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Z MD 2 > other > Flashcards

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1
Q

empiric AB choice for febrile neutropaenia

A

piperacillin/tazobactam

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2
Q

how do you diagnose dengue

A

4 fold rise in Ab titre over 2 weeks

Flavivirus PCR

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3
Q

common prodrome to Guillan-Barre

A

viral illness or vaccination

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4
Q

what are the 3 mechanisms that can cause hypercalcaemia in malignancy

A
  • osteolytic metastasis with local release of cytokines
  • tumour secretion of PTHrP
  • tumour production of 1,24 Vit D
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5
Q

presentation of eaton-Lambert syndrome

A

opposite to MG

  • stronger muscle response with repetition
  • recovery of lost deep tendon reflexes
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6
Q

when are the ONLY two reasons to treat asymptomatic bacteruria

A

pregnant

having a urological procedure

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7
Q

treatment of Bell’s palsy

A

prednisolone +/- valciclovir +/- tape eye shut

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8
Q

treatment of dengue fever

A

symptomatic and supportive therapy

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9
Q

clinical presentation suggestive of epidural abscess

A

fever and localised back pain

and focal neurological deficits

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10
Q

definition of febrile neutropaenia

A
  • neutrophils less than 0.5

- once off fever of more than 38.3 or a sustained temp of more than 38 for more than 1 hour

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11
Q

top 2 complications of diabetes

A

CVD

infection

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12
Q

3 cardinal features of claudication

A

pain with exertion
relieved by rest
reproducible

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13
Q

when do you do an ERCP with pancreatitis

A

when you suspect gallstones and cholangitis (high bilirubin)

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14
Q

clinical presentation of malaria

A 
fever
flu like illness
N&V, diarrhoea
anaemia, jaundice
cough
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15
Q

What cancers, other than SCC, are patients post-transplant particularly susceptible to

A
  • HPV - cervical/vulval
  • EBV - lymphoma, lymphoproliferative
  • HHV8 - Kaposi’s sarcoma
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16
Q

explain how HIV enters CD4 cells

A

gp120 protein on HIV virus binds to CD4 –> structural rearrangement of gp120 –> binding site for CCR5/CXCR4 protein of T cells –> binding –> structural rearrangement of gp41 protein on HIV virus –> fusion with CD4 T cell

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17
Q

4 major side effects or interactions of azathioprine

A

macrocytosis
myelosuppression –> cancer
dangerous with allopurinol = causes severe BM toxicity
can cause pancreatitis

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18
Q

specific indications for dialysis

A

uraemia –> pericardial rub, pleuritis, bleeding diathesis
fluid overload refractory to surgery
electrolyte imbalance

19
Q

Clinical presentation of dengue

A

fever, headache, myalgias, RASH

20
Q

standard treatment for meningitis

A

dexamethasone –> ceftriaxone, vancomycin and penicillin –> CT –> LP

21
Q

Homonymous hemianopia is always due to a problem with which artery

A

posterior cerebral artery

22
Q

Common areas for Dengue

A

South East Asia

Caribbean

23
Q

treatment of typhoid

A

antibiotics

24
Q

why don’t you give anti-coagulants with a stroke presentation

A

it increases the chance of ischaemic transformation

25
Q

treatment of acute ischaemic limb

A

immediate heparinization

urgent revascularisation

26
Q

what infections should you consider in a patient with HIV at different CD4 counts

A

CD4 less than 200 = PJP
CD4 less than 100 = toxoplasmosis
CD4 less than 50 = MAC

27
Q

what clinical presentation do you get with conduction aphasia

A

poor ability to repetition

28
Q

when do you give alteplase with stroke

A

ischaemic stroke less than 3 hours (up to 4.5)

29
Q

explain the presentation of steroid myopathy

A

symmetrical proximal weakness

30
Q

treatment of falciparum malaria

A

artesunate combinations or malarone

ADMISSION

31
Q

which movements of the hip are limited in OA of the hip

A

extension
abduction
internal rotation

32
Q

clinical presentation of tyhpoid

A

fever

bloody diarrhoea or constipation

33
Q

treatment and prevention of cluster headache

A

Rx - oxygen or triptans

prevention - CCB

34
Q

treatment and prevention of tumour lysis syndrome

A

prevention - hydration and allopurinol started 24 hours prior to chemo
treatment - haemodialysis if in renal failure

35
Q

Strep bovis is associated with

A

colorectal cancer

36
Q

where is Wernicke’s area

A

posterior temporal and parietal lobes

37
Q

clinical presentation of motor neuron disease

A

mixture of UMN and LMN signs with NO SENSORY changes

38
Q

why don’t you give radiotherapy for colon cancer

A

bowel moves too much

39
Q

indications for home oxygen

A

PaO2 less than 50mmHg or less than 60mmHg if signs of RHF or high Hct

40
Q

acute and longer term management of hyercalcaemia due to malignancy

A

acute - saline + calcitonin

longer - bisphosphonates

41
Q

treatment of immune thrombocytopaenia

A

prednisolone and IVIg

2nd line = splenectomy

42
Q

what causes the severe complications of Plasmodium falciparum

A

endothelial adherence of infected RBCs

43
Q

highest risk areas for malaria

A

Sub-Saharn Africa
Papua New Guinea
Soloman Islands

44
Q

what are 3 specific physical signs for Grave’s disease

A

thyroid acropatchy
proptosis
pre-tibial myxoedema

Z MD 2 (15 decks)

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