Passmed Flashcards
Insulin when ill
Continue it, don’t change it but check blood glucose more frequently
Cancer patient VTE
6 months DOAC
pityriasis versicolor orgnaism
Malassezia furfur
prevention of vaso-occlusive crisis in sickle cell
Hydroxyurea
How long is shingles infective for?
5-7 days, until the lesions have crusted over
What is used for prophylaxis of oesophageal bleeding?
Propranolol
What drugs are contraindicated in people with hypertrophic obstructive cardiomyopathy?
ACEi
Codeine to morphone
Divide by 10
Primary hyperparathyroidism
- Tumour
- PTH high
- Calcium high
Secondary hyperparathyroidism
- low vitamin D/CKD
- high PTH
- low/normal calcium
Tertiary hyperparathyroidism
- hyperplasia
- high PTH
- High calcium
Chronic kidney disease staging
1: eGFR>90
2: 60-90 +some signs
3a: 45-59
3b: 30-44
4: 15-29
5 <15
Type of anaemia CKD
Normochromic normocytic
Management of bone disease secondary to CKD
- low phosphate diet
- phosphate binders
- vitamin D
- calcium
MEN 1
- primary hyperparathyroidism,
- pancreatic tumours,
- pituitary tumours
MEN 2a
- medullary thyroid carcinoma
- phaeochromocytoma
- hyperparathyroidism
MEN 2b
- medullary thyroid cancer
- phaeochromocytoma
- marfanoid body habitus
- neuroma
Diagnosis of phaeochromocytoma
24 hour urinary collection of metanephrines
Water deprivation test cranial diabetes insipidus
- starting plasma osmolality high
- final plasma osmolality <300
- desmopressin >600
Water deprivation test nephrogenic diabetes insipidus
- starting plasma osmolality high
- final plasma osmolality <300
- desmopressin <300
What is the reversal agent of dabigitran?
Idarucizumab
What is used for prevention of cluster headaches?
Verapamil
What causes lower zone lung fibrosis?
A: Asbestos
C: connective tissue disease
I: idiopathic pulmonary fibrosis
D; Drugs: e.g. methotrexate or nitrofuratoin
Atypical lymphocytes
Mono
First trimester when give iron
110
Second and third trimester when give iron
105
Sickle cell most common cause of osteomyelitis
Salmonella
What neurovascular structure is most likely to be compromised in a scaphoid fracture?
Dorsal carpal arch of the radial artery
When to repeat pregnancy test after termination
3 weeks
Which diabetes medications are contra-indicated in pregnancy?
- gliclazide
- liraglutide
Switch to metformin
What are the causes of tunnel vision?
- papilloedema
- glaucoma
- retinitis pigmentosa
- choroidoretinitis
- optic atrophy secondary to tabes dorsalis
- hysteria
Patau syndrome chromosome
13
NICE red flag for paeds traffic light
- Moderate or severe chest wall recession
- Does not wake if roused
- Reduced skin turgor
- Mottled or blue appearance
- Grunting
What is the most common complication of meningitis?
Sensorineural hearing loss
What does a preceding influenza predispose to
Staph aureus pneumonia
post splenectomy sepsis
Streptococcus pneumoniae
Haemophilus influenzae
Meningococci
What causes syphillis
Treponema pallidum
Conservative management of pneumothorax
Follow up every 2-4 days as an outpatient
normal pressure hydrocephalus
Urinary incontinence + gait abnormality + dementia
Visible haematuria following a URTI in a child
- IgA if 1-3 days
- post streptoccocal if 7-14 dyas
What do you give to treat an episode of severe alcoholic hepatitis
prednisolone
Treatment of vault prolapse
Sacrocolpopexy
What visual defect can a prolactinoma cause?
bi temporal superior quadrantanopia
What type of STEMI can affect the AV node?
Inferior STEMI
Features of achondroplasia
- short limbs and stature
- trident hands
- frontal bossing
- lumbar lordosis
- flattened nasal bridge
What cancer is linked to coeliac?
T cell lymphoma
Bloods tumour lysis syndrome
- hyperkalaemia
- hypocalcaemia
- incrased phosphate
- urate/uric acid high
Presentation of tumour lysis
- oligouria/renal failure
- confusion
- seizures
- nausa and vomiting
- muscle cramps and tetany
Renal colic pain mangement
IM diclofenac
Bacteria in periotoneal dialysis peritonitis
staph epidermis
What are the cerebellar signs?
- Dysdiadochokinesia
- Ataxia
- Nystagmus
- Intention tremor
- Slurred or staccato speech
- Hypotonia
Management of pyoderma gangrenosum
steroids
medical management of urge vs stress incontinence
urge: oxybutinin
duloxetine: stress
Management of angia
- 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
When should you give a platelet infusion?
Platelet transfusion is appropriate for patients with a platelet count < 30 x 109 and clinically significant bleeding
What drug should be stopped before coronary angiogrpahy?
Metformin due to lactic acidosis
Breech baby normal baby check
All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
Morphine for palliative patients with mild/moderate renal impairment
Oxycodone
Local anaesthetic toxicity
IV 20% lipid emulsion
Chronic myeloid leukaemia drug
Imatinib
How do you calculate positive predictive value?
Positive predictive value = TP / (TP + FP)
What are the signs of osmotic demyelination syndrome (also known as central pontine myelinolysis)?
symptoms of brainstem damage, such as spastic quadriparesis, pseudobulbar palsy, and emotional lability (i.e. pseudobulbar affect). Therefore, spastic quadriparesis is the correct answer.
How do you reduce the risk of peripheral retinopathy of isoniazid
pyridoxine
What increases the risk of azathioprine toxicity?
Allopurinol
What valve abnormality is turners associated with?
Bicuspid aortic valve