Quick cards Flashcards
Used using summary revision boxes of multiple question books - made to be quick to diagnose from buzzwords/typical signs & sx
1
Q
Colicky loin pain radiating to groin
A
Ureteric colic
2
Q
Constant right upper quadrant pain +/- jaundice
A
Biliary colic
3
Q
Severe epigastric pain radiating to back with vomiting and history of alcohol
A
Acute pancreatitis
4
Q
Periumbilical pain radiating to right iliac fossa
A
Acute appendicitis
5
Q
Central abdominal pain with expansible pulsatile mass
A
Abdominal aortic aneurysm
6
Q
Iliac fossa pain with +ve pregnancy test
A
Ectopic pregnancy
7
Q
Severe abdominal pain with rigid abdomen
A
Perforated viscus
8
Q
Pt presents w wt loss, anaemia, and dysphagia
What do you need to rule out?
A
Oesophageal carcinoma
9
Q
Pt presents w wt loss, and painless obstructive jaundice
What do you need to rule out?
A
Pancreatic head carcinoma
10
Q
Pt presents w wt loss, haemoptysis, and is a smoker
What do you need to rule out?
A
Lung cancer
11
Q
Pt presents w wt loss, change in bowel habit, and rectal bleeding
What do you need to rule out?
A
Sigmoid/rectal carcinoma
12
Q
Pt presents w wt loss and painless haematuria
What do you need to rule out?
A
Bladder carcinoma
13
Q
Pt presents w flushing, abdominal pain, diarrhoea, and heart failure
What do you need to rule out?
A
Carcinoid syndrome
14
Q
Middle-aged lady presents w pruritus, jaundice, and pigmentation
Which antibody do you expect to see?
A
Antimitochondrial antibody positive
15
Q
Middle-aged lady presents w pruritus, jaundice, and pigmentation
Top dx?
A
Primary biliary cirrhosis
16
Q
Middle-aged man presents w pruritus, jaundice, abdominal pain on a background of ulcerative colitis
Top dx?
A
Primary sclerosing cholangitis
17
Q
Chronic liver disease associated with early-onset emphysema
A
α-1 antitrypsin deficiency
18
Q
Chronic liver disease associated with pigmentation and diabetes
A
Haemochromatosis
19
Q
Chronic liver disease associated with dysarthria, dyskinesia, dementia, and Kayser-Fleischer rings
A
Wilson’s disease
20
Q
Abdominal X-ray shows free air under diaphragm
A
Perforated viscus (e.g. diverticulum/
duodenal ulcer)
21
Q
Abdominal X-ray shows sentinel loop
A
Acute pancreatitis
22
Q
Abdominal X-ray shows inverted U loop
A
Sigmoid volvulus
23
Q
Abdominal X-ray shows loss of haustral pattern
A
Ulcerative colitis (when barium enema)
24
Q
Abdominal X-ray shows cobblestoning
A
Crohn’s disease (when barium enema)
25
Abdominal X-ray shows apple-core lesion
Colon carcinoma
26
Everted edge, lymphadenopathy w skin lesion
Squamous cell carcinoma
27
Rolled, pearly edge w skin lesion
Basal cell carcinoma
28
Central necrotic core, horn projection,
spontaneous resolution w skin lesion
Keratoacanthoma
29
Firm swelling moves with tendon
(often dorsum wrist)
Ganglion
30
Skin lesion that causes tingling, may be multiple
Neurofibroma
31
Lobulated, compressible mass skin lesion
Lipoma
32
Itchy, bleeding, changing shape/colour skin lesion
Melanoma
33
Woman with solitary neck mass and haematogenous spread (e.g. bone)
Follicular thyroid carcinoma
34
Often multifocal neck mass with early lymph node spread, and biopsy shows Orphan Annie nuclei and Psammoma bodies
Papillary thyroid carcinoma
35
Elderly patient with rapidly growing neck mass causing airway compression
Anaplastic thyroid carcinoma
36
Thyroid cancer associated with MEN syndrome
Medullary carcinoma
37
Patient with neck mass presents with hepatomegaly, splenomegaly, and night sweats
Lymphoma
38
Unilateral palatal swelling and uvula displacement with neutrophilia and fever
Quinsy (lol)
39
Bilateral tonsil swelling w erythema and spotty white exudate
