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Year 3 Conditions > Passmed > Flashcards

Passmed Flashcards

1
Q

How does oesophagitis present

A

Odonyphagia
Dysphagia
Systemically well

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2
Q

Risk factors for oral candidiasis

A

HIV

Steroid inhalers

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3
Q

Difference between primary and secondary addisons

A

Primary problem is at level of adrenals

Secondary problem is at level of pituitary

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4
Q

Causes of primary adrenal insufficiency

A

TB
Autoimmune
Metastasised cancer
Waterhouse friederichsen syndrome

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5
Q

Causes of secondary addisonian insufficiency

A

Tumours, radiation and infiltrative diseases of pituitary

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6
Q

In which type of adrenal insufficiency is hyperpigmented skin seen

A

Primary

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7
Q

What is most common complication of meningitis

A

Sensorineural hearing loss

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8
Q

Complications of meningitis

A 
Sensorineural hearing loss
Intracerebral abscess
Sepsis
Hydrocephalus
Epilepsy
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9
Q

If have acute mastoiditis what is most important cause to rule out

A

Meningitis

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10
Q

What factors would suggest rythm control as opposed to rate

A

Under 65
Symptomatic
Secondary to identifiable source like alcohol
First presentation

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11
Q

What factors would suggest just rate control in a fib

A

Over 65

IHD history

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12
Q

What is drug given in HF for AF

A

Digoxin

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13
Q

Alternatives to beta blockers in AF rate control

A

CCB

Digoxin

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14
Q

Rythm controlling drugs AF

A

Flecainide
Amiodarone
Sotalol

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15
Q

Does ablation reduce stroke risk

A

No- must anticoagulate still for life

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16
Q

If having ablation what is preparation

A

Anticoagulate for 4 weeks

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17
Q

Complications of ablation

A

Cardiac tamponade
Pulmonary valve stenosis
Stroke

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18
Q

What gives AF or an SVT a broad complex tachycardia

A

A bundle branch block

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19
Q

Treatment for torsades des pointes

A

IV magnesium sulphate

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20
Q

Contraindications for a chest drain

A

Bullae
INR less than 1.3
Platelets less than 75
Pleural adhesions

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21
Q

What test is used to diagnose herpes

A

Nucleic acid amplification test

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22
Q

Stage 1 AKI

A

Creatinine 1.5-1.9 x baseline

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23
Q

Stage 2 AKI

A

Creatinine 2.0-2.9x baseline

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24
Q

Stage 3 AKI

A

Creatinine >3X baseline or on RRT

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25
Q

What does tumour lysis syndrome lead to

A

AKI

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26
Q

Affected motility in ank spond

A

Reduced lateral flexion

Reduced forward flexion

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27
Q

What happens to spine shape in ank spond

A

Loss of lumbar lordosis

Accentuated thoracic kyphosis

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28
Q

What is main valvular disease associated with ehlers danlos

A

Mitral regurg

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29
Q

In questions how does ehlers danlos present

A

Hypermobility of joints

Striae

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30
Q

What type of disorder is ehlers danlos

A

Collagen disorder

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31
Q

First line treatment for all generalised seizures

A

Sodium valproate

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32
Q

First line treatment for all focal seizures

A

Carbamezapine

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33
Q

Second line tx for tonic clonic seizures

A

Lamotrigine

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34
Q

Problem with carbamezapines for generalised seizures

A

Can exacerbate absence and myoclonic seizures

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35
Q

What does it mean if glucose unrecordable

A

That its extremely high not low as can always be measured no matter how low

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36
Q

Pathophysiology of DKA

A

Insulin should inhibit lipolysis but this process becomes poorly controlled leading to conversion of fatty acids to ketones

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37
Q

If patient has low GRACE risk what do

A

Dual antiplatelets

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38
Q

In NSTEMI and UAP when would you not immediately give fondaparinaux

A

If having PCI soon

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39
Q

When must EBV testing be done

A

In second week of disease

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40
Q

What is NICE diagnostic criteria for EBV

A

Monospot and FBC in second week of disease

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41
Q

Which are 2 beta blockes shown to improve mortality in HF

A

Carvedilol

Bisoprolol

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42
Q

Causes of hyposplenism

A

Coeliac disease

Splenectomy

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43
Q

Blood film findings of hyposplenism

A 
target cells
Howell-Jolly bodies
Pappenheimer bodies
siderotic granules
acanthocytes
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44
Q

