally progresses towards the central vision
- A veil or curtain over the field of vision or FLOATERS
- Straight lines appear curved
Central visual loss

Vitreous haemorrhage
- uusually painless

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

cold aggulatans

increase titre of complement

A

found in mycoplasma –> haemollytic anaemia

psuttascosis

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

bladder cancer

  • most common type WORLD WIDE
  • some risk factors
A

Transitional cell carcinoma = developed countries. Smoking, Exposure to aniline dyes, Rubber manufacture, Cyclophosphamide
Squamous cell carcinoma = most in world: Schistosomiasis, Smoking

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

pain in knee walking up and down the stairs

tennage girl

A

chondromalacia patella

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

toxoplasmpos effects on baby - CHICM

A

chonoreintis
HYDROCEPHalus
INtracranial CALICficaion
MICROcephaly

vs CMV = periventri calc, sens HL, microceph

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

coeliac disease

  • antibodies
  • how long on glut
  • important to check for
A

IgA tTGA IgA EMA
6 weeks BD – or it needs to be a biopsy
IgA def

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

UKMEC 4

A

Examples of UKMEC 4 conditions include
more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation

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

step wise decline in function

1st line for alzethimers

A

more likley vascular dementia

the three acetylcholinesterase inhibitors (donepezil, galantamine and rivastigmine)
- momentine is 2nd line

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

tx of thrush in paeds

A

miconazole gel 7 days

then nystain 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q 
DVLA - time off in CV disorders
- annual review
1 wee
4 weeks
6mo/lifelong
A

annual review = AAA >6

1 week = angio, pacemaker, ablation (2days)

4 weeks = CABG, ACS, H transplant (6)

6monghs/life = ICD insertion, AAA >6.5

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

casues of hyperprolaectaemia

  • women : period problems and galatoorhoea
  • men : ED and low libido
A 
pit tumours
preg 
excessive exercise
hypothryoid
chronic renal failure
cushings 
drugs: risperidone, metocholpramide, domperidone, TCA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ulcerated, crusty lesion - can be there for a few years . rarely mets
on leg = marjolins ulcer
suncream prevents recuurence

A

squamous cell carcinoma

  • on eye, more likely is a basal cell carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

which tropical illness will give you all over body pain

A

dengue

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

Most common cause of hypogond

A

Klinefeleters (47 XXY)

Nondisjuctioj meiosis

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

best tx for personality disorders

A

psychotherapy

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

step wise tx of psoarsis

A

emollients –> betamethasone

  • salicyclic acid can by used if ++scaling
  • coal tar
  • vit d analogues e.g.. calcipotriol

UV light
Ciclosporin, methorexate

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

Common Abx okay to give in Pen Anaphylaxis

A

amikacin, cipro, clari, clindamycin, co-trimazole, doxy, erthrmycin, gent, metro, rifampicin, vanc, nitro, trimeth

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

contraception

  • within 72hrs
  • wtihin 120
  • iwthin 5 days (or on d 5 to 14 ov)
A

Levongrestrol
Uliprsitol
Copper IUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

adren dose for 11yr old boy

A

0.3ml of 1/1000 solution IM

  1. 15 is <6
  2. 5 if >12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

DDx of Beckers to Duchenes

A
  • beckers cramping, able to walk

- duchenns delayed motor mile stones, big old calfs

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

bacterial conjunctivitis

- when to treat?

A

after 3 days

chlorprmphencial for 5 days

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

low Ca

high PO4, ALP, PTH

A

CKD

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

Contras for live vaccines

A

Pret, symptomatic HIV, radiation

Other - prev anaphalyxis
- intercurrent illness

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

Gardnerella leads to
whats on thr mivcropsy

what does tric vaginalis have

A

baci vag
clue cells

motile trophozoites

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

what type of eye drops to help elivate pain

A

mydriatics (dilate) rest the pupil - cyclopentolate

- precents posterio syntheaia in anterior uveitits

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

change of an ulcer - painful, slough

A

?marjolins

- malignancy

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

progressive dysphagia from solids to liquids and PAIN on swallowing

A

hypopharyngeal ca

v sunexplainined hoarsness = squamous larngeal ca

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

pressure sore that you can see fat

A

grade 3

2 - 4 = warm moist enviroment

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

bullous pemphigoid vs pemphigus

A

BP - blisters, elderly, not involving mucosa - tx steroids

PV - blisters involving mucosa, jews - tx steroids
- not itchy

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

Dyspepsia assessment + treat

A

Trial OTC antacids
Eradication treatment
Hyplori

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

S/Es : Hair loss, nose bleeds, sore lips, dry mouth, lipids and eyes
tetrogenic

A

oral retinoids

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

?thyroid nodule but assymetatic

- most useful IX

A

fine needle aspira
hot - adeneno
cold - malignant non-sec adeno

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

Parkinsons treat - on l dopa

  • symptoms not controlled
  • dyskinesia due to therapy
A
  • add in a dopamine agaonist (bromocriptine, cabergoline) to use a long side
    rx - pulmonary fib

*offer MAO-B (selegiline) or COMT (entacapone)

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

what causes rheumatic fever

A

group a strpetococcus

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

Most common cause bone primary
- most common site
Name the childhood one

A

Osteosarcoma
- metaphyes of long bones
Ewing’s only in children (peristeal gives onion appearance)

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

Schwartz sign

A

Otosclerosis

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

What doesn’t reduce relapse RATE in MS

A

IVMP reduces duration and severity but not rate or long term disability

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

choice in SSRI in 1st depressive epiosdes

  • but if has triptan
  • when would you give PPI
A

an SSRI (e.g citalopram)

  • would giver mirtazapine
  • older adults also on NSAIDs or aspirin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Treatment algorithm for those tolerant for metformin and Hba1c is >6,5%
- i.e second line options

A

Metformin up to 1g BD
2nd line
Pioglitazone (thiazolidinediones)
- Issues: weight gain, avoid in Bladder Ca , HF, Xrisk and macular oedema

Sulphonurea: gliclazide, glipizide
- issues: weight gain, high hypo risk, avoid in renal failure

DDP4 inhibitors: Gliptins

  • weight neutral, low hypo risk
  • GI upset with panc

SGLT2: canagliflozin

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

referral to genetic services

A

1st degree relative <45
two close relatives <60
3 or more with similar cancers <60
a hx of a predisoping conditions e.g FAP

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

H.pylori erd tx

A

PPI
amox
clarith or met
for 7 days

if persists - use Abx not used initally
alternate includes levoflaxcin

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

measures to red rx of hiv in preg/deliv
(1%)

observing baby - how many tests

A

meds, ideally c -section atfer 39 weeks
can do vaginal if load <50
don;t breast feed

HIV DNA PCR at 48hrs. 6 weeks and 12weels
then anitbody test at 18months

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

tx for hyperemesis gravidarum

A

1st line = promethazine, cyclizine or prochloperazine

2nd line = metoclopramide or ondasterom

hosp - dehydrated, hypotenisve, urinary ketone

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

post coital bleeding

A

if persistence = urgent gynae ref

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

orbital cellulitis - features that make likely

A

painful eye movements
loss of colour vision
proptosis

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

full dilation ?

A

10cm

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

COPD FEV 35%

A

severe

50-79% mod, <80% mild

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

Ix if suspect Lyme?