Tonsillitis
40
Bilateral tonsil swelling w white membranous exudate and positive Paul Bunnell test
Glandular fever
41
Barium swallow shows ‘bird-beak’
achalasia liquids narrowing at gastro-oesophageal junction
Oesophageal achalasia
42
Dysphagia + cough + dysphonia + dysarthria
Bulbar palsy
43
Midline neck swelling that moves on swallowing and tongue protrusion
Thyroglossal cyst
44
Lateral neck swelling anterior to sternocleidomastoid that trans illuminates, patient also presents with infection
Branchial cyst
45
Wasting at thenar eminence
Loss of sensation, lateral palmar surface 3.5 digits
Weakness in abductor pollicis brevis
Median nerve implicated
46
Wasting at hypothenar eminence
Sensory loss over medial 1.5 fingers
Weakness in abductor digiti minimi
‘Claw hand’ deformity
Positive Froment’s sign
Ulnar nerve implicated
47
Weakness of wrist extension leading to ‘wrist drop’
Anaesthesia over 1st dorsal interosseous muscle
Radial nerve implicated
48
Failure of abduction after shoulder dislocation
Anaesthesia over military badge area of shoulder
Axillary nerve implicated
49
Winged scapula
Long thoracic nerve implicated
50
Paralysis of intrinsic muscles of the hand
Loss of sensation in ulnar distribution
Horner’s syndrome sometimes present
Klumpke's palsy (C8, T1)
51
Loss of shoulder abduction and elbow flexion
Arm held internally rotated
‘Waiter’s tip’ sign if arm adducted behind back
Erb's palsy (C5, C6)
52
Often, blow to lateral aspect of knee is described
Weakness in dorsiflexion and eversion of foot
Sensory loss over dorsum of foot
Common peroneal nerve implicated
53
Inability to invert foot or stand on tiptoe
Tibial nerve implicated
54
Foot-drop (e.g. after hip replacement)
Sensation loss below knee, except medial lower
leg (saphenous nerve)
Sciatic nerve
55
Thickening, fibrosis palmar fascia
Dupuytren’s contracture
56
‘Dinner fork deformity’
Colles fracture
57
Wrist pain on forced thumb adduction, flexion
De Quervain’s syndrome
58
Pain, paraesthesia with median nerve distribution
Carpal tunnel syndrome
59
Shoulder pain on abduction 60–120°
Painful arc syndrome/supraspinatus
tendonitis
60
Lump in upper arm after lifting
Ruptured long head of biceps
61
Reduced active/passive movement, stiffness of
shoulder
Frozen shoulder/adhesive capsulitis
62
Locked knee, with positive McMurray’s test
Meniscal tear
63
Excessive anterior glide of tibia on femur
Anterior cruciate ligament tear/rupture
64
Typically a sport injury: non-contact
deceleration with twisting in valgus position
(e.g. skiing, basketball, football)
Excessive posterior glide of tibia on femur Posterior cruciate ligament tear/rupture
Posterior cruciate ligament tear/rupture
65
Prominent tender tibial tubercle
Osgood–Schlatter’s disease
66
Painful soles of feet
Look out for associated diseases
(e.g. ankylosing spondylitis)
Plantar fasciitis
67
Elderly patient unable to weight-bear after fall
Shortened and externally rotated leg
Fracture neck of femur
68
Pain over dorsum foot/metatarsal
Athlete, history of excessive walking
March fracture (metatarsal)
69
Usually children/adolescents
Long bones, limb girdle
‘Onion-peel’ sign
Ewing’s sarcoma
70
Usually adolescent
Older peak (in patients with Paget’s)
Periosteal elevation (Codman’s triangle)
Osteosarcoma
71
Blurred vision, haloes
Hazy cornea
Pupil fixed and dilated
Raised intraocular pressure
Acute closed-angle glaucoma
72
Blurred vision, photophobia
Inflammatory cells
May be autoimmune disease
Anterior uveitis
73
Vision normal, injected conjunctiva
Mucopurulent/lid crusting if bacterial
Bacterial conjunctivitis
74
Usually bilateral, watery eyes
Preceding viral illness
