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YEAR 4 > Prep 4 > Flashcards

Prep 4 Flashcards

1
Q

ADHD diagnostic triad

A

inattention
hyperactivity
impulsivity

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2
Q

MSE

A 
appearance and behaviour
speech
emotion (mood and affect)
perception
thought (content, form)
insight
cognition (MMSE)
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3
Q

cloazapine se

A

agranulocytosis

cardiomyopathy, weight gain

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4
Q

management of GAD

A

education and active monitoring
low intensity psychological intervention (self- help, groups)
high intensity psychological intervention (CBT, applied relaxation) or drug treatment (SSRIs - sertraline)

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5
Q

most common psychiatric problem after a CVA?

A

depression

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6
Q

Management of ADHD?

A

methylphenidate (monitor growth, psychiatry every 6months) se abdo, nausea, dyspepsia
atomexitine

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7
Q

three components of orientation

A

time
place
person

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8
Q

What is wernickes encephalopathy and what causes it?

A

neuropsychiatric disorder due to thiamine (B1) deficiency
seen commonly in alcoholics
triad: ophthalmoplegia, ataxia, confusion
if untreated can develop into korsacoffs (amnesia and confabulation)

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9
Q

step wise dementia

A

vascular

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10
Q

What is a rumination

A

focused attention on ones symptoms of stress and the causes and consequences but not solutions

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11
Q

excessive daytime sleepiness and sudden attacks of sleep

A

narcolepsy

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12
Q

sleep disorder in depression

A

early wakening

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13
Q

3 core symptoms of depression

A

anergia, anhedonia, low mood

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14
Q

antideprassant in pregnancy

A

sertraline

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15
Q

test for chlamydia

A

NAAT and PCR (endocervical swab or first pass urine)

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16
Q

management of opiod overdose

A

naloxone

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17
Q

coccaine overdose signs

A

dilated pupils

hyperstimulation

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18
Q

heroin overdose signs

A

shallow breaths

pinpoint pupils

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19
Q

man treated with antibiotics for presumed pneumonia, smoker, returns in 6 weeks still hoarse

A

refer to ENT immediately

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20
Q

bullous pemphigoid

A

IgG linear at BM no acantholysis

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21
Q

stabbed in neck and then shoulder pain

A

right axillary nerve

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22
Q

Elbow replacement then tingling in ring finger, positive froments sign

A

cubital tunnel syndrome (ulnar nerve palsy - weakness of APL, loss of thumb adduction)
abnormal pinch FPL innervated by median nerve compensates and thumb IPJ flexes

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23
Q

posterior hip dislocation

A

internal rotation

shortening

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24
Q

treatment of a tibial fracture in middle aged

A

closed fractures with minimal discplacement or stable reduction (long leg cast - delay cast application for 3-5 days to allow swelling to go down)
unstable fractures - operative fixation

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25
Q

DDH screening tests

A

ortolani (abduct and push thigh anteriorly - trying to relocate)
barlow (adduction of hip and push posteriorly - trying to dislocate)
clicks normal clunks abnormal

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26
Q

AAA screening

A

abdo USS >5.5cm in males needs repair

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27
Q

back pain, small pupils, red eyes

A

ank spon

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28
Q

treatment for anterior uveitis

A

topical prednisolone

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29
Q

treatment for acute angle closed glaucoma

A

IV acetazolamide

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30
Q

Prevention of pre-eclampsia

A

aspirin

hydralazine, labetalol, nifedipine

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31
Q

Treatment of eclampsia

A

mg sulphate

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32
Q

women with TAHBSO age 45 hot flushes and night sweats

A

oestorgen only hrt

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33
Q

39 year old woman with TAHBSO for endometriosis

A

sequential hrt

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34
Q

managing squints first step

A

correct refractive errors first

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35
Q

large for dates pregnancy missing GI tract

A

polyhydraminos is common in fetal anomoly

duodenal or oesophageal atresia

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36
Q

post menopausal lady with menorrgagia and intermenstrual bleeding

A

urgent referral to gynae

endometrial Ca, endometrial polyps, atrophy, endometrial hyperplasia, HRT

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37
Q

What is radiotherapy prescribed in?

