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UKMLA Incorrecy > Paper 1 > Flashcards

Paper 1 Flashcards

1
Q

Left sided murmurs are louder on what?

A

Left sided louder on expiration, right sided louder on inspiration

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2
Q

IVDU IE cause?

A

Staph aureus

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3
Q

OSA Gold standard Mx

A

CPAP

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4
Q

Peripheral neuropathy in T2DM with nephropathy. Analgesic choice?

A

Amitriptyline (Duloxetine CI in eGFR<30)

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5
Q

What can you do to reduce risk of candidiasis with ICS?

A

Use large-volume space

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6
Q

Ix for acute angle-closure glaucoma

A

Intraocular pressure (increased)

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7
Q

Bleeding gums & Petechiae. Micronutrient deficiency?

A

Vitamin C

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8
Q

What feature of C. diff makes it so hard to destroy?

A

Spore formation

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9
Q

Acute eye pain, loss of vision + RAPD, Dx?

A

Optic neuritis

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10
Q

Bariatric surgery referral guidelines?

A

BMI>35 with comorbidities or BMI>40

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11
Q

Serum osmolality is:

A

2 x(Na) + Urea + glucose

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12
Q

neuropathic bladder due to multiple sclerosis, mx?

A

Intermittent self catheterisation

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13
Q

most appropriate radiological test for suspected acute cholecystitis?

A

Abdo USS

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14
Q

What common drug should be stopped before doing a contrast scan (esp in renal impairment)?

A

Metformin

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15
Q

PKD Ix of choice?

A

Renal USS

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16
Q

Renal malignancy Ix?

A

CT KUB

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17
Q

Painful red eye without discharge. Diffuse area of redness in medial sclera. No change in vision. Dx and Mx?

A

Scleritis & same day ophthal assessment

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18
Q

Tongue deviates to the right when he is asked to protrude it. Which nerve damaged?

A

Right hypoglossal nerve

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19
Q

Most appropriate topical treatment for Bowen’s disease?

A

Efudix (5-fluorouracil cream)

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20
Q

Aortic Coarctation, S&Sx?

A

Elevated blood pressure,
radiofemoral delay, and chest X-ray findings of notching of the ribs in the midclavicular line.

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21
Q

Which class of antihypertensives can cause ankle swelling?

A

CCBs eg amlodipine

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22
Q

Central retinal artery occlusion. S&Sx?

A

Sudden loss of vision
RAFD
Red spot in macula (cherry red spot)

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23
Q

Ix for biliary colic?

A

USS Abdo

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24
Q

Mx for aortis stenois with LV EF <55% ?

