PLABABLE FOR PA QUESTIONS Flashcards
Out of the following, which one is not a complication of Eczema?
1) Impetigo
2) Molluscum
3) Sleep disturbance
4) Eczema herpeticum
4) Arthritis
6) Depression
7) Behavioural problems
Arthritis
Arthritis is a complication of what skin condition?
Psoriasis
What imaging is offered to a patient presenting with ureteric calculi?
Non-contrast CT KUB
What imaging is offered to a pregnant patient with a kidney stone?
US KUB
What is the most common causative bacteria of pyelonephritis?
E coli
What are the triad of symptoms of pyelonephritis that differentiate it from a normal UTI?
Fever
Loin/back pain
Nausea/vomiting
How do you manage a non-pregnant patient with pyelonephritis? (either one)
Cefalexin 7-10 days
Co-amoxiclav 7-10 days
What is the first line management for impetigo?
Topical fusidic acid for 5 days and hygiene measures
What advice should you give to parents about school exclusion in a child presenting with impetigo?
Stay off school until lesions have crusted over and 48 hours after starting antibiotics
What are the symptoms suggestive of Paget’s disease? (4)
Bone pain
Hearing loss
Change in facial shape
Raised ALP
What is paget’s disease?
Disorder of bone turnover where there is disorganised formation and reabsorption leading to bone enlargement and deformity that increases risk of fractures
What two bones does Paget’s disease normally affect?
Long bones
Skull
What lab findings are indicative of Paget’s disease?
Raised ALP with normal calcium
What is the management of Paget’s disease?
Bisphosphonates
What is the initial thing you should do in a patient presenting with new acute urinary obstruction?
Admit
How long before a catheter is inserted should an alpha blocker be started for urinary retention?
At least 24 hours
What treatment do you prescribe for the mother and for the baby if a baby above 4 months presents with oral thrush (even if the mother has no breastfeeding symptoms?)
Miconazole cream - mother
Miconazole gel - baby
(anti-fungal)
What is myelodysplastic syndrome?
myeoid cells have gone spastic
Syndrome where the myeloid bone marrow cells do not mature properly and do not form healthy bloody cells
What three things would you see on a FBC to confirm myelodysplastic syndrome?
Anaemia
Neutropenia
Thrombocytopenia
What is the first line investigation for myelodysplastic syndrome?
Bone marrow aspiration with iron stain
Name 4 risk factors of developing carpal tunnel syndrome?
1) Repetitive strain
2) Acromegaly
3) Rheumatoid arthritis
4) Hypothyroidism
What nerve is compressed in carpal tunnel syndrome?
Median nerve
How do patients present with carpal tunnel syndrome? (onset, when it’s worse, symptoms)
Gradual onset
Intermittent
Worse at night
Numbness
Paraesthesia
Pain
Weakness
What are the two special tests for carpal tunnel syndrome?
Phalen’s test - flexion
Tinnel test - tap
What is the primary investigation for establishing the diagnosis of carpal tunnel syndrome?
Nerve conduction studies
What is the initial treatment of carpal tunnel syndrome?
Wrist splints at night for 4 weeks
If the wrist splints do not help, what is the next treatment for carpal tunnel?
Steroid injections / surgery
What are somatoform disorders?
Group of psychiatric disorders in which patients present with myriad of clinically significant but unexplained physical symptoms
What is the treatment for a pt presenting with somatoform disorder alongside anxiety/depression?
CBT & SSRI
What is the treatment for a pt presenting with somatoform disorder without anxiety/depression?
CBT
What would you see on an x-ray for viral pneumonia?
Multiple focal patchy pleural infiltrates
Pt with unexplained lymphadenopathy and leukocytosis in FBC - management?
2WW Haematology Cancer
Pt with unexplained lymphadenopathy with no abnormal FBC - management?
2WW Head & Neck
What is the treatment for a patient with chronic myeloid leukaemia?
Oral Imatinib
What do pts with leukaemia have on their FBC?
Pancytopenia
- low RBC
- low WHC
- low platelets
What is the initial investigation for Leukaemia?
FBC
What would you see on a blood film for ALL?
Blast cells
What would you see on blood film for CLL?
Smear / smudge cells
What would you see on a blood film for AML?
Blast cells –> Auer rods
When would you see Tumour Lysis Syndrome?
In a patient having chemotherapy as it destroys cells and causes the release of uric acid
In an elderly pt with lower back pain and no hx of trauma, what serious diagnosis should you think of?
Multiple myeloma
What are the features of myeloma?
C - High calcium
R - Renal failure
A - Anaemia
B - Bone lesions/pain
What would you see in a pts blood suspecting myeloma?
- low WBC and Hb
- high calcium
- high ESR
- High creatinine
What would you see on an x-ray for multiple myeloma?
- Punched out lesions
- Lytic lesions
- Raindrop skull
What would you see on an x-ray for multiple myeloma?
- Punched out lesions
- Lytic lesions
- Raindrop skull
What is the first line management for constipation?
Bulk forming laxative - Isphaghula
What is the second line management for constipation?
Osmotic - lactulose
What is a contraindication for metformin?
eGFR less than 30
What is a contraindication for glicazide (Sulphonylurea)?
Renal impairment -> hypo
High BMI ->weight gain
What is a rectocoele?
Part of rectum has prolapsed into vagina, causing a bulge in the posterior wall of the vagina
What condition is associated with a rectocele?
Constipation
What is a cystocele?
Bladder has prolapsed into the anterior wall of the vagina
What symptoms would be associated with a cystocele and uterine prolapse?
Urinary symptoms
What is the non-conservative management of a prolapse?
Pessaries
What factor is reduced in haemophilia A?
Factor 8
What factor is reduced in Haemophilia B?
Factor 9
What is von-willebrand disease?
Autosomal dominant Inherited abnormal bleeding disorder
What medication stimulates the release of VWF in the treatment of von wilibrand disease?
Desmopressin
What type of seizure is associated with lip smacking and a post-ictal state?
Complex partial seizure
What are the four Fs in relation to acute cholangitis?
Fat
Female
Forty
Fertile
What is the triad for ascending cholangitis?
Fevers & Rigors
RUQ Pain
Jaundice
What medication should you start in a patient presenting with temporal arteritis?
What medication should you start in a patient presenting with temporal arteritis?
Prednisolone
