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Danny's Phase 3A Medicine > PassMed Questions > Flashcards

PassMed Questions Flashcards

1
Q

Why and when are irradiated blood products given?

A

To prevent graft versus host disease following a bone marrow or stem cell transplant

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2
Q

How may the following present?

Missed miscarriage

Threatened miscarriage

Inevitable miscarriage

Incomplete miscarriage

A

Missed miscarriage - sac with no foetal part seen (closed cervical os)

Threatened miscarriage - painless bleeding with a closed cervical os

Inevitable miscarriage - heavy bleeding with clots, pain and open cervical os

Incomplete miscarriage - not all products of conception have been expelled with heavy bleeding and open cervical os

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3
Q

cause of genital warts?

A

HPV

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4
Q

Treatment of genital warts?

A

multiple, non-keratinised warts: topical podophyllum

solitary, keratinised warts: cryotherapy

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5
Q

What is a common consequence of sub-arachnoid haemorrhage?

A

Syndrome of inappropriate anti-diuretic hormone secretion (SIADH)

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6
Q

What two antidepressants should never be combined and why?

A

SSRIs and MAOIs should never be combined as risk of serotonin syndrome

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7
Q

What is a major feature of sepsis?

A

Decreased systemic vascular resistance

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8
Q

What is often high in cardiogenic shock?

A

Pulmonary artery occlusion

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9
Q

Why is cardiac output low in hypovolaemia?

A

decrease preload

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10
Q

Signs of Cor Pulmonale/ right sided heart failure?

A
  • Raised JVP
  • Oedema
  • Hepatomegaly
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11
Q

Most common cause of infective exacerbation of COPD?

A

1) haemophilus influenza

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12
Q

What is known to be a protective factor for endometrial cancer?

A

COCP and smoking

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13
Q

treatment of Adenomyosis?

A

Hysterectomy

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14
Q

Endometrial Hyperplasia presentation and treatment?

A

Abnormal bleeding (post, inter menstrual/ menopausal)

Tx - high dose progestogens/ intra-uterine system

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15
Q

Most common cause of Ambiguous genitalia?

A

Congenital Adrenal Hyperplasia

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16
Q

Anorexia biochemical signs?

A

Most things low

Gs and Cs HIGH (cortisol, GH, glucose, salivary glands, cholesterol)

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17
Q

Poor prognosis factors of ALL?

A 
age < 2 years or > 10 years
WBC > 20 * 109/l at diagnosis
T or B cell surface markers
non-Caucasian
male sex
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18
Q

What is Palivizumab?

A

Monoclonal antibody used to prevent RSV for those at risk

Immunocompromised, CHD, prematurity

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19
Q

What is the difference between AML and ALL on blood film sample?

A

AML - Auer rods, fine chromatin, large cells

ALL - glycogen granules, coarse chromatin, smaller cells

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20
Q

Neuroblastoma symptoms?

A

Lump in abdomen

lump in chest

Back pain

bruising round eyes

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21
Q

Investigations of Neuroblastoma?

A

Bone marrow aspiration and biospy

normally from pelvic bones

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22
Q

Emergency treatment for serious Croup?

A

High flow O2 and nebuliser Adrenaline

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23
Q

Treatment of PPH?

A

1st - IM Oxytocin

signs of hypovolaemia? = RESUS

1) bimanual uterine compression to manually stimulate contraction
2) IV oxytocin and/or ergometrine
3) IM carboprost
4) intramyometrial carboprost
5) rectal misoprostol
6) surgical intervention such as balloon tamponade

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24
Q

What is a mild/moderate/severe PPH?

A 
Mild = 500-1000ml
Moderate = 1000-2000ml
Severe = Over 2000ml
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25
Q

Most common cause of PPH?

A

Uterine Atony

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26
Q

What is Ergometrine contraindicated in?

A

Hypertension

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27
Q

What is Carboprost contraindicated in?

A

Asthma

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28
Q

Placenta Abruption vs Placental Praevia?

