PassMedicine Flashcards
1
Q
Urinary incontinence + gait abnormality + dementia =
A
normal pressure hydrocephalus
2
Q
This condition presents with dementia as well as psychiatric symptoms, the most common of which are hallucinations.
A
Lewy body dementia
3
Q
is a Parkinson’s plus condition. Thus, the condition shares many of the core features of Parkinson’s disease (tremor, rigidity, bradykinesia) as well as additional symptoms
A
Multiple system atrophy
4
Q
cardinal features of Parkinson’s disease
A
(tremor, rigidity and bradykinesia)
5
Q
Newly diagnosed patient of black African or African–Caribbean origin with hypertension - add a
A
calcium channel blocker
6
Q
have reduced efficacy in black patients and are therefore not used first-line
A
ACE inhibitors
7
Q
typically causes an early diastolic murmur
A
Aortic regurgitation
8
Q
most common valvular defect after infective endocarditis
A
aortic regurgitation
9
Q
Intensity of the murmur is increased by the handgrip maneuver
Collapsing pulse
Wide pulse pressure
A
Aortic regurgitation
10
Q
is a murmur that occurs with a patent ductus arteriosus, which is a type of congenital heart defect where the ductus arteriosus does not close after birth.
A
continuous machine-like murmur
11
Q
An ejection systolic murmur is heard with
A
aortic stenosis
12
Q
A low-pitched diastolic murmur, sometimes called a rumbling murmur, is caused by
A
mitral stenosis
13
Q
A pansystolic murmur, or holosystolic murmur, is a murmur present throughout all of systole and is typical for
A
mitral regurgitation
14
Q
This may cause a small volume pulse, a fourth heart sound and a thrill.
A
pansystolic murmur, or holosystolic murmur, mitral regurgitation
15
Q
Headache caused by raised intracranial pressure due to brain cancer (or metastases) can be palliated with
A
dexamethasone
16
Q
can reduce cerebral oedema, and therefore, reduce intracranial pressure, help alleviate symptoms of headaches and improve associated neurological deficits.
A
Dexamethasone
17
Q
would not improve the raised intracranial pressure, and can take up to 72 hours to reach peak serum concentrations.
A
Fentanyl patch
18
Q
is preferable to topiramate in women of childbearing age (i.e. the majority of women with migraine)
A
Propranolol
19
Q
propranolol is preferable to topiramate, as the latter may be
A
teratogenic
20
Q
it can reduce the effectiveness of hormonal contraceptives
A
topiramate
21
Q
is a medication which can be used to prevent predictable menstrual migraine.
A
Frovatriptan
22
Q
is considered a first-line option for migraine prophylaxis, but it can be teratogenic and it can reduce the effectiveness of hormonal contraceptives
A
Topiramate
23
Q
is a medication which can be used to prevent predictable menstrual migraine
A
Zolmitriptan
24
Q
are used in the acute treatment of migraine
A
5-HT receptor agonists
25
First line management of acute pericarditis involves
combination of NSAID and colchicine
26
This might be a suitable choice if NSAIDs or colchicine were contraindicated or have failed or when there is a specific indication such as an autoimmune disease.
Prednisolone
27
Over-replacement with thyroxine increases the risk for
osteoporosis
28
reduced bone mineral density and osteoporosis
Over-replacement with thyroxine
29
is seen in thyrotoxicosis associated with Graves' disease, due to the autoantibody-mediated activation of orbital fibroblasts.
Exophthalmos (proptosis)
30
is more commonly associated with hyperglycaemia, rather than hypoglycaemia.
Thyrotoxicosis
31
is a cause of high-output heart failure
Severe anaemia
32
as it causes cardiac stress through tachycardia and increased stroke volume.
high-output heart failure
33
This occurs when blood accumulates in the myocardium, usually following trauma.
Cardiac tamponade
34
It typically presents with Beck's triad and requires immediate pericardiocentesis.
Cardiac tamponade
35
It does typically affect patients in this age group but is a genetic condition causing the heart muscle to be thicker, and is a cause of sudden death in young people. It is not related to severe anaemia.
Hypertrophic cardiomyopathy
36
is an inflammation of the heart muscle which can cause heart failure
Myocarditis
37
is an inflammation of the pericardium
Pericarditis
38
Discontinue SAMA (switch to SABA) if commencing LAMA
COPD
39
Serial peak flow measurements at work and at home are used to detect
occupational asthma
40
The onset of cough and wheeze after starting a new job coupled with the improvement of symptoms whilst on holiday suggests a diagnosis of
occupational asthma
41
A baker is a high-risk profession for occupational
asthma
42
Schistosomiasis is treated with
praziquantel
43
which commonly causes a 'swimmer's itch', particularly in patients who return from Africa
schistosomiasis
44
This usually causes an itchy rash to form commonly on the legs due to swimming in infected water.
schistosomiasis
45
is commonly used in the management of cellulitis.
Flucloxacillin
46
can be used for the management of nematodes.
Thiabendazole
47
is a parasitic flatworm infection
Schistosomiasis, or bilharzia
48
Definitive diagnosis of sickle cell disease is by
haemoglobin electrophoresis
49
This patient is presenting with a history of thrombotic crises, typical of
sickle cell anemia
50
the sickle-shaped red blood cells occlude the vessels causing
momentary ischemia
51
The treatment is supportive, with analgesia and abundant fluids.
sickle-shaped red blood cells occlude the vessels causing momentary ischemia.
52
Serum-free light chain assay is used to diagnose
multiple myeloma
53
is a contraindication to statin therapy
Pregnancy
54
Thymomas are commonly associated with
myasthenia gravis
55
Lambert-Eaton myasthenic syndrome is commonly associated with
small-cell lung cancer
56
is a life-threatening medical emergency that requires immediate treatment with pericardiocentesis
Cardiac tamponade
57
triad consists of muffled heart sounds, raised JVP and hypotension.
Beck's triad
58
Cardiac tamponade is an emergency and requires immediate
pericardiocentesis to drain the blood in the pericardium.
59
is a procedure used to aspirate air from the pleural cavity in patients with a tension pneumothorax.
Thoracocentesis
60
It is important to remember that strokes can be caused by
hypercoagulable states and hyperviscosity
61
which usually also presents with bone marrow infiltration, splenomegaly and sometimes lymphadenopathy.
