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Year 4 part 2 > Passmed Qs we get wrong > Flashcards

Passmed Qs we get wrong Flashcards

1
Q

Eczema Herpticum vs Chickenpox

A

Eczema herpeticum typically spreads and crusts within days whilst Chickenpox has a slower onset

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2
Q

Vitreous Haemorrhage vs Retinal detachment symptom wise

A

Vitreous Haemorrhages cause your central vision field to get worse on LYING DOWN

Retinal Detachment is peripheral vision first and then central vision loss

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3
Q

Management of toxoplasmosis gondii

A

Pyrimethamine + Sulphadiazine

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4
Q

First line management of Rosacea

A

Topical ivermectin

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5
Q

What dose of rectal diazepam is given in the vent of a seizure

A

10mg

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6
Q

Management of pityriasis rosacea

A

Supportive only

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7
Q

What condition predisposes oligohydramnios

A

Pre-eclampsia

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8
Q

Management of scarlet fever

A

10 days of oral penicillin or azithromycin

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9
Q

What is chushing;s triad (raised ICP signs)

A

Widened pulse pressure
Respiratory changes
Bradycardia

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10
Q

First line management of syphillis

A

IM Benazthine Penicillin

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11
Q

Management of an inguinal hernia in a newborn

A

IMMEDIATE surgery

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12
Q

Onset of alcohol withdrawal

A

72 hours

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13
Q

What is retinopathy of prematurity

A

<32 weeks

Giving them oxygen can cause neovascularisation and bilateral LOSS of red reflex

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14
Q

Complication of diverticulitis in women

A

Colonvesical fistuals (posing through the vagina)

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15
Q

Characteristic sign of meniscal tears

A

Locking of the knee

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16
Q

What paCO2 level indicates the need for non invasive ventilation in cold exacerbation

A

If over 6 and medical management is not working

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17
Q

How long does CRP stay elevated in the body after an infection

A

48 Horus

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18
Q

Is a CT head in a head injury done with contrast or without

A

Without contrast

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19
Q

What two types of cancers can acanthosis nigricans

A

gastric

pancreatic

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20
Q

What medication causes ventricular tachycardia

A

Verapamil

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21
Q

What is a characteristic effect of MAO B inhibitors

A

Tyramine cheese reaction - causes hypertensive crisis

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22
Q

Management of complete heart block and Mobitz type II block

A

Causes bradycardia/asystole

Transvenous pacing

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23
Q

Symptoms of an acetabular labral tear

A

Hip/groin pain and snapping sensation

Can weight bear

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24
Q

What part of the lungs does extrinsic allergic alevolitis

A

Uppper zone fibrosis

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25
Q

Management of extrinsic allergic alveolitis

A

Stop triggers

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26
Q

Spirometry results in extrinsic allergic alveolitis

A

FVC reduced

FEV1 normal

FEV1/FVC > 80%

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27
Q

What medication must be stopped when clarithromycin is started

A

Statins

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28
Q

Indications for sttarting orlistat

A

BMI > 30

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29
Q

How long is orlistat given for

A

1 year

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30
Q

4 features of HSP

A
  1. Palpable rash
  2. Asymmetrical oligoarthritis
  3. Abdo pain
  4. Renal dailure
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31
Q

How is adrenaline given in asystole

A

IV

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32
Q

Symptoms specific to cubital tunnel syndrome

A

Symptoms worsen when elbow is resting on a firm surface or flexed for a long time