Pain?
blood colour?
Uterus tender?
General condition?
Lie and presentation?
Foetal heart/ distress?
Coagulation problems? 
placenta position? 
Associated history?
A

ABRUPTION VS PRAEVIA

Pain vs painless
Dark red vs bright red
Tender vs relaxed 
Inconsistent with external loss vs consistent with external loss 
No malpresentation vs malpresentation 
Distressed vs normally okay 
Coagulation problems in abruption 
Normal position vs low position 
Pre-eclampsia/HTN/ trauma vs none
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29
Q

hereditary non-polyposis colorectal carcinoma disposes you high risk to what cancers?

A

Colo-rectal 1st

Endometrial 2nd

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30
Q

What is cervical excitation seen in?

A

PID

Ectopic Pregnancy

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31
Q

What is associated with Coarctation of the aorta?

A

Turner’s Syndrome
Bicuspid aortic valve
Berry aneurysms
Neurofibromatosis

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32
Q

causes of raised serum alpha-feto-protein (AFP) in pregnancy?

A

Neural tube defects
Abdominal wall defects
Multiple pregnancy

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33
Q

causes of low serum alpha-feto-protein (AFP) in pregnancy?

A

Maternal DM
Maternal Obesity
Down’s Syndrome
Edward’s Syndrome

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34
Q

Pneumonia treatment in kids?

If the cause is Mycoplasma or chlamydia?

If the cause is associated with influenza?

A

IV Amoxicillin

Macrolides

Co-amoxiclav

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35
Q

what syndromes are associated with:

Bronchiectasis?

Mitral valve prolapse?

supravalvular aortic stenosis?

A

Bronchiectasis - Kartagener’s Syndrome

Mitral valve prolapse - Fragile X Syndrome

supravalvular aortic stenosis - William’s Syndrome

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36
Q

When do the following reflexes typically disappear?

Moro

Grasp

Rooting

Stepping

A

Moro - 3/4 months

Grasp - 4/5 months

Rooting - 4 months

Stepping - 2 months

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37
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

glandular fever

A

No exclusion

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38
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Coxsackies (hand, foot,mouth)

A

No exclusion

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39
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Measles/ Rubella

A

4 days after onset of rash

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40
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Mumps

A

5 days from onset of swollen glands

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41
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Chickenpox

A

After all lesions have crusted over

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42
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Whooping cough (Pertussis)

A

48hrs after Antibiotics start or 21 days after onset of symptoms / cough

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43
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Fifth disease (slapped cheek)

A

No exclusion

44
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Impetigo

A

When all lesions have crusted over or 48hrs after antibiotic commencement

45
Q

SCHOOL EXCLUSION

When should a kid with the following return to school?

Scarlet fever

A

24hrs after Abx commencement

46
Q

What may Roseola infantum cause?

A

Febrile convulsions

47
Q

What is Roseola infantum caused by?

A

human herpes virus 6 (HHV6)

SIXTH disease!

48
Q

Treatment of threadworm?

A

Mebendazole single dose

May need another 2 weeks later

49
Q

How does Sheehans Syndrome present?

A

common complication of PPH (pituitary gland = necrosis manifests as hypopituitarism)

  • presents with lack of milk production and amenorrhoea
50
Q

Management of dysmenorrhoea already on long term contraception?

A

Mefenamic Acid

51
Q

Associations with Hyperemesis Gravidarum?

A

Nulliparity
Obesity
Trophoblastic disease

Hyperthyroidism
Increased beta hCG
Multiple pregnancies

52
Q

What is associated with a decreased incidence of hyperemesis?

A

Smoking

53
Q

What is a rare adverse effect of Lamotrigine?

A

Stevens-Johnson syndrome

(flu like prodrome 2 months after starting anti-convulsant)

(after this, rapid onset red, blistering rash, starting on the trunk extending to face/limbs)

54
Q

Name some localising features of a focal temporal seizure

A

HEAD

Hallucinations
Emotional
Automatisms (lip smacking, grabbing)
Deja Vu, Dysphasia post-ictal

55
Q

Name some localising features of a focal frontal seizure

A

Jacksonian march,
post-ictal weakness
head and leg movements

56
Q

Name some localising features of a focal parietal seizure

A

Paraesthesia

57
Q

Name some localising features of a focal occipital seizure

A

Floaters, flashes

58
Q

Long term prophylaxis of cluster headaches?

A

Verapamil

59
Q

Side effects of Rifampicin?

