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Passmed Mistakes > Paper 2 prep > Flashcards

Paper 2 prep Flashcards

1
Q

Mx of fibromyalgia?

A

Explain + CBT

Aerobic exercise - best evidence

neuropathic pain meds

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1
Q

Shoulder dislocations - which is when?

A

95% + = anterior (external rotation and abduction)

Seizure = posterior

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2
Q

Calf squeeze + absent plantar flexion = ???

Ix?

A

Achilles tendon rupture (simmonds test +ve)

US + refer to ortho

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3
Q

What to do when starting allopurinol for gout prevention?

A

Provide NSAID or colchine cover as it can trigger acute flare up

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4
Q

Which nerve is used for finger abduction and adduction? How can you distinguish if leison is at the wrist or elbow?

A

Ulnar (palmer and dorsal interossei muscles)

Ulnar injury at wrist : marked claw
Ulnar injury at elbow : less claw but get worse before getting better
(The closer to the paw, the bigger the claw)

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5
Q

Which is better to diagnose ank spond:

Lumbar XR = bamboo spine

Pelvic XR = sacro iliits

A

Pelvic XR = sacro iliits - the other is a late stage sign

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6
Q

Loss of foot dorsiflexion + sensory loss of dorsum of foot = what nerve root leison?

A

L5

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7
Q

How to distinguish between L3 and L4 nerve root compression?

A

Both cause:
- Reduced knee reflex
- +ve femoral stretch test

L3:
- Sensory loss over anterior thigh
- Weak hip flexion, knee extension and hip adduction

L4:
- Sensory loss anterior aspect of knee and medial malleolus
- Weak knee extension and hip adduction

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8
Q

Mx of achilles tendonitis?

A

Rest, NSAIDs, and physio if symptoms persist beyond 7 days

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9
Q

What are some RFs for achilles tenrdon disorders?

A

quinolone use (e.g. ciprofloxacin) is associated with tendon disorders

hypercholesterolaemia (predisposes to tendon xanthomata)

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10
Q

ITP type of hypersenitivity?

A

Type II hypersensitivity reaction

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11
Q

DMARD w/ mouth ulcers?

A

Methotrexate

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12
Q

What drug can cause dupuytrens contracture?

A

Phenytoin

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13
Q

The humeral head is seen in a subcoracoid position in anteroposterior view on X-ray

A

Anterior shoulder dislocation

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14
Q

Compression of what nerve root = present with back, groin, and anterior thigh pain. There may be weakness of hip flexion but lower limb reflexes tend to be normal.

A

L2

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15
Q

Compression of what nerve root = present with back, groin, and anterior thigh pain. There may be weakness of hip flexion but lower limb reflexes tend to be normal.

A

L2

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16
Q

Ulnar parasthesia + weak digit flexion (inc thumb) =??

A

C8 radiculopathy

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17
Q

A knee radiograph identifies a triangular area of new subperiosteal bone in the metaphyseal region of the femur, with a ‘sunburst’ pattern

Dx??

A

Osteosarcoma

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18
Q

Signs of primary raynauds (disease)?

A

Bilateral raynauds + onset <40y

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19
Q

Best initial mx of open fractures?

A

IV Abx

photography of wound

application of a sterile soaked gauze and impermeable film

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20
Q

Behcets - derm finding?

A

Erythema nodosum

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21
Q

Nursemaid elbow mx (subluxation of radial head - pulled elbow)?

A

Passive supination of the elbow joint whilst flexed to 90 degrees

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22
Q

Mx of patellar fractures?

A

Undisplaced fractures with intact extensor mechanism:
- Non-operative management
- Hinged knee brace for 6 weeks
- Full weight bearing allowed

Displaced fractures or those with disrupted extensor mechanism:
- Operative management with various techniques (tension band wire, interfragmentary screws or cerclage wires)
- Hinged knee brace for 4 to 6 weeks
- Full weight bearing allowed

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23
Q

allergic contact dermatitis - hypersenitivity type?

A

Type 4 (IV)

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24
Q

What is antisynthetase syndrome?

A

Myositis with +ve anti-Jo1 antibodies can predispose to lung fibrosis

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25
Q

Why may a pt w/ temporal arteritis have a pale and oedematous optic disc on fundoscopy?

A

Anterior ischaemic optic neuropathy

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26
Q

What nerve is damaged:
Weakness in hip adduction, numbness over the medial thigh

A

Obturator

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27
Q

What nerve is damaged:
Weakness in knee flexion and foot movements, pain and numbness from gluteal region to ankle

A

Sciatic

27
Q

What nerve is damaged:
Weakness in ankle dorsiflexion, numbness of the calf and foot

A

Lumbosacral

28
Q

Weakness in knee extension, loss of the patella reflex, numbness of the thigh

A

Femoral

29
Q

Mx of suspected scaphoid fracture w/ no signs on initial XR?