A

just start doxy

only do ELISA if you aint got a rash

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

causes of clubbing

A 
lung ca
fibrosing alveolitits
bronchiectasis, 
empyema
lung abscess
CF
mesothelioma
Cyanotic CHD
IE!!
cirrhosis
IBD
coeliac dissease
thyroid acropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Ovarian torsion vs cyst

A

torsion shrap onset that doesnt resolve

cyst will then self-resolve

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

low thyroid levels, goitre (which is a bit tender)

A

hashimotos - Antithyroid peroxidase antibodies positive

de quervians - POST VIRAL, tender (high then low)

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

When and what is in the combined screening

A

11 + 13 weeks

  • nuchal transluency
  • bHCG + PAPP-A
  • maternal age`
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

criterica for PCOS

tx for hirsuitism

A

clinical hyperandrogeism or test raised
oligomenorrhoea
US showing polystic
- test up, oest up, LH up, FSH normal

weight loss, hiar removal then topical eflornithine or fianette

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

What part of ear does otosclerosis affect

Type of hearing loss

A

Stapes

Conductive

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

when should aspirin be given in preg

A

> 40, bmi >35

fhx preeclamp

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

Side effects of viagra (sildenfail)
4
When to avoid

A

Headaches
Facial flushing
Dyspepsia
Blue green vision

Avoid - recent stroke or MI, low BP, nitrates or nicorandil

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

poor prognosis factors for schizo

A 
Factors associated with poor prognosis
strong family history
gradual onset
low IQ
prodromal phase of social withdrawal
lack of obvious precipitant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q 
PAIN meds: morphine PO to SC
to oxycodone 
to diamorphine (SC/IM)
to tramadol 
to fentyl patch
A 
divide 2 
times by 2/3 
divide 3 
times 10
half 24 dose and then go for patch lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

HAS BLED

A 
Hypertension
Abnormal renal and liver function
Stroke
Bleeding
Labile INR
Elderly
Drugs or alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Digoxin toxicity

A

Measure levels within 8-12hrs of dose
Cl - unwell, confused, green/yellow vision, arrhythmias, gynaecomastia

Causes - hypokalaemia, age, RENAL failure, MI
Drugs - amidoarone, verapamil, diltiazem, spiro, thiazides, loop

Tx - digibind

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

low PO4

high Ca, ALP, PTH

A

prim hyperPTH

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

anaemia of chronic disease

A

low Hb and rest within normal limits

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

viral warts on vagina causes by ___
- tx is
Cervical cancer called by ____

A

HPV 6, 11
- imiquimod
HPV 16, 18

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

amnesia types

A

anterograde is inability to make new memories after the event

retrograde is loss of memories before event

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

timeframe of chest pain to be seen on same day

A

12 to 72hrs

if longer within 2weeks and consider starting aspirin, statin and GTN

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

ECG changes in hypocalacemia

A

prolonged QT + ST seg

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

heterophile antibodies in serum indicate

A

mono

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

Ix of SAH

A

non-contrast within 6hrs

- if negative LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q 
section 2 
section 3 
section 4
section 5(2)
section 135
A

28 days –> by pyschiatrist, for tx
6months
72hrs assessment order - GP, bring in to hosp
preventing a patient leaving for 72hrs
police remove someone from house if concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q 
Achondroplasia
Gilberts
Huntingtons
Neurofirbeom
Protein C def 
osteogen imperfecta
A

AD

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

IVDU with patchy consolifation

- orgainsim?

A

likely staph aeurus

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

NES vs serotonin syndrome

A

NEW: haloperidol
hyperthermia, fluctuating consiousness, muscle ridigity, tachy, sweating, redcue reflex
Tx = stop drug, given bromocriptine (can last 5days)

SS - SSRIs, MAOIs, ectasy
fatser onsent, increase relfex, clonus
Tx = IV fluids, benzos, cyprohepatine/chloropromazine in severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

drug causes of HTN

Endocrine causes

A

EtOH, COCP, ciclosporin, prednisolone. venlaflaxine and celecoxib

conns, cushings, phaeochromovytome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Chronic pancreatitis vs ca

A

Streathorroea

Jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Perthes disease

- what is the classic examintion findinig

A

ABDuction and INTERNAL rotation is limited

- 4-8yrsm ANN

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

leser-trelat sign

A

lots of seb. kerotsisis

?internal maliganacy

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

Tx for Diabetes insidious

A

Cranial - desmopressin
Nephrology- bendrofluothiazide

(Demeclocycline is SIADH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

safe choice of antiepl for preg
(if seziure>2yrs, look at stopping)

drug choice in hyperthry

A

carabamezamine
lamotrigene

proplochouricl PTU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Sciatica stepwise tx

A

Rest, paracetamol and NSAIDs

Physio if remains at 6weeks

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

what does colummnar epith indicate

due to which type of ca

A

metasplasia –> barrtets (pre-maliganant)

adenocar (more common that squa which is upper 2/3rd)

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

keratoacanthoma features

A

erupting volcano

dome shape - slowing grow

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

Priapism

prostatitis

A

uro emergency - take blood from it and given iv phenylephrine

ciprofloxacin 500mg BD for 14 days

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

30 - 35 BMI

A

Obesity 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

leflunomide is an immunodul drug for RA

- 3 S/Es

A

HTN, GI upset, hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Dx - renal failure, haemoptysis and nose bleeds

A

GPA (Wegners) is more likley than goofpastures

  • c-anca positive
  • nephritic syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

bone pain, bossing of skul

high ALP

A

pagets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

strabismus

  • esotropia
  • hypertropia
A

eye turns inwards

eye turns upwards (but would turn turn downwards in uncover test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Bladder Ca Tx

  • non invasive
  • invasive
  • spread m/non operable
A

Intravesicl BCG and TURBT
Radial cystectony + formation of ileal conduit
Chemotherapy (also if recurrence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

squints
- what would an eye going out in a conver uncover test mean

if only seen in cross cover

A

Convergent squint (esotropia)

eeophoria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

sentinel node biopsy is done when positive node on US

when is clearance performed

A

if there is clinically palpable lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

migraine tx

A

NSADs, paracetamol or triptan - try dual
ergotamine = avoid in pill, PVD, IHD + preg
preventive = propranolol, amitrtirpylline, topiramtae (pill interferevce), pizotifien

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What is chlormbucil used in

A

NHL or CLL
as less aggressive

  • Rituximab is alternative for b cell lymphm (also in ITP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

two options for postponing peroids

A

Norethisterone
- start 3 days before period
Medfroxyprogresterone acetate
- if >35 or rx for VTE, smoker, overweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

what nerve supplies diaphragm

A

phrenic nerve!

- from C3=5 +> ?significant SC injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

ER+ breast Ca –> what are you going to give

A 
Tamoxifen = oesteogen antagonis/agonist 
Anastrozole = aramotase inh --> OP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

auer rods

rouleaux formation

smear cells

A

AML

high esr –> infections, maliganacy

CLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

UKMEC catergories for breastfeeding women

A

1 for everything apart from

COCP - is 4 within first 6 weeks, then 2 till 6months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Drugs to induced abortions

A

Mifepristone then misoprostol 7 days later (PG anaologues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

empirical Abx for treatment of ?PID

A

ofloxacin + metro for 14days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

who is at risk of pseudomaonas?