A

gray

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38
Q

How are chemotherapy doses calcuated

A

patient’s calculated surface area

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39
Q

If SVCO is caused by an intrinsic clot which treatment should not be used

A

stent

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40
Q

what kind of back pain is typical in spinal cord compression

A

radicular

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41
Q

initial management in a patient with hypercalcemia

A

iv fluids

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42
Q

what type of lung cancer is most likely to lead to hypercalcemia

A

squamous cell

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43
Q

what is breakthrough dose for 30mg bd morphine sulphate tablets

A

10mg oromorph

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44
Q

what virus causes a significant proportion of oropharyngeal cancers

A

EBV

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45
Q

what 3 screening programmes are there in the uk

A

breast, bowel, cervical

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46
Q

When can tamoxifen be used in breast cancer

A

pre-menopausal women

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47
Q

when does ovarian cancers normally present

A

late

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48
Q

side effects of chemo

A

alopecia, vomiting, pancytopenia, oedema

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49
Q

Patient is diagnosed with oesophageal cancer, who do you refer to

A

upper gi and oncology

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50
Q

managment of malignant hyper calcemia

A

hydration

bisphosphonates

51
Q

most likely of bilateral internuclear ophthalmoplegia in young

A

MS

cant adduct affected eye and nystagmus in the other - damage to MLF tract that is heavily myelinated

52
Q

features of dermatoyositis

A

symmetrical proximal muscle weakness and characteristic skin lesions (photosensitive rash, helitrope rash, gottrons paupules- roughened surfaces over extensor surfaces of fingers)

53
Q

What are the 3 main inflammatory myopathies

A

polymyositis
dermatomositis
inclusion body myositis

54
Q

What is addisons disease

A

primary adrenal insufficiency (low cortisol and aldosterone, most commonly AI destruction of adrenal cortex)

55
Q

why does addisons cause hyperpigmentation

A

MSH and ACTH have same precursor (increased ACTH results in more of the precursor being produced thus MSH)

56
Q

function of aldosterone

A

increases reaborption of Na and excretion of K at distal tubules and collecting duct (works to increase BP)

57
Q

diagnosis of addisons

A

short synacthen test (plasma cortisol measured before and after ACTH administration 250mcg im)

58
Q

features of addisonian crisis

A

hyperkalemia (more k retained at kidney)
hyponatremia (less Na reabsorption - lack of aldosterone)
hypoglycema (loss of glucocorticoid effect)
metabolic acidosis (H+ retention at kidneys)

59
Q

acne treatment and contraceptive

A

dianette (contains cyproterone acetate - antiadrogen and acts as form of progesterone and contains eostrogen)

60
Q

bilateral red eye in child

A

chlamydial conjunctivitis (a - c serological group)

61
Q

what is a dermatofibroma

A

benign fibrous nodule that commonly arises on lower leg

firm and tethered to skin surface move over underneath tissue

62
Q

when can graduated compression be used on leg ulcers

A

ABPI >0.8 indicating venous cuase

63
Q

ABPI 0.4

A

refer to vascular surgeon

64
Q

histology in psoriasis

A

absent granular layer

hyperproliferation of keratinocytes

65
Q

What drugs interact macrolide abx (clarithromycin etc)

A

statins
theophylline
(potent inhibitors of P450 enzymes involved in metabolising these drugs, increased levels of statin and theophylline in the blood and se more likely)

66
Q

What does the combination of ACEi, NSAID and diuretic increase the liklihood of

A

high risk of AKI

67
Q

physiological change in elderly

A

increased heterogenity

68
Q

benzodiazepines causing memory loss

A

idiosyncratic effect

69
Q

first order drug kinetics

A

rate of administration = rate of elimination (elimination is proportional to drug concentration)

70
Q

when are patches preferred to oral/iv morphine

A

CKD

71
Q

side effect of calcium

A

gi upset

72
Q

what drugs commonly cause tremor

A 
caffeine
salbutamol
lithium
neuroleptics
cyclosporine
73
Q

when is metformin CI

A

renal impairment

74
Q

exudate vs transudate

A

transudate protein <25 (HF, cirrohosis, hypoproteinaemia)

exudate protein >25 (malignancy, infection and inflammation)

75
Q

Empyeme findings

A

pH <7.2
low glucose
raised LDH

76
Q

walking up stairs and losing consciousness

A

vertebrobasilar insuffieciency

77
Q

difference between alpha blockers (tamulosin, doxasosin) and 5-alpha reductast inhibitors (finasteride)

A

alpha blockers relax smooth muscle of prostate and bladder affect acheived in days and se postural hypotension
5-aloha reductase inhibitors reduce prostatic metabolism of testosterone take several months until effect se loos of libido and erectile dysfunction

