Pass medicine learning points Flashcards
1
Q
Antipsychotic side effects
A
Parkinsonism
Acute dystonia
Akathisia (restlessness)
Tardive dyskinesia (involuntary movements)
2
Q
Charles bonnet risk factors
A
Peripheral visual impairment Advanced age Social isolation Sensory impairment Early cognitive impairment
3
Q
How long before a PTSD diagnosis
A
2 months
4
Q
Depression in winter
A
Seasonal affective disorder
5
Q
Schizophrenia first rank symptoms
A
auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions
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
7
Q
What should you do if there are symptoms of mania in primary care
A
Urgent referral to community mental health team
8
Q
How is mania different to hypomania
A
Mania is persistently elevated mood state with psychotic symptoms (hypomania is normally 7-10 days)
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
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
11
Q
Histiroinic personality disorder
A
Crave attention and are inappropriate
12
Q
What is clozapine
A
Atypical antipsychotic
13
Q
Clozapine side effects weight gain
A
weight gain excessive salivation agranulocytosis neutropenia myocarditis arrhythmias
14
Q
Hyperkalaemia, low chloride, alkalotic
A
Bulimia nervosa
15
Q
Rapid speech and topics but no connection
A
Knights move, schizophrenia
16
Q
Rapid speech and topics but with a connection
A
Flight of ideas, bipolar, mania
17
Q
SSRI SE
A
GI symptoms
Drug interactions
QT elongation
18
Q
TCA SE
A
drowsiness dry mouth blurred vision constipation urinary retention lengthening of QT interval
19
Q
After you’ve changed the lithium dose when do you need to recheck the levels
A
7 days and 12hours later
20
Q
What class of antidepressant is venlafaxine
A
Serotonin and noradrenaline reuptake inhibitors
21
Q
Clozapine life threatening SE
A
Agranulocytosis
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
23
Q
Group B strep prophylaxis
A
BenPen IV
24
Q
4 year constipation in child
A
Diet and exercise, osmotic laxative.
25
What is a red flag for hirschprungs disease
Passage of meconium after 48 hours, MEN2
26
Hip dysplasia red flags
```
Female
Breech
Family History
Oligohydramnios
Birth weight over 5kg
```
27
Which contraceptive can cause a delay in fertility returning
Progesterone only injection
28
What is the most effective form of emergency contraception
Copper intrauterine device (not affected by BMI)
29
Ovarian cyst early in pregnancy
normal
30
25-49 cervical screening frequency
3 years
31
50-65 cervical screening frequency
5 years
32
65+ cervical screening frequency
If they havent since 50
33
Child needs treatment for life and parents refuse what do you do
Have to give as best interests
34
Torticollis
wry neck, tight on one side, can be from haloperidol, example of acute dystonia
35
Paediatric life support how many compressions a minute
100-120
36
How does a threatened miscarriage present
painless per vaginal bleeding and a closed cervical os
37
Woman wants to concieve and has large fibroids treatment
Myomectomy
38
vomiting, dry skin, tiredness and raised B-hCG. Foetus large for date
Molar pregnancy
39
Meningitis in under 3 month olds what do you need to give in addition to cefotaxime to cover for listeria
Amoxicillin
40
menstrual disorders, infertility, acne, hirsutism, and metabolic syndrome.
