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Finals flashcards > Passmed > Flashcards

Passmed Flashcards

1
Q

Calculate breakthrough dose of morphine

A

1/6 of total daily dose.

Prescribe with laxative, potentially anti-emitic. Oral modified-release morphine is preferential to transdermal.

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2
Q

Difference b.w RAST and skin prick test

A

Skin prick test also tests for irritants. Useful for contact dermatitis.

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3
Q

Causes of hypercalcaemia

A

Primary hyperparathyroidism and malignancy are most common.

Sarcoidosis, thiazides.

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4
Q

How does achalasia present?

A

Dysphagia of solids and liquids from start + heartburn.

Regurg of food can = cough, aspiration pneumonia

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5
Q

RF for oesophageal candidiasis causing dysphagia

A

HIV
Steroid use
Tx with systemic AB

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6
Q

How does myasthenia gravis dysphagia present?

A

Solids and liquids,

Ptosis or extra-ocular muscle weakness.

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7
Q

How does oesophagitis present?

A

Odynophagia, possibly heartburn. No weight loss.

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8
Q

How does oesophageal cancer present?

A

Dysphagia + weight loss, possible vomiting during eating.

PMH: Barrett’s, GORD, smoker/drinker

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9
Q

Investigations for dysphagia

A

Upper GI endoscopy.
Fluoroscopic swallow studies for motility disorders.
Manometry for achalasia.

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10
Q

How is aplastic anaemia defined?

A

Bone marrow failure = pancytopenia

Normocytic anaemia + leukopenia + thrombocytopenia.

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11
Q

How does aplastic anaemia present? Causative drug?

A

May have bleeding.

Phenytoin

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12
Q

Drugs causing Parkinsonism

A

Anti-psychotics, metoclopramide

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13
Q

How do you differentiate tremor in idiopathic vs drug-induced Parkinsonism?

A

Idiopathic = unilateral resting tremor, older patient.

Drug-induced = symmetrical tremor, possibly hx of schizophrenia.

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14
Q

What do tear drop cells on a blood film indicate?

A

Thalassaemia, myelofibrosis or megaloblastic anaemia.

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15
Q

What is myelofibrosis and how may it present?

A

Blood cancer affecting bone marrow.

Old patient with anaemia, weight loss/night sweats (from hypermetabolism), early satiety (massive splenomegaly).

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16
Q

Mx of secondary pneumothorax

A

Over 2cm/sob- chest drain, otherwise aspirate if 1-2cm.

If under 1cm, admit with 02.

17
Q

Mx of primary pneumothorax

A

Over 2cm = Chest drain.

Under 2cm, either discharge or aspirate if sob.

18
Q

What is haematocrit?

A

Ratio of volume of rbc to the volume of blood

19
Q

Status epilepticus mx

A

ABC
IV lorazepam, repeat after 10-20mins
If status is ongoing, start second line agent (phenytoin, phenobarbital).
If refractory, general anaesthetic.

20
Q

Differentiating polycythaemia

A

A true polycythaemia can be primary (myeloproliferative disorder), or secondary (reactive to abnormal EPO or O2). Hypercoaguable state.

A relative polycythaemia is from dehydration/diuretics.

21
Q

Acute interstitial nephritis: cause, presentation, mx

A

Usually drugs- AB.
Fever, rash, joint pain. Deranged Us and Es.
Most cases resolve when AB is stopped.

22
Q

Recommended weekly alcohol intake

A

Max 14 units (men and women).

Pregnant women shouldn’t drink.

23
Q

How much is one unit of alcohol?

A

10ml ethanol

strength x volume / 1000

24
Q

How does neuroleptic syndrome present and in whom?

A

Pyrexia, muscle rigidity (raised CK and potential AKI), delirium, autonomic lability (tachy, hypertension)

Patients taking antipsychotics, or stopping levodopa suddenly

25
Q

Mx of neuroleptic syndrome

A

Stop anti-psychotic

IV fluids to prevent renal failure.

26
Q

MOA for furosemide and bumetanide

A

Block NaKCl co-transporter on ascending loop, so less is reabsorbed

SE: hyponat, k, magnesaemia

27
Q

What does the facial nerve supply? (FETT)

A

Facial expression muscles
Ear- nerve to stapedius
Taste- anterior 2/3 of tongue
Tear- parasympathetic fibres to lacrimal glands and salivary glands

28
Q

Differentiate UMN and LMN lesions

A

UMN lesion spares the forehead, LMN affects all facial muscles.
UMN = contralateral
LMN = ipsilateral

29
Q

Causes of LMN lesion of facial nerve

A

Ramsay-hunt syndrome (due to Herpes Zoster)
Bell’s palsy
MS
Acoustic neuroma

30
Q

Cause of UMN lesion of facial nerve

A

Stroke

31
Q

What does APTT measure?

A

Intrinsic pathway (APTT- factor VIII, for which VWF is a carrier molecule)

vs

Extrinsic (PT- factor VII)

32
Q

Who and how does haemolytic uraemic syndrome present?

A

Young children with a triad of:

AKI
Haemolytic anaemia
Thrombocytopenia

33
Q

Cause of HUS

A

Most commonly due to E.coli producing shiga toxin. Causes diarrhoea that becomes bloody 1-3 days into onset.

34
Q

Inv for HUS

A

FBC including film, Us and Es, stool culture

35
Q

Mx of HUS

A

Supportive: fluids, dialysis, transfusion if required. AB little role.

Finals flashcards (15 decks)

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