78
Q

tolteridone

A

antimuscarinic used in urge incontinence

79
Q

bisphosphonate mechanism

A

increase apoptosis of osteoclasts

80
Q

what combination is ueful in reducing fracture risk

A

bisphosphonate, calcium, vit d

81
Q

mycobacterium tb features

A

acid fast bacilli
strict aerobe
stains ZN bright red

82
Q

caseated granuloma

A

tb

83
Q

ghon focus

A

tb

84
Q

dka

A

metabolic acidosis

85
Q

how can cushings cause infertility

A

pituitary adenoma with over secretion of ACTH

other pituitary hormones affected reduces FSH & LH production

86
Q

23 year old para 0+0 woman is currently at 20 weeks gestation. She is currently well. Her sister had severe early onset pre-eclampsia and delivered a growth-restricted infant at 28 weeks. Which test should be performed to further assess this patient’s risk of developing pre-eclampsia

A

urinalysis for proteinurea
BP
Maternal artery doppler (in pre-eclampsia there is a pathological increase in placental vascular resistance - absent end diastolic flow or reversed end diastolic flow)

87
Q

GORD in pregnancy

A

antacids (maalox)

alginates (gaviscon)

88
Q

what should women at high risk of pre-eclampsia take

A

aspirin 75mg from week 12 until birth (previous htn, ckd, AI disorders, DM)

89
Q

management and prophylaxis of seizures in pre-eclampsia

A

mg sulphate 4g IV

90
Q

hrt in endometriosis

A

combined hrt (even if TAH BSO)

91
Q

active 3rd stage of labour drug

A

syntocinon

92
Q

definition of hypertension in pregnancy

A

> 140/90 or DBP>110 or >30/15 from booking visit

treat with labetalol, nifidepin or hydralazine

93
Q

drugs in urge incontinance after bladder drills (at least 6 weeks)

A

oxybutinin (avoid in frail elderly)

tolteridone (antimuscarincs relax the over active detrusor)

94
Q

treatment of stress incontinence

A

pelvic floor excerises for at least 3 months then consider surgery

95
Q

what can cause polyhydraminos

A

monchorionic twins
anomolys (GI atresias, anencephaly, downs and edwards) maternal diabetes
hydrops fetalis

96
Q

management of persistent eclamptic seizure

A

diazepam 10mg iv

97
Q

Post menopausal lady with menorrhagia and intermenstrual bleed

A

urgent gynaereferral

98
Q

first line hormonal treatment of menorrhagia

A

IUS

non hormonal tranexamic acid or mefanamic acid

99
Q

contraception for pcos

A

COCP (increases ABG) or

diannete (co cyprindiol) has antiadonergics effects

100
Q

pcos management for fertility

A

clomifine (anti-oestorgen)

+/- metformin

101
Q

contraception if BMI >35

A

POP

102
Q

what drug should be used for hyperthyroidism in pregnancy

A

propylthiouracil

103
Q

PCOS criteria

A

> 2 of:
clinical or biochemical raised androgens
oligo/amenorrhea
polycystic ovaries on USS

104
Q

flagellae under microscope

A

trachomonas

105
Q

G-ve diploccoi

A

gonorrhoae

106
Q

painful ulcers on labia

A

HSV

107
Q

40ish woman, still having periods, but mood swings and hot flushes, what HRT?

A

oestrogen and mirena

108
Q

51 year old Woman with hot flushes, night sweats, 18 months since last period

A

continous combined

109
Q

Younger woman, still having irregular periods

A

sequential HRT

110
Q

what cancer does tamoxifen increase risk of

A

endometrial (is a oestrogen receptor antagonist at breast but not at endometrium)

111
Q

How long is tamoxifen used for after removal of oestrogen sensitive breast ca

A

5 years

112
Q

management of vault prolapse

A

sacrospinous fixation

113
Q

best treatment for a urethrocele no other medical problems

A

pelvic floor exercises

114
Q

tx endometrial polyps

A

myomectomy

115
Q

what is term

A

38-42weeks

116
Q

presentation

A

part presenting into pelvis

117
Q

postion

A

baby facing OA OP

118
Q

lie

A

foetal axis to maternal axis

119
Q

inducing ovulation in pituitary adenomas

A

GnRH

dopamine agonists

120
Q

what does imperforate hymen increase risk of

A

endometriosis (retrograde menses)

121
Q

tests to confirm menopause

A

FSH and LH levels

122
Q

next investigation after increased endometrial thickness

A

endometrial biopsy

123
Q

maagement of PID

A

IM ceftrioxone
metronidizole
doxycycline

124
Q

deep dyspareunia fixed retroverted uterus

A

endometriosis

YEAR 4 (27 decks)

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