MSRA 1 Flashcards
1
Q
Polymyalgia Rheumatica - Associations and treeatment
A
Temporal arteritis
Oral steroids
2
Q
POEMs syndrome
A
polyneuropathy
organomegaly
endocrinopathy (hypothyroidism)
m-protein band from plasmacytoma
skin pigmentation
3
Q
Associated syndromes of hypothyroidism
A
Downs syndrome
Turners syndrome
POEMs syndome
CF
PBC (NOT PSC)
4
Q
vocal resonance/fremitus
A
INCREASED = Consolidation
DECREASED = effusion, collapse
5
Q
Acute asthma - types
A
Moderate: PEF 50-75%
SpO2 > 92%
Acute severe: PEF 33-50%
SpO2 > 92%
RR >25
HR >110
Cannot complete sentences
Life threatening: PEF <33%
Silent chest, cyanosis, poor resp effort
Arrythmia, hypotension
Exhaustion
Altered conciousness
6
Q
Epiglottitis
A
H influenzae type B
Tripod sign
Lateral neck X-ray - thumbprint sign
Cefotaxime (cephalosporin) and corticostseroids
7
Q
Meniere disease
A
triad - hearing loss, tinnitis, vertigo
Age 35-55
Lastshours
sensorineural hearing loss
Cinnarizine or prochlorperazine
REGULAR - betahistine hydrochloride as prophylaxis
8
Q
methotrexate pneumonitis treatment
A
methotrexate cessation
high dose steroids
9
Q
Babies sitting independent
A
6-8 months
10
Q
symptoms of hypocalcaemia
A
cicumoral paraesthesis
mental status changes
tetany
carpopenal spasm
laryngospasm
seizures
QT prolongation on ECG
Cardiac arrest
11
Q
chvostek
A
tapping facial nerve in preauricula area = facial contraction
12
Q
trousseau
A
inducing carpal spasm upon inflation of BP cuff
13
Q
superior homonymous quadrantopia
A
temporal lesion
14
Q
inferior homonymous quadrantopia
A
parietal lesion (think i remembered PITS???)
15
Q
felty syndrome
A
SANTA - splenomegaly, anaemiea, neutropenia, thrombocytopenia, arthritis (rhematoid)
16
Q
Tx of rheumatoid
A
DMARD - methotrexate and sulfalazine
no need to start with NSAIDS
17
Q
bloodshot, itchy eyes
cracked red lips
A
Riboflavin (Vitamin B2) deficiency
cracked red lips
inflammation of lining of mouth and tongue
mouth ulcers
angular cheilitis
sore throat
also associated with oral-ocular-genital syndrome
18
Q
Lung abscess Ix and Mx
A
CT scan
clindamycin 4-6 weeks
19
Q
antidepressants in post partum breastfeeding women
A
imipramine and nortriptylline , paroxetine, sertraline
DO NOT give citalopram or fluoxeine (can consider if used sucessfully with one of these during pregnancy.
