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PLAB > PLAB > Flashcards

PLAB Flashcards

1
Q

Beck’s triad

A

cardiac tamponade
increased JVP
muffled heart sound
HoTN

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2
Q

IE criteria

A

Duke’s criteria (2maj + 1min OR 1maj + 3min OR 5min)

Major: (+) blood culture/ (+) echo

Minor: FROM JANE
Fever >38'C
Roth's spot
Osler nodes
Murmur

Janeway lesion
anaemia
Nail haemorrhage
Emboli

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3
Q

empirical tx of infective endocarditis

A

NVE: amoxicillin + genta
if penicillin allergic/ MRSA: vanco + genta

prosthetic valve: van + genta + rifampicin

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4
Q

CHA2DS2-VASc

A 
Congestive HF
HTN
Age >75 (2)
DM
Preve stroke, TIA, thromboembolism (2)
Vascular disease (MI, PAD, aortic plaque)
Age 65-74 (2)
Sex cat (Female)

if >2 give Warfain/ DOAC

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5
Q

NTEMI tx

A
  1. NSTEMI ECG
  2. Check Tropnin if elevated
  3. LMWH or fondaparinux + aspirin 300mg
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6
Q

post MI long-term tx

A

AABC + S

Aspirin life long
ACEi
BB @ least 12mo
Clopidogrel 12mo
Statin
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7
Q

Pulmonary oedema Tx

A

MONF

Diamorphine 2.5-5mg iv slowly
O2
Nitrate GTN spray 2 puff sublingual
Furosemide

pulmonary oedema secondary to HF: add ACEi

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8
Q

Multiple sclerosis dx, tx

A

REMEMBER OPTIC NEURITIS

Dx:
MRI: dissemination in space should be confirmed
CSF: increased total protein, high oligoclonal

Tx:
relapses: po/ iv methylprednisolone 500mg/d 5d
disease modifying: INF-b, Glatiramer

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9
Q

Trigeminal neuralgia tx

A

anti-convulsant: carbamazepine

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10
Q

DM neuropathy tx

A

1st: amitryptiline

gabapentin, duloxetine, pregabalin

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11
Q

Diabetic drugs safe to use for renal impairment

A

RIP (repaglinide, linagliptin, pioglitazone)

insulin, DDP4-i (gliptin)

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12
Q

diabetic drugs cause weight gain

A

SPR

sulphonylureas (gliclazide)

pioglitazone

repalignide

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13
Q

Pioglitazone

A

weight gain

bladder cancer concern

heart failaure

fracture

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14
Q

antiDM med not to use in RF

A

MS

metformin

sulfonylureas

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15
Q

Impaired glucose tolerance

A

Impaired glucose tolerance

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16
Q

antiDM cause hypoglycaemia

A

sulfonylurea, repaglinide

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17
Q

Adrenal insufficiency

A

Primary: Addison
Secondary: HPA (iatrogenic)

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18
Q

Addison disease

A

Low cortisol, low aldosterone

hyperK+

hypo: Na+, glycaemia
Metabolic acidosis

Tx: hydrocortisone 15-30mg
if primary: give fludrocortisone 50-30ug/d

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19
Q

Glucocorticoid excess

A

Cushing disease, sy: metyrapone, ketoconazole, mitotane

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20
Q

Hyperaldosteronism

A

Pri: Conn’s disease

Secondary

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21
Q

Conn’s disease

A

Hyperaldosteronism
HyperNa+, hypoK+
metabolic alkalosis

tx: spironolactone (Aldosterone ATG)

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22
Q

SIADH

A

tx: vaptan (vassopressin R- ATG), furosemide, fludrocortisone

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23
Q

DI

A

ineffective ADH

central: desmopressin
nephro: bendroflumethiazide

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24
Q

Primary PTH

A

high PTH
High Ca2+
Low PO4
Vit D: norm/ low

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25
Q

Secondary PTH

A

high PTH
Low/ norm Ca2+
high/norm PO4
V. Low Vit D

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26
Q

Tertiary PTH

A

V. High PTH
High Ca2+
High PO4
Low/ norm vit D

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27
Q

SIADH tx

A

fluid restriction 800-1000ml/d
vasopressin R ATG: tolvaptan, conivaptan
Severe: demeclocycline

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28
Q

hypokalaemia ECG, sx

A

fainting, tiredness/weakness, leg cramps, generalised wekaness, constipation, severe muscle weakness, paralysis, resp failure, tetany

ECG: flat T-watnes, ST depression, U waves Prolonged QT interval

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29
Q

hypokalamiae tx

A

<2.5mmol/l or <3mmol/l w/ ECG
- 40mmol/l KCl in 1L 0.9% normal saline w infusion rate NOT >20mmol/hr

> 2.5mmol/l w/ no ECG changes
- oral K-supplement stbl TDS po Sando-K

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30
Q

hyperkalaemia sx (>5.5mmol/l)

A

ECG: tall-tented T, flattening p-waves, broad QRS, sinu wave pattern, VFib

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31
Q

hyperkalaemia tx

A

stop drug
1st line: iv-Ca-gluconate
insulin + dextrose
Salbutamol inhalation

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32
Q

hypercalcaemia sx

A

polyuria, polydipsia, depression, muscle weakness, constipation, PT shortened

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33
Q

hypercalcamia tx

A 
1st line: fluid
bisphosphonate
calcitonin
steroids
cinacalcet
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34
Q

hypocalcaemia sx

A

siezure, tetany, spasm, perioral paraesthesia, muscle tone increased, orentation impaired, dermatitis, impetigo herpetiformis, chvostek, trousseau

ECG: prolonged QT

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35
Q

hypocalcaemia tx

A

Ca-gluconate

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36
Q

Wernicke-Korsakoff sy

A

COAT RACK

confusion
ophthalmoplegia
Ataxia
Thiamine NB aspect of tx

Retrograde amnesia
anterograde amnesia
confabulsation
Korsakoff’s psychosis

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37
Q

TCA poisoning tx

A

0.9% norm saline 250ml + 8.4% NaHCO3 50mmol/l iv slowly

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38
Q

Paracetamol poisoning N-acetylcysteine admin

A

Pt present >8hrs after ingestion
uncertatinty of timing of overdose
unconscious or have suspected overdose
staggered overdose

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39
Q

stages of hypovolaemic shock

A

stage 1: norm, 10-15%
stage 2: >100bpm, 15-30%
stage 3: >120 30-40%
stage 4: >140 >40%

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40
Q

smudge cell

A

CLL

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41
Q

Auer Rod

A

AML

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42
Q

DIC bleeding time

A

increased: PT, aPTT, INR, D-dimer,
decreased: fibrinogen, plt

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43
Q

haemophilia bleeding time

A

increase aPTT + muscle/ joint bleeding

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44
Q

vWD bleeding time

A

increase aPTT + BT + mucosal bleeding

decreased fVIII
Normal PT
plt count norm

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45
Q

ITP bleeding time

A

decreased: plt + Bleeding/ purpura w/ or w/o Hx URTI

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46
Q

anaemia in preg

A

MUST NEVER GO BELOW <10g/dL
T1: <11g/dL
T2: <10.5g/dL
T3: <10g/dL

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47
Q

What cell are found in G6PD deficiency?

