Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute Care > Pastest > Flashcards

Pastest Flashcards

1
Q

Most common cause of osteomyelitis in a patient with sickle cell?

A

Salmonella

staph aureus for everyone else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

First line for carpal tunnel syndrome?

A

Corticosteroid injection

no role for NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the commonest # of childhood?

A

Supracondylar # of the humerus

Often involve brachial artery compromise and involvement of median, radial or ulnar nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are supracondylar # classified?

A

Garland classification

Type 1 = non displaced
Type 2 = angulated with intact posterior cortex
Type 3 = posterior displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Back pain worse on extension of the back?

A

Facet joint pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ottawa ankle rules

A

X-ray is only required if bony tenderness in the malleolar zone +

Inability to weight bear for 4 steps
Bony tenderness in distal tibia
Bony tenderness in distal fibula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What tests do patient need before starting hydroxychloroquine?

A

Ophthalmology exam due to risk of retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

First line treatment for new RA?

A

Methotrexate + another DMARD e.g. leflunomide

+ a short dose of oral prednisolone to control acute flare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does anti-Jo 1 antibodies in polymyositis mean?

A

Worse prognosis and increased risk of interstitial lung disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Syringomeylia

A

Formation of a cystic cavity within the spinal cord

Commonest is with Arnold-chairi malformation

Typically affected the spinothalamic tract —>pain and sensory loss in the upper limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Feature of Brown - Sequard syndrome?

A 
Hemisection of spinal cord e.g. stab injury
Ipsilateral paralyses (pyramidal tract) and loss of proprioception and fine touch (dorsal column)

Pain and temperature loss is on the contralateral side (spinthalamic tract cross below the injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

APTT will be increased in anti-phospholipid syndrome. Associated with anit-cardioplipi and lupus anti-coagulant antibodies. What are the features?

A

C - coagulation defects
L - livedo reticularis
O - obstetric loss
T - thrombocytopenia (low platelets)

1ST DVT = warfarin for 6 months
>1 = lifelong warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of reactive arthritis?

A

NSAIDs- can’t pee, can’t see, can’t climb a tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which test is used to assess for hyper mobility?

A

Brighton score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of anti-synthetase syndrome?

A

Myositis
Cracked hands
Raynauds
Interstitial lung disease

Anti-jo 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ESR and CK in polymyalgia rheumatica?

A

ESR is elevated
CK is normal (no true myositis)

Remember there is no true weakness - it is limited by pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most common eye complication of RA

A

Keratoconjunctiva sicca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most likely bone tumour in middle age?

A

Chondrosarcoma

‘Popcorn calcification’ and axial skeleton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Distal radial # with volar angulation?

A

Smiths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Intra-articulate # of the base of the 1st MCP

A

Bennets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bi-malleolar ankle fracture. Often after fall from height?

A

Potts #

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dislocation of the proximal radio-ulnar joint with ulnar #

A

Monteggia #
(usually occurs after fall on outstretched hand with forced pronation)

(PM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Radial shaft # fracture with dislocation of the radio-ulnar joint

A

Galeazzi #

GD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Retinal haemorrhage after femoral #?

A

Fat embolism

Intra-arterial fat globules is also suggestive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What test is used to conform de quervains tenosynovitis?

A 
Finklesteins test
(put thumb in closed fist then extend wrist down)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is de quervains tenosynovitis?

A

Inflammation of the sheath containing the extensor policis brevis and abductor policis longus

Treat with analgesia or steroid injection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Positive lachman test?

A

ACL rupture

Remember that PCL occurs due to hyperextension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The sciatic nerve divides into the tibial and commonest peroneal nerves. Features of common peroneal nerve damage?

A

Foot drop
Sensory loss over dorsum of foot
Weakness of dorsiflexion, foot eversion and extensor hallucis longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Hills Sach lesion visible of x-ray

A

Anterior glenohemoral dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Rim’s sign, light bulb sign. Trough sign…

A

All suggestive of a posterior shoulder dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

IVDU with back pain, fever and likes to lie on back with knees flexed?

A

Psorias abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the expected calcium and alk phos in pagets disease?

A

Calcium = Normal

Alk phos = high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Alk phos and calcium in osteomalacia?

A

Low calcium and phosphate

Alk phos is high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

First line analgesia for managing low back pain?

A

NSAIDs such as naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

RF for DDH

A
  • Female
  • First born
  • FH
  • breech
  • oligohydramnios
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Teenager hit in knee with hockey stick. Knee is tense and swollen but no # on x-ray. Likely diagnosis?