PCOS
41
Obstetric cholestasis treatment
Ursodeoxycholic acid and vitamin K. Then delivery at 37 weeks to prevent still birth
42
When is the COCP contraindicated
before 6 weeks post partum
43
First rank schizophrenia symptoms
auditory hallucinations, thought disorders, passivity phenomena and delusional perceptions
44
ADHD treatment
Methylphenidate
45
Bronchiolitis peak incidence
3-6 months
46
Main bronchiolitis causative organism
RSV
47
Someone hasnt gone into labour and has had a sweep, whats next
Vaginal prostaglandin gel
48
What type of ovarian cancer causes endometrial hyperplasia
granulosa cell tumours
49
Akathesia
Severe restlessness
50
Ascending infection, back ache, losing cloudy liquid, slightly open os
Chorioamnionitis
51
Breech at 36+ weeks
External cephalic version
52
Initial management of hirschprungs
Bowel irrigation
53
What is the best measure of ovulation
28 day progesterone
54
Severe preeclampsia near term treatment
IV magnesium sulphate and plan immediate delivery
55
infants with symptoms of breathlessness worse on exertion (e.g. feeding), sweating, poor feeding and recurrent chest infections
Heart failure
56
Preceding infection, mild effusion, pain, stats normal
Transient synovitis, rest and analgesia
57
How do your cancer risks change with COCP
Higher breast and cervical rates
| Lower ovarian and endometrial rates
58
How are depression and dementia different
Depression has a shorter and more rapid history
59
Common cause of microcephaly
Fetal alcohol syndrome
60
Lots of vomiting leads to what blood gas
Elevated bicarbonate, low K+, low Cl-
61
Fever, itchy. Face and trunk then spreads. Macular then papular then vesicular
Chicken pox
62
Prodrome, Koplik spots, rash starts behind ears then whole body. Discrete then becomes confluent
Measles
63
Fever, muscle pain. Parotitis (ear ache and pain on eating) unilateral then bilateral
Mumps
64
Face then body. Pink maculopapular. Facial lymphadenopathy
Rubella
65
Erythema infectiosum
Slapped cheek, Parvovirus B19, slapped cheek distribution spreads to proximal arms and extensors
66
GABHS, rash spares mouth, strawberry tongue
Scarlet fever
67
Coxsackie A16, vesicles in mouth and on palms and soles
Hand foot and mouth
68
Pulmonary hypoplasia can lead to
congenital diaphragmatic hernia
69
Fragile X head size
Larger than normal
70
Congential diaphragmatic tell tale sign on examination
Bowel signs on resp exam, intubate and ventilate
71
Most common causes of cyanotic heart disease
Tetralogy of fallot, transposition of the great arteries, tricuspid atresia
72
Acyanotic heart disease
VSD, ASD, PDA, Coarctation, AS
73
Turners syndrome heart sign
Ejection systolic as bicuspid aortic valve
74
Lithium overdose leads to which heart defect
Ebstein anomaly, atrialisation of right ventricle
75
APGAR
Pulse, Respiratory effort, colour, muscle tone, reflex irritability
76
Hypernatraemic dehydration
```
jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma
```
77
Abdo pain, draws knees up to chest, vomitting, blood in stool, sausage shaped mass RUQ
Intussusception (US Ix, target)
78
Cleft palate risk factors
Mothers benzo, antiepileptic, smoking or rubella. Childs trisomy 13, 15, 18
79
Fragile X
Neurodevelopmental delay, long face, protruding ears, recurrent ottitis media
80
Obesity in children
```
growth hormone deficiency
hypothyroidism
Down's syndrome
Cushing's syndrome
Prader-Willi syndrome
```
81
Jaundice but otherwise fine baby management
Urgent serum bilirubin
82
What injections at 2 months
6 in 1
Men B
PCV
83
What injections at 3 months
6 in 1
84
First line treatment in PPH (800ml) due to uterine atony
Uterine atony
85
When is croup most common
Autumn
86
Indications for CTG in labour
```
Suspected sepsis
HTN >160/110
Oxytocin
Significant meconium
Fresh vaginal bleeding in labour
```
87
Triad of shaken baby syndrome
Retinal haemorrhages
Subdural haematoma
Encephalopathy
88
First sign of puberty in boys
Testicular growth. >4ml
89
First sign of puberty in girls
Breast development
90
What is the most common explanation for less variability and movements of a baby for less than 40 mins
Foetus is sleeping
91
Pregnant woman exposed to chickenpox who hasnt had it before
Varicella immunoglobulin
92
When is a nuccal down syndrome scan done
12 weeks
93
What happens at your booking appointment (before 12 weeks)
