Past papers Flashcards
First line for haemorrhoids
Proctoscope
What to remember about haemorrhoids if no visible masses on examination
Can be internal haemorrhoids
Target glucose in self monitoring throughout the day
Waking- 5-7
Before any meal 4-7
90 mins after eating 5-9
First line investigation for non severe/systemic constipation
Anal manometry
First line for AAA
US
What is arteriography
CT angio or MRI angio
What do if d dimer comes back as negative in suspected PE
Stop anticoagulation and consider other diagnosis
What are Hb, MCV and reticulocytes
Low Hb
Normal MCV
High reticulocytes
What gives headache better on lying down
Low ICP such as post LP
What can PTH be in primary hyperparathyroidism
Normal or high
In STEMI where fibrinolysis has been given when should ECG be next repeated
2-3 hours
Triad for liver failure
Encephalopathy
Jaundice
Coagulopathy
If patient has impaired GCS/ consciousness what give
IM glucagon or IV glucose
What is murmur for atrial septal defect
Ejection systolic louder on inspiration
How can ITP present
Petechiae
Easy bleeding like epistaxis and menorrhagia
If a patient presents with new onset TB symptoms and was recently started on a drug what would most likely be cause
A biologic as causes reactivation
After CXR what is next best investigation for lung cancer
CT not bronchoscopy
Most sensitive test for SLE
ANA
Main problem of alpha 1 antitrypsin
Leads to hepatocellular carcinoma
What time frame is necessary for orthostatic hypotension
3 mins
When investigating neoplastic spinal canal stenosis what is given while waiting for urgent MRI
Dexamethasone
If patient has acute fast AF and signs of HF what do if BPnormal
Still cardiovert as HF indication regardless
Most important advice post pneumothorax
Stop smoking
First line investigation for chronic HF
BNP not echo
What prophylactic Abx given in COPD
Azithromycin
If stage 1 HTN when is only time can give first line meds
No cardiac disease No end organ failure No renal disease No diabetes Q risk less than 10%
In questions where AF management and has HTN what must bear in mind with BP
Just above 90/60 is concerning
What causes high BNP that isnt HF
eGFR less than 60
What pH would prompt an acute asthma to go to ICU
Less than 7.33
What antibiotic should be avoided in long QT
Clarithomycin
Which dementia is associated with MND
Frontotemporal dementia
Which meningitis causing organism would stain positive for india ink
Cryptococcus
Do you use direct or indirect coombs test for haemolytic anaemia
Direct
Indirect is for new borns
Difference in anaemia between autoimmune haemolytic and hereditary spherocytosis
Anaemia mild in hereditary spherocytosis
ABG finding addisons vs cushings/conns
Cushings- metabolic alkalosis
Addions- metabolic acidosis
If has second MI 5-10 days after first what is best blood test to carry out
CK-MB as only high for 3-4 days post MI whereas troponin would still be high
3 things that cause widened mediastinum
Goitre
Lymphoma
Thoracic aortic aneurysm
Which gastroenteritis has longest incubation period
Giardiasis
Which gastroenteritis organism causes steatorrhoea
Giardia
How is myxoedema coma treated
IV liothyroxine and hydrocortisone
Half life of adenosine
10 seconds
How early can alpha 1 antitrypsin be diagnosed
Prenatally
Enlarged CKD kidneys causes
HIV
Diabetic
Amyloidosis
PCKD
Antibodies found in LEMS
Anti voltage gated calcium channel antibodies
Most appropriate way to measure diabetic neuropathy
Monofilament test
Causes of gout mnemonic
DART Diuretics Alcohol Renal disease Trauma
Osteoarthritis arthtrocentesis
Calcium phosophate crystals
Coffin lid shaped
Arhtrocentesis rheumatoid
Cholesterol crystals
Rhmobic shaped
Most common cause of hepatocellular carcinoma UK
Hep B
Hep C worldwide
Most common anaphylaxis trigger in children
Food
What is any new LBBB treated as
MI regardless of ST elevation
Investigation ordered for aortic dissection
CT angio of chest abdo and pelvis
Can a GP prescribe anti epileptics after 1 seizure
No must refer to epilepsy clinic
Where does uvula deviate in relation to vagus lesions
Away from side
What CN palsy causes vertical diplopia
Trochlear nerve
How does hepatomegaly feel in cor pulmonale
Tender
Pulsatile
Smooth
2 medications given for hepatic encepahlopathy prophylaxis
Rifaximin
Lactulose
If have nephrotic syndrome then develop haematuria and left sided flank pain what is cause
Renal vein thrombosis
What age do men have to be to be reffered for 2ww gastroscopy and colonoscopy with IDA
Any!