A

Patellar disclocation

often spontaneously reduce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the investigation of choice in suspected osteomyelitis?

A

MRI

38
Q

Epidural abscess is a complication of discitis

A

Suspect in a patient with discitis who continues to spike a fever/ is not improving

39
Q

What is osteopetrosis?

A

Autosomal recessive
Present with anaemia or low platelets
‘Marble bone’ - no differentiation between cortex and medulla

40
Q

1 year old presents with FTT, small, big head, and cupping of the epiphysis of long bones

A

Rickets

Childhood form of osteomalacia (Weak bones due to vitamin D deficiency)

41
Q

Treatment of talipes equinovarus?

A

Club foot
Treat with manipulation and progressive casting e.g. the Ponsetti method
Night time braces until 4 years old

42
Q

What is club-foot associated with?

A

Spina bifida
Edwards
Cerebral palsy

43
Q

L5 lesion

A

Loss of foot dorsiflexion and sensory loss dorsum of the foot

Remember if L3/L4 then the knee reflex would be reduced
If S1 then ankle jerk is reduced

44
Q

Common complication of anterior shoulder dislocation?

A

Axillary nerve damage - badge patch

45
Q

Red, hot swollen joint with reduced sensation in a patient with a history of poorly controlled DM?

A

Charcot joint - as there is lots of peripheral neuropathy it is not as painful as might be expected

46
Q

Wasting of the thenar eminence is characteristic of carpal tunnel. Remember the rest of the hand is innervated by ulnar nerve - except…

A

LOAF muscles

  • lateral 2 lumbricals
  • opponens pollicis
  • abductor pollicis
  • flexor pollicis brevis
47
Q

Dupuytrens is associated with….

A 
Alcohol excess
FH
Liver disease
Manual labour
Male
48
Q

Classic symptoms of frozen shoulder

A

Active and passive movement restricted

External rotation worse

49
Q

Treatment of choice for a sub-trochanteric hip #

A

Interdmedullary nail

50
Q

Suspected cauda equina syndrome

A

MRI ASAP

Within 6 hours

51
Q

How does the management of an intra-capsular hip fracture vary depending on age/ mobility?

A

Younger and more active —> total hip replacement

Old and less mobile —> hemiarthroplasty

52
Q

Define AVN. What are the risk factors?

A

Death of bone tissue secondary to loss of blood supply

RF = steroids, chemotherapy, alcohol excess and trauma

53
Q

How does AVN present?

A

Can occur in any joint
Often long bones such as femur
Asymptomatic —> joint pain

Osteopenia, microfractures and collapse of intra-articulate surfaces are seen early on

Test with MRI

54
Q

Which antibiotic is associated with tendinitis and new tendon rupture?

A

Ciprofloxacin

55
Q

What clinical examination should be done in a patient with suspected Achilles’ tendon rupture?

A

Simmonds triad

  • look —> altered angle of dangle
  • feel —> palpate for a gap
  • move —> squeeze calf - normally there will be plantar-flexion of foot
56
Q

Describe the gustilo and Anderson tissue classification?

A

Classification of low open #

1 - low energy wound <1cm
2 - >1cm wound with moderate soft tissue damage
3 - high energy >1cm with extensive tissue damage
3a - adequate tissue coverage
3b - inadequate tissue coverage
3c = associated arterial injury

57
Q

Foot drop in an old man who has had a total hip replacement revision?

A

Sciatic nerve damage

remember common peroneal is an important branch

58
Q

Remember the entire posterior compartment of the lower leg is innervated by the tibial nerve

A

E.g. soles, gastrocnemius, tibialis posterior and flexors digitorum and hallucis longus

59
Q

Sensation on lateral aspect of foot and weakness of plantar-flexion?

A

S1

60
Q 
Knee = L4
Ankle = S1
A 
Bicpes = C5
Brachioradialies = C6
Triceps = C7
61
Q

All reflexes are normal but there is reduced dorsiflexion of big toe?

A

L5 nerve involvement

Can’t be L3/4 or S1/S2 as they are involved in reflexes

62
Q

Sensory loss over dorsum of foot =

A

L5

Also weakness in foot and big toe dorsiflexion but reflexes are ok

63
Q

Burning thigh pain…

A

Meralgia parasthetica due to compression of the lateral cutaneous nerve of the thigh

64
Q

Oslers nodes?

A

Painful pink/ purple lesions on the fingers and toes

Caused by immune complex deposition and associated with infective endocarditis and SLE

65
Q

Action in suspected hip fracture (clinically) but x-ray is normal?

