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Quick recall Flashcards

1
Q

Features of serotonin syndrome

A

3As

  1. Altered mental status
  2. Neuromuscular abnormalities
  3. Autonomic hyperactivity
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2
Q

Plummer-vinison syndrome characterised by triad of what:

A

Plummers DIE

D- dysphagia
I- iron deficiency anaemia
E- eosophageal webs

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3
Q

A 5-year-old boy presents with recurrent episodes of sinusitis. The casualty staff are surprised to find his liver lying in the left upper quadrant of the abdomen

A

Kartagener’s syndrome
- immotile cilia syndrome
- assocaited with sinus inversus

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4
Q

What is vestibular neuronitis?

A

–> cause of vertigo
–> develops following viral infection

Features:
1. recurrent vertigo attacks lasting hours or days
2. nausea and vomiting may be present
3. horizontal nystagmus is usually present
4. no hearing loss or tinnitus

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5
Q

Differentiating vestibular neuronitis from posterior circulation stroke

A

HiNTs exam

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6
Q

Management of vestibular neuronitis:

A
  1. buccal or intramuscular prochlorperazine : rapid relief for sever cases
  2. vestibular rehab exercises for patients with chronic symptoms
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7
Q

mydriasis

A

dilated eye

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8
Q

miosis

A

smaller pupil

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9
Q

3rd nerve palsy characterised by:

A
  1. ptosis
  2. down and out eye
  3. mydriasis
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10
Q

Status epilepticus management

A

Management
1. ABC
2. BENZOs
–> Prehospital –> PR diazepam or buccal midazolam
–> Hospital IV lorazepam –> repeated once after 5-10 mins
3. Established status
–> leve, phenytoin, sodium valproate
4. No response w/i 45 mins?
–> call the anaesthetist!–> RSI

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11
Q

Mx Bells palsy

A
  1. PRED, w/i 72 hrs onset of bells palsy
  2. Eyecare
    –> artificial tears
    –> eye lubricants
  3. refer to ENT if paralysis no improvement 3/52
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12
Q

51 y/o female
PC: facial flushing + diarrhoea
HPC: 6/12 facial flushing, worse on exertion, associated palpitations. 3/12 diarrhoea.
OE: peripheral oedema, soft mid-diastolic murmur

characteristic of:

A

CARCINOID SYNDROME
–> secretion of serotonin, kinins and amines leads to flushing

Murmur –> tricuspid stenosis, R heart failure

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13
Q

Investigation for carcinoid syndrome

A

24 hour collection of urinary 5-HIAA

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14
Q

Management of carcinoid syndrome

A
  1. Somatostatin analogues e.g. octreotide
  2. diarrhoea: cyproheptadine
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15
Q

What occurs in primary hyperparathyroidism?

A

Cause –> solitary parathyroid adenoma –> increase release of PTH

Result:
–> high calcium and low phosphate
–> increase bone turnover by OC activation –> more ALP

Presentation: hypercalcaemia symptoms: constipation and mood changes

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16
Q

Describe secondary hyperparathyroidism:

A

Chronically low serum [Ca2+] –> parathyroid hyperplasia

Increased PTH secretion will not be able to reverse chronically low calcium and high phosphate caused by condition.

PTH –> excessive bone turnover –> high ALP

Presentation: bone pain, tenderness, proximal myopathy and recurrent fractures

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17
Q

Tertiary hyperparathyroidism is caused by:

A

ongoing hyperplasia of parathyroid glands after correction of long standing renal disorder.

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18
Q

Presentation of tertiary hyperparathyroidism

A
  • high calcium
  • elevated PTH
  • decreased phosphate
  • elevated ALP
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19
Q

management of endometrial hyperplasia

A

Simple w/o atypia –> high dose progestogens with repeat sampling in 2-4 months. maybe IUS.

