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msra- my cards > Other (mainly Gastro/ ID) > Flashcards

Other (mainly Gastro/ ID) Flashcards

1
Q

What is Shigella gastroenteritis characterised by?

A

Bloody diarrhoea and abdo pain

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1
Q

What is staph aureus gastroenteritis characterised by?

A

Short incubation time (eg hours) severe vomiting and less common to have diarrhoea.

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2
Q

What are the features of Primary Bilary Choleangitis ?

A

3 M Rule= middle age females, Anti MITOCHONDRIAL antibodies and ism

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3
Q

What is Primary Sclerosising Choleangitis a/w?

A

Associated with inflammatory bowel disease

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4
Q

Prolonged APTT and low platelets indicate with blood clotting disorder?

A

Antiphospholipid (miscarriages/ DVT/PEs etc)

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5
Q

What are some signs of Zinc deficiency?

A

acrodermatitis - red crusted lesions around mouth (may be seen in anorexia nervosa)

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6
Q

In ER receptor pos breast cancer when is Tamoxifen used vs Anastrozole?

A

Tamoxifen is used for pre menopausal/ perimenopausal. Anastrozole is used for post menopausal.

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7
Q

What is first line treatment for UTIs in males?

A

Trimethoprim or Nitrofuratoin for 7 days

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8
Q

What is the breast screening regime in the UK?

A

Age 50-70, every 3 years

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9
Q

Immune Thombocytoepnia in Adults- what is the defining feature and what is the first line tx.

A

Isolated LOW platelets AND first line tx is oral prednisolone

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10
Q

Hereditary Haemorrhagic Telectangtasia presents with?

A

Epistaxis are a common symptom

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11
Q

What is the conversion from oral codeine to oral morphine?

A

10mg codeine = 1mg morphine.
Divide by 10

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12
Q

What does the median nerve supply?

A

Thumb, middle finger

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13
Q

How to start Allopurinol in urate lowering therapy?

A

Allopurinol can be started after acute attack. Need colchicine or NSAID “cover” when starting allopurinol.

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14
Q

How to test the exocrine function in pancreatitis?

A

Feacal elastase

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15
Q

What are the type of crisis’s that can present in sickle cell?

A

Thrombotic, aplastic, sequestrian

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16
Q

How does a thrombotic crisis in sickle cell present?

A

Following infection/ dehydration. Presents with pain ++

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17
Q

Which ulcers IMPROVE with eating?

A

Duodenal ulcers- symptoms improve with food

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18
Q

When should uric acid lowering therapy reduce for gout?

A

After first episode of gout can consider starting allopurinol once symptoms have resolved.

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19
Q

How does the wells score work for DVT?

A

Score of 2 or more= DVT likely and therefore USS
Score of 1 or less= DVT less likely and therefore d dimer

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20
Q

How to diagnose CKD 1

A

egfr > 90 but with either proteinuria or electrolyte disturbances

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21
Q

How does leukoplakia present?

A

White patches on the inside of the mouth

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22
Q

What may be some differentials for leukoplakia?

A

Candidia/ Lichen plants/ SCC

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23
Q

What is the drug used in the prophylaxis of variceal bleeds in the context of known varices?

A

Propanalol (non cardiac selective BB)

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24
Q

What are the features of familial hypercholesterolemia?

A

High total lipids
Raised LDL
Personal family history of CVS disease

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25
Q

What cancers is the BRAC 2 a/w?

A

Breast.
Men- prostate
Women- ovarian

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26
Q

How does HYPO calcaemia present vs HYPER calcaemia?

A

High calcium- muscle weakness/ hyporeflexia
Low calcium- brisk reflexes/ percussion over facial nerve= spasm (Chvosteks sign).

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27
Q

What does sickle cell do to your HBA1C?

A

Reduces it. HB1AC would be lower than expected in sickle cell.

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28
Q

What are the diagnostic tests for H-pylori?

A

Stool test and Urea breath test

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29
Q

What is the inheritance for Huningtons?

A

Autosomal dominant

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30
Q

How does a chancroid ulcer present?

A

Painful genital ulcer a/w lymphadenopathy

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31
Q

What is the management for life threatening C.diff infection?

