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Passmed Questions Flashcards

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1
Q

Values of impaired glucose toleranve test

A

After 2 hours it increases to 7.8 or higher but below 11.1

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2
Q

Prophylaxis treatment for cluster headache

A

Verapamil

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3
Q

Are c-peptide levels high in type 1 or type 2 diabetes

A

T2DM

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4
Q

1st and second line treatment for muscle rigidity and spasms in MA

A

First line baclofen
Second line gabapentin

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5
Q

What supplements can affect levothyroxine

A

Iron or calcium tablets can affect absorption levothyroxine resulting in low T4 and high TSH

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6
Q

Tamoxifen action

A

Selective oestrogen receptor modulator

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7
Q

what would affect PSA levels and how long should you wait before performing the test ?

A

prostate biopsy - 6 weeks
UTI - 4 weeks
DRE - 1 week
ejaculation and vigorous exercise - 2 weeks

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8
Q

TREATMENT FOR LYME DISEASE IF DISSEMINATED INFECTION

A

Ceftriaxone

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9
Q

single most important indicator for liver transplant in paracetamol overdose

A

PH < 7.3

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10
Q

USS screening in AAA

A

< 4.5 = 12 monthly
4.5 - 5.5 = 3 monthly
>5.4 or rapidly growing aneurysm = rapid referral to vascular

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11
Q

difference in anaemia of chronic disease and iron deficiency anaemia on blood results

A

both low iron and transferrin
iron deficiency has high TIBC
anaemia of chronic disease has low TIBC

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12
Q

what drugs are contraindicated with concurrent use of sidenifil

A

nitrates or nicorandil

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13
Q

what heart condition is associated with turners syndrome?

A

bicuspid aortic valve (ejection systolic murmur)
coarctation of aorta (late systolic)

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14
Q

what’s the most serious long term complications associated with turners syndrome?

A

aortic dilatation and aortic dissection

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15
Q

in what condition should donepezil be avoided?
(also what is donepexzil’s action and what is it used for?)

A

cholinesterase inhibitor
used in alzheimers
increases vagal tone thereby causing bradycardia.
avoided in sick sinus syndrome and other heart conditions

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16
Q

adverse effects of donepezil

A

insomnia
bradycardia

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17
Q

indomethacin or prostaglandin E1 for treatment of PDA

A

indomethacin to close duct
prostaglandin E1 to keep duct open if there is a concurrent congenital heart defect that requires repair

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18
Q

what is the theoretical risk associated with giving the rotavirus too late?

A

intussusception

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19
Q

at how many weeks should the first and second doses of rotavirus be given by

A

1st dose by 14 weeks
2nd dose by 25 weeks (6 months)

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20
Q

what condition is found in 50% of patients with degenerative cervical myelopathy

A

carpal tunnel syndrome

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21
Q

Hg, MCV and reticulocyte count found in sickle cell patients

A

Hg low
MCV normal
reticulocyte high

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22
Q

drugs that can cause pancreatitis

A

azathioprine, mecaptopurine, sodium valproate, furosemide, bendroflumethiazide, pentamidine, steroids
pancreatitis makes anyone furious because its so sore

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23
Q

been abroad recently and presented with constipation and fever

A

typhoid fever (salmonella typhii)

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24
Q

What rise in creatinine and drop in eGFr is acceptable when starting ACE inhibitors