Waldenstrom's macroglobulinaemia
62
Pyridostigmine is a long-acting acetylcholinesterase inhibitor that reduces the breakdown of acetylcholine in the neuromuscular junction, temporarily improving symptoms of
myasthenia gravis
63
are used to treat myasthenic crisis where there is respiratory muscle weakness
Plasmapheresis and IV immunoglobulin
64
Immunosuppressive agents such as prednisolone can be used to treat relapses however it may take months of treatment to achieve remission.
myasthenia gravis
65
would be considered if the disease is not easily controlled by pyridostigmine or there was evidence of a thymoma to prevent local invasion.
Thymectomy
66
Posterior MI typically present on ECG with
tall R waves V1-2
67
usually occurs due to an occlusion of the posterior descending artery (posterior interventricular artery).
Posterior myocardial infarction
68
In 80% of people, this artery branches from the right coronary artery.
posterior descending artery (posterior interventricular artery)
69
In this case there is a high risk wound and symptoms so tetanus ___________would be advised alongside a muscle relaxant such as diazepam, and ventilatory support if needed.
immunuglobulin
70
Wounds burns needing surgery delayed more than 6 hours
Wounds contaminated with soil
Compound fractures
Wounds containing foreign bodies
Wounds/burns in people with systemic sepsis
High risk wounds
71
Signs of right-sided heart failure are
raised JVP, ankle oedema and hepatomegaly
72
describes the hypertrophy of the right ventricle and right heart failure that are caused by pulmonary arterial hypertension.
Cor pulmonale
73
hypoxia induces pulmonary vasoconstriction, eventually causing
pulmonary hypertension
74
Shortness of breath on exertion, orthopnoea and paroxysmal nocturnal dyspnoea are more indicative of
left-sided heart failure
75
Chest pain on exertion is indicative of angina due to
coronary artery disease.
76
is a sign of right-sided heart failure
Hepatomegaly
77
sign may be seen in pancreatic cancer
The 'double duct'
78
New onset diabetes (HbA1C of 7.3%) in someone of this age should ring alarm bells for
pancreatic cancer and prompt referral.
79
A raised serum lipase and painless jaundice also add to the case.
pancreatic cancer and prompt referral.
80
this is seen on brain imaging and can indicate progressive supranuclear palsy (PSP)
Hummingbird sign
81
Pulmonary stenosis is louder on
inspiration
82
causes an ejection systolic murmur that is louder on inspiration.
Pulmonary stenosis
83
An ejection systolic murmur that is louder on expiration is characteristic of
aortic stenosis
84
A holo-systolic murmur that is louder on expiration is indicative of
mitral regurgitation.
85
A holo-systolic murmur that is louder on inspiration is indicative of
tricuspid regurgitation
86
Late systolic murmurs indicate
mitral valve prolapse and coarctation of the aorta
87
A mid-systolic click is caused by
prolapse of the mitral valve
88
is the gold standard test for diagnosing venous sinus thrombosis
MR Venogram
89
slow-onset severe headache, diplopia, nausea and seizures. These are all features of
increased intracranial pressure
90
past medical history of antiphospholipid syndrome coupled with pregnancy, which induces a
hypercoagulable state, lead to a diagnosis of venous sinus thrombosis.
91
is defined as a thrombotic obstruction of the cerebral veins and/or dural sinuses.
Venous sinus thrombosis
92
MR venogram is a form of MRI which is used to diagnose this condition
Venous sinus thrombosis
93
This is the investigation of choice to diagnose meningitis, which would present with fever, photophobia and neck stiffness
Lumbar puncture - CSF sent for cell counts and gram stain
94
This is the investigation of choice to diagnose a subdural haematoma when a CT head is negative
Lumbar puncture with CSF sent for xanthochromia
95
severe, sudden onset thunderclap headache, photophobia and neck stiffness
subdural haematoma
96
is normal in around 70% of patients affected by venous sinus thrombosis.
Non-contrast CT head scan
97
describes patients with ischaemic symptoms suggestive of an ACS and no elevation in troponins, with or without electrocardiogram changes indicative of ischaemia
Unstable angina
98
This patient is presenting with chest pain accompanied by deeply inverted T waves in V2-3 and a 0.5mm ST depression in the same leads.
unstable angina
99
would present with a sharp, tearing pain in the anterior chest or back.
Aortic dissection
100
It is a type of progressive cellulitis that invades the floor of the mouth and soft tissues of the neck.
Ludwig's angina
101
presents with chest pain and ST-segment depression
Non-ST elevation myocardial infarction
102
needs an ST elevation greater than 1.5 mm in V2-3 in women to be diagnosed and elevated troponin levels.
ST elevation myocardial infarction
103
classically presents as visible haematuria following a recent URTI
IgA nephropathy
104
episodes of macroscopic haematuria, typically associated with a recent respiratory tract infection and mild proteinuria.
IgA nephropathy
105
which is caused by immune complex (IgG, IgM, and C3) deposition in the glomeruli.
post-streptococcal glomerulonephritis
106
This happens more slowly, typically 7-14 days following a group A beta-hemolytic Streptococcus infection and causes proteinuria.
post-streptococcal glomerulonephritis
107
is an X-linked dominant disease. It presents with microscopic haematuria, bilateral sensorineural deafness, and lenticonus.
Alport's syndrome
108
can present as nephrotic syndrome, haematuria, or proteinuria.
Membranoproliferative glomerulonephritis
109
disease is very common in children, but nearly always presents as nephrotic syndrome.
Minimal change
110
causes renal failure by tubular cell necrosis
Myoglobinuria
111
The history and a very high serum creatine kinase give a diagnosis of
rhabdomyolysis
112
can cause a restrictive lung defect on spirometry
Kyphoscoliosis (e.g. ankylosing spondylitis)
113
a normal chest examination along with a normal chest x-ray make clinically significant ILD unlikely
Pulmonary fibrosis
114
The x-ray may show emphysema, flattened hemidiaphragms and hyperinflation. In obstructive lung disease, the FEV1/FVC ratio is < 0.7.
COPD
115
should be stopped in AKI as may worsen renal function
ACE inhibitors
116
is a 5α-reductase inhibitor and treats benign prostatic hyperplasia (BPH) by blocking dihydrotestosterone synthesis.
Finasteride
117
'Unprovoked' pulmonary embolisms are typically treated for
6 months
118
is used to suppress nausea and vomiting with intracranial tumours
Dexamethasone
119
can reduce the oedema of CNS tumor can relieve nausea and vomiting.
Dexamethasone
120
is commonly prescribed in malignant nausea, it is not the best drug for nausea secondary to brain tumours because it does not directly treat the cause of nausea.
histamine H1-receptor antagonist (antihistamine)cyclizine
121
helps to reduce labyrinth disorders related symptoms.
Prochlorperazine
122
is analogous to chlorpromazine; both of these agents antagonize dopaminergic D2 receptors in various pathways of the central nervous system.
