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Year 5 Specialties > PassMed > Flashcards

PassMed Flashcards

1
Q

Low T3

T4, TSH Normal

A

Sick euthyroid

stress-induced T3 dysregulation (anorexia, pneumonia)
treat the cause, no supplementation needed

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2
Q

BMI <17.5 or
wt 15% less than expected

Distorted Body image

Reduce calorie intake, xs exercise, laxatives, diuretics, drugs. Diabetics skip insulin

HPG axis affected - amenorrhoea and infertility in M. Loss libido in both

A

Anorexia Nervosa

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3
Q

when to admit pt with anorexia

A

BMI<13.5
extreme rapid wt loss or physical complications
high suicide risk

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4
Q

Binge eating (compulsion)
Purging
Body image distortion
BMI >17.5

A

Bulimia Nervosa

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5
Q

G’s and C’s raised
growth hormone,glucose, salivaryglands,
cortisol,cholesterol,carotinaemia

A

Anorexia

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6
Q

rectal bleeding
offensive stools
child age 2

A

Meckel’s diverticulum

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7
Q 
episodic crying and drawing legs to chest + become pale
mass on ULTRASOUND (target sign)
red-currant jelly stool 
invagination ileo-caecal region
child <9m
A

Intususseption

Mx = air insufflation

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8
Q

Child should smile by

refer by

A

smile by 6 weeks

refer at 10 weeks

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9
Q

Wertheim’s radical hysterectomy

A

removal of lymph nodes for

stage IIB endometrial carcinoma

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10
Q

RIF pain
all tests normal
after viral infection

A

Mesenteric adenitis
inflamed lymph nodes within the mesentery.

no Tx needed

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11
Q

scaphoid abdomen + bilious vomiting

A

intestinal malrotation and volvulus
High caecum at the midline

urgent upper GI contrast study and ultrasound is required.
Tx = laparotomy. Ladd’s procedure if volvulus present

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12
Q

presenting <2 years or >10 years
Male sex
having B or T cell surface markers
and having a WCC > 20 * 10^9/l at diagnosis.

A

Poor prognosis for ALL

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13
Q

commonest complication of open myomectomy for fibroids

A

adhesions

others= bladder injury, uterin perforation

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14
Q

1t line Tx fibroid

A

IUS (levonogestrel)

others = tranexamic acid, COCP

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15
Q

reduce size of fibroids with

A

GnRH agonist

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16
Q

Complications fibroids

A

red degeneration

haemorrhage into tumour - commonly occurs during pregnancy

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17
Q

Bicuspid aortic valve
ejection systolic murmur

associated with

A

Turner’s

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18
Q

lie supine, flexion and abduction of the maternal hips

A

McRobert’s maneouvre for shoulder dystocia

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19
Q

agitation, hyperthermia, hyperreflexia, sweating and dilated pupils

A

serotonin syndrome

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20
Q

CVS risk of antipsychotics

A

stroke and VTE risk

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21
Q

Exrapyramidal SE of antipsychotics

A

Parkinsonism
acute dystonia (e.g. torticollis, oculogyric crisis)
akathisia (severe restlessness)
tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)

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22
Q

Endrocrine SE of Antipsychotics

A

hyperprolactinaemia

impaired glucose tolerance (diabetes)

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23
Q

Mx of akathisia (restlessness)

A

Propranolol

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24
Q

Mx of acute dystonia (toricollis, oculogyric crisis)

A

Procyclidine and benztropine

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25
Q

Mx severe tardive dyskinesia (involuntary movements)

A

Tetrabenazine

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26
Q 
hip pain
unable to weight bear
\+/- low fever
post viral infection 
age 2-10 years
A

transient synovitis

Mx = rest and reassure

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27
Q

Lithium therapeutic range

A

0.4-1.0 mmol/L

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28
Q

Lithium excreted in

A

kidneys

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29
Q

Osgood-Schlatter inflammation on which bony prominence

A

inflammation (apophysitis) at the tibial tuberosity

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30
Q

Use cephalosporin e.g. ceftriaxone whilst breastfeeding?