  • treatment
  • bacteria in kids
A

CF + bronchiectasis patients
azithro neb or clipro oral with neb colomycin
- staph is more in childhood cf => flucox
- burkia is tramsmissiable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

what level causes hearing loss at long periods of time

A

90 decibles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Conditions with koebner phenomenon

A

[spriasis, lichen planus, viral warts, molluscum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What is Galeazzi sign

A

Unequal knees on examination

Used after 3 months for DDH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

changes seen in proliferative retinopathy

A

cotton wool spots
cluster haemorrhages
rubeosis iridis - neovascularisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

What are high rx women offered (from combined test)

A

CVS if 11 to 14

Aminocentesis after 15weeks
- riskier for misscarriage in 1st

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Features of lichen planus

A

shiny flat topped plaques at FLEXORS
itchy, koebner phenom
wicken striae = fine white lines on plaques and in oral cavity
tx = itch relifey or steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

gastritits that improves with eating

commonest cause

A

duodenal

h.pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Churg straus- 3 features

A

Sinusitis
Asthma
had/GI pain/renal issues

P anca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

extended breech
flexed breech

fetal heart lying in the flank

A

buttocks first
mix of but and feet first

transverse lie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

stress ECG

A

for those with KNOWN CAD disease to quanitify risk

CI for an exercise ECG - recent MI, AS, HF, pul oedema, unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q 
painful vision loss
acruate scotoma (lower half)
haloes, N/V + headache
semi-dilated pupil
disc cupping

Dx, Rx + treatment

A

Acute angle closure glaucoma (>20)

LANTANOPROST (PG analogue)
Timolol or bromide drops
to reduce aqueus formation carbonic anhydrase inhibitor — e.g. acetazolamide 500mg IV started

Rx - myopia, HTN, DM, TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

g positive coccus, black disgusting foot, unwell pt

- ?

A

nec fas - group A strep!

ddx: gas gangrene (c.perfing) –> crepitius + g rod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

all over body pain, weakness in shoulder/legs, maybe some tingling
calcium is around 2 and ALP is raised

A

osteomalcia second to vit d def

pagets - ca would be normal, again pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What happens at 28 week appointment

A

OGTT is at risk of GD (would start aspirin if so)
1st anti D proph if rhesus negative
Vaccinations - whooping cough etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

CES vs SC compression

A

CES is BELOW level of L2

a lesion T10 to L1 would have loss of reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

when fasting glucose is more than 7, but OGTT is between 7.8 and 11.1

A

IGT

IFG is fasting between 6 and 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

B12
C
D
E

A

Cyanocobalamin= Megaloblastic anaemia, peripheral neuropathy

Ascorbic acid Scurvy, gingivitis, bleeding

Ergocalciferol, cholecalciferol Rickets, osteomalacia

Tocopherol, tocotrienol Mild haemolytic anaemia in newborn infants, ataxia, peripheral neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Asthma pt not controoled on SBA, ICS, TRA and LABA

- whats the max dose of steroids

A

can go to 100mcg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

Felty syndrome

A

RA
Neutropenia
Splenomegaly —> low Plt and Hb from hypersplenism

Need a splenectomy
Can give rituximab and leflunomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

when should patients with TIA be referred to hosp

A

score >4 (also start 300mg asp)
2 or more within 1 week
has symptoms on warfarin

<3 = see within a week

rem long term clopi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

most DIAGNOSTIC test for Acromegaly

A

OGTT + GH measure

Insulin like factor = screening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

post bilateral adrenelctomy - hyperpig + bitmpo hom heminopeia

A

nelson syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

chlamydia - tx for sti

  • test
  • ulcer on penis: other symptoms
A

doxy 7 days (consider stat azithroymycin in young man who might not take it all)

NAAT + 2weeks after exposure

Lymphogranuloma venereum - chalmaydia trachomatis (same as STI)
- also with painful lymph nodes + erythema nodosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

what is sialolithiases

A

submandiular gland stone - radio-opaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

scalp psoarsisi tx plan

can get itchy plaques under boobs (

A

topical steroids

oral steorid + vit d analogue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

gential herpes = painful ulcers + blisters

causes by ____

A

HSV 2 (1 is cold sores)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

leading cause of blindness in the world

A

trachoma

- can lead to trichalisis (in ward growth of lases)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

OCD medication options

A

Sertraline max dose (or fluxo)

then clomipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

paraphimosis

A

unretractable foreskin - push back with pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Where would you find q fever

A

cattle farm! likely with GI upset and flu like symptoms

Tx - classical atypical with erythro (marcolade)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

chicken pox in preg - now with signs

A

acyclovir, too late for Ig

eye defects, hypoplasia, microcephaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

Treatment of mets breast ca

A

Chemo - to prolong life (if too far gone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

tx for liver mets

A 
usually inoperable (unless single from CRC), tx with pallative
rxt doesnt work
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

1st line for symptomatic ventricular extra systole

A

beta blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Trastuzimab is what?

A

hercpertin, Her 2. Rx of HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

actinis keratosis
tx for a few lesions
tx for lots of lesions (>4)

A
  • cryotherapy
  • topical 5-fluroacil cream
    (mild cases can try topical dicolfenac)

pre-malig => safe sun + remove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

acute severe asthma exacerbation

A

RR >25
Tachycardic
struggling to complete sentences
PEFR 33-50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

IQ of moderate LD

A

35 - 49

  • greater is mild (>69 is normal)
  • profound is <20
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q 
Transudate causes (prot <25)
- disruption of hydrostatic and oncotic pressures across pleural membrane
A

HF, liver cirrhosis, renal failure, hypothryoid

low albymin and meig (ovarian tumour) and malabortopns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

What is the most common cancer in men

A

Prostate - Afro Caribbean is a major risk and age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

focal seizures

or partial seizures

A

carbamazepine or lamotrigine

- then keppra, oxcarbaezmine of epilem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What can be treated with steroids, regaine, fintserdie (BPH)

A

alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

what conditions require higher dose of folic acid in preg (5mg vs 400mcg)

Up till 12weekd

A 
anti-epileptics
BMI >30
DIabetes
Sickle or Thalassaemia - take till term
FHx or personal hx of NTD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

when are brachial cysts commonly seen

A

3rd decade

slowly grow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

indications for dialysis

A

hyperkalaemia >7
met acidosis
pulmonary oedema
ureaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

lupus Abs

  • most prevalent
  • most specific
  • in between the both
  • DRUG induced (procaniamide, HYDRALAZINE, isonisizid, phenytonin)
A
  • ANA
  • smith
  • dsDNA
  • anti-histone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

addinsons crisis

A

just IV hydro –> flucort when stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

T2DM aims

  • BP
  • HbA1c
  • fasting glucose
A

140/80
7.5% (58mmol)
- 6.5% if diet controlled or single drug
4 - 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

paronychia tx (staph aureus)

A

fluclox or clair with I+D

preg/bfeeding + pen aller - erythroymucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Raised PTH, but low Ca
And then high phosp
Also short fingers

A

Pseudo hyper parathyroid sun

Pseudo pseudo is with normal Biochem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

antibitocis causes of cholestatsis

A

NITROFURONIN, co-amox + fluxoc

170
Q

lower GI Ix

  • pilles
  • UC
  • Crohns
  • Coelic
A
  • proctoscopy

- flex sig

171
Q

Complications of haemochromo

  • 2 reversible
  • 4 not
A

Skin discolouration, cardiomyopathy

Liver cirrhosis, DM, hypogonatriphic hypogondaism, arthropathy

172
Q

MGravis - treatment options x5

A

Ab against Ach receptors at NMJ

  • Thymectomy
  • Pyridostigmine cholinesterase inhibitor (stops enzyme breaking down ACh)
  • aziothioprine
  • steroids
  • plasma exchange
173
Q

Chronic granulomatous disease causes by klebsiella

A

Rhinoscleroma

Enlarging nose - tx tetracycline

174
Q

slow growing pulastile lump which can move side to side in neck

A

carotid body tumour

- an aneursym would may have features of CV insuff

175
Q

apnoea during ENT surgery likley cause

A

displaced tracheal tube

176
Q

what can myelofibrosis porgress to ?

