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Phase 3A > Pass medicine learning points > Flashcards

Pass medicine learning points Flashcards

1
Q

Antipsychotic side effects

A

Parkinsonism
Acute dystonia
Akathisia (restlessness)
Tardive dyskinesia (involuntary movements)

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2
Q

Charles bonnet risk factors

A 
Peripheral visual impairment
Advanced age
Social isolation
Sensory impairment
Early cognitive impairment
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3
Q

How long before a PTSD diagnosis

A

2 months

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4
Q

Depression in winter

A

Seasonal affective disorder

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5
Q

Schizophrenia first rank symptoms

A

auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions

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6
Q

Second rank symptoms of schizophrenia

A 
impaired insight
incongruity/blunting of affect (inappropriate emotion for circumstances)
decreased speech
neologisms: made-up words
catatonia
negative symptoms
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7
Q

What should you do if there are symptoms of mania in primary care

A

Urgent referral to community mental health team

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8
Q

How is mania different to hypomania

A

Mania is persistently elevated mood state with psychotic symptoms (hypomania is normally 7-10 days)

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9
Q

Describe schizotypal personality disorder

A

Patients diagnosed with schizotypal personality disorder lack close friends other than family and can have odd or eccentric behaviour, speech and beliefs

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10
Q

What is the difference between schizoid and schizotypal personality disorder

A

Both loners but schizoid don’t want sex whereas schizotypal are eccentric

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11
Q

Histiroinic personality disorder

A

Crave attention and are inappropriate

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12
Q

What is clozapine

A

Atypical antipsychotic

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13
Q

Clozapine side effects weight gain

A 
weight gain
excessive salivation
agranulocytosis
neutropenia
myocarditis
arrhythmias
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14
Q

Hyperkalaemia, low chloride, alkalotic

A

Bulimia nervosa

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15
Q

Rapid speech and topics but no connection

A

Knights move, schizophrenia

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16
Q

Rapid speech and topics but with a connection

A

Flight of ideas, bipolar, mania

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17
Q

SSRI SE

A

GI symptoms
Drug interactions
QT elongation

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18
Q

TCA SE

A 
drowsiness
dry mouth
blurred vision
constipation
urinary retention
lengthening of QT interval
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19
Q

After you’ve changed the lithium dose when do you need to recheck the levels

A

7 days and 12hours later

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20
Q

What class of antidepressant is venlafaxine

A

Serotonin and noradrenaline reuptake inhibitors

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21
Q

Clozapine life threatening SE

A

Agranulocytosis

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22
Q

Hand foot and mouth disease

A

Viral infection in a child. Mouth ulcers, rash on hands and feet. Sometimes legs and buttocks. Fever, anorexia, sore throat

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23
Q

Group B strep prophylaxis

A

BenPen IV

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24
Q

4 year constipation in child

A

Diet and exercise, osmotic laxative.

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25
Q

What is a red flag for hirschprungs disease

A

Passage of meconium after 48 hours, MEN2

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26
Q

Hip dysplasia red flags

A 
Female
Breech
Family History
Oligohydramnios
Birth weight over 5kg
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27
Q

Which contraceptive can cause a delay in fertility returning

A

Progesterone only injection

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28
Q

What is the most effective form of emergency contraception

A

Copper intrauterine device (not affected by BMI)

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29
Q

Ovarian cyst early in pregnancy

A

normal

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30
Q

25-49 cervical screening frequency

A

3 years

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31
Q

50-65 cervical screening frequency

A

5 years

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32
Q

65+ cervical screening frequency

A

If they havent since 50

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33
Q

Child needs treatment for life and parents refuse what do you do

A

Have to give as best interests

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34
Q

Torticollis

A

wry neck, tight on one side, can be from haloperidol, example of acute dystonia

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35
Q

Paediatric life support how many compressions a minute

A

100-120

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36
Q

How does a threatened miscarriage present

A

painless per vaginal bleeding and a closed cervical os

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37
Q

Woman wants to concieve and has large fibroids treatment

A

Myomectomy

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38
Q

vomiting, dry skin, tiredness and raised B-hCG. Foetus large for date

A

Molar pregnancy

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39
Q

Meningitis in under 3 month olds what do you need to give in addition to cefotaxime to cover for listeria

A

Amoxicillin

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40
Q

menstrual disorders, infertility, acne, hirsutism, and metabolic syndrome.

