Passmed niche topics Flashcards
How long after taking lithium should you measure levels?
12hr
Common complicatio of POSTERIOR hip dislocation?
Sciatic nerve injury (10-20% cases)
OCD first line management
Exposure and response prevention
Which SSRI for OCD?
Fluoxetine
Last line OCD treatment
Clomipramine
Acute angle glaucoma is associated with which vision change?
Hypermetropia (near objects are blurred)
New onset mania, which investigation should you do?
CT head
Antibodies in drug induced lupus
Antihistone antibodies
Hydralazine can cause which drug induced rheumotological condition?
Drug induced lupus
Superficial burns features
Pink skin
Blisters
Wallace’s rule of X for % covered in burns
9s
Full thickness burn features
White/brown/black
No blisters
No pain
Times to refer burns to secondary care
All deep dermal (2nd degree) upwards
Any genitalia, face, hands
Inhalation
Electrical or chemical
Formula for calculating how much fluid is needed after a burn
Parkland formula
Treatment of herpes simplex keratitis
Topical aciclovir
Features of herpes simplex keratitis
Red eye Burning pain Photophobia Excessive lacrimation Fluorescein shows linear, branching epithelial defect
What is urticaria?
Hives
Which drug is contraindicated in patients with salicylate hypersensitivity?
Sulfasalazine
Oral ulcers
Genital ulcers
Anterior uveitis
Behcet’s
What actually IS Behcet’s disease?
Autoimmune small cell vasculitis
Which rash is associated with Behcet’s disease?
Erythema nodosum
Management of shingles
Oral aciclovir
Vertigo and hearing loss on one side
With an absent corneal reflex on the same side
Acoustic neuroma
Drugs than can cause hearing loss
Furosemide
Symptoms of vestibular neuritis
Vertigo
Dizziness
Hearing loss
What is vestibular neuritis?
Inflammation of the vestibular nerve
Risk factors for OA
Previous trauma to the joint
Hypermobility of a joint
Occupation
Nodes in OA
Heberdens
Bouchards
These are as a result of osteophyte production
Management of scaphoid fracture
X-ray
Repeat x-ray after 7-10 days because can take time to appear radiographically
First line management for bilateral primary open angle glaucoma
Latanoprost eye drops
Which drugs can reduce aqueous production in primary open angle glaucoma?
Beta blockers such as timolol
Which drug can reduce ICP in open angle glaucoma?
Pilocarpine (muscarinic agonist)
How long should the break between courses of steroids be in psoriasis?
4 week break between flares
Management of chronic plaque psoriasis
Regular emollients
Potent corticosteroids + vitamin D analogue applied once daily
Thromboprophylaxis in anti-phospholipid syndrome who has never had a clot before
Low-dose aspirin
Osler-weber-rendu is also known as
Hereditary haemorrhagic telangiectasia
Features of HHT
Epistaxes
Shortness of breath
Coughing up blood
Normal examination other than maybe some telangiectasia on nose/lips
What is pseudotumor cerebri
False brain tumour Signs of increased pressure in the brain (papilloedema) Headache Blurred vision WHooshing in ears Vision loss
Electrolyte cause of papilloedema
Hypocalcaemia
Rarely caused by vit A toxicity
Respiratory cause of papilloedema
High CO2
Because dilates cerebral vessels
Mottled, webbed rash implies
Livedo reticularis
Anti-phospholipid syndrome is associated with which rash?
Livedo reticularis
Antibodies in anti-phospholipid syndrome
Anti-cardiolipin
Treatment of choice for Raynauds
Daily nifedipine
Bilateral ‘grittiness’ in eyes, which condition should you think of?
Blepharitis
Symptoms of blepharitis
Gritty eyes
Sticky eyes
Erythematous eyelid borders
Management of blepharitis
Hot compresses
Removal of debris with cotton wool buds dipped in cooled, boiled water
Artificial tears
Signs of conjunctivitis
Bilateral red itchy eyes
Sticky purulent discharge
Treatment of conjunctivitis (bacterial)
Topical chloramphenicol drops
What should you do before applying fusidic acid to impetigo?
Softly remove crusted areas by soaking with soapy water
How do you treat cold sores?
Over the counter anti-viral creams
How should you manage a childhood squint? Cross-eyed?
Refer to opthalmology
Which SLE medication is safe to use in pregnancy? Also used in IBD?