Prochlorperazine
123
the antiemetic action of ____________is due to its antagonist activity at D2 receptors in the chemoreceptor trigger zone in the central nervous system, it will not reduce the oedema of the tumour which causes the symptoms
metoclopramide
124
is a type of benzodiazepine which will reduce his agitation
Lorazepam
125
should be urgently referred for assessment by specialist spinal services (neurosurgery or orthopaedic spinal surgery)
degenerative cervical myelopathy
126
degenerative cervical myelopathy
Cervical decompressive surgery
127
SGLT-2 inhibitors have been linked to necrotising fasciitis of the genitalia or perineum (Fournier's Gangrene)
Dapagliflozin
128
is an SGLT-2 inhibitor used in type 2 diabetes. It acts to inhibit sodium glucose co-transporter 2 in the proximal convoluted tubule which reduces glucose reabsorption and increases urinary glucose excretion.
Dapaglifozin
129
Ileocaecal resection may result in
vitamin B12 deficiency
130
is absorbed in the terminal ileum, therefore resection of the terminal ileum as part of ileocaecal resection would reduce
vitamin B12
131
would cause anaemia and glossitis
Iron deficiency
132
Cortisol: suppressed
ACTH: suppressed
High-dose dexamethasone suppression test with a pituitary adenoma
133
Suppressed ACTH and cortisol on high-dose dexamethasone suppression
Cushing's disease (pituitary adenoma)
134
Suppressed ACTH but unsuppressed cortisol on high-dose dexamethasone
adrenal adenomas
135
Unsuppressed ACTH and cortisol on high-dose dexamethasone suppression
Ectopic ACTH syndrome
136
following possible exposure give immunglobulin + vaccination
Rabies
137
there will be an abnormally large drop in BP during inspiration, known as pulsus paradoxus
In cardiac tamponade
138
drop in blood pressure on inspiration
pulsus paradoxus
139
The symptoms three months ago were likely due to optic neuritis, a common presenting feature of ___________.
multiple sclerosis
140
The combination of low platelet counts and raised FDP in this setting make ________ the most likely diagnosis.
Disseminated intravascular coagulation
141
is most commonly caused by cavernous sinus tumours.
Cavernous sinus syndrome
142
the nasopharyngeal malignancy has locally invaded the left cavernous sinus
Cavernous sinus syndrome
143
Diagnosis is based on signs of pain, opthalmoplegia, proptosis, trigeminal nerve lesion (opthalmic branch) and Horner's syndrome.
Cavernous sinus syndrome
144
Measure of disease activity in rheumatoid arthritis
DAS28
145
Helps estimate the risk of a patient having a deep vein thrombosis
Wells score
146
Mini-mental state examination - used to assess cognitive impairment
MMSE
147
Used in the assessment of suspected obstructive sleep apnoea
Epworth Sleepiness Scale
148
Indicates prognosis in prostate cancer
Gleason score
149
is the second most common association of HNPCC after colorectal cancer
Endometrial cancer
150
are 'critical' medicines which should not be stopped on acute admissions and must be delivered on time
Levodopa and other antiparkinsons drugs
151
presents with the triad of sudden onset abdominal pain, ascites, and tender hepatomegaly
Budd-Chiari syndrome
152
Gallstones are likely to cause a greater increase in
ALP
153
causes a rise in bilirubin after an acute stress on the body eg: illness or fasting.
Gilbert's syndrome
154
DVT investigation: if the scan is negative, but the D-dimer is positive
→ stop anticoagulation and repeat scan in 1 week
155
Sexual dysfunction is an important side effect of
thiazide-like diuretics such as indapamide
156
Due to it's action as an insulin secretagogue, it can cause hypoglycaemia.
Gliclazide
157
Hypsarrhythmia on EEG suggests
infantile spasms (West's syndrome)
158
typically present with tonic-clonic movements and a loss of consciousness, with a history of fever, most commonly between the ages of 6 months and 3 years.
Febrile seizures
159
typically presents in adolescence with infrequent generalised seizures.
Juvenile myoclonic epilepsy
160
Nasogastric tubes are safe to use if
pH <5.5 on aspirate
161
develops in around 10% of primary sclerosing cholangitis patients
Cholangiocarcinoma
162
is the most common cause of an exudative pleural effusion
Pneumonia
163
protein level >35 and the LDH >200 point
exudative effusion
164
can immediately be ruled out as they are both transudative.
heart failure and renal failure
165
ITP - give oral
prednisolone
166
is the first-line treatment for immune thrombocytopenic purpura (ITP) which is defined as an isolated low platelet count
Oral prednisolone
167
3 sets of blood cultures are recommended in the investigation of
infective endocarditis
168
is used for symptomatic bradycardia if atropine fails
External pacing
169
typically presents with haematuria, proteinuria/oedema, hypertension and oliguria
Post-streptococcal glomerulonephritis
170
periorbital oedema, oliguria, proteinuria and haematuria after impetigo.
Post-streptococcal glomerulonephritis
171
profuse diarrhoea due to infection with Escherichia coli O157
Haemolytic uraemic syndrome
172
presents similarly and also occurs after an upper respiratory tract infection, but has a shorter latency period (1-2 days following the infection)
IgA nephropathy
173
It could result in dark ('cola coloured') urine due to myoglobinuria
Rhabdomyolysis
174
infection is a common cause for non-specific urethritis (dysuria +/- urethral discharge)
Chlamydia trachomatis
175
most common symptom of Crohn's disease in children?
Abdominal pain
176
COPD - still breathless despite using SABA/SAMA and asthma/steroid responsive features →
add a LABA + ICS
177
is used first-line to prevent angina attacks
A beta-blocker or a calcium channel blocker
178
Newly diagnosed patient with hypertension who has a background of type 2 diabetes mellitus - add
an ACE inhibitor or an angiotensin receptor blocker regardless of age
179
Motor (6 points) Verbal (5 points) Eye opening (4 points). Can remember as '654...MoVE'
GCS
180
A sudden anemia and a low reticulocute count indicates parvovirus
sickle cell anaemia
181
It is important to remember that strokes can be caused by
hypercoagulable states and hyperviscosity
182
UTI in a pregnant woman in the third trimester - use
amoxicillin or cefalexin
183
is the recommended treatment for symptomatic UTI in pregnant women near term
Cefalexin
184
is the treatment of choice for some sexually transmitted infections such as Chlamydia in pregnant women
Azithromycin
185
postural hypotension may be seen in Parkinson's disease the ataxic gait point towards a diagnosis of
multiple system atrophy
186
is associated with faecal-oral spread, commonly affecting shellfish and pork products. Blood results show elevated bilirubin and significant transaminitis.
