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Phase 3A > Passmed General 2 > Flashcards

Passmed General 2 Flashcards

1
Q

What is the typical presentation of Guillain-Barre syndrome?

A

Ascending, progressive, symmetrical weakness of all the limbs often preceded by an infection. Reduced reflexes,

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2
Q

What is the pathophysiology of Guillain-Barre syndrome?

A

immune-mediated demyelination of the PNS

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3
Q

Where are the majority of ectopic pregnancies?

A

97% are in the fallopian tubes

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4
Q

Which location are fibroids that are likely to prevent embryo implantation?

A

Submucosal

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5
Q

What medications are used to manage menorrhagia secondary to fibroids?

A

NSAIDs (mefenamic acid), tranexamic acid, COCP, POP

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6
Q

What medications can be used to shrink fibroids?

A

GnRH agonists

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7
Q

What tests are included in the combined test for Down’s syndrome?

A

bHCG (raised)
PAPP-A (low)
nuchal translucency (thickened)

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8
Q

What tests are included in the quadruple test for Down’s, Edwards syndrome and neural tube defects?

A

alpha-fetoprotein, unconjugated oestriol, HCG, inhibin A

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9
Q

What tests can be offered after combined screening?

A

Non-invasive prenatal screening (looks at cell-free fetal DNA)
Amniocentesis and Chorionic villous sampling

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10
Q

Which part of the pituitary secretes ADH and oxytocin?

A

Posterior

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11
Q

What is a glaucoma?

A

Optic neuropathy associated with raised intraocular pressure

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12
Q

What is the treatment for primary open-angle glaucoma?

A

1st Selective laser trabeculopathy, 2nd prostaglandin analogue eye-drops, 3rd BB eye-drops, carbonic anhydrase, sympathomimetic eye-drops

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13
Q

Which cranial nerve lesion causes a dilated fixed pupil?

A

CN III

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14
Q

What does Phenelzine do?

A

Monoamine oxidase inhibitor

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15
Q

Name three SSRIs

A

1st Citalopram and fluoxetine
2nd Sertraline

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16
Q

What investigations do you do in an acute exacerbation of asthma?

A

Vital signs
ABG if O2 sats are below 92%

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17
Q

What ECG change is associated with Wolff-Parkinson-White syndrome?

A

Short PR interval, wide QRS - with delta wave

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18
Q

What blood levels can you use to distinguish an upper GI bleed from a lower GI bleed?

A

High urea in upper GI bleed - due to blood being digested

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19
Q

What is the immediate management of patients with bradycardia and signs of shock?

A

500ug atropine - repeated up to 3mg max

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20
Q

What is the first line management of acute pericarditis?

A

NSAIDs (Naproxen) and Colchicine

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21
Q

What are the features of pericarditits?

A

Chest pain, relieved by sitting forwards, pericardial rub, saddle-shaped ST elevation, PR depression

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22
Q

What is the first line treatment for painful diabetic neuropathy?

A

Duloxetine/amitriptyline/gabapentin/pregabalin

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23
Q

What is the difference in findings of pre-renal and renal AKI?

A

Pre-renal = low urinary sodium - kidneys hold onto sodium to preserve volume
Renal = high urinary sodium - kidneys cannot retain it

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24
Q

What is the criteria for malignant hypertension?

A

BP over 180/120mmHg - send to secondary care immediately

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25
Q

What are the ECG findings on patients with hypokalaemia?

A

U waves, small or absent T waves, long PR interval, ST depression, long QT

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26
Q

What is the clinical indication for giving patients with acute bronchitis antibiotics?

A

CRP level > 100mg/L give Abx immediately
CRP level 10-100mg/L offer delayed prescription

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27
Q

What is the typical presentation of acute bronchitis?

A

Cough that typically starts off dry then becomes productive, usually resolves within 3 weeks.

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28
Q

How can you tell the difference between pneumonia and acute bronchitis?

A

bronchitis - no focal chest signs other than wheeze
pneumonia - dull to percussion, crepitations, bronchial breathing, systemic features

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29
Q

What is the difference between bronchitis and pneumonia?

A

Pneumonia is an infection of the alveoli, bronchitis affects the larger airways

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30
Q

What are the three stages of AKI?

A

1: increased creatinine to 1.5-1.9 x the baseline
reduced urine output by 0.5 for > 6 hours
2: Increased creatinine to 2-2.9 x the baseline
reduced urine output by 0.5 for > 12 hours
3: Increased creatinine to >3 x the baseline
reduced urine output by 0.3 for > 24 hours

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31
Q

What are the complications of acute lymphocytic leukaemia?

A

Anaemia, low IgG leading to infections, autoimmune haemolytic anaemia, transformation to high-grade lymphoma (Richter’s transformation)

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32
Q

What is the treatment for necrotising fasciitis?

A

Surgical debridement, IV abx

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33
Q

What changes are seen in different kidney diseases?

A

diabetic nephropathy - bilaterally enlarged then bilaterally normal
CKD - shrunken kidneys
Congenital defect - horseshoe kidney

34
Q

What is the management of a patient with a wells score for 2 +?

A

Proximal leg US within 4 hours, interim anti-coagulation

35
Q

What is the management of a patient with a wells score of 1 point or less with a suspected DVT?

A

D-dimer within 4hrs with interim anticoagulation

36
Q

What are the first line anticoagulants used in DVT?

A

Apixaban or rivaroxaban

37
Q

How long should people with DVTs have anticoagulation?

