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MRCP/MSRA > MSRA Clinical 2 > Flashcards

MSRA Clinical 2 Flashcards

1
Q

L3 nerve root compression

A
  • Sensory loss over anterior thigh
  • Weak quadriceps
  • Reduced knee reflex
  • Positive femoral stretch test
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2
Q

L4 nerve root compression

A
  • Sensory loss anterior knee
  • Weak quadriceps
  • Reduced knee reflex
  • Positive femoral stretch test
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3
Q

L5 nerve root compression

A
  • Sensory loss dorsum of foot
  • Weakness in foot and big toe dorsiflexion
  • Reflexes intact
  • Positive sciatic nerve stretch test
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4
Q

S1 nerve root compression

A
  • Sensory loss posterolateral leg and lateral foot
  • Weakness in plantar flexion
  • Reduced ankle reflex
  • Positive sciatic nerve stretch test
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5
Q

Ottawa rules

A

Ankle x-ray if there is pain in malleolar zone and one of:

  1. Bony tenderness at lateral malleolar zone (including distal 6cm fibular)
  2. Bony tenderness at medial malleolar zone (including distal 6cm tibia)
  3. Inability to weight bear 4 steps immediately and in ED
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6
Q

Golfer’s elbow

A

Medial epiondylitis

  • Tender medial epicondyle
  • Medial wrist pain on resisted wrist pronation
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7
Q

Tennis elbow

A

Lateral epicondylitis

  • Tender lateral epicondyle
  • Lateral elbow pain on resisted wrist extension
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8
Q

Causative organism bone infections in SCA/malaria

A

Non-typhi salmonella

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9
Q

Patellofemoral pain syndrome AKA

A

chondromalacia patellae

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10
Q

Patellofemoral pain syndrome features

A

Softening of cartilage of patella
Teenage girls
Anterior knee pain on alking up/down stairs and rising from prolonged sitting
Responds to physio

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11
Q

Infraptellar bursitis

A

=clergyman’s knee

Associated with kneeling

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12
Q

Prepatellar bursitis

A

=Housemaid’s knee

Associated with upright kneeling

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13
Q

ACL injury

A

Caused by twisting of knee + popping noise
Rapid knee effusion
Positive draw test

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14
Q

PCL injury

A

Anterior force applied to proximal tibia (eg knee hitting dashboard)

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15
Q

Collateral ligament injury

A

Tenderness over affected ligament

Knee effusion

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16
Q

Mensical lesion

A

Caused by twisting of the knee
Locking and giving way are common features
Tender joint line

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17
Q

OA of knee

A

Intermittent swelling, crepitus, limitation of movement

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18
Q

Methotrexate side effects

A

Myelosuppression
Liver cirrhosis
Pneumonitis

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19
Q

Sulfasalazine side effects

A

Rashes
Oligospermia
Heinz body anaemia
Interstitial lung disease

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20
Q

Leflunomide side effects

A

Liver impairment
Interstitial lung disease
Hypertension

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21
Q

Hydroxychloroquine side effects

A

Retinopathy

Corneal deposits

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22
Q

Prednisolone side effects

A 
Cushingoid
Osteoporosis
Impaired glucose tolerance
Hypertension
Cataracts
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23
Q

Gold side effects

A

Proteinuria

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24
Q

Penicillamine side effects

A

Proteinuria

Exacerbation of myasthenia gravis

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25
Q

Etanercept side effects

A

Demyelination

Reactivation of Tb

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26
Q

Infliximab side effects

A

Reactivation of Tb

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27
Q

Adalimumab side effects

A

Reactivation of Tb

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28
Q

Rituximab side effects

A

Infusion reaction

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29
Q

Hip OA findings

A

Reduction in internal rotation

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30
Q

Referred lumbar spine pain

A

Femoral nerve stretch positive

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31
Q

Ankylosing spondylitis A features

A 
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
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32
Q

