Past Paper Mistakes Flashcards
p450 inducers
PC BRAS Phenytoin Carbamazepine Rifampicin Alcohol Barbiturates Sulphonylureas
Bacterial meningitis on LP?
Bacterial are turbid, they go to the gym, they don’t eat much sugar but love their protein, and they love PMNs and keep their WCCs at least over 500 for maximal gains!
Turbid Glucose <2.2 Protein >1 WCC >500 Lots of PMNs
Viral meningitis on LP?
Virals are Veggie so don’t like protein, they have a normal relationship with sugar but like to keep their WCC under 1000.
Clear
Glucose normal
Protein <1
WCC < 1000
TB meningitis on LP?
Fungal/TB meningitis is a weird combination of the two…
Protein 0.5-1
Glucose 1.6-2.5
WCC 100-500
Monocytes
Diabetic retinopathy classification
Background: hard exudates, blot haemorrhages, microaneyrusms
Pre proliferative: cotton wool spots, venous beading, deep dark cluster haemorrhages, >3 blot haemorrhages
Proliferative: retinal neovascularisation
hard blots and dots, cotton beads & haemorrhages
Tx for chronic simple open angle glaucoma
- Beta blocker drops (timolol, betaxolol)
- Prostaglandin analogues (Lanatoprost)
- Alpha agonists (brimonidine)
- Carbonic anhydrase inhibitors
- Miotics
Typical pancreatic cancer presentation, what imaging modality is best?
- Painless obstructive jaundice, dark urine pale stools
- epigastric pain radiates to back
- wt loss
- palpable gallbladder, epigastric mass
Imaging
- Endoscopic USS
- CT
Palliative care options for pancreatic cancer
Endoscopic percutaneous stenting of CBD
Palliative bypass surgery
Pani relief
A large hyperechoic lesion in the presence of normal AFP
Hemangioma
HNPCC (Lynch syndrome)
Germline mutations of DNA mismatch repair genes
Risk of
Colo rectal, Endometrial & Gastric cancer
Cardiac tamponade
Beck’s triad: elevated JVP, reduced arterial pressure, reduced heart sounds.
Definition of chronic limb ischaemia
Ankle artery pressure <50mmHg and either
- Persistent rest pain requiring analgesia >2wks
- Ulceration or gangrene
Definition of critical limb ischaemia
Rest pain + ulceration/gangrene
So chronic is ankle pressure + critical
Garden classification
Type I: Stable fracture with impaction in valgus
Type II: Complete fracture but undisplaced
Type III: Displaced fracture, usually rotated and angulated, but still has boney contact
Type IV: Complete boney disruption
Osteomyelitis organism regular vs sickle cell?
Usually staph aureus, in SSD usually salmonella
Rim’s sign, light bulb sign.
Associated with Trough sign
Posterior shoulder dislocation
Ix of choice for Achilles tendon rupture
USS
bimalleolar fracture of the right ankle.
Pott’s fracture (ankles potter around)
Tenderness over anatomical snuffbox and pain on longitudinal thumb compression
Scaphoid facture; risk of avascular necrosis (Snuff = Scaph)
Monteggia and Galeazzi?
Monteggia fracture - Ulnar
Galeazzi - Radial
Manchester United
Glasgow Rangers
Osteoarthritis of knee/hand first line?
paracetamol + topical NSAIDs (if knee/hand)
second-line treatment is oral NSAIDs/COX-2 inhibitors, opioids, capsaicin cream and intra-articular corticosteroids
Bone disease management in CKD
Phosphate binders (e.g. calcium carbonate) Vitamin D
What changes in patients with nephrotic syndrome predispose to the development of venous thromboembolism?
Loss of antithrombin III
Organism responsible in infection of peritoneal dialysis
Staph epidermis/aureus
Erb’s palsy
Arm is pronated and medially rotated
Damage involving brachial trunks C5-6.
Klumpke’s paralysis
weakness of the hand intrinsic muscles, may have Horner’s syndrome
involving brachial trunks C8-T1
drug treatment for neuropathic pain?
amitriptyline, duloxetine, gabapentin or pregabalin
Extra-renal features of ADPKD
Hepatic cysts Diverticulosis Intracranial aneurysms Ovarian cysts Mitral valve disease
Normal anion gap acidosis
Addison’s
Diarrhoea
Raised anion gap
DKA
Sepsis
Renal failure
proteinuria, haematuria, oliguria and hypertension
NEPHRITIC SYNDROME
Interstitial nephritis and acute tubular necrosis are usually caused by nephrotoxic drugs or an infection. They usually present with acute renal failure.
mastoiditis signs
painful erythema pushing the ear forward
emergency!! tx with IV abx
Behcet’s syndrmoe
Oral ulcers
Genital ulcers
Anterior uveitis
“facial gone wrong”
Thrombophlebitis
Erythema nodosum
It is a vasculitis
MEN1? MEN2?
MEN1: “PPP”
Pituitary
Parathyroid
Pancreas
MEN2A: “PPM”
Parathyroid
Phaeochromocytoma
Medullary
MEN2B: “PMM”
Marfan’s
Medullary
Phaeochromo
Osteomalacia
Low calcium
Low phosphate
Generalised bone pain
side effects of biphosphonates
osteonecrosis of jaw
oesophagitis
oesophageal ulcers
Tx of osteoporosis
Alendronate
Raloxifene - selective oestrogen receptor modulator (SERM)
Strontium ranelate
Drug induced lupus
Anti histone antibody
Structure affected by scaphoid fracture
Dorsal carpal branch of radial artery
Morton’s neuroma
Middle of foot pain on dorsal
Hypoparathyroidism
Alpha calcidol
soap bubble
giant cell
ewings
onion
most appropriate first-line treatment for initial empirical therapy of meningitis (aged > 50 years)?
Intravenous cefotaxime + amoxicillin
Often strep pneumonia
