QUESTIONS KNOWLEDGE Flashcards
What ECG change is seen in hypothermia?
J waves
What additional sound is heard on auscultation in LVF?
3rd heart sound
What disorder are associated with mitral regurg?
Collagen disorders
What is Quinkes sign?
Nailed pulsation
What is Quinkes sign seen n?
Aortic regurgitation
What is trifascular block?
RBBB + 1st degree heart block + LV strain
What is c-ANCA used for?
Wegenetz (GPA)
What are Call-Exner bodies seen in?
Granulosa cell tumour
What are transitional cells seen in (ovarian)?
Brenner tumour
What are endocervical looking cells seen in (ovarian)?
Mucinous cystadenoma
When can amniocentesis be done from?
15 weeks
When can CVS be done?
11-13+6 weeks
What is cotton wool calcification seen in?
Paget’s and chrondrosarcoma
What does supraspinatus do?
Initiates abduction
What does teres minor do?
Adduct and laterally rotate
What does infraspinatus do?
Lateral rotation
What does subscapularis do?
Adduct and medially rotate
What type of pulse is seen in aortic regurgitation?
Collapsing
What type of pulse is seen in aortic stenosis?
Slow rising pulse
What is given in a high risk injury for tetanus (with a clear and complete vaccination history)?
IM immunoglobulin
What is given in a high risk injury for tetanus (with an unclear and incomplete vaccination history)?
IM immunoglobulin + booster
How is tetanus managed?
Supportive + metronidazole
What is tetanus caused by?
Tetanospasmin exotoxin released from bacteria prevents GABA release
What immunisations are given at 2 months?
6 in 1 (DTaP, IPV polio, HiB, Hep B), rotavirus, PCV + men B
What immunisations are given at 3 months?
6 in 1, rotavirus
What immunisations are given at 4 months?
6 in 1, PCV + men B
What immunisations are given at 12-13 months?
HiB+men C, MMR, PCV + men B
What immunisations are given at 3yrs and 4 months?
DTaP/IPV booster, MMR
What immunisations are given at 12-13 years in females?
HPV
What immunisations are given at 14 years?
Td/IPV booster, Men ACWY
Which vaccines are live?
BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid
Where does a branchial cyst originate from?
Second pharyngeal arch
What does the gallbladder do to bile?
Stores and concentrates it
What do you do for bone pain in cancer patients?
Radiotherapy, IV bisphosphonates
What heart defects do you get in Turners?
Coarctation of aorta and other aorta stuff
What do Leydig cells?
Produces testosterone
What do Sertoli cells do?
Produces androgen binding protein
How do you diagnose Sickle cell?
Hb electrophoresis
What dose of ferrous sulphate do you give to correct and iron deficiency?
600mg
What does of ferrous sulphate do you give as prophylaxis for iron deficiency?
100mg
What is a phase 1 study for?
To determine half-life
What is a phase 2 study for?
Drug dose
What is a phase 3 study for?
Side effects (common)
What is a case-control study for?
Aetiological factors
When do you x-ray a scaphoid fracture?
14 days after
What is the presentation of CJD?
Urinary incontinence + gait + memory
What is the first line management of a gastric MALT lymphoma?
eradicate H pylori
What causes a metabolic ketoacidosis (normal/low BG)?
Alcohol
What is a Hill-Sachs lesions seen in?
Glenohumeral dislocaition
When can you get pregnant after stopping methotrexate?
3 months
What is the management of pneumocystis jiroveci?
Co-trimoxazole
What CD4 count corresponds to pneumocystis jiroveci?
CD4 < 200
What drugs cause erythema nodosum?
COCP, penicillins, sulphonamides (trimethoprim)
What is a dinner fork deformity?
Colles
What do you give for magic mushroom overdose?
Activated charcoal
What is the management of dermatitis herpetiformis?
Oral dapsone
What Ig is seen in acute disease?
IgM
What Ig is seen in chronic disease?
IgG
What would cause the following presentation: refractory PUD,, watery diarrhoea, weight loss?
Gastrinoma
How is gastrinoma?
Octreotide
Which bacteria antibody is a serological marker for Crohn’s?
Anti-s cervisiae
How is haemachromatosis inherited?
Autosomal recessive
How is Marfan’s inherited?
Autosomal dominant
How is OI inherited?