A

Orange bodily fluids,
rash,
hepatotoxicity (induces PY450)
drug interactions

60
Q

Side effects to Isonaizid?

A

Peripheral neuropathy,
psychosis,
hepatotoxicity (inhibits PY450)

61
Q

Side effects of Pyrazinamide?

A

Arthralgia,
gout,
hepatotoxicity,
nausea

62
Q

Side effects of Ethambutol?

A

Rash and Optic Neuritis

63
Q

ADENOMYOSIS

Features?

Ix?

Treatment

A
  • Dysmenorrhoea
  • Menorrhagia
  • Enlarged boggy uterus

Ix - MRI

Tx- GnRH agonists/ Hysterectomy

64
Q

Triad of Vasa Praevia

A
  • Rupture of membranes
  • Followed by painless bleeding
  • Fetal bradycardia
65
Q

Rhyme to remember Reactive Arthritis?

A

Cant:

See (conjunctivitis)
Pee (Urethritis)
Or climb a tree (Arthritis of lower Limbs)

circinate balanitis (painless vesicles on the coronal margin of the prepuce)
keratoderma blenorrhagica (waxy yellow/brown papules on palms and soles)
66
Q

Management of Myasthenic Crisis

A

IV Immunoglobulins

Plasmopheresis (removes circulating antibodies- those responsible for MG too)

67
Q

What is first line treatment for neuropathic pain?

A
  • Amitriptyline
  • Duloxetine
  • Gabapentin
    Pregabalin

2nd line rescue therapy - Tramadol

68
Q

Drugs associated with Stevens Johnson Syndrome?

A 
Lamotrigine 
Carbamazepine
Sulfonamide
Salicylates 
Allopurinol 
Phenytoin
Sertraline
69
Q

Management of candida nappy rash?

A

topical imidazole

70
Q

Whats the most common cause of nappy rash?

A

Irritant dermatitis - typically creases are SPARING

71
Q

Metabolic signs of Molar pregnancy?

A

Extremely high beta hCG
Low TSH
High Thyroxine

(beta hCG is similar shape to LH, FSH and TSH so can mimic these hormones)

72
Q

What layers do you cut through in a LSCS?

A

1) Superficial fascia
2) Deep fascia
3) Anterior rectus sheath
4) Rectus Abdominis
5) Transversalis fascia
6) Extraperitoneal connective tissue
7) Peritoneum
8) Uterus

73
Q

Medication to suppress lactation?

A

Cabergoline

74
Q

when should you suspect chorioamnionitis?

A

Triad of:

1) Maternal Tachycardia
2) Foetal Tachycardia
3) Maternal Pyrexia

+ Preterm PROM

75
Q

Classical history of Vestibular Schwannomas? (acoustic neuromas)

A

combination of vertigo, hearing loss, tinnitus and an absent corneal reflex (CN, V, VII, VIII)

CN V = Absent corneal reflex
CN VII = Facial palsy
CN VIII = Vertigo, hearing loss, tinnitus

76
Q

Investigation of Vestibular Schwannomas?

A

MRI of cerebellopontine angle + Audiometry

77
Q

Typical features of Normal pressure Hydrocephalus?

A

urinary incontinence
gait abnormality (may be similar to Parkinson’s disease)
Dementia

(WET, WOBBLY, WHACKY)

78
Q

Triad of Shaken Baby syndrome?

A

Retinal haemorrhages, subdural haemotoma and encephalopathy

79
Q

Metabolic signs in Congenital Adrenal Hyperplasia?

A

Hyponatraemia Hyperkalaemia ( SALT LOSERS!)

80
Q

What is the double bubble sign?

A

Sign seen in duodenal atresia (common in Downs Syndrome

81
Q

What may chlamydia infection at birth cause?

A

Neonatal Conjunctivitis, Pneumonia

Chorioamnionitis

preterm PROM

82
Q

What should everyone who has an MI be given?

A

Aspirin

P2Y12 receptor antagonist (Clopidogrel/ Ticagrelor)

Unfractioned Heparin / LMWH

83
Q

CSF findings for MS patient?

A

Oligoclonal bands

IgG antibodies

84
Q

Best anti-emetic for Parkinson’s?