Main risk factors for toxic mutlinodular goitre
Iodine deficiency
Elderly
Management steps to graves
Beta blockers
PTU or carbimazole
Radioiodine
Thyroidectomy
Management of thyroid storm way to remember
4 Ps
4 Ps of thyroid storm
Propylthiouracil
Potassium iodide
Propanolol
Pred
What is main danger of thyroid storm
AF which can deteriorate into high output HF
What iatrogenic methods cause hypothyroidism
Amiodarone
Thyroidectomy
Lithium
Management of myxoedema coma
Liothyroxine
IV corticosteroids
Supportive
What thyroid cancer is associated with hashimotos
Thyroid lymphoma
Which thyroid cancer presents with compression sx
Anaplastic
How to remember carcinoid syndrome sx
CARC Cutaneous flushing Asthmatic wheeze Right sided mumur Cramps and diarrhoea
2 skin changes get in carcinoid
Telengiectasia
Cutaneous flushing
Investigations for carcinoid syndrome
Urinary 5-HIAA
CT/MRI to find tumour
Endoscopy/bronchoscopy for histology
4 complications of acromegaly
Diabetes
Cardiomyopathy
Colorectal cancer
HTN
First line investigation for acromegaly
Serum IGF-1
Second line investigation for acromegaly
OGTT
First line for acromegaly
Trans-sphenoidal hypophysectomy
Second line management for acromegaly
Somatostatin analogues (octreotide) Growth hormone-receptor antagonist (pegvisomant) Dopamine agonists (bromocriptine/cabergoline)
Third line management of acromegaly
Radiotherapy if medical/surgical resistant
Hypogonadism in females typical symptoms
Delayed puberty Amenorrhoea Infertility Low libido Night sweats and hot flushes
Physiological cause of hypogonadism
Pregnancy
Primary causes of hypogonadism in females
Turners syndrome
Gonadal damage
PCOS
Primary ovarian failure
What is primary ovarian failure
Early menopause
What are some causes of gonadal damge
Trauma
Radiotherapy
Autoimmune
Causes of secondary hypogonadism in females
Kallmans syndrome Pituitary/hypothalamic failure from tumour/infiltration Hyperprolactinaemia Functional- stress, eating disorder Post OCP
Infiltrative causes of hypogonadism from pituitary failure
Haemochromatosis
Pre pubertal signs of hypogonadism in women
No secondary sexual characteristics and primary amenorrhoea
Post pubertal hypogonadism signs
Regression of secondary sexual characteristics- breast atrophy and loss of sexual hair
Sign of kallmans as cause of hypogonadism
Anosmia
Sign of turners as cause of hypogonadism
Webbed neck
Short stature
Sign of hyperprolactinaemia
Galactorrhoea
Visual field defects
Investigations for primary hypogonadism in females
Pregnancy test Bloods - oestridol - LH and FSH - prolactin - TFTs Genetic testing, pelvic MRI/USS
Investigations for secondary hypogonadism in females
Pituitary function tests, MRI
Signs of hypogonadism in males
Delayed puberty
Erectile dysfunction
Infertility
Low libido
Primary causes of hypogonadism in men
Klinefelters
Gonadal damage- torsion, irradiation, trauma
Post orchitis from mumps
Secondary causes of hypogonadism in men
Kallmans
Pituitary/hypothalamic tumours
Hyperprolactinaemia
Prader willi
Post pubertal signs of hypogonadism in men
Hair loss
Gynaecomastia
Pre pubertal signs of hypogonadism in men
High pitched voice Small undescended testicles Small penis Decreased pubic and facial hair Eunuchoid proportions
Signs of klinefelters as underlying cause of hypogonadism
Low IQ
Behavioral problems
What is LH and FSH in promar hypogonadism
Very high
What is LH and FSH in secondary hypogonadism
Very low
What is main hormone in female that is reduced in all causes
Oestradiol
Serous discharge from breast is what
Intraductal papilloma
What causes non infectious mastitis
Duct ectasia
How does breast abscess feel
Single red lump
Fluctuant
What is wedge shaped lump on breast
Mastitis
Management of non lactating mastitis
Analgesia
Co-amoxiclav
Management of moderate lactating mastitis
Analgesia
Milk removal by hot towel etc
Advise to carry on lactation
Abx if sx dont improve
Management of severe lactating mastitis
Breast milk culture and refer to hospital
When do you give abx in lactating mastitis
If sx dont improve after 24 hrs
Management of breast abscess
Referral to hospital for surigcal drainage urgently
How does fat necrosis appear