20
Q
common organisms in copd penumonia
A
strep pneumonia
h influenzae
moraxella catarrhalis
21
Q
klebsiella penumoniae
A
alcoholic patients, may cavitate
22
Q
mycoplasma pneumonia
A
disease of younger people
fever, malaise, several days duration, non-productive cough
faint bilat interstitial infiltrates
23
Q
lidocaine max dose
A
1% lidocaine = 10mg/ml
max dose = 3mg/kg OR 7mg/kg with epinephrine
24
Q
femoral hernias
A
below inguinal ligament
lateral and inferior to pubic tubercle (INGUINAL IS SUPERIOR AND MEDIAL)
25
distribution of colon cancer
rectum (45%)
signmoid
caecum and ascending colon
transverse
descending
26
2ww criteria for colon ca
>40yo, weight loss + abdo pain
> 50 yo, rectal bleeding
>60 yo with IDA, OR change in bowel habit
+ve faecal occult blood
27
GRACE score
assess ACS - identifying higher risk patients (age, HR, SBP, renal function, CHF, ST segment deviation, cardiac arrest, elevated biomarkers)
28
Interpretation of DVT Wells score
<2 - unlikely, consider D-diemr
2 or over: leg vein imaging
29
CHADVASc score interpretation
Oral anticoagulation for all AF patients with CHA2DS2-VASc score 1 or more
30
ORBIT score
risk of major bleeding with anticoagulation with patients with AF
31
Pre-labour scoring system
PEDSS
Position of cervix
Effacement or length of cervix
Dilation of cervix
Softness (or consistency) of cervix
Station of foetus
5 or under: labour unlikely to start without induction
9 or more - labour will likely commence spontaenusly
32
first trimester uti
nitrofurantoin
33
adult asthma- non acute
salbutamol
low dose icx
add - inhaled LABA (fixed dose or MART)
increase ICX to medium dose OR add LTRA (consider stopping laba if no respond)
refer
34
anal pain whilst defecating, blood, red/purplish pea size lump at anal margin
perianal haematoma
35
haemorrhoid grades
1: do not prolapse outside anal canal
2. prolapse of defacation but reduce spontaneously
3. requires manual reduction
4. cannot be reduced
36
sentinel pile
torn, bunched up strip of mucosa at base of anal fissue
37
corneal ulceration - mx
chloramphenicol
38
sarcoidosis mx
steriods
39
uti, hearing loss
gentamicin - vestibulotoxin , permanent loss
nephrotoxic - ATN
40
loss of vision, cherry red spot
central retinal artery occlusion
retina pale and opaque due to odema
41
treatment of pseudogout
from calcium pyrophosphate crystals
treatment is symptomatic
aspiraiton
NSAIDs
intra-articular steroid injection
systemic steriods
cochicine if above contraindicated
42
Snellen - 6/12 vision
person can read at 6 metres what a normal person can read at 12
43
Caplan's syndrome
pulmonary fibrosis, usually in coal miners who have rheumatoid arthritis
multiple, round, well-defined nodules, usually 0.5-2cm in diameter, can cavitate
treat with steroids
44
myotonic dystrophy
cataract, muscle weakness, frontal balding **** exam q
autosomal dominant
severity increases in successive generations (anticipation)
45
active tb treatment
RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol (2 months)
THEN
R AND I for 4 months
If latent TB: R and I (3 monhts) OR I alone for 6 months)
46
commonest cause of CAP
Strep pneumoniae
47
rose coloured macular rash following fever
roseola (exathmem subitum)
roseola infantum (HHV-6)
incubation period 10 to 15 days
high fever, mild pharyngitis, lymphadenopathy
rose-pink macular non-pruiritic rash
48
drugs after STEMI
ACEi - indefinitely
dual antiplatelet therapy - aspiring indefinitely, P2Y12 inhibitor 12 months)
beta blocker - indefinitely if reduced LVEF, or 12 months if not
statin - indefinitely
49
menieres , and management
triad: vertigo, tinnitus, hearing loss
cinnarizine, prochlorperazine - acute attack
betahistine hydrochlordie - prohylaxis
50
most common bladder cancer
painless haematuria
transition cell carcinoma
51
pinworm infection
mebendazole - single oral dose. all family should be treated together . repeated in 203 weejs in case re-infection has occured
52
drop to constrict /dilate pupil
constrict: pilocarpine
dilate: tropicamide, cyclopentolate, atopine, phenylephrine
53
most common cause of infective endocarditis
staph aureus
54
most common childhood epilepsy
benign rolandic epilepsy - 7-10 yeras, focal motor aware seizures (simple partial seizures), night, involves one side of face and muscles affecting speech and swallowing
55
impotence, joint pains, increased skin pigmentation
haemochromatosis - iron overload disorder - abnormal HFE gene
autosomal recessive
TRIAD: cirrhosis, DM, skin pigmentation
56
budd chiari syndrome
obstruction to hepatic venous outflow
hepatomegaly, ascites, abdo pain
LFT mildly elevated
ascitic fluid high protein content
57
bergers disease (IgA nephropathy)
visible haematuria (nephritic syndrome) 24-48hrs after a URTI.