A

heinz bodies, bite cells

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48
Q

what cells are found in CLL?

A

Smudge cells

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49
Q

CYP450 inducers

A 
Bull Shit CRAP GPS
Barbiturate
St Johns Wort
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
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50
Q

CYP450 inhibitor

A 
SICKFACES.COM
Sodium valporate
Isoniazide
Cimetidine
ketoconazole
fluconazole
alcohol
Chloramphenicol
Erythromycin
sulfonamide
ciprofloxacin
omeprazole
metronidazole
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51
Q

status epilepticus tx

A
  1. 2 separate doses: iv lorazepam (hospital)/ buccal midazolam or rectal diazepam (outpt)
  2. iv phenytoin>phenobarbital
  3. iv phenobarbital
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52
Q

restless leg sy tx

A

1stline: n-ergot DA-AG

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53
Q

medullary stroke

A

ipsilat horner sy
loss pain & temp of face
contralat loss pain & temp limb

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54
Q

trigeminal neuralgia tx

A

carbamazepine 1st line

gabapentin + ropivacaine injection

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55
Q

PID empirical tx

A

OM!!/ CDM

ceftriaxone 500mg single dose im –> doxycycline 100mg x2/d + metronidazole 400mg x2/d 14d

po ofloxacin 400mg x2/d + po metronidazole 400mg x2/d 14d

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56
Q

PID hospital tx

A

CDM-DM

iv doxycycline 100mg x2/d, single dose iv ceftriaxone 2g od, iv metronidazole –> po doxycycline 100mg x2/d + metronidazole 400mg x2/d 14d

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57
Q

Pre-eclampsia MgSo4

A

MgSO4 loading dose 4g infusion 5-10min in 0.9% NaCl 100ml –> further infusion 1g/hr maintained for 24hrs after last seizure

If recurrent seizures: bolus 2g MgSO4 or increase infusion rate 1.5-2g/hr

Maintenance 1g/hr for 24hrs

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58
Q

Chlamydial cervicitis

A

ABCD

Azithromycin before chlamydial doxycycline

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59
Q

Gonorrhoea cervicitis

A

A+C

Ceftriaxone 1g im as single dose
Azithromycine 1g po

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60
Q

CI for COCP

A

smoking or Hx smoking, obesity >30kg/m2, Hx thromboembolism, learning difficulties, postpartum (if breast feeding >6mo if not 6wks), migraine w/ aura, HTN even if controlled

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61
Q

Acute alcohol w/drawal sx management

A

BDZ: chlordiazepoxide/ diazepam first then thiamine

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62
Q

alcohol hallucination/ seizure (Delirium Tremens)

A

iv Lorazepam OR diazepam

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63
Q

Wernicke’s encephalopathy

A

vit B1

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64
Q

What to check for pt on Li?

A

TFT, Renal

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65
Q

What to check for pt on amiodarone?

A

electrolytes, urea

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66
Q

steps for ectopic preg?

A 
Urine preg test (+)
TBUS check if uterus empty
if pt stable check hCG
    - >1400: laparoscopy
    - <1400: observe &amp; repeat vagina US later

if unstable SBP <90mmHg laparotomy

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67
Q

Rapid tranquilisers

A

HOL

Haloperidol, olanzapine, lorazepam

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68
Q

tardive dyskinesia management?

A

depot risperidone

EPS: long term antipsychotic SE

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69
Q

antidepressant for pt w/ MI?

A

sertraline> citalopram

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70
Q

Antidepressant for pt taking warfarin?

A

mirtazapine

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71
Q

antidepressant for young people & children?

A

fluoxetine

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72
Q

Plummer Vinson Sy

A

Dysphagia
Fe-def anaeamia
Esophageal Webs

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73
Q

Dx acute pancreatitis

A

initial: lipase & amylase (lipase more specific & sensitive)
confirm: CT w/ contrast of pancreas

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74
Q

Charcot Triad

A

FRJ

Fever, RUQ pain, jaundice

Seen in pt w/ acute cholangitis

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75
Q

Cholangitis

A

Inflammation of bile duct

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76
Q

Traveller’s diarrhoea empirical ABTx

A

Most common E. Coli

ciprofloxacin 500mg bd for 3d

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77
Q

Campylobacter jejuni w/ travel Hx in Southeast Asia ABtx

A

Quinolone resistance

1st line: erythromycin (clari/ azithro if erythro NOT well tolerated)

2nd line: ciprofloxacin

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78
Q

Salmonella tx

A

1st line: Ciprofloxacin

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79
Q

Giardiasis Tx

A

Metronidazole

alternative: Tinidazole

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80
Q

Bloody diarrhoea organism

A

Bampylobacter
Shigella
Salmonella
E. Coli O.157

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81
Q

Campylobacter ABtx

A

usually not required

1st line: erythromycin 250-500mg pds for 5-7d

Azithromycin/ Clarithromycin alternative
Ciprofloxacin 500mg bd 5-7d alternative

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82
Q

H. Pylori tx

A

do NOT perform urea breath test/ Stool Ag test if PPI used w/in 2wks OR ABtx used w/in 4wks

1st line: 7-14d PPI+ amoxicillin 1g + clarithromycin 500mg OR metronidazole 400mg (all x2/d)

2nd line: PPI, amoxicillin + clarithromycin OR metronidazole (whichever not used in first line)

3rd line: PPI + bismuth subcitrate + tetracycline + metronidazole

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83
Q

Triple tx for H/ Pylori

A

PPI + Amoxicillin + clarithromycin 7-14d

eg. esomeprazole 20mg bid
amoxicillin 1g bid
clarithromycin 500mg bid

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84
Q

DX Coeliac disease

A

Auto-Ab: TTG (IgA), EMS (TTG 1st choice)

jejunal/ duodenal biopsy

pt should be on gluten for ~6wks before testing!!!