Antiphospholipid syndrome clotting screen

A

Paradoxically prolonged APTT

Low platelets

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33
Q

Drugs which cause drug-induced lupus

A
  • procainamide
  • hydralazine

less common causes:

  • isoniazid
  • minocycline
  • phenytoin
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34
Q

Indication for secondary prevention of osteoporotic fracture

A

After osteoporotic fracture in post-menopausal woman with confirmed osteoporosis (T-score of -2.5 SD or below)

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35
Q

Antibodies associated with diffuse cutaneous systemic sclerosis

A

anti-scl-70

+ ANA + RF

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36
Q

Antibodies associated with limited cutaneous systemic sclerosis

A

anti-centromere

+ ANA + RF

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37
Q

Lesch-Nyhan syndrome

A

Inherited enzyme deficiency.
“juvenile gout”,
self-mutilation behaviour

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38
Q

Pseudogout findings

A
  • calcium pyrophosphate dihydrate crystals
  • x-ray: chondrocalcinosis
  • aspiration: weakly-positively birefringent rhomboid crystals
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39
Q

Pseudogout risk factors

A
  • haemochromatosis
  • hyperparathyroidism
  • acromegaly
  • low magnesium, low phosphate
  • Wilson’s disease
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40
Q

Kocher criteria for septic arthritis

A
  • fever >38.5
  • non-weight bearing
  • raised ESR
  • raised WCC
41
Q

Common side effect of Amoxicillin

A

Rash with infectious mononucleosis

42
Q

Common side effect of Co-amoxiclav

A

Cholestasis

43
Q

Common side effect of Flucloxacillin

A

Cholestasis (usually develops several weeks after use)

44
Q

Common side effect of Erythromycin

A

Gastrointestinal upset

Prolongs QT interval

45
Q

Common side effect of Ciprofloxacin

A

Lowers seizure threshold

Tendonitis

46
Q

Common side effect of Metronidazole

A

Reaction following alcohol ingestion

47
Q

Common side effect of Doxycycline

A

Photosensitivity

48
Q

Common side effect of Trimethoprim

A

Rashes, including photosensitivity
Pruritus
Suppression of haematopoiesis

49
Q

Antibiotics harmful in pregnancy

A
  • Tetracyclines
  • Aminoglycosides
  • Sulphonamides and trimethoprim
  • Quinolones
50
Q

Non-antibiotic drugs which are harmful in pregnancy

A
  • ACEi, ARBs
  • Statins
  • Warfarin
  • Sulfonylureas
  • Retinoids (including topical)
  • Cytotoxic agents
51
Q

Statin monitoring

A

LFTs at baseline, 3 months and 12 months

52
Q

ACEi monitoring

A

U&E prior to treatement, after increasing dose, at least annually

53
Q

Amiodarone monitoring

A

TFT, LFT, U&E, CXR prior to treatment

TFT, LFT every 6 months

54
Q

Methotrexate monitoring

A

FBC, U&E, LFT prior to treatment.
Repeat weekly until stabilised.
Thereater every 2-3 months