A

yes

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31
Q

Use ciprofloxacin, tetracyclin, chloramphenicol, sulphonamides whilst breastfeeding?

A

no

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32
Q

use BDZ whilst breastfeeding?

A

no

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33
Q

Use sulfonylureas, aspirin or amiodarine whilst breastfeeding?

A

no

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34
Q

Low-pitched sound heard at the lower left sternal edge

A

Still’s murmur

innocent, in children

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35
Q

Alcohol withdrawal initial Sx

A

6-12 hours

tremor, sweating, tachycardia, anxiety

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36
Q

Peak incidence seizures in alcohol withdrawal

A

36hr

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37
Q

Delirium tremens onset

Sx

A 
48-72 hours
coarse tremor
confusion, delusions
auditory and visual hallucinations
fever, tachycardia
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38
Q

Mx delirium tremens

A

Chlordiazepoxide (BDZ)

Carbamazepine can also be used

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39
Q

pruritis in pregnancy >20 weeks

no rash

A

cholestasis of pregnancy

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40
Q

jaundice, mild pyrexia

pregnancy >20 weeks

hepatitic LFTs - ALT raised
hypoglycaemia
raised WBC
coagulopathy
steatosis on imaging
malaise, fatigue, nausea
A

acute fatty liver

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41
Q

maternal pyrexia, maternal tachycardia, and fetal tachycardia
preterm PROM

A

chorioamnionitis

ascending bacterial infection of the amniotic fluid / membranes / placenta

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42
Q

5% pre-pregnancy weight loss
dehydration
electrolyte imbalance

A

hyperemesis gravidarum

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43
Q

hyperemesis gravidarum
diplopia and ataxia

Mx?

A

Wernicke’s encephalopathy

thiamine (Vitamin B1) with a vitamin B and C complex (e.g. Pabrinex) is indicated.

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44
Q

Mx hyperemesis gravidarum

A

antihistamines e.g. promethazine, cyclizine is

ondansetron, metoclopramide second-line

ginger and P6 (wrist) acupressure:

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45
Q

age sit without support

refer at

A

7-8m

refer at 12m

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46
Q

age squats to pick up ball

A

18m

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47
Q

age pull to standing

A

8-10m

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48
Q

SSRI in kids

A

Fluoxetine

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49
Q

SRI that causes QT prolongation and Torsades de pointes

A

Citalopram

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50
Q

ROM
painless vaginal bleeding
fetal bradycardia

A

Vasa praevia

51
Q

factor decreases incidence hyperemesis

A

smoking

52
Q

How long is UPT +ve post-TOP?

A

up to 4 weeks

53
Q

active Mx 3rd stage labour

A
  1. uterotonic (oxytocin)
  2. delayed clamping/cutting of cord (1-5min)
  3. controlled cord contraction after placental separation
54
Q

child
pink maculopapular rash on face then to body
disappears day 3-5
sub occipital, postauricular lymphadenopathy

A

Rubella

55
Q

irritable conjunctivitis fever
then rash behind ears to body
white spots on buccal mucosa

A

Measles

56
Q

when do USS for lochia

A

6 weeks post partum

57
Q

Microcephalic, small eyes Cleft lip/palate Polydactyly Scalp lesions

A

Patau (13)

58
Q

Trisomy 13

A

Patau

59
Q

Micrognathia
Low-set ears
Rocker bottom feet Overlapping of fingers

A

Edward (18)

60
Q

Trisomy 18

A

Edward

61
Q

Learning difficulties Macrocephaly Long face Large ears Macro-orchidism

A

Fragile X

62
Q

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

A

Noonans

63
Q

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

A

Pierre-Robinson

64
Q 
Hypotonia 
Hypogonadism, infertility
Dysmorphism
Obesity
Short stature
LD
behavioural problems adolescence

Mode of inheritance?

A

Prader Willi

genetic imprinting (long arm Chr 15)

  • gene deleted from father = PW
  • deleted from mother = Angelman syndrome
65
Q

Short stature
Learning difficulties
Friendly, extrovert personality Transient neonatal hypercalcaemia
Supravalvular aortic stenosi

A

Williams

66
Q

APGAR

A 
Appearance
Pulse
Grimace (cries/grimace/none)
Activity (move/flex/none)
Resp (strong cry/weak irregular/none)
67
Q

APGAR score cause to worry

A

<7

68
Q

pediculosis capitis

A

head lice

69
Q

school exclusion for head lice?

