p year 2 Flashcards
cardioversion vs defibrillaiton
c- synchronised/ awake
d-unsynchronised/emergency
2) Epistaxis anterior and posterior packing failed, what artery would you ligate?
Sphenopalatine
what type of drugs are tamsulonsin and finasteride?
tamsulosin- alpha blocker
finasteride- 5 alpha reductase
finasteride
5-alpha-reductase.
normal pressure hyrocehphalus symptoms + treatment?
dementia
incontinence
gait abnormality
vp shunt
spastic paraplegia, Spastic diplegia, hemiplegia difference
p- legs
d- all four limbs but mostly legs
h- one side of body
- Pathophysiology of high haemoglobin in pre-eclampsia
In pre-eclampsia, high levels of haemoglobin can be a result of hemoconcentration due to decreased plasma volume, as well as increased erythropoietin production in response to impaired placental blood flow.
parkisons dementia vs lewys bodies
parkisons- motor first
lewys pscych first
pcos higher risk of which cancer
endometrial
what is an imca
An Independent Mental Capacity Advocate (IMCA) is an advocate appointed to act on your behalf if you lack capacity to make certain decisions.
how to treat otitis externa fungal?
Antifungal ear drops, such as fluconazole and clotrimazole
otitis externa treatment
Mild otitis externa may be treated with acetic acid 2% (available over the counter as EarCalm). Acetic acid has an antifungal and antibacterial effect. This can also be used prophylactically before and after swimming in patients that are prone to otitis externa.
Moderate otitis externa is usually treated with a topical antibiotic and steroid, for example:
Neomycin, dexamethasone and acetic acid (e.g., Otomize spray)
Neomycin and betamethasone
Gentamicin and hydrocortisone
Ciprofloxacin and dexamethasone
serve may need oral
- Aural toilet + topica antifungal clotrimazole.
2) Pregnant woman took spiramycin during pregnancy, baby came out with problems, what infection?
Toxoplasmosis
signs of opiod withdrawal?
Features of opioid misuse
rhinorrhoea
needle track marks
pinpoint pupils
drowsiness
watering eyes
yawning
- Dilated pupils + lack of sleep + abdo pain, tachy or brady. Know presentation properly, wasnt typical runny nose etc. (everything runs)
treatment resistant psoriasis
Rarely, where topical treatments fail with severe and difficult to control psoriasis, children may be started on unlicensed systemic treatment under the guidance of an experienced specialist. This might include methotrexate, cyclosporine, retinoids or biologic medications.
There are two products that contain both a potent steroid and vitamin D analogue that are commonly prescribed and worth being aware of. These not licensed in children and will be guided by a specialist.
Dovobet
Enstilar
- Anorexic – which of the following is diagnostic hypokalemaia, low cortisol, high tsh, anaemia
hypokalemia
- Staging of endometrial cancer
MRI pelvis
burpropian what is it can u give in epilepsy?
antidpressent and no
restrictive lung disease pattern
Reduced FEV1 (<80% of the predicted normal) Reduced FVC (<80% of the predicted normal) FEV1/FVC ratio normal (>0.7)
low tclo
- Chinese and cervical lymph node on left and some ear something
nasopharyngeal carcinoma
- Bacteria in osteomyelitis
Staphylococcus aureus causes most cases of osteomyelitis.
- Treatment of eczema – oral treatment – gave side effect of high creatinine and high urea and hair on face (under chin) in woman what oral medication caused this
corticostroids
- Rubella treatment in pregnancy – recently exposed to rubella 2 days ago and not vaccinated give IV tingz
f Human Normal Immunoglobulin (HNIG).
- Stage 3 labour or something and person has high blood pressure – oxytocin, ergometrine, syntometrine (oxytocin+ergometrine)
oxytocin
toe extension nerve root
l5
- Kid has squint – eye looking in
hypermetropia
- Patient been on sertraline for 18 months, not getting on with it - what would you give next
another SSRI (citalopram or fluoxetine), if still doesn’t work – mirtazapine or venflaxine (SNRI
paeds bls
- paeds
- If not breathing normally, 5 rescue breaths
- If no signs of life, 15 chest compressions followed by 2 rescue breaths
Epistaxis management after pressure attempted, what next
ligate sphenopalatine
Psoriasis question, gentleman doesn’t want to take anything oral,
Narrow light UV-B
Which sign indicates varicose ulcer -
surrounding lipodermatosclerosis
- Which test do you need to do to diagnose menopause in a 51 year old who was 14 months amennorhoea with hot flushes?
none
- Diabetic proliferative retinopathy - how to prevent eyesight damage in later life?