Follicles on conjunctiva
Viral conjunctivitis
75
Bilateral itchy eyes
History of atopy (e.g. asthma, eczema)
Allergic conjunctivitis
76
History of trauma/contact lens use
Pain, photophobia, blurred vision
Corneal ulceration
77
Painful eye, photophobia
May have history of other HSV infection
(e.g. cold sores)
Fluoroscein stain: branch-like lesion
Dendritic ulcer (HSV)
78
Pain, hypopyon, really bad vision
Usually after ophthalmic surgery
Endophthalmitis
79
Silver wiring, AV nipping, cotton wool spots,
flame/dot blot haemorrhages
Hypertensive retinopathy
80
Hard exudates, microaneurysms, haemorrhages, macular oedema
Diabetic retinopathy
81
Stormy sunset appearance in retina
Central retinal vein occlusion
82
Cherry red spot at macula
Central retinal artery occlusion
83
Optic disc cupping
Glaucoma
84
Blurred, elevated disc swelling
Absent venous pulsations
Associated raised intracranial pressure
Papilloedema
85
Bone spiculing in retina
Retinitis pigmentosa
86
Loss of red reflex
Cataract
87
‘Mozzarella pizza’ appearance in retina
History of immunocompromise (e.g. HIV)
CMV retinitis
88
Cranial nerve III palsy
Defective elevation, depression, adduction
89
Cranial nerve IV palsy
Defective depression in adduction
Vertical diplopia worse in down gaze
90
Cranial nerve VI palsy
Failure to abduct
Horizontal diplopia worse on abduction
91
Where is the visual field defect?
a) bitemporal hemianopia
b) superior quadrantanopia
c) inferior quadrantanopia
d) homonymous hemianopia
e) central scotoma
a) Chiasma lesion (e.g. pituitary tumour)
b) Temporal lobe lesion
c) Parietal lobe lesion
d) Optic radiation, visual cortex injury
e) Macula (degeneration/oedema)
92
Hypertensive retinopathy grading
93
Background diabetic retinopathy features
Microaneurysms, hard exudates, flame/dot
haemorrhages
94
Maculopathy diabetic retinopathy features
Background + macular retinopathy
95
Pre-proliferative diabetic retinopathy features
Maculopathy + cotton wool spots, blot
haemorrhages, venous beading
96
Proliferative diabetic retinopathy features
Pre-proliferative + neovascularization of
disc/retina
97
History of trauma
Particularly elderly/alcoholic in EMQ
CT: white crescentic lesion concave to skull
Subdural haemorrhage
98
Usually clear history of significant head trauma
Lucid interval
CT: white lesion convex (lentiform shape) to skull
Extradural haemorrhage
99
Anosmia, rhinorrhea
Periorbital bruising (‘racoon eyes’)
Bruising behind ear/haemotympanum
Basal skull fracture
100
Significant head injury, comatosed but normal CT
Diffuse axonal injury
101
Sudden-onset severe debilitating headache
Meningism (e.g. neck stiffness)
Lumbar puncture: xanthochromia
Subarachnoid haemorrhage
102
Irregularly irregular pulse
Atrial fibrillation
103
Slow-rising pulse
Aortic stenosis
104
Collapsing pulse
Aortic regurgitation
105
Bounding pulse
Acute CO2 retention
Hepatic failure
Sepsis
106
Radiofemoral delay
Coarctation fo aorta
107
Jerky pulse
Hypertrophic obstructive cardiomyopathy
Mitral regurgitation
108
Pulsus bisferiens
Mixed aortic valve disease
Hypertrophic obstructive cardiomyopathy
109
Pulsus paradoxus
Constrictive pericarditis
Cardiac tamponade
110
Raised, fixed JVP
Superior vena cava obstruction
111
JVP rising on inspiration
Cardiac tamponade
Constrictive pericarditis
112
Large 'v' waves on JVP inspection
Tricuspid regurgitation
113
Absent 'a' waves on JVP inspection
Atrial fibrillation
114
Cannon 'a' waves on JVP inpsection
Complete heart block
Atrioventricular dissociation
Ventricular arrhythmias
115
Tapping apex beat
Loud first heart sound
Rumbling mid-diastolic murmur at apex
Which murmur? When and where is it heard loudest?