Skin retraction and thickening
Irregular shape
What gives full feeling in breast
Intraductal papilloma
Which atypical pneumonia causes bilateral consolidation
Legionella
What do if malignant HTN reading but no signs of organ damage on examination
Bloods, urinalysis, ECG to look for other signs of organ damage
What are syndesmophytes seen in
Ank spond
Role of calcium resonium in hyperkalaemia management
Removes potassium from body
What causes upper bitemporal hemianopia
Pituitary adenoma
What causes lower bitemporal hemianopia
Craniopharyngioma
Prophylactic abx for encephalopathy
Ciprofloxacin
Best investigation for mycoplasma pneumonia
Serology
If clopidogrel not tolerated in stroke prevention what is alternative
Aspirin and modified release dipyrimadole
What can often appear like someone is appearing drunk
Hypoglycaemia
X ray findings of ank spond
subchondral erosions, sclerosis
and squaring of lumbar vertebrae
What is lemon tinge to skin associated with
Perncious anaemia
What x ray is done in ank spond
Pelvic
What is typically in history if have an aspergilloma
TB as child
What does management of HAP depend on
How long in hospital
If under 5 days give co amoxiclav
If over give piperacillin with tazobactam
What antithyroid drug can be given while waiting for beta blockers to work if sx bad
Carbimazole
Most important drug acute HF
IV furosemide
What are lipid rich masses seen on CT of adrenals
Most commonly benign masses
Most common inherited condition leading to bleeding
Von wilebrand
MOst common extra renal symptoms of PCKD
Liver cysts
Which cancer is someone most at risk of with HNPCC that isnt colorectal
Endometrial
Management of barretts oesophagus with no dysplasia
Surveillance and high dose PPIs
Management of barretts oesophagus with dysplasia
Ablation
Management of toxic multinodular goitre
Radioiodine
AF rate control in asthmatics
Diltiazem
What factors can lower Hba1c
Losing weight
Poor renal function
What is cut off for giving potassium with fluids in DKA and HHS
Only give if potassium less than 5.5
When is only time can give IV insulin in DKA
If potasssium greater than 3.5
What is charcots joint
Joint in foot that where people lose sensation they walk differently putting further pressure on it that can lead to fractures
3 diabetic neuropathies
Peripheral neuropathy
Mononeuropathy
Autonomic neuropathy
Examples of diabetic mononeuropathy
Wrist drop
Foot drop
3rd nerve palsy
Examples of autonomic neuropathy in diabetes
Dysphagua
Constipation
Bladder dysfunction
Postural hypotension
Post renal cause of diabetes insipidus
Ureteric obstruction
Treatment for cranial diabetes insipidus
Intranasal desmopressin
What should people on desmopressin be told not to do
Not drink large amounts of water
How is nephrogenic diabetes inspidus treated
Thiazides or NSAIDS
Pulmonary causes of SIADH
Pneumonia
Bronchiectasis
Treatment order to SIADH
Fluid restrict and treat cause
If this doesnt work use demeclocycline
Severe give hypertonic saline
What does central pontine myelinolysis lead to
Paralysis
Pseudobulbar palsy
Seizures
When only do you give hypertonic saline in SIADH
If reduced GCS or seizing
Causes of hypernatraemia
Unreplaed water loss like GI losses and sweat Osmotic diuresis Diabetes insipidus Cushings Conns Iatrogenic hypertonic saline
How to treat hypernatraemia
5% dextrose
0.9%saline
How do pituitary adenomas affect rest of hormones
They compress rest of gland leading to hypopituitarism
Causes of hyperprolactinaemia
Pregnant Breast feeding Prolactinoma Pituitary adenoma Primary hypothyroidism
How does hyperprolactinaemia present in men
Loss of libido ED Infertility Gynaecomastia Effect of mass ie headache blurred vision etc
How does hyperprolactinaemia present in women
Galactorrhoea Secondary amenorrhoea Loss of libido Infertility Effect of mass ie headache blurred vision etc
Investigations for hyperprolactinaemia
Pregnancy test
TFTs
Basal serum prolactin
MRI
Above what serum prolactin suggests adenoma
6,000
First line for prolactinomas
Dopamine agonist- bromocriptine or cabergoline orally
How does primary hypothyroidism lead to hyperprolactinaemia
Increases TRH that triggers prolactin release
