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Phase 4 > Passmed (Oct) > Flashcards

Passmed (Oct) Flashcards

1
Q

How do you treat uncomplicated Chlamydia?

A

Doxycycline, 100mg BD, 7 days

If pregnant - azithromycin / erythromycin / amoxicillin

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2
Q

Trichomonas vaginalis - microscopy?

A

Flagellated protozoa

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3
Q

How do you treat Trichomonas vaginalis?

A

Metronidazole

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4
Q

Complication of shoulder dystocia (plus features)?

A

Erb’s palsy - damage to the brachial plexus

Presents as adduction and internal rotation of the arm.

RFs - foetal macrosomia (birth weight >4kg)

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5
Q

Child presents to GP with honey-coloured crusted lesions on chin - Dx? treatment? how long before can go back to school?

A

Impetigo

Rx - topical hydrogen peroxide 1%

Can go back to school when lesions crusted and healed or 48hrs after starting abx

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6
Q

PPI side effects??

A

Usual - GI, N+V, dizziness
Other - insomnia, hypomagnesia (leading to hypocalcaemia and hypokalaemia)

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7
Q

Patient presents with right-sided hearing loss, vertigo and tinnitus. O/e there is an absent corneal reflex - Dx?

A

Vestibular schwannoma (acoustic neuroma)

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8
Q

Vestibular schwannoma (acoustic neuroma) can affect which cranial nerves?

A

cranial nerve VIII: vertigo, unilateral sensorineural hearing loss, unilateral tinnitus

cranial nerve V: absent corneal reflex

cranial nerve VII: facial palsy

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9
Q

What are the features of acute tubular necrosis?

A

Urinary Na >40
Urine osmolality <350
Poor response to fluid challenge
Normal serum urea:creatinine ratio
Brown granular casts

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10
Q

Women presents with multiple non-healing leg ulcers. She reports feeling generally unwell for many months. Examination findings include a blood pressure of 138/72 mmHg, pulse 90 bpm, pale conjunctivae and poor dentition associated with bleeding gums. Dx?

A

Vit C deficiency (scurvy)

Features:
gingivitis, loose teeth
poor wound healing
bleeding from gums, haematuria, epistaxis
general malaise

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11
Q

Osteoarthritis - X-ray signs?

A

‘LOSS’

loss of joint space (joint space narrowing)
osteophyte formation
sclerosis
subchondral cysts

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12
Q

What is Felty’s syndrome?

A

Triad of rheumatoid arthritis, splenomegaly and low WCC

Rare complication of RA

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13
Q

Temporal arteritis - Rx?

A

No vision loss = high dose pred

VIsion loss = IV methylpred

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14
Q

Anterior uveitis - presentation? Associations? Treatment?

A

Acute onset, red eye, ocular pain/discomfort, photophobia

Associated with HLA-B27 (ank spond, reactive arthritis etc)

Urgent ophthalmology review, cycloplegics (dilates the pupil which helps to relieve pain and photophobia) e.g. Atropine, cyclopentolate

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15
Q

Limited systemic sclerosis (CREST syndrome) - presentation?

A

Calcinosis
Raynaud’s phenomenon
oEsophageal dysmotility
Sclerodactyly
Telangiectasia

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16
Q

Patient presents with:
Pruritis (worst after taking showers or hot baths).
Tingling, burning, and numbness in arms, hands, and feet.
Headaches and lethargy.
Splenomegaly.
Elevated haemoglobin on full blood count
Dx??

A

Polycythaemia vera

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17
Q

Treatment of polycythaemia vera?

A

Venesection

Aspirin - reduce risk of thrombotic events

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18
Q

How do you treat hypomagnesaemia?

A

If <0.4 OR arrhythmias or seizures = IV magnesium

If >0.4 = oral magnesium salts (SE - diarrhoea)

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19
Q

What Ix should be carried out in someone with suspected multiple sclerosis?

A

MRI brain and spine without contrast

LP (oligoclonal bands)

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20
Q

If INR 5-8 - what do you do?

