passmed all (2) Flashcards
Reason for: Isolated fever in well patient in first 24 hours following surgery?
Physiological response to operation/surgery
ddx: wound infection: but symptoms would come after 48 hours post-op.
Women having medical management of a miscarriage should be offered ? (as well as vaginal misoprostol: with no cardiac activity)
Antiemetics and pain relief
when is warfarin preferred over DOAC?
- prosthetic valve
- antiphospholipid syndrome
- upper GI bleed
Most sensitive and specific lab finding for diagnosis of liver cirrhosis in those with chronic liver disease?
Thrombocytopenia (platelet count <150,000 mm^3) is the m
- NB: platelet and clotting factors effected
ukmec 4 eg. condition CI COCP?
Positive antiphospholipid antibodies (e.g. in SLE) is UKMEC 4 for the COCP
what medication is associated with Achilles tendon rupture?
Ciprofloxacin
what is given to treat: von willebrand and haemophilia?
Desmopressin
- because it stimulates release of Von-Willebrand factor from endothelial cells.
another name for Buerger’s disease?
Thromboangiitis obliterans:
presents with: Raynaud’s + extreme ischaemia
L sided homo hemianopia?
Homonymous hemianopia
incongruous defects: lesion of optic tract
congruous defects: lesion of optic radiation or occipital cortex
macula sparing: lesion of occipital cortex
opposite side as affected
Treatment for chronic heart failure?
ABC
- 1st) Ace-inhibitor
- 2nd) beta blocker
- 3rd) Spironolactone
common cause of unilateral conductive hearing loss?
Ear wax build up
NB: Age-related hearing loss and Noise-related hearing loss are both types of sensorineural hearing loss.
Medication to stop before surgery (Anaesthetics)
Advise women to stop taking their COCP/HRT 4 weeks before surgery
eg. Femoston
SSRI of choice in children and teens (includes if patient is 16 years old).
Fluoxetine is the SSRI of choice in children and adolescents.
Depression + mania symptom management: (if already on sertraline) ?
STOP sertraline, (lithium takes long to work, therefore not good for emergency symptom management) but lithium can take up to 2 weeks to become effective, so a second-generation antipsychotic (eg. Olanzapine) would be used first. Lithium would be used if the response to the antipsychotic is inadequate.
1st c -section mother: what mode of delivery is optimal for 2nd child?
Planned Vaginal birth after Caesarean (VBAC) is an appropriate method of delivery for pregnant women at >= 37 weeks gestation with a single previous Caesarean delivery. (70-75% have successful delivery)
Fibroadenoma mx. if experiencing discomfort, pain and more than 3cm in size?
Refer patient for surgical excision.
PPROM: (preterm prelabour rupture of membranes)= management?
In preterm prelabour rupture of membranes, antenatal corticosteroids (IM steroids) should be administered to reduce the risk of respiratory distress syndrome
Name of transfusion management in sickle cell crisis? (with high reticulocytes)
give Exchange transfusion
SUFE surgical management?
Internal Fixation
Fitz-Hugh Curtis Syndrome:
Pelvic inflammatory disease may progress to perihepatitis, characterised by RUQ pain
(Underlying cause= Chlamydia/STI)
Anaesthetics: Dropping oxygen saturations following intubation
Oesophageal intubation:
Endotracheal tube is most likely accidentally placed down oesophagus
Tamoxifen side effects:
- VTE
- Endometrial cancer
NB: Anastrozole side effects: is osteoporosis (think because post-menopause)
Pseudomonas Aeruginosa mx. in cystic fibrosis young child?
Oral Ciprofloxacin: must treat this over bronchiectasis chest physiotherapy first.
what is Pyogenic Granuloma
Pyogenic granuloma
Trauma is a common precipitant of pyogenic granuloma and contact bleeding and ulceration are common.
Abx treatment for legionella pneumonia?
Macrolides such as cLarithromycin are used to treat Legionella
Hypercalcaemia + bilateral hilar lymphadenopathy, what diagnosis?
Sarcoidosis
Primary Hyperaldosteronism (conn’s): most likely cause?
- NB: presents with= very high BP and Hypokalaemia
if palpitations then ddx= Phaeochromocytoma
1) bilateral adrenal hyperplasia
2) Adrenal adenoma
Urinary incontinence + gait abnormality + dementia = ? diagnosis
normal pressure hydrocephalus
Mx: is Ventriculoperitoneal shunting
Heart failure + reduced ejection fraction (if continue to have symptoms) mx? (if already on ACE-i and BB), next line?
Offer a mineralcorticoid receptor antagonist (spironolactone), in addition to an ACE inhibitor (or ARB) and beta-blocker, to people who have heart failure with reduced ejection fraction if they continue to have symptoms of heart failure.
not furosemide
Rheumatic fever:
Presentation of a preceding sore throat, migratory joint pains involving large joints such as knees, hips and ankles, pink ring-shaped lesions on the trunk (erythema marginatum), and jerking movements of the face and hands (Sydenham chorea) are all characteristic features of rheumatic fever.
Management of spasticity in MS?
Baclofen and Gabapentin= 1st line
diabetes medication: for high bmi patient?
SGLT-2 inhibitors have the beneficial side effect of weight loss in patient with T2DM
what condition will show: Extremely high-voltage QRS complexes?
Left ventricular hypertrophy (LVH).
Tender goitre (thyroid) what condition?
Subacute De quervain’s thyroiditis
If NON-tender goitre + raised free T4+ low TSH= Graves disease
Side effects of thiazide diuretics?
All thiazide-related diuretics commonly result in:
- Hyponatraemia
- Hypokalaemia
- Hypercalcaemia
- Hypocalciuria.
what investigation should all TIA patients have?
Should have an urgent carotid doppler unless they are not a candidate for carotid endarterectomy.