A

20% drop in eGFR
30% rise in creatinine

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25
at what size is a breast fibroadenoma for surgical excision
> 3cm
26
most common causative organism of epididymo-orchitis
chalmydia
27
if antibiotics are required for campylobacter what is abx of choice
clarithromycin
28
1st line imagine for suspected stroke
head CT non-contrast
29
what type of collagen makes up the vitreous humor of the eye
type II
30
what type of collagen makes up the lens of the eye
type III
31
causative organisms of chest infection post influenza infection
staph aueus
32
how to test for the main adverse effect of kawasaki
aortic aneurysms - echo
33
criteria for expectant management in ectopic pregnancy
size < 35mm no symptoms no foetal heart beat bHCG < 1000 unruptured
34
criteria for medical management in ectopic pregnancy
size < 35mm pain no foetal heart beat bHCG < 1500 unruptured
35
criteria for surgical management in ectopic pregnancy
size >35mm pain foetal heart beat ruptured bHCG >5000 intrauterine pregnancy
36
surgical management for ectopic pregnancy
salpingectomy salpingotomy if risks of infertility such as contralateral tubal damage
37
pathophysiology of subcortical vascular dementia
small vessel disease
38
CURB scoring
confusion (abbreviated mental score 8 or more) urea >= 7 RR >= 30 BP <= 90 systolic +/or <= 60 diastolic
39
mode of action of rifampicin
inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA
40
prophylactic medication given in people with varices
propanolol is given to prevent variceal bleeding
41
hydroxychloroquine side effects
corneal deposits 'bulls-eye retinopathy'
42
what DMARD can cause demyelination
etanercept
43
drugs that should be avoided whilst breast feeding
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides psychiatric drugs: lithium, benzodiazepines aspirin carbimazole methotrexate sulfonylureas cytotoxic drugs amiodarone
44
management for gestational diabetes and glucose values associated with treatment options
if fasting glucose < 7 then trial of diet and exercise for 1-2 weeks. If this fails then start metformin if fasting glucose >=7 then start insulin
45
contraindications to sildenafil
hypotension recent stroke or MI nitrates or or nicorandil
46
treatment for croup
emergency treatment - high flow 02 + nebulised adrenaline management - single dose oral dex regardless of severity
47
treatment for latent TB
isoniazid and pyridoxine for 6 months
48
treatment for toxoplasmosis
treatment not required in immunocompetent patients if immunocompromised or complications then treat with pyrimethamine and sulphadiazine for 6 weeks
49
class III vs class IV haemorrhagic shock
class III 30-40% blood loss, BP drops, confused, urine 5-15ml, HR > 120 class IV >40% blood loss, BP drops, lethargic, urine < 5ml, HR > 140ml
50
first line treatment for gestational hypertension in a patient with asthma
nifedipine
50
prophylactic treatment for household members of a patients with neisseria meningitidis
oral ciprofloxacin
50
when can copper IUD be used for emergency contraception
5 days after unprotected sex 5 days after first day of ovulation
51
causative organism for measles
RNA paramyxovirus
52
normal value of anion gap ? causes of raised anion gap metabolic acidosis
8-14 Lactate: shock, hypoxia Ketones: DKA, alcohol urea: CKD acid: salicyclates, methanol 5-oxoproline: chronic paracetamol use
53
neurotransmitter effects of alcohol withdrawal
decreased inhibitory GABA and increased excitatory glutamate
54
extra-articular manifestations of crohns that is related to disease activity
arthritis erythema nodosum episcleritis osteoporosis
55
exposure to chickenpox < 20 weeks pregnant. Course of action?
if not vaccinated = IVIG if vacciated = no action if unsure = immediately arrange for varicella Ab testing
56
exposure to chicken pox >20 weeks pregnant. Course of action?
if not vaccinated = IVIG or aciclovir if vaccinated = no action if unsure = immediately arrange for varicella Ab testing
57
1st line investigation for suspected prostate cancer
multiparametric MRI
58
1st lin emanagement if suspected cows milk protein intolerance
switch to extensive hydrolysed formula if this fails then try amino-acid based formula
59
ramsey hunt syndrome treatmentn
steroids + aciclovir
60
monitoring of LFTs when starting a statin
at baseline, 3 months, then 12 months
61
first line antihypertensive treatment if < 55
ACE inhibitor / ARB
62
first line antihypertensive if diabetic?
ACE or ARB
63
first line antihypertensive if > 55
CCB
64
first line anti-hypertensive if afro carribean?
CCB
65
first line antihypertensive if > 55 with diabetes
ACE inhibitor
66
wolf parkinson white features
accessory pathway in conduction leading to atrio-ventricular re entry tachycardia. Can lead to VF. right axis deviation if left sided accessory pathway and vice versa short PR interval, wide QRS with slurred upstroke 'delta wave'