A

AML

177
Q

INR: 5-8 with no bleeding

- if minor bleeding

A
  • with-hold 1-2doses and reduce next dose

- give 1-3mg vit k and restart once inr <5

178
Q

high BP, low K, high Na

low renin + raised aldo

A 
Conns = primary hyperaldo due to adrenal adenoma 
tx = sprio
179
Q

pallative - boney pain

A

NSAIDDs better

radiotherapy only used to shrink a tumour causing pain

180
Q

tx of discoid lupus

how would diff from discoid ecezema

A

topical steroids or fluconidide cream

discoid ecezema wouldnt affect face - mostly extremitiites, also hyperpig (no hypopig like lupus)

181
Q

RA with picture pulmonary fibrosis

A

Caplans syndrome

- May cavitate and resemble TB

182
Q

lots of sweatinf after parotid surgery

A

freys syndrome

183
Q

causes ataxia

A 
cerbellar lesion - stroke, lesion
infection - varicella
malignancy/paraoneoplastic
proptiception sensory loss - b12 def,  b1/wernickes peripheral neuropathy
medications - baributates

inheritence - frereichs

184
Q

finklestein test

A

de quervains tenosynovitis

185
Q

what hypersensivity would ABO/MG/haemoylsis/goodpastures be in

A 
type 2 (antibody)
3 is RA/SLE (immune)
4 is delayed contacted dermattis
186
Q

Extrapyramidal side effects

  • most common in (x3)
  • symtpoms
A

prochlorperazone, heloperidol and depot injections

- PD symtoms, dystonia, dyskinesia, akasthasia, tardic dyskindesia

187
Q

awareness vs incomplete paralysis in surgery

A

awareness - finger twitching + increase BP –> give midaz post op
incomplete paralysis - tachycardia and more general muscle spasms

188
Q

1st rank schizo

drug of choice

A
  1. delusional perception = deluge of false belief that can’t be corrected by logic
  2. auditory hallucinations
  3. thought disorder
  4. passivity/delusion of control
  5. somatic hallucinations

risperidone - i/m injection every 2weeks
or chlorpramizine

189
Q

nicotine withdrawl

drugs tx
when to r/v

A

can be up to 3 weeks
weight gain, irrtibaility

r/v 2 weeks
NRT - 16hr or 24hrs
vareniciline - start BEFORE quite day, partial recptor agonsit => reduces affects
bupropion

190
Q

COPD patient is on a SABA or a LABA

  • next stage is asthma features
  • if no asthma features
A

LABA with ICS
LABA with LAMA
final stage is all 3 - esp if recent hospital admission

191
Q

STEMI treatment

A

is presenting within 12hrs (+PCI can be given in 120mins) –>prasugrel or tig with aspirin
- Glycoprotein IIb/IIIa Inhibitors (tibfrian)

if PCI not possible = fibro with reteplase/alteplase/streptokinase (and with heparin in fusion)

192
Q

LTOT conditions

A 
hypoxia <7.3 (or <8 with polycthaemia/pulHTN)
COPD, ILD, Crhonic HF, Pul HTN
severe chronic asthma
CF
bronchiectasis 
Pulmonary vacular diease
pumonary maliganacy
193
Q

ovarian ca

  • risks
  • tx
  • pallative tx
A

anything increasing oestogen
BRCA1 or the BRCA2 gene, early menarche, late menopause, nulliparity

surgery and chemo

pallative is radiothepat

194
Q

Swollen pale turbinate

Mobile mass

A

Allergic rhinosinustis

Nasal polyp

195
Q

rx for placenta praevia

A

maternal age, soking, prev praevia increase pariety, prev c -section

cl - painless bleeding after 20th week

196
Q

tumours for WLE

- RxT offered

A

solitary lesion
peripheral
small in a large bood
DCIS <4cm

197
Q

<6mon old has an atypical uti

<3 - admit to paeds

A

US during acute
DMSA within 6 weeks
(if it was typical - then just US within 6weeks)

198
Q

two types of bipolar

A

1 - manic episodes with major depressive, manic presenting often needs hospitalisaion

2 - hypomania with severe depression

199
Q

When is the repeat anomonly scan

When is second rhesus

A

32 weeks

34

200
Q

bipolar tx options

A

litium –> thyroid disorders, cognitive impairment

carbamazepine if unresponsive

201
Q

LFTs: whats most raised in cholestaisis

  • acute liver damage (viral, hepatits)
A
  • ALP

- ALT

202
Q

BMI 25 - 30

A

Overweight

203
Q

polcytgemia vera tx

A

asymp = venesection + aspirin

symp = immunosupression, then last resort is splenoecomy

204
Q

pretibial myoxemedam + thyroid acropathy are features of

A

graves

205
Q

seborrhoeic dermatitis - red scaly rash around scalp, nasolabial folds, cheeks

A

daktacort (fungal with steroid)

206
Q

4th CN lesion (trochelar)

A

innverates SO

- vertical diplopia, worse on looking down or AWAY from lesion side

207
Q

Tx for ADHD

A

Pyshcoloscoail

Methylphendiate (ritalin), second line dexamfetamine

208
Q

Sickle cell, CF, Tay sachs, McArdlers, Wilsons, PKU all examples of

A

AR

209
Q

rheum disease associated with hep B and high BP

A

polyarteris nodusa

medium cell vasculitis

210
Q

Oesophageal cancer

- signs to refer

A

Ref - Wright loss + dysphagia
Or - weight loss + >55, with upper abdo pain, reflux or dyspepsia
Endoscopy if dyspepsia + >55 and Anaemia, Loss of weight, anorexia, recent onset, melanoma, swallowing diff

Squamous most common (adeno is lower down)

Ex - etoh, smoking, GORD, achalasia (solids + liquids with cough), Plummer-vinson, fatty diet, vit A C def

211
Q

best thing for OCD tx

A

exposure and response prevention

drug - fluoxetine

212
Q

Dupuytrens risk factors

A 
Manual labour
Trauma
Phenytoin 
Peyronie’s disease
Myxoedema 
Norther Europeon 
FHx 
Smoking and alcohol 
Diabetes and epilepsy
Lipids

Injecting enzyme therapy sometimes tried (Xiapex) or surgery

213
Q

causes of polydraminos

A
  • anecphaly
  • oedophageal or duodenal atresia
  • anaenia
  • spina bidifia
  • maternal diabeets
  • multiple preg
214
Q

diff between cushing syndrome and disease

A 
syndrome = excess steroids (usually pre etc) - acth will be low 
disease = overproduction by pituitary adenoma (acth high, with bilateral adrenal hyperplasia)

disease is suppressed by hig dose dex meth

215
Q

drugs that can flare psoariasis

A

BB, hydroxychloroquine, lithium, NSAIDs + alcohol

216
Q

indications for statins

Dose for primary prev

A 
T1DM >40 or diabetes >10yrs or CVRx
CKD
Qrisk >10%
Atrovstatin 20 
Increases to 80 is for secondary prev (has stroke)
217
Q

what drug is interferon used in

liver

A

hep c

218
Q

IBS

  • conspitation is an issue
  • diarrhoea
  • abdo cramping
  • all measure tried and till pain
A
  • Movicol (avoid lactose)
  • codeine or loperamide
  • pepp oil and mebvereine
  • TCAs, amitrpylline
219
Q

aplastic anaemia causes

A

Carbamazepine, phenytoin

quinine, chloramphenicol

220
Q

features of a innocent murmur

A

change in intensity
venous hum can have ‘machinary’ quality - chanegs with neck posture
systloic - likley ejection
- pansystolic is more likley to be abnormal

221
Q

things that alter PSA levels

A

ejaculation or exercise wtihin 48hrs
UTI
prostated biopsy 6 weeks ago
current tx with finasteride

222
Q

changes seen in background retinopathy

A

micro anuerysma and haemoorhages

NO MACULA involvement

223
Q

Multiple system atrophy

A

orthostatic hypotension
incontinet of urine
dry mouth and skin

224
Q

Most common hormonal producing pituitary tumours

A

Eosinophilia GH adenoma - adults
Basiophillic ACTH
Prolactin Adenoma - children

225
Q

describe boutinerres deformity

A

button hole deform
PIP felx with DIP hyperestension
rupture of central slip of extensor

226
Q

tx of hyperprolactaeimae

A

cabergoline

bromocriptine

227
Q

feautres of SCLC vs NSCLC

tx

A

SCC - SIADH, ACTH smokers, central , Lamberton-eton (MG-like picture)
- tx Chemo + radiation v good

NSCC

  • Sqaumous = HPOA, PTHr
  • adeno (non-smok), gynaecomas
  • large cell (bchcg)
  • surgery better
228
Q

Swallowing worse after few bites

Bit of a chronic cough

A

Pharyngeal pouch

- elderly

229
Q

NF - inhertiance, how many cafe au lait sports

tumours

A

AD, >6 is characteriayic
pupberty - neurofibroma
children - optic glioma (brain tumour from astrocyst) –> casues squint and vision problems

230
Q

unstable angina

A

load aspitin
LMWH (dalt/fond)
work out grace score –>PCI /angio within 72hrs if high

231
Q

Ann arbour staging 3?