Investigations for subacute thyroiditis

A

ESR

Iodine 131 radiouptake

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45
Q

Iodine 131 radio uptake finding de quervains

A

Reduced globally

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46
Q

Management of subacute thyroiditis

A

NSAIDS

Normally self limiting

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47
Q

What is name of thyroid iodine 131 uptake scan

A

Thyroid scintigraphy

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48
Q

If present with STEMI after 12 hours what would indicate PCI

A

Cardiogenic shock

On going ST elevation

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49
Q

What is associated spleen complication of coeliac

A

Hyposplenism

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50
Q

What do you do for someones regular insulin in DKA

A

Stop short acting and continue long acting insulin

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51
Q

What happens to PR segment in pericarditis

A

PR segment depression

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52
Q

If a patient has antiphospholipid syndrome and severe new onset headache what is most likely cause

A

Cavernous sinus thrombosis

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53
Q

Medical causes of third nerve palsies

A

DM

Vasculitis

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54
Q

Associated conditions of IgA nephropathy

A

alcoholic cirrhosis
coeliac disease/dermatitis herpetiformis
Henoch-Schonlein purpura

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55
Q

Most common exacerbating organism for COPD and bronchiectasis

A

Haemophilus influenzae

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56
Q

Who is isolated systolic HTN seen in

A

The elderly

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57
Q

How is isolated systolic HTN managed

A

Same as normal HTN

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58
Q

How should patients on methotrexate or other immune modifying drugs be managed when have gastroenteritis

A

Stool sample and abx

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59
Q

Which BP drug gives cold peripheries

A

Beta blockers

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60
Q

Management of idiopathic bilateral adrenal hyperplasia

A

Spironolactone

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61
Q

What is conns syndrome

A

Aldosterone producing adenoma

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62
Q

What is most common cause of primary hypperaldosteronism

A

Idiopathic bilateral adrenal hyperplasia

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63
Q

2 most common cause of primary hyperaldosteronism

A

Idiopathic bilateral adrenal hyperplasia

Conns syndrome

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64
Q

How does primary aldosteronism present

A

HTN

Hypokalaemia sx like polyuria and weakness

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65
Q

First investigation for suspected primary hyperaldosteronism

A

Aldosterone/renin ratio

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66
Q

Rfx for carpal tunnel

A

Pregnancy
Diabetes
Acromegaly

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67
Q

2 tests for carpal tunnel

A

Tinnels- tap on the wrist to elicit tingling

Phalensflexion of hands for 1 minute against eachother

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68
Q

What drug can lead to post prandial hyperglycaemia problems

A

Thiazides

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69
Q

When can aspirin only be given in stroke

A

Once CT performed

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70
Q

Most common source of mets to brain

A

Lung

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71
Q

What is test used to track eradication of H pylori

A

urease breath test

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72
Q

What conditions are associated with thymomas

A

MG
SLE
SIADH
Dermatomyositis

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73
Q

In NSTEMI if is high risk of bleeding what is given alongside aspirin

A

Clopidogrel

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74
Q

In NSTEMI if is no high risk of bleeding what is given alongside aspirin

A

Ticagrelor

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75
Q

How does a myxoedema coma tend to present

A

Confusion

Hypothermia

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76
Q

How can macrocytic anaemia be classified

A

Megaloblastic

Normoblastic

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77
Q

What rythm control is used AF in HF

A

Amiodarone

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78
Q

What antibiotic most commonly cause C diff

A

Ceftriaxone

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79
Q

What causes painful stiff joint after trauma in young person with normal x ray

A

Haemophilia A

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80
Q

Management plan for inducing remission crohns

A

1st line- glucocorticoids
2nd line- 5-ASA drugs
3rd line- mercatopurine or azathioprine/methotrexate

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81
Q

Management plan for maintaining remission crohns

A

1, azathioprine or mercatopurine

2. methotrexate

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82
Q

What causes recurrent hypoglycaemia in a chronic T1DM sufferer

A

Neuropathy of autonomic NS

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83
Q

Most important dietary tip with ascites

A

Restrict sodium

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84
Q

What is headache with swinging fever typically

A

Brain abscess

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85
Q

Causes of hypoglycaemia

A 
Too much insulin
Missing meals
Liver disease
Insulinoma in pancreas
Autonomic neuropathy in long term T1DM
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86
Q