A

Domperidone

85
Q

Treatment of Restless Leg Syndrome?

A

Dopamine agonists (ropinirole)

86
Q

What do you do if low grade CIN I is found on colposcopy?

A

Discharge and repeat in 12 months

87
Q

Cervical cancer features?

A

Postcoital bleeding
Purulent discharge
Red brown discharge!

+ Risk factors!!!

88
Q

Most common type of vaginal cancer?

Most common type of primary vaginal cancer?

A

80% Metastases (cervix or endometrium)

Primary = Squamous cell carcinoma (85%)

89
Q

Blood test results in PCOS?

Testosterone 
SHBG
LH
FSH
Progesterone
A 
Testosterone       - HIGH 
SHBG                   - LOW
LH                        - HIGH 
FSH                     - NORMAL
Progesterone     - LOW
90
Q

Faecal impaction treatment?

A

1st - Macrogol (Movicol Paediatric Plain)
2nd - Stimulant laxative (Senna)
3rd - Osmotic laxative (Lactulose)

91
Q

When do the following rashes normally present?

Naevus Flammeus (port-wine stain)

strawberry naevus (cavernous haemangioma)

Erythema toxicum (neonatal urticaria)

A

Naevus Flammeus (port-wine stain) - BIRTH

strawberry naevus (cavernous haemangioma) - FIRST MONTH

Erythema toxicum (neonatal urticaria) - 2/3 DAYS

92
Q

Causes of Non Immune Hydrops Fetalis?

A

● Severe anaemia – congenital parvovirus B19 infection, alpha thalassaemia major, massive materno-feto haemorrhage
● Cardiac abnormalities
● Chromosomal – Trisomy 13, 18, 21, or Turners
● Infection – toxoplasmosis, rubella, CMV, varicella
● Twin- Twin transfusion syndrome (in the recipient twin)
● Chorioangioma

93
Q

Test to ensure enough anti D given?

A

Kleinhauer Test = test amount of foetal Hb in mothers blood

94
Q

Diagnosis of haemolytic disease of newborn?

A

Direct Coombs test

95
Q

When should ECV be offered in

Nulliparous women?

Multiparous women?

A

Nulliparous = 36 weeks

Multiparous = 37 weeks

96
Q

Risk factors for Obstetric Cholestasis?

A

Hepatitis C
Multiple Pregnancy
Obstetric cholestasis in a previous pregnancy
Presence of gallstones

97
Q

How would a breast fibroadenoma feel?

A

painless Small rubbery mass that moves and is larger/ tender when menstruating

98
Q

When would fat necrosis of the breast occur?

A

After trauma

99
Q

Ductal papilloma symptoms?

A

Bloody/ clear discharge and mass felt around the nipple

100
Q

How may alveolar oedema be described on X-ray?

A

Bat wing opacities

101
Q

What is the leading cause of sudden cardiac death in the young?

A

Hypertrophic Cardiomyopathy

102
Q

If a patient has primary adrenal insufficiency, what should be done to their medication if they have a febrile illness?

In what other circumstances would you do the same?

A

Double their Hydrocortisone

Breaking a bone// other body stressor diarrhoea/cold

103
Q

Risk factors of SAH?

A
  • Ehlers Danlos Syndrome
  • Alcohol, Cocaine, Smoking
  • Polycystic kidney disease
  • coarctation of the aorta
104
Q

Most common causative agents of infective COPD exacerbation?

A

Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae

105
Q

What do the following liver function tests suggest?

A. ↑AST+↑ALT with an AST/ALT ratio of 2:1
B. ↑AST+↑ALT with an AST/ALT ratio of 1:2
C. Predominant ↑ALP
D. Isolated ↑ALP
E. Isolated ↑Bilirubin

A

A. ↑AST+↑ALT with an AST/ALT ratio of 2:1 = Alcoholic Liver Disease

B. ↑AST+↑ALT with an AST/ALT ratio of 1:2 = viral hepatitis or possibly non-alcoholic fatty liver disease

C. Predominant ↑ALP = cholestatic picture of LFTs

D. Isolated ↑ALP = breakdown of bone e.g bony metastases

E. Isolated ↑Bilirubin = gilberts syndrome

Danny's Phase 3A Medicine (10 decks)

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