Hepatitis E
187
Pneumocystis jiroveci penumonia is treated with
co-trimoxazole, which is a mix of trimethoprim and sulfamethoxazole
188
are the investigation of choice in genital herpes
Nucleic acid amplification tests (NAAT)
189
Optic neuritis can be a feature of
multiple sclerosis
190
should first be investigated with a Holter monitor after initial bloods/ECG
Palpitations
190
should first be investigated with a Holter monitor after initial bloods/ECG
Palpitations
191
are best visualized by MRI of the cerebellopontine angle
Acoustic neuromas
192
Regular opioid medication can lead to
medication overuse headaches
193
In life-threatening Clostridium difficile infection treatment is with
ORAL vancomycin and IV metronidazole
194
are generally used first-line in the management of patients with warm autoimmune haemolytic anaemia
Steroids (+/- rituximab)
195
Lying/standing blood pressure is a very important investigation in the elderly who present with
falls
196
often presents with raised CK and leukocytosis
Neuroleptic malignant syndrome
197
accounts for the majority of lung cancer cases in non-smokers
Adenocarcinoma
198
is an X linked disorder affecting red cell enzymes.
Glucose-6-phosphate dehydrogenase deficiency
199
PPI + amoxicillin + clarithromycin, or
| PPI + metronidazole + clarithromycin
H. pylori eradication:
200
is associated with Takayasu's arteritis
Renal artery stenosis
201
Patients with a suspected pulmonary embolism should be initially managed with a
direct oral anticoagulant (DOAC)
202
There is no need for prophylactic antibiotics for Lyme disease in
asymptomatic patients bitten by a tick
203
causes peripheral neuropathy
Isoniazid
204
are first-line in benign prostatic hyperplasia if the patient has troublesome symptoms
Alpha-1 antagonists
205
pseudopolyps seen on endoscopy
Ulcerative colitis
206
should be prescribed in all patients with suspected hepatic encephalopathy
Lactulose
207
Obese, young female with headaches / blurred vision think
idiopathic intracranial hypertension
208
painless bright red vaginal bleeding
Placenta praevia
209
Right upper quadrant tenderness and bilious fluid in the intra-abdominal drain would suggest
bile leak following the cholecystectomy
210
Patients with GORD being considered for fundoplication surgery require
oesophageal pH and manometry studies
211
disease is a cause of hypoglycaemia
Addison's
212
A grossly elevated APTT may be caused by
heparin therapy, haemophilia or antiphospholipid syndrome
213
include flu-like symptoms and a dry cough, relative bradycardia and confusion. Blood tests may show hyponatraemia
Stereotypical features of Legionella
214
Poorly controlled hypertension, already taking an ACE inhibitor - add
a calcium channel blocker or a thiazide-like diuretic
215
Guidelines continue to recommend the use of IM diclofenac in the acute management of
renal colic
216
Pneumonia caused by Streptococcus pneumoniae is associated with
cold sores
217
If a uterine fibroid is less than 3cm in size, and not distorting the uterine cavity, medical treatment can be tried
(e.g. IUS, tranexamic acid, COCP etc)
218
is the persistent belief in the presence of an underlying serious disease, e.g. cancer
Illness anxiety disorder (hypochondriasis)
219
Isolated fever in well patient in first 24 hours following surgery?
Think physiological reaction to operation
220
should be stopped in AKI as may worsen renal function
Angiotensin II receptor antagonists
221
must be temporarily stopped when a macrolide antibiotic is started
Statins
222
Adult with asthma not controlled by a SABA -
add a low-dose ICS
223
This is a common cause of itch in the third trimester of pregnancy
intrahepatic cholestasis of pregnancy
224
a high ALP and GGT, with a lesser rise in ALT
cholestatic picture of liver function tests (LFTs)
225
are now the first-line test for acromegaly
Serum IGF-1 levels
226
is at risk with duodenal ulcers on the posterior wall
Gastroduodenal artery
227
Primary biliary cholangitis - the M rule
IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females
228
should be offered to women with a previous baby with early- or late-onset GBS disease
Maternal intravenous antibiotic prophylaxis
229
can cause orange tears/urine
Rifampicin
230
congenital adrenal hyperplasia is most common cause in newborns
Ambiguous genetalia
231
most commonly affects neonates in the first 30 days of life and is most commonly bilious
Malrotation
232
Pregnant women who have a first degree relative with diabetes should be screened for gestational diabetes with an oral glucose tolerance test (OGTT) at
24-28 weeks
233
is a dislocation of the distal radioulnar joint with an associated fracture of the radius
A Galeazzi fracture
234
test is the most reliable test to confirm ovulation
Day 21 progesterone
235
Patients with raised ICP may exhibit Cushing's triad:
widening pulse pressure
bradycardia
irregular breathing
236
To detect a subarachnoid haemorrhage the LP should be done at least
12 hours after the start of the headache
237
is used in non-falciparum malaria to destroy liver hypnozoites and prevent relapse
Primaquine
238
purpura classically presents with abdominal pain, arthritis, haematuria and a purpuric rash over the buttocks and extensor surfaces of arms and legs
Henoch-Schonlein purpura
239
A young woman complains of feeling lonely. She has stopped seeing her old friends as she is worried about not being liked or criticised -
avoidant personality disorder
240
if both parents are carriers (heterozygote) there is a 25% chance of having an affected (homozygote) child
autosomal recessive conditions
241
Prolactin release is persistently inhibited by
dopamine
242
External rotation (on both active and passive movement) is classically impaired in
adhesive capsulitis
243
Small cell lung carcinoma secreting ACTH can cause
Cushing's syndrome
244
Chest x-ray in transient tachypnoea of the newborn may show
hyperinflation and fluid in the horizontal fissure
245
is the most effective form of emergency contraception and is not affected by BMI
The copper intra-uterine device
246
The presence of proximal muscle weakness with dermatological signs should raise suspicion of
dermatomyositis
247
Careful speculum examination to look for pooling of amniotic fluid in the posterior vaginal vault is the first-line investigation for
preterm prelabour rupture of the membranes
248
is the most common metabolic complication in patients with cancer
Hypercalcaemia
249
maternal fever, tachycardia and neutrophilia (note that the normal range is elevated during pregnancy).