How does UC appear on barium swallow

A

loss of haustrations
superficial ulceration, ‘pseudopolyps’
long standing disease: colon is narrow and short -‘drainpipe colon’

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87
Q

What are fusion and capture beats

A

When P wave and QRS complex merge often seen in VT

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88
Q

When are only times try to manage rythm in AF

A

If HF
First presentation
Is reversible cause

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89
Q

What are 4 types of AF

A

First time detected
Paroxysmal
Permenant
Persistent

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90
Q

What is paroxysmal AF

A

Recurrent episodes that termiante spontaneously lasting less than 7 days

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91
Q

What is permenant AF

A

When AF refractory to cardioversion so is continuous

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92
Q

What is persistant AF

A

Episodes of AF lasting more than 7 days that dont spontaneously terminate

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93
Q

What is likely cause of parkinsons in a young person

A

Wilsons

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94
Q

What shows a starry night appearance on histology

A

Burkitts lymphoma

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95
Q

What presents with tall R waves in leads V1-4

A

Posterior MI

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96
Q

Features of beta thalassaemia trait

A

Disproportionate microcytic anaemia

Raised HbA2

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97
Q

Causes of resp alkalosis

A 
anxiety leading to hyperventilation
pulmonary embolism
salicylate poisoning early on
CNS disorders: stroke, subarachnoid haemorrhage, encephalitis
altitude
pregnancy
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98
Q

Wihch cause of nephrotic syndrome has strong association with malignancy

A

Membranous change nephropathy

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99
Q

What is PTH in tertiary hyperparathyroidism

A

Massive

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100
Q

O/E of liver abscess

A

RUQ tenderness
Fever
Hepatomegaly
Jaundice

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101
Q

Risk factors for liver abscess

A

Underlying biliary tree disease
Intrahepatic procedures
DM

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102
Q

When cant aspirate liver abscess

A

If entamoeba suspected

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103
Q

Main way to tell if ramsay hunt syndrome

A

Vesicles in ear

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104
Q

What presents with red eye lids

A

Blepharitis

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105
Q

Management abx for COPD infective excacerbation

A

Amox then either clarithomycin or doxycycline

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106
Q

If Chad Vasc score is 0 in recently diagnosed AF what is next step in management

A

Do an echo to exclude valvular disease

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107
Q

What is main condition get torsades des pointes from

A

Long QT

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108
Q

How to assess volume status

A

Skin turgor
Mucosal membranes
Look at BP and HR
Cap refill

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109
Q

What can cause ST elevation with no coronary blockage

A

Takotsubo

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110
Q

What is drug given in myxoedema coma

A

Liothyroxine as is active T3

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111
Q

What type of MI do you often see new onset HB

A

Inferior as AVN is supplied by RCA

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112
Q

What oxygen should all critically ill COPD patients be given

A

15L as hypoxia kills

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113
Q

What causes AKI in patients who have fallen and been there dor a while

A

Rhabdomyolysis

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114
Q

Most appropriate fluid replacement in rhabdomyolysis

A

Normal saline

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115
Q

What happens to calcium in rhabdomylolysis

A

Low as binds to myoglobin

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116
Q

What happens to phosphate in rhabdomyolysis

A

High as releases from myocytes

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117
Q

What can give disproportionately high creatinine

A

Rhabdomyolysis

118
Q

What is eplerenone

A

Aldosterone antagonist

119
Q

First line management of HF long term

A

Beta blocker or ACEi- ideally just start 1 at a time

120
Q

Second line management of HF long term

A

K+ sparing diuretics

121
Q

What must be measure constantly when on spironolactone or eplerenone

122
Q

Third line management of HF long term

A

Done by specialist

  • digoxin
  • resynchronisation therapy
  • ivabradine
  • hydralazine if afro carribean
123
Q

What is management plan of someone in acute heart block

A

Atropine if bradycardic

External pacing

124
Q

SEs of hypothyroid therapy

A

hyperthyroidism: due to over treatment
reduced bone mineral density
worsening of angina
atrial fibrillation

