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MSRA 9 Flashcards

1
Q

What is the chromosome problem in CML?

A

Philadelphia chromosome

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2
Q

What is Angelmans syndrome?

A

P is Papa - father deletion
Angel is Mama - mother deletion
Microdeletion of 15-13
Angels in the HEAVENS”: Happy-go-lucky, Easily Excitable personality, Ataxia, Verbal underdevelopment, Epileptic seizures, abNormal facial features, Severe intellectual disability.

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3
Q

Pierre Robin syndrome

A

Maxillofacial malformation

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4
Q

What are the 4 Cs for Toxoplasmosis congenital infection?

A

4 Cs of congenital toxoplasmosis: Cerebral calcifications, Chorioretinitis, hydroCephalus, and Convulsions.

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5
Q

What are the 4 “others” pregnancy infections

A

Syphilis
Listeria
HZV
Parvovirus

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6
Q

What is the Hutchinsons triad for congenital syphilis?

A

Hutchinson triad: interstitial keratitis, sensorineural hearing loss, Hutchinson teeth

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7
Q

What are the features of a congenital listeria infection?

A

Granulomatosis infantiseptica

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8
Q

What are the features of a congenital VZV infection?

A

Hypertrophic scars (cicatricial skin lesions)
Limb defects (e.g., hypoplasia)
Ocular defects (e.g., chorioretinitis, cataracts, microphthalmia)
CNS defects (e.g., cortical atrophy, seizures, intellectual disability), hydrocephalus

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9
Q

What is hydrops foetalis?

A

A fetal condition characterized by generalized edema and accumulation of fluid in serous cavities (e.g., pleural effusion, pericardial effusion, ascites). Diagnosed via ultrasound. Etiologies include severe fetal anemia (e.g., hemolytic disease of the newborn, hemorrhage), congenital infections (e.g., parvovirus B19), chromosomal abnormalities, and congenital heart defects. Associated with a high rate of perinatal mortality.

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10
Q

What are the features of a congenital parvovirus B19 infection?

A

Hydrops foetalis

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11
Q

What are the features of a congenital Rubella infection?

A

CCC-Triad of congenital rubella syndrome: Cataracts, Cochlear defects, Cardiac abnormality

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12
Q

What are the features of a congenital CMV infection?

A

Similar to the 4Cs of Toxo except there is microcephaly instead of hydrocephalus

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13
Q

What are the features of a congenital HSV infection?

A

Skin, eyes, and mouth involvement: vesicular lesions, keratoconjunctivitis
Localized CNS involvement: meningoencephalitis

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14
Q

Which NSAID has the greatest risk for an MI?

A

Diclofenac

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15
Q

Which HRT is best for menopause in migraines?

A

Transdermal HRT

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16
Q

What are the rules for HRT in CVD?

A

It is CI

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17
Q

What is the side effect of leukotriene receptor antagonists (monteleukast)

A

Bad dreams, other psych effects, bruising, headaches

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18
Q

If the person has ongoing symptoms of allergic rhinitis and a history of asthma, which medications can you give?

A

Consider adding a leukotriene receptor antagonist such as montelukast to an oral or intranasal antihistamine.

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19
Q

Which nasal medication if taken longer than 5days causes rhinitis medicamentosa leading to nasal congestion caused by overuse?

A

Xylometazoline

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20
Q

What are the 4 MAOI?

A

Tranylcypromine
Isocarboxazid
Phenelzine
Moclobemide

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21
Q

Which SSRI has the longest half life?

A

Fluoxetine

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22
Q

what is special about propranolol?

A

It is not cardio selective

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23
Q

Which antibiotic can cause oesophagitis?

A

Doxycycline

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24
Q

What is the antibiotic for syphilis and what is the reaction when you start killing the syphilis

A

Benpen
Jarisch-Herxheimer reaction - flu like symptoms (fever, chills, tahcycardia)