A

PCOS

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41
Q

Obstetric cholestasis treatment

A

Ursodeoxycholic acid and vitamin K. Then delivery at 37 weeks to prevent still birth

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42
Q

When is the COCP contraindicated

A

before 6 weeks post partum

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43
Q

First rank schizophrenia symptoms

A

auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions

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44
Q

ADHD treatment

A

Methylphenidate

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45
Q

Bronchiolitis peak incidence

A

3-6 months

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46
Q

Main bronchiolitis causative organism

A

RSV

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47
Q

Someone hasnt gone into labour and has had a sweep, whats next

A

Vaginal prostaglandin gel

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48
Q

What type of ovarian cancer causes endometrial hyperplasia

A

granulosa cell tumours

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49
Q

Akathesia

A

Severe restlessness

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50
Q

Ascending infection, back ache, losing cloudy liquid, slightly open os

A

Chorioamnionitis

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51
Q

Breech at 36+ weeks

A

External cephalic version

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52
Q

Initial management of hirschprungs

A

Bowel irrigation

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53
Q

What is the best measure of ovulation

A

28 day progesterone

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54
Q

Severe preeclampsia near term treatment

A

IV magnesium sulphate and plan immediate delivery

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55
Q

infants with symptoms of breathlessness worse on exertion (e.g. feeding), sweating, poor feeding and recurrent chest infections

A

Heart failure

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56
Q

Preceding infection, mild effusion, pain, stats normal

A

Transient synovitis, rest and analgesia

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57
Q

How do your cancer risks change with COCP

A

Higher breast and cervical rates

Lower ovarian and endometrial rates

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58
Q

How are depression and dementia different

A

Depression has a shorter and more rapid history

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59
Q

Common cause of microcephaly

A

Fetal alcohol syndrome

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60
Q

Lots of vomiting leads to what blood gas

A

Elevated bicarbonate, low K+, low Cl-

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61
Q

Fever, itchy. Face and trunk then spreads. Macular then papular then vesicular

A

Chicken pox

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62
Q

Prodrome, Koplik spots, rash starts behind ears then whole body. Discrete then becomes confluent

A

Measles

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63
Q

Fever, muscle pain. Parotitis (ear ache and pain on eating) unilateral then bilateral

A

Mumps

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64
Q

Face then body. Pink maculopapular. Facial lymphadenopathy

A

Rubella

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65
Q

Erythema infectiosum

A

Slapped cheek, Parvovirus B19, slapped cheek distribution spreads to proximal arms and extensors

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66
Q

GABHS, rash spares mouth, strawberry tongue

A

Scarlet fever

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67
Q

Coxsackie A16, vesicles in mouth and on palms and soles

A

Hand foot and mouth

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68
Q

Pulmonary hypoplasia can lead to

A

congenital diaphragmatic hernia

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69
Q

Fragile X head size

A

Larger than normal

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70
Q

Congential diaphragmatic tell tale sign on examination

A

Bowel signs on resp exam, intubate and ventilate

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71
Q

Most common causes of cyanotic heart disease

A

Tetralogy of fallot, transposition of the great arteries, tricuspid atresia

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72
Q

Acyanotic heart disease

A

VSD, ASD, PDA, Coarctation, AS

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73
Q

Turners syndrome heart sign

A

Ejection systolic as bicuspid aortic valve

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74
Q

Lithium overdose leads to which heart defect

A

Ebstein anomaly, atrialisation of right ventricle

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75
Q

APGAR

A

Pulse, Respiratory effort, colour, muscle tone, reflex irritability

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76
Q

Hypernatraemic dehydration

A 
jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma
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77
Q