125
Q

How long must patient eat gluten for before being tested

126
Q

Thing to remember with 80 in CORD-80

A

If over 80 and stage 1 dont treat

127
Q

If COPD isnt a chronic retainer what is O2 sats target

128
Q

How to tell from ABG if chronic retainer of CO2

A

Look if HCO3 raised

129
Q

What condition is associated with takayashus

A

Renal artery stenosis

130
Q

Which thyroid cancer appears in young females

131
Q

Which is heart site where have problem of supplied by 80% in most people and 20 in others

A

Posterior
Circumflex in 80%
Right in 20%

132
Q

Which blood test is most useful in eliciting cause of hypocalcaemia

133
Q

What are 3 early signs of haemochromatosis

A

Erectile dysfunction
Arthralgia
Fatigue

134
Q

Other than hands what can an essential tremor affect

A

The vocal chords- see change in voice

135
Q

Gold standard diagnosis for PSC

136
Q

Management of psittacosis

A

Doxycycline 1 st line

Erythomycin 2nd line

137
Q

In an asymptomatic patient how many abnormal Hba1c’s are needed

138
Q

What causes SOB in Lupus

139
Q

In SLE what are the types of pleural effusion

140
Q

How often can you repeat adrenaline in anaphylaxis

A

Every 5 mins

141
Q

What commonly do children with migraines also have

A

GI disturbances

142
Q

Complications of mycoplasma pneumonia

A

Haemolytic anaemia
Erythema multiforme
GBS

143
Q

What electrolyte disturbances does long term PPI use cause

A

Hypomagnesia

PPIs

144
Q

Causes of AKI if had resp infection 3 weeks ago and started on abx

A

Could be post strep glomerulonephritis

ATN from abx

145
Q

How does ATN respond to fluids

A

Very poorly

146
Q

CNS complications of HIV

A

Toxoplasmosis

CNS primary lymphoma

147
Q

How to differentiate CNS lymphoma from toxoplasmosis in HIV patient

A

CNS lymphoma normally only one lesion

148
Q

What is buergers disease also caused

A

Thromboangiitis obliterans

149
Q

What is main risk factor for buergers disease

150
Q

How does buergers disease present

A

Raynauds phenomena

Limb ischaemia signs

151
Q

Strongest risk factor for bell palsy

152
Q

Which dementia tends to have the most fluctuating episodes of cognition

153
Q

NICE definition of NASH

A

Must have consumption of less than 20g (2.5 units) per day in women, and less than 30g (3.75 units) per day in men