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25
Which antibiotic causes an altered sense of taste?
Metronizadole
26
What effect can Pen V cause?
Thrombocytopaenia
27
What are the CI for HRT?
Current, past, or suspected breast cancer. Known or suspected oestrogen-dependent cancer. Undiagnosed vaginal bleeding. Untreated endometrial hyperplasia. Previous idiopathic or current venous thromboembolism (deep vein thrombosis or pulmonary embolism), unless the woman is already on anticoagulant treatment. Active or recent arterial thromboembolic disease (for example angina or myocardial infarction). Active liver disease with abnormal liver function tests. Pregnancy. Thrombophilic disorder.
28
Which gout drug should not be co-prescribed with marcrolides?
Using colchicine — risk of colchicine toxicity, particularly in the elderly or those with renal insufficiency.
29
What are the choices of antibiotics for pylonephritis?
1st line is Cefalexin 500 mg twice or three times a day (up to 1– 1.5 g three or four times a day for severe infections) for 7-10 days. Co-amox and trimethoprim is given if there are sensitivities Cipro is last line if other antibiotics are not appropriate
30
What are the early signs of Huntington's?
Personality change and clumsiness
31
What are the CI for exercise ECG
Unstable angina Electrolyte disturbance Recent MI within 7days Aortic stenosis HF with pulmonary oedema
32
What are the dual antiplatelets you before a PCI? What would give instead if there is a high risk of bleeding and over 75? What would you give instead if they have had a previous stroke or TIA or are already on a anti-coagulant?
Aspirin and Prasugrel Ticagrelor or Clopidogrel Clopidogrel and aspirin (Prasugrel is CI in previous stroke/TIA)
33
What are the investigations to arrange for stable angina?
CT coronary angiogram If it is inconclusive then functional stress echocardiogram or nuclear perfusion
34
What does sick sinus syndrome cause? What are the risk factors for sick sinus syndrome? What is the management?
Bradycardia CAD, HTN, DM, Obesity, RBBB, old age. Pacing
35
What are Signs of AV dissociation
No relation of P and QRS indicating atrial and ventricular contractions are occurring independently
36
What joint symptoms do you get in HSP?
Arthritis
37
What are the causes for ITP? What is its causes in children? What are its possible complications? Do you get splenomegaly in it?
Primary - idiopathic (commonest) Secondary - (SLE, APLS, Malignancy, Infection, Drug) Post viral No splenomegaly
38
What is benign rolandic epilepsy (Benign epilepsy with centrotemporal spikes)?
Centrotemporal spikes Seizures when asleep In children, resolves in puberty
39
What is Charcot MT better known as?
Motor sensory neuropathy (Charcot MT is the commonest one)
40
What is the bilirubin level for jaundice?
>30mmol/L
41
What are the causes of neonatal jaundice in the first 24hours of life (pathological jaundice)
ABO incompatibility Rhesus haemolytic disease G6PD deficiency Spherocytosis TORCH infection
42
What are the causes of neonatal jaundice from 24hours to 14 (21 if preterm) days
Physiological jaundice Breast feeding jaundice Infection Haemolytic disorders Bruising
43
What are the causes for prolonged neonatal jaundice
Common cause of prolonged jaundice is exclusive breastfeeding (‘breast milk jaundice’), and immature neonatal mechanisms and prematurity can also cause benign ‘physiological jaundice’ after 14 days. Infection CF, hypothyroidism, Rhesus haemolytic disease, Sepsis, Crigiller Najjar syndrome, Gilbert syndrome Conjugated jaundice - commonly biliary atresia, neonatal hepatitis,
44
What is pendred syndrome
Autosomal recessive causing sensoryneural hearing loss and hypothyroidism
45
When is respiratory distress seen in a neonate?
In premature babies who have no surfactant
46
What are the features of neonatal hypothyroidism
The 7 P's of congenital hypothyroidism are Pot-bellied, Pale, Puffy-faced, Protruding umbilicus, Protuberant tongue, Poor brain development, and Prolonged neonatal jaundice
47
Which skin cancer is the ONLY ONE TO ULCERATE
SCC
48
What is the organism causing pityriasis versicolor
Yeast infection Malassezia furfur
49
What is the culprit for tinea infections?
Trichophyton
50
What is the difference between discoid lupus and discoid eczema
Eczema leave hyperpigmented lesions and only affects the extremities.
51
What is post-partum endometritis? What is septic pelvic thrombophlebitis?
Endometritis you get in PID. Septic pelvic thrombophlebitis is a blood clot that blocks one or more pelvic veins. It can develop due to infection and inflammation in the pelvic region.
52
What is a uterine leiomyosarcoma? What is it's differential and which is the benign and malignant condition/
A malignant growth of the smooth muscle or the myometrium of the uterus, it is suspected in a rapid very large pelvic mass. Also presents with bleeding. Leiomyoma (benign) Leiomyosarcoma (malignant)