A

PO Vancyomycin and IV metronidazole

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32
Q

What is the antibiotic for prophylaxis of SBP?

A

Oral ciprofloxacin

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33
Q

What are the components of CREST syndrome?

A

CREST syndrome is a subtype of limited systemic sclerosis and includes: calcinosis, Raynaud’s phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia

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34
Q

How may polycythaemia present?

A

Swelling of joints, itchiness, ruddy complexion, peptic ulcer disease

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35
Q

If starting medium/long term steroids on a patient over aged 65 what also needs to be prescribed?

A

Bone protection- start if aged over 65 and starting steroids.

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36
Q

Mnuemonic for remembering LIVE vaccines?

A

Boys LOVE THE crime

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37
Q

What are the live vaccines?

A

B- BCG
O-oral polio
Ys - Yellow Fever
LIVE
The- Typhoid
Chickenpox
Rubella
Influenza
Mumps/measles
Endemic typhus

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38
Q

What is a sequestrian crisis in sickle cell- how may it present?

A

May present with splenomegaly/ anaemia/ cardiovascular collapse due to anaemia. More common in childhood

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39
Q

What is the treatment for urge incontinence/ overactive bladder?

A

Antimusclarinics eg oxybutanin

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40
Q

Paracetamol overdose would do what to your LFTs?

A

Raised ALT
Normal ALP

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41
Q

Typhoid is caused by?

A

Salmonella

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42
Q

What is the blood test for diagnosing HIV?

A

p24 antigen and HIV antibody test

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43
Q

Haemophillia A presents with what on the bloods?

A

Prolonged APTT, normal PT

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44
Q

Calcitonin is a tumour marker in which cancer?

A

Medullary thyroid cancer.

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45
Q

When would Ciprofloxacin be used for prophylaxis against SBP?

A

If ascitic protein = 15 or less

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46
Q

What drug is used to help with ascites?

A

Sprinolactone (aldosterone antagonist)

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47
Q

ATN (Acute tubular necrosis)- what is the defining feature on investigations?

A

High urinary sodium but everything else is low.

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48
Q

Post exposure prophylaxis of HIV- what is the process?

A

Antiretrovirals for 4 weeks
and testing at 12 weeks

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49
Q

What is the investigation for suspected Lyme disease?

A

Blood test for serology (ELISA)

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50
Q

Insectiside poisoning is treated with?

A

Atropine

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51
Q

Antifreeze poisoning is treated with?

A

Fomepizole

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52
Q

Topical NSAIDs are indicated for which joints?

A

Knee or hand

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53
Q

What infection can cause fetal hydrops?

A

Parvovirus 19

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54
Q

What group of people can be severely affected by Parvovirus infection?

A

Sickle cell- can trigger aplastic crisis

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55
Q

What is a bisphosphonate holiday?

A

If PO bisphonates for >5 years and LOW risk then can have repeat DEXA/FRAX and have a 2 year holiday.

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56
Q

What is the treatment for Pagets?

A

Bisphosphonates

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57
Q

Primary Bilary cirrhosis has which antibody?

A

Anti-mitochondrial antibody. (IgM, middle aged females).

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58
Q

Psudeopolyps are seen in UC or Crohns?

A

UC

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59
Q

If GI side effects are experienced with alendroate what bisphosphonate should be offered instead?

A

Risedronate or etidronate

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60
Q

How to diagnose stage 1/ stage 2 AKI?

A

Stage 1 increase in creatinine 1-1.5 times over baseline
Stage 2: increase in creatinine 2-2.9 times baseline

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61
Q

What crystals are seen in psudegout?

A

Positive RHOMBOID biofringent crystals

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62
Q

What are the heart complications with Ankylosing spondylitis?

A

AV node block and aortic regurgitation

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63
Q

What imaging is first line for achilles tendonitis?

A

USS

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64
Q

What is the inheritance of haemachromatosis?

A

Autosomal recessive

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65
Q

How would chondromalacia patellae present?

A

Runners, anterior knee pain over patella. softening of cartilage over patella.

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66
Q

In anaphylaxis, how often can you give adrenaline?