58
wegeners dranulomatosis
granulomatosis with polyangiitis - systemic vasculitis involves small and large vessels
TRIAD: upper and lower resp tract involvement, pauci-immune glomerulonephritis
59
haemolytic uraemic syndrome
e coli (enterohaemorrhagic)
60
reversal of severe INR increase
prothrombin complex concentrate (PCC) eg. octaplex
has clotting factors 2, 7, 9 and 10
do not use ffp unless no pcc avaliable
61
HFrEF treatment
beta blocker
ACE inhibitor
62
organism in CSOM - chronic suppurative otitis media
p aeruginosa
63
pterygia vs pingueculae
pterygia grows over edge of cornea but pingueculae does not
64
MEN1
age of onset - teenage years
hypercalcaemia
recurrent nephrolithiasis (hyperparathryoidism - in 80% of patients)
amenorrhoea (hyperprolactaemia)
acromegaly (excess GH)
65
MEN2
Relates to medually thyroid cancer (MTC)
hyperparathyroidism
phaeochromocytosa
hypertension, episodic sweating, diarrhoea, pruritis skin lesions, lumb in neck, hypercalacaemia 2nd to hyperparathyrodism
66
bubbles in urinary stream, foul smelling, green-brown urine. diagnosis and Ix of choice
pneumaturia
passage of gas mixed with urine, vesico-colic fistula
67
ruptured achilles tendon after abx
ciprofloxacin
68
punched out, small, dome-shaped, pearly lesions in young boy
molluscum contagiosum - no need for exclusion,
caused by pox virus
69
painful ear, pinna tender to movements, canal partially occluded by red swelling close to entrance of canal
furunculosis - infection of hair follicle - staphylococcus
70
painful vesicles on tympanic membrane and deep meatal skin
bullous myringitis
associated with mycoplasma or viral resp infections (influenza)
71
autoantibodies to thyroid peroxaidase
hasimotos thyroiditis
72
head lice mx
dimeticone 4% lotion
DO NOT USE PERMETHRIN
73
fungal nail infection
5% amorolfine nail lacquer - 6 months fingernails or 12 months toenails
terbinafine 250mg daily for 12 weeks fingernaisl, 6 months toenails
74
labyrinthitis
inflammatory disorder of inner ear, 2nd to viral/bacterial infection or ischaemic event in elderly
acute vertigo
tinnitus
sensorineural deafness
nystagmus towards side OPPOSITE lesion
75
labyrinthitis vs vestibular neuronitis
vestibular neuronitis is inflammation of vestibular apparatus and the causes and symptoms are similar to labyrinthitis.
Can be differentiated by ABSENCE OF TINNITUS OR DEAFNESS
76
Low back pain, radiates to leg, associated with walking, relieved by rest. pain stops when leaning forwards
spinal stenosis
77
best marker for acute phase of Ibd
faecal calprotectin
78
drugs for glaucoma
aims to CONSTRICT pupil
Note: reduce IOP
beta blockers
sympathomimetics
carbonic anhydrase inhibitors
increase drainage of aqueous humour:
prostaglandin analogues
sympathomimetics
miotics (eg. pilocarpine)
acetazolamide
79
most common pathogen in otitis externa
p aeurogenosa
80
confusion, ataxia, horizontal nystagmus
wernicke's encephalopathy - defiency of thiamine (Vit B1)
81
types of inguinal hernias
indirect: lateral to inferior epigastric artery
direct: originate medial to inferior epigastric artery
82
organism in fifths disease
human parvovirus b19
83
management of patient w/ lung cancer w/ intractable cough
oral morphine
84
Mx of c difficile
vancomycin oral
85
Mx of amoebic liver abscess
metronidazole
86
HTN and diabetes, first line
ACEi
87
ashermans syndrome
intrauterine adhesions within uterus, cavity becomes partly obliterated
frequently after D&C
hysteroscopy gold standard
presents with amenorhhea
88
goodpastures
anti-BGM antibodiy
haemoptysis, renal failure
89
telangiectasia, recurrent epistaxis, positive FH
osler-Weber-rendu syndrome, AD disorder
90
chinese, nosebleeds and hearing loss
nasopharyngeal carcinoma
associated with EBV
91
extracorporeal memberane oxygenation
ECMO
used to support cardiac and respiratory in patients, primary pulmonay HTN or respiratory distress syndrome