If patient has prediabetes Hba1c what test carry out
fasting glucose- Hba1c isnt as sensitive for DM as fasting glucose
Inheritacne of MODY
Dominant
When there is raised ICP on one side(right lets say here) and there is a CN palsy what side typically gets affected
The side of bleed
What drug can be used in management of severe alcoholic hepatitis
Pred
What is double duct sign seen in
Pancreatic cancer
Before a gastroscopy how long before should PPIs be stopped
2 weeks
If someone presents with acute breathlessness and chest is clear what is most likely diagnosis
PE
If DM patient starts seizing after fluid resus what is most likely cause
Cerebral oedema
ECG findings in hypothermia
bradycardia 'J' wave - small hump at the end of the QRS complex first degree heart block long QT interval atrial and ventricular arrhythmias
What does a hypodense crescenteric finding on head CT suggest about subdural
That it is chronic
What is activated protein C resistance another name for
Factor V leiden
If someone is in AF permenantly but is chad vasc of 0 what do
No treatment
If CTPA negative and PE suspected what do
Offer proximal leg US
If patient experiencing chest pain post PCI still in hospital what offer
CABG
Why cant ppl with migraines be given the OCP
Risk of stroke
Metabolic predispositions to osteoarthritis
Wilsons
Haemochromatosis
Acromegaly
How is diagnosis for osteoarthritis made
If over 45 can be clinical
If under do X ray
What is palindromic rheumatism
short, self limiting episodes of inflammatory arthritis (joint pain, swelling, stiffness) of only a few joints
Most common site of purpuric rash in amyloidosis
Periorbital purpura
Which signs only occur in AL amyloid
Cardiomyopathy
Macroglossia
Metabolic associations of pseudogout
Acromegaly
Wilsons
Haemochromatosis
Hyperparathyroidism
What are crystal arthropathies often preceded by
Infection
Trauma
X ray finding of gout
Rat bite erosions
How long does uric acid take to be elevated in gout
4-6weeks
3 ways osteomyelitis can be caused
Spread in blood
Continuous spread
Direct inoculation
Main risk factors for osteomyelitis
IVDU Immunosuppression DM Sickle cell Cellulitis Ulcers Penetrating injury Surgery
If have sickle cell what is cause of osteomyelitis
Salmonella
In children what bones are typically affected in osteomyelitis
Long bones
In adults what bones are typically affected in osteomyelitis
Vertebrae
Invesitigations for osteomyelitis
Bloods- WCC,CRP,ESR
XR/MRI
Bone/swab/ blood culture
What is best imaging for osteomyelitis
MRI
What is seen on imaging of osteomyelitis
Darkened in affected areas
Periosteal thickening
How long does it take for osteomyelitis imaging signs to be seen
2 weeks
What do you get brittle slow growing toe nails in
Intermittent claudication
What does atrophic skin occur in
CLI
When is IC pain worse
When walking uphill
Investigations for PVD
Bloods- glucose, lipids ECG ABPI Duplex scan Magnietic resonance angiography
What is beneficial about magnetic resonance angiogram in PVD
Is no contrast
Normal ABPI
.9-1.2
CLI ABPI range
Less than .5
First line for leriche syndrome
CT angio
Which ulcers have pale base from grey granulation tissue
Arterial
Ulcer night pain worse supine
Arterial
What are edges in arterial ulcers
Well defined
Ulcer that is itchy and swollen
Venous
What are 4 signs of venous ulcers
Lipodermatosclerosis
Atrophie blacnhe
Haemosederin deposition
Stasis eczema
What is atrophie blanche
Area of white shiny atrophie skin
Gold standard investigation for arterial and venous ulcer
Duplex USS
Why would you biopsy venous ulcer
If possibility of marjolins ulcer
What is a marjolin ulcer
One where a squamous cell carcinoma develops from areas of chronnic inflammation
Management plan for venous ulcers
Gradeed compression stocks with greatest pressure distally
Debride and clean
Abx if infeted
Moisturising cream
If want to treat venous ulcers with compression stockings first what must do
Exclude DM, neuropathy and PVD
How is a AAA defined
Enlargement of arota greater than 3cm or 50% of previous size
What is a false aneurysm
Tear in tunica intima leading to false lumen like in dissection
Whatvare 2 true aneursysms of AAA