154
Q

If started on PPIs for suspected GORD and they dont work what is next management

A

Test for H pylori

155
Q

What is difference in use of rockall and batchford

A

use the Blatchford score at first assessment, and

the full Rockall score after endoscopy

156
Q

Why is sushi chef significant in dysphagia history

A

Means eaten a lot of fish that contain nitrosamines a known carcinogen

157
Q

What can stomach fullness in SBA mean

A

Splenomegaly

158
Q

Management of necrotising fasciitis

A

IV abx and surgical debridement

159
Q

First line treatment for c diff

A

Metronidazole then vancomycin if not responding

160
Q

When can aspirin be continued if in AKI

A

If aspirin is cardioprotective

161
Q

What type of seizure is parasthesia seen in

162
Q

What type of seizure are plucking at clothes and hallucinations seen in

163
Q

What type of seizures are floaters seen in

164
Q

DDx for floaters seen on vision

165
Q

What are ddx for floaters seen in vision

A

Migraine

Epilepsy

166
Q

What is hyperthyroidism even in absence of exopthalmos and pretibial myxoedma

167
Q

Blood findings of antiphospholipid syndrome

A

Very paradoxical as have prolonged APTT and reduced plts

168
Q

Way to remember thyroid cancer

A

Please follow my arse

169
Q

Which thyroid cancer most commonly presents with compression sx

A

Anaplastic

170
Q

Which thyroid cancer secretes calcitonin

171
Q

What arthritis gives pencil in a cup appearance

A

Psoriatic arthritis

172
Q

Diagnostic test for haemochromatosis

A

Liver biopsy showing perl stain

HFE genetic testing

173
Q

Differentials for sun tanning

A

Haemochromatosis

Primary addisons

174
Q

What is most common organ causing infection secondary to peritoneal dialysis

A

Staph epidermis

175
Q

What antibodies are tested for in polymyositis

A

Anti jo

Anti Mi 2

176
Q

Which bone does pagets most commonly affect

177
Q

Which bones does pagets generally affect

A

Pelvis
Long bones
Skull

178
Q

What is prefferred anticoagulant for stroke prevention

A

Clopidogrel

179
Q

What is second line stroke anticoagulant

A

Aspirin and MR dipyramidole

180
Q

What happens to complement in SLE

A

C3 and C4 are very low

181
Q

How long does it take for HIV abs to form

A

up to 12 weeks

182
Q

Long term management of coeliac

A

Avoid gluten

Pneumococcal vaccination

183
Q

What murmur is associated with carcinoid syndrome

A

Plmonary stenosis

184
Q

Management plan for barretts oesophagus

A

endoscopic surveillance with biopsies
high-dose proton pump inhibitor: whilst this is commonly used in patients with Barrett’s the evidence base that this reduces the change of progression to dysplasia or induces regression of the lesion is limited

Endoscopic surveillance
for patients with metaplasia (but not dysplasia) endoscopy is recommended every 3-5 years

If dysplasia of any grade is identified endoscopic intervention is offered. Options include:
endoscopic mucosal resection
radiofrequency ablation

185
Q

O/E of TB

A 
Fever
Bronchial breath sounds
Crackles
Erythema nodosum
Cachexia
186
Q

What is cough like in TB

A

In first 2 weeks dry then becomes productive

187
Q

What is in posterior stroke classification

A

LOC
Isolated homonymous hemianopia
Cerebellar signs or brainstem signs

188
Q

What is in lacunar stroke syndrome

A

Full sensory loss
Weakness in 2 together of face arms and leg
Ataxic hemiparesis

189
Q

What are 5 types of lacunar stroke

A 
Pure sensory loss
Mixed sensorimotor
Clumsy hand
Ataxic hemiparesis
Pure motor
190
Q

What do clumsy hand strokes present with

A

Dysarthria

Weakness of hands when epsecially writing

191
Q

What happens in ataxic hemiparesis

A

Ataxic signs with weakness on that side too- stroke is contralateral

192
Q

What causes flash pulmonary oedema in an MI

A

Mitral regurg

193
Q

Management of listeria meningitis

A

Ampicillin plus gentamycin

194
Q

What is aphasia called when lesion on arcuate fasiculus

A

Conduction aphasia- difficulty repeating self, speech fluent and comprehension intact

195
Q

Causes of hep b flare ups

A

Alcohol

Hep D superinfection

196
Q

What ab can be positive in UC

197
Q

What cancer does H pylori infection predispose you to

A

Gastric lymphoma in the antrum

198
Q

How do gastric lymphomas present from H pylori

A

Fever
Dyspepsia
Wt loss

199
Q

What causes shooting pains after shingles

A

Post herpetic neuralgia

200
Q

Treatment for post herpetic neuralgia

A

Amitryptiline
Gabapentin
Duloxetine
If isnt working you switch dont add drugs

201
Q

Examples of neuropathic pain

A

Trigeminal neuralgia
Diabetic neuropathy
Prolapsed inter-vertebral disc
Post herpetic neuralgia

202
Q

What patch can be used for post herpetic neuralgia

203
Q

What causes a DKA patient to become confused after being treated

A

Cerebral oedema

204
Q

Complications of DKA

A

gastric stasis
thromboembolism
arrhythmias secondary to hyperkalaemia/iatrogenic hypokalaemia
iatrogenic due to incorrect fluid therapy: cerebral oedema*, hypokalaemia, hypoglycaemia
acute respiratory distress syndrome
acute kidney injur

205
Q

What post MI complications leads to persistent ST elevation and LVF

A

Aneurysm formation

206
Q

What is most sensitive blood part to measure to see if patient with chronic liver disease has progressed to cirrhosis

A

Platelets less than 90

207
Q

In liver cirrhosis what does LFT picture look like

208
Q

How is liver cirrhosis managed

A

Stop drinking
When first diagnosed OGD to look for varices
US every 6 months to look for liver hepatocellular carcinoma and measure serum AFP