Azathioprine
Hydrocychloroquine
Drugs not safe in pregnancy
Methotrexate
Cyclophosphamide
Mycophenolate
Rituximab
What is onychomycosis?
Fungal infection of the nail
Symptoms of onchomyocosis
Looks like you’d expect for a fungal nail infection
Ix for onchomyocosis
Nail clippings
Management of onchomyocosis
Can leave it if you fancy but to fix it cosmetically can use oral terbinafine (antifungal)
Most likely cause of sudden sensironeural hearing loss with no associated symptoms
Idiopathic?!!!!
Initial treatment for sinusitis 10 day< Hx
Intra-nasal corticosteroid
Symptoms of acute sinusitis
Facial pain worse on bending forward
Thick, purulent nasal discharge
Nasal obstruction
Mx of sinusitis
Analgesia
Intranasal corticosteroids if going on 10days<
Severe -> oral antibiotics
Scalded rash 30%< body after a new drug =
TEN
Mx of TEN syndrome
Stop precipitating factor
Supportive care
IVIG
Features of Horner’s
Ptosis
Anhydrosis
Miosis
Causes of Horner’s syndrome
Carotid artery dissection
Cervical rib
Pancoast tumpur
Bilateral grittiness, think…
Blepharitis
Bilateral grittiness with sticking eyelids in the morning =>
Blepharitis
What is blepharitis
Inflammation of the eyelid margins
Meibomian gland dysfunction)
What eye condition is rosacea a RF for?
Blepharitis
Mx of blepharitis
Hot compresses
Lid hygiene by removing with cotton wool buds
What can you do to shrink nasal polyps?
Intranasal steroid spray
31 year old man with bilateral hearing loss and tinnitus
FH of similar problems
Audiometry shows bilateral conductive hearing loss
Otosclerosis
2yo with repeated otitis media infections and problems with hearing and delayed speech
Glue ear
Recurrent, one sided hearing loss, tinnitus and vertigo
Feeling of fullness in the ear
Menieres
Progressive hearing loss with tinnitus and vertigo
Cranial nerve signs
Acoustic neuroma
Drugs that cause ototoxicity
Gentamicin
Furosemide
Aspirin
Red itchy scalp with dandruff
Sebhorreic dermatitis
Red scalp with white scales =>
Psoriasis
Treatment of scalp psoriasis
4w potent topical corticosteroids
Bullous pemphigoid =
Tense blisters
Bullous = bullae
What is polymorphic eruption of pregnancy?
Pruritic condition associated with last trimester
Like an itchy rash all over but often start in abdominal striae
Mx of polymorphic eruption of pregnancy
Emollients
Mild topical steroids
What is pemphigoid gestationis?
Pruritic blistering lesions
Often develop in the peri-umbilical region
Look like pemphigus a bit (or like patches of psoriasis)
Features of otitis externa
Red ear canal Conductive hearing loss (reduced hearing) Discharge Regional lymphadenopathy Cellulitis spreading beyond the ear FEVER
Mx of otitis externa
Topical antibiotics +/- steroids
What is a pyogenic granuloma also known as?
Eruptive haemangioma
Features of eruptive haemangioma
Hx of trauma in that site
Head/neck or hands
Initially small red spot
May bleed or ulcerate
Mx of eruptive haemangioma
Cutterage and cauterisation
Excision
Small growth under the nail, no pigment
Amelanotic melanoma
Dry mouth
Grittiness in eyes
Diffuse swelling of parotid
Sjogren’s syndrome
18yo with pancreatitis, orchitis and bilateral parotid enlargement
Vital parotitis (from mumps)
What is a Warthin’s tumour?
Benign tumour of salivary glands
Bilateral parotid gland enlargement
Dry mouth
Bilateral facial nerve palsys
Improves with steroid treatment
Sarcoidosis
Common complications of seborrhoeic dermatitis
Blepharitis
Otitis externa
Which examination should you always do in paediatrics
ENT
Bulging tympanic membrane and ear pain indicates
Otitis media
Bulging tympanic membrane, ear pain and purulent discharge from the ear indicates
Otitis media with perforation
When would you give antibiotics in otitis media?
4 day duration
Purulent discharge
How might otitis media present in a young child?
Off food
Clingy to mum
Pulling at the ears
Fever
Complications of otitis media
Mastoiditis
Meningitis
Brain abscess
Colour vision loss
Worsening vision
Pain on eye movement
Normal appearance of retina
Optic neuritis
Commonest cause of optic neuritis
MS
Mx of optic neuritis
High dose steroids