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33
Q

Management of lidocaine toxicity

A

IV 20% Lipid imulsion

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34
Q

Management of GI syjmptoms in metformin

A

Switch to modified release metformin

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35
Q

What happens to the size of the kidneys in Diabetic nephropathy

A

They enlarge rather than shrink

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36
Q

What medication can slow the rate of CKD progressin in ADPKD

A

Tolvaptan

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37
Q

How do we manage allergic reactions in blood transfusions

A

Temporary transfusion termination + antihistamine

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38
Q

When should someone be given a 2 week wait referral to resp team

A

> 40 with unexplained haemoptysis

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39
Q

Name two metabolic disturbances caused by thiazide diuretics

A

Hyponatraemia
Hypercalcaemia

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40
Q

Pulomnary stenosis vs aortic stenosis on examination

A

Pulmonary stenosis = louder on inspiration

Aortic = louder on expiration

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41
Q

What is sick euthyroid syndrome

A

Normal TSH but low T3/T4

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42
Q

What is the AST/ALT ratio for alcohoilic hepatitis

A

2:1

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43
Q

When is a total hip replacement preferred to a hemiarthroplasty

A

THR is given to someone with a relatively high life expectancy who is active

Hemiarthroplasty would be given to less mobile individuals

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44
Q

Why would a biopsy need to be repeated in giant cell arthritis

A

Due to skip lesions making biopsies normal

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45
Q

Firts line treatment for hereditary haemochromatosis

A

Venesection

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46
Q

When is spironolactone given for hypertension vs alpha and beta blockers

A

If K+ < 4.5 = spironolactone

If K+ > 4.5 = alpha blocker

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47
Q

Triad for MEN Type 1

A

Peptic ulceration
Galactorrhoea
Hypercalcaemia

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48
Q

Inguinal hernia vs femoral hernia

A

Femoral hernia is lateral and inferor to the pubic tubercle

Inguinal hernia is medial and superior to the pubic tubercle

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49
Q

How can we treat maiodarone-caused hypothyroidism

A

COntinue amiodarone. + start levothyroxine concurrently

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50
Q

Management of scaphoid fractures with proximal scaphoid pole fractures

A

Surgical fixation

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51
Q

At what age threshold should people on SSRIs be followed up 1 week after starting

A

<25

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52
Q

Management of facial flushing in rosacea

A

Brimonidine gel

Metronidazole is for papules and pustules

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53
Q

Is a tender goitre seen in graves disease?

A

No - just de quervain’s thyroiditis

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54
Q

Triad of fat embolism

A

Petechial rash
Hypoxemia
Neurological deficits

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55
Q

Management of ABO incomptaibility in renal transplants

A

TAKE THE GRAFT OUT

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56
Q

In what time frame is a post splenectomy infection most common

A

within 2 years of the operation

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57
Q

Management of mania

A

Rispiridone

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58
Q

Tricuspid vs mitral regurgitation

A

Tricuspid - inspiration makes it louder

Mitral - expiration makes it louder

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59
Q

Common cause of late decelerations in a neonate

A

Acidosis/hypoxia

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60
Q

What autoimmune condition is associated with a MALT lymphoma

A

Hashimoto’s thyroiditis

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61
Q

What anitbiotic typically caues cholestasis

A

Co amoxiclav

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62
Q

Most common cause of Cushing’s syndrome

A

Pituitary adenoma

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63
Q

Where are parentreral nutrition lines installed

A

Subclavian vein

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64
Q

What is th emost common complication of intraventricular haemorrhages (intracerebral bleed on CT)

A

Hydrocephalus

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65
Q

Complications seen in RA

A

IHD

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66
Q

What should be corrected first in osteoporosis

A

Calcium/Vit D THEN give bisphosphonates

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67
Q

What anaesthetic has the strongest analgesic effect

A

Ketamine (used hevaily in emergencies)

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68
Q

What is the most sensitive and specific lab result that indictaes cirrhosis of the liver

A

Low platelet counts

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69
Q

What is the criteria for adding on a GLP-1 mimic (-tides) to diabetic control

A

BMI still over 35
Has T2DM
Weight loss >3% at 6 months

OR

BMI <35 and insulin is not wanted

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70
Q

Management of pseudomonas infections

A

Ciprofloxacin

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71
Q

What is a HiNTs exam

A

used to differentiate vestibular neuronitis from posterior circulation strokes

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72
Q

What anti emetic may cause galactorrhoea

A

Metoclopramide

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73
Q

What is Wellen’s syndrome

A

Critical stenosis of the left anterior descending artery (EMERGENCY)