92
cysts in neck
branchial cysts - lateral in neck
cystic hygromas - posterior triangle
thyrogloassal cyst - midline, moves upwards if protrudes tongue
93
first line, stable angina
beta blocker
CCB (like verapamil)
94
humeral head under coracoid process
anterior dislocation
95
peritonsillar abscess organism and treatment
strep pyogenes
quinsy
benzylpenicillin and metronidazole
96
reduced visual acuity, reduced colour perception, preceded by orbital pain worst on exercise
optic neuritis - denyelinating inflamamtion of optic nerve usually associated with MS
note: reduced colour perception = dyschromatopsia
97
commonest congenital cardiac defect in down syndrome
atrioventricular septal defect
98
weber and rinne test
webers test: localisation to left implies either L middle ear deafness OR right nerve deafness
Rinne +ve on R = nerve deafness
99
recurrent episodes of vertigo lasting days , preceding illness
vestibular neuritis
100
how to differentiate between vertigo
BPPV - seconds, Menieres disease - hours, vestibular neuritis - days
101
initial investigation for polycystic kidney disease
USS abdo
102
drugs contraindicated with azathioprine
ACEi (eg. ramipril)
azathioprine is metabolised by TPMT enzyme
103
lupus vulgaris
painful, cutaneous tuberculosis skin lesions with nodular appearance
104
conjunctivitis, urethritis, arthritis
reactive arthritis
reiters
can't see, cant pee, can't bend the knee
105
ankle swelling with antihypertensive
amlodipine
106
types of cushings syndrome
bought on by exogenous steriods
acth dependent: increased acth, can include exogenous ACTH administration, pituitary (cushing disease) and ectopic cushings
acth independent - increased cortisol but acth decreased due to neg feedback. caused by exogenous administration of glucocorticoids or by adrenal adenoma, carcinoma or nodule hyperplasia
107
most likely shoulder dislocation
anterior (95% of time)
108
Haemolytic uraemic syndrome triad
acute renal failure
microangiopathic haemolytic anaemia
thrombocytopenia
109
siplopia, ptosis, ubable to adduct eye
3rd nerve palsy
110
most common bacterial sti
chylamdia (note bacterial)
111
treatment of chlymdia
dozycycline
112
mx of gout
colchicine or nsaid in acute
prednisolone if cannot tolerate both
allopurinol after acute attack
113
dysphagia in elderly men, first mouthful easy then gradually worst
pharyngeal pouch
confirm by barium swallow
do not do endoscopy
114
electrolytes in addisons
hyperkalaemia
hyponatraemia
115
coal miner, eggshell calcification on lymph nodes on CXR
silicosis
116
cirrhosis, DM and skin pigmentation
haemochromatosis
117
painful genital ulcer, swollen inguinal lymph nodes, no discharge
trichomas vaginalis - chancroid
118
strawberry cervix
trichomonias, strawberry cervix
green, odour, fishy
119
first line anticoagulant for AF
DOAC
120
risk of cocp
breast ca
cervical ca
vte
mi
stroke
121
steeple sign
subglottic narrowing - croup
122
brown sequard syndrome
incomplete spinal cord lesion - hemisection of spinal cord
ipsilateral loss of proprioception and motor
contralateral loss of pain and temp
123
young man, pleuritic chest pain, rusty colour sputum
strep oneumoniae
124
treatment of alopecia areata
minoxidil
125
fertility testing for women
28 day progesterone - mid luteal cycle progesterone
(aim for sample taken 7d prior to expected period - i.e d21 on d28 cycle
126
best indicator for diabetic rephropathy
microalbuminuria
127
young man, 3 week hx steadily progressive cough - organism?
mycoplasma pneumonia
128
HTN, muscle cramps, weakness, hypok
conns - increased aldosterone secretion from adrenal glands, suppressed renal activity, HTN, hypokaelamia
129
pathognomic ecg feature in hypothermia
j-waves
130
37 weeks pregnant, uti
cefalexin 7 days
131
HIV patient, meningoencephalitis - organism?