If Atypia: HYSTERECTOMY w/ bilateral salpingectomy

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20
Q

what sound be suspected in a patient who develops post operative shortness of breath and hypoxaemia

A

Atelectasis

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21
Q

management of atelectasis

A
  1. position patient upright
  2. chest physio: breathing exercises
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22
Q

What rules are used to minimise use of X-rays in patients presenting with ankle injuries

A

OTTAWA ANKLE RULES

  1. inability to weight bear for 4 steps
  2. tenderness over distal tibia
  3. bone tenderness over distal fibula
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23
Q

Weber classification

A

A - below syndesmosis (CAM + weight bearing)
B- tibial plafond may extend proximally to involve syndesmosis
C - above syndesmosis (ORIF)

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24
Q

What is Wolff-Parkinson-White syndrome?

A
  • accessory pathway that bypasses the AVN
  • causing early depolarisation of the ventricles
  • short PR interval (<120ms)

Possible ECG features
- short PR
- widened QRS

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25
Q

Management of WPW syndrome

A

Definitive treatment –> radiofrequency ablation of accessory pathway

Medical therapy: amiodarone, flecainide

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26
Q

THIS

may be used in patients with stress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention

A

duloxetine

27
Q

Triad which is seen in children with haemolytic uraemic syndrome

A
  • AKI
  • microangiopathic haemolytic anaemia
  • thrombocytopenia

Most cases caused by: shiga toxin producing E.coli

28
Q

DDs for painless red eye

A

If the eye is painless and red, hold on a SEC

S- subconjunctival haemorrahge
E- episcleritis
C- conjunctivitis

29
Q

Diagnostic criteria for PCOS

A

Rotterdam 2/3 present.

  1. infrequent / no ovulation
  2. polycystic ovaries on USS
    3 hyperandrogenism signs (hirsutism, acne, or elevated total or free testosterone)
30
Q

In Broca’s you Fumble your speech

A

STRIFE
STR: Superior temporal: Receptive aphasia
IFE: Inferior frontal: Expressive aphasia

31
Q

tetralogy of fallot

A
  1. VSD
  2. RV hypertrophy
  3. RV OTO, Pulmonary stenosis
  4. overiridng aorta
32
Q

management of toxoplasmosis

A

Only treated in HIV/immunosuppressed patients.

Mx: pyrimethamine plus sulphadiazine for atleast 6 weeks

33
Q

Group B strep and pregnancy management

A
  1. Universal screening.
  2. If positive: intrapartum ABx prophylaxis.
  3. if pyrexia during labour –> give IAP

Choice of Abx –> benzylpenicllin

34
Q

first-line treatment for syphilis.

A

Benzathine penicillin G (IM stat dose)

35
Q

Local anesthetic toxicity can be treated with

A

IV 20% lipid emulsion

36
Q

Diagnostic criteria for multiple sclerosis

A

Macdonald criteria
- two or more clinical episodes which are disseminated over time and affect anatomically different areas

37
Q

Multiple sclerosis: investigations

A

MRI
- Dawson’s fingers? hyperintense lesions perpendicular to corpus callosum

38
Q

Management of renal stones

A

Renal stones:
- watchful waiting if <5mm and asymptomatic
- 5-10mm –> shockwave lithotripsy
- 10-20mm –> SL or ureteroscopy
- > 20mm percutaneous nephrolithotomy

Uretic stones
- shockwave lithotripsy +/- alpha blockers < 10mm
- 10-20mm ureteroscopy

39
Q

Syringomyelia

A

selectively affects the spinotholamic tracts.

40
Q

TB management

A

RIPE drugs
First 2 months: initial phase
R-rifampicin
I-isoniazid
P- pyrazinamide
E-ethambutol

Continuation phase
R-rifampicin
I-isoniazid

41
Q

Subacute combined degeneration of the spinal cord is due

A

vitamin B12 deficiency resulting in impairment of the:
1.dorsal columns
–> impaired proprioception and vibration
2. lateral corticospinal tracts
–> muscle weakness, hyperreflexia and spasticity
–> brisk knee reflexes
–> absent ankle jerk
3. spinocerebellar tracts
–> sensory ataxia: gait abnormalities
–> positive romberg’s sign

42
Q

The classic presentation is painless, bright red vaginal bleeding that occurs during the second or third trimester.