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74
Q

Management of wellen’s syndrome

A

Urgent PCI

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75
Q

ECG findings in Wellen’s syndrome

A

DEEP inverted T waves in V2-3 + no ST elevation

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76
Q

What fracture can cause raidal nerve palsies

A

Fracture of the humeral shaft

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77
Q

What fracture is associated with axillary nerve injruy

A

Fracture of the humeral neck

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78
Q

What nerve is injured in fractures to the olecronon

A

Ulnar nerve

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79
Q

What formula is used to calculate the amount of fluid IV required for burns resusciation

A

Parkland formula: burn % * weight * 4

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80
Q

WHen is fluid IV required in burns (criteria)

A

> 10 % burns in children

> 15% burns in adults

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81
Q

How to calculate percentage burns

A

Wallace rule of 9: 9% for head and neck

9% for each arm

9% for each anterior part of the leg

9% for each posterior part of the leg

9% anterior chest

9% posterior chest

9% anterior abdomen

9% posterior abdomen

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82
Q

Management of circumferential burns around the torso

A

Escharotomy to divide burnt tissue

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83
Q

What structure is compromised by scaphoid fractures if left untreated

A

dorsal carpal branch of the radial artery

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84
Q

Under what age is an S3 sound considered ‘normal’ variant

A

Dilated cardiomyopathy

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85
Q

What is the daily required glucose intake

A

50-100 g/day irrespective of weight

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86
Q

What is the potassium, sodium and chloride intake needed a day

A

1mmol/kg/day

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87
Q

Why is chicken pox a risk factor for necrotising fasciitis

A

Because it allows group A strep to invade soft tissue

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88
Q

Surgical management of SUFE

A

Internal fixation

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89
Q

What usually cuases Hep E infections

A

Undercooked pork

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90
Q

Laeukamia vs lymphoma on data interpretation

A

Non hodgkin’s lymphom adoes not have raised neutrophil counts (unlike CML)

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91
Q

What is the first line surgical intervention for uterine atony if syntocinon fails

A

Intrauterine balloon tamponade

92
Q

Management of whooping cough

A

Clarithromycin

93
Q

If Anti-HBs stays the same after 3 months of recieving the injection, what shouhld be done

A

Give anotehr vaccine

94
Q

Under 20 weeks, gestation, how is VZV exposure treated

A

VZIG

> 20 weeks: Aciclovir or VZIG

95
Q

Management of reactive arthritis

A

NSAIDs

96
Q

What dermatome is responsibel for knee sensations

A

L4

97
Q

Is acidosis seen in HHS

A

No

98
Q

What blood is a universal donor of fresh frozen plasma

A

AB RhD negative blood

99
Q

WHat time frame is needed to give a diagnosis of chronic fatigue syndrome

A

3 months

100
Q

Management of bed wetting in children <5

A

Advice and reassurance

101
Q

Indication for adding SGLT-2 inhibitors to DM treatment

A

If there are signs of IHD/HF (add it regardless of glucose levels)