Mitral stenosis
- louder in left lateral position on expiration
116
Displaced, volume overloaded apex beat
Soft first heart sound
Pansystolic murmur at apex radiating to axilla
Which murmur? When is it heard loudest?
Mitral regurgitation
- louder in expiration
117
Narrow pulse pressure
Heaving undisplaced apex beat
Soft second heart sound
Ejection systolic murmur
Which murmur? Where is it heard?
Aortic stenosis
- murmur heard in aortic area radiating to carotids and apex
118
Wide pulse pressure
Displaced, volume-overloaded apex beat
Early diastolic murmur
Which murmur? Where and when is it heard?
Aortic regurgitation
- lower sternal edge, best heard in expiration leaning forward
119
Large systolic 'v' waves
Pansystolic murmur lower left sternal edge
Which murmur? When is it heard best?
Tricuspid regurgitation
- best heard in inspiration
120
Harsh pansystolic murmur lower left sternal edge
Left parasternal heave
Which murmur?
Ventricular septal defect
121
1 sign associated with mitral stenosis
Malar (cheek) flush
122
1 sign associated with tricuspid regurgitation
Pulsatile hepatomegaly
123
4 signs associated with aortic regurgitation
Corrigan's (carotid pulsation)
De Musset's (head nodding)
Quincke's (capillary pulsations in nail bed)
Traube's (Pistol-shot heard in femorals)
124
3 signs associated with infective endocarditis
Roth's spots (retinal haemorrhages)
Osler's nodes (hard swellings in fingers/toes)
Janeway's lesions (erythematous blanching on palmar surface)
125
Saw-tooth pattern with normal complexes on ECG
Atrial flutter
126
Absent 'p' waves on ECG
Atrial fibrillation
Sinoatrial block
127
Bifid 'p' waves on ECG
Left atrial hypertrophy i.e. mitral stenosis
128
Peaked 'p' waves on ECG
Right atrial hypertrophy i.e. pulmonary HTN, tricuspid stenosis
129
Saddle-shaped ST elevation on ECG
Acute constrictive pericarditis
130
SIQIIITIII pattern on ECG
Severe pulmonary embolus
131
Tall tented 't' waves, wide QRS complex on ECG
Hyperkalaemia
132
Flattened 't' waves, prominent 'U' waves
Hypokalaemia
133
Long Q-T interval on ECG
Tetany, perioral paraesthesia, carpopedal spasm O/E
Hypocalcaemia
134
Where would you see ECG changes for an inferior infarct?
Leads II, III, aVF
135
Where would you see ECG changes for an anterolateral infarct?
Leads I, aVL, V2-V6
136
Where would you see ECG changes for an anterior infarct?
Leads V2-V5
137
Where would you see ECG changes for a posterior infarct?
Reciprocal changes in V1, V2 (tall R waves, ST depression, tall upright T waves)
138
Which respiratory conditions cause clubbing?