A

MRI is best (but CT may be done to wider availability)

66
Q

Triad of:

Claudication in buttocks and thighs
Atrophy of leg muscles
Impotence

A

Leriche syndrome

Athersosclerotics occlusive disease of abdominal aorta +/or both iliac arteries

67
Q

Investigations in a patient with suspected spinal stenosis?

A

MRI

68
Q

Describe the different types of nerve damage which can occur following a forceps delivery

A

Femoral = weak knee extension, loss patella reflex and numb thigh

Sciatic = weak knee flexion and foot movement

Obturator = weak hip adduction

69
Q

Which nerve supplies biceps brachii?

A

Musculocutanoues nerve
(C5-C7)

Elbow flexion

70
Q

Which nerve supplies deltoid muscle?

A

Axillary

C5/C6

Shoulder abduction

71
Q

Which nerve in the upper limb does extension?

A

Radial

72
Q

Weakness of dorsiflexion, eversion and extensor hallucis longus can all be explained by…

A

Common peroneal nerve palsy

73
Q

Which muscle does the first 20 degrees of shoulder abduction?

A

Supraspinatous
after that, deltoid takes over

SI
SA
IE
TE

74
Q

How does serotonin syndrome present?

A

Cause by excess SSRI, TCA act

Features = restlessness, hyperthermia, tachycardia, confusion, increased reflexes and movement (basically everything increases and D&V is common)

75
Q

Foot drop..

A

Common peroneal nerve palsy - often due to tight fitting plaster cast

76
Q

What is the correct management for a perforated eardrum?

A

Discharge and advice to keep dry for 6 weeks while it heals.

See GP in 6-8 weeks

Surgery is only considered if not healing

77
Q

Patient on metronidazole develops vomiting after having a few drinks. What is happening?

A

Disulfarim reaction

The activity of acetaldehyde is blocked —> large increase in serum acetaldehyde levels following alcohol

Patients are sick, dizzy and have a terrible headache.

This is how Antabuse (the drug that makes alcohol very unpleasant works

78
Q

Adrenaline in anaphylaxis….

A

Adult= 500 micgrogram IM

Child = 300 microgram IM

Child >6 = 150 microgram IM

79
Q

Best investigation in a patient with suspected phaeochromocytoma but normal MRI?

A

MIBG scan

MIBG labelled with radioactive iodine resembles nor-adrenaline and concentrates in adrenals or areas of adrenal phaeochromocytoma

80
Q

What is Waterhouse Friederichsen syndrome?

A

Primary adrenal failure which is most commonly caused by neisseria meningitidis

81
Q

Remember, LFT and UE are taken from the same blood tube. If LFT could not be performed due to haemolysis then it is possible that a raised K is due to haemolysis too

A

Take repeat bloods but probably do an ECG just in case

82
Q

Which type of shock is most common in acute pancreatitis?

A

Fluoxetine d depletion or hypovolaemic due to loss of fluid into the intra abdominal space

83
Q

What is Charcots triad?

A

Fever, jaundice and RUQ pain which is suggestive of acute cholangitis

84
Q

Likely diagnosis in an ICU patient who develops sudden onset haematemesis with no underlying peptic ulcer disease?

A

Stress ulceration due ischaaemic injury to the gastric mucosa and disruption of the mucosal barrier

Prevent by using PPI/ ranitidine

85
Q

Remember that a central venous line can be really useful in patients with heart failure who need carful fluid balance e.g. you want them hydrated but not overloaded

A

Remember that a central venous line can be really useful in patients with heart failure who need carful fluid balance e.g. you want them hydrated but not overloaded

86
Q

Type 2 reaction = antibody mediated hypersensitivity e.g. haemolytic anaemia

A

Type 3 = immune complex mediated e.f. RA or SLE

TyPE 4 = T cell medicated e.g.g contact dermatitis

87
Q

Which drug is used for radiation emergencies?

A

Potassium iodide

used if significant exposure to radioactive iodine

88
Q

Target BP in a patient with a pelvic #

A

Ideally 100/70 as lower pressure = less bleeding and less clot destruction

89
Q

Smith # are usually managed with MUA or ORIF

A

Colles fractures are often managed conservatively

90
Q

How is an acute dystonic reaction managed? E.g. after ingestion of metoclopramide?

A

Drugs such as benztropine or procyclidine

Procyclidine is most likely (it is more available and is used as an anti-Parkinsonism drug)

Acute Care (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions