Passmed Learning Points Flashcards

1
Q

hCG has a similar structure to LH, FSH, and TSH so…

A

This can stimulate the thyroid to produce excess T4/T3 and this can loop back to suppress TSH.

So, molar pregnancies can have
++hCG, ++T3/++T4, and –TSH.

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2
Q

TRALI

vs

TACO

A

Transfusion-Related Acute Lung Injury = Low BP, High HR, Low O2, fever. (Central Venous Pressure / CVP = 8-12mmHg) [Same as normal anion gap :)) but in mmol/L obvs )

TACO = High BP, Pulm oedema - Stop transfusion + Give furosemide + oxygen.

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3
Q

PMS; Mild/moderate/severe treatment:

A

Mild: Lifestyle; Lots of complex carbs

Moderate: COCP if not contraindicated

Severe: SSRIs like Fluoxetine.

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4
Q

Opioid Conversions

Increase in palliative care?

PRN dose?

A

30-50% increase in morphine if uncontrolled

1/6th - 1/10th daily dose

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5
Q

Follow RILE

Peripheral oedema: which side more likely?

Pansystolic

A

I really messed this question up:

RILE; Right side heard louder on inspiration

Peripheral oedema: More likely right side

Pansystolic: AV-Valve Regurgitation OR Outlet-Valve Stenosis.

What confused me was that it was heard at the left lower sternal edge:

Answer? Tricuspid Regurgitation.

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6
Q

Different bacterial pneumonia types and common signs:

Klebsiella

Legionella

Mycoplasma

Staph Aureus

Strep. Pneumo

Haem. Influ

A

Kleb: Lots of alcohol, redcurrent jelly sputum.

Legioenlla: Low sodium, holiday in spain / unventilated baths.

Mycoplasma: Erythema multiforme (target lesions)

Staph aureus: Cavities.

Strep. Pneumo: Literally no history of anything.

Haem influ: COPD / Bronchiectasis

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7
Q

Paget’s Disease: Bloods

A

Isolated rise in ALP

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8
Q

Warfarin and LMWH okay in breast feeding

Low K+ often leads to alkalosis; H+ drawn into cells so that K+ can be sent out.

A
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9
Q

GNRH agonist and the Anti-Androgen antagonist names:

Why are they both used in prostate cancer?

A

GNRH: Goserelin

Anti-Androgen: Cyproterone

GNRH agonist causes a small spike in LH before inhibiting it, this needs to be covered by the anti-androgen temporarily.

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10
Q

Dr C BraVADO!

A

Define Risk (E.g, pre-eclampsia, GD, etc)

Contractions (4-5 in 10 mins)
Base-RAte (>110 good)
Variability (5-25bpm good)
Accelerations (present = good)
Decelerations (None, or early, or variable without other characteristics = good)

Overall impression:
Sus = 1 non-reassuring
Path = 2 non-reassuring or 1 abnormal.

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11
Q

Iozoniazid to be taken with which vitamin to prevent peripheral neuropathy?

A

B6 - Pyridoxine.

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12
Q

PANCREAS for remembering acute pancreatitis

A

PO2 <8
Age >55
Neutrophillia (WCC > 15)
Calcium <2 (Phosphate release)
Renal function (Urea >16 )
Enzymes (AST / LDH)
Albumin (<32)
Sugar (>10 - Insulin dysfunction)

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13
Q

H.U.S

Cause?

Treatment to avoid?

Treatment you can give?

A

Shiga-Toxin, produced by E.Coli or Shigella- Attacks glomerular capillary bed.

Anything precipitating MORE shiga-toxin; Avoid antibiotics, avoid anti-gut-motility agents, avoid NSAIDs (AKI).

Mostly supportive; Fluids, assist high BP with CCBs. Potentially give shiga-binding drugs (Expensive).

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14
Q

ORBIT Mneumonic

A

O lder than 74
R ed blood cells (?Anaemic)
B leeding history
I nsufficient Kidneys (GFR < 60)
T hrombolytics (Antiplatelets?)

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15
Q

Syphilis Testing; What do these mean?

EIA

TPPA

RPR

A

Enzyme Immunoassay (IgM Levels; shows acute infection)

Trep-Pallidum Particle Agglutination (Specific to Syphillis; often remains positive)

Rapid Plasma Reagin (Number of syphilis particles in a liquid; 1 in 8 means that it needs to be diluted 8 times to make the syphilis undetectable; Gives an idea of how active current syphilis is).

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16
Q

CKD: Anaemia treatment:

A

Iron studies then EPO

Tranfusion if Hb < 70

17
Q

Osteoporosis: Risk factors

A

Low BMI

Tamoxifen PROTECTS against it (Oestrogen agonist in bone and endometrium),
Letrozole IS A RISK.

Chronic Kidney Disease, eGFR <60.

18
Q

Sickle-Cell; Vaso-occlusive crisis: How to diagnose?

A

Diagnose clinically; initiate treatment asap.

19
Q

Post-op illeus; findings?

Tests?

A

-Absence of bowel sounds
-Abdo distention
-Post-op (duh)
-Nausea / vomiting

U&Es measured daily in ileus and any abnormalities should be corrected.

20
Q

Sentinal Node Biopsy Before Surgery? Why even if the axillary ultrasound is negative?

A

If ultrasound was positive, a biopsy of the axillary nodes would be performed.

The sentinal biopsy is to rule out microscopic metastisis.

21
Q

Haemorrhoids vs Anal Fissure surgical management:

Line which separates lower rectum from upper rectum?

A

All after laxatives and ++fibre diet:

Haemorrhoids: Band Ligation

Anal Fissure: Sphincetotomy.

Pectinate / dentate line (Remember like teeth in the mouth, the teeth of the anus.

22
Q

JIA Diagnosis

A

No other cause
>6 weeks joint pain
<16 years old

+Joint pain
+Joint stiffness
+Joint swelling

23
Q

TIA counts for 2 in CHADVASC

A

Yeah

24
Q

Compartment syndrome: What features may make you suspect it, early?

A

-Parasthesia as a first neuro symptom

-Assessment of tone painful, compared to strength (Passive motion excessively painful)

25
Q

Billary Collic: ALP, GGT, ALT, AST levels?

A

ALLL Normal

26
Q

AAA : Endovascular repair when?

A

-Symptomatic (painful, expansatile)
-Asymptomatic but >4cm and grown 1cm in 1 year

-Asymptomatic but >5.5cm

27
Q

Most common cause of viral meningitis?

A

Coxsackie B / Enterovirus

28
Q

TV Ultrasound Scan for endometrial cancer is a test of:

A

Exclusion! <4mm has a very high negative predictive value for endometrial cancer.=

29
Q

Chronic Kidney Disease Classification

A

Requires eGFR < 120 as expected

BUT

Also requires signs of actual kidney disease; Electrolyte imbalance, proteinuria, haematuria, urea. creatine issues.

30
Q
A
31
Q

Aortic Valve Replacement Criteria?

A

Symptomatic or

Valve gradient of >40mmHg