Chorioamnionitis
250
classically presents as visible haematuria following a recent URTI
IgA nephropathy
251
inhibits the Na-K-Cl cotransporter in the thick ascending limb of the loop of Henle
Furosemide
252
Bisphosphonates can cause a variety of
oesophageal problems
253
in infants use a two-thumb encircling technique for chest compression
Paediatric BLS
254
is associated with bilateral vestibular schwannomas
Neurofibromatosis type 2
255
Investigation for diabetes insipidus
water deprivation test
256
this is 7 days before the end of the lady's regular cycle when progesterone levels should be tested.
Day 28
257
Haemoarthroses are a common feature of
haemophilia
258
can present several weeks after the initial head injury
Subdural haematomas
259
Urinary incontinence in a man with a history of gonorrhoea may be due to a
urinary stricture
260
is a risk factor for hyperemesis gravidarum
Multiple pregnancy
261
Lip smacking + post-ictal dysphasia are localising features of a
temporal lobe seizure
262
The most appropriate treatment of a patient with signs and symptoms consistent with _______________ is urgent, same day referral for assessment by an opthalmologist
anterior uveitis
263
once-daily insulin dose should generally be reduced by 20% on the day before and the day of surgery
Surgery / diabetes
264
In an infant, the appropriate places to check for a pulse are the brachial and femoral arteries
Paediatric BLS
265
are known to exacerbate plaque psoriasis
Beta-blockers
266
Ligamentous injuries of the knee joint are best confirmed through
magnetic resonance imaging (MRI)
267
Isoniazid inhibits the
P450 system
268
classically associated with a pansystolic murmur
Ventricular septal defect
269
is the investigation of choice for intussusception
Ultrasound
270
Pneumonia caused by Streptococcus pneumoniae is associated with
cold sores
271
A complication of epidural anesthesia is a
epidural haematoma
272
is the number one cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years.
Meckels diverticulum
273
Urinary incontinence - first-line treatment:
urge incontinence: bladder retraining
| stress incontinence: pelvic floor muscle training
274
is associated with a history of recurrent self-harm and intense interpersonal relationships that alternate between idealization and devaluation
Borderline (emotionally unstable) personality disorder
275
is a contraindication for injectable progesterone contraceptives
Current breast cancer
276
is a key investigation for a suspected perforated peptic ulcer
An erect chest x-ray
277
are seen in SSRI discontinuation syndrome
Gastrointestinal side-effects such as diarrhoea
278
presents with the triad of sudden onset abdominal pain, ascites, and tender hepatomegaly
Budd-Chiari syndrome
279
Gottron’s papules, roughened red papules over the knuckles mainly, are seen in
dermatomyositis
280
direct oral anticoagulant (DOAC) should be offered first-line for reducing stroke risk in
atrial fibrillation (AF)
281
may also present with shoulder pain and upper limb neurological signs due to local extension of the tumour
As well as Horner's syndrome, Pancoast tumours
282
Patients who have received an organ transplant are at risk of
skin cancer (particularly squamous cell carcinoma) due to long-term use of immunosuppressants
283
Liver transplantation criteria in paracetamol overdose
pH < 7.3 more than 24 hours after ingestion
284
The standard HbA1c target in type 2 diabetes mellitus is
48 mmol/mol
285
demonstrated by severe itching, jaundice, obstructive LFTs, normal WBC and no evidence of coagulopathy.
cholestasis of pregnancy
286
If a uterine fibroid is less than 3cm in size, and not distorting the uterine cavity, medical treatment can be tried (e.g.
IUS, tranexamic acid, COCP etc)
287
is associated with ‘tear drop’ poikilocytes on blood film
Myelofibrosis
288
is a non-cancerous growth of squamous epithelium that is 'trapped' within the skull base causing local destruction.
Cholesteatoma
289
are ANA positive, therefore it is a useful rule out test
Over 99% of patients with SLE
290
An itchy rash affecting the face and scalp distribution is commonly caused by
seborrhoeic dermatitis
291
if both parents are carriers (heterozygote) there is a 50% chance of having a carrier (heterozygote) child
For autosomal recessive conditions
292
may be diagnosed in patients who are overly sensitive and can be unforgiving if insulted, question loyalty of those around them and are reluctant to confide in others
Paranoid personality disorder
293
is the most common hereditary sensorimotor neuropathy
Charcot-Marie-Tooth Disease
294
is the most suitable management option for epistaxis where the bleed site is difficult to localise
Anterior packing
295
COPD symptoms in a young person - think
alpha-1 antitrypsin (A1AT) deficiency
296
is a complication of acute pancreatitis
Acute respiratory distress syndrome
297
Human bites, like animal bites, should be treated with
co-amoxiclav
298
typically involves loss of motor or sensory function. May be caused by stress
Conversion disorder
299
sudden painless loss of vision, severe retinal haemorrhages on fundoscopy
Central retinal vein occlusion
300
HRT: unopposed oestrogen increases risk of
endometrial cancer
301
hyperpigmentation of the palmar creases
Addison's disease
302
is the imaging of choice in suspected renal colic
Non-contrast CT-KUB
303
should be continued during an acute attack in patients presenting with an acute flare of gout who are already established on treatment
Allopurinol
304
Pneumocystis jiroveci penumonia is treated with
co-trimoxazole, which is a mix of trimethoprim and sulfamethoxazole
305
Newly diagnosed patient with hypertension (< 55 years) - add an
ACE inhibitor or an angiotensin receptor blocker
306
Gestational diabetes can be diagnosed by either a:
fasting glucose is >= 5.6 mmol/L, or
| 2-hour glucose level of >= 7.8 mmol/L
307
fibrinolysis should be offered within 12 hours of onset of symptoms if primary PCI cannot be delivered within 120 minutes
STEMI management
308
is a safer opioid to use in patients with moderate to end-stage renal failure
Oxycodone
309
Behcet's syndrome is associated with
erythema nodosum
310
should be suspected in patients with continuous dribbling incontinence after prolonged labour and from an area with limited obstetric services.
Vesicovaginal fistulae
311
Use of the contraceptive pill should be ceased before an operation to prevent a
pulmonary embolism
312
Coeliac disease increases the risk of developing enteropathy-associated
T cell lymphoma
313
are recommended for superficial thrombophlebitis
Compression stockings
314
The main ECG abnormality seen with hypercalcaemia is
shortening of the QT interval
315
Diagnosis of a mesothelioma is made on histology, following a
thoracoscopy
316
is the investigation of choice for suspected aortic dissection (depending on stability of patient)
CT angiography
317
normally presents within 5-10 days post-operatively. The shortness of breath makes a diagnosis of
Venous thromboembolism
318
ultrasound with Doppler flow studies is very sensitive and should be the initial radiological investigation
Budd–Chiari syndrome
319
X-ray changes of osteoarthritis (LOSS)
Loss of joint space
Osteophytes forming at joint margins
Subchondral sclerosis
Subchondral cysts
320
Chickenpox exposure in pregnancy - first step is to
check antibodies
321
If 2 pills missed in week 3, finish the pills in the current pack and start new pack immediately, omitting pill-free interval
COCP
322
is used in patent ductus arteriosus to promote duct closure
Indomethacin or ibuprofen
323
neuroimaging findings: ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement
Normal pressure hydrocephalus
324
HBsAg negative, anti-HBs positive, IgG anti-HBc negative -
previous immunisation
325
A protein found on the surface of the hepatitis B virus and only positive in active infection.
