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Finals > Passmed > Flashcards

Passmed Flashcards

1
Q

Insulin when ill

A

Continue it, don’t change it but check blood glucose more frequently

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2
Q

Cancer patient VTE

A

6 months DOAC

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3
Q

pityriasis versicolor orgnaism

A

Malassezia furfur

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4
Q

prevention of vaso-occlusive crisis in sickle cell

A

Hydroxyurea

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5
Q

How long is shingles infective for?

A

5-7 days, until the lesions have crusted over

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6
Q

What is used for prophylaxis of oesophageal bleeding?

A

Propranolol

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7
Q

What drugs are contraindicated in people with hypertrophic obstructive cardiomyopathy?

A

ACEi

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8
Q

Codeine to morphone

A

Divide by 10

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9
Q

Primary hyperparathyroidism

A
  • Tumour
  • PTH high
  • Calcium high
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10
Q

Secondary hyperparathyroidism

A
  • low vitamin D/CKD
  • high PTH
  • low/normal calcium
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11
Q

Tertiary hyperparathyroidism

A
  • hyperplasia
  • high PTH
  • High calcium
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12
Q

Chronic kidney disease staging

A

1: eGFR>90
2: 60-90 +some signs
3a: 45-59
3b: 30-44
4: 15-29
5 <15

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13
Q

Type of anaemia CKD

A

Normochromic normocytic

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14
Q

Management of bone disease secondary to CKD

A
  • low phosphate diet
  • phosphate binders
  • vitamin D
  • calcium
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15
Q

MEN 1

A
  • primary hyperparathyroidism,
  • pancreatic tumours,
  • pituitary tumours
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16
Q

MEN 2a

A
  • medullary thyroid carcinoma
  • phaeochromocytoma
  • hyperparathyroidism
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17
Q

MEN 2b

A
  • medullary thyroid cancer
  • phaeochromocytoma
  • marfanoid body habitus
  • neuroma
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18
Q

Diagnosis of phaeochromocytoma

A

24 hour urinary collection of metanephrines

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19
Q

Water deprivation test cranial diabetes insipidus

A
  • starting plasma osmolality high
  • final plasma osmolality <300
  • desmopressin >600
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20
Q

Water deprivation test nephrogenic diabetes insipidus

A
  • starting plasma osmolality high
  • final plasma osmolality <300
  • desmopressin <300
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21
Q

What is the reversal agent of dabigitran?

A

Idarucizumab

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22
Q

What is used for prevention of cluster headaches?

A

Verapamil

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23
Q

What causes lower zone lung fibrosis?

A

A: Asbestos
C: connective tissue disease
I: idiopathic pulmonary fibrosis
D; Drugs: e.g. methotrexate or nitrofuratoin

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24
Q

Atypical lymphocytes

A

Mono

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25
Q

First trimester when give iron

A

110

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26
Q

Second and third trimester when give iron

A

105

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27
Q

Sickle cell most common cause of osteomyelitis

A

Salmonella

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28
Q

What neurovascular structure is most likely to be compromised in a scaphoid fracture?

A

Dorsal carpal arch of the radial artery

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29
Q

When to repeat pregnancy test after termination

A

3 weeks

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30
Q

Which diabetes medications are contra-indicated in pregnancy?

A
  • gliclazide
  • liraglutide

Switch to metformin

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31
Q

What are the causes of tunnel vision?

A
  • papilloedema
  • glaucoma
  • retinitis pigmentosa
  • choroidoretinitis
  • optic atrophy secondary to tabes dorsalis
  • hysteria
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32
Q

Patau syndrome chromosome

A

13

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33
Q

NICE red flag for paeds traffic light

A
  • Moderate or severe chest wall recession
  • Does not wake if roused
  • Reduced skin turgor
  • Mottled or blue appearance
  • Grunting
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34
Q

What is the most common complication of meningitis?