Bronchial carcinoma
Bronchiectasis
Lung abscess
Empyema
Cystic fibrosis
Cryptogenic fibrosing alveolitis
Mesothelioma
TB
*NOT ASTHMA, NOT COPD
139
Howell-Jolly bodies seen in
Hyposplenism
140
Burr cells seen in
Uraemia
141
Heinz bodies seen in
Glucose-6-phosphate dehydrogenase deficiency
142
Reticulocytosis seen in
Bleeding
Haemolysis
143
Target cells seen in
Liver disease
Iron deficiency anaemia
144
Macrocytic anaemia
+ glossitis, peripheral neuropathy
Vitamin B12 deficiency
145
Macrocytic anaemia
+ on phenytoin/trimethoprim
Folate deficiency
146
Macrocytic anaemia
+ dry thin hair, slowly relaxing reflexes
Hypothyroidism
147
Pt with skull bossing, maxillary hypertrophy, and increased HbF
Beta-thalassaemia
148
Pt bleeds excessively into joints and muscles, decreased factor VIII assay
Haemophilia A
149
Pt has dark urine in the morning and a +ve Ham's test
Paroxysmal nocturnal haemoglobinuria
150
Wt loss
+ anaemia, dysphagia
Oesophageal carcinoma
151
Wt loss
+ painless obstructive jaundice
Carcinoma head of pancreas
152
Wt loss
+ painless total haematuria
Bladder carcinoma
153
Wt loss
+ haemoptysis, heavy smoking hx
Bronchial carcinoma
154
Wt loss
+ change in bowel habit, PR bleeding
Colorectal carcinoma
155
Wt loss
+ flushing, abdominal pain, diarrhoea, and heart failure
Carcinoid syndrome
156
Wt loss
+ bladder outflow obstruction, bone pain
Prostate carcinoma with metastatic disease
157
Reed-Sternberg cells on blood film
Hodgkin's lymphoma
158
Auer rods on blood film
Acute myeloid leukaemia
159
Middle aged pt with +++ WCC, gout, and Philadelphia chromosome
Chronic myeloid leukaemia
160
Elderly pt w bone pain, retinal haemorrhages, renal failure
What would you see on electrophoresis and bone marrow biopsy?
Monoclonal Ig band & plasma cell infiltration
*Myeloma
161
Doxorubicin side effect
Cardiotoxocity
162
Drugs that cause pulmonary fibrosis
Bleomycin
Methotrexate
Busulphan
163
Cyclophosphamide side effect
Haemorrhagic cystitis
164
Chemotherapy drugs that causes peripheral neuropathy
Vinca aklaloids
- vincristine
Platinum compounds
- cisplatin
Taxanes
- paclitaxel
165
Heat intolerance, wt loss, diarrhoea, anxiety
Hyperthyroidism
166
Cold intolerance, wt gain, depression, constipation, dementia, despression
Hypothyroidism
167
Change in facial appearance, visual problems
Acromegaly
168
Wt gain, hirsutism, menstrual problems, depression
asian women i.e. hafsa
jk
Cushing's syndrome
169
Macroglossia, spade-like hands and feet
Acromegaly
170
Buccal/palmar crease hyperpigmentation, postural hypotension
Addison's disease
171
Moon-shaped face, centripetal obesity, proximal myopathy, purple striae, hypertension, diabetes mellitus
Cushing's disease
172
Bradycardia, dry thin hair, goitre, loss of outer third of eyebrow, slowly relaxing reflexes
Hypothyroidism
173
Tachycardia, goitre, atrial fibrillation, lid lag
Hyperthyroidism
174
UMN lesion features
Involves corticospinal tract
Weakness in upper limb extensors, lower limb flexors (pyramidal distribution)
Increased tone
Hyperreflexia, clonus
Pronator drift
Loss of abdominal reflexes
Extensor plantar response
175
LMN lesion features
Lesion at level of anterior horn or distal to it
Fasciculation and wasting
Loss reflexes
Hypotonia
176
Gait apraxia, confusion, incontinence
Normal pressure hydrocephalus
177
Optic neuritis, leg weakness, sx worsen with heat
What would you see in CSF and on electrophoresis?