Abdo pain, draws knees up to chest, vomitting, blood in stool, sausage shaped mass RUQ

A

Intussusception (US Ix, target)

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78
Q

Cleft palate risk factors

A

Mothers benzo, antiepileptic, smoking or rubella. Childs trisomy 13, 15, 18

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79
Q

Fragile X

A

Neurodevelopmental delay, long face, protruding ears, recurrent ottitis media

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80
Q

Obesity in children

A 
growth hormone deficiency
hypothyroidism
Down's syndrome
Cushing's syndrome
Prader-Willi syndrome
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81
Q

Jaundice but otherwise fine baby management

A

Urgent serum bilirubin

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82
Q

What injections at 2 months

A

6 in 1
Men B
PCV

83
Q

What injections at 3 months

A

6 in 1

84
Q

First line treatment in PPH (800ml) due to uterine atony

A

Uterine atony

85
Q

When is croup most common

A

Autumn

86
Q

Indications for CTG in labour

A 
Suspected sepsis
HTN >160/110
Oxytocin
Significant meconium
Fresh vaginal bleeding in labour
87
Q

Triad of shaken baby syndrome

A

Retinal haemorrhages
Subdural haematoma
Encephalopathy

88
Q

First sign of puberty in boys

A

Testicular growth. >4ml

89
Q

First sign of puberty in girls

A

Breast development

90
Q

What is the most common explanation for less variability and movements of a baby for less than 40 mins

A

Foetus is sleeping

91
Q

Pregnant woman exposed to chickenpox who hasnt had it before

A

Varicella immunoglobulin

92
Q

When is a nuccal down syndrome scan done

A

12 weeks

93
Q

What happens at your booking appointment (before 12 weeks)

A

Booking visit
general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes
BP, urine dipstick, check BMI
Booking bloods/urine
FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies
hepatitis B, syphilis, rubella
HIV test is offered to all women
urine culture to detect asymptomatic bacteriuria

94
Q

What can you do at 12 weeks

A

Downs screening

Scan to confirm dates and exclude multiple pregnancy

95
Q

What happens at your 20 week appointment

A

Anomaly scan

96
Q

If someone is a primip how is their scan storyline different

A

They get a 25 week scan

97
Q

What happens at 28 week appointment

A

Routine care: BP, urine dipstick, SFH
Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron
First dose of anti-D prophylaxis to rhesus negative women

98
Q

What happens at 34 week appointment

A

Routine care as above
Second dose of anti-D prophylaxis to rhesus negative women*
Information on labour and birth plan

99
Q

What happens at 36 week appointment

A

Routine care as above
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, ‘baby-blues’

100
Q

Diet advice for CF

A

High calorie, high fat, pancratic enzyme replacement for every meal

101
Q

Gestational hypertension over 150/90 treatment

A

Oral labetalol

102
Q

Describe transient synovitis child

A

Acute onset
Usually accompanies viral infections, but the child is well or has a mild fever
More common in boys, aged 2-12 years

103
Q

Describe osteomyelitis child

A

Unwell child, high fever

104
Q

Describe JIA child

A

Painless limp

105
Q

Who gets developmental dysplasia of the hip

A

Girls, detected neonatally

106
Q

What is perthes disease

A

Due to avascular necrosis of the femoral head

107
Q

Describe slipped upper femoral epiphysis

A

10-15 years - Displacement of the femoral head epiphysis postero-inferiorly

108
Q

What to do if a kid is getting nose bleeds

A

Short course of topical chlorhexidine and neomycin and discourage the child from picking his nose

109
Q

High fever lasting >5 days, red palms with desquamation and strawberry tongue

A

Kawasaki disease

110
Q

What if the person is under 13 having sex

A

They are unable to consent and you must break confidentiality

111
Q

When should a baby smile

A

6-8 weeks

112
Q

What disease is neonatal hypotonia associated with

A

Prader Willi (hypothyroidism, neonatal sepsis and spinal muscular atrophy)

