QM/BM Flashcards
How does measles present?
This child with an incomplete immunisation status likely has measles. High fever, conjunctivitis and a maculopapular rash are commonly seen shortly following the onset of symptoms. Koplik spots (areas of grey discolouration) may also be visible on examination of the oral mucosa.
What is a key piece of advice to give when prescribing isotretinoin?
Isotretinoin can potentially worsen mental health following use; it is, therefore, important to screen for pre-existing mental health conditions before prescribing it. It is also highly teratogenic; if this patient were female, they should also be commenced on effective contraception.
Where does vulval cancer most commonly present?
Labia majora
What is the positive predictive value?
Positive predictive value (PPV) is the proportion of people with a positive test who actually have the disease.
How do we re-test for H. pylori after treatment
Carbon-13 urea breath test
How does tetanus present?
This man presents with fever and gradual-onset muscle spasms and trismus of the jaw, consistent with the features of tetanus. Tetanus causes a progressive spastic paralysis and requires prompt treatment with tetanus immunoglobulin to prevent complications including respiratory failure and asphyxia.
How does serotonin syndrome present?
He is complaining of diarrhoea and appears confused. On examination, he is hyperthermic, generally hyper-reflexic and has dilated pupils.
What is a case control study?
To do
What is a cohort study?
To do
What is Capgras syndrome?
In Capgras syndrome, patients believe that someone familiar to them (eg. a friend or relative) has been replaced by an exact clone
What sign would be seen on AXR with a sigmoid volvulus?
A characteristic ‘coffee-bean’ sign
How does prodromal schizophrenia present?
Being socially withdrawn, loss of motivation in life, poor personal hygiene and lack of interest in day-to-day activities.
How does the rash differ in SLE and acne rosacea?
Rosacea: facial rash that does not spare the nasolabial folds and worsens with heat.
What is Ekbom syndrome?
In Ekbom syndrome, patients experience a delusional belief that they are infested with parasites. A feeling of ‘crawling’ in the skin is often reported. In this patient, it is most likely secondary to psychotic illness.
How do we confirm a diagnosis of pernicious anaemia?
This is a case of pernicious anaemia, which is an autoimmune condition caused by antibodies to intrinsic factor and parietal cells (which produce intrinsic factor). This causes atrophic gastritis and results in malabsorption of vitamin B12, because B12 binds to intrinsic factor in the stomach so it can be absorbed in the small intestine. The presence of anti-intrinsic factor or antiparietal cell antibodies confirms the diagnosis.
What is Sézary syndrome?
This patient has presented with a skin rash known as erythroderma. When erythroderma is present alongside lymphadenopathy and hepatosplenomegaly, a diagnosis of Sézary syndrome can be made. This is a form of cutaneous T-cell lymphoma characterised by Sézary cells in the circulation.
What are the oestrogenic SEs of HRT
Nausea and bloating
Breast swelling
Breast tenderness
Headaches
Leg cramps
What are the progestogenic SEs of HRT
Mood swings
Bloating
Fluid retention
Weight gain
Acne and greasy skin
Which autoantibodies do we test for in SLE?
Antinuclear antibodies (ANA)
Basically tests for all of anti-Ro, anti-histone, anti-sm, anti-nRNP and anti-dsDNA
Which cancer does SLE increase the risk of?
Non-Hodgkin’s lymphoma
What is suxamethonium apnoea?
Suxamethonium is a depolarising muscle blocker used to blunt airway reflexes during the induction of anaesthesia. Normally it is broken down rapidly by plasma cholinesterases, thus the effects wear off within a few minutes. If the enzyme is mutated then the breakdown can take much longer – up to 4 h. During this period the muscles will still be in a state of paralysis. That is why this patient is reliant on the ventilator, as her diaphragm is still paralysed. Some patients will have a family history of suxamethonium apnoea, as some forms are genetic.
Name an osmotic laxative. How does it work?
Macrogol. It is an inert substance which draws water into the bowel, softening stool and making it easier to pass. It is often used for bowel preparation prior to endoscopic procedures.
What is a Heller’s myotomy used for?
This is a typical description of achalasia, which is an oesophageal motility disorder characterised by a loss of oesophageal peristalsis and incomplete relaxation of the lower oesophageal sphincter. A Heller’s myotomy involves an incision of the lower oesophageal sphincter to allow food and liquid to pass through.
What is a myomectomy?
Surgical removal of a fibroid