cyrptococcosis
132
Section 5(2) duration
drs holding power - detained for 72 hrs - must be admitted to ward
133
Section 5(2) duration
drs holding power - detained for 72 hrs - must be admitted to ward to hosp
134
aplastic anaemia vs mds
aplastic anaemia - hypocellular marrow , marrow stops making enough stem cells
mds - hypercellular marrow, marrow produces abnormal cells and in some not enought stem cells
135
3 month old, failure to thrive, symmetrically poor weight gain, reduced length and head circumference, umbilical hernia
congenital hypothyroidism
136
abx that stains teeth
tetracycline
137
fatigue, pruirits, steatorrhoea, dry eyes, mouth, jaundiced, xanthelasma, enlarged liver and spleen
Primary biliary cirrhosis - antimitochondrial antibodies
138
chronic pain and tingling of butt. pain worse sitting on toilet/chair. no lumbar pain. pain on internal rotation of extended thigh
piriformis syndrome
139
rubella triad
sensorineural hearing loss
ocular abnormalities (cataracts, rubella retinopathy)
congenital heart defects
140
neonate, double bubble sign on uss
duodenal atresia
141
dix-hallpike positive
BPPV
142
tx of impetigo
if localised non-bullous impetigo - hydrogen peroxide 1% cream, OR if unsuitable fusidic acid or mupirocin
if widespread non-bullous impetigo - short course of topical or oral abx
143
anion gap formula
(na + k) - (hco3 + cl)
144
itchy, flat, purplish, flat-topped pustules with interspersed lacy white lines on wrist
lichen planus
145
definition of imparied fasting glucose
fasting glucose >6.1 - 7.0
146
acute cholangitis presentation
triad: fever, RUQ, jaundice
147
types of elbow pathology
lateral epicondylitis (tennis elbow) - overuse injury involving extensor muscle that originate on lateral epicondylar region of distal humerus
148
positive simmons/thompson test
+VE TEST = RUPTURE
absences of normal plantar flexion on squeexing the calf muscle indicates a complete tendon rupture
149
treatment in mild myasthenia gravis
pyridostigmine - acetylcholinesterase inhibitor
150
caution when using simvastatin
max dose of simvastatin is 20mg if used in conjunction with amlodipine - as amlodipine is a weak inhibitor of CYP3A4
151
what drug can treat spironolactone
tamoxifen
NOT spirolactone - this causes gynaecomastia
152
ringworm infection of scalp
griseofulvin
153
resistant htn treatment
if K <4.5 - spironolactone
if K >4.5 - alpha or beta blocker
154
commonest cause of pcb
cervical ectropion
155
commonest organisms in erysipelas
streptococcus PYOGENES
borders of infection are sharply demarcated
156
purpura, arthritis, abdo pain, GI bleeding, orchitis, nephritis
Henoch-Schonlein purpura - systemic vasculitis by deposition of immune complexes containing IgA in skin and kidney
157
young boy, painful knees, lumps over tibial tuberosities
Osgood schlatter
small avulsion fractures within tibial tuberosity
158
optic palsies
2 - lack of sight
3 (oculomotor) - down and out, ptosis
4 (trochler) - superior oblique, deviated upwards, difficulty going upstairs
6 - abducens, lateral rectus, failure in ABDUCTION
159
soft transilluminable mass in posterior triangle
cystic hygroma
160
longstanding, solitary, painless mass on lateral side of neck
branchial cyst
161
ccb not tolerated in black pt
thiazide like diuretic like indapamide
162
21yo, new onset asthma, what to start on
salbutamol and steriods
163
lung cancer, hypercalacaemia
squamous cell carcinoma (secretes PTHrP)
164
deranged LFTs, macrocytic anaemia. presented acutely confused. ataxic gait, horizontal nystagmus and bilat abducens nerve palsy. offending drug?
