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1
Q

pericarditis can be caused by

A

uraemia

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2
Q

key conounders of creatinine

A

muscle maass and diet

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3
Q

overflow proteinuria

A

myeloma

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4
Q

most common proteinuria

A

glomeruli

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5
Q

what does microalbumuria mean

A

excretion of albumin in abnormal quantities but still below the limit of protein detection by dipstick

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6
Q

what is used to assess tubular function

A

urine osmolality

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7
Q

if urine osmolality is exactly the same as serum osmolality this indicates

A

tubules are not function

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8
Q

especially at risk of what if on dialysis

A

osteopaenia

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9
Q

are water and food restricted on dialysis

A

yes

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10
Q

dialysis happens via

A

diffusion

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11
Q

what is downside with fistula for dialysis

A

needs 6-12 weeks before can be used

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12
Q

haemodialysis involves

A

diffusion, conventionna and adsorption

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13
Q

adsorption affects what

A

plasma proteins

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14
Q

haemofiltration mainly removes solutes via

A

convection

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15
Q

key difference of haemofiltration as opposed to haemodialysis

A

haemofiltration- there is replacements of the ultra convective ultrafiltrare through the dialysis period

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16
Q

in peritoneal dialysis solute removal is via .. and water removal is via…

A

diffusion, osmosis

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17
Q

what dialysis is driven by high glucose concentration of the dialyse fluid

A

peritoneal dialysis

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18
Q

complication sof HD/HDF

A

hypotension, haemorrhage

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19
Q

tunneled catehter venous catheter infection is most likely due to … can lead to endocarditis

A

staph aureus

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20
Q

antibiotics for TCVC infection

A

vancomycin and gentamicin

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21
Q

complications of peritoneal dialysis

A

peritonitis, fluid overload, uraemia, hernias

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22
Q

when to start dialysis

A

resistant hyperkalaemia, egfr <7, urea >40, unresponsive metabolic acidosis

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23
Q

complaint of too rapid a correction of toxins in dialysis

A

disequilibrium syndrome- cerebral oedema and possible confusion and death

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24
Q

patient needs to have a life expectancy of what to get kidney transplant

A

> 5years

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25
Q

what events can make you have antibodies that make you less likely to respond to kidney transplant

A

blood, transfusion, pregnancy or previous transplant

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26
Q

drug that can help with desesnsitation

A

rituximab

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27
Q

when kidney is transplanted it is attached to what

A

external iliac artery and vein

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28
Q

what rejection can be treated with immunosuppression

A

acute

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29
Q

what is an important morbidity in immunosuppressed patients in first 3 months of transplant

A

CMV

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30
Q

common malignancies after kidney transplant

A

non melanoma and lymphoma

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31
Q

referred to urology if got asymptotic non visible ahematuria and over

A

40

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32
Q

what is best to see on CT with no contrast

A

calculi

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33
Q

CT contrast induced nephropathy is when

A

impaired renal function occurs within 3 days follwoign contrast and get rise in serum creatine and urea

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34
Q

how to avoid CT contrast induced nephorpathy

A

oral hydration before and after scan

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35
Q

MR renal angiogram is only used to

A

see vessels only eg renal artery stenosis

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36
Q

MR is used for

A

renal cystic disease

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37
Q

CT urogram main indication isi

A

macroscopic ahematuria to look for filling defects suspicious of transitional cell carinoma