A

Every 5 minutes

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67
Q

Camplylobacter is treated with?

A

Clarithromycin

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68
Q

What are the guidelines around long term steroids and bisphosphonates?

A

If steroids over > 3 months then start vit D, calcium and bisphosphonates

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69
Q

Treatment of latent TB ( 2 options)

A

3 months of Isoniazid and rifampicin
or just 6 months of isoniazid

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70
Q

Primary sclerosing choleangitis is associated with which other conditions?

A

UC, Crohns and HIV

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71
Q

AMA autoantibodies are pathognomic for which condition?

A

Primary bilary cirrhosis

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72
Q

Leptospirosis/ Weils disease presents how?

A

Contact with rat urine
Mild flu like illness OR AKI and jaundice (wiels disease)

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73
Q

Prior to a urea breath test which drugs need to be avoided?

A

No antibiotics for 4 weeks
No PPI for 2 weeks

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74
Q

Most common cause of travellers diarrhoea?

A

E-coli

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75
Q

What is the H pylori eradication drugs?

A

Omeprazole 20 mg BD
+ Amoxicillin BD
+ either clarithromycin or metronidazole

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76
Q

What is pellagra?

A

Niacin defiency (Vitamin B3)
3 D’s= dementia, dermatitis and diarrhoea

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77
Q

What is the presentation of malaria?

A

Fever, hepatospelomegaly

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78
Q

How does Chagas present?

A

Brazil,
Cardiomyopathy, Cardiac death, irregular heart beat, constipation.

79
Q

How does Yellow Fever present?

A

Non specific, fever, headache, malaise, N+V

80
Q

Presentation of Toxoplasmosis?

A

Immunocompent- non specific illness
Immunocompromised- CNS complications. ring enhancing lesions
Meningioencephalitis

81
Q

Onchocerciasis - what is it?

A

“River blindness” causes patches of skin depigmentation and alterations in vision. Caused by black flies

82
Q

What tumour marker is the screening tool for hepatocellular carcinoma?

A

AFP.

83
Q

What are the common notifiable diseases in the UK?

A

Measles, mumps and food poisoning

84
Q

What are the symptoms of gonorrhoea in a man?

A

Urethral discharge, dysuria, perianal or anal pain, pruritis or bleeding in rectal infection.

More common in MSM

85
Q

How does Salicylate poisoning present?

A

Mixed respiratory alkalosis and metabolic acidosis
Hyperventilation
N+V
Sweating
Seizures and coma

86
Q

Antidote to Salicylate poisoning?

A

urinary alkalinization with intravenous sodium bicarbonate
Haemodialysis

87
Q

What is the diagnostic test for Hiatus hernia?

A

Barium meal is most diagnostic. But first line is usually endoscopy

88
Q

What is the management of hiatus hernia?

A

Medical mx = PPI therapy

89
Q

What are the histological findings with Barretts oesophagus?

A

Squamous to columnar epithelium

90
Q

What are the characteristics of Type 1 vs Type 2 autoimmune hepatitis?

A

Type 1: ANA antibodies/ smooth muscle antibodies.Adults and children

Type 2: Children

91
Q

How does Typhoid fever present?

A

RASH
Rash- trunchal rash
A- Abdominal pain and constipation
S Splenomegaly
H- hepatomegaly and headaches

92
Q

How does Dengue fever present?

A

HARMS
Haemorrhage / headache
Rash- facial flushing
Myalgia
Serology and short of WBC (leucopenia)

93
Q

What is ethylene glycol and what is the antidote for poisoning OD?

A

Ethylene glycol is antifreeze
Antidote: first line Fomipizole
Second line: ethanol.

94
Q

What is salicylate- and what is the antidote?

A

salicylate is Aspirin/ willow bark leaves.
Antidote: Urinary alkalisation with Bicarbonate or Haemodialysis

95
Q

Management of Acutely thrombosed external haemorrhoids?

A

If presents within 72 hours then refer to surgery for reduction or excision

96
Q

How does chronic pancreatitis present?

A

Pale stools
Pain after meals
Diabetes
(Most common in hx of high alcohol intake)

97
Q

Amoebic gastroenteritis - what type of organism and what is the management?