glucose
infusion of glucose in a chronic thiamine deficiency can precipitate wernickes encephalopathy - triad of acute mental confusion, ataxia, ophthalmoplegia
165
recurrent infections
diarrhoea
dermatitis
failure to thrive
paeds
scid
166
kid, bulging opaque tympanic membrane
acute otitis media
167
aggressive thyroid carcinoma
anaplastic
features of hoarsenss and dyspnoea
168
thyroid cancer, diarrhoea and flushing
medually due to excessive calcitonin
169
old man, progressive deafness, ringing bilat. audiometry shows bilar loss of hearing at higher frequencies
presbycusis
170
young woman, progressive bilar hearing loss and tinnitus. low frequency conductive hearing loss
otosclerosis
171
missed progesterone pill
if >3 hrs overdue, take missed pill now and use extra precautions for 48 hrs
172
side effect of SGLT inhibitors
lower limb amputation
173
se of pioglitazone
bladder ca
174
se of metformin
decreased Vitamin 12 levels
175
goodpastures
triad of
diffuse pulmonary haemorrhage
glomerulonephritis
circulating anti GBM antibodies
176
contraception for someone with past breast cancer
no hormones
copper intrauterine device
177
interpretation of PE wells score
>4 CTPA
4 of less, - d simer and start therapeutic anticoagulation
178
k w/ steriods and furosemide
hypok
179
pregnant woman, new onset hyperthyroidism
prothiouracil and carbiazole
avoid carbimazole in first trimester - teterogenic
180
active cancer, has dvt
doac
181
treatment of scabies
permethrin 5%
182
side effect of tb drugs
R: orange secretions (orange coloured tears), liver, reddish colour urine
I: peripheral neuropathy, liver, agranulocytosis, TINGLING SENSATION IN HANDS
P: hyperuricaemia, hepatitis
E: (EYES) optic neuritis, red-green colour blindness, peripheral neuropathy
183
painful vesicles on tympanic membrane
bullous MYRINGITIS
184
htn drug causing hypok
indapamide (thiazide diuretic
185
htn causing hyperk
spironolactone, beta b, acei. arb, digoxin, heparin, trimethoprim
186
mx of roseasea
metronidazole (topical)
187
mx of uncomplicated acute diverticulitis
co-amoxiclav
188
small child, whoop sound cough, Dx and Mx
bordetella pertussis / pertussis
3 days azithromycin or 7 days clarithromycin
189
ecg changes in digoxin toxicity
st depression
inverted t waves in v5 to v6 (reverse tick)§
190
ecg changes in hypokalaemia
small or flatted t waves,
prominent u waves
prolonged pr interval
depression st segments
191
punched on left jaw, which nerve affected, unable to oppose teeth
mental nerve
192
drug that can provoke seizures
tramadol
short tonic-clonic seizures
193
mx of menopausal in woman not keen for hrt
antidepressants like citalopram
clonidine
gabapentin
194
osmolality equation
2Na +urea +glucose
195
drug used in rheumatoid. caused reduced visual acuity
hydroxychloroquine - ocular toxicity
whorl like corneal deposits
bulls eye macular lesions
therefore ALL patients taking chloroquine should have regular ocular examinations
196
depression, breastfeeding medications
sertraline, paroxetine
197
tingling and weakness of intrinsic muscles of L hand as well as ipsilateral ptosis
pancoast tumour
leads to horners syndrome - miosis enopthalmos, ptosis
198
treatment of acute Superior venous cava obstruction
dexamethasone
other treatment includes radiotherapy, chemotherapy, vascular stent
199
lachman test positive
acl injury
200
tremor, hyperreflexia, ataxia, flattened T wave - what toxicity? ***
lithium
201
se of hyoscine
dry mouth
202
se of clozapine
increase saliva production
203
orbit score
assess risk of bleeding in pts with AF on anticoag (more accurate than prev used hasbled
204
abcd2
risk of stroke in days after a tia
205
spondylolisthesis
forward slippage of a vertebra and the spine above it relative to the vertebra below
206
side effects of tamoxifen
PREVENTS BONE LOSS (benefit)
endometrial damage inc. hyperplasia, cancer etc
VTE
fatty liver
hypertriglyceridaemia
207
wild flinging of limbs
