Passmedicine Qs Flashcards
What’s the difference between priamry and secondary dysmenorrhea
primary dysmenorrhoea there is no underlying pelvic pathology
Secondary dysmenorrhoea typically develops many years after the menarche and is the result of an underlying pathology.
Mx of secondary dysmenorrhea
Refer to gynae for investigation
Mx of primary dysmenorrhea
NSAIDs
Mefanemic acid
2nd line - COCP
When do you surgically excise a fibroadenoma
If it is above 3cm
Tx for hepatitis A+E
Supportive care
Which genetic condtion is associated with supravalvular aortic stenosis
Williams syndrome
Difference between lambert Eaton syndrome and myasthenia gravis
Lambert Eaton usually worse affected in the legs and associated with SMALL CELL LUNG CANCER
What should be prescribed alongside SSRIs
PPI as it has gastric effects
When would you not give topiramate in migraine prophylaxis
In women of child bearing age - lead to pregnancy complications
Eron class for cellulitis
Eron I - no signs of systemic toxicity and no uncontrolled co-morbidities
Eron II - systemically unwell or systemically well but with a co-morbidity
Eron III - systemic upset such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable co-morbidities
Eron IV - sepsis syndrome or a severe life-threatening infection such as necrotizing fasciitis
Samters triad
Asthma
Nasal polyps
Aspirin/ NSAID sensitivity
What are the shockable rhythm
Ventricular fibrillation
Pulse less ventricular tachycardia
Edward’s syndrome quadruple test results
Alphafeto protein - low
Oestriol - low
beta HCG - low
Inhibin A - normal
Give some medications to avoid in end stage renal failure
NSAIDS
Lithium
Metformin
Nitrofurantoin/tertracyclines
Main side effect of giving magnesium
Diarrhoea
Features of optic neuritis
CRAP
Central scotoma - blind spot in middle eye
Reduced red vision
Acuity (reduced)
Painful eye movement
When do you use each of
Ondansetron
Haloperidol
Prochlorperazine
Metoclopramide
In treating sickness
Ondansetron from you Oncologist - after chemo
Haloperidol for causes in your Head - raised ICP
Prochlorperazine for when you feel Peculiar (i.e. dizzy) - vestibular causes
Metoclopramide for things attached to the Mesentry - GI causes
Why do you give lorazepam in patients with liver cirrhosis and delirium tremens
Because chlordiazepoxide is not metabolised properly in patients with liver cirrhosis
Difference between chlamydia and gonorrhoeal conjunctivitis
Chlamydia - 5 days/ 2 weeks - later onset
Gonorrhea - from 24 hours to 5 days - earlier onset
What is the post exposure prophylaxis of HIV
Oral Antiretrovirals for 4 weeks
HSV encephalitis CT shows?
temporal lobe changes
Urea levels in upper vs lower gi bleed
High urea levels can indicate an upper GI bleed versus lower GI bleed
When is carboprost CI
Asthma
What differentiates mania from hypomania
grandiose delusions according to the DSM-5 criteria
Pilocarpine what type of drug
M3 agonist
What is the classic persistent vomiting picture with electrolyte
Metabolic alkalosis
-hypokalaemia
-hypochloreamia
-elevated bicarbonate
What is the treatment for invasive diarrhoea (bloody diarrhoea and fever)
Ciproflaxacin
Travellers diarrhoea treatment
Clarithromycin
Most effective form of emergency contraception
IUD
Different age groups for perthes and SUFE
Perthes = Primary school (4-8)
SUFE = secondary school + obese (10-15)
Haemoglobin level cutoff for iron supplementation in pregnancy
1st trimester
2nd/ 3rd trimester
Postpartum
1st trimester - 110
2nd/ 3rd trimester - 105
Postpartum -100
What organism is associated with erythema multiforme
Mycoplasma pneumonia
Why would you not give metacloperamide for more than 5 days
Causes extrapyramidal side effects as it is a dopamine antagonist
Why should oxybutinin not be used in elderly
As it increases risk of falls due to postural hypotension
How do you manage with hyposplenism with coeliac disease
-vaccine against pneumococcal, haemophilus type B, meningococcus type C
-influenza vaccine yearly
Fluid resuscitation amount for paeds
10 ml/kg bolus
What is acute dystonia and whats its treatment
Acute dystonia - involuntary muscle contractions and abnormal postures, particularly affecting the face, neck, and sometimes the limbs.
Tx- procyclidine (anticholinergic)
What is tardive dyskinesia and what is the Tx
involuntary repetitive body movements, which may include grimacing, sticking out the tongue or smacking the lips
Tx - tetrabenzine
Tx for akathisia
Propanalol
Tx for essential tremor
1st line - Propranolol
2nd line- primidone
What diseases can cause false positive syphilis VDRL results (4)
Some times mistakes happen
S - SLE
T- TB
M- malaria
H- HIV
Partial vs total stroke
total has all three symptoms and partial has any two.
1.hemiparesis
2.homonymous hemianopia
3.higher function loss e.g. Speech
What is a Jarisch Herxheimer reaction
A temporary reaction to antibiotics that usually occurs within 24 hours of administration by syphilis or Lyme disease or leptospirosis - causes tachycardia, fever, chills, myalgia
At first administration how should clozapine be checked
Once every week for 18 weeks
Most common vaginal cancer type
Overall -secondary metastatic cancer form endometrium of cervix
Primary cancer - squamous cell carcinoma