HBsAg - hepatitis B surface antigen
326
hepatitis B surface antibody. Individuals produce anti-HBs following natural infection or vaccination. Therefore, positive anti-HBs indicates immunity but does not differentiate between previous infection or previous vaccination.
Anti-HBs (sometimes written HBsAb)
327
These are antibodies produced against the hepatitis B core antigen. The vaccine does not contain core antigen, only exposure to the hepatitis B virus gives positive anti-HBc. IgM antibodies indicate current infection (high titre indicates acute infection, low titre indicates chronic infection), while IgG antibodies indicate a previous infection.
Anti-HBc (HBcAb) - hepatitis B core antibody.
328
HBsAg positive
anti-HBs negative
IgG anti-HBc negative
IgM anti-HBc positive (high titre)
Acute infection:
329
HBsAg positive
anti-HBs negative
IgG anti-HBc negative
IgM anti-HBc positive (low titre)
Chronic infection:
330
HBsAg negative
anti-HBs positive
IgG anti-HBc positive
IgM anti-HBc negative
Immune due to natural infection:
331
HBsAg negative
anti-HBs negative
IgG anti-HBc negative
IgM anti-HBc negative
No immunity or infection:
332
is the most common inherited clotting disorder
Von Willebrand's disease
333
should be used for children with pneumonia if mycoplasma is suspected
A macrolide e.g. erythromicin
334
is a risk factor for hyperemesis gravidarum
Multiple pregnancy
335
Elderly, alcoholic, head injury, insidiuous onset symptom -
subdural haematoma
336
Passage of meconium after 48 hours is a red flag
Hirschsprung's disease
337
Red or black lump, oozes or bleeds, sun-exposed skin
Nodular melanoma
338
Endotracheal intubation may be necessary to protect the airway in
acute epiglottitis
339
Trophoblastic disease is a risk factor for
hyperemesis gravidarum
340
An effective treatment for borderline personality disorder is
dialectical behaviour therapy (DBT)
341
Any person on anticoagulants with a head injury must receive a
CT head within 8 hours
342
hormone replacement therapy (HRT) or a combined oral contraceptive pill should be offered to women until the age of 51 years
Premature ovarian insufficiency
343
Membranous nephropathy is frequently associated with
malignancy
344
should be used as the first-line treatment in opioid detoxification
Methadone or buprenorphine
345
ulcers usually occur around the medial malleolus (gaiter region)
Venous
346
are first-line treatment for prolactinomas, even if there are significant neurological complications
Dopamine agonists (e.g. cabergoline, bromocriptine)
347
slapped-cheek syndrome, also known as erythema infectiosum.
parvovirus b19
348
Dysphagia, aspiration pneumonia, halitosis → ?
pharyngeal pouch
349
syndrome produces pain on passive stretch
Compartment
350
A common endocrine complication of small cell lung cancer is
SIADH
351
As well as xanthochromia, CSF findings consistent with subarachnoid haemorrhage include a
normal or raised opening pressure
352
Bone pain, tenderness and proximal myopathy (→ waddling gait) → ?
osteomalacia
353
Benzylpenicillin is the antibiotic of choice for ________prophylaxis
GBS
354
Patients are at increased risk of bladder, colon, and rectal cancer following radiotherapy for
prostate cancer
355
Bilious vomiting on the first day is likely due to
intestinal atresia
356
Bilateral idiopathic adrenal hyperplasia is the most common cause of
primary hyperaldosteronism
357
Unstable angina or NSTEMI?
Elevation in troponin points towards NSTEMI
358
if the patient is conscious and able to swallow the first-line treatment is a fast-acting carbohydrate by mouth i.e.. glucose liquids, tablets or gels
Hypoglycaemia treatment
359
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller → ?
dengue
360
Corticosteroids may cause
proximal myopathy
361
If a hernia cannot be reduced it is referred to as
an incarcerated hernia
362
The low-dose (overnight) dexamethasone suppression test is the best test to diagnosis
Cushing's syndrome
363
Use of the contraceptive pill should be ceased before an operation to prevent a
pulmonary embolism
364
Haemolytic uraemic syndrome - classically caused by
E coli 0157:H7
365
is a common cause of bacterial otitis media
Haemophilus influenzae
366
should be considered if a bradycardia doesn't respond to drugs or transcutaneous pacing
Transvenous pacing
367
is elevated in biliary atresia
Conjugated bilirubin
368
Neutrophil predominant leucocytosis is present in 80–90% of people with
appendicitis
369
can cause AKI due to acute tubular necrosis
Rhabdomyolysis
370
raises the possibility of Ramsey-Hunt syndrome but this is actually quite common in Bell's palsy
The pain around the ear
371
T2DM with abnormal LFTs - ?
non-alcoholic fatty liver disease
372
Confusion, ataxia, nystagmus + ophthalmoplegia are features of
Wernicke's encephalopathy
373
is an important side effect of amiodarone
Thyroid dysfunction
374
A child aged 6-11 years should be administered adrenaline at a dose of 300 micrograms (0.3ml), repeated every 5 minutes if necessary
Anaphylaxis
375
The AST/ALT ratio in alcoholic hepatitis is
2:1
376
extend beyond the limits of the incision.
Keloid scars
377
if the fasting plasma glucose is < 7 mmol/l a trial of diet and exercise should be offered for 1-2 weeks
Gestational diabetes
378
hydrocortisone + fludrocortisone
Addison's disease management
379
can cause fluid retention and is therefore contraindicated in patients with heart failure.