102
Q

Management of athlete’s foot

A

TOpical antifungal then oral terbinafine

103
Q

What dementia is associated with MND

A

frontotemporal dementia

104
Q

Is defirbillation required for asystole

A

No

105
Q

Management of digoxin toxicty

A

Cease digoxin - review levels in 8 hours

106
Q

Transudative vs exudative causes of pleural effusions on data findings

A

Exudative: protein/serum ratio > 0.5

Transudative: protein/serum ratio < 0.5

107
Q

Causes of transudative pleural effusions

A

HF
Hypoalbuminaemia (nephrotic syndrome)
Liver cirrhosis

108
Q

Causes of exudative pleural effusions

A

Pneumonia
Cancer
PEs

109
Q

How is malignant hyperthermia inherited

A

Autosomal dominant

110
Q

What type of person is predisposed to ACL ruptures

A

Foootballers due to high twisting force applied to a flexed knee

111
Q

What is an indication for a liver transplant in people with paracetamol overdose

A

If pH < 7.3 after 24 hours of ingestion

112
Q

Monitoring people on IV MG SO4

A

Monitor reflexes + RR

113
Q

Management of gastroparesis

A

Metoclopramide

114
Q

Symptoms of gastroparesis

A

Bloating and vomiting after eating

115
Q

Management of children <0.4th centime for height

A

Referral to paediatrics

116
Q

Can the MMR vaccine be given during pregnancy

A

No

117
Q

What part of the brain is affected to cause weber’s syndrome

A

Midbrain

118
Q

What are Osler nodes

A

Painful purple lesions on the index finger (SLE and IE)

119
Q

What is red man syndrome

A

Causes facial flushing from rapid IV vancomycin infusion

120
Q

What cannula is given for fluids

A

20g pink cannula

121
Q

When are intraosseous access indicated

A

When people are peripherally shut down

122
Q

When are PICC lines/ Hickman lines indicated

A

Long term treatment and management of a patient

123
Q

What anaesthetic cannot be used in a pneumothorax

A

NO

124
Q

Side effect of indapamide

A

Sexual dysfunction

125
Q

What artery is occluded in an MI that can cause a heart block

A

right coronary artery lesion

126
Q

When is a V/Q perfusion scan indicated over a CTPA for a suspected PE

A

If renal impairment is present (can’t be given contrast for a CTPA)

127
Q

What is seen on an ECG for a posterior MI

A

Tall R waves in V1 and V2

128
Q

What lifestyle factor can cause dilated cardiomyopathy

A

Chronic alcohol use

129
Q

What drug is the most common angi-oedema causer

A

ACEi

130
Q

If someone’s albumin: creatinine ratio >30, how should hypertension be managed

A

ACEi first (can help with nephropathy)

131
Q

Aortic rupture vs tension pneumothorax

A

Aortic rupture has PERSISTENT hypotension vs Tension pneumothorax where this is terminal syptoms

132
Q

Cause of croup

A

Parainfluenza virus

133
Q

When does malrotation commonly affect children

A

First 30 days of life

134
Q

How does ACEi cause renal impairment

A

Usually if patient suffers from bilateral renal artery stenosis

135
Q

What dose of adrenaline is given during cardiac events

A

10ml 1:10,000 IV

or

1ml of 1:1000 IV

136
Q

What type of ysndrome is focal segmental glomerulosclerosis

A

Nephrotic syndrome

137
Q

Management of alcoholic hepatitis

A

Prednisolone

138
Q

Early signs of lithium toxicity

A

POlyuria

139
Q

If someone has presented to the GP within 7 days of having a TIA, under what time frame should they be seen at a TIA clinic

A

24 hours

140
Q

What drug can be given to reduce the incidence of calcium stones forming

A

Thiazide diuretics (make it make sense)

141
Q

Signs of a retinoblastoma on fundoscopy

A

Absent red reflex

Bilateral white pupil

142
Q

Strongest risk factor for bladder cancr

A

Smoking

143
Q

First line investigation for posts abscess

A

CT Abdomen

144
Q

Most common complication post renal transplant

A

Squamous cell carcinoma of the skin

145
Q

Pituitary adenoma vs pituitary apoplexy

A

Pituitary apoplexy = ACUTE

Pituitary adenoma = gradual

146
Q

What is the threeshold for offering a 6 month trial of levothyroxine

A

<65 AND TSH between 5.5 and 10 mU/L with symptoms

Otherwise if TSH > 10mU/L on two separate occasions if asymptomatic

147
Q

What ECG finding is characteristic of hypothermia

A

J waves

148
Q

Management of Spontaneous Bacterial Peritonitis in hospital

A

IV Cefotaxime

149
Q

Prophylaxis for spontaneous bacterial peritonitis

A

Ciprofloxacin

150
Q

What is an escharostomy needed for

A

To stop ventilation issues (especially if burns are on the torso)