A

no

70
Q

Mx pediculosis capitis

A

malathion, wet combing, dimeticone, isopropyl myristate and cyclomethicone

71
Q

herald patch

oval patches

A

Pityriasis rosea

?HHV7
self-limiting

72
Q

cause guttate psoriasis

A

streptococcal sore throat 2-4 weeks

73
Q

Dx Bronchiolitis

A

fluorescent antibody test on nasopharyngeal secretions

74
Q

CF mutation

A

delta F508 Chr 7

75
Q

CF carrier rate

A

1 in 25

76
Q

CF infections

A

Staphylococcus aureus
Pseudomonas aeruginosa
Burkholderia cepacia*
Aspergillus

77
Q

Mx cranial DI

A

desmopressin

78
Q

Mx nephrogenic DI

A

thiazide diuretics (increases sodium in urine)

79
Q

high plasma osmolality

low urine osmolality

A

DI

Ix = water deprivation test

80
Q

Mx Enterobius vermicularis

A

threadworms

GIve mebendazole

81
Q

Kid runny nose
temp 37.6
wheeze
Mx?

A

Paracetomal

NO bronchodilators in bronchiolitis

82
Q

Knows 2-6 words

Refer at

A

12-15m

refer at 18m

83
Q

vocab 200 words

A

2.5 years

84
Q

Contraindicatins to MMR

A 
immunosuppression
neomycin allergy
another live injection in last 4wk
pregnancy (avoid getting pregnant until >1m post)
Ig therapy in last 3m
85
Q

painless limp

A

juvenile idiopathic arthritis

86
Q

when to admit SCD adult

A

severe pain

temp >38

87
Q

when to admit SCD child

A

severe pain

temp

88
Q

Sickle sell crisis Mx

A 
analgesia e.g. opiates
rehydrate
oxygen
Abx if evidence of infection
blood transfusion
exchange transfusion: e.g. if neurological complications
89
Q

Sarcoptes scabiei

Type hypersensitivity

A 
Scabies
Type IV (starts 30 days later)
90
Q 
microcephaly 
short palpebral fissures (small eye opening)
hypoplastic upper lip 
absent philtrum
reduced IQ
variable cardiac abnormalities.
A

foetal alcohol syndrome presents

91
Q

risk of miscarriage, stillbirth, pre-term labour, IUGR

A

smoking

92
Q

cataract + deafness + cardiac abnormalities

Possible features: jaundice, hepatosplenomegaly, microcephaly, reduced IQ

A

Rubella

most at risk first 16 wks

93
Q

skin scarring
eye defects (small eyes, cataracts or chorioretinitis)
reduced IQ, abnormal sphincter function, microcephaly
1% foetuses affected if mother has primary infection in 3-28wk
(due to deactivation in utero)

A

Foetal varicella syndrome

94
Q 
Rhinitis
saddle shaped nose
deafness (sensorineural)
Hutchinson’s incisors
Hepatosplenomegaly, lymphadenopathy, anaemia, jaundice
A

Maternal syphilis infection

95
Q 
2 wk old
abdominal distension, tenderness
blood in her nappy 
bilious vomit
decreased movement
struggling to feed

premature baby

A

NEC

Ix = abdo Xray - pneumatosis intestinalis (gas in gut wall)

96
Q

Mx NEC

A

stop oral feeds, barrier nurse and give antibiotics (cefotaxime and vancomycin

97
Q

distended abdomen ed current jelly stool children (5m-12m)

A

Intususseption

Ix = abdo USS

98
Q

Causes gross motor developmental delay

A 
variant of normal
cerebral palsy
neuromuscular disorders (e.g. Duchenne muscular dystrophy)
99
Q