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85
Q

PBC ass disease

A

sjogren

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86
Q

PSC ass disease

A

IBD UC>CD

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87
Q

Clostridium Difficile tx

A

1st line: Metronidazole

2nd line: vancomycin

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88
Q

Acute Fatty liver of preg

A

ELLP + low glucose + high NH3

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89
Q

laxative: no impacted stool

A

phosphate enema

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90
Q

laxative: hard stool + NO impacted

A

stool softeners: liquid paraffin

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91
Q

laxative: constipation w/ soft stool

(stimulant laxative) also used for cancer pt

A

increased fibre diet
Senna (+) laxative 1st line

2nd line: latulose, macrogol

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92
Q

laxative: preg

A

lactulose 1st line

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93
Q

severe UC/ acute exacerbation

A

6, 30, 90

>6 bowel movements + visible blood in lare amounts
ESR >30
HR >90 bpm
temp >37.8
Anaemia
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94
Q

Diffuse oesophageal spasm dx, tx

A

Barium meal: corkscrew appearance

most accurate test: manometric studies

Tx: CCB, Nitrate

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95
Q

CD tx

A

inducing remission: CS, if CI budesonide or 5-ASA

Maintaining: azathioprine, mercaptopurine, MTX

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96
Q

UC tx

A

inducing: 5-ASA topical then rectal (rectal 5-ASA> rectal steroid)

2nd line: add oral pred

Remission: oral aminosalicylates/ po azathioprine or mercaptopurine

for acute exacerbation iv hydrocortisone

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97
Q

Gilbert’s sy

A

AR disorder: low UGT-1

unconjugated hyperBb; no haemolysis; norm liver enzymes; NO evidence of liver disease!!!

Tx: no need

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98
Q

Hb level BEFORE surgery?

A

Elective
>100g/L (>10g/dL): proceed
<100g/L (10g/dL): investigate
<80g/L (<8g/dL): + sx: transfuse & defer surgery

EMERGENCY
If Hb <100g/L (10g/dL): always proceed w/ emergency operation
<80g/L (8g/dL): transfuse w blood

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99
Q

Reynolds pentad

A

Acute cholangitis:

Fever, abdom pain, jaundice
+ confusion, HoTN

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100
Q

Scabies tx

A

1st line: Topical Permethrin 5%

2nd line: Malathion 0.5% aqueous liquid

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101
Q

Lyme disease tx

A

erythema migrans
2-3wks Doxycyclin 100mg bd OR amoxicillin 500mg tds
Defuroxime 500mg bd if both CI

Preg, Breast feeding, Children <12yrs: amoxicillin or cefuroxime

Systemic: Ceftriaxone iv

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102
Q

outpt meningitis tx

Adults & children

A

Children: Benzylpenicillin im/ iv

<1yr: 300mg
1-9yrs: 600mg
>10yrs: 1200mg

Adults: Benzylpenicillin or 3rd gen cephalosporin immediately

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103
Q

inpt initial meningitis empirical tx

A

> 3mo <60yrs: iv ceftriaxone (cefotaxime preferable)

> 60yrs: iv ampicillin/ amoxicillin

<3mo: iv cefotaxime + amoxicillin/ ampicillin

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104
Q

Listeria meningitis

A

<3mo: iv amoxillinc/ ampicillin 21d + gentamicin least first 7d + ceftriaxone

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105
Q

Cryptococcal meningitis

A

Amphotericin B

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106
Q

meningitis prophylaxis for contacts

A

ciprofloxacin&raquo_space; rifampicin

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107
Q

HIV/ADIS vaccination cI

A

NO BCG, Yellow fever

If <200cells/ml NO MMR in adult!!!
<1yr: <750cells
1-5 <500cells
>5yr <200cells

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108
Q

Nesseria meningitis tx

A

iv ceftriaxone 7d

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109
Q

Toxoplasmosis tx

A

immunocomp: pyrimethamin, sulfadiazine, folinic acid 4-6wks
immunocompromised: trimethoprim/ sulfamethoxazole prophylaxis

Mat & foetal infection: spiramycin asap!

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110
Q

Malaria N-falciparum malaria

A

Chloroquine if fail quinine, artemether + lumefantrine OR atovaquonone proguanil

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111
Q

P. falciparum malariae

A

quinine + doxycycline OR clindamycin for preg

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112
Q

Schuffner’s dots

A

primaquine

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113
Q

Prophylaxis for malaria

A

Mefloquine

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114
Q

ABtx neutropenic sepsis

A

Empiric ABtx: piperacillin w/ tazobactam immediately

if after 48hrs: meropenem + vanco

if pt still unwell 4-6d: investigate for fungal infection

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115
Q

Mumps (MMR) vaccine HIV (+) pt

A

Contraindicated

Adults: <200cells/ml
>5yrs: <200
1-5yrs: <500
<1yrs: <750

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116
Q

otitis externa tx

A

Acetic acid 2% + aminoglycoside + topical CS

Avoid AG (gentamicin) if there is TM perforation rather use ciprofloxacin

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117
Q

Otitis Media tx

A

reassess after 3mo

ALL pt w/ AOM:
- pain & fever: paracetamol, ibuprofren
Most children 5d amoxicillin if allergic–> erythromycin/ clarithromycin

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118
Q

Benign Paroxysmal positional vertigo dx & tx technique

A

dx: Hallpike’s Manoeuvre

Tx: Epley

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119
Q

Hearing test in Children

A

<6mo: otoacoustic emission, audiological brainstem response

6-18mo: distraction testing

2-4: speech discrimination, conditioned response audiometry

> 5yrs: Pure tone audiogram

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120
Q

whipple’s disease biopsy result

A

deposition of Ma in lamina propria containing granules which stain (+) PAS

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121
Q

PJP tx

A

Co-trimoxaole (Trimethoprim-sulfamethoxazole)`

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122
Q

MRSA tx

A

Vancomycin

Teicoplanin

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123
Q

Tonsillitis ABtx

A

if >3 Centro criteria

5-10d phenoxymethylpenicillin (allergic: clarithromycin/ erythromycin)

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124
Q

Tonsillectomy criteria

A

episodes of sore throat disabling & prevent norm functioning
>7 sore throats 1yr
>5 2yrs
>3 each of preceding 3yrs

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125
Q

Centro criteria

A

tonsillitis criteria <1 (+) unlikely to have group A beta strep

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126
Q

Acute attacks of Meniere disease tx

A

vertigo & causea: prochlorperazine, cinnarizine, cyclizine, promethazine

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127
Q

c-ANA

A

Wegener’s Granulomatosis (granulomatosis w/ polyangiitis)