A

nodes at eith side of diaphram

232
Q

first line contracep in young with no risk factors

A

cocp

233
Q

meds used in GAD

A

1st line Antidepressant = SSRI => Paroxetine, sertaline, fluxo in younger

if s/es –> Vanlafaxine or Duloxetine (SNRII

Propanolol and diazepam used but technically not an antidepressant

234
Q

notifiable diseases

A 
anyone with vaccine
scarlet fever
TB
malaria
invasive strep

NO: HIV, opthal neonatrium, lepto

235
Q

Causes for each

Eosinophilia

Neutrophils
Lymphocytes

Lymphopenia

A

E - Gold, penicillin, parasites, allergy

N - bacteria, L viral

L - aids, steroids, malignancy, liver disease, renal, sarcoidosis

236
Q

3rd line option for diabetic control (still >6.5%)

A

GLP-1 mimetic

  • dulaglutide, exenatide
  • issues: slows gastric emptying (weight loss!), its injectional, cholecystitis and pancreatitis rx

Acarbose - fltulence + diarrhoea s/e

237
Q

indications for RRT

A 
CKD 4
malnutrion 
ureamia enceph 
hyperkaelaemic not responsive to tx
pleuritits and pericarditis
238
Q

tx of prostatitis

Ix too

A

cipro 500mg BD for 14days
- ofloxacin alterative

Is - multiparameteic MRI

239
Q

What is v jaundice, frontal bossing and haemolytic anaemia likely to be

A

Beta thalassemia - major/cooley’s

Alpha more Asian/African
3 genes - moderate anaemia (2 mild)
4 genes - barts hydros

240
Q

ims at 2 months

same at 3 but whatinstead of ____

4 - same as 2 without

A

‘6-1 vaccine’ (diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B)
Oral rotavirus vaccine
Men B

PCV at 3

no rota at 4

241
Q

When is ECV

A

After 36

242
Q

HF when the cardiac output can increase with exertion

peripheral oedema, raised jvp and ascites

A

low output heart failure

right-sideded

243
Q

most common for on newborn intensital obstruction

1/10000

A

hirschsprung

244
Q

What dizziness lasts for few hours

A

Menieres

Few mins BBPV or central vertigo

Days more Labyrinthitis

245
Q

<5yr with asthma

  • 8 week trial of mod dose ICS
  • continues to be poor depsite low ICS
A

if improvement - stop

  • if retur, after 4 weeks, re-start low odse as maintenance
  • if return <4, repeat the 8 week trial

add in LTRA

246
Q

tx for renal osteodystrophy

A

low ca and high phsopha

tx = ca + vit d (alfacalcidol)

247
Q

risk for gout - 3main drugs

alternative for allopurinol

A 
Thiazide, ACEi, BB, ciclosporin 
hyperuricaemia 
FHx
obesity 
diet - red meet

febuxostat

248
Q

AF anticoag rules

A

if CHA2DS2 VSc is >2

- most won’t have antiplatet prescribed along side NOAC (unless v high risk)

249
Q

screening test for cognitive function

score for ?dementia

A

MMSE - <10 = severe (max score 30)

<24 ?dementia

250
Q

Sulfasalazine: inhibits output of TNF + cytokines
3 s/es
infliximab s/e

A

S/Es: hepatotoxic, Steven Johnson Syndrome, reduced sperm count
- CCF

251
Q

PANCREAS

GET SMASHED

A 
PaO2 <8kPa
Age <55y, 
Neutrophils>15,
Calcium <2 
Urea >16 
Enzymes - ldh ast 
Albumin <30 
Sugars >10 
>3 = needing icy

GallstonesEthanol, Trauma , Steroids, Mumps + other infections, Autoimmune Scorpion, Hyperlipidaemia/hypercalacaeima/hypothermia, ERCP, Drugs – thiazides, azathioprine, metoclop, diabetic drugs, valporate

252
Q

Systolic murmur vs Diastolic

A

Sys = AS, MR/TR (pans), MVP (late sys)

Dias = AR(early), MS(mid), TS (early + large a waves)
PR = graha steel due to pul HTN = early dais
253
Q

tx to induce rem for UC

A

1st 5ASA (mesalazine –> pred –> azathioprine

maintaining is sulf/5asas

254
Q

hypertensive eye disease

A 
AV nipping 
flame haemorrhages
hard educates
cotton wool (retinal infracts 
macular oedema
255
Q

rules for switchign SSRIs

rule for trying

A

cross titrate over 4-6 week
except fluxoteine - need 4-7day wash out period (i.e can just stop)
x2 diff SSRI or mirtaz then switch to SNRI (e.g venalfaxine) or tca

256
Q

1st line Abx for UTI in preg

A

NITRO, can give amox or cefalaxine

257
Q

treatment of radiation pneumonitits

A

prednisolone

258
Q

positive anti-HBs, rest negative

A

immunization

259
Q

what is most freq type of testicular ca

markers

A

most germ-cell tumours.

  • Seminomas Senior (>35) maybe bHCG
  • non-seminomas: teratoma Teen (25) and embryonal, yolk sac, AFP LDH

Non-germ cell tumours include Leydig cell tumours and sarcomas.

260
Q

thrush

>16

A

pessary and topical for 7days

  • can be oral in not preg
  • no pessarys for <16
261
Q

graunula casts in urine micrcopsy

A

CKD

hyaline can be normal

262
Q

where are target cells seen

A

IDA, liver disease, thalassaemia post splen

263
Q

tx of graves opthalopathy

A

high dose steroids

compression if threatened vision

264
Q

pyleo vs uti

A

flank pain

would given co-amox or trimeth for 7-14days

265
Q

painless ulcer, lymph nodes up and now a maculopapular rash

A

syphillis (t2)

266
Q

tx for acute iritis

A

steroid drops + cyclopentolate or atropine

267
Q

what type of bacteria is gonorrhoea

Tx

A

G negative diplococcus
IM ceftriaxone
- can given azithromycin with IM cef in young man

268
Q

autoimmune hepatitis antbodies in T1

what about T2

A

anti-smooth muscle
ANA
- ? if pt has goitre (autoimmune link)

T2 - antibodies to liver and kidney

269
Q

what is lights criteria

but what singificance is ph?