A

Entamoeba histolytica protozoan
Mx - Metronidazole + Diloxanide Furoate (Intraluminal Agent)

98
Q

Ecoli gastroenteritis- what type of organism and mx?

A

Escherichia coli
- Gram Negative Rod
- Mx - Self Limiting

99
Q

What is the triad for Haemochromotosis?

A

Diabetes
Hepatomegaly
Bronze discolouration

100
Q

What is the presentation of Primary Binary Cirrhosis (Choleangitis)?

A

AMA
Classic presentation: itching in a middle aged woman
Pruritis/ Jaundice
Cholestatic jaundice

101
Q

Hydrocele vs Epididymal cyst

A

Both transilluminate.
Epididymal cyst is a lump that is anterior to the testicle.

102
Q

What 4 malignancies are associated with Epstein Barr virus ?

A
  1. Nasopharyngeal
  2. Burkitts lymphoma
  3. Hodgkins lymphoma
  4. HIV associated central nervous system lymphomas
103
Q

What is an example of a Type 1 Hypersensitivity reaction?

A

Asthma/ anaphylaxis
IgEEEEEE

104
Q

What is an example of a Type 2 Hypersensitivity reaction?

A

Goodpastures
ITP
Pernicous anaemia
IgG OR Igm

105
Q

What is Type 3 Hypersensitivity reaction?

A

Lupus
Post streptococcocal glomerulonephritis

106
Q

What is Type 4 Hypersensivity reaction?

A

T cell mediated
Graft vs Host
Scabies

107
Q

What is the mnemonic for remembering Hypersensitivity reactions?

A

ACID

A- allergy/ rapid onset
C- Cell mediated / cytoxic
I- immune complexes eg SLE
D- Delayed eg. allergic contact dermatitis

108
Q

Sjogrens is associated with which antibody?

A

Anti La

109
Q

What antibodies are positive in systemic sclerosis?

A

ANA
RF
anti-scl-70 with DIFFUSE

110
Q

Treatment of Typhoid ?

A

Ciprofloxacin/ Azithromycin

111
Q

Typhoid is caused by which bacteria? and what is the presentation?

A

Salmonella
Rose spots/ constipation/ bradycardia

112
Q

Replacing B12 - what to remember?

A

Treat the B12 first if deficient in both B12 and folate.

Need to avoid subacute degeneration of the cord!

113
Q

What are the causes of Liver Cirrhosis?

A

Alcohol
NAFLD
Viral hep B and C
Hereditary haemochromatosis
Wilsons
Alpha 1 antitripsin deficiency

114
Q

What are the features of Haemochromotosis?

A

Disorder of iron absorption
Bronze diabetes
Cirrhosis
Severe anaemia
Arthralgia
Erectile dysfunction

115
Q

Management of Haemochromotosis?

A

Venesection
desferrioxamine (binds iron)

116
Q

What is the presentation of Wilsons disease?

A

CNS abnormalities, renal disease, tremor and dystonia due to copper build up.

117
Q

Treatment for Wilsons disease?

A

Penicillamine (chelates copper)

118
Q

How does Primary Sclerosing Choleangitis present?

A

Cholestasis (Raised bilirubin and ALP)/ Jaundice/ RUQ Pain
Association with UC

119
Q

Wernickes encephalopathy is associated with defiency in which vitamin?

A

B1= Thiamine

120
Q

How would a defiency in B12 present? and what is important about replacing it?

A

Megaloblastic anaemia, peripheral neuropathy
Important to replace B12 first if also folate deficient

121
Q

Granular mucosa suggests?

A

Inflammatory bowel disease

122
Q

What is diagnostic for coeliac disease?

A

Duodenal biopsy (need to reintroduce gluten for 6 weeks prior)

123
Q

CEA is a tumour marker for?

A

Colon cancer.

124
Q

How to manage pain in Irritable bowel syndrome?

