PassMed July & August Flashcards
What is Nelson’s Syndrome? How does it present?
Rapidly enlarging ACTH pituitary tumour that occurs after bilateral adrenalectomy
Sx = Hyperpigmentation and brain compression Sx
What is a cephalohaematoma?
Occurs 2-3 days after birth (usually an instrumental delivery). Swelling does NOT cross suture lines
What is a caput succundum?
Occurs immediately after birth and does cross the suture lines
If a patient’s angina is not controlled on Beta blockers and GTN what should you do?
Add calcium channel blocker
Which drug is a direct contraindication to prescribing beta blockers?
Verapamil (risk of complete heart block)
What do diarrhoea and vomiting do to the blood respectivley?
Diarrhoea causes a normal anion gap metabolic acidosis
Vomiting causes metabolic alkalosis
What is Transfusion-Related Acute Lung Injury? How may it present and how should you treat?
Due to too rapid blood transfusion
Hypoxia, fever and hypotension (ARD symptoms)
Give oxygen. STOP transfusion
What is Transfusion-Associated Circulatory Overload? How may it present and how should you treat?
Seen in those with pre-existing heart failure who have blood transfusion
Pulmonary oedema and hypertension
Give IV loop diuretic and oxygen. STOP transfusion
What is Acute Haemolytic Reaction? How may it present and how should you treat?
ABO incompatibility - will occur rapidly after transfusion
Fever, abdo pain and hypotension
STOP transfusion and give fluid resucitation
What should you suspect in a young woman with deranged LFTs and secondary amenorrhoea?
Autoimmune hepatitis
When should you prescribe PPIs in upper GI bleed?
AFTER endoscopy has been performed
How should you treat toxoplasmosis infection in the immunocompromised?
With pyrimethamine and sulphadiazine
What is hepatorenal failure? What are the types?
Chronic liver failure => renal failure
Type 1 = rapid (<2 weeks) onset often following upper GI bleed
Type 2 = gradual decline in renal function associated with ascites
What movement is controlled by C8?
Finger and thumb flexion - grip
What is Actinic Keratoses? How should you treat?
Premalignant skin condition which develops due to chronic sun exposure. Presents with small scaly/crusty lesions on sun exposed sites
Tx = Fluorouracil Cream
How can you manage perianal fistulas in patients with Crohn’s disease?
Metronidazole
Sx of haemachromatosis?
Excess iron build up - liver, pancreatic, heart and pituitary issues. Fatigue, hyperpigmentation and low libido
Tx of haemachromatosis?
1st line - Venesection
What antibiotic should be used to treat animal bites (including human bites)?
Co-Amoxiclav
What is a narrow complex tachycardia? How should you treat it?
SVT
Vasovagal manoeuvres and then if that fails IV adenosine
What is a broad complex tachycardia? How should you treat it?
VT
IV amiodarone if no adverse features
DC cardioversion if adverse features (e.g. shock - systolic BP <90, syncope, MI or HF)
Which drug is known to cause both hyperthyroidism and hypothyroidism due to its high iodine content?
Amiodarone
What is TLCO? How will it change in pulmonary fibrosis?
A gas transfer test which measures the uptake of oxygen in the lungs. It will be reduced in pulmonary fibrosis
Which antibiotic is commonly used as prophylaxis treatment in those with COPD?
Azithromycin
What metabolic abnormality is caused by persistent vomiting?
Hypochloraemic, hypokalaemic metabolic alkalosis
How much adrenaline should you give in cardiac arrest?
1mg (1:10,000)
What adverse effect can citalopram cause?
Dose dependant QT prolongation
What should you use to treat bradycardia with adverse signs (e.g. hypotension and shock)?
500mcg Atropine, repeat up to 3mg
How should you treat recurrent vaginal candidiaisis?
Oral fluconazole
In VF/Pulseless VT what should you give after delivering 3 shocks and adrenaline?
300mg IV amiodarone
Which COPD patients can definitely be offered long term oxygen therapy?
Non smokers with a pO2<7.3
What should you do to investigate abdominal pain with leucocytes and blood in the urine? What are you looking for?
CT abdomen and renal tract. Looking for renal stones
What is transfusion associated circulatory overload? How should you treat it?
Pulmonary oedema and hypertension seen in those with pre-existing HF
Treat with IV loop diuretic and oxygen
What is transfusion related acute lung injury? How should you treat it?
Acute respiratory distress leading to hypoxia, fever and hypotension
Treat with oxygen
What is acute haemolytic reaction? How should you treat it?
ABO incompatibility. Causes fever, abdo pain and hypotension
Treat with fluid resucitation
A young female presents with deranged LFTs and secondary amenorrhoea. What condition should you suspect?
Autoimmune hepatitis
When should you give PPIs in an upper GI bleed?
Not until endoscopy has been performed!
How should you treat toxoplasmosis in the immunocompromised?
Pyrimethamine and Sulphadiazine