A

Sensorineural hearing loss

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35
Q

What does a preceding influenza predispose to

A

Staph aureus pneumonia

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36
Q

post splenectomy sepsis

A

Streptococcus pneumoniae
Haemophilus influenzae
Meningococci

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37
Q

What causes syphillis

A

Treponema pallidum

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38
Q

Conservative management of pneumothorax

A

Follow up every 2-4 days as an outpatient

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39
Q

normal pressure hydrocephalus

A

Urinary incontinence + gait abnormality + dementia

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40
Q

Visible haematuria following a URTI in a child

A
  • IgA if 1-3 days
  • post streptoccocal if 7-14 dyas
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41
Q

What do you give to treat an episode of severe alcoholic hepatitis

A

prednisolone

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42
Q

Treatment of vault prolapse

A

Sacrocolpopexy

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43
Q

What visual defect can a prolactinoma cause?

A

bi temporal superior quadrantanopia

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44
Q

What type of STEMI can affect the AV node?

A

Inferior STEMI

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45
Q

Features of achondroplasia

A
  • short limbs and stature
  • trident hands
  • frontal bossing
  • lumbar lordosis
  • flattened nasal bridge
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46
Q

What cancer is linked to coeliac?

A

T cell lymphoma

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47
Q

Bloods tumour lysis syndrome

A
  • hyperkalaemia
  • hypocalcaemia
  • incrased phosphate
  • urate/uric acid high
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48
Q

Presentation of tumour lysis

A
  • oligouria/renal failure
  • confusion
  • seizures
  • nausa and vomiting
  • muscle cramps and tetany
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49
Q

Renal colic pain mangement

A

IM diclofenac

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50
Q

Bacteria in periotoneal dialysis peritonitis

A

staph epidermis

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51
Q

What are the cerebellar signs?

A
  • Dysdiadochokinesia
  • Ataxia
  • Nystagmus
  • Intention tremor
  • Slurred or staccato speech
  • Hypotonia
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52
Q

Management of pyoderma gangrenosum

A

steroids

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53
Q

medical management of urge vs stress incontinence

A

urge: oxybutinin
duloxetine: stress

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54
Q

Management of angia

A
  • GTN spray to stop attacks
  • aspirin and statin
  • CCB or BB first line
  • Add in either CCB or BB if not controlled by one alone
  • If cant tolerate a CCB then add in a long acting nitrate
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55
Q

When should you give a platelet infusion?

A

Platelet transfusion is appropriate for patients with a platelet count < 30 x 109 and clinically significant bleeding

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56
Q

What drug should be stopped before coronary angiogrpahy?

A

Metformin due to lactic acidosis

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57
Q

Breech baby normal baby check

A

All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery

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58
Q

Morphine for palliative patients with mild/moderate renal impairment

A

Oxycodone

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59
Q

Local anaesthetic toxicity

A

IV 20% lipid emulsion

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60
Q

Chronic myeloid leukaemia drug

A

Imatinib

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61
Q

How do you calculate positive predictive value?

A

Positive predictive value = TP / (TP + FP)

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62
Q

What are the signs of osmotic demyelination syndrome (also known as central pontine myelinolysis)?

A

symptoms of brainstem damage, such as spastic quadriparesis, pseudobulbar palsy, and emotional lability (i.e. pseudobulbar affect). Therefore, spastic quadriparesis is the correct answer.

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63
Q

How do you reduce the risk of peripheral retinopathy of isoniazid

A

pyridoxine

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64
Q

What increases the risk of azathioprine toxicity?

A

Allopurinol

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65
Q

What valve abnormality is turners associated with?

A

Bicuspid aortic valve

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66
Q

What is vitiligo associated with?

A
  • addisons
  • T1DM
  • autoimmune diseases
67
Q

For how long does lactational amenorrhoea work as contraceptive?

A

For 6 months

68
Q

What is given for preterm prerupture of the membranes?

A

Dexamethasone

69
Q

mania referral

A

urgent community

70
Q

raised ICP imaging

A

CT head to rule out haemorrhage

71
Q

what is a contraindication to digoxin?