A

Placenta Praevia
- placenta partially / completely covers the cervix

43
Q

This condition often presents with painful vaginal bleeding and uterine contractions

A

Placental abruption
- premature separation of placenta from uterine wall
- abdominal pain
- uterine irritability

44
Q

This condition
- vaginal bleeding
- fetal distress
- severe abdominal pain: shoulder tip
- abnormal CRG
- shock

A

Uterine rupture

45
Q

CRAP induces liver enzymes
carbamazepine, rifampin, alcohol (chronic), phenytoin,

A
46
Q

ECG features of hypokalaemia

A
  • U waves
  • small or absent T waves (occasionally inversion)
  • ST depression
  • long QT

* U have no Pot and no T, but a long PR and a long QT

47
Q

Pulmonary embolism: management

A

Anticoagulation
1. DOAC
If contraindicated:
a) LMWH + WARFARIN (vit k antagonist)
–> given in renal impairment
b) LMWH + dabigatran/edoxaban

**Length of coagulation **
1. Provoked?
- AC stopped after **3 months **
2. Unprovoked ?
- AC stoppped after **6 months **

PE w/ haemodynamic instability
1. Thrombolysis w/ alteplase

48
Q

Scoring system used to assess bleeding risk in patients with PE

A

ORBIT

49
Q

Atrial fibrillation: management

A

1. W/I 48hrs
–> electrical DC cardioversion
–> or pharmalogical w/
———> a) amiodarone (structural HD)
———> b) flecaindied / amiodarone (w/o SHD)

2. AFTER 48hrs
–> AC for atleast 3 weeks before cardioversion
OR –> TOE to exclude left atrial appendage

50
Q

Management of intratrochanteric fracutres vs subtrochanteric

A

Intratrochanteric –> DHS

Subtrochanteric –> Intramedullary nail

51
Q

DHS

REVISION

A
52
Q

Intramedullary nail

REVISION

A
53
Q

Anti-phospholipid syndrome characterised by:

A
  1. Predisposition to both venous and arterial thromboses.
    CLOT
  2. C - Clotting time increased, increased APTT
  3. L - Livedo reticularis
  4. O - obstetric complications
  5. T - thrombocytopenia
54
Q

Haemochromatosis characterised by:

A
  1. Fatigue
  2. Erectile dysfunction
  3. Arthralgia
55
Q

vesicles extending to the tip of the nose:

A

Hutchinson’s sign

Associated w/ Herpes zoster opthalmicus

56
Q

Herpes zoster opthalmicus: mx + complications

A
  1. oral antiviral 7-10 days
    - start w/i 72hrs
    - IV is severe / immunocompromised
  2. topical corticosteroid for inflammation of eye
  3. urgent opthalmology review if ocular involvement

Complications
a) OCULAR –> conjunctivitis, keratitis, epislceritis, anterior uveitis
b) ptosis
c) post-herpetic neuralgia

57
Q

This patient presents with signs and symptoms of anaemia (tiredness, pale conjunctivae and increased pulse), massive splenomegaly and erratic blood tests results:

Likely diagnosis:

A

CML
- anaemia
- splenomegaly
- thrombocytosis

58
Q

systolic murmur in the pulmonary area and a fixed splitting to the second heart sound

A

Atrial septal defect

Patients may experience:
- SOB
- lethargy
- poor appetite and growth

59
Q

Ventricular septal defect

A

Pansystolic murmur in lower left sternal border

60
Q

Coarctation of the aorta

A

Crescendo-decrescendo murmur in the upper left sternal border

61
Q

Patent ductus arteriosus

A

Diastolic machinery murmur in the upper left sternal border

62
Q

Pulmonary stenosis

A

Ejection systolic murmur in the upper left sternal border

63
Q
A
64
Q
A

MLA Content (25 decks)

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