A

3 months if provoked
6 months if unprovoked

38
Q

Which blood marker is used to assess severity of a C.Diff infection?

A

Raised white cell count

39
Q

What is the first line treatment of C.Diff?

A

Oral Vancomycin for 10 days

40
Q

What blood gas changes are seen in vomiting?

A

Metabolic alkalosis - loss of protons, potassium and chloride ions

41
Q

What is the motor section of the GCS score?

A
  1. obeys commands
  2. localises to pain
  3. withdraws from pain
  4. abnormal flexion to pain
  5. extending to pain
  6. none
42
Q

What is the verbal response section of the GCS score?

A
  1. orientated
  2. confused
  3. words
  4. sounds
  5. none
43
Q

What is the eye-opening response for the GCS score?

A
  1. spontaneous
  2. to speech
  3. to pain
  4. none
44
Q

Can you give a blood transfusion to the child of jehovah’s witnesses in a life-threatening situation?

A

Yes

45
Q

Which infectious disease presents with koplik spots (small white lesions on buccal mucosa)?

A

Measles

46
Q

What is the treatment for stress incontinence?

A

Pelvic floor exercises, duloxetine (SNRI)

47
Q

What is the first line treatment of urinary incontinence?

A

urge incontinence: bladder retraining
stress incontinence: pelvic floor muscle training

48
Q

What are the features of roseola infantum?

A

high fever: lasting a few days, followed later by a maculopapular rash
Nagayama spots: papular enanthem on the uvula and soft palate
febrile convulsions occur in around 10-15%
diarrhoea and cough are also commonly seen

49
Q

What is the causative organism of roseola infantum?

A

Human Herpes Virus 6

50
Q

What are the features of hypernatremia?

A

jittery movements
increased muscle tone
hyperreflexia
convulsions
drowsiness or coma

51
Q

What is a raised Gamma GT indicative of?

A

Liver problems, alcohol misuse disorder

52
Q

What is the first line medication used in stress incontinence?

A

duloxetine

53
Q

What is the first-line investigation in reflux nephropathy?

A

Micturating cystography

54
Q

What is the treatment for pain in palliative patients with mild-moderate renal failure?

A

Oxycodone
(Fentanyl or buprenorphine for severe renal impairment (<30ml/min))

55
Q

Give an example of a macrolide antibiotic

A

axithromycin/clarithromycin

56
Q

What is the action of metformin?

A

It increases peripheral insulin sensitivity

57
Q

What age do men have AAA screening?

A

65

58
Q

What screening tests are offered to women at their booking appointment?

A

Syphilis, HIV, hep B, sickle cell and thalassaemia

59
Q

What is the first line antibiotic for tonsillitis?

A

Phenoxymethypenicillin - 10 day course

60
Q

How do you treat Ramsey-hunt syndrome?

A

Oral aciclovir and corticosteroids

61
Q

What is the treatment for suspected PE with confirmed DVT?

A

low molecular weight heparin

62
Q

How does the progesterone only pill interact with antibiotics?

A

No interactions

63
Q

What must you give in patients with an SSRI and NSAID?

A

PPI

64
Q

What type of pulse is associated with patent ductus arteriosus?

A

bounding, collapsing pulse

65
Q

Which medications are used for migraine prevention?

A

Propanolol
Topiramate (not in women of childbearing age or on contraceptives)
amitriptyline

66
Q

What is a common trigger of cluster headaches?

A

Alcohol

67
Q

In gestational diabetes with a fasting glucose of <7 what is the first line management?

A

Diet and exercise for 1-2 weeks

68
Q

What do you give to a woman exposed to chicken pox for the first time in pregnancy?

A

Varicella Zoster IgG

69
Q

What is the mechanism of action of benzodiazepines?

A

Enhances the effects of GABA

70
Q

What is otosclerosis?

A

Adherence of the stapes footplate to the middle ear - bilateral conductive hearing loss with a family history

71
Q

What is presbyacusis?

A

bilateral sensorineural hearing loss - age related, gradual onset, affects higher frequencies first

72
Q

What is open-angle glaucoma?

A

Most common glaucoma - increased intraocular pressure with visual field loss

73
Q

What can be used to manage open angle glaucoma?

A

topical prostaglandins, topical beta-blockers, topical carbonic anhydrase inhibitor, topical alpha agonist (all decrease amount of aqueous humour)

74
Q

What are the features of acute angle glaucoma?

A

subacute - episodic halos, impaired vision, eye pain, worse in the dark. fixed dilated pupil, hazy cornea

75
Q

What is the treatment for acute angle glaucoma?

A

refer to ophthalmology, drainage

76
Q

What are the common causes of central vision loss?

A

B12 deficiency, MS, macular degeneration

77
Q

What are the stages of hypertension?

A

Stage 1 – 140/90
Stage 2 – 160/100
Severe - >180 systolic or >100 diastolic

78
Q

What are the symptoms of hypercalcaemia?

A

Bones, stones, abdominal groans and psychic moans (high Ca low PO4)

79
Q

What is the first-line management of stable angina?

A

BB/CCB/long-acting nitrate
BB - if previous MI
CCB - if hypertension
Nitrates - if preferred or cannot have the other meds

80
Q

What medications can be used to treat an overactive bladder?

A

anti-muscarinics - oxybutynin and tolterodine

81
Q

What conditions are generally autosomal recessive and dominant?

A

Autosomal recessive conditions are ‘metabolic’ - exceptions: inherited ataxias
Autosomal dominant conditions are ‘structural’

Phase 3A (14 decks)

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