Passpaper Flashcards
Causes of coma?
hypoglycaemia hyperuraemia hypoxaemia trauma meningitis opioid overdose alcohol
What causes a fixed dilated pupil?
Compression of 3rd cranial nerve
4 features of brainstem death?
No respiratory effort without ventilator Fixed pupils unreactive to light No corneal reflex No cough reflex No response to supra orbital pressure Flat EEG
What screening for microvascular damage in diabetes?
Retinal Screening
Kidney - urine albumin and serum creatinine
Foot care screening - monofilament
What AD safe in breatfeeding?
paroxetine
Features to look out for on breast axam?
Axial lymph node involvement
Is lump tethered or movable from the skin
Nipple discharge
Erythema
Peau D’orange
Paget’s disease of the nipple
What artery supplied the superior and inferior vesical arteries?
Internal iliac
What lymph nodes should surgeron consider when removing bladder and prostate?
External Iliac
Obturator
Internal iliac (hypogastric)
Common Iliac nodes
Heart sound in pericarditis?
Pericardial rub
Constrictive pericarditis vs Tamponade?
ff
Two causes of floaters?
Retinal Detachment Posterior vitreous detachment Eye Injury Vitreous degeneration Ageing
Investigations of retinal detachment? What would you see?
Fundus photography - Schaffer’s sign - thin beam of bright light without a lens and see fine pigment floating in the anterior vitreous
Opthamoscopy
USS - flying angel sign
3 defining features of a health economic evaluation?
cost of both services
benefits of both services
comparison of cost and benefit of the service and alternative service
What are two features comprising a QALY?
number of years
quality of life (utility)
What system do health economists use to evaluate disability?
DALYS - disability adjusted life years
Define healthcare economic efficiency?
getting maximum cost/health benefit outcomes from a service
What is the term when treatment is given elsewhere and benefit foregone other patients?
Opportunity cost
What are the paraneoplastic changes seen in different lung cancer?s
Small cell - ADH, ACTH
Squamous cell - PTH
Salter-harris classification?
hh
How would you describe a fracture?
complexity type location comminution displacment
mention - AP film
3 methods of rate control?
3 methods of rhythm control?
i) beta-blocker, digoxin, diltiazem/verapimil
ii) amiodarone, flecanide, dc cardioversion
What is the cause of ramsay-hunt? Where does it reside?
varicella zoster
geniculate ganglion
What would it be if there was low PTH and high calcium?
Bony mets
Myeloma
Complications of iron overload due to transfusion?
Diabetes Hypothyroid Hypoparathyroid Hypogonadism Cardiomyopathy Liver cirrhosis
Investigations of beta-thalassaemia?
FBC - microcytic hypochromic anaemia
haemoglobin electrophoresis
What is the pathophysiology behind anaphylaxis?
Type I hypersensitivity - IgE and mast cells
vasodilation, increases vascular permeability, bronchocoonstrictor
RFs for bladder cancer?
smoking
aromatic amines in indistrial dyes
pelvic radiation
schistomiasis (squamous cell)
2 groups of lymph nodes which drain bladder?
Obturator
External iliac
internal iliac
Common iliac
Vesical arteries supply bladder? Where do these branch from?
Internal iliac arteries
superior vesical artery branches from umbilical artery whcih branches from internal iliac
Differential diagnoses for breast lump?
Cancer
Fibroadenoma
Cysts
Fat necrosis
Intraductal papilloma
3 features of malignant lump?
hard
painless
fixed to surrounding
nipple inversion
skin changes (peau d’orange)
irregular margins
bloody discharge
Treatments for ER positive, HER2 +?
radiotherapy
tamoxifen (pre-menopause) anastrozole (post-menopause)
herceptin (trastuzumab)
Complication with cancer, thirst confusion, constipation? treatment?
Hypercalcaemia due to bony mets
IV fluids
Common site for bone marrow biopsy?
Post iliac crest
genetic translocation for patients with CML? Name?
reciprocal translocation 9 and 22
philadelphia - causes increased tyrosine kinase activity. Thats why tyrosine kinase inhibitor!!! imatinib
How can you identify philadelphia chromosome?
FISH
karyotyping
Test cancer, invest?
test USS
Incision for orchidectomy, where and why?
Inguinal incision = avoid seeding in the scrotum
Blood supply for scrotum and testical are different
4 members present at MDT?
Radiologists
Surgeron
Oncologist
Specialist nurse
Pathologist
Neutropenic sepsis? invest?
FBC, LFTs
Blood culture
CXR
urine culture
sputum culture
swabs of infected wounds
4 symptoms make you concerned about spinal cord compression?
lower limb weakness
bladder dysfucntion
loss of bowel function
severe back pain
Treatment for spinal cord compression?
Surgery to stabilise spine
Radiotherapy
Steroids