209
Q

Most specific imaging for diagnosing liver cirrhosis

A

Liver biopsy showing regenerative nodules

210
Q

Modern less invasive way of determining if progressed to cirrhosis

A

Transient elastography

211
Q

What is transient elastography

A

US waves is passed through liver and determines how ‘elastic’ the liver is

212
Q

What is anticoagulation given to severe renal failure patients for a PE

213
Q

How does shingles present on chest

A

Pain precedes the rash

214
Q

Main examination sign for boerhaves perforation

A

Crepitus over mediastinum

215
Q

What is triad for boerhaves perforation called

216
Q

What is in mackler triad

A

vomiting
thoracic pain
subcutaneous emphysema

217
Q

CXR finding of mitral stenosis

A

Left atrial enlargement

218
Q

What are main risk factors for dermatomyositis

A

CTD

Underlying malignancy from normally ovarian, breast and lung

219
Q

What is main feature of dermatomyositis skin rashes

A

Photosensitive

220
Q

Investigations for dermatopolymyositis

A

ANA
Anti Jo 1
Anti Mi 2

221
Q

How do you differentiate between unilateral and bilateral adrenal hyperplasia if CT is unremarkable

A

Adrenal venous sampling

222
Q

What happens in adrenal venous sampling

A

Adrenal veins are cannulated

223
Q

If someone with addisons is vomiting in their illness what is management step

A

Switch to IM steroids

224
Q

How does AIN present

A

Normally following abx prescription
Widespread erythematous rash
Joint pain
AKI signs

225
Q

Investigations for AIN and findings

A 
HTN on obs
Bloods
- eosinophilia
- mild AKI
Urinalysis
- white cell casts
- sterile pyuria
226
Q

What is 4th heart sound heard in

A

HTN
Aortic stenosis
HOCM

227
Q

Investigations for a vestibular schwannoma

A

audiogram and gadolinium-enhanced MRI head scan

228
Q

For stable angina what CCB must be given alongside a beta blocker

A

Amlodipine or nifedipine

229
Q

If on a CCB monotherapy in stable angina what drugs can be given

A

Verapamil or diltiazem

230
Q

Why cant beta blockers and verapamil/diltiazem be given together

A

Risk of complete HB

231
Q

If patient with stroke is under 55 and ECG shows no abnormalities what is next investigation

A

Autoimmune and thrombophilia screen

232
Q

What causes excess bleeding in the elderly with increased APTT

A

Acquired haemophilia

233
Q

What can cause acquired hemophilia

A

Malignancy
Pregnancy
Old age

234
Q

What is the hepatomegaly in budd chiari

235
Q

If spirometry is negative for suspected asthma what is next step

A

FeNO testing as asthma cant be ruled out

236
Q

What is used for rate control in AF if b blockers contraindicated

A

CCB like diltiazem

237
Q

What is whipples triad

A

hypoglycaemia with fasting or exercise
reversal of symptoms with glucose
recorded low BMs at the time of symptoms is hallmark for an insulinoma

238
Q

What are insulinomas associated with

239
Q

What is electrical alternans seen on ECG of

A

Cardiac tamponade

240
Q

How to differentiate between ATN and AIN on standard urine dip

A

AIN has high WCC

241
Q

What presents with more pain on swallowing saliva

A

Globus pharyngis( feeling of lump in throat)

242
Q

What tumours are NF1 associated with

A

phaeochromocytromas

243
Q

How does NF1 affect children

A

Can delay growth

244
Q

How can sepsis affect neutropenic count

A

Neutropenia

245
Q

What tends to precipitate G6PD crises

A

Broad beans
Ciprofloxacin
Quinines

246
Q

What can be done to prevent SVTs from happening

A

Beta blockers

Ablation

247
Q

What drug is contraindicated in VT

248
Q

Other than myelofibrosis what else can PCV transform to

249
Q

What is first investigation for a thyroid nodule

A

Ultrasonography

250
Q

If a black diabetic is diagnosed with HTN waht drug started on

251
Q

If patient needs to be cardioverted in 3 weeks due to AF sx>48hrs what is management

A

Oral anticoagulation
Bisoprolol
DC cardioversion in 3 weeks not chemical as if sx over 2 days then has to be DC