Fusiform
Saccular
What is difference between saccular and fusiform aneurysms
Fusiform is distended on both sides but saccular only 1
Symptoms of AAA
Normally asymptomatic but can have back or tummy pain
Symptoms of ruptured AAA
Sudden pain anywhere in back or tummy
Shock
Syncope
Sign on examination of burst AAA
Grey turners sign
Sign on examination of AAA
Pulsatile and expansile mass on palpation
Abdominal bruit
First line investigation for AAA
US
First line investigation for ruptured AAA
CT angio
Investigation done for ruptured AAA if allergic to contrast or renal impairment
MR angion
What does murmur heard on back suggest
Aortic dissection
What is crack cocaine often a risk factor for
Aortic dissection
Diagnostic test for aortic dissection
CT angio
Definition of varicose veins
Subcutaneous permenantly dilated venis over 3mm
Main risk factors for varicose veins
Age
Female
Obestiy
White
What causes 98% of varicose veins
Idiopathic valvaular incompetence
How can secondary causes of varicose beins be classified
Venous outflow obstruction
DVT
AV malformations
Venous outflow obstruction causes of varicose veins
Pregnancy
Ascites
Ovarian cysts
Pelvic malignancy
Symptoms of varicose veins
Visible dilation of veins
Leg aching on standing
Swelling and itching
Can bleed
When are varicose veins most painful and visible
On standing
First line investigation for varicose veins
Duplex US
Conservative management of varicose veins
Compression stockings
Weight loss
Leg elevation
Endo vascular treatment of varicose veins
Radiofrequency ablation
Endovenous laser ablation
Microinjection scleropathy
Surgical management of varicose veins
Stripping of the long saphenous vein
Saphenofemoral ligation
Avulsion of varicosities
Complications of varicose veins
Venous ulcers
Stasis eczema
Lipodermatosclerosis
Haemosederin deposition
Signs on examination of varicose veins
Veins feel hard or tender
Bruits
What is tap test
Used in varicose veins
Tap VV distally and will feel thrill over saphenofemoral junction
Odonyphagia in HIV patient
Candidiasis
First line investigation for people with stable chest pain
CT angio
Most common cause of meningitis in middle aged person
Strep pneumonia
What is new test used to diagnose hereditary spherocytosis
EMA binding test
Who does type 2 AIH occur in
Children
Dactylitis in an arthritis history of hands
Psoriatic arthritis
If have addisons and are ill what is done to hydrocortisone and fludrocortisone dose
Hydro x2
Fludro keep the same
Which lymphoma is coeliac associated with
Enteropathy associated T cell lymphoma
Which lymphoma is H pylori infection associated with
MALT lymphoma
Which underlying disease can lead to a false mantoux test when have TB
Sarcoidosis
Which virus most commonly causes meningitis
Cockasackie B
What does diarrhoea worse around periods suggest
IBS from stress
What is needed to diagnose TLS
Arrythmia
High creatinine
Seizure
What do to antiplatelets if someone has stable CVD then develops AF
Stop clopidogrel and start DOAC
What scar is made in whipple procedure
Rooftop
Most significant determinant of c diff disease
WCC
If someone has steatorrhoea post cholecystectomy what is treatment
Cholestyramine
What can differentiate on presentation pancreatic cancer from PSC or PBC
Appetite
Some common triggers of ulcerative colitis
NSAIDS
Abx
Smoking cessation
In crohns refractory to steroid treatment what drug is used
Infliximab
What is excessive salivation associated with
Wilsons
Which other cancer in men can HNPCC be linked to
Renal
Gastroenteritis organism if person has been in swimming pools
Giardia
Gastroenteritis organism if steatorrhoea
Giardia
What is used to determine severity of liver cirrhosis
Child pugh
Caecal volvulus management
Right hemicolectomy
Rfs for caecal volvulus
Pregnancy
Adhesions
Treatment for mild/moderate UC
Rectal aminosalicylate
What does double target sign on CT suggest
Liver abscess
What is bleeding gums seen in
Vit C deficiency
Which cancer will PSC cause in questions
Cholangiocarcinoma
Which cancer other than gastric will cause sister mary joseph node
Cholangiocarcinoma
What is given first line to someone with
Bulk forming laxatives