Pioglitazone
380
A tension pneumothorax should not be investigated if suspected but should be immediately
decompressed with a needle
381
is the mainstay for acute PR bleeds if patient is haemodynamically stable
Supportive management
382
Rapid correction of hyponatraemia can cause
osmotic demyelination syndrome
383
Trichomonas vaginalis + bacterial vaginosis are associated with a pH
> 4.5
384
are first line for lower back pain
NSAIDS
385
acute treatment: subcutaneous sumatriptan + 100% O2
Cluster headache
386
is a risk factor for developing adhesive capsulitis
Diabetes mellitus
387
may present with upper quadrant abdo pain
Lower lobe pneumonia
388
is a restrictive lung condition. Therefore spirometry results will commonly show a normal or slightly reduced FEV1 and a reduced FVC
Pneumoconiosis
389
Carbamazepine is a P450 enzyme
inductor
390
The standard target time for thrombectomy in acute ischaemic stroke is
6 hours
391
Multiple painful genital ulcers, sexually active -
genital herpes
392
acute alcohol intake is not associated with an increased risk of developing hepatotoxicity and may actually be protective
Paracetamol overdose
393
The main ECG abnormality seen with hypercalcaemia is
shortening of the QT interval
394
Complications of thyroid surgery - damage to parathyroid glands can result in
hypocalcaemia
395
Ptosis + dilated pupil = third nerve palsy; ptosis + constricted pupil =
Horner's
396
is a highly specific test for SLE
Anti-dsDNA
397
stroke causes leg weakness but not face weakness or speech impairment
Anterior cerebral artery
398
rule out thyroid disease
Anxiety
399
is recommend for patients with an acute ischaemic stroke who present within 4.5 hours
A combination of thrombolysis AND thrombectomy
400
Trichomonas vaginalis + bacterial vaginosis are associated with a pH
> 4.5
401
The sudden fall in haemoglobin without an appropriate reticulocytosis is typical of an
aplastic crisis, usually secondary to parvovirus infection
402
Organophosphate insecticide
atropine
403
helps to distinguish pseudogout from gout
Chondrocalcinosis
404
In life-threatening Clostridium difficile infection treatment is with
ORAL vancomycin and IV metronidazole
405
In women at risk of neural tube defects, folic acid should be started
before conception
406
Investigating suspected PE: if the CTPA is negative then consider a
proximal leg vein ultrasound scan if DVT is suspected
407
symptoms suggests idiopathic Parkinson's
Asymmetrical
408
Dominant hemisphere middle cerebral artery strokes cause
aphasia
409
is an option for nausea and vomiting in pregnancy, but it should not be used for more than 5 days due to the risk of extrapyramidal effects
Metoclopramide
410
is a good first line anti-emetic for intracranial causes of nausea and vomiting
Cyclizine
411
is used for long-term prophylaxis of cluster headaches
Verapamil
412
increased risk of breast and cervical cancer
| protective against ovarian and endometrial cancer
Combined oral contraceptive pill
413
toxicity - avoid beta-blockers
Cocaine
414
levels can indicate an upper GI bleed versus lower GI bleed
High urea
415
cancer may present with cholestatic LFTs
Pancreatic
416
Tracheal deviation, resonant to percussion and absent breath sounds in the context of respiratory distress and shock - think a
tension pneumothorax
417
Hormonal contraception can be started immediately after using levonorgestrel (Levonelle) for
emergency contraception
418
fever, jaundice and right upper quadrant pain
Charcot's cholangitis triad:
419
Gastrointestinal side-effects such as diarrhoea and bloating are a common side effect with
metformin
420
Otoacoustic emission test is used to screen newborns for
hearing problems
421
is a risk factor for developmental dysplasia of the hip
Breech presentation
422
Fever on alternating days, think
malaria
423
although surgery is definitive management, patients must be medically managed before surgery using alpha blocker then beta blocker
Phaeochromocytoma
424
in breastfeeding must be avoided
Lithium
425
can present with sweating, tremor, confusion and hyperreflexia
Serotonin syndrome
426
is the screening test for adult polycystic kidney disease
Ultrasound
427
Activated protein C resistance (Factor V Leiden) is the most common inherited
thrombophilia
428
HNPCC/Lynch syndrome is a strong risk factor for
endometrial cancer
429
A patient develops acute heart failure 5 days after a myocardial infarction. A new pan-systolic murmur is noted on examination -
ventricular septal defect
430
HOCM may present with
exertional dyspnoea
431
Pernicious anaemia predisposes to
gastric carcinoma
432
Diabetes treated with SGLT-2 inhibitors are at particular risk of
necrotising fasciitis
433
The most common causes of arrest in children are
respiratory
434
malignant tumour that occurs most frequently in the metaphyseal region of long bones prior to epiphyseal closure
Osteosarcoma
435
The short synacthen test is the best test to diagnose
Addison's disease
436
classically presents with abdominal pain, arthritis, haematuria and a purpuric rash over the buttocks and extensor surfaces of arms and legs
Henoch-Schonlein purpura
437
is characterised by a sandpaper rash
Scarlet fever
438
presents with flu-like symptoms, RUQ pain, tender hepatomegaly and deranged LFTs
Hepatitis A
439
is a common complication in subarachnoid haemorrhages
Hyponatraemia
440
it can develop up to 4 weeks after precipitating infection and can run a relapsing-remitting course over several months
Reactive arthritis
441
are associated with a significant increase in mortality in dementia patients
Antipsychotics
442
may cause precipitation of digoxin toxicity
Thiazides
443
are the investigations of choice in primary sclerosing cholangitis
ERCP/MRCP
444
is a cause of autoimmune haemolytic anaemia
SLE
445
Poorly controlled hypertension, already taking an ACE inhibitor and a thiazide diuretic -
add a calcium channel blocker
446
expectant management is not suitable if evidence of infection or increased risk of haemorrhage
Miscarriage
447
Agranulocytosis/neutropenia is a life-threatening side effect of
clozapine - monitor FBC
448
Visual loss, eye pain and red desaturation are all classical symptoms of
Optic neuritis
449
is the most common cause of stridor in infants.
Laryngomalacia
450
A prostaglandin analogue should be used first-line in patients with a history of asthma.
glaucoma
451
increases the risk of lactic acidosis - suspend during intercurrent illness eg. diarrhoea and vomiting
Metformin
452
infection can cause rose spots on the abdomen
Salmonella typhi
453
can present as chewing, jaw pouting or excessive blinking due to late onset abnormal involuntary choreoathetoid movements in patients on conventional antipsychotics
Tardive kinesia
454
Urinary incontinence - first-line treatment:
urge incontinence: bladder retraining
| stress incontinence: pelvic floor muscle training
455
are first-line in benign prostatic hyperplasia if the patient has troublesome symptoms
Alpha-1 antagonists
456
Consider fibromuscular dysplasia in young female patients who develop AKI after the initiation of an
ACE inhibitor
457
1st line of treatment for blepharitis is
hot compresses
458
Ferritin and transferrin saturation are used to monitor treatment in
haemochromatosis
459
High-resolution CT scanning is the diagnostic investigation of choice for
pancreatic cancer
460
can be used within an hour of an aspirin overdose
Activated charcoal
461
The first-line investigation of a testicular mass is an
ultrasound
462
Non-contrast CT head scan is the first line radiological investigation for
suspected stroke
463
Sudden death, unusual collapse in young person - ?