Autosomal dominant
How is achondroplasia inherited?
Autosomal dominant
What is the most common brain tumour in kids?
Medulloblastoma
What is the membrane attack complex composed of?
C5, 6, 7, 8, 9
What does C3b do?
Opsonisation
What are side effects of amiodarone?
Thyroid dysfunction, corneal deposition, pulmonary fibrosis, liver cirrhosis, slate grey appearance
What do you do for retained products after day 1?
Exam under anaesthesia
What do you do for blood matching for a lap chole?
Group & save
What do you do for blood matching for a total gastrectomy?
X-match 2-6 units
What do you do for blood matching for a C section?
G & S
Which drugs exhibit first order kinetics?
Phenytoin, alcohol, high dose aspirin, heparin
What do you do for late decelerations on a CTG?
Fetal blood sampling; ph < 7.2 = deliver
What type of CBT do you use for anorexia?
Family based therapy
What is the tumour marker for breast ca?
CA 15-3
What do you monitor is extremes of weight and on LMWH?
Anti-Xa
What is used to prevent attacks in Menieres?
Betahistine
How is osteomyelitis diagnosed?
MRI
What is stage 1 ovarian ca?
Confined to ovary
What is stage 2 ovarian ca?
Within pelvis
What is stage 3 ovarian ca?
Within abdomen
What is stage 4 ovarian ca?
Distant metastases
What is the management of constipation of children?
Advice on diet + movicol
Which is painful, scleritis or episcleritis?
Scleritis
What is SAAG for?
Determines if ascites is caused by portal hypertension
How can IVDUs with endocarditis present?
Discitis
How do you investigate the C-spine?
CT
What is croup caused by?
Parainfluenza virus
What haem thing is nephrotic syndrome associated with?
Hypercoaguable state due to loss of antithrombin III
What is the presentation of pellagra?
Dermatitis, dementia/delusions, diarrhoea
What can CLL transform to?
high grade lymphoma
How do you calculate breakthrough dose?
1/6th daily morphine dose
How do you manage HOCM?
Implantable defibrillator
What signs will a raised ICP cause?
Hypertension + bradycardia
What are the conditions of doing a urease breath test?
No antibiotics in 4 weeks, no PPI in 2 weeks
What is used for diffuse axonal injury?
MRI
What happens to iodine uptake in graves?
Increased
What do you give pregnant women who’ve had a previous VTE?
LMWH antenatally and 6 weeks postnatally
When should clopidogrel be stopped before surgery?
7 days
What is a marker of early labour?
High fibrinonectin
When should warfarin be stopped before surgery?
5 days
Which vitamins are fat soluble?
ADEK
How long should you be seizure free before driving with no diagnosis?
6 months
How long should you be seizure free before driving with a diagnosis?
12 months
When does diffuse proliferative GN?
Post-strep, SLE
What do you give a pregnant women less than ten days after chickenpox exposure who is non-immune?
VZIG
What do you do for someone who is less than 55 and has a stroke?
AI and thrombophilia
When does gestational hypertension occur?
> 20 weeks gestation
From which day postpartum can you get pregnant if not breastfeeding?
Day 21
What is contraindicated in less than six weeks postpartum?
COCP
What is the adrenaline dose for anaphylaxis?
0.5ml in 1 in 1,000 IM
What is the adrenaline dose for anaphylaxis?
10ml of 1 in 10,000 IV
How is AF lasting more than 48 hours managed?
Anticoagulate + rate control for 3 weeks then electrically cardiovert
What is N meningitides?
Gram -ve diplococci
What risk do SSRIs in the first trimester cause?
Small risk of congenital heart disease
What is Rovsings sign positive in?
Appendicitis
Is it safe for women with Hep B to breastfeed?
Yes
What is tamoxifen a RF for?
Endometrial cancer
What does loss of haustrations on ba enema indicate?
UC
What are features of rubella?
SNHL, ‘salt and pepper’ chorioretinitis
How is croup managed?
Dexamethasone
What is the gene translocation in Burkitts?
c-myc
What is the TEL-JAK2 mutation seen in?
Myelofibrosis
What is common post-viral gastroenteritis?
Transient lactose intolerance
What is factor V leiden?
Activated protein C deficiency
What can be used to differentiate between seizure and pseudo seizure?