151
Q

Malaria vs Dengue

A

Splenomegaly vs no splenomegaly

152
Q

What routine prescription drug can cause c.diff infections

A

PPIs

153
Q

Prophylaxis of hepatic encephalopathy

A

Lactulose and Rifaximin

154
Q

Wilson’s vs Haemochromatosis

A

Wilson’s presents with neurological deficits (can happen in haemochromatosis but is very rare)

155
Q

What Lithium levels are indicated for hameodialysis

A

SEVERE: >2 mmol/L

156
Q

First line management of euvolaemic and hypervolaemic hyponatraemia

A

Fluid restirction

157
Q

Indication for hypertonic saline in hyponatraemia

A

Severe: <120 mmol/L

158
Q

Management of hypovolaemic hyponatraemia

A

IV 0.9% NaCl

159
Q

Symptoms of ischaemic colitis

A

Generalised abdominal pain after eating

160
Q

What cerebral artery would cause leg weakness but not affect the face

A

Middle cerebral artery

161
Q

Most common cause of an infection in bronchiectasis

A

H. influenzae

162
Q

What surgery is indicated for an ascending aortic dissection

A

Aortic root repair

163
Q

First line management of endometriosis

A

Ibuprofen (manage dyspareunia first)

164
Q

Management of placental abruption if no distress signs vs distress signs

A

No distress signs = steroids and admit

distress signs = c-section

165
Q

Ferritin levels in anaemia of chronic disease

A

Raised

166
Q

Management of legionella pneumonia

A

Clarithromycin

167
Q

Name an SGLT-2 inhibitor

A

Canagliflozin

168
Q

Symptoms of hypocalcaemia

A

Perioral paraesthesia
Cramps and numbness in hands
Tetany

169
Q

When is amiodarone indicated in ALS

A

Ventricular fibrillation: Give 5 shocks and then amiodarone

170
Q

Signs of hypokalaemia on an ECG

A

prolonged QT

171
Q

How does Sodium Valproate affect INR

A

Increases it as it’s an enzyme inhibitor

172
Q

Management of a PE during CPR

A

Alteplase

173
Q

What defines a postpartum haemorrhage

A

Over 500ml blood loss

174
Q

ECG findings for hypertrophic obstructive cardiomyopathy

A

LVH
T wave inversions
deep Q waves

175
Q

How long should a woman wait after taking ullipristal, before starting the COCP again

A

5 days

176
Q

Side effect of trastuzumab

A

Cardiac toxicity

177
Q

What substance causes hepatic encephalopathy

A

Ammonia crossing the BBB

178
Q

What drug commonly interacts with SSRIs

A

Triptans

179
Q

In VT, when should amiodarone and adrenaline be given

A

After three unsuccessful shocks

180
Q

What bone tumour typically has sunburst sclerosis

A

Osteosarcoma

181
Q

Anaemia of chronic disease vs iron deficiency anaemia

A

TIBC is raised in iron deficiency anaemia, but normal in anaemia of chronic disease

182
Q

How is Marfan’s inherited

A

Autosomal dominant

183
Q

What should be done to PPIs prior to endoscopy

A

Be stopped two weeks before

184
Q

What should be seen in a fundoscope for GCA

A

Swollen pale disc and blurred margins

185
Q

Gold standard for diagnosing hydronephrosis

A

USS

186
Q

When does rhythm control become first line for AF management

A

If there is coexistent HF

First onset AF

Or an obvious reversible cause

187
Q

When should adrenaline be given in systole

A

ASAP (no shocks are needed)