hemiballismus - due to infarction/haemorrhage in the contralateral subthalmic nucleus
208
semi-directed, irrgeular movements, not repetitive or rhythmic, appears to flow from one muscle to next
chorea
209
march fracture
stress fracture from repeitive walking or running - commonest site is 2nd MT shaft, tender lump on dorsum of foot
210
se of copper iud
prolonged, heavier, more painful periods
211
mx of myasthenia gravis
acetylcholinesterase inhibitors - pyridostigmine
212
mx of onychomycosis
oral terbinafine - for fungal nail infection caused by trichophyton rubrum - for several months
213
Hartnup disease
**** exam q****
inborn abnormality of renal and intestinal transport involving neural amino acids
pellagra like dermatitis - red, scaly, photosensitive rash on face, arms, extremities and sun exposed areas
neurological involvement - sudden ataxia, unsteady gait, dysarthria, tremors, speasticity
needs high protein diet, avoid sulphonamide drugs. supplementation with nicotinamide or niacin
214
neonate, chorioretinitis, intracranial calcifications, hydrocephalus
congenital toxoplasmosis
215
teenager, widespread rash. multiple discreet flat red lesions (small) and one larger lesion about 5cm on torso
pityriasis ROSEA
has a herald patch - characteristic of rosea
**prev exam q
216
rash with christmas tree distribution
guttate psoarsis
217
ulcerative colitis is associated with which condition
PSC!!!
218
pruritis, xanthelasmtic lesions around eye, hepatosplenomegaly , jaundice
PBC - primary biliary cirrhosis
autoimmune condition!
antimitochondrial antibodies
219
worldwide illness, facial flushing, fever, abdo pain
dengue fever, diagnosed with serology
220
breast cancer tumour marker
15-3
221
cancer related to lambert eaton
small cell carcinoma of lung
222
memory issues, down syndrome
alzheimers
223
is hiv a notififiable disease?
no
224
rocker bottom feet
edward syndrome
225
risk of down syndrome baby in 40yo mohter
1 in 100
226
conversion disorder
'hysteria'
alteration or loss of physical function suggestive of physical disorder - loss of motor or sensory function
pt does NOT consciously geign the symptoms and are not seeking for material gain
227
drugs causing impotence
atenolol, thiazide diurectics, beta blockers
oestrogens
finasteride
antiandrogens
benzodiazepines
phenothiazines
228
colles fractures
dorsally displacted, distal radius fracture
229
long face, big testicles
fragile X
learning difficulties
large jaw
230
se of amiodarone
pulmonary fibrosis
corneal deposits
skin pigmentation (blue/grey) on sun exposed areas
thyroid disturbance
hepatotoxicity
231
se of digoxin
dizziness
zanthopsia (blurred/yellow vision)
arrythmyas
ST depression and inverted T waves in V4-6 (reverse tick)
232
se of adenosine
flushing
bronchospasm
chest pain
233
drug which can predispose to gallstones
cholestyramine - binds bile in the GI tract to prevent its reabsorption which are then excreted in faeces
also causes consitpation
234
drug causing severe flushing
nicotinic acidl
235
large irregular pupil that constricts slowly to light but accomodates nromally
holmes-adie pupil: considered variation of normal
236
shining light on normal eye causes full constriction of both pupils. but when light shines on affected eye there is apparent dilation of both pupils
marcus gunn pupil - unilateral lesion in afferent visual pathway anterior to chiasm
237
small irregular pupil that DO NOT react to light but accomodates normally
argyll roberson pupil:most common cause is syphilis
"the prostitutes pupil - doesn't react but accomodates
238
causes of small bowel obstruction
most likely cause is adhesions postoperative (60%)
malignancy
crohns
hernias
239
fixed flexion deformity at PIP joint along with hyperextension of DIP joint in fingers
boutonniere deformity
240
hyperextension of interphalangeal join and fixed flexion and subluxation of the metacarpophalangeal joint
z deformity
occurs in RA
241
when can you use surgical haemorrhoidectomy
reserved for grade 4