Laser treatment(aka panphotocoagulation because once u got u got it u cant get vision back once u lost it),
- Timing of oxytocin for 3rd stage
with anterior shoulder
- Varicella exposure in pregnancy - patient not immune = give IVIG
VZIG
- Infective endocarditis presentation
(fever with new murmur)
- Renal artery stenosis imaging?
ANGIOGRAPHY
SECTION 4 (72hrs)
You need to be detained under section 4 if:
you have a mental disorder
it is urgently necessary for you to be admitted to hospital and detained, and
waiting for a second doctor to confirm that you need to be admitted to hospital on a section 2 would cause “undesirable delay”.
You can be sectioned by one doctor only (together with the approved mental health professional) and you can be taken to hospital in an emergency and assessed there.
PNEUMONIA sounds
INCREASED VOCAL FREMITUS
- Cardiac tamponade presentation TRIAD
– distended jvp, low bp, muffled heart sounds)
- Commonest cause preterm
Idiopathic / Infection
NEC biggest RF
PRETERM
- Most common cause of PID
Chlamydia (more) or gonorrhoea
- Swollen fingers + eosophageal
systemic slerosis
how to image acl tear
mri
CT show calcification in alcoholic patient
Chronic pancreatitis
- Acne treatment causing blue patch -
minocycline
- Hip problem in 7 year old, trendelenburg +ve →
perthes
- Baby with asymmetrical gluteal creases, what investigation do you do
USS Hip (if under 3 months)- sign of congenital dysplasia of hip
- Hep B Immune marker to indicate Hepatitis division/multiplying -
HbEAg - E = Infectivity
pcos treatment after weight loss
Clomifene
You are reviewing an elderly man in outpatient clinic who has been referred with a history of rigidity and falls. He reports difficulty in climbing the stairs at home. On examination he is bradykinesic and has axial rigidity. During examination of his cranial nerves you notice he is unable to look upwards.
Which of the following the most likely diagnosis?
Progressive supranuclear palsy
A 53 year old man has had migraine attacks with severe pain two to three times a week for the last few months, lasting most of the day. Ibuprofen and trying to avoid triggers haven’t helped.
What would be the most appropriate treatment?
Select one:
Sumatriptan
Naproxen
Carbamazepine
Codeine phosphate
Topiramate
Topiramate
As he is having frequent and severe episodes, a prophylactic agent should be considered. Both Topiramate and Propanolol are recommended as standard first line prophylactic agents for patients having more than 3 days a month with disabling headaches.
A 57 year old man has suffered a traumatic brain injury.
Which of the following acute endocrine dysfunctions commonly develops in this context?
Select one:
Cerebral salt wasting
Hypothyroidism
Addison’s disease
Anterior hypopituitarism
Correct!
Syndrome of inappropriate ADH
syndrome of inappropriate ADH
A 40 year old man develops numbness in the right leg and over four days it spreads to affect both arms and the left leg. He has brisk reflexes and bilateral extensor planter responses.
What is the most likely diagnosis?
Select one:
Guillain-Barre syndrome
Vitamin B12 deficiency
Acute attack of multiple sclerosis
Brain tumour
Cervical cord compression
cervival cord compression
40 year old man suffered a neck injury in a motorcycle accident resulting in a traumatic C7 incomplete spinal cord injury and subsequently developed a spastic tetraparesis with severe spasticity in his trunk and legs
Which of the following is the first line treatment of choice for his spasticity?
Select one:
Oral Dantrolene
Intrathecal Balclofen
Oral Baclofen
Phenol nerve blockade
Botulinum toxin
oral balclofen
A 64 year old woman has developed a rest tremor of the left hand hand with some rigidity on that side.
Which of her following drugs is the most likely to be responsible?
Select one:
Salbutamol
Metaclopramide
Lisinopril
Omeprazole
Theophylline
metaclopramide
A 55YO woman presents with vomiting, abdominal pain, distension and change in bowel motions on a background of unintended weight loss over the last 6 months. Initial management does not resolve her symptoms. Which of the following surgeries is best indicated?
Diagnostic laparoscopy
Subtotal colectomy
Resection of rectosigmoid colon with formation of end colostomy
Defunctioning ileostomy
Rigid colnoscopy
Resection of rectosigmoid colon with formation of end colostomy
A 60YO has recently been diagnosed with bladder cancer. Which of the following is not a risk factor?
2-naphthylamine, 4-aminobiphenyl and benzidine exposure
Smoking
Recurrent UTI
Schistosomiasis
Female
female
falsley raised psa
smoking
A 23YO female accidentally poured boiling water over her arm when she tripped. She has developed burns over her left forearm. o/e the area is red with blisters, there is pain and associated swelling. How severe would you categorise the burns?
superfical partial thickness
quinsy treatment
aspirate first
expected urinary output
0.5mL/kg per hour
breast screening
Every 3 years between 50 and 70