A

Aortic valve replacement

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25
USS scan every 12 months. Abdominal Aorta size?
3-4.4 cm
26
USS scan every 3 months. Abdominal Aorta size?
4.5-5.4cm
27
When should an AAA be referred to surgery?
>= 5.5cm
28
Trigeminal neuralgia. Mx?
Carbamazepine
29
Paracetamol OD. WHich Ix to determine restoration of liver synthetic function?
PT (albumin not good for acute liver injury)
30
INR 4.6 & intracranial haemorrhage? Mx?
IV Vit K + Prothrombin complex concentrate
31
L5 affected, which S&Sx?
Loss of pinprick sensation over big toe Foot drop
32
B1 deficiency?
Thiamine Wernicke's, Korsakoffs Beriberi
33
B2 deficiency?
Riboflavin Angular stomatitis
34
B3 deficiency
Niacin Glossitis & pellagra
35
Vitamin A deficiency?
Keratomalacia Night blindness Dry skin
36
Androgen Insensitivity Syndrome
cells are unable to respond to androgen hormones due to a lack of androgen receptors X-linked recessive Genetically male with female secondary sexual characteristics & infertile Infant with inguinal hernias or at puberty with primary amenorrhoea Hormone tests: raised LH, normal/raised FSH, normal/raised test, raised oestrogen Mx: bilateral orchidectomy, oestrogen therapy
37
Congenital Adrenal Hyperplasia
congenital deficiency of the 21-hydroxylase enzyme -> underproduction of cortisol & aldosterone and overproduction of androgens Autosomal recessive Females at birth with virilised genitalia Skin hyperpigmentation, amenorrhoea, facial hair Cortisol & aldosterone replacement with hydro & fludrocortisone
38
Mesenteric adenitis?
Swollen abdo LN in children following illness S&Sx similar to appendicitis
39
Drug mx for PPH?
1. Oxytocin, slow IV 2. Ergometrine (CI in HTN) 3. Oxytocin infusion 4. Carboprost 5. Misoprostol
40
Methods of IOL?
Vaginal prostaglandins - ripen cervix Amniotomy - if cervix ripe, to break membranes Membrane sweep - indicated at 40-41 weeks
41
Multiple tender ulcers on the preputial skin of penis following recent sexual intercourse. Dx?
HSV
42
Symptoms of malaise and pain in the arms and legs, morning stiffness lasting for 3 hours each day, difficulty washing and dressing, inability to lift her arms above her head, and elevated CRP. Dx?
PMR
43
solitary, painless, firm, mobile breast mass Histology: duct-like structures lined by regular, low columnar cells separated by loose fibrous tissue, with well-defined margins. Dx?
Fibroadenoma
44
Marker for tumour lysis syndrome?
Urate levels
45
First line Mx for Hodgkin's Lymphoma?
Chemotherapy
46
Retinal Detachment, S&S?
4F's: floaters, flashers, field loss, falling acuity Dense shadow that starts peripherally progressing centrally (like a veil/curtain closing). Straight line appear curved. Painless
47
Commonest cause of upper GI obstruction in children with Down syndrome?
Duodenal atresia -> complete obstruction or narrowing of duodenal lumen. Characteristic green vomit
48
Laryngeal cancer 2ww referral?
If >=45 with persistent unexplained hoarseness of neck lump
49
POI characteristics?
Menopausal symptoms & high FSH & LH due to loss of negative feedback from ovarian steroids and decreased ovarian reserve and diminished ovarian function. Dx: Elevated FSH>30 on 2 blood samples 4 - 6 weeks apart.
50
What causes amaurosis fugax?
(transient painless visual loss in one eye for 20-30mins) is often due to emboli from atherosclerotic plaques in the internal carotid artery (ipsilateral side)
51
What is a safe anti-emetic to use in PD?
Domperidone is a safe anti-emetic in PD. Avoid metoclopramide and haloperidol
52
Herpetic keratitis. S&Sx and Mx?
S&Sx: red, painful eye and dendritic corneal lesions on slit lamp examination has a classic presentation of herpetic keratitis Mx: Topical aciclovir eye drops
53
Vitreous Haemorrhage. S&S and Mx?
Sudden painless loss of vision in poorly controlled diabetic. Red haziness. Mx: Vitrectomy
54
Acronmyn to remember homonymous hemianopias?
PITS -> Parietal -inferior Temporal = superior
55
Alternating fever, headache, myalgia, hepatomegaly foreign travel. Likely Dx?
Malaria
56
What common electrolyte abnormality do PPIs cause?
Hyponatraemia
57
What vaccination is recommended in MSM?
Hepatitis A
58
Anterior uveitis Mx?
Steroid & cycloplegic (mydriatic - atropine or cyclopentolate) drops -> reduce inflammation and dilate pupil to help with pain relief
59
Diarrhoea - Acid base disturbance?
Metabolic acidosis with normal anion gap -> GI loss of bicarb causes a reciprocal increase in serum chloride
60
Vomiting - acid base disturbance?
Metabolic alkalosis -> gastric secretions lost
61
Septic shock - acid base disturbance?
Metabolic acidosis with raised anion gap -> rise in lactic acid
62
What mx is used to prevent vasospasm following an SAH?
Nimodipine 21d (dihydropyridine CCB)
63
How do you treat animal or human bites?
Co-amoxiclav Pen allergic -> doxy with metro
64
Which medication can worsen plaque psoriasis?
discontinuing steroids, initiating NSAIDs, lithium, antimalarials and BBs
65
Where and what are the functions of Broca's and Wernicke's areas?
Wernicke's - Temporal - comprehension Then passes through arcuate fasciculus to Broca's area Broca's - frontal lobe (near mouth) to create fluent speech
66
Initial emergecy Mx for acute angle-closure glaucoma?
Combination eye drops: Direct parasympatheomimetic eyedrops (pilocarpine) - poupillary constriction to allow humour to drain BBs eyedrops (timolol) => reduce aqueous humour production