113
Q

Can haemophilia be passed male to male

A

No

114
Q

Severe preeclampsia at 39 weeks management

A

IV labetalol, aim for diastolic 80-100mmhg

115
Q

Asthma: on saba, nighttime symptoms and using more than 3 times a week =

A

Paediatric low dose inhaled corticosteroid

116
Q

Medical management of an ectopic drug

A

Methotrexate

117
Q

Can you accept gifts from patients

A

You should not accept substantial gifts from patients or gifts which could be seen to affect how you prescribe, treat or refer patients

118
Q

COCP IMB and PCB

A

Cervical ectropian

119
Q

Kawasaki disease

A

Echocardiogram to exclude coronary artery aneurysms

120
Q

Ectopics in which place have an increased risk of rupture

A

Isthmus

121
Q

What is the most common cause of respiratory distress in a newborn

A

Transient tachypnoea of the newborn

122
Q

Methotrexate and trying for a baby

A

Both men and women should stop it for 6 months before trying for a baby

123
Q

Painful bleeding in a pregnant lady

A

Placental abruption?

124
Q

Painless bleeding in a pregnant lady

A

Placenta praevia?

125
Q

What is a specific clinical sign in preeclampsia

A

Brisk tendon reflexes

126
Q

Do children with downs syndrome snore

A

Yes

127
Q

Which drugs cause hyponatraemia

A

SSRIs

128
Q

Painless bleeding after 24 weeks

A

Placenta praevia

129
Q

If a newborn has abnormal hearing test, which test are they offered

A

Auditory brainstem response test

130
Q

A baby is born with micrognathia, low-set ears, rocker bottom feet and overlapping of fingers

A

Edwards syndrome (trisomy 18)

131
Q

Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

A

Patau (trisomy 13)

132
Q 
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
A

Fragile X

133
Q

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

A

Noonan syndrome

134
Q

Hypotonia
Hypogonadism
Obesity

A

Prader willi syndrome

135
Q

What does a bishops score under 5 suggest

A

Labour wont happen without induction (needs vaginal prostaglandin)

136
Q

Risk factors for placenta praevia

A

ivf
Multiparity
Previous pregnancies

137
Q

HTN before 20 weeks

A

Chronic hypertension

138
Q

HTN after 20 weeks

A

Preeclampsia

139
Q

Easiest way to visualise pyloric stenosis

A

Abdominal ultrasound

140
Q

How long should a child be drowsy for after a simple febrile seizure

A

1 hour

141
Q

Clang associations

A

Words/ trails of thought are linked together by rhymes or similar sounding words

142
Q

Neologism

A

Patient makes up a word or uses a word incorrectly

143
Q

Echolalia

A

Patient repeats words or phrases of the person they are talking to

144
Q

Aphasic speech

A

Patient loses the ability to form language

145
Q

Where to check pulse in an under 1

A

Brachial and femoral

146
Q

Where to check pulse in an over 1

A

Carotid and femoral

147
Q

What drugs can cause benign leucocytosis (benignly raised WBC)

A

Lithium, corticosteroids and beta blockers

148
Q

Age play near other children

A

2 years old

149
Q

Age play with other children

A

4 years old

150
Q

Treatment of uterine atony

A

IV oxytocin and or ergometrine

then carboprost

151
Q

Zopiclone

A

Increased risk of falls

152
Q

Folic acid doses

A

Normally 400mg, 5milligrams if reasons

153
Q

Who can make decisions for a child without capacity

A

when a child lacks capacity, consent from one parent is sufficient to administer treatment as long as it is in the best interests of the child