A

(pro >0.5, LDH >6, pleural ldh >2/3)

?empyema and ph <7.2 –> CT

270
Q

when is glucose levels self-monitored

A

on insulin
hypoglycaemic epiosdes
meds with hypo risk
pregs

271
Q

chloramphenical vs chlorpheniramine

A

antibiotic

antihistamine (sedating), non-sedating - loratadine or sertraline

272
Q

Alports

  • inheritance
  • issues
A

X, AR or AD
SHL + CKD
eye provlems

273
Q

when mastectomy is done

- RXT if t3.4 or lots of positive nodes

A

multifocal, central

DCIS >4cm

274
Q

stepwise tx for endometerosis

A

1 - paracetamol, nsaids
2 - COCP, POP, Implant or mirena
3 - ablation
4 - hysterectomy

275
Q

tx pf lewy body dementia

what makes it worse

A

rivastigmene

l-dopa

276
Q

OA: Bouchard vs herbens

A

bouch proximal, herbens distal

277
Q

proximal muscle weakness in a diabeteic
vs

glove/stocking distrubtion loss and painful lower limbs (tx)

A

amyotrophy ‘proximal neuropathy’

sensory polyneuropathy –> TCAs, gabapentin

278
Q

TB drug S/Es
lenght of TX
- inclu miliary/mengitits or pericarditis

A

Active = all RIPE for 2 months, then R + I for 4 months
Active TB meningitis/ military TB or pericarditis = 10months of R + I plus oral pred

Rifampicin = cytochrome P450 induced, hepatic metabolism
- Rash, hepatitis, yellow/orange discolouration of bodily fluids, flu-like symp

Ioniazid = hepatic metabolism

  • Rash, hepatitis, peripheral neuropathy, agranulocytosis
  • Co-prescribed with Pyridoxine (Vit B6) to prevent neurological S/Es

Pyrazinamide = hepatic metabolism
- Rash, hepatitis, arthralgia & gout (hyperuricemia)

Ethambutol = renal metabolism
- Optic neuritis => monitor acuity during therapy

279
Q

Mutation in chromosome 7

neonatal presentation

A 
Transmembrane conductor regulator gene = CF
df508 = commonest mutation
meconium ileus 
haemorrhagic disease of newborn 
constipation
failure to thrive
280
Q

TLS bloods - whats low

A

Calcium

281
Q

diagnostic imaging for RAS

A

digital subtraction angiograpghy

most common causes Fibromuscular dysplasia or athersclerosis

282
Q

how long have to use condoms if starting POP after day 5

A

48hrs (COCP is 7days)

283
Q

When is dating scan

A

10-13 weeks

284
Q

tx of bells palsy

A

50mg pred for 10day (within 72hrs)

285
Q

which virus is related to laryngeal papillomatosis

tx for wa

A

HPV

286
Q

Gest DM associations

A

polyhydro, macrosomia, hypogly, hyperbilirubineam, pre-eclpasia

287
Q

BPH tx

A

Alpha-1 antagonists e.g. tamsulosin, alfuzosin, tarazosin

  • decrease smooth muscle tone (prostate and bladder)
  • adverse effects: dizziness, postural hypotension, dry mouth, depression

5 alpha-reductase inhibitors e.g. finasteride (simil s/e risk to thalaiodmide)

  • block the conversion of testosterone to DHT
  • slow disease progression. (reduced prostate size)

-adverse effects: erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia

288
Q

defitinvitve tx for stress incontinence

urge

A

mesh cling/surgery options

  • duloxetine is alternative
  • solficaicin

Bladder retraining
Oxybytynin (old mirabegron), botux or sacral nerve stimulation

289
Q

scleritis vs episcleritits

A

episcler = blanches, mild pain/none, often self-limiting

scler - painful+, needs steroids + nsaids + opthal r/v

290
Q

statins upper limit in lfts
- checked at 3 and then 12mo

expected affect on HDL chol

A

x3
should also be stopped in preg (and 3mo prior)

> 40% reduction (if not, increase dose)

291
Q

Bariatric surgery indications

A

> 40 BMI

35-40 but with a comorb that would benefit from weight loss T2DM

292
Q

White marks on tongue you can’t scrap off

A

leukoplakia –> need ot biospy as pre-maligant

293
Q

anastmotic leak in the peri-operative period

A

gastrogaffin enema

- CT is some time after surgery

294
Q

ERCP use as IX

A

for CHRONIC pancreatits problems, not acute

also GB/Bile duct

295
Q

Step wise pain management for SCD

A

Simple paracet and NSAID

If more than 2 morphine, need PCA

296
Q

Where a J waves seen

A

hypercalaemia
brugada syndrome
hypothermia

297
Q

slow growing red scaly plaque

squamous cell carcinom ain situ

A

bowens disease

Tx cryotherapy or topical 5-flurouracil cream

298
Q

post-natal depression drug choices

A

SSRI (flux the safests), oestorgens contravesial
TCAs

avoid benzos

299
Q

DVLA - time off in neuro disorders

A

1 month : syncope explainined, stroke/tia recovered

3 month - multiple TIAs

6months: syncope unexplained, first seziure in normal brain , withdrawl of antiseziure meds, post pit brain surgery

1 yr : Knonw epilesy + further seziure, two or more syncopes and craiotomy

300
Q

LFTS for alcoholic LD

for hepatitis

A

increase AST

increase more ALT (acute Liver)

301
Q

Tx of quinsy

A

I&D, or Aspiration
IV Abx
BG if tonsillitis - then do a tonsillectomy

302
Q

Mycosis Fungoides - dry itch plaques

?

A

Cutaneous form of T-Cell lymphoma

303
Q

absences

A

SV or ethosuximbe

- defs avoid carbamazepine

304
Q

bp measurements for pre-eclamp

A

rised >30/20
reading is >160/90
140/90 (HTN normall) but with protein or signs of IUGR

305
Q

dermatomyositisis antibodies

A

anti-jo, anti-MI

306
Q

dacryocystitis vs dacryoadenitis

A

Lac sac,medial swelling

Lac gland, lateral swelling

307
Q

antibodies in APL syndrome

coag signs

A

anti-cariolipin
anti-b2-glycoprotein
lupus anticoagulant

prolonged APTT (intrisinic)

308
Q

Dose for Citalorpram
sertraline
mirtazepine
fluxoteine

A

10mg anxiety, 20mg depression up to 40mg

sert - if recent mi, 50mg max 200mg

mirtazepine - 30mg up to 45/45

fluxo = 20 up to 40

309
Q

lymphoma work up - 3 things

A

Ann Arbor Staging = from both HL + NHL, via CxR, CT/PET + biopsy
I = single region, one lymph node to IV = disseminated involvement (liver, BM)

310
Q

ix of haemoatospermia

A 
PSA test (if>40)
mid-stream urine microscopy + culture
311
Q

Phaeochromcytomas link to 3 malignancies

A

Von Hippel Landu
MEN
NF

312
Q

what vitamin is Naphthoquinone

A

Vit K –> Haemorrhagic disease of the newborn, bleeding diathesis

313
Q

drugs causing renal stones

A

acetzaolamide, allopurinol. laxatives, asorbic acid

314
Q

pain after exercise, with swelling and locking

A

osteochondritis dissecans

315
Q
  • empty stomach
  • > 200mls of water + whole table
  • stay upright for 30mins
  • dental check
A

bisphosphonates

316
Q

what Ix for erectile dysfunction

A

Testesterone, BP, BM, Lipidis, exam (?peynoids)

- if LUTS add in PSA

317
Q

renal cancer most common type

assoications

A

clear cell

asso: TS, VHL syndrome, smoking

318
Q

diagnosis of amylodosis

AL + AA

A

congo red stain
red/green poisitive birefrigmeent

10% of myeloma will develop AL
Tx: Oral Melphalan + prednisolone

AA will not affect heart, more chronic inflam disease

319
Q

as and when tx for allergic rhinitis

A

IN aselastime spray

- if not for nasal = certirizine/loratadine

320
Q

cutaenous lava migrans

pediculscapularis

A

hookworm (cats/dogs) –> topical bezdazole

head lice –> malathion, permethin

321
Q

tx of typid fever

fever, malasia, hepatspleno, rose spots, bradyacaria

A

salmoneall virsus

CIPROFLOXACIN of azthromycin

322
Q

what drugs are avoided in g6pd def (3)