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128
Q

p-ANCA

A

Churg Strauss (Eosinophilic granulomatosisw/ polyangiitis)

UC

Primary sclerosing cholangitis (PSC)

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129
Q

anti-mitochondiral (AMA)

A

PBC

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130
Q

Mild SLE tx:

Skin, arthralgia, myalgia, malaise

A

NSAIDS, local CS, hydroxychloroquine–> 1st line but (retinal toxicity)

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131
Q

Severe SLE tx: lupus nephritis, vasculitis, cerebral disease

A

Cyclophosphamide (resna; haemorrhagic cystitis), systemic CS, mycophenolate mofetil

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132
Q

SLE Maintenance tx:

A

po CS (prednisolone); azathioprine, MTX

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133
Q

Drug induced SLE: causative drugs

A

SHIPP

sulfasalazine
**Hydralazine
isoniazid
Phenytoin
**Procainamide
**quinine
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134
Q

Antihistamine for pregnancy

A

chlorpheniramine

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135
Q

N-sedating H1 anti-histamine

A

cetirizine, loratadine

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136
Q

Acne Rosacea

A

Mild-mod: Topical metronidazole

Mod-severe: oxytetracycline, tetracycline

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137
Q

Tinea capitis

A

children: griseofulvin

Adult: terbinafine, itraconazole, fluconazole

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138
Q

Impetigo Tx

A

Localised infection: fusidic acid, topical retapamulin 2nd line

Extensive disease: flucloxacillin 1st line

erythromycin 2nd line

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139
Q

Goodpasture’s characteristic

A

haematuria + haemoptysis

Acute rapidly progressive GN + pulmo alveolar haemorrhage

anti-glomerular BM Ab (anti-GBM Ab)

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140
Q

Goodpasture’s sy tx

A

prednisolone, cyclophosphamide, plasma exchange

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141
Q

Acute pyelonephritis tx

A

Fluid analgesia

Adults: 1st line ciprofloxacin OR co-amoxiclav 7d (500mg bd OR 500/125mg tds)
Trimethoprim used if culture confirms sensitivity 200mg bd 14d

Children: 1st line co-amoxiclav; 2nd line cefixime

Preg: cefalexin

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142
Q

Nephrolithiasis tx

A

<0.5cm (5mm): increase ifluid intake get rid of it in urine

0.5-2cm: ESWL or ureteroscopy w/ dormia basket

Stone >2cm: percutaneous nephrolithotomy

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143
Q

HUS triad

A

Haemolytic anaemia
Uremia
Thrombocytopenia

E. Coli

144
Q

TTP sx

A

HUS triad
Fever
Neurological manifestation

145
Q

Septic arthritis

A

Flucloxacillin 4-6wks longer if infection

Clindamycin if penicillin allergy

MRSA: vanco 4-6wks

Gonococcal gram (-): cefotaxime/ ceftriaxone 4-6wks

146
Q

Reiter’s triad

A

seronegative spondyloarthritis: reactive arthritis

CANNOT SEE: conjunctivitis, uveitis

CANNO PEE: urethritis

CANNOT CLIMB A TREE: arthritis

+skin manifestation

147
Q

Reactive arthritis skin manifestation

A

Circinate Balanitis: apinless vesicles on coronal margin of prepuce

Keratoderma blenorrhagica: waxy yellow/ brown papules on palms & soles

Erythema nodosum: tender red nodules over shins

148
Q

Superficial peroneal nerve

A

lat compartment of leg

EVERT!!!

149
Q

Deep peroneal nerve

A

ant compartment of leg DORSIFLEX, sensation in web space btw BIG TOE & 2nd TOE

150
Q

T1 nerve root injury

A

finger abduction & finger adduction

weakness upon adduction of thumb

151
Q

Anterior uveitis ass disease

A

ankylosing spondylitis

reactive arthritis

UC, CD

152
Q

Anterior uveitis

A

cycloplegics (cyclopentolate)

Prednisolone: reduce inflammation

153
Q

Central retinal artery occlusion tx

A

If w/in 90-100min: ocular massage

Lower IOP: acetazolamide, w/drawal little fluid from ant chamber

154
Q

Central retinal artery occlusion ass disease

A

giant cell arteritis (temporal arteritis)

155
Q

Acute closed angle glaucoma

A

Initial: topical glaucoma med + iv acetazolamide
BB: timolol
Steroids: Prednisolone 1every 15min for hrly

acetazolamide iv

Pilocarpine -2% for pt w/ natural lens
Phenylephrine 2.5% for pt who do NOT have their own lens

156
Q

Scaphoid fracture

A

Tender in anatomical snuff box & over scaphoid tubercle

157
Q

osteoarthritis tx

A

drugs: Paracetamol &/or topical NSAIDS then opioid

intra-articular injection: CS injection

158
Q

thiazide SE

A

bendroflumethiazide, chlorthalidone, indapamide

HYPONa+
HYPOK+
GOUT: increases uric acid levels
HYPERGLYCAEMIA: impaired glucose tolerance

159
Q

Loop diuretics SE

A

Furosemide, bumetanide, ethacrynic acid

HYPONa+
HYPOK+
Gout
Postural HoTN
HYPOCa2+
160
Q

K+ sparing diuretics SE

A

Spironolactone, eplerone, amiloride, tiramterene

HYPERK+
HYPONa+
Gynecomastia

161
Q

cyclizine indication

A

antiemetic: antimuscarinic & antihistamine action CNS

Motion sickness, vestibular disorder & palliative care

162
Q

Odansetron

A

Selective 5HT3-R ATG prevent N/V due to chemotx, radiotx, surgery

163
Q

Parkinson CI indicated anti-emetics

A

haloperidol
metocloprammide

Use levomepromazine

164
Q

Antiemetics for vertigo

A

Severe N/V: Buccal prochlorperazine

Less severe N/V: po prochlorperazine, cinnarizine, cyclizine, promethazine

165
Q

po morphine to sc morphine

A

divide 2

166
Q

po morphine to sc diamorphine

A

divide 3

167
Q

po tramadol to iv morphine

A

divide 20

168
Q

Breakthrough pain morphine

A

1/6 of total 24hr opioid dosage

169
Q

Calculate alcohol unit for pure alcohol

A

strength (ABV) % x volume (ml)/ 1000 units

170
Q

Neuroleptic malignant sy Tx

A 
stop antipsychotic
Rapid cooling
iv fluids to prevent renal failure
Dantrolene: NMS muscle relaxant
DA-agent: Bromocriptine
171
Q

NMS Sx

A 
AMS: catatonia, mutism
hyperpyrexia
autonomic instability
metabolic acidosis
Rhabdomyolysis
LEAD PIPE RIGIDITY

SLOW ONSET 1-3d; no exposure to triggers!!