154
Q

Does absence of bleeding rule out placental abruption

A

No

155
Q

First step in neonatal resuscitation

A

Dry the baby

156
Q

What at birth can lead to increased bilirubin levels

A

Bruising

157
Q

Whats the difference between schizoid and schizotypal personality disorders

A

Schizoid has negative symptoms, no delusions

Schizotypal has positive symptoms, odd thoughts not psychotic but odd

158
Q

Treatment and a risk factor for transient tachypnoea of the newborn

A

Observation

C section a risk factor

159
Q

What follow up does a breech baby need

A

USS for Developmental dysplasia of the hips at 6 weeks

160
Q

Treatment of hand food and mouth disease

A

Symptomatic only

161
Q

Whats the first line new born hearing test

A

automated otoacoustic emissions test

162
Q

Whats the second line new born hearing test

A

automated auditory brainstem response test

163
Q

Heel prick test for CF, whats tested

A

Immunoreactive tripsinogen

164
Q

What depot can be given of antipsychotic

A

Olanzapine

165
Q

Most common ovarian cancer

A

Serous carcinoma

166
Q

Chocolate cysts

A

Endometriotic cysts

167
Q

Simple cysts aka

A

Follicular cysts

168
Q

Progressive loss of fine motor control

A

Degenerative cervical myelopathy

169
Q

Whats the proper name for frozen shoulder

A

Adhesive capsulitis

170
Q

What do you call a stroke that only causes either motor or sensory/ specific symptoms

A

Lacunar stroke

171
Q

Can you do surgery on a child without consent

A

If it is emergency

172
Q

What is indirect coombs test

A

Looks for autoimmune haemolytic anaemia

173
Q

What is direct coombs test

A

Done antenatally to test for antibodies which could pass to baby

174
Q

Should you give antiD after an ectopic is managed surgically

A

Yes

175
Q

Which heart defect do fragile x kids get

A

Mitral valve prolapse

176
Q

Describe fragile x face

A

Big everything: enlarged mandible, long face, low set ears

177
Q

What is most common complication of measles

A

Ottitis media

178
Q

When do people get neuroleptic malignant syndrome

A

As soon as they are started on medication

179
Q

Sinusitis, fever and focal neurology

A

Brain abscess

180
Q

What can precipitate a myasthenic crises

A

Beta blockers

181
Q

Times you can break confidentiality

A 
Required by law
With consent
In the public interest
To protect the patient
To protect others
182
Q

Atypical endometrial hyperplasia postmenopausal

A

Total hysterectomy with bilateral salpingo oophrectomy

183
Q

Biconvex shape on imaging

A

Extradural haematoma

184
Q

Convex shape on imaging

A

Subdural, old people have glasses

185
Q

Definition of a TIA

A

Transient and reversible episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without acute infarction

186
Q

When should a chickenpox kid go back to school

A

When the lesions have crusted over

187
Q

Who should tell the DVLA if the patient has dementia and cant

A

You should

188
Q

Preterm PROM, maternal and fetal tachycardia and maternal pyrexia

A

Chorioamniotiis

189
Q

Which diet for epilepsy

A

Ketogenic

190
Q

What type of drug is pyridostigmine

A

Long acting acetylcholinesterase inhibitor

191
Q

How to investigate post menopausal bleeding

A

TVUSS then pipelle biopsy then hysteroscopy with biopsy

192
Q

Vomiting causes what electolyte changes

A

Hypokalaemic, hypocholoric metabolic alkalosis

193
Q

Urge incontinence first line

A

Bladder retraining

194
Q

Stress incontinence first line

A

Pelvic floor exercises

195
Q

Endometriosis symptoms

A

Pelvic pain, dysmenorrhoea, dyspareunia and subfertility

196
Q

Symptoms of sexual abuse

A

Anal fissures and recurrent UTIs

197
Q

Continous blowing noise below the clavicles

A

Venous hum

198
Q

Strep B infection management

A

Intrapartum antibiotics

199
Q

Most common type of MS

A

Relapsing and remitting

200
Q

How to undo a psychotic psychotic induced EPS

A

Procyclidine

201
Q

Billious vomiting

A

Intussusception

202
Q

?ovarian cancer

A

CA125 and US

203
Q

Vertigo, hearing loss, tinnitus and absent corneal reflex

A

Acoustic neuroma- vestibular schawnnoma

Phase 3A (25 decks)

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