A

1st line: Antispasmodics eg mebeverine hydrochloride
2nd line TCA Antidepressant eg: Amitriptylline

125
Q

H pylori eradication routine and pen allergy

A

Routine: PPI, Amox and Clarithromycin
Pen allergy: PPI, Metronidazole and Clarithomycin

126
Q

Hepatitis B Serology:

HBsAg
Anti-HBs
IgM anti-HBc
HbeAg

A

HBsAg - Acute disease (surface antigen) HOWEVER if around for > 6 months = chronic disease.

Anti-HBs- Immunity (either from past infection or VACCINATION)

IgM anti-HBc - acute or recent infection

HbeAg - marker of infectivity

127
Q

Gastroparesis in diabetics- presentation and management?

A

Bloating/ erratic BM control and vomiting
Autonomic neuropathy
Mx) Metoclopramide

128
Q

Von Hippel-Lindau disease predisposes to?

A

Benign and malignant tumours. Examples include renal clear cell carcinomas

129
Q

Treatment of Giardia infection?

A

Metronidazole

130
Q

Bartonella bacilliformis- transmitted via? Presentation and Antibiotic?

A

Sand fly in South America
Neurological presentation
Antibiotic - penicillin based

131
Q

Cholera- incubation time, presentation?

A

Incubation 0-5 days
Presentation- profuse watery diarrhoea
Contaminated water- facael-oral route
Travel to SE Asia

132
Q

Rickettsia rickettsii causes which disease?

A

Rocky mountain spotted fever
Spread by Ticks
Headache, fever, rash

133
Q

What test is used to diagnose infectious mononucleosis?

A

heterophil antibody test (Monospot test)

134
Q

Typhoid -

Causative organism
Presentation
Abx

A

Salmonella
Presentation- rose spots on trunk/ systemic upset/ constipation
Azithromycin

135
Q

Treatment for the following causes of Gastroenteritis
- Ecoli
- Giardiasis
- Cholera
- Staph aureus
- Campylobacter
- Bacillus cereus
- Amoebiasis

A
  • Ecoli - no treatment
  • Giardiasis- Metronidazole
  • Cholera - no treatment
  • Staph aureus- no treatment
  • Campylobacter- Clarithromycin if severe
  • Bacillus cereus - no treatment
  • Amoebiasis - Metrondiazole and antiprotozoa
136
Q

What are the 2 main causes of bloody diarrhoea?

A

Shigella
Amoebiasis

137
Q

Features of Salicylate overdose ?

A

Directly stimulates respiratory centre so get a hyperventilation. Increased RR
Tinnitus

-Mixed respiratory alkalosis and metabolic acidosis.

Remember that antidote is urinary alkalisation +/- haemodialysis

138
Q

Paralytic ileus vs small bowel obstruction examination findings?

A

Small bowel obstruction= Tinkling bowel sounds. Hx of past abdominal surgery- adhesions

Paralytic ileus- No bowel sounds/ hypoactive. Presents after abdominal surgery

139
Q

HIV associated infections:
coccidioidomycosis- causes which infection?

Cryptococcosis - causes which infection?

Cryptosporidiosis

A

Coccidioidomycosis- causes pneumonia. Treatment is with fluconazole

Cryptococcosis - Lungs and meningoencephalitis

Cryptosporidiosis- Watery diarrhoea

140
Q

What is Lupus Vulgaris?

A

Complication of TB
Nodular granulomas
Can occur where BCG vaccination is

141
Q

What is the presentation in amphentime use?

A

Anxiety, sweating, Increased HR, Palpitations, Dilated pupils, Halluncinations

142
Q

What are the two main causative organisms for food poisoning in the UK?

A

Salmonella and Camplylobacter

143
Q

What is the screening for patients with UC?

A

Colonoscopy screening every 1,3, or 5 years depending on risk. + BIOPSIES

Screening starts 10 years from onset of symptoms

144
Q

How is Shingles (Varicella Zoster) spread?

A

Direct contact with rash. If rash is covered with a dressing then minimises infectivity

145
Q

What are the features and causes of small bowel obstruction?

A

Causes- primarily adhesions, HERNIAS, malignancy
Tinkling bowel sounds
Valvular committees- lines go all the way across

146
Q

What are the encapsulated bacteria and why are these important clinically?