172
Q

Neuropathic pain Tx

A

Away Goes D neruopathic Pain

Amitriptyline 1st line
Gabapentin, Duloxetine, Pregabalin

173
Q

1% of lidocaine

A

1g/100ml

1000mg/100ml

174
Q

medication to stop for dehydration pt

A 
DAMN
Diuretics
ACEi/ ARB
Metformin
NSAIDS
175
Q

osteoid osteoma characteristic

A

<1cm dense osteoid benign bone tumour

Pain worse @ night relieveed by NSAIDS!!!

176
Q

Urge incontinence (Detrusor overactivity) Tx

A

Leakage of urine when there is sensation of need to void

Bladder drill (retraining): gradually increase periods betw voiding for 6wks
Antimuscarinic: oxybutynin
177
Q

Benign prostatic hyperplasia Tx

A

drugs: alpha ATG (Tamsulosin, doxazocin, alfuzosin, prazosin)

5-alpha-reductase inhibitor: finasteride, dutasteride

TURP surgery

178
Q

PSA level according to age

A

40-49: >2ng/ml
50-59: >3ng/ml
60-69: >4ng/ml
>70: >5ng/ml

179
Q

Seminoma marker

A

LDH

180
Q

yolk sac tumour of testes

A

AFP

181
Q

VUR Dx

A

initial: Renal US + urinalysis, urine culture, sensitivity

Gold std: MCUG

Parencymal damage: cortical scars: DMSA

182
Q

Hunner’s ulcer

A

reddened mucosal area ass w/ small vessels radiating toward central scar ==> INTERSTITIAL CYSTITIS

183
Q

epididymo-orchitis Empirical ABtx

A

STD: ceftriaxone 250mg im single dose + doxycycline 100mg po x2/d 10-14d

Enteric: ofloxacin OR ciprofloxacin

Pseudomonas: cefuroxime

184
Q

Rhmatoid arthritis ass eye sx

A

keratoconjunctivitis sicca: most common
episcleritis: presents w/ erythema (pain also present but less severe than scleritis)
Scleritis: presents w/ erythema & pain
Iatrogenic steroid-induced cataracts

185
Q

dacrocystitis tx

A

inflmmation of lacrimal sac result of infection

children: co-amoxiclav or defaclo

Adults: co-amoxiclav or defalexin

186
Q

SLE Ab

A

anti-dsDNA; Anti-smith, ANA

187
Q

drug induced lupus Ab

A

anti histone

188
Q

Systemic sclerosis

A

anti-scl70

189
Q

anti-centromere

A

limited sclerosis/ CREST sy

190
Q

polymyositis

A

anti-jo> anti-mi

191
Q

sjogren’s disease Ab

A

anti-ro anti-la

192
Q

PBC Ab

A

AMA

193
Q

dermatomyositis

A

Anti-Mi> Anti-jo

194
Q

Polymyalgia Rheumatica tx

A

Corticosteroid required for 1-2yrs

195
Q

systemic sclerosis Ab

A

Anti-topoisomerase 1 (anti-Scl 70)

Anti-centromere Ab

Anti-RNA polymerase III Ab

Anti-fibrillarin (anti-U3RNP)

196
Q

Giant cell arteritis tx

A

steroid: start immed 40mg prednisolone/ day

if claudication sx: 60mg/d

NEED osteoporosis prophylaxis needed: bisphosphonate

Low dose aspirin + PPI

197
Q

Acute gouty attack tx

A

1st line: NSAIDS (diclofenac, naproxen, indomethacin)

Colchicine

corticosteroid when both fail!

198
Q

Gout tx btw attacks

A

normally lifelong & regular monitoring needed

Allopurinol: never started during acute attacks wait for 1-2wk after attack resolves. May cause acute attack co-prescribe colchicine or low dose NSAIDS and do not stop their allopurinol during acute attacks!

199
Q

reactive arthritis tx

A

NSAIDS, corticosteroid- intra articular injection or systemic tx

ABtx identified causative organism

200
Q

de Quervain’s tenosynovitis

A

washerwoman’s sprain, gamer’s tjumb

pain under root of thumb

201
Q

Rheumatic arthritis

A 
Rheumatoid facotr (+) 60-70%
anti-CCP Ab: if pt (-) for rheumatoid factor
202
Q

Rheumatic arthritis Tx

A

DMARDS
1st line: hydroxychlorquine

Other: MTX, leflunomide, sulfasalazine

203
Q

polymyalgia Rheumatica ass disease

A

temporal arteritis

ESR >30 CRP >6

204
Q

Mikulicz’s sy

A

persistent swelling of lacrimal & parotic gland
Dry mouth, face swelling

Lymphocytic infiltration

205
Q

light criteria

A

pleural fluid protein/ serum protein >0.5

pleural fluid LDH/ LDH >0.6

Pleural fluid LDH ?2/3 upper limits of norm serum LDH

206
Q

anti-emetic for increased ICP

A

cyclizine

Dexamethasone: help relieve the increased ICP by shrinking the oedema around the tumour & relieve the nausea & other sx

207
Q

capsular pain management

A

NSAIDS: ibuprofen/ naproxen

208
Q

analgesic ladder

A

1: paracetamol, NSAIDS, Aspirin
2: codein, tramadol, dihydrocodeine
3: morphine, fentanyl patches, diamorphine, oxycodone

209
Q

Hiccups

A

metoclopramide: intractable hiccup due to liver pㅁ가metastasis–> periph hiccup due to diaphragmatic irritation by liver metastasis

210
Q

Cystic Fibrosis screening test

A

Guthrie test: geel prick test 7-10d old

211
Q

Alport Sy characteristics

A

SD

kidney disease: haematuria, proteinuria, ESRD
Hearing loss SNHL
Eye abnormalities

212
Q

Jarisch-Herxheimer reaction tx

A

reaction to tx for Syphilis

antipyretics
reassure

213
Q

Refeeding sy electrolyte disturbance

A

hypo phospate, Mg2+, K+

214
Q

Neisseria gonorrhoea

A

uncomplicated gonococcal anogenital infection: Ceftriaxone 500mg im stat + (azithromycin 1g po stat NOT Anymore!!!!! )

215
Q

Chlamydia tx

A

uncomplicated chlamydial infection: doxycycline 100mg x2/d 7d OR single dose 1g azithromycin