HOCM
464
Coal workers' pneumoconiosis typically causes
upper zone fibrosis
465
Prophylactic IV antibiotics are given prior to
appendicectomy
466
Complete heart block following a MI? -
right coronary artery lesion
467
is the antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic
Erythromycin
468
demonstrated by jaundice, mild pyrexia, hepatitic LFTs, raised WBC, coagulopathy and steatosis on imaging.
acute fatty liver of pregnancy
469
is a common complication in subarachnoid haemorrhages
Hyponatraemia
470
Juxta-articular osteoporosis/osteopenia is an early x-ray feature of
rheumatoid arthritis
471
Patients with a suspected pulmonary embolism should be initially managed with a
direct oral anticoagulant (DOAC)
472
Patients with tachycardia and signs of shock, syncope, myocardial ischaemia or heart failure should receive
up to 3 synchronised DC shocks
473
Hypertension in diabetics - ACE inhibitors/A2RBs are first-line regardless of
age
474
The classical history of vestibular schwannoma includes a combination of vertigo, hearing loss, tinnitus and
an absent corneal reflex
475
Hypothermia, hyporeflexia, bradycardia and seizures, think
myxoedemic coma
476
An elective laparoscopic cholecystectomy is the treatment of choice for
biliary colic
477
presents with the 6 P's: pale, pulseless, pain, paralysis, paraesthesia, perishingly cold
Acute limb-threatening ischaemia
478
DPP-4 inhibitors increase levels of incretins such as GLP-1 and GIP
Sitagliptin
479
in elevated JVP, persistent hypotension and tachycardia despite fluid resuscitation in a patient with chest wall trauma
Consider cardiac tamponade
480
side effects of antipsychotics include dysglycaemia, dyslipidaemia, and diabetes mellitus
Metabolic
481
release serotonin, so will cause a raised urinary 5-HIAA
Carcinoid tumours
482
Disproportionate microcytic anaemia - think
beta-thalassaemia trait
483
is a good first line anti-emetic for intracranial causes of nausea and vomiting
Cyclizine
484
- radioactive iodine is the treatment of choice
Toxic multinodular goitre
485
increases the risk of developing enteropathy-associated T cell lymphoma
Coeliac disease
486
is associated with erythema multiforme
Mycoplasma
487
in diabetics - ACE inhibitors/A2RBs are first-line regardless of age
Hypertension
488
Scrotal swelling you can’t get above:
inguinal hernia
489
is the only test recommended for H. pylori post-eradication therapy
Urea breath test
490
The presence of pain distinguishes scleritis from
episcleritis
491
Liver transplantation criteria in paracetamol overdose
pH < 7.3 more than 24 hours after ingestion
492
is the investigation of choice for suspected aortic dissection (depending on stability of patient)
CT angiography
493
are the commonest extra-renal manifestation of ADPKD
Liver cysts
494
must be taken within 72 hours of UPSI
Levonorgestrel
495
Patients with intracranial bleeds, who become unresponsive should receive an urgent CT scan to check for
hydrocephalus
496
has a longer half-life than amylase when investigating suspected acute pancreatitis and may be useful for late presentations > 24 hours
Serum lipase
497
absolutely contraindicated in women over 35 smoking 15 cigarettes or more a day
combined hormonal contraception
498
More than 90% of colorectal cancers are
adenocarcinomas
499
- carbamazepine is first-line
Trigeminal neuralgia
500
```
Somatisation = Symptoms
hypoChondria = Cancer
```
Unexplained symptoms
501
accelerations present, variability >5bpm, no decelerations, HR 110-160
Normal CTG
502
In patients with non-alcoholic fatty liver disease, enhanced liver fibrosis (ELF) testing is recommended to aid diagnosis of
liver fibrosis
503
In a young woman taking COCP, cervical ectropions are a common finding in the context of
post-coital bleeding
504
An isolated rise in bilirubin in response to physiological stress is typical of
Gilbert's syndrome
505
is a risk factor for embolic acute limb ischaemia
Atrial fibrillation
506
are associated with drug-induced lupus
Antihistone antibodies
507
ECT is indicated in life-threatening major depressive disorder, where
catatonia in present
508
You cannot interpret TTG level in coeliac disease without looking at the
IgA level
509
are first-line in patients with benign prostatic hyperplasia
Alpha-1 antagonists
510
Myelodysplasia may progress to
acute myeloid leukaemia
511
tumours are the most common cause of brain metastases
Lung primary
512
In Cushing's disease, cortisol is not suppressed by low-dose dexamethasone but is suppressed by
high-dose dexamethasone
513
needs to be excluded in all adults presenting with painless jaundice.
Pancreatic cancer
514
Lambert-Eaton syndrome or myasthenia gravis?
Weakness in Lambert Eaton improves after exercise, unlike myasthenia gravis; which worsens after exercise
515
should be used to treat acute gout if NSAIDs are contraindicated for example a peptic ulcer.
Colchicine
516
Most common clinical sign in a PE
tachypnoea (96%)
517
A total hysterectomy with bilateral salpingo-oophorectomy, in addition, is advisable for all postmenopausal women with
atypical endometrial hyperplasia, due to the risk of malignant progression
518
is far the most likely cause of primary post-partum haemorrhage.
An atonic uterus
519
For an SVT, the Resus Council recommend escalating adenosine doses of
6mg → 12mg → 18 mg
520
are ANA positive, therefore it is a useful rule out test
Over 99% of patients with SLE
521
Target saturations in COPD are
94-98% if CO2 is normal on ABG
522
An asymmetrical presentation suggests psoriatic arthritis rather than
rheumatoid
523
Aspirin is a common cause of
urticaria
524
Patients with focal seizures may experience
post-ictal weakness (Todd's paresis)
525
intrauterine system (Mirena) is first-line
Menorrhagia
526
Moderate-severe aortic stenosis is a contraindication to
ACE-i
527
CSF lymphocytosis combined with a glucose greater than half the serum level points towards a
viral meningitis
528
Migraine
| acute:
triptan + NSAID or triptan + paracetamol
| prophylaxis: topiramate or propranolol
529
Normal laboratory findings in pregnancy:
Reduced urea, reduced creatinine, increased urinary protein loss