A

Spleen protects against encapsulated bacteria. Splenectomy therefore vulnerable to encapsulated bacteria.

“Some Nasty Killers Have Some Capsule Protection”

Streptococcus pneumonia
Neisseria meningitis
Klesbsiella
Haemophilus influenza
Salmonella
Cryptococccus
Psudemonas aurginosa

147
Q

How are suspected haemorrhoids DIAGNOSED?

A

Proctoscope/ Anoscope

148
Q

What is the diagnostic test for UC?

A

Colonoscopy with biopsies

149
Q

What is the management of hepatic mets?

A

Chemotherapy is mainstay
Hepatic arterial embolisation
Hepatic injections of chemotherapy

150
Q

Management of HCC ?

A

Surgical resection
Liver transplant!/ percutaneous radiofrequency ablation
Management is mainly palliative

151
Q

First line for PBC

A

First line = Urso
Can also consider liver transplant if Bilirubin >100

152
Q

Management of autoimmune hepatitis?

A

Steroids
Immunosupprents (Aziothopine and Ciclosporin)
Liver transplant
Interferon is contraindicated!

153
Q

Ecoli is what type of organism?

A

Gram neg ROD
“Enterobacter”

154
Q

How does oesophageal spasm present and how is it diagnosed?

A

Can present with anginal symptoms- retrosternal chest pain.
Diagnosis is with Barium swallow ( corkscrew)

155
Q

Portal hypertension- what are the pre/ intrahepatic and post hepatic causes?

A

Pre Hepatic: Portal vein thrombosis/ Fistula

Intrahepatic: Any causes eg hepatitis

Post hepatic: heart stuff eg constrictive pericarditis.

156
Q

What is the equation to calculate serum osmolarity?

A

2Na+ Urea + Glucose

157
Q

How does Gilberts present?

A

Raised bilirubin
Otherwise fit and healthy
NO haemolytic anaemia

158
Q

Primary Bilary Choleangitis is associated with?

A

Sjogren’s syndrome (seen in up to 80% of patients)
rheumatoid arthritis
systemic sclerosis
thyroid disease

159
Q

Investigation for Typhoid fever?

A

Blood culture

160
Q

What are some examples of X linked recessive?

A

Becker muscular dystrophy
Duchenne muscular dystrophy
Haemophillia
G6DH defiency
Colour blindness

161
Q

Psudeomembraneous colitis is a complication of what?

A

C diff infection

162
Q

Chronic pancreatitis- who are at risk and what is the presentation ?

A

At risk: Alcoholics and Cystic Fibrosis/ Haemochromotosis

Presentation- pain after eating / steatrhorrea and development of DM

163
Q

Spigelian hernia - what population mainly seen in?

A

Elderly patients

164
Q

Anti Gliadin antibody is a/w with what?

A

Coeliac (although testing is not reccomended by NICE)

165
Q

What are the features of Sarcoidosis?

A

Lupus pernio
Bilateral hilar lymphadenopathy
Restrictive lung disease
Symmetrical lymphadenopathy

Tx- steroids

166
Q

What is the tumour marker for colorectal cancer?

A

CEA

167
Q

AFP is a tumour marker for which 2 cancers?

A

Hepatocellular cancer
Non seminoma testicular cancer

168
Q

Budd Chiari syndrome?

A

Obstruction of hepatic vein
Ascites and jaundice
Caudate lobe is seen on imaging!

169
Q

H pylori is associated with?

A

Peptic ulcers
Duodenal ulcers
Gastric ca.
MALT lymphoma
IDA due to impaired absorption

170
Q

What cereals need to be avoided in a gluten free diet?

A

wheat, barley, and rye all contain gluten

171
Q

What is the cancer screening for bowel cancer?

A

Aged 60-74
FIT test every 2 years

172
Q

Vitamin defiencies cause what?