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38
Q

MR urogram is a

A

poor test not very good

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39
Q

ultrasound of the bladder requires what

A

full bladder to assess outline

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40
Q

Ct gold standard in bladder for

A

nodal and metastatic disease staging

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41
Q

MRi is gold standard for

A

local tumour staging

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42
Q

what scan to image urethra in males

A

urethrogram

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43
Q

scan to image urethra in females

A

MRI

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44
Q

uterus, ovaries and prostate imaging

A

biopsies

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45
Q

hysterolsapingofram assesses

A

tubal patency

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46
Q

what is used for prostate cancer

A

MRI

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47
Q

what tones can be used for those with tinnitus

A

warble

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48
Q

normal hearing is between

A

-10 to 20

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49
Q

damage to what occurs naturally as part of the ageing process

A

cochlear

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50
Q

rubella causes what kind of hearing loss

A

sensorineural

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51
Q

in conductive hiring loss what is within normal limits

A

boen conduction

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52
Q

charts notch at 2000

A

otoscerlsosi

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53
Q

tympanoemtry measures function of what part of the ear

A

middle

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54
Q

to get orlistat need to lose what % of weight in first 3 moths

A

greater than 5%

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55
Q

BMi for bariatic suregry

A

> 30 or greater than 28 with co- morbidities

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56
Q

what deficit is recommended for diabetes

A

600kcal

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57
Q

glycemic index is

A

rate at which food makes blood glucose rise

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58
Q

hypoglycaemia from exercise can occur how long after

A

12-24

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59
Q

alcohol increases activity of what

A

insulin

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60
Q

battery

A

acting without consent

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61
Q

blood glucose should be tested at least how many times a day

A

5

62
Q

diabetic who is unwell and stops eating they should still take

A

insulin

63
Q

illness and infection raise

A

blood glucose levels

64
Q

what is ultimately used to inform guidelines

A

critical appraisal

65
Q

main issue with cohort study

A

confounders

66
Q

case control

A

subjects with disease or condition are indentified

67
Q

difference between cohort and case control

A

cohort - people with disease
case controlled - select disease and non disease

68
Q

nonsense

A

generation of stop codon

69
Q

test for single gene

A

genration sequencing

70
Q

next generation sequencing uses for

A

disease with genetic heterogeneity

71
Q

pituitary gland is well seen on

A

MRi

72
Q

what sinus is anterior to pituitary

A

sphenoid

73
Q

what arteries are lateral to pituitary

A

carotid

74
Q

thyroid is in what relation to the trachea and oesophagus

A

it is anterior

75
Q

thyroid scintigraphy of throidits

A

very dark grey

76
Q

right adrenal lies posterior to what

A

IVC

77
Q

deontology

A

patients right to refuse treatment

78
Q

criteria used to clear c spine in minor trauma

A

nexus
CT in major trauma

79
Q

bone scan is a map of what activity

A

osteoblastic

80
Q

scan to see ligaments

A

ONLY MRI

81
Q

damaged ligaments wil be what colour

A

light

82
Q

best test for sciatica

A

MRI

83
Q

soft tissue swelling is seen in

A

RA

84
Q

what is the hallmark fo RA

A

marginal erosions

85
Q

pannus in ra is

A

inflamed thickened synovium

86
Q

seronegative arthritis characterised by

A

synovitis and enthesitis

87
Q

Reiters tends to affect what kind of joints

A

large lower limb

88
Q

early sign of inflammatory joint disease

A

periarticular bone marrow oedema

89
Q

what fractures tend to occur with a shearing force

A

oblique

90
Q

communication fracture has

A

3 or more fragments

91
Q

segmental injury is when

A

bone is fractured in 2 separate places

92
Q

bone that is a common mimic of avulsion fracture

A

sesamoid bone

93
Q

intra articular fractures have a greater risk of what

A

stiffness, pain and OA

94
Q

bone appears sclerotic in

A

impaction

95
Q

spinal canal is also a

A

bony ring

96
Q

what are often invisible on radiograph that are foreign bodies

A

plastic and wood

97
Q

tomogram is used in what kind of fractures

A

mandibular

98
Q

US good for seeing

A

tendons

99
Q

what are good for detecting stress fractures

A

Technetium bone scans

100
Q

what becomes visible if an elbow effusion is present

A

posterior fat pad sign

101
Q

fracture mimic

A

sesamoid bones:
5th metatarsal in adolescents
posterior calcaennous in kids
fabella- femur
ostrigonum - talus

102
Q

toxic shock organism

A

staph aureus

103
Q

commonest cause of toxic shock

A

TSST-1

104
Q

fever, hypotension and diffuse macular rash

A

toxic shock

105
Q

what binding is seen in osteomyelitis

A

collagen

106
Q

PVL has a specific toxicity for

A

leukocytes

107
Q

PVL associated with

A

necrotising fasciitis

108
Q

what comprises the most of strep A

A

progenes

109
Q

pharyngitis associated with

A

s. pyrogens

110
Q

necrotising fasciitis (2) moat common is caused by

A

pyrogens and aureus

111
Q

nec. fasciitis type 1 is caused by

A

clostridia

112
Q

layers of scalp

A

Skin
Conenctive tissue
Aponeurosis
Loose connective tissue
Periosteum

113
Q

lignocaine

A

is an an anaesthetic

114
Q

curettage and cautery involves

A

scraping of abnormal tissue

115
Q

what holes from punch biopsy do not always heal well

A

round

116
Q

heuristics

A

quick judgement based on previous experiences

117
Q

uva or B penetrates the skin more

A

A

118
Q

which phototherapy if first line

A

UVB

119
Q

what is first line for pustular psoriasis or erythrdermsi psoriasis

A

UVA

120
Q

UVB COMMON SIDE EFFEECT

A

erythema

121
Q

PUVA is

A

Psoralen and UV A

122
Q

treatment for granuloma annaualre

A

UVA1

123
Q

birth by c-section can reduce what

A

transmission of HIV

124
Q

should women in the Uk with HIV breastfeed

A

it is recommended to avoid

125
Q

does breast size affects the amount of milk produced

A

no

126
Q

what inhibits prolactin, inhibiting milk production

A

progesterone

127
Q

oxytocin levels are greater when

A

mother and baby are in contact

128
Q

what is the first form of milk produced immediately following delivery of the newborn

A

colostrum

129
Q

colostrum paraticlary has

A

lactoferrin

130
Q

painful swelling of the breasts

A

engorgeemtn

131
Q

what is positive sign in terms of nappies within first 24hrs

A

6+ wet and 3+dirty

132
Q

all pregnancy and breastfeeding mothers should take what supplement

A

vit d

133
Q

do breast fed or formula fed babies need to take vitamin D up to 1 year of age

A

breastfed

134
Q

do breast fed or formula fed babies need to take vitamin D up to 1 year of age

A

breastfed

135
Q

is dried powder formula sterile

A

no

136
Q

parental feeding

A

into bloodstream

137
Q

exclusive breastfeeding recommended for

A

first 6 months

138
Q

when can solid foods start

A

6 months

139
Q

consequcen of late wearing

A

deficiency of iron and zinc

140
Q

greater than what percentile is overweight

A

91st

141
Q

greater than what percentile ic clinically obesity

A

98

142
Q

what gender affected by x linked recessive

A

female

143
Q

who are more severely affected by x linked dominant

A

males

144
Q

is the test fro sex determination and trisomy testing invasive

A

no

145
Q

you can terminate pregnancy before

A

13 weeks

146
Q

first line for acutely unwell child with likely momongenetic disorder

A

tri exome sequencing

147
Q

ngs to look for

A

small mutations

148
Q

parental responsibility cut off sat

A

4 may 2006

149
Q

difference between passive and active immunity

A

active- produced by individual own immune system
passive - passed from mother to baby

150
Q

MMR, rotavirus are what vaccines

A

live

151
Q

pertisos and typhoid are what vaccines

A

inactivated

152
Q

can’t give yellow fever or flu vaccine if got allergy to what

A

egg

notion 2 (9 decks)

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