Increased CSF protein
Oligoclonal IgG bands
*Multiple sclerosis innit
178
Lead-pipe rigidity, cog-wheel rigidity, pill rolling tremor, festinant gait with poor arm swing
Parkinson's disease
179
Young woman presents w weakness muscles
O/E bilateral ptosis, proximal muscle weakness
What would EMG show?
Decreased muscle action potential after continuous stimulation
*Myasthenia gravis, acetylcholine receptor antibodies fuck it upp
180
Saddle anaesthesia, bowel/bladder disturbance, bilateral leg pain
Cauda equina syndrome
181
Ipsilateral pyramidal signs and contralateral loss of pain and temperature
Brown-Sequard syndrome
182
Ascending symmetrical flaccid muscle weakness, preceding recent resp/GI infection
Guillain-Barre syndrome
183
Nystagmus, ophthalmoplegia, ataxia
Wernicke's encephalopathy
184
Shuffling, festinant gait screams
Parkinson's disease
185
High-stepping/stamping gait screams
Sensory ataxia
- e.g. peripheral neuropathy
186
Scissor gait screams
Spastic paraplegia
187
Wide-based gait screams
Cerebellar lesion
188
Shuffling small steps screams
Cerebrovascular disease
- marche a la petit pas for the cultured few
189
Bilateral, pinpoint pupils with respiratory depression
Which OD?
Opiate overdose
190
Bilateral, dilated pupils with increased pulse, low BP, and urinary retention
Which OD?
Tricyclic antidepressant overdose
191
Dilated pupil, ptosis, eye deviated laterally and downwards
Third nerve palsy
192
Dilated pupil, irregular, reacts poorly to light and accommodation
Myotonic pupil
193
Constricted pupil, irregular pupils, reacts to accommodation but not light
What is this called?
Argyll Robertson pupil
- neurosyphilis
- diabetes mellitus
194
Constricted pupil, unilateral ptosis, anhidrosis
Horner's syndrome
195
Wasting thenar eminence, loss of sensation on lateral palmar surface of 3.5 digits, weakness in abductor pollicis brevis
Median nerve (C6-T1)
196
Wasting hypothenar eminence, sensory loss over medial 1.5 digits, weakness of abductor digiti minimi, claw hand deformity
Ulnar nerve (C8-T1)
197
Weakness of wrist extension, leading to wrist drop, anaesthesia over first dorsal interosseous muscle
Radial nerve (C5-T1)
198
Weakness in dorsiflexion and eversion of foot
Common peroneal nerve (L4-S1)
199
Inability to invert foot or stand on tip-toe, sensory loss over sole of foot
Tibial nerve (L4-S3)
200
Paralysis of intrinsic muscles of the hand, loss of sensation in ulnar distribution, sometimes Horner's syndrome present
Klumpke's palsy
- lower brachial plexus affected
201
Loss of shoulder abduction and elbow flexion, arms held internally rotated
Erb's palsy
- 'waiter's tip'
- upper brachial plexus affected
202
Unilateral weakness/sensory deficit, homonymous hemianopia, higher cerebral dysfunction (dysphasia, neglect)
Anterior circulation stroke
203
Cranial nerve palsies/cerebellar signs, isolated homonymous hemianopia
Posterior circulation stroke
204
Vertigo
Dysarthria
Ataxia
Choking
What's affected?
Cerebellum
205
Pt has vertigo, vomiting, dysphaiga
O/E Right Horner's syndrome and nerve VI palsy, left sided loss of pain, temperature, sensation in face
Lateral medullary syndrome
- Right PICA thrombosis
206
Ipsilateral features of lateral medullary syndrome
Ataxia
Horner's syndrome
Nerve V, VI palsy
207
Contralateral features of lateral medullary syndrome
Loss of pain, temperature, and sensation in face
208
Pt can understand you but replies in non-fluent speech
What is this and which lobe affected?
Broca's (EXPRESSIVE) dysphasia
- dominant frontal lobe
209
Pt has impaired comprehension, speech is fluent and jargon
Wernicke's (RECEPTIVE) dysphasia
- dominant temporoparietal love