A

Thiazide like diurtetics

72
Q

Statins in pregnancy

A

stop them

73
Q

what drugs to avoid in G6PD

A

sulf drugs

74
Q

When is metaformin contraindicated?

A

If eGFR is less than 30

75
Q

otitis externa if diabetes

A

ciprofloxacin to cover for pseudomonas

76
Q

how long no food/non clear liquids before surgery?

A

6 hours

77
Q

renal colic imaging

A

non contrast CTKUB

78
Q

codeine to morphine

A

divide by 10

79
Q

breakthrough dose

A

1/6th

80
Q

ECG hypercalcaemia

A

Shortened QT

81
Q

ECG hypocalcaemia

A

prolonged QT

82
Q

correction of hypocalcaemia

A

calcium gluconate 10ml of 10%

83
Q

ECG hyperkalaemia

A
  • tall tented T waves
  • small p waves
  • widened QRS
84
Q

What are the causes of an alkalosis and hypokalaemia?

A
  • vomit
  • diuretics
  • cushings
  • conns
85
Q

What are the causes of acidosis and hypokalaemia?

A
  • diarrhoea
  • renal tubular acidosis
  • acetazolamide
86
Q

ca125

A

ovarian

87
Q

ca 19 9

A

pancreatic

88
Q

ca 15-3

A

breast

89
Q

AFP

A

hepatocellular, teratoma

90
Q

CEA

A

colorectal

91
Q

investigation neoplastic spinal cord compression

A

whole spine MRI within 24 hours

92
Q

which cancer is most common in non smokers?

A

Adenocarcinoma

93
Q

Which cancers are central in lung

A

Squamous

94
Q

Which cancers are peripheral in the lung?

A

Large cell
adenocarcinoma

95
Q

What is the presentation of myxoedema coma?

A

Hypothermia and confusion

96
Q

What is the management of myxoedema coma?

A
  • IV thyroid replacement
  • IV fluid
  • IV corticosteroids (until the possibility of coexisting adrenal insufficiency has been excluded)
  • electrolyte imbalance correction
97
Q

Presentation of thyroid storm

A
  • fever >38.5
  • tachycardia
  • confusion and agitation
  • nausea and vomiting
  • hypertension
  • heart failure
  • abnormal liver function test
98
Q

Management of thyroid storm

A
  • beta blockers
  • symptom management e.g. paracetamol
  • anti-thyroid drugs
  • dexamethasone
99
Q

What are the side effects of Biguanides

A

e.g. metformin - GI upset, lactic acidosis

100
Q

What are the side effects of GLP-1 mimetics?

A

nausea, vomiting, pancreatitis

101
Q

What are the side effects of thiazolidinediones?

A

e.g. pioglitazone

bladder cancer

102
Q

What is given for premature rupture of the membranes?

A

10 days of erythromycin

103
Q

MS prolapse

A

high dose methylprednisolone

104
Q

Type 1 error

A

null hypothesis is rejected when true

105
Q

Type 2 error

A

null hypothesis is accepted when flase

106
Q

Late sign of cauda equina

A

Urinary incontinence

107
Q

Hypotensive bradycardia

A

DONT SHOCK

108
Q

What is power

A

the probability of detecting a statistically significant difference

109
Q

How long should you wait before titrating up metformin?

A

a week

110
Q

What is the method of the newborn hearing test?

A

Otoacoustic emission then if abnormal auditory brainstem response

111
Q

Auscultation of idiopathic pulmonary fibrosis

A

fine end inspiratory crackles

112
Q

Side effect of amiodarone

A

thrombophelbitis

113
Q

If a semen sample test is abnormal, when should you retest

A

3 months

114
Q

Melanosis coli

A

pigmentation of the colon due to laxative abuse

115
Q

Impaired fasting glucose

A

A fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l

116
Q

What is sildenafil contraindicated by?

A

Nitrates and nicorandil

117
Q

Chondrocalcinosis joint

A

pseudogout

118
Q

Impaired glucose tolerance

A

fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

119
Q

Which drugs worsen glycaemic control

A

Thiazide diuretics

120
Q

How should you test for HIV?