Prolactin
When does bow legs usually resolve by?
4 years
What do you give for status epilepticus?
IV lorazepam 4mg –> phenytoin –> GA
What do you give for neutropenic sepsis?
IV taz and pip
What does wasting of the hypothenar eminence indicate?
Ulnar nerve damage
What is used for cryptococcal meningitis?
India ink staining
What do exercise induced desaturations indicate?
Pneumocystis jiroveci
What is neonatal hypotonia associated with?
Downs, prader willi
What is a Colles fracture?
Distal radius fracture with dorsal displacement
What is a Smiths fracture?
Distal radius fracture with volar displacement
What is the pharmacological management of postural hypotension?
Fludrocortisone
How do NSAIDs impact lithium levels?
Increase them
How do you manage no ACS + Hb > 70?
Oral iron
What do you give post breast cancer surgery?
Radiotherapy
What is whirlpool sign seen in?
Ovarian torsion
How is primary PPH managed?
IV syntocinon, ergometrine, syntocinon infusion, carboprost, mifopristol
What is the commonest cause of blood stained nipple discharge?
Intraductal papilloma
What a gastrograffin enema good for?
Anastomotic leak
What is Plummer-Vinson?
Post-cricoid web due to iron deficiency
What does laxative abuse cause?
Melanosis coli
What ECG change is seen in hypothermia?
J waves
What ECG change is seen in hypocalcaemia?
U wave
What is the investigation of choice for pericarditis?
Echo
What would you look for in an ECG of a long standing diabetic with autonomic neuropathy?
Bradycardia (type 1 HB)
What do you give for someone with heart failure who’s already on an ACEi and diuretic?
B blocker
What would you give someone who’s on an ACEI and gets hyperkalaemia (HF)?
Isosorbide mononitrate
What do you do if you give someone fluids and they rapidly deteriorate?
Stop fluids and give Iv frusemide
How do you monitor someones progression after being treated for pneumonia?
CRP
What do dot and blot haemorrhages indicate?
Diabetic retinopathy
What do you give to people who won’t tolerate a colonoscopy?
CT colonography
What is hyoscine hydrobromine for?
Travel sickness
What is hyoscine butyl bromide for?
Abdo cramps
What is the MOA of cyclising?
Antihstamine
What is the mechanism of ondansetron?
5Ht receptor antagonist
What is the MOA of domperidone/prochlorperazine?
Antidopamine
What are the features of Plummer Vinson?
Dysphagia and anaemia
What juice should be avoided if on a statin?
Grapefruit
What type of mouth disease do people with Crohn’s have?
Aphthous ulcers, angular chelitis
What is Dukes A?
Confined to mucosa
What is Dukes B?
Tumour spread to serosa, no LN
What is Dukes C?
Same as B with nodes (C1 local, C2 distant)
What is Dukes D?
Widespread mets
How much water is absorbed in small intestine?
90%
How is ascites managed?
Spironolactone
What is the anatomy of a femoral hernia?
Inferolateral to pubic tubercle
What is the anatomy of a direct inguinal hernia?
Superomedial to pubic tubercle
What is the anatomy of an indirect inguinal hernia?
Superolateral to pubic tubercle
What type of insulin is given once a day?
Basal (lantus)
Which diabetic drug is weight neutral?
DPP4 inhibitors
What is the cause of polyuria in diabetes?
Osmotic effect of glucose
How does acarbose work?
Binds to glucose
What is the most common type of renal stone?
Calcium oxalate
How do you diagnose RAS?
Angiography
What passes through the cell membrane most readily?
Cations
Which nerve supplies biceps reflex?
C5
Which nerve supplies knee reflex?
L4
Which nerve supplies ankle reflex?
S1
which nerve can be damaged by doing an IM injection in the butt?
Sciatic nerve
Which column is first to go in diabetic neuropathy?
Dorsal
Alzheimers has what NTM defect?
Low 5-hydroxytryptamine
Headache after sex
Benign coital cephalgia
What is section 2 of MHA?
short term detention
What is section 3 of MHA?
CTO
What is section 5.2 of MHA?
Emergency certification
What is section 5.4 of MAH?
Similar to emergency but senior nurse can detain for up to 6 hours
How do you manage psychosis in a diabetic patient?
Typical antipsychotics