188
Q

Management of an uncontrolled vatical bleed after IV terlipressin

A

Sengstaken-Blakemore tube

189
Q

Diagnosis of toxic megacolon

A

Abdominal X-Ray

190
Q

How to calculate a pre renal cause of disease

A

divide creatinine by 10

If urea is greater than creatinine = pre renal disease

191
Q

When can calcium gluconate be given without an ECG tracing

A

If K+ > 6,5 mmol/L

192
Q

Spinal stenosis vs disc prolapse

A

Spinal stenosis: pain improves on bending forward

Disc prolapse: Pain gets worse on bending forward

193
Q

A patient presents with reducedoxygen count and reduce breath sounds in BOTh lung bases, what is the diagnosis (post operatively)

A

Bilateral atelactasis: assocaied with pain

194
Q

When is an ascitic tap, the first line investigation in suspected liver disease

A

If there is diffuse abdomen tenderness and a fever

195
Q

ICP in meningitis

A

Raised

196
Q

What causes upper lobe fibrosis

A

CHARTS

Coalworker’s pneumoconiosis
Hypersensitivity pneumonitis
AS
Radiation
TB
Sarcoidosis/SIlicosis

197
Q

Management of pituitary apoplexy

A

IV Hydrocortisone (prevents adrenal crisis)

198
Q

Management of thrombosis in APL

A

Low dose aspirin

199
Q

Management of toxic megacolon

A

Subtotal colectomy

200
Q

Management of UC Crohn’s with recurrent fistulas and rectal bleeding

A

Proctectomy (need to avoid sepsis)

201
Q

Management of testicular torsions

A

Within 6 hours = bilateral orchidopexy (attach to the back of the scrotal wall

After 6 hours = orchidectomy

202
Q

What can cause septic arthritis from joint prosthesis

A

Staph Epidermis

203
Q

How does the supraspinatus attach to the humerous

A

greater tubercle

204
Q

What two muscles of the shoulder is innervated by the accessory nerve

A

Teres minor
Deltoid

205
Q

Name the four rotator cuff muscles

A

Supraspinatus
Infraspinatus
Subscapularis
teres Minor

206
Q

Role of the spuraspinatus

A

Abduction

207
Q

Role of the trees minor and infraspinatus

A

External rotation

208
Q

Role of the subscapularis

A

Internal rotation

209
Q

What does a painful arch between 60 and 120 degrees show

A

subacromial Impingement syndrome

210
Q

Where in the painful arch is acromio-clavicular joint dysfunction seen

A

180 to 170 degrees

211
Q

What blood finding is an indication for Androgen Insensitivity Sydnrome

A

Raised Testosterone > Oestrogen

212
Q

What gene abnormality is Androgen insensitivty syndrome

A

XY46 (men but look female)

213
Q

Early symptoms of AIS

A

Cryptorchidism

214
Q

Define primary infertility vs secondary

A

Primary - couple was never able to concieve

Secondary - couple can no longer concieve after previously being able to do so

215
Q

Consequence of having an IUD fitted in

A

Cervical shock: vasovagal reaction + bradycardia

216
Q

Management of later stage endometrial cancer

A

External beam radiotherapy + Chemotherapy §§

217
Q

What lymph nodes do endometrial cancers typically spread through

A

Inguinal lymph nodes

218
Q

First line management of hospital acquired pneumonia

A

Co-Amoxiclav (if been in hospital for 5 days)

219
Q

What murmur is heard in Turner’s Syndrome

A

Ejection Systolic Murmur

220
Q

When is dexamethasone contraindicated for meningitis

A

If a purpural rash is present (meningococcal septicaemia) - just used in bacterial and viral meningitis without rash

221
Q

Risk Factors for neonatal sepsis

A

Pre-Term and Low Birth Weight

222
Q

What medication can be given to stop breastfeeding (lactation)

A

Cabergoline

223
Q

How should a low lying placenta at 20 weeks be managed

A

Rescan at 32 weeks

224
Q

At what week can the baby be felt

A

12 weeks

225
Q

What prophylaxis is given for GBS during pregnancy

A

Benzylpenecillin

Year 4 part 2 (10 decks)

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