216
Q

Meig sy

A

Benign ovarian tumour + ascites + pleural effusion

217
Q

Meckel’s diverticulum dx

A

initial dx: radioisotope scan

Definitive dx: laparotomy

218
Q

Scarlet fever pathogen

A

strep pyogene

219
Q

scarlet fever tx

A

ABtx: penicillin or azithromycin 10d; amoxicillin used in children if compliance w/ penicillin problem

2nd line: cephalosporin

220
Q

Broncholitis

A

RSV 80%

supportive, NGT, humidified O2

221
Q

croup tx

A

Parainfluenza virus

po dexamethasone
severe: O2 + nebulised adrenaline

222
Q

otosclerosis

A

commonest progressive conductive hearing loss in Young Adults 15-45yrs

223
Q

Dx prostate cancer

A
  1. DRE
  2. serum PSA
  3. if clinically suspect localised prostate cancer: multiparametric MRI
  4. follow up PSA
224
Q

tetanus vaccine

A

2,3,4mo
3-5yr
13-18yrs

after 5th vaccine: immunity considered for life

225
Q

Tetanus management

A

If dirty/ contaminated/ compound fracture
-yes: pt not fully accinated: tetanus Ig

if fully vaccinated 5 doses: do nOT give tetanus vaccine

if incomplete: give complete course of vaccine or full course of DTP

226
Q

HIV PEP

A

start asap after exposure: n-safe sexual intercourse w/ high risk indiv, needle stick injury

48-72hrs continued for @ least 28d

reassure contact person: antiretroviral >6mo & HIV viral load <200

227
Q

Generalised tonic-clinic seizure

A

Na-valporate; if unsuitable offer lamotrigine

228
Q

Absence seizure

A

ethosuximide/ Na-valporate to children, young people & adults

229
Q

focal seizure

A

carbamazepine/ lamotrigine

230
Q

stroke management

A

Alteplase <4.5hrs

ASA 300mg for 2wks

clopidogrel 75mg

231
Q

DOAC

A

READ

Rivaroxaban
endoxaban
apixaban
dabigatran

232
Q

AFib management

A

Rate control: 1st line

RATE: BB/Ca2+; Amiodarone

233
Q

Mallet finger

A

rupture of terminal extensor tendon attachment

234
Q

SSRI

A

citalopramfluxetine

Sertraline

235
Q

SNRI

A

venlafaxine

Duloxetine

236
Q

TCA

A

amitriptyline

237
Q

pericarditis vs dressler sy

A

percarditis 2d; dressler sy 2-6wks after MI

pleuritic chest pain worsens by lying flat during insp
Pericardial rub, widespread saddle shaped ST elevation

238
Q

dressler sy

A

2-6wks post MI
autoimmune reaction against antigenic proteins formed as myocardium recovers

ECG: widespread saddle shaped ST elevatopm; PR depression

Tx: NSAIDS

239
Q

LMWH example

A

dalteparin, enoxaparin

240
Q

NSTEMI Tx

A

Aspirin 300mg+ ticagrelor 180mg + LMWH/ fondaparinoux

if low GRACE score: ASA, ticagrelor, BB, statin, ACEi
igh GRACE: PCI
V. high GRACE: GP IIb/IIIa (eptifibatide/ tirofiban)

241
Q

oral candida infection tx

A

children: miconazole gel/ fluconazole 50mg od po for 7d OR fluconazole oral suspension
immunocompromised: po miconazole gel or by statin suspension.

242
Q

menorrhagia only

A

tranexamic acid

243
Q

menorrhagia w/ dysmenorrhoea

A

mefanamic acid

244
Q

nerve injury with Colle’s fracture

A

Median nerve

245
Q

colles fracture definition

A

distal radial fracture where displacement of carpus dorsal/ posterior!!

dinner fork deformity

246
Q

Smith/ reversed colle’s fracture

A

distal radial fracture + displacement in volar/ anterior position!

Garden spade deformity

247
Q

vestibular neuritis

A

inflammation of vestibular nerve but aetology vestibular neuropathy

Hx URTI
vertigo, vomiting
vertigo may be exacerbated by movement

248
Q

Labyrinthitis

A

vertigo + Hx common cold + hearing loss/ tinnitus

249
Q

Lewy body dementia

A

Parkinsonism + dementia + visual hallucination with or w/o delusion

fluctuating course w/ lucid intervals of hallucination

250
Q

Shy Drager sy sx

A

Shy gy: erectile function, wets his pants

Drags his feet: cerebellar ataxia

Drops his BP: postural HoTN

251
Q

Multiple systemic atrophy hallmark

A

glial cytoplasmic inclusion (GCI)

252
Q

guillain-barre sy management

A

plasma exchange
IvIg: severe disease started w/in 2wks from onset
corticosteroid

253
Q

Guillain-barre sy dx

A

LP: high CSF protein; NO elevation in CSF cell counts
Ab to periph & central nerves
Nerve conduction study most useful confirmatory test

254
Q

acute cholecystitis management

A

stable pt: laparoscopic cholecystectomy

n-stable: emergency laparotomy

incidental finding gallstone: reassure

gallstone in CBD: laparoscopic cholecystectomy

255
Q

Diphtheria dx

A

definitive: (+) culture from resp tract secretion or cutaneous lesion & (+) toxin assay

256
Q

Diphtheria tx

A

ABtx: erythromycin, azithromycin, clarithromycin, penicillin

contacts: ALL contacts erythromycin/ penicillin

257
Q

Erythema migrans

A

round pink/red/ purple erythema rash target like appearance caused by Lyme disease

258
Q

which drugs shouldn’t be used with levothyroxine

A

oral ferrous sulphate: Fe supplements interfere w/ absorption of levothyroxine

259
Q

type of cough in croup & resp sx

A

barking cough

STRIDOR: harsh low pitched noise during insp heard @ rest or only when child is agitated or active