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
What can you do at 12 weeks
Downs screening
| Scan to confirm dates and exclude multiple pregnancy
95
What happens at your 20 week appointment
Anomaly scan
96
If someone is a primip how is their scan storyline different
They get a 25 week scan
97
What happens at 28 week appointment
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
What happens at 34 week appointment
Routine care as above
Second dose of anti-D prophylaxis to rhesus negative women*
Information on labour and birth plan
99
What happens at 36 week appointment
Routine care as above
Check presentation - offer external cephalic version if indicated
Information on breast feeding, vitamin K, 'baby-blues'
100
Diet advice for CF
High calorie, high fat, pancratic enzyme replacement for every meal
101
Gestational hypertension over 150/90 treatment
Oral labetalol
102
Describe transient synovitis child
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
Describe osteomyelitis child
Unwell child, high fever
104
Describe JIA child
Painless limp
105
Who gets developmental dysplasia of the hip
Girls, detected neonatally
106
What is perthes disease
Due to avascular necrosis of the femoral head
107
Describe slipped upper femoral epiphysis
10-15 years - Displacement of the femoral head epiphysis postero-inferiorly
108
What to do if a kid is getting nose bleeds
Short course of topical chlorhexidine and neomycin and discourage the child from picking his nose
109
High fever lasting >5 days, red palms with desquamation and strawberry tongue
Kawasaki disease
110
What if the person is under 13 having sex
They are unable to consent and you must break confidentiality
111
When should a baby smile
6-8 weeks
112
What disease is neonatal hypotonia associated with
Prader Willi (hypothyroidism, neonatal sepsis and spinal muscular atrophy)
113
Can haemophilia be passed male to male
No
114
Severe preeclampsia at 39 weeks management
IV labetalol, aim for diastolic 80-100mmhg
115
Asthma: on saba, nighttime symptoms and using more than 3 times a week =
Paediatric low dose inhaled corticosteroid
116
Medical management of an ectopic drug
Methotrexate
117
Can you accept gifts from patients
You should not accept substantial gifts from patients or gifts which could be seen to affect how you prescribe, treat or refer patients
118
COCP IMB and PCB
Cervical ectropian
119
Kawasaki disease
Echocardiogram to exclude coronary artery aneurysms
120
Ectopics in which place have an increased risk of rupture
Isthmus
121
What is the most common cause of respiratory distress in a newborn
Transient tachypnoea of the newborn
122
Methotrexate and trying for a baby
Both men and women should stop it for 6 months before trying for a baby
123
Painful bleeding in a pregnant lady
Placental abruption?
124
Painless bleeding in a pregnant lady
Placenta praevia?
125
What is a specific clinical sign in preeclampsia
Brisk tendon reflexes
126
Do children with downs syndrome snore
Yes
127
Which drugs cause hyponatraemia
SSRIs
128
Painless bleeding after 24 weeks
Placenta praevia
129
If a newborn has abnormal hearing test, which test are they offered
Auditory brainstem response test
130
A baby is born with micrognathia, low-set ears, rocker bottom feet and overlapping of fingers
Edwards syndrome (trisomy 18)
131
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions
Patau (trisomy 13)
132
```
Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism
```
Fragile X
133
Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis
Noonan syndrome
134
Hypotonia
Hypogonadism
Obesity
Prader willi syndrome
135
What does a bishops score under 5 suggest
Labour wont happen without induction (needs vaginal prostaglandin)
136
Risk factors for placenta praevia
ivf
Multiparity
Previous pregnancies
137
HTN before 20 weeks
Chronic hypertension
138
HTN after 20 weeks
Preeclampsia
139
Easiest way to visualise pyloric stenosis
Abdominal ultrasound
140
How long should a child be drowsy for after a simple febrile seizure
1 hour
141
Clang associations
Words/ trails of thought are linked together by rhymes or similar sounding words
142
Neologism
Patient makes up a word or uses a word incorrectly
143
Echolalia
Patient repeats words or phrases of the person they are talking to
144
Aphasic speech
Patient loses the ability to form language
145
Where to check pulse in an under 1