252
Q

What is seen in mouth of someone with haemochromatosis

A

Grey slate areas

253
Q

Investigations ordered for haemochromatosis

A 
Bloods
- serum transferrin and TIBC low
- Hba1c up
HFE gene testing
Liver biopsy and MRI can show iron concentrations in liver
254
Q

What tests can be used to measure iron in liver

A

MRI

Biopsy

255
Q

What valvular disease can pulmonary HTN cause

A

Tricuspid regurg

256
Q

What are investigations for wilsons

A

Bloods- low serum copper, high blood free copper, low caeruplasmin
Liver biopsy showing high copper conc
MRI of brain showing face of giant panda sign, typically affects basal ganglia

257
Q

What is face of giant panda seen in

A

Wilsons disease

258
Q

Which thyroid cancer spreads quickly to lymph nodes

259
Q

What is management of severe c diff infection ie with hypotension

A

Metro and vanco

260
Q

What is livedo reticularis seen in

A

Anti phosopholipid syndrome seen in

261
Q

What is done immediately for unstable NSTEMI patients

262
Q

If in status elipticus what are 2 things to immediately rule out

A

Hypoxia

Glucose problems

263
Q

Aneurysm in what artery tends to cause third nerve palsy

A

Posterior communicating

264
Q

What can lead to elevated CK

A

Polymyositis

265
Q

What tends to cause polymyositis

A

Underlying cancer

266
Q

What gastroenteritis often presents with a flu like prodrome

A

Campylobacter

267
Q

If thrombolysing a patient what must be given alongside alteplase

A

An antithrombin drug like enoxaparin

268
Q

Rfx for pseudogout

A

haemochromatosis
hyperparathyroidism
low magnesium, low phosphate
acromegaly, Wilson’s disease

269
Q

How to differentiate between aortic stenosis and aortic sclerosis on auscultation

A

Sclerosis doesnt radiate to carotids

270
Q

What site of gall stones may prompt surgical intervention

A

Common bile duct

271
Q

What blood test can differentiate between T1DM and T2DM

A

C-peptide will be high in T2

272
Q

What is a slit lamp test

A

Used in wilsons diagnosis- very complicated machine

273
Q

What can be heard on auscultation of pulmonary HTN

274
Q

Prophylaxis of meningitis given to contacts

A

Ciprofloxacin

275
Q

DDx for acute joint pain

A

Septic arthritis
Crystal arthritis
Reactive arthritis
Haemoarthritis

276
Q

What is CREST syndrome a subtype of

A

Limited cutaneous systemic sclerosis

277
Q

What is main complication of diffuse systemic sclerosis

A

ILD
Others include
Pulmonary HTN
Severe renal disease

278
Q

How does a severe systemic sclerosis renal crisis present

A

abrupt onset severe hypertension alongside a rapidly progressing, often anuric or oliguric, renal failure

279
Q

What presents with sudden onset headaches and oligouria

A

Malignant HTN

Often think about systemic sclerosis

280
Q

What can be seen on x ray of aortic coarctation

A

Notching of the inferior part of the ribs

281
Q

Which CKD causes lead to enlarged kidneys

A

Diabetic nephropathy
PCKD
Amyloidosis

282
Q

On MCS of CSF what gives gram positive diplococci/chain

A

Strep pneumoniae

283
Q

On MCS of CSF waht gives gram negative bacilli

284
Q

On MCS what gives gram negative coccobacilli

A

H influenzae

285
Q

On MCS what gives gram positive rod

A

L monocytogenes

286
Q

What cant be given to patient prior to upper gi endoscopy

287
Q

Pneumonia with skin changes

A

Mycoplasma

288
Q

What can present with sudden onset weight loss

289
Q

What is given to afro carribean patient moving onto second step of HTN management

A

ARB not ACEi

290
Q

What causes nephrotic syndrome in a 30 year old male

A

FSGS- can be often idiopathic

291
Q

Cuases of predominantly hypercholesterolaemia

A

nephrotic syndrome
cholestasis
hypothyroidism

292
Q

Causes of predominantly hypertriglyceridaemia

A 
diabetes mellitus (types 1 and 2)
obesity
alcohol
chronic renal failure
drugs: thiazides, non-selective beta-blockers, unopposed oestrogen
liver disease

Year 3 Conditions (33 decks)

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