53
What does congenital gonorrhoea present as?
Purulent discharge from eyes with eye lid swelling - urgent ophthalmology referral needed to prevent corneal ulceration
54
How is labour induced at 40-42weeks?
40-41weeks is membrane sweep 41-42week is medical induction
55
What is the perinatal period
From 24week up till 7days post partum
56
What is the difference between Sheehans and Ashermans
Asherman is intrauterine adhesions after dilatage and curettage Sheehans is pituitary insufficiency
57
How is a new diagnosis of gestational hypertension managed?
Refer to secondary care
58
Is meconium stained liqueur a sign to go straight for an emergency c-section?
No, not unless there are signs of foetal distress
59
What are the anti-bodies associated with dermatomyositis
Anti-Mi2
60
Which drugs do you give in post influenza exposure?
Oseltamivir and zanamivir
61
What is anti-topoisomerate -1 antibody assocaited with?
systemic sclerosis
62
What is Nelson's syndrome
If the adrenals are removed in Cushing's disease, the ACTH macroadenoma continues to grow and press on structures causing ocular palsys
63
What are the different types of thyroid cancers and their frequencies?
Papillary carcinoma, commonest which has an excellent prognosis with a 10-year survival rate of over 90%. Follicular carcinoma is the second most common type and has a slightly lower survival rate. Medullary carcinoma and anaplastic carcinoma are less common but have a poorer prognosis.
64
How can Sheehans syndrome cause SIADH?
Cranial diabetes insipidus
65
Which sex does Kallmann effect?
Girl or Boy
66
What is thyroid acropachy
is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal
67
What is Lid lag a sign of
Thyrotoxicosis
68
What is Tabes dorsalis
Degeneration of the dorsal columns of the spinal cord caused by tertiary syphilis. Manifestations include dysesthesias, gait ataxia, and progressive loss of proprioception.
69
What is mononeuritis multiple
Damage to 2 or more nerves from a variety of conditions causing asymmetrical symptoms which damages nerves
70
IGT trumps IFG
ok
71
What is the character of vision loss in vitreous haemorrhage?
Streaky and sudden (Branch retinal vein is hours to days)
72
What is the treatment for proliferative diabetic retinopathy?
Laser photocoagulation
73
What is HLA-B5 associated with?
Behcet's - japanese, mediterranean
74
Which type of infection caused by chalmydia if left to be chronic causes blindness?
Trachoma
75
Which nerve is the abducent nerve?
6th nerve
76
Simmonds test
Achilles tendon rupture
77
What are the classical features of EDS?
The classic presentation of EDS involves hyperextensible skin, joint hypermobility, and a tendency to bleed easily.
78
What are the things to know about polyarteritis nodosa?
Suspect it in a stroke with no risk factors It has not blood tests, it is only diagnosed on biopsy
79
How is microscopic polyangiitis different to GPA or Churgstraus?
Clinical features are very similar to those of granulomatosis with polyangiitis (GPA), but MPA spares the vessels in the upper respiratory tract (no sinusitis or rhinitis). [4]
80
Why are xrays good for back pain?
Xrays show vertebral fractures
81
What is the investigation of choice for suspected pulmonary fibrosis/ILD due to methotraexate?
HR CT chest
82
Psoriasis treatment that has worsened the rash?
Its fungal and the medication you have given is a steroid
83
What is Erythema toxicum neonatorum (ETN)
is a common, harmless rash that appears on the skin of many healthy newborns
84
artemisinin combination therapy is used to treat what?
Malaria Proguantil (folate inh) +Chloraquinel (epilepsy and ventricular arrhythmias) / atovaquine
85
What electrolyte abnormalities do you get with SIADH? What causes the symptoms? What are the severe symptoms caused by SIADH?
Low serum osmolality and sodium, high urinary osmolalty and sodium? Thirst, headache, confusion, muscle cramps - caused by hyponatraemia Cerebral oedema due to hyponatraemia - seizure and coma
86
What are the causes for SIADH?
Antidepressants, Antipsychotics, Chronic disease, CNS lesions
87
How does St John worts affect serotonin
Increases serotonin levels
88
What are the 4 bone cancers?
Ewing sarcoma - 22onions Osteosarcoma - SOCK (sunburst, Osteosarcoma, Codman, Knee region) Chondrosarcoma - Moth eaten Chondroma - extremely rare
89
What is the opposite to exotropia (away from nose) And hypotropia (downwards)
Exotropia and esotropia Hypotropia and hypertropia
90
What are special about venlaflaxine and paraoxetine (SNRI)
They have long discontinuation symptoms
91
When is amniocentesis
After 15weeks
92
When is chrioamniocentesis?
before 13weeks
93
What birth defect does topiramate cause?
Cleft palate
94
What is dacryocystitis
Inflammation of the lacrimal (tear) ducts
95
What does a failure to treat a strbismus result in?
Amblyopia

MSRA (12 decks)

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