passmed hwg again Flashcards
if a child has a palpable abdominal mass what do you suspect
- neuroblastoma
- Wilm’s tumour
refer to paediatric consultant immediately
side effect of SGLT2
UTIs
in nephrogenic DI, what is the urine osmolality after desmopressin and after fluid deprivation
low after both
is fludrocortisone required in addisonian crisis
no
what is the most common cause of primary hyperaldosteronism
bilateral adrenal hyperplasia
treatment for a thyrotoxic storm
- corticosteroids
- beta blockers
- prophyliouracil
what is the whipple’s triad for an insulinoma
- hypoglycaemia with fasting or exercise
- reversal of symptoms with glucose
- low blood glucose at time of symptoms
what medication can be used for primary hyperparathyroidism
cinacalcet (calcium mimemic)
if someone presents to the emergency department with unrecordable blood glucose, confusion and abdo pain, what is suspected
DKA
most common drug to cause gynaecomastia
spironolactone
initial management of DKA
IV 0.9% NaCl (saline)
what drugs for immunosuppression
- steroids
- cyclophophamide/rituximab
what indicates that kidney disease is chronic and not acute
hypocalcaemia
how can hydroceles be differentiated from other testicular lumps
they are not separate from the testes and transilluminate
what drugs cause hyaline casts in urine
loop diuretics
what is used as pre-treatment before goserelin in prostate cancer
flutamide
first line management for chronic urinary retention
intermittent self catheterisation
what are the classic symptoms of acute interstitial nephritis
allergic type picture
- raised urinary WCC
- IgE
- eosinophils
- rash
- wheeze
what is a risk of using 0.9% NaCL in patients requiring large volumes
hypercholaraemic metabolic acidosis
which meniscal tear has pain and swelling
medial mensicus
what does bone pain and isolated ALP indicate
Paget’s disease
what does prescribing folic acid with methotrexate reduce the risk of
myelosuppression
what is a late sign of cauda equina syndrome
urinary incontinence
when can patients weight bear after hip fracture surgery
full weight bearing immediately post op
theres is wasting of what in carpal tunnel syndrome
thenar eminence
if theres impaired external rotation on passive and active movement in the shoulder what does this suggest
adhesive capsulitis
in what part of the bone does osteomyelitis most commonly occur in children
metaphysis
if someone has bone pain, tenderness, proximal myopathy and waddling gait what does this suggest
osteomalacia
eye side effect of hydroxychloroquine
retinopathy
what rheumatoid disease are chemo patients at increased risk of getting
gout
treatment for acute reactive arthritis
NSAIDs
best way of diagnosing ankylosing spondylitis
pelvic x-ray
symptoms of dermatomyositis
- proximal muscle weakness
- macular rash over back/shoulders
- violet periorbital rash
- red papules over extensor surfaces of fingers
how do you manage acute flares of rheumatoid arthritis
intramuscular steroids
what are x-ray features of ankylosing spondylitis
- sacroliitis: subchondral erosions, sclerosis
- squaring of lumbar vertebrae
- bamboo spine
- syndesmophytes
treatment for an undisplaced fracture of the scaphoid waist
cast for 6-8 weeks
complication of discitis
epidural abscess
which antibody for UC
pANCA
what type of nodes do people with SLE get
osler nodes
what is squaring of the thumb base indicative of
osteoarthritis
what is squaring of the thumb base indicative of
osteoarthritis
management for subluxation of the radial head
passive supination of the elbow joint whilst flexed 90 degrees
features of an S1 lesion
- Sensory loss of posterolateral aspect of leg and lateral aspect of foot
- weakness in plantar flexion of foot
- reduced ankle reflex
- positive sciatic nerve stretch test
what is this
eczema
what is this
psoriasis
what is the next step in the management of psoriasis after 8 weeks of topical corticosteroid has been tried with no effect
topical vit D analogues
which bacteria contributes to the development of acne
propionibacterium acnes
which autoimmune disorders are associated with vitiligo
- autoimmune thyroid disease
- pernicious anaemia
- SLE
- alopecia areata
- type 1 diabetes
- addisons
how long is shingles infectious for
until vesicles have crusted over (usually 5-7 days after)
first line treatment for scalp psoriasis
topical corticosteroids
treatment for shingles
antivirals
first line treatment for hyperhidrosis
topical aluminium chloride
treatment for rosacea
mild/moderate - topical metronidazole
severe - oral tetracycline
what medication is contraindicated if you get migraines
the pill
which antibiotic is safe to use in breastfeeding for acne
erythromycin
at what ABPI is compression bandaging not used
<0.8
are venous ulcers painful
no
what is seen histologically in psoriasis
acanthosis
-increase in the epidermis depth
what is seen here histologically
hyperkeratosis
what is seen here histologically
papillomatosis
-skin surface elevation caused by hyperplasia and enlargement of continuous dermal papillae
what is seen here histologically
acanthosis
what is seen here histologically
spongiosis
what does bowen’s disease present as
irregular, scaly macule or patch
what type of UV causes actinic keratoses
UVB
what is seen here
bullous pemphigoid
definitive treatment for proliferative retinopathy
panretinal laser photocoagulation
who do you refer a child with a squint to
opthalmologist
what does ptosis and constricted pupil suggest
horner’s
what does ptosis and dilated pupil suggest
third nerve palsy
what is seen on fundoscopy in papilloedema
- blurring of the optic disc margin
- venous engorgement
- elevation of optic disc cup
- loss of optic disc cup
investigation for laryngeal cancer
chest x-ray
complication of thyroid surgery
damage to parathyroid glands can cause hypocalcaemia
in a diabetic with otitis externa what is the most likely causative organism and what antibiotic would you use for it
pseudomonas
-ciprofloxacin
what is the findings in a positive dix-hallpike maneouvre
onset of rotatory nystagmus
management of acute otitis media with perforation
oral antibiotic
common bacterial cause of otitis media in children
haemophilus influenzae
management of a patient with a new stridor after a neck surgery
remove sutures and call for senior help
-if there is a bleed post-operatively under the sutures, then this can press on the trachea