67
Use of 0.9% NaCl for fluid therapy in pts requiring large volumes can lead to what?
Hyperchloraemic metabolic acidosis
68
What drugs can worsen myasthenia gravis?
BBs Lithium Phenytoin Abx - gentamicin, macrolides, quinolones, tetracyclines
69
When to consider LTOT in COPD pts?
pO2 of 7.3-8 AND one of the following: - secondary polycythaemia - peripheral oedema - pulmonary HTN
70
Mx for rosacea?
Predominant erythema: topical brimonidine cream Mild-moderate papules: topical ivermectin Severre: topical ivermectin + oral doxy
71
Life-threatening C. diff infection. Abx choice?
IV metronidazole and oral vancomycin
72
Mx for hiccups in palliative care?
Haloperidol or chlorpromazine
73
When is the peak of seizures and delirium tremens post-alcohol withdrawal?
Seizures - 36hrs DT = 72hrs
74
Bronchiolitis
<1yo, RSV, dry cough, conservative mx
75
CML Mx?
Imatinib (tyrosine kinase inhibitor)
76
Intracranial cause for N&V. Mx?
Cyclizine
77
Cyanotic congenital heart disease. Mx before surgery?
Alprostadil (Prostaglandin E1 - to keep patent ductus arteriosus)
78
Chest crisis, mx?
Exchange transfusion
79
PMR Bloods?
High ESR &CRP, normal CK. Respond well to steroids
80
L3 motor?
Decreased power in Hip flexion, knee extension and hip adduction
81
L4 motor?
Decreased power in knee extension and hip adduction
82
Gonorrhoea Mx?
IM Ceftriaxone
83
What should you offer to pts in with chronic liver disease with history of ascites & SBP?
Prophylactic Ciprofloxacin oral
84
What would you replace co-careldopa with in a PD pt on admission who is NBM?
Dopamine agonist patch (rotigotine)
85
What do you use as secondary prevention following a stroke?
Clopi
86
What type of stroke causes painful third nerve palsy?
PCA stroke - eye classically has down and out appearance
87
Which lobe is affected with a focal aware seizure?
Frontal lobe
88
Mx for acute limb ischaemia?
IV heparin, analgesia and vascular review
89
Which abx combined with a statin can cause rhabdo?
Ery/Clarithromycin
90
Mx for F UTI with haematuria?
MSU (atypical organisms) & oral nitro 3d
91
Most common cause of viral meningitis in adults?
Enteroviruses - Coxsackie B virus
92
Which pneumonia-causing organism in COPD?
H. influenza (-ve cocco-bacilli)
93
Which pneumonia-causing organism associated with cavitation?
Staph aureus (normally post-influenza) +ve cocci in grape-bunch clusters
94
Which pneumonia-causing organism is common in alcoholics?
Klebsiella (-ve rod)
95
Which pneumonia-causing organism common in hotels with AC?
Legionella (urinary antigen test & serology) Presents with confusion, abdo pain, diarrhoea
96
Which pneumonia-causing organism in young people?
Mycoplasma pneumoniae (dry cough, arthralgia, cold agglutinin test) Treat with tetracyclin or macrolide
97
Hepatitis A
Acute hepatitis - fever, abdo pain, jaundice Faecal-oral transmission Largely supportive care - never chronic infection
98
What are the classifications of the GOLD staging for COPD?
GOLD 1 (mild) - FEV1>= 80% predicted GOLD 2 (moderate) - FEV1 50-79% GOLD 3 (severe) - FEV1 30-49% GOLD 4 (very severe) - FEV1<30% predicted
99
What is COPD?
Syndrome of progressive airflow obstruction which is not fully reversible and does not change markedly over several months
100
Management options for COPD?
Smoking cessation - most important SABA - in everyone Antimuscarinics if no asthmatics - LAMA/LABA Triple therapy - if >2 exacerbations a year or asthmatics Abx prophylaxis Mucolytics LTOT Pulmonary rehabilitation Vaccinations Long-term NIV
101
What drugs cause drug-induced parkinsonism?
Lithium, metoclopramide, typical anti-psychotics
102
Multisystem atrophy
autonomic dysfunction, postural hypotansion, bladder dysfunction
103
Progressive supranuclear palsy
loss of vertical gaze, frequent falls, dementia later
104
How would you manage OA?
Conservative: - MDT approach - Lifestyle measures - weight loss, exercise - physio - walking aids Medical: - Analgesia - topical NSAIDs, oral paracetamol / ibuprofen - joint injection - corticosteroid up to every 3mo Surgical: - arthroscopic lavage - if locking - arthroplasty
105
Complications of knee replacement?
Immediate: - bleeding - infection - injury to surrounding structures Early: - VTE - wound infection/poor healing Late - instability - reduced ROM - malalignment - revision - readmission - death
106
DDx for midline sternotomy?
valve replacement congenital heart surgery bypass surgery
107
Indications for aortic valve replacement?
Symptomatic triad: angina, dyspnoea, syncope Echo findings: AVA <1.0cm2, mean pressure gradient >40mmHg Evidence of LV failure
108
What are the two types of valve replacement?
Mechanical - last 20-30yrs, need warfarin for life, recommended for younger people Tissue - last 10-15yrs if pt not active - no need for warfarin
109
Cx of valve replacement surgery?
- bleeding - infection - damage to structures - stroke/TIA - arrhythmias - valve failure - valve leakage
110
What should you avoid in a pt with aortic stenosis and coronary artery disease?
Avoid excessive use of nitrates -> lower cardiac output which is already reduces in AS
111
What is PD?
Progressive neurological condition due to a loss of dopaminergic neurons in the substantial nigra -> triad of tremor, rigidity and bradykinesia

UKMLA Incorrecy (2 decks)

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