Ix

A

diuretics - indapamide
fava beans
ciprofloxacin

Ix: non-immune haemolytic crisis (neg direct coombs) +heinz bodies

323
Q

low Ca, PO4

high ALP, PTH

A

osetomalacia

  • bone pain
  • proximal myopathy
  • looser zones (pseudo#)
324
Q

respiatroy test for upper airway function

test for lung function in IPF

A

spirometery

lung diffusion

325
Q

causes of gynaecomastia

A

Kidney or liver failure
Endocrine disturbances - hyperthyroid
Malignancy
Drugs - spiral, finasteride, cimetidine, digoxin, Gostelin, anaebolic steroids

326
Q

whats needed for diagnosis of ank spond

A

radiological sacroillitis

327
Q

Gentamicin, cipro, quinine, aspirin and furosemide (IV) all cause what

A

Tinnitus

328
Q

Painless ulcer in the most

A

Think SCC before aptholous (which would be painful)

329
Q

rx for prostate ca

A

fhx
black
brca1/2
increasing age

330
Q

COCP

- UKMEC 3

A

more than 35 years old and smoking less than 15 cigarettes/day
BMI > 35 kg/m^2*
family history of thromboembolic disease in first degree relatives < 45 years
controlled hypertension
immobility e.g. wheel chair use
carrier of known gene mutations associated with breast cancer (e.g. BRCA1/BRCA2)
current gallbladder disease

331
Q

ddx between hydrocele and epididymal cyst

A

cyst can be seperated - excisoin

both translum

332
Q

tx for viral conjunctivitis

- small follicles seen in eyelid

A

self-limiting

sterile water cleaning

333
Q

Travellers diarrhoea

A

E Coli

334
Q

choices of antidepressant

  • co-exisiting chronic pain
  • post MI
  • acute depressive episodes in bipolar
A
  • Amitriplyine
  • Seraline
  • citalopram
335
Q

Treatment for GTC seziures

A

SV (obvs not if pregs)

then lamotrigine or carbamaezpine

336
Q

pt with active ca develops clot - tx?

A

just lmw hep for 6months

337
Q

current acute Hep B infection

A

anti-IgM HBc

338
Q

allergic conjunctivits

A

conjunc erythema, chemosis (swelling), itch

seasonal = summer/spring

perennial = dust mites

first-line: topical or systemic antihistamines
second-line: topical mast-cell stabilisers, e.g. Sodium cromoglicate and nedocromil

339
Q

13-18 years

A

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)

Men ACWY

340
Q

13-18 years

A

‘3-in-1 teenage booster’ (tetanus, diphtheria and polio)

Men ACWY

341
Q

Associations with acanthosis nigricians

A

Obesity
Diabetes
Stomach Ca - also oesophageal, lymphoma and pancreatic

342
Q

what is cholrprozamine used in

s/e

A

schizo

- shaky, abnormal body movements

343
Q

what does minocycline cause

anx for acene

A 
drug induced lupus!
others: Isoniazid.
Hydralazine.
Procainamide.
Tumor-necrosis factor (TNF) alpha inhibitors (such as etanercept, infliximab and adalimumab)
Quinidine.
344
Q

Smith vs colles

Monteggia vs Galeazzi

A

Smith - distal radius is tilted anteriorly
Colles - posteriorly

Mon - #ulna and dislocation of radial head

Gal - #radial shaft and disclosure of inferior radio-ulnar joint

345
Q

simple ecezema on chin

A

1% hydrocortisone

if signs of infection - dakacort or another with abx

346
Q 
Pulsus paradoxous
Slow rising/plataeu
Collapsing
Pulsus alternans
Bsferiens '2 peaks'
Jerky
A 
severe asthma or cardiac tamponade
aortic stenosis 
aortic regurg or PDA
severe LVF
mixed aortic valve disease
HOCM
347
Q

INR >8 and no bleeding

- if bleeding

A

give vit k oral and restart once inr <5

  • give 1-3mg vit k and restart once inr <5

major bleed = IV vit k with prothrombin complex

348
Q

febrile seziures - incidence of further piosdes

peak ages

A

1 in 3

12 to 18months

349
Q

Epididymo-orchitis tx

- if likely chalr/gon

A

ceftriaxone 500mg IM single dose, plus doxycycline 100mg by mouth BD for 10-14 days

350
Q

Dodgy nose

A

Evucate haematoma

Then manipulate under GA within 1 weeks

351
Q

Bladder Cancer referral criteria

A

non-visible haematuria, - direct in >60, or if still present <60
WBC or dsyuria in absent of UTI

352
Q

Diff between microscopic polyangitis and wegnes?

And antibodie

A 
P anca  (wegner c-anaca)
Eosinophilia
353
Q

H pylori

A

Test with breath or stool
Can re check after eradication (stool will remain positive)
Abc

354
Q

when is islet transplant indicated

A

multiple hypo epiosdes, icnluding impaired response

355
Q

good pastures has which antibodies

A

anti-gbd

can progress to rpgn

356
Q

Mx of tension headache

A

simple analegesia

prev: 10weeks acupunture
- low dose amitripyline (off label)

357
Q

12-13 months ims

A

Hib/Men C
MMR
PCV
Men B

358
Q

time frame a nasal trauma nose can be manipulated

A

2 weeks ->after it needs rhinoplasty

359
Q

what is pulm oedema 6hr after lots of transfusion

A

transfusion related acute lung injury

1degree temp increase is just febrile reaction –>slow the rate

360
Q

when is quadruple

A

15 to 20 weeks (2nd tr)

- AFP, uncog estradiol and inhibin A, along with bHCG

361
Q

Necorsis looking ulcer

A

attempt debridement/maggot –> amuptation

362
Q

CI to POP

A

active liver disease

breast ca within 5yrs

363
Q

which herina passes THROUGH the internal ring of the inguinal canal
- 80%

A

Indirect - neonates

(direct older people, weight lifting)

open surgical repair for most (mesh)
laprscopic if bilaterlal

364
Q

CHOP for NHL with s/es

?Hodgkins - ABVD

A

Cyclophosphamide (cysitis/hair loss/bm supp)
Hydroxyurbic (doxrubacin/Adriamycin) - cardiomyopathy
Vincristin - perip neuropathy
Prednisone

Adriamycin (doxrubacin),
Bleomycin (pulmonary fibrosis),
Vinblastine, Darcarbazin)

365
Q

Induction of labour

IV and one oral

A 
IV oxytonin
Oral misoprostol (or vaginally)
366
Q

whats needed prior to anti-tnf

when x2 dmardshave failed

A

cxr, hep screen, hiv

367
Q

what can hamartoma of the post hypothalamus causes

A

precocious puberty in a girl <2

368
Q

tx to induce remission for crohns

A
  1. glucosteroids, budesonide if ileocaeacl
    then its meslaazine %ASA
    perianal = metrondiazole

maintaining woud be azathioprine or metotrexate

369
Q

Myolconics

A

SV

  • then clonaezpam or lamotrigine
  • avoid carbamazepine
370
Q

features of SCC skin

A

bleeds, slow growings, asymmetrical, can met

can occur after transplant

371
Q

what is the 1 st line tx for aortic valve replacementin children

A

balloon valvuplasty (also those not fit for valve placement or TAVI in adults)

372
Q

tx of acute sinusitis

A

avoid abx, paracetamol

>10days - nasal steroid, nasal decongest, lavage

373
Q

test for ACL

- pop, swelling, difficult weight bearing

A

lachman’s test

374
Q

what can focal dystonia be treated with

e.g. writers cramp

A

betablocker or botulin injections

375
Q

Diagnostic criteria for IBS

A

Abdo pain, bloating, change in bowel habit

Or abdo pain with

Altered stool passage (straining)
Abdo distension
Worsening from eating
Mucous stools

376
Q

myopia vs hypermyopia

A

myo = short sighted, CONCAVE lense
- risk of detahcmenet, glucoma and cataract

hyper = long sighted, CONVEX

377
Q

in an UMN facial palsy - where must the lesion be

A

above pons - i.e. stroke

378
Q

duodeneal vs gastric ulcer

A

DU - more common, 2-3hrs after meal or at night, easised with snack

  • more common
  • 90% hpylroi

GU - worse with eating, 60% hpyori, will need biopsy

379
Q

Ix of haemorrhoids

A

PROCTOSCOPY

380
Q

Low Ka, Low Chloride and met alkalosis

?