Vit A
B1
B3
B6
B12
C
D
K

A

Vit A - Night time blindness

B1 (Thaimine) Alcohol - Wernickes/ korsakoffs. Berberi (peripheral neuropathy/ cardiomyopathy)

B3 - Pellagra niacin (dermatitis/dementia/ diarrhoea)

B6 Pyroxidine- Anaemia, irritability and seizures. Sideroblastic anaemia

B12 Cyanocobalamin- megaloblastic anaemia

C - poor wound healing/ scurvy/ bleeding gums
D- Rickets/osteomalacia

K- haemorraghic disease of the newborn

173
Q

Causes of hypokalaemia

A

D+V
Conns
Cushings

174
Q

Hypocalcemia does what to reflexes?

A

Hyperreflexia- trousssers/ chovostack

175
Q

Management of Goodpastures

A

Plasmophoresis
Steroids

176
Q

Features of Peutz-Jeghers syndrome? and inheritance?

A

Autosomal dominant
Polyps in GI tract
Pigmentation around lips

177
Q

Dyspepsia - what are the ALARM symptoms?
In the absence of alarm symptoms what is the management?

A

Dysphagia, upper abdominal mass, Patients aged >= 55 years who’ve got weight loss, AND any of the following: upper abdominal pain, reflux
and dyspepsia.

In the absence of alarm symptoms then treat as ‘undiagnosed dyspepsia’
- lifestyle advice
- 1 month of full PPI
- H pylori testing

178
Q

Facts about tetanus vaccination?

A

Full course is 5 doses as part of childhood imm schedule
This lasts for 10 years.
If tetanus prone wound within this time no need for repeat

179
Q

How to remember autosomal dominant vs autosomal recessive?

A

Autosomal dominant= structural problems EG polycystic kidneys, FAP, Peutz-Jagher, Tuberous sclerosis

Autosomal recessive- enzyme/metabolic. EG: Cystic fibrosis/ Haemachromotosis/ Gilberts/ Sickle cell

180
Q

How to replace if both B12 and folate deficient?

A

Replace B12 FIRST, then folate to avoid subacute degeneration of the cord.

181
Q

Hartnup diease - what is it?

A

Rare inherited metabolic disorder
Presents similar to pellagra (niacin deficiency)
Neurological and dermatological manifestations
Need to have a high protein diet

182
Q

Amoebiasis - causes gastroenteritis but what are some of the other complications?

A

LIVER ABCESS
Important complication in rectal sex
Treat liver abscess with metronidazole!!

183
Q

Risk factors for developing HCC

A

Hep B
Hep C
Liver cirrrhosis
Primary bilary cirrhosis
Alcohol
Haemochromotosis

184
Q

Treatment for Lyme Disease

A

Doxycycline is first line

185
Q

How many units in
- 1 glass of 175ml wine
- Pint of beer
- I shot of spirit

A

175mls of wine = 2 units
Pint of beer = 2-3 units
Single shot= 1 unit

186
Q

Brucellosis infection- associated with?

A

Farm animals! eating/ drinking unpasteurised products.

187
Q

Morphine conversions PO to
- SC Morphine
- SC Diamorphine
- Transdermal fentanyl patch
- Tramadol PO

A

PO morphine to
SC morphine divide by 2
SC Diamorphine divide by 3
Fentanyl patch divide by 3

Tramadol x10. PO Morphine is 10 x as strong as PO Tramadol

188
Q

What is the diagnostic criteria for irritable bowel syndrome?

A

Rome criteria

189
Q

What are the characteristic features of MEN 2

A

Men 2 is a/w medullary thyroid ca AND phaeochromocytoma

190
Q

Management of gallstones

A

If causing obstructive jaundice: ERCP and spincherotomy

If acute cholecystitis- can have laparoscopic cholecystectomy within a week

If asymptomatic or just living in gall bladder then no treatment required. BUT refer if the gallstones are in CBD

191
Q

Abx for acute diverticulitis?

A

Co-amoxiclav

192
Q

Upper GI Bleeding- what are the 2 scores and how are they used?

A

Glasgow-blatchford score for assessing severity
Rockall- AFTER endoscopy to calculate risk of rebleeding and mortality.

193
Q

What are the causes of large bowel obstruction?

A

Carcinomas
Diverticular disease
Volvulus

194
Q

What are the causes of small bowel obstruction?

A

Hernia
Adhesions

195
Q
A

msra- my cards (15 decks)

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