55
Q

Azathioprine moniroting

A

FBC, LFT before treatment

FBC weekly for first 4 weeks

FBC, LFT every 3 months

56
Q

Lithium monitoring

A

TFT, U&E prior to treatment

Lithium levels weekly until stabilised, then every 3 months

TFT, U&E every 6 months

57
Q

Sodium Valproate monitoring

A

LFT, FBC before treatment

LFT periodically during first 6 months

58
Q

Glitazones monitoring

A

LFT before treatment and regularly during treatment

59
Q

Drugs which may cause urinary retention

A
  • TCAs
  • Anticholinergics
  • Opioids
  • NSAIDs
  • Disopyramide
60
Q

Common side effects of calcium channel blockers

A

Headache
Flushing
Ankle oedema

Verapamil also causes constipation

61
Q

Common side effects of beta-blockers

A

Bronchospasm
Fatigue
Cold peripheries
Sleep disturbance

62
Q

Common side effects of Nitrates

A

Headache
Postural hypotension
Tachycardia

63
Q

Common side effects of Nicorandil

A

Headache
Flushing
Anal ulceration

64
Q

Features of organophosphate poisoning

A

Accumulation of acetylcholine = SLUD

Salivation
Lacrimation
Urination
Defecation/diarrhoea

Hypotension, bradycardia, sall pupils, fasciculation

65
Q

Management of organophosphate poisoning

66
Q

Common side effects of ACE inhibitors

A

Cough

Hyperkalaemia

67
Q

Common side effects of Bendroflumethiazide

A

Gout
Hypokalamia
Hyponatraemia
Impaired glucose tolerance

68
Q

Common side effects of Doxazosin

A

Postural hypotension

69
Q

Managemeny of beta-blocker overdose

A

If bradycardic then atropine

Glucagon in resistant cases

70
Q

Features of beta-blocker overodse

A

Bradycardia
Hypotension
Heart failure
Syncope

71
Q

Finasteride - indications

A

BPH

Male-pattern baldness

72
Q

Finasteride - mechanism of action

A

Inhibitor of 5 alpha-reductase, and enzyme which metabolises testosterone to dihydrotestosterone

73
Q

Finasteride - adverse effects

A
  • impotence
  • decreased libido
  • ejaculation disorders
  • gynaecomastia and breast tenderness
74
Q

Salicylate overdose management

A

haemodialysis

75
Q

Benzodiazepine overdose management

A

Mainly conservative as flumazenil increases risk of seizures

76
Q

TCA overdose management

A

IV bicarbonate may reduce risk of seizure and arrhythmia

77
Q

Lithium overdose management

A

Saline

Haemodialysis

78
Q

Digoxin overdose management

A

Digoxin-specific antibody fragments

79
Q

Lead overdose management

A

Dimercaprol, calcium edetate

80
Q

Cyanide overdose management

A

Hydroxocobalamin

81
Q

Additional ACS treatment in MI secondary to cocaine use

A

IV benzodiazepine

82
Q

Metformin and contrast CT

A

Discontinue metforming for 48 hours following contrast CT

83
Q

Common side effects of rifampicin

A

Orange bodily fluids
Rash
Hepatotoxicity
Drug interactions

84
Q

Common side effects of Isoniazid

A

Peripheral neuropathy
Psychosis
Hepatotoxicity

85
Q

Common side effects of pyrazinamide

A

Arthralgia
Gout
Hepatotoxicity
Nausea

86
Q

Common side effects of Ethambutol

A

Optic neuritis

Rash

87
Q

Common side effects of metformin

A

GI upset

Lactic acidosis

88
Q

Common side effects of sulfonylureas

A

Hypoglycaemia
Increased appetite and weight gain
SIADH
Cholestasis

89
Q

Common side effects of glitazones

A

Weight gian
Fluid retention
Liver dysfunction
Fractures

90
Q

Common side effects of gliptins

A

Pancreatitis

91
Q

Side effect bleomycin

A

lung fibrosis

92
Q

Side effect doxorubicin

A

cardiomyopathy

93
Q

Side effect 5-FU

A

myelosuppression, mucositis, dermatitis

94
Q

side effect vincristine

A

peripheral neuropathy

paralytic ileus

95
Q

side effects cisplatin

A

ototoxicity
peripheral neuropathy
hypomagnenaemia

96
Q

Drugs used in mild to moderate Alzheimer’s: 1st line

A

Acetylcholinesterase inhibitor: donepezil, galantamine or rivastigmine

97
Q

Drugs used in Alzheimer’s: 2nd line

A

Memantine (NMDA antagonist)

98
Q

Palliative care: hiccups

A

chlorpromazine

MRCP/MSRA (15 decks)

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