260
Q

X-ray or croup

A

steeple sign

261
Q

Bronchiolitis resp sx

A

wheeze, crackles on chest auscultation

Persistent dry cough

262
Q

addison’s disease definition

A

Primary adrenal insufficiency

low cortisol + aldosterone

263
Q

Addison ass disease

A

vitiligo, Pri hypothyroidism, DM1, neuro deficits

264
Q

adrenal crisis management

A

blood, cortisol, ATCH
Hydrocortisone 100mg iv stat, iv fluid bolus (crystalloid/ colloid); monitor blood glucose

continue: glucose iv if hypoglycaemic, iv fluids, continue hydrocortisone 120mg/8hrs iv/im
change to oral steroids after 72hrs

hydrocortisone iv/im: 100mg adult; 50-100mg >6yrs; 50mg 1-5yrs; 25mg <1yr

265
Q

VT, SVT drug management

A

SVT: adenosine
VT: Amiodarone

266
Q

radiation of aortic stenosis

A

radiate carotid

Ejection systolic

267
Q

radiation of pulmo stenosis

A

radiate infraclavicular

ejection systolic

268
Q

radiation to mitral regurgitation

A

radiate Axilla

PAN systolic

269
Q

LEFT vs Right heart murmur insp Or exp

A

LEFT: EXP
Right: insp

270
Q

Straight heart border

A

Mitral valve stenosis

271
Q

rupture of papillary muscle

A

2-15d postMI
Acute mitral regurgitation

early to mid systolic/ pansystmolic murmur

272
Q

gold std for chronic pancreatitis dx

A

Contrast CT

273
Q

Acute pancreatitis tx

A

NPO, iv infusion 0.9% saline, analgesia (pethidine, morphine)

274
Q

migraine aura relationship

A

aura: gradual onset over min, last 5min-hr before H/A

275
Q

galactosaemia sx

A

poor feeding, vomiting, hepatomegaly
Hepatomegaly, cataracts, mental handicap

yellow stool, pale urine

276
Q

pre-eclampsia definition

A

SBP >140mmHg DBP >90mmHg in 2nd half or preg w/ >1+ proteinuria or >0.3g

277
Q

MgSO4 side effect

A

confusion, loss of reflexes (deep tendon reflexes), resp depression, HoTN

278
Q

Burn when to give fluid replacement

A

adult: >15% TBSA or child >10%

adult: 4ml Hartmann’s solution/kg BW/ & total body surface area
half of this calculated bolume given in first 8hrs other half given over following 16hrs

children: replacement fluid above + maintenance 0.45% saline w/ 5% dextrose

279
Q

parkland formula

A

TBSA (%) x weight (kg) x 4ml

280
Q

anti-plt MI

A

Aspirin lifelong + ticagrelor/ clopidogrel 12mo

281
Q

PCI anti-plt

A

Aspirin life + prasugrel or ticagrelor 12mo

282
Q

TIA anti-plt

A

Aspirin 300mg 2wks the clopidogrel 75mg life

283
Q

Afib + ischaemic stroke

A

Aspirin 300mg 2wks–> start anti-coagulation (warfarin/ DOAC)

284
Q

Asthma steps

A
  1. SABA
  2. SABA + ICS
    or alternative LT-R ATG/ Na-cromoglicate/ theophylline
  3. ICS + LTRA
  4. ICS + LABA
  5. increase ICS or add LT-R ATG or tiotropium LAMA
  6. oral steroids
285
Q

life threatening asthma

A
  1. O2 + nebulised salbutamol + ipratropium; po pred OR iv hydrocortisone
  2. single dose MgSO4 1.2-2g over 20min
286
Q

exercise asthma tx

A

SABA
SABA + ICS
SABA + ICS or LTRA/ LABA/ Na-cromogligate

287
Q

Acute exacerbation adults

A

O2
SABA
Corticosteroid: iv hydrocortisone/ po prednisolone

288
Q

MgSO4 indication

A

eclampsia- seizured
TdP
refractory asthma

289
Q

Acute exacerbation in paeds

A 
O2
SABA back to back
\+ LAMA nebuliser
CS: po pred/ iv hydrocortisone
If still in asthma exacerbation: iv SABA/ iv aminophylline/ iv MgSO4
290
Q

placenta praevia dx

A

TVUS

291
Q

c8 radiculopathy sx

A

thumb abduction & extension, ulnar deviation of the write

292
Q

T1 raddiculopathy

A

finger abduction + adduction

293
Q

schistosomiasis sx

A

clacified contracted bladder & evidence of obstructive uropathy

S. mansoni: intestine, liver
S. haematobium: urinary bladder

294
Q

Leptospirosis Dx

A

zoonotic infection
Red discolouration of eye- subconjenctival haemorrhage

Dx: blood first 7-10d
Urine: after 7d upto 30d

295
Q

sulfonylureas eg

A

gliclazide/ glibenclamide

296
Q

ECG of LV aneurysm

A

usually post MI 4-6wks

ECG: ST elevation + LV failure

297
Q

HIV ass lymphoma

A

NHL

298
Q

TIA ass w/ Afib management

A

DOAC (READ rivaroxaban, edosaban, apixaban, dagabitra)+ statin

299
Q

RIA ass w/o AFib

A

clopidogrel + statin

300
Q

Preop ABtx for colectomy

A

Cefuroxime + metronidazole

301
Q

Number needed to treat

A

1/ absolute risk reduction

Absolute risk reduction= AR control - AR tx

302
Q

Relative risk

A

risk of disease in exposed/ risk of disease in unexposed

303
Q

Absolute risk

A

number of event in tx or control/ number of people in that group

304
Q

Mycoplasma pneumoniae sx

A

Dry cough

erythema multiforme/ erythema nodosum/ urticarial

305
Q

Mycoplasma pneumoniae CXR

A

bilat patchy consolidation, reticular nodular shadowing

306
Q

Legionella: sx, electrolyte disturb, CXR

A

tends to be most severe of penumonia. Natural water supplies & soil

HYPONa+

patchy alveolar infiltrates, bibasal consolidation

307
Q

Legionella tx

A

Macrolide: clarithromycin/ azithromycin + (rifampicin)

fluoroquinolone, tetracycline

308
Q

Klebsiella CXR

A

cavitating pneumo upper lobe

309
Q

correction of deficit in children

A

deficit in ml= weight (kg) x % dehydration x 10

310
Q

Maintenance fluid claculation in children

A

100ml first 10kg
50ml for next 10kg
20ml any weight after 20kg

311
Q

Anal fissure tx

A

fluid intake, fiber diet

5% lidocaine ointment + GTN ointment 0.2-0.4% OR topical diltiazem 2%

312
Q

ECG pulmo embolism

A

S1Q3T3

RBBB

313
Q

anaphylaxis tx

A

Adult: 0.5mg= 500ug un

> 12yrs: 0.5mg= 500ug

6-12: 0.3mg= 300ug

<6yrs: 0.15mg= 150ug

314
Q

antiphospholipid Ab

A

aPL
anticardiolipin
Lupus coagulation

315
Q

antiphospholid management in preg pt

A

antenatal admin LMWH + low-dose aspirin 75mg throughout preg

316
Q

vWD tx

A

tranexamic acid for mild bleeding

desmopressin: increase vWF
fVIII concentrate

317
Q

Meningitis initial secondary care

A

dexamethasone: children ?3mo suspected/ confirmed bact meningitis asap 0.15mg/kg x4/d

Adults 10mg x4/d for 4d if penumococcal infection confirmed

318
Q

meningitis menigococcis tx

A

iv ceftriaxone 7d

319
Q

HIB meningitis

A

> 3mo: ceftriaxone 14d

adults: cefotaxime/ ceftriaxone

320
Q

complication of tonsillectomy

A

pri haemorrhage: w/in first 24hrs inadequate haemostasis–> operation

Sec haemorrhage: after discharge 1-10d ABtx

321
Q

hyperthyroidism tx in preg pt

A

PTU: preferred PREconception & T1

Carbimazole: T2 + T3

322
Q

Hyperthyroidism tx

A

in emergency PTU> carbimazole

When not acute: carbimazole > PTU

BB

323
Q

when should you add 2nd hypoglecaemic agent?