but can be considered for grade 3
242
monitoring for lithium patient
*past exam paper
lithium needs THYROID function tests
aksi beeds fbc, u&e, calcium, ecg
243
chronic pain and stiffness to L foot, poorly localised to forefoot, related to activity, minor foot injurt a few months ago
freiberg's disease - osteochondrosis affecting the toes - articular surgaces of 2nd and 3rd metatarsal heads collapse
244
mx of vit d overdose
bisphosphonates
pt presents with signs of hypercalcaemia
245
drugs causing raised serum calcium levels
thiazide diuretics, lithium, antacids, cholcalciferol
246
9 weeks into pregnancy, small pv bleeding, cramping painds. scan shows confirmed death of foetus at 7 wees
missed miscarraige
247
delusion of being loved generally by someone of superior social status
de clarambault syndrome / erotomaia
248
familiar person falsely identified by strangers
fregoli syndrome
249
familiar person supplanted by stranger who is their exact double
capgras sydnrome
250
nihilistic delusions of body/self disappeared
cotard syndrome
251
steeple sign on xray
croup
252
asbestosis, most common cancer
*past exam q
lung ca not mesothelioma
253
weight loss, palpaitions, trmor. grossly enlarged anterior neck swelling . high t4, low tsh
toxic nodular goitre
also known as plummers disease
2nd most common cause of hyperthyroidism after graves
254
6 week. baby, rash on face and neck, apyrecix, well in self
erythma toxicum neonatorum
254
antiemetics in bowel obstructions
functional - metoclopramide
mechanical - cyclixine
255
antiemetic used for pts with hypercalcaemia
haloperidol (for metabolic causes of vomiting - hypercalcaemia, renal failure
256
vaginal discharge green/yellow, cervix has strawberry spots
metronidazole
trichomonas vaginalis
257
RUQ pain, white vaginal discharge, gram -ve
gonorrhoea
ceftrixone
258
poly uria, poly dipsia, dehydration, rickets or osteomalaxia
fanconi syndrome - results from excessive urinary loss of ca and phos and defect in hydrozylation of 25-yhydroxyvitamin D3 and impared growth
259
drug that causes gout
bendroflumethiazide (past exam q)
diuretics
salicyclates
ethambutol
nicotinic acid
pyreazinamide
260
detection of neural tube defects if uss is equivocal
amniotic fluid a-fetoprotein obtained by amniocentesis at 16 weeks
261
se of pop
irregular bleeding - most commn resason to stop
breasth tenderness
weight gain
acne
headaches
262
most common organism in acute otitis media
rsv, rhinorus, adenovirus, influexna, parainfluenza
strep pneumonia
h influenza
moraxella catarhalis
263
50yo caucasian man cannot tolerate acei
arb
264
started on risperidone, restless, lower-limb movment.
akathisia - prominence of lower limb restlessness after starting antipsychotic
the restless leg syndrome differens as it is restlessness interfering wiht sleep
265
mx of listeria
amox and gent
266
mx of syphilis
from treponema pallidum
benzathine benzylpenicillin
267
mx of toxoplasmosis
spiramycin
268
what. is pseudoobstruction
colonic obstruction but a MECHANICAL causes cannot be found
usually in elderly and bedrudden pts
gas in rectum on abdo xray
269
vomiting, hyperventiliation, tinnitus, sweating, respiratory alkalossi
aspirin overdose
270
dry mouth, dilated pupils, blurred vision, tachy, seizures, wide qrs complexes
amitripllyine overdose
give activated charcoal
271
most common cause of septic arthritis
staph aureus
272
rapidly expanding, painless, ulcerating nodules
squamous cell carcinoma
273
non-healing ulcer, edges are rolled
basal cell
274
drugs that worsen glycaemic control
bendrofluzamide (thiazide)
beta blockers
glucocorticoides
antipsychotic drugs
275
drug to give after thrombolysis in acs
heparin or lmwh
also consider iv betablocker
276
drug to avoid in renal artery stenosis
ace inhibitor
277
commonest se to ssri
increase f=gi bleeding
GIVE Ppi with it
also increased anxiety and agitation
278
treamtn of trigeminal neuralgia
carbamazepine
DO NOT CLICK AMITRIPLLINE
past q