Brachial and femoral
146
Where to check pulse in an over 1
Carotid and femoral
147
What drugs can cause benign leucocytosis (benignly raised WBC)
Lithium, corticosteroids and beta blockers
148
Age play near other children
2 years old
149
Age play with other children
4 years old
150
Treatment of uterine atony
IV oxytocin and or ergometrine
| then carboprost
151
Zopiclone
Increased risk of falls
152
Folic acid doses
Normally 400mg, 5milligrams if reasons
153
Who can make decisions for a child without capacity
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
Does absence of bleeding rule out placental abruption
No
155
First step in neonatal resuscitation
Dry the baby
156
What at birth can lead to increased bilirubin levels
Bruising
157
Whats the difference between schizoid and schizotypal personality disorders
Schizoid has negative symptoms, no delusions
| Schizotypal has positive symptoms, odd thoughts not psychotic but odd
158
Treatment and a risk factor for transient tachypnoea of the newborn
Observation
| C section a risk factor
159
What follow up does a breech baby need
USS for Developmental dysplasia of the hips at 6 weeks
160
Treatment of hand food and mouth disease
Symptomatic only
161
Whats the first line new born hearing test
automated otoacoustic emissions test
162
Whats the second line new born hearing test
automated auditory brainstem response test
163
Heel prick test for CF, whats tested
Immunoreactive tripsinogen
164
What depot can be given of antipsychotic
Olanzapine
165
Most common ovarian cancer
Serous carcinoma
166
Chocolate cysts
Endometriotic cysts
167
Simple cysts aka
Follicular cysts
168
Progressive loss of fine motor control
Degenerative cervical myelopathy
169
Whats the proper name for frozen shoulder
Adhesive capsulitis
170
What do you call a stroke that only causes either motor or sensory/ specific symptoms
Lacunar stroke
171
Can you do surgery on a child without consent
If it is emergency
172
What is indirect coombs test
Looks for autoimmune haemolytic anaemia
173
What is direct coombs test
Done antenatally to test for antibodies which could pass to baby
174
Should you give antiD after an ectopic is managed surgically
Yes
175
Which heart defect do fragile x kids get
Mitral valve prolapse
176
Describe fragile x face
Big everything: enlarged mandible, long face, low set ears
177
What is most common complication of measles
Ottitis media
178
When do people get neuroleptic malignant syndrome
As soon as they are started on medication
179
Sinusitis, fever and focal neurology
Brain abscess
180
What can precipitate a myasthenic crises
Beta blockers
181
Times you can break confidentiality
```
Required by law
With consent
In the public interest
To protect the patient
To protect others
```
182
Atypical endometrial hyperplasia postmenopausal
Total hysterectomy with bilateral salpingo oophrectomy
183
Biconvex shape on imaging
Extradural haematoma
184
Convex shape on imaging
Subdural, old people have glasses
185
Definition of a TIA
Transient and reversible episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without acute infarction
186
When should a chickenpox kid go back to school
When the lesions have crusted over
187
Who should tell the DVLA if the patient has dementia and cant
You should
188
Preterm PROM, maternal and fetal tachycardia and maternal pyrexia
Chorioamniotiis
189
Which diet for epilepsy
Ketogenic
190
What type of drug is pyridostigmine
Long acting acetylcholinesterase inhibitor
191
How to investigate post menopausal bleeding
TVUSS then pipelle biopsy then hysteroscopy with biopsy
192
Vomiting causes what electolyte changes
Hypokalaemic, hypocholoric metabolic alkalosis
193
Urge incontinence first line
Bladder retraining
194
Stress incontinence first line
Pelvic floor exercises
195
Endometriosis symptoms
Pelvic pain, dysmenorrhoea, dyspareunia and subfertility
196
Symptoms of sexual abuse
Anal fissures and recurrent UTIs
197
Continous blowing noise below the clavicles
Venous hum
198
Strep B infection management
Intrapartum antibiotics
199
Most common type of MS
Relapsing and remitting
200
How to undo a psychotic psychotic induced EPS
Procyclidine
201
Billious vomiting
Intussusception
202
?ovarian cancer
CA125 and US
203
Vertigo, hearing loss, tinnitus and absent corneal reflex
Acoustic neuroma- vestibular schawnnoma