A

when HbA1c >58mmol/l

324
Q

pericarditis tx

A

viral/ idiopathic: NSAIDS

ASA 2-4g/d
ibuprofen 1200-1800mg/d 7-14d
Indomethacin 75-150mg/d

325
Q

Osler node

A

seen in IE painful, red nodules on had/ feet that can persist for hrs to days

326
Q

Janeway lesion

A

IE: vascular

n-tender, small, erythematous/ haemorrhagic macular or nodular lesion on soles or palms

(they occur due to septic micro-emboli that deposit bacteria under skin)

327
Q

n-sedating antihistamine

A

cetririzine, loratidine, fexofenadine

328
Q

Central retinal artery occlusion

A

retina pale + macula cherry red spots + attenuation of vessels

329
Q

Central retinal vein occlusion

A

retina haemorrhagic, flam-shaped scattering haemorrhage & macular swollen

330
Q

Edward sy

A

trisomy 18

prominent calcaneus
Prominent occiput
microcephaly
 micrognathia (small jaw)
hands clenched into fist
331
Q

Patau sy

A

trisomy 13

prominent calcaneus 
cleft lip + palate
microcephaly
microphthalmia (small eyes)
polydactyly
332
Q

Alzheimer tx

A

ACHEi: Rivastigmine, Donepezil, Galantamine

2nd line: Memantine NMDA-ATG

333
Q

Toxoplasmosis CNS lesion

A

Multiple ring-enhancing lesion

Foetal/ neonatal: ventriculomegaly, CNS calcification, placental changes, hepatomegaly, splenomegaly, ascites, pericardial/ pleural effusion

334
Q

Bradycardia tx

A

1st line: atropin 0.5mg iv push repeat up to 3mg

2nd line: dopamine/ epinephrine

335
Q

volvulus sx & imaging

A

BILIOUS vomiting common: Green or yellow vomiting presumed to have volvulus until proved otherwise!!!

AXR: dilated small-bowel loops, marked gastric or prox duodenal dilatation w/ or w/o intestinal gas & air-fluid level may be seen: Double bubble might be seen

336
Q

When to give anti-D Ig to Rh (-) pt

A

28 & 34GW

337
Q

restrictive lung disease lung function test

A

FEV1 decrease
FVC decrease

FEV1/FVC: normal

338
Q

DIC management

A

Tx underlying condition

Transfusion plt/ plasma: severe bleeds or high risk of bleeding plt <50x 109/L

Bleeding pt w/ CID @ prolonged TP, aPTT: admin FFP

critically ill, n-bleeding pt: prophylaxis heparin/ LMWH

339
Q

Placental abruption what to do first

A

1st: CTG!!! (not US)

if foetal distress: C/S

if norm: TVUS r/o placenta previa

340
Q

Lichen Planus

A

topical steroid
Other: azathioprine, calcineurin inhibitor, mycophenolate mofetil, dapsone, retinoids

Psoralen + PUVA

341
Q

Electrolyte in rhabdomyolysis

A

high: K+; phosphate
Low: Ca2+

342
Q

G6PDH dx

A

G6PD enzyme activity definitive test: done 6wks after haemolytic episodes !!!

343
Q

Hunner’s ulcer

A

interstitial cystitis

344
Q

interstitial cystitis management

A

1st line: bladder training, pelvic floor exercise, NSAIDS

2nd line: amitriptyline, oxybutynin, gabapentin

345
Q

SVT management

A

1st: carotid massage
2nd: 6mg adenosine rapid iv bolus (CCB: verapamil if CI)–> give 12mg iv if no effect–> give 12mg iv adenosine
3rd: DC cardioversion

346
Q

Epidural haematoma tx

A

If n-comatose pt EDH <30cm volume: conservative observe

> 30cm3: surgical evacuation
high ICP: iv mannitol

347
Q

metastasis of seminoma

A

para-aortic nodes

348
Q

metastasis of teratoma

A

liver, lung, bone, brain (haematogenous)

349
Q

Urine testing for UTI in children

A

<3mo: surgent microscopy & culture. Refer to paediatrician

> 3mo <3yrs: urgent microscopy & culture. Wait for result before giving ABtx

> 3yrs: if leukocyte esterase & nitrate (+): ABtx start

leukocyte esterase (-); nitrite (+): start ABtx

Leukocyte esterase (+); nitrite (-): send urine sample for microscopy & culture; only start ABtx if evidence of infection

350
Q

UTI follow up examination in children

A

<6mo: USS during infection; DMSA 4-6mo after infection; MCUG

6mo-3yrs: USS w/in 6wks; DMSA 4-6months after acute infection, consider MCUG

> 3yrs: USS w/in 6wks; DMSA 4-6mo after infection

If <6mo: US w/in 6wks

If >6mo: do NOT US if straightforward UTI

MCUG for >3yrs always wrong!!

351
Q

Auspitz sign

A

psoriasis: vigorous scraping causes pinpoint bleeding

352
Q

kobner’s reaction

A

psoriasis: new lesion @ site of injury or trauma to skin

353
Q

Polycythaemia rubra vera management

A

Low risk: phlebotomy, low dose ASA

High risk: cytoreductive- hydroxycarbamide & INF-alpha std 1st line, Busulfan, chlorambucil, pipobroman

JAK2: Ruxolitinib

354
Q

sarcoidosis management

A

1st line: glucocorticoids
antimetabolite: MTX, azathioprine, leflunomide, mycophenolate
Anti-TNF: low dose glucocorticoids + antimetabolite

355
Q

Cluster H/A management

A

Acute: sumatriptan + 100% O2 mask

Prophylaxis: verapamil 1st line; perdnisolone, Li, melatonin, topiramate, Na-valporate, ergotamine, nifedipine

PLAB (1 decks)

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