A

No bleeding - withhold warfarin for 1-2 says and restart on lower dose

Minor bleeding - stop warfarin, IV vit K, restart when INR below 5

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21
Q

What is the most common cause of infective endocarditis?

A

Staph aureus

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22
Q

What is the most common cause of infective endocarditis in a new valve replacement?

A

Staph epidermis

23
Q

What to do if INR >8

A

No bleeding - stop warfarin, oral vit K, repeat dose if INR still high after 24hrs, restart warfarin when INR <5

Minor bleeding - stop warfarin, IV vit K, repeat dose if INR still high after 24hrs, restart warfarin when INR <5

24
Q

Most commonly affected i]valve in infective endocarditis?

A

Mitral valve

Note: in IVDU is tricuspid

25
Q

What test should be used if symptoms still persisting after H.pylori eradication?

A

Urea breath test

26
Q

First line management of hepatic encephalopathy?

A

Lactulose (add rifaximin to prevent recurrence)

27
Q

Classic triad in Budd-Chiari syndrome?

A

Sudden onset:
Abdo pain
Ascites
Hepatomegaly

28
Q

Live and neurological disease….?

A

Wilson’s

29
Q

Risk factors for Budd-Chiari syndrome?

A

COCP (20%)
Pregnancy
Polycythaemia vera
Thrombophilia

30
Q

Which area is most likely to be affected in ischaemic colitis?

A

Splenic flexure

31
Q

Intestinal angina - triad?

A

Post-prandial abdominal pain
Weight loss
Abdominal bruit

32
Q

Bronchiectasis and dextrocardia is suggestive of what?

A

Kartagener’s syndrome

33
Q

What are the indication for corticosteroid treatment in sarcoidosis?

A

Hypercalcaemia
Uveitis
Neuro involvement
Cardiac involvement
Parenchymal lung disease

34
Q

Breast cancer tumour markers?

A

CA 15-3

35
Q

What is the initial management of acute limb ischaemia?

A

Analgesia, IV heparin, vascular review

36
Q

Addisonian crisis - treatment?

A

IV hydrocortisone

37
Q

Prevention of Meniere’s disease attacks?

A

Betahistine

38
Q

If pregnant and had chickenpox exposure - how do you treat?

A

Urgently check varicella antibodies - if not immune….

<20 weeks = varicella immunoglobulins

> 20 weeks = oral acyclovir 7-14 days after exposure

39
Q

Ix findings in Kallmann syndrome?

A

LH and FSH low - normal

40
Q

Diabetes and HTN - first line treatment??

A

ACEi regardless of age eg Ramipril

41
Q

Aortic stenosis - what medications are contraindicated?

A

Nitrates

42
Q

Amlodipine drug type?

A

Calcium channel blocker

43
Q

Raised ICP - Cushing’s reflex?

A

Wide pulse pressure, bradycardia, irregular breathing

44
Q

A 54-year-old woman presents to ophthalmology with a painful, red left eye and photophobia. On examination, you note a dendritic corneal ulcer. She has recently completed a course of oral prednisolone for an asthma exacerbation. Dx?

A

Herpes simplex keratitis (dendritic corneal ulcer)

Rx - topical acyclovir

45
Q

What cancer might myelodysplasia develop into?

A

AML

46
Q

Schizophrenia - what prognostic factor is indicative of poor prognosis?

A

Gradual onset

47
Q

What is the definition of 1 pack year?

A

20 cigarettes per day for one year

48
Q

Ulcerative colitis - most commonly affected area?

A

Rectum

49
Q

Symptoms of hypercalcaemia

A

painful bones, renal stones, abdominal groans and psychic moans

50
Q

Bacterial vaginosis - treatment?

A

Oral metronidazole, 5-7days (even throughout pregnancy and breastfeeding)

51
Q

At what age do febrile convulsions typically occur?

A

6 months - 5 years

52
Q

What is Samter’s triad?

A

Asthma, aspirin sensitivity, nasal polyps

53
Q

Shaken baby syndrome - classic triad?

A

Retinal haemorrhages, subdural haematoma and encephalopathy

54
Q

T2DM - target HbA1c?

A

48

Phase 4 (3 decks)

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