67
associations with Wolf-parkinson white syndrome
hocm ebsteins anomaly mitral valve prolpase thyrotoxicosis secundum ASD
68
1st line treatment for capillary haemangioma
propranolol
69
1ts, 2nd, 3rd and 4th line treatment for psoriasis
1st line - once daily topical steroid and vit D analogue 2nd line - twice daily vit D analogue 3rd line - twice daily topical steroid or coal tar 4th line - phototherapy or MTX
70
treatment in heart failure to improve mortality after all medical options have been optimised
cardiac resynchronised therapy (if qrs > 120 OR ejection fraction < 35%) LVAD or transplant if young
71
treatment for moderate-severe pustular acne rosasea?
ivermectin + doycycline
72
treatment for otitis externa
mild - topical acetic acid 2% spray modera/severe (discharge, hearing loss, lymphadenopathy, debris) = topical antibiotic + topical steroid
73
drugs that can cause galactorrhoea
metoclopramide domperidone phenothiazines (i.e. chlorpromazine) haloperidol very rare: SSRIs, opioids
74
treatment for lichen planus
topical clobetasone
75
congenital condition with rocker bottom feet and overlapping fingers
edward syndrome (trisomy 18)
76
small eyes and polydactyly
patau syndrome
77
learning difficulties and macrocephaly
fragile X
78
micrognathia, posterior displacement of tongue, cleft palate
pierre-robin syndrome
79
supravalvular aortic stenosis, hypercalcaemia, short stature, learning difficulties
williams syndrome
80
when is the OCP, POP, IUD, mirena and nexplanon effective
IUD - immediately POP - 2 days COCP, implant, injection and mirena (IUS) - 7 days
81
with diagnosis of chlamydia, what partners should you notify?
symptomatic men - all partners past 4 weeks women + asymptomatic men - past 6 months
82
what condition should ullipristal be used with caution in
asthma
83
antiphospholipid findings on blood test
prolonged APTT thrombocytopenia
84
what artery is affected if there is complete heart block after an MI
right coronary artery
85
induction of labour if bishop score < 6
vaginal prostaglandin or oral misoprostol (cervical balloon may be inserted if previous c-section or risk of hyperstimulation)
86
induction of labour if bishop score < 6
amniotomy or iV oxytocin infusion
87
red, painful eye with small pupil, ciliary flush
anterior uveitis
88
red, painful eye with mid-dilated pupil, haloes
acute angle closure glaucoma
89
abx of choice for dental abscess
amoxicillin
90
abx of choice for mastitis whilst breast feeding
flucloxacillin
91
chocolate ovarian cyst
endometriotic cyst
92
criteria for stage 1, 2, and 3 AKI
stage 1 - rise in creatining >26 in 24 hours or > 1.5x baseline in 7 days. or < 0.5ml/kg/hr for 6 hours stage 2 - creatinine 2-2.5x baseline - urine < 0.5ml/kg/hr > 12 hours stage 3 - creatinine > 3.5x baseline or > 354 - urine < 0.3ml/kg/hr 24 hours or anuric for 12 hours
93
calcium and phosphate in rhabdomylysis
hypocalcaemia hyperphosphataemia (calcium binds to myoglobin)
94
cervical cancer screening
25-49 -> every 3 years 50-64 -> every 5 years
95
first line treatment for syphillis
IM benzathine penicillin
96
decreases BNP levels
Beta blockers Obesity ACE inhibitors ARB Aldosterone inhibitors
97
what anti-diabetic medication is contraindicated in heart failure
pioglitazone causes fluid retension and worsens HF
98
what medication is given to someone post-MI with reduced LVEF
aldosterone antagonist e.g. spironolactone
99
biochemical effects of tumour lysis syndrome
high potassium and phosphate low calcium
100
glucose levels in fasting glucose and 2 hours post glucose challenge which is diagnostic for gestational diabetes
fasting - 5.6 mmol 2 hours post - 7.8 mmol
101
enzyme inducing drugs
st johns wart phenytoin
102
enzyme inhibiting drugs
erythromycin isoniazid
103
describe the missed pills rules for COCP
if missed 1 pill then take 1 active pill even if its 2 in a day and continue as usual if missed 2 in week 1 then emergency contraception needed if in week 2 then take active pill + extra precautions if in week 3 then take active pill + omit pill free interval
104
what medication can lead to hypoglycaemic unawareness in diabetic patients
betablockers as they mimic hypoglycaemia
105
treatment in hospital for suspected meningitis in child < 3 months and > 3 months
IV ceftriaxone if < 3 months add IV amox for listeria cover
106
most common causatie organisms in meningitis in < 3 months
neonate (up to 3 months); group B strep Neissieria meningitidis listeria
107
most common causative organisms meningitis 1month -6 years
neissiseria meningitidis strep pneumoniae hamophillus influenzae
108
most common causative organisms meningitis > 6 years
neissiseria meningitidis strep pneumoniae
109
non-sedating antihistamines
loratadine and cetirizine
110
what PH9-Q score would you start anti-depressants and/or CBT only
PH9-Q score < 16 = CBT > 16 add in anti-depressants

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