A

This could well be a scaphoid fracture and should be temporarily immobilised pending further review.

A futura splint will immobilise better than an arm sling for this problem.

Clinic review @7-10d

30
Q

Chemo pts - gout or pseudogout?

A

GOUT

31
Q

Which antibodies are associated w drug induced lupus?

Which drugs can cause this?

A

Anti histone

Drugs:
- Most common = Procainamid + hydralazine
- Less common = Isoniazid, minocycline and phenytoin

32
Q

What indicates that hip pain may be due to referred lumbar spine pain?

A

+ve femoral nerve stretch test

33
Q

Gout meds - cause of diarrhoea?

A

Colchicine

34
Q

What can cause a false +ve VDRL / RPR (for syphilis)

A

SLE, TB, Malaria, HIV

35
Q

Bilateral conjunctivitis, bilateral calf pains and high fevers in a sewage worker suggests what infection?

A

Leptospirosis

36
Q

Mx of chlamydia trachomatis - in pregnancy and otherwise?

A

Pregnancy = azithro, erythro / amox

Non-pregnant = doxycycline

37
Q

Mx of pubic lice?

A

Malathion / permethrin

38
Q

Mx of flagellated protozoa - STI?

A

Trichomonas vaginalis -> Metronidazole

39
Q

PainLESS penile ulcer - likely organism?

A

Treponema pallidum - syphilis

40
Q

Ix for symptomatic schistosomiasis?

A

Stool + Urine microscopy - look for eggs

chronic infection mx = 1 dose praziquantel

41
Q

Exudative tonsiliits - organism

A

Strep pyogenes

42
Q

What is post exposure prophylaxis for HIV?

A

Refer to ED and oral ART 4w

43
Q

Ongoing diarrhoea, lethargy, bloating, flatulence, steatorrhoea, weight loss +/- recent travel → ???

ix?

mx?

A

Giardiasis

ix = stool microscopy, antigen detection assay = more sensitive + quicker
mx = metronidazole

44
Q

Syphilis test result interpretations:
RPR and TPHA

A
45
Q

Skin hypopigmentation + Loss of sensation = ???

A

Leprosy

mx = RDC - rifampicin, dapson and clofazimine

46
Q

MRSA (when pt is vancomycin allergic)

A

Linezolid

47
Q

Most common cause of diarrhoea in HIV pts?

A

Cryptosporidium

48
Q

Pt w/ previous TB + An X-ray is taken which shows a target-shaped lesion in the right upper lobe with air crescent sign present

Likely dx?

A

Aspergilloma - developing in lung cavity caused by TB

49
Q

Farmer, fever, transaminitis - dx and mx?

A

Q fever - Coxiella burnetti (from animals)

Doxycycline

50
Q

When to suspect reinfection w/ syphilis?

A

If RPR rises by 4x or more

51
Q

What is CSF glucose like in bacterial meningitis?

A

CSF glucose is <1/2 of serum glucose

52
Q

HIV, neuro symptoms, widespread demyelination - dx?

A

progressive multifocal leukoencephalopathy (PML) - JC / BK Virus

53
Q

IDA + itchy rash + Eosinophilia -> dx?

A

Hookworm

54
Q

Man returns from trip abroad with maculopapular rash and flu-like illness

A

HIV seroconversion

55
Q

What pneumonia is often preceeded by influenza infection?

A

Staph aureus

56
Q

Returning south american traveller + primary skin leisons w/ mucosal involvement - dx?

A

Leishmaniasis

57
Q

undercooked pork - which hep?

A

HEP E

58
Q

Avoid usuing hypotonic (0.45%) in paeds pts - why?

A

Risk of hyponatraemic encephalopathy

59
Q

When should suxamethonium be avoided in anasthesia?

A

Suxamethonium is contraindicated for patients with penetrating eye injuries or acute narrow angle glaucoma, as suxamethonium increases intra-ocular pressure

60
Q

Ix for anastomotic leak

A

CT abdo

61
Q

Adhesions - more common in laparoscopic or open surgeries?

A

Open - lap reduces risk

62
Q

Mx of hypocalcaemic tetany following thyroidectomy?

A

IV ca

63
Q

How much should morphine doses be increased by in palliative pt if pain isnt conrolled by current dose?

A

30-50%

64
Q

Mx of Warm AIHA?

A

Steroids +- Rituximab

65
Q

What drug can cause renal failure in MM?

A

NSAIDs

66
Q

typical blood film findings of hyposplenism?

A

Howell-Jolly bodies and siderocytes

Passmed Mistakes (9 decks)

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