A

Bartters syndrome
- inherited (AR) like furosemide

Vs conns where BP is rasied

381
Q

tired all the time bloods

A

FBE, CRP/ESR, LFTs, UEC, TFT, HBA1c, IgA tissue transglut

only vit d if muscle ache/body pain
- course is 400 IU all yeat

382
Q 
A	 = keratomalacia
B1	- th
B3	- ni the 4Ds
B6	 - 
B7	0 bio
B9 - fol
A

Retinoids Night-blindness (nyctalopia)

Thiamine Beriberi
polyneuropathy, Wernicke-Korsakoff syndrome
heart failure

Niacin Pellagra
dermatitis, diarrhoea, dementia

B6 Pyridoxine Anaemia, irritability, seizures

B7 Biotin Dermatitis, seborrhoea

B9 Folic acid Megaloblastic anaemia, deficiency during pregnancy - neural tube defects

383
Q

positive anti-HBs and HBsAg

A

prev infection of hep b and carrier

antigen neg would not be arrier

384
Q

smooth annular plaque which is red-pink in colour

asso DM

A

granuloma annular

= delayed sensitivity reaction

385
Q

causes of exudate effusion (pro >35)

A

maligancy, infection, sepsis and inflammation

386
Q

features of BCC

A

most common, pearly and slow growing

non-urgent referral

387
Q

Most common type of thyroid cancer is ___

Most common in elderly is ___

A

Papillary

Anaplastic type

388
Q

tx of Polycythenia

A

venesection

low dose aspirin

389
Q

whic Ig is:
first in infection
most prevalent

A

IgM first and biggets

IgG everywhere and crosses placenra

390
Q

anorexia nervosa bloods

diagnosis wieght

A 
everything low apart from 
- GH 
- glucose
- cholesterol 
carotin 
cortisol

below 15% of normal (17.5)

391
Q

slow growing painless lump in superfifcal lobe of parotid gland

A

pleomorphic adenoma

ddx warthins tumour

392
Q

TIA
- if suspected to have occured within last week

  • if >1week ago
  • if more than one episode
A

refer to stroke specailist and start 300mg Asp
- in already on, just continue

  • assessment within 1 week
  • urgent referral today
393
Q

eyes stye vs chalazion

if eye lases are lost

A

stye ‘ouch’ tender lump, eyelash
chaz - clogged firm gland

worried its a cancer

394
Q

ischaemic/arterial ulcer
vs
venous

A

aterial rx factors, punched out edges, LATERAL side/pressure points, reduced pulses
- tx hydrocolloid dress (moist)

MEDIAL aspect, v painful

395
Q

diffuse systemic sclerosis
vs
limited systemic sclerosis
(CREST) - calcinosis, raynuads, oesophageldysmotility, sclerodactly, telangiectasia

A

anti-scl-70

anti-centromere

396
Q

where is folate and b12 absorderd

A

duodenum and prox jejnum

termal ileum

397
Q

travellers diarrhoea

  • watery
  • blood
  • prolonged and non-bloodr
A
  • e.coli most common
  • campylobacter (flu sym) or shigella
  • giardiasis

3 different samples for stool cultutre
dont routinely offer abx

398
Q

hyperemisis rx factors

A 
multiple preg
mola preg
hx of eating disorders
primiparous 
(non-smoking)`
399
Q

Hearing test in newborns

6-9months?

Speech/performance testing till 2.5, what after

A

Otoacustic emission
Then brain stem response if abnormal

Distraction

Pure tone once >3yrs

400
Q

stoma care for conspitation and diarrhoea

A

constipation –> osmotic laxative like mag sulp

diarrhoea –> loperamide + codeine

401
Q

what is thomas test used in

A

achilles tendon rupture - squeeze calf

402
Q

return from peru, flu like symptoms

slow pulse and elevated fever (fagets)

A

yellow fever

403
Q

causes of bm failure

A

Aquired = radiation, drugs, chloramphenicol, EBV, hep B, CMV, preg, Graft-verus-host disease
b12 and folat def
Inherited + malignancy

404
Q

prostate advances tx

- 2 diff options, types and some s/es

A

Flutamide = anti-androgen tablet, can cause gynaemoastia

Gosreline is a LHRH analague injection
- also cause gyanemaotasia but can casue tumour flare

Bone pain - give bisphosphates

405
Q

ddx of propotsis

A

unilateral = orbital myositis
Bilat + slower = thyroid eye disease
red = orbital cell

406
Q

ecezema v v itch

A

?scabies incontigo

407
Q

Wilms tumour vs Neuroblastoma

A

Wilms:

  • asso WAGR syndrome (aniridia) + Beckwith-weidrman
  • doesn’t cross midline
  • microscopic haematuria, may have HTN
Neuroblastoma 
- asso ospoclonus myoclonus, blueberry muffin skin, anaemia 
- can cross midline 
- urine catechilamines 
- HTN, fever
From neural crest of adrenal medulla
75% retroperitoneum
408
Q

1 point about each thyroid cancer

  • anaplastic
  • medullary
  • papillary
A

old people, v. ill = pallative

hypocalacomia – calcintonin, men 2 related

most common, young gals

409
Q

Rubella congenital features - T, J, H, C

When is highest risk

A

Thrombocytopenia, jaundice, hepatosplenomegaly, cerebral calcification (=> cerebral palsy)
1st trimester

410
Q

tx for SEVERE legionella

A

erthyromycin/clarith + rifampicin

411
Q

screening

  • glasgow vs ransons
  • waterlow
  • SCOFF
A

pancreatitis GS + alocholol panc
pressure sores
eating disorders

412
Q

2 screening tests for CVD

A

qrisk and framingham

413
Q

PAD

  • what pressure is claudification
  • tx options

acute limb ischaemi tx options

  • thombosis (hours)
  • embolus (sudden)
A
  • <0.9
  • aspirin/clop
  • angioplasty

thrombolysis iafter dx from angio
embolectomy, and then warfarin

414
Q

recommeded weekly units
beer vs wine
single spirit and then bottle of wine

A

14
2, 1
1, 10

415
Q

ca risks in coeliac

A

lymphoma

SB carcinoma NOT colon ca

416
Q

10 year absolute risk of osteoporotic fractures

what age of people without the risk factures

A

qfratcure
FRAX (with or without BM)

65 women
75 men

417
Q

right sided infarct

A

left hom hemiphonia

left sided weakness

418
Q

diff in blood for subclinical and clinical hypothy

A 
subclinical = TSH is HIGH to keep T4 in normal range
clinical = T4 is low , with raised tsh
419
Q

WHO PAIN LADDER
1 -
2 -
3 -

A

paracetamol with an NSAID

then add weak opiod eg codeine 60mg QDS

then add strong opiod

  • morphine
  • if still, ?change route e.g fentyl patch (total dose in 24hr /2)
420
Q

Cushing syndrome vs disease

A

Syndrome is ectopic ACTH secretion - often predict => NOT able to be suppressed

Disease is pit adenoma -> high dose suppresses

Alice (1 decks)

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