What vitamin deficiency affects acclimatisation to light
Vitamin A
First line for alcohol withdrawal
Benzodiazepine
What vitamin defiency presents with mass bleeding in infancy
K
Conditions associated with NF1
Phaeos
Scoliosis
Most common non motor feature of parkinons
Depression
If gastroenteritis doesnt disappear after 2 weeks what investigation is done next
Stool sample
What is seen on CT of pyelonephritis
Gas
What congenital kidney defect leads to hypercalciurua
Medullary sponge
If there is an acute badder obstruction what would be seen on imaging of KUB
Bilateral hydronephrosis
What test would you carry out to confirm T2DM in a symptomatic patient
Random gluocse
What is it called when get cushings following removal of adrenals
Nelson syndrome
What are faggot cells seen in
APML
What blood cancer is downs a risk factor for
AML
Risk factors for non hodgkins lymphoma
Sjogrens
How is lymphoma staged
Ann arbor
What is seen on bone marrow aspirate of myeloma
Plasma cells of over 10%
What is MGUS
Premalignant condition where get accumulation of some plasma cells but no CRAB features
Primary vs secondary myelodysplasia
Primary is intrinsice BM problem
Secondary radiation and chemo
What is tetany caused by
Hypocalcaemia
How to diagnose haemophilia
Factor assay that will distinguish A from B
What is difference between acute overt and chronic non overt DIC
Acute occurs in sepsis and leads to depletion of of plts and clotting factors so is bleeding
Chronic non overt they dont get used up so compensatory mechanisms mean factors are replaced leading to more clotting than bleeding
What Vwb disease presents with normal vwb levels
Type 2
Levels of vwb factor in all 3 types
T1- reduced levels of normal vwf
T2- normal levels of defective vWF
T3- complete lack of vwf and factor 8
What is MCV in SCD
Normal
Clotting factor affected in Haemophilia A vs B
A 8
B 9
Inheritance of types of VWB
1 and 2 dominant
3 recessive
What condition changes threshold of Hb for transfusion
ACS
Makes it 80 instead of 70
If flu and fever are present what does this suggest about SCD patients exacerbation
Parvovirus leading to aplastic crisis
Young person with IDA what should be screened for
Coeliac
Anaemia in young person from northern europe
HS
What causes erythema infectiosum
Parvovirus B19
What is progression in richters transformation
CLL to diffuse large b cell NHL
Most common contaminated infection for platelet transfusions
Bacterial
Meningitis with CN involvement
Listeria
What is dextrocardia on ECG
Inverted p waves
At what temperature can patients in VF/VT be shocked
Above 30
If topical 5-ASA dont work to begin with in moderate UC what do next
Oral 5-ASA then if this doesnt work add oral pred
Which pneumonia leads to reactivation of HSV
Strep pneumonia
Which organism would lead to sepsis pneumonia after a splenectomy
Pneumococcal
AF rate management if NBM
Metoprolol
Order of most common cushings causes
Exogenous steroids
Cushings disease
Adrenal tumour
Ectopic ACTH
Order to cushings investigations
24 hour cortisol/ low dose dexamethasone
Midnight ACTH
High dose dexamethasone/petrosal venous sampling
Alternative test to high dose dexamethasone
petrosal venous sampling
2 associations of phaeochromocytoma
Von hippel landau
MEN 2
Diagnostic criteria for PCOS
Diagnostic criteria (2 out of 3):
Amenorrhoea/Oligomenorrhoea
Clinical or biochemical hyperandrogenism
Polycystic ovaries on USS
What is a decubitus ulcer
Pressure ulcer
When cant you give IM glucagon
Alcohol
What are seizure auras
Actually seizures- if have grand mal after aura is secondary tonic clonic
If someone on chemo presents severely with sepsis what is most important first investigation
FBC- neutropenia
What does parallel lines on CXR suggest
Bronchiectasis
How does myeloma increase stroke risk
Paraproteinaemia
First line investigation for metastatic prostate cancer
MRI
What give if elderly with varicella zoster
Oral aciclovir
What give if elderly with disseminated varicella zoster
IV aciclovir
What can cause a rapid drop in plts after heparin treatment
Heparin induced thrombocytopenia
What can happen when shingles reactivated in facial distribution
Conjunctivitis