Causes child Speech and language problems

A

always check hearing

other causes include environmental deprivation and general development delay

100
Q

still births + neonatal deaths in 7 days per 1,000 births after 24 weeks gestation

around 8 per 1,000

A

Perinatal mortality rate

101
Q

deaths in pregnancy, labour & 6 weeks afterwards / total maternities * 1000

A

Maternal mortality rate

102
Q

babies born dead after 24 weeks / total births (live + stillborn) * 1000

A

Stillbirth rate

103
Q

babies dying between 1-28 days / total live births * 1000

A

Neonatal death rate

104
Q

Neonate

visual and hearing loss
microcephaly
long-term neurodevelopmental disability
hydrocephalus
IUGR

NO congenital heart defects

A

Cytomegalovirus (CMV)

commonest congenital infection

60% mums had a prior infection
If contracted in pregnancy 40–50% risk foetal transmission

105
Q 
Mum: mild infection in pregnancy/ASx
neonate:
chorioretinitis
macro- or microcephaly
convulsions
long-term neurodevelopmental delay
A

Toxoplasma gondii

undercooked meat and cat faeces

106
Q

organism in pregnancy

increases risk miscarriage, stillbirth or preterm delivery

A

Listeria monocytogenes

unpasteurized cheeses and patés

107
Q

SE oxybutinin for urge incontinence

A

dry mouth
constipation
urinary retention

108
Q

white offensive discharge
fishy odour
clue cells
loss of vaginal acidity

A

Bacterial vaginosis

109
Q

vaginal discharge- offensive, yellow/green, frothy
vulvovaginitis
strawberry cervix
pH > 4.5

in men is usually asymptomatic but may cause urethritis

A

Trichomonas vaginalis (STI)

microscopy -motile trophozoites

110
Q

Mx BV and trichomonas

A

Metronidazole

111
Q

crackles and wheeze and less than 1yr supportive care only (oxygen/optiflow/cpap/intubation/NG feeds)

A

Bronchiolitis

112
Q

> 1 yr, wheeze but less crackles

treat with bronchodilators

A

Wheeze

113
Q

Mx Gonorrhoea

A

IM ceftriaxone 1g

114
Q

Mx Chlamydia

A

Doxycycline or Azithromycin

Azithro if pregnant

115
Q 
Rash
Koplik spots (like tiny grains of salt on the buccal mucosa)
A

MEasles

116
Q

Childhood rash

Cervical lymphadenopathy and arthralgia

A

Rubella

117
Q

Childhood rash
bright red cheeks
maculopapular rash limbs - lacy patterm after physical activity

A

Erythema infectiosum (parvovirus)

118
Q

Fever then rash 12-48 hr later
starts on neck/groin then spreads

sandpaper texture
rash spare mouth/nose (circumoral pallor)

rash initially chest/stomach -> other parts
temperature, headache, vomiting and malaise

increased rash intensity in the axillae and groins in a linear distribution (Pastia’s lines)

tongue - white coated with red oedematous papillae (white strawberry)-> five days the coating peels off to leave a red strawberry tongue

skin begins to peel + rash fades after four to five days - Desquamation of hands and feet

A

Scarlet fever

10 days penicilliv V

azithromycin if allergic

complications = glomerulonephritis, rheumatic fever

DDx - Kawasaki if fever > 5 days
- necrotising fasciitis/ toxic shock strep
PAIN

119
Q

cause scarlet fever

A

group A beta haemolytic streptococcal

120
Q

Mx Kawasaki

A

IVIG and aspirin

121
Q

erythematous rash that is polymorphous and can be urticarial, scarlatiniform or morbilliform; there may be small aseptic pustules

Cervical lymphadenopathy

Oedema (may be subtle)

Erythema palms and soles + desquamation of the hands and feet occurs

Bilateral conjunctival injection

Change in mucous membranes in the upper respiratory tract (eg injected pharynx, dry cracked lips, or strawberry tongue).

A

Kawasaki

122
Q

cause roseola infantum/exanthum subitum

A

HHV6

123
Q

need school exclusion for roseola infantum?

A

no

124
Q

high fever
then develop rash
Nagayama spots: papular enanthem on the uvula and soft palate
febrile convulsions
diarrhoea and cough are also commonly seen

A

Roseola infantum (HHV6)

Year 5 Specialties (2 decks)

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