A

HIV p24 antigen and HIV antibody

121
Q

What type of haemorrhage causes pinpoint pupils?

A

Pontine haemorrhage

122
Q

In ACS what is contraindicated in patients with hypotension?

A

Nitrates

123
Q

What are a risk factor for C diff?

A

PPIs

124
Q

How do you calculate standard error?

A

standard deviation / square root of number of patients

125
Q

What is the management of sudden onset sensori-neural hearing loss

A

Refer to ENT and give high dose oral prednisolone

126
Q

antibiotic causing jaundice

A

co amoxiclav

127
Q

Opioids for renal failure

A
  • buprenorphine
  • alfentanil
  • fentanyl
128
Q

What is a normal ABPI?

A

0.9-1.2

129
Q

PAD ABPI

A

Less than 0.9

130
Q

osteomalacia

A
  • low calcium
  • low phosphate
  • high ALP
  • Hight PTH
131
Q

Bradycardia failure to atropine

A
  • subcutaneous pacing
  • transvenous pacing
132
Q

Sarcoidosis

A
  • skin rash (erythema nodosum) and cough
  • test ACE
133
Q

What electrolyte abnormality can lead to VT?

A

Hypokalaemia

134
Q

MRSA pre surgery

A
  • nasal mupirocin
  • clorhexidine for skin
135
Q

side effect of trimethoprim

A

Tubular damage leading to hyperkalaemia and raised serum creatinine

136
Q

painless ulceration on genitals

A

syphilis

137
Q

what is the treatment for sypilis

A

benzylpenicillin

138
Q

what causes bacterial vaginosis?

A

gardnerella vaginalis

139
Q

what is the main cause of rheumaitc fever

A

group A beta haemolytic streptococci

140
Q

Restrictive cardiomyopathy echo

A

increased ejection fraction, reduced left ventricular volume

141
Q

When would you do CABG over PCI for angina?

A
  • over 65
  • diabetes
  • complex 3 vessel disease
142
Q

Long term management of WPW

A

catheter ablation of the accessory pathway

143
Q

What drugs are contraindicatied in WPW

A
  • NDP CCB e.g. verapamil
  • Digoxin
144
Q

What heart condition haemochromotosis?

A

Dilated cardiomyopathy

145
Q

Diastolic murmur + face erythema + opening snap

A

mitral stenosis

146
Q

What murmurs are louder on expiration

A
  • mitral
  • aortic
147
Q

what murmurs are louder on inspiration

A
  • pulmonary
  • tricuspid
148
Q

ejection systolic mumurs

A
  • aortic stenosis
  • pulmonary stenosis
149
Q

pansystolic murmurs

A
  • mitral regurg
  • tricuspid regurg
150
Q

mid/late diastolic murmur

A
  • mitral stenosis
  • tricuspid stenosis
151
Q

What reduces clopidogrel action

A

Omeprazole

152
Q

mid humeral shaft fracture nerve

A

Radial nerve - wrist drop

153
Q

Which drugs exacerbate psoriasis

A

beta blockers

154
Q

Test for C diff

A

Stool toxin

155
Q

What drugs cause gynaecomastia?e

A
  • spironolactone (most common drug cause)
  • cimetidine
  • digoxin
  • cannabis
  • finasteride
  • GnRH agonists e.g. goserelin, buserelin
  • oestrogens, anabolic steroids
156
Q

What is the formula for osmolarity

A

2Na + 2K + urea + blood glucose

157
Q

Acute mesenteric ischaemia investigations

A

blood gas to show raised lactate

158
Q

What is the max dose of metformin?

A

1g BD

159
Q

How often should people with sickle cell get the pneumococcal vaccine?

A

Once every 5 years

160
Q

Pancytopenia post chemo

A

myelodisplastic syndrome

161
Q

lead pipe

A

ulcerative colitiis

162
Q

trigeminal neuralgia

A

carbamazepine

163
Q
A

Finals (37 decks)

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