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MLA Content > Quick recall 2 > Flashcards

Quick recall 2 Flashcards

1
Q

Drugs to give for neuropathic pain:

A

Don’t Get Pain Again
1. Duloxetine
2. Gabapentin
3. Pregabalin
4. Amitriptyline

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2
Q

Erythematous pustular rash, sunlight exacerbates symptoms: diagnosis

A

ROSCEA

Features: nose, cheeks, forehead
Late sign: Rhinophyma
Ocular involvement: blepharitis

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3
Q

Acne Rosacea: mx

A
  1. Sunscreen
  2. Topical brimonidine if predominant flushing
  3. Topical ivermectin (mild-moderate pustules)
  4. Topical ivermectin + oral doxy (moderate to severe)

Refferal consideration:
1. Prominent telangiectasia –> laser therapy
2. Rhinophyma

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4
Q

Urinary incontinence + gait abnormality + dementia :

A

Normal pressure hydrocephalus: wet, wobbly, wackly

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5
Q

Normal pressure hydrocephalus: mx

A
  1. Ventriculoperitoneal shunting

Dilatation of 3rd and lateral ventricles, absence of sulcal enarlgement

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6
Q

Head injury: NICE guidance on investigation

A

CT within 1 hour
* GCS < 13 on initial assessment
* GCS < 15 , 2hrs post injury
* open or depressed fracture
* basal skull fracture ?
* post-traumatic seizure
* focal neurological deficit
* > 1 episode vomitting

CT Within 8 hours
* 65 y/o <
* on AC, bleeding pmhx
* dangerous MOI
* > 30 mins retrograde amnesia

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7
Q

Types of MS

A

**1. Relapsing-remitting **
- most common!
- acue attacks (1-2 months) followed by periods of remission

**2. Secondary progressive disease **
- R-R pts who have deteriorated and have neurolgoical symptoms between relapses
- gait / bladder disorders

**3. Primary progressive **
- progressive deterioration from onset

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8
Q

Cytotoxic drugs

A
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9
Q

Presentation, investigation and Management of Meckels

A

Presentation:
- abdo pain
- painless rectal bleeding
- intestinal obstruction

**Investigation
**
- if haemodynamically stable –> meckel scan (99m technetium pertechnetate)
- mesenteric arteriography (severe cases)

Management
- removal if narrow neck or symptomatic

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10
Q

This condition usually presents with:
- paroxysmal abnominal colic pain
- sudden onset inconsolable crying
- pallor
- child may draw knees up to check
- 3-12 months of age

A

Intussception

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11
Q

What monitoring is important for a patient starting citalopram?

A

ECG

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12
Q

What monitoring is important for patients on SNRIs such as venlafaxine?

A

Blood pressure
- assocaited with HTN

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13
Q

Menopausal women suffering from vasomotor symptoms may be given:

A

SSRI
- fluoxetine

Clonidine may also be used

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14
Q

Contraindications for HRT?

A
  • Current or past breast cancer
  • Any oestrogen-sensitive cancer
  • Undiagnosed vaginal bleeding
  • Untreated endometrial hyperplasia
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15
Q

Risks of HRT

A

1. VTE:
- in oral, no increased risk with transdermal
2. Stroke
- slightly increased with oral oestrogen
3. Breast cancer
- increased risk with all combined HRT
4. Ovarian cancer

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16
Q

ECG changes and coronary territories:

A
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17
Q

Cluster headache Mx

A
  1. Bleep the neurologist!
  2. Acute
    - 100% oxygen
    - subcut triptan
  3. Prophylaxis
    - verapamil
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18
Q

Takotsubo cardiomyopathy

A

Bottom of heart does not contract therefore appears to balloon out.

Tx - supportive

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19
Q

AF post stroke: mx

A
  1. Exclude haemorrhage!
  2. Longer tern stroke prevention: warfarin
  3. Following TIA –> AC start immediately for AF
  4. In acute stroke –> AC start 2 weeks after. Give Antiplatelet therapy in the interrim
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20
Q

A wide-based gait with loss of heel to toe walking is called an

A

ataxic gait

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21
Q

Causes of ataxic gait

A

P - Posterior fossa tumour
A - Alcohol
S - Multiple sclerosis
T - Trauma
R - Rare causes
I - Inherited (e.g. Friedreich’s ataxia)
E - Epilepsy treatments
S - Stroke

22
Q

Immunisation schedule

23
Q

Bilious vomiting within 24 hours of birth is most commonly caused by

A

intestinal atresia

24
Q

72 Male: SOB, central chest pain, RR24, 102bpm, temperature 37.3 Likely diagnosis:

A

Pulmonary embolism:
- saddle embolus

25
Q

Severe, sudden abdominal pain + out-of-keeping physical exam findings + AF?

may point to diagnosis of:

A

ACUTE MESENTERIC ISCHAEMIA

Management: immediate laparotomy

26
Q

Diuretics revision

A

**1. Thiazide diuretics **
* increase excretion of [Na]
* excretion of [k+]
2. Loop diuretic **
* inhibits sodium reabsorption in ALOH
* increased excretion of sodium + potassium
** 3. Potassium sparing diuretic
* leads to hyperkalaemia

27
Q

Important SE of hydroxychloroquine

A

Bull’s eye retinopathy

28
Q

Antibodies in anti-phospholipid syndrome

A
  1. antibodies
    anticardiolipin antibodies
    anti-beta2 glycoprotein I (anti-beta2GPI) antibodies
    lupus anticoagulant
  2. thrombocytopenia
  3. prolonged APTT
29
Q

treatment of choice for Gonorrhoea

A

gram negative diplococcus

1st line - IM Ceftraizone 1g

OR

Oral cefizime 400mg + Oral azithromycin 2g (both single dose)

30
Q

Key features of disseminated gonococcal infection

A

tenosynovitis
migratory polyarthritis
dermatitis (lesions can be maculopapular or vesicular)

31
Q

SGLT-2i : Important adverse effects include

A
  1. Increased risk of UTIs
  2. Fournier’s gangrene
  3. Normoglycaemic ketoacidosis
  4. Increased risk of lower limb amputation
32
Q

Rule of thumb: LOAF muscles of the hand are median innervation, all other flexor hand muscles are ulnar.

A

L ateral two lumbricals
O pponens pollicis
A bductor pollicis brevis
F lexor pollicis brevis

33
Q

The most common infective causes of COPD exacerbations are:

A

Bacterial:
Haemophilus influenzae (most common cause)
Streptococcus pneumoniae
Moraxella catarrhalis
**Viral **
- human rhinovirus

34
Q

Acute exacerbations of COPD: mx guideline

A
  1. Increase bronchodilator use, consider nebs
  2. PREDNISOLONE 30mg 5 days
  3. Abx -** amoxicillin / clarithromycin** OR doxycycline
35
Q

COPD: Severe exacerbations requiring secondary care mx

A

1. O2 –> aim 88-92% w/ 28% venturi @ 4l/min
2. Neb bronchodilator
a) Salbutamol (SABA)
b) Ipratropium (muscarinic antagonist)
3. Steroid
a) IV hydrocortisone > oral pred
4. IV theophilline

T2RF?

If Resp acidosis –> NIV , BiPap

36
Q

2 Level PE Wells test

A
37
Q

If ruptures may cause pseudomyxoma peritonei:

A

**Mucinous cystadenoma

Pseudomyxoma peritonei:

second most common benign epithelial tumour

38
Q

Ovarian cysts?

The most common type of epithelial cell tumour

A

Serous cystadenoma

39
Q

Diabetes drug which does not cause weight gain:

A

DPP-4 inhibitor (-gliptins)

‘the fat flows with the tides’
SGLT2- flozins
GLP-1 - tides

40
Q

The FEV1/FVC of a normal healthy lung is

A

70-80%

41
Q

What should be given before starting allopurinol and why:

A

NSAID or colchicine cover

Allupuronol –>xanthine oxidase inhibitor
–> reduces production of uri

42
Q

Headaches, amenorrhoea, visual field defects →

A

prolactinoma

High levels of prolactin from prolactinoma –> hypogonadotrophic hypogon

Diagnosis: MRI

Management: dopamine agonist (cabergoline, bromocriptine) , or surgery trans-phenoidal approach

43
Q

Anion gap interpreation

A

Elevated –> metabolic acidosis

44
Q

Drugs which increase uvoscleral OUTflow

Pout
- Pilocarpine and prostaglandin analogues

A

Drugs that inhibit aqueous humour production

Hold aqueous humous production BAC

Beta blockers
Alpha 2 agonists (increase and block , non-selective!)
**Carbonic anhydrase inhibitors **

45
Q

A 42-year-old woman presents with a goitre. On examination the goitre feels ‘lumpy’. The blood results reveal a TSH of 12 mu/l and a free T4 of 2 pmol/l. Antithyroid peroxidase antibodies are high.

A

Hashimoto’s thyroiditis
- goitre
- hypothryoidism
- anti-thyroid peroxidase

46
Q

An elevated T4 and a low TSH should indicate this diagnosis.

A

Thyrotoxicosis

47
Q

2 y/o F, 1 day hx rash on legs - now spread to rest of body

A

Erythema multiforme
- target lesions!

48
Q

60 Male:

flushing, diarrhoea, bronchospasm, hypotension, and weight loss

classical hx of:

A

**Carcinoid tumours
- tumour will secrete serotonin
Ix = 5HIAA, plasma chromogranin A

Management:
- somatostatin analogues e.g. octreotide
- diarrhoea: cryp

49
Q

drug induced lupus:

A

S: Sulfonamide - ABx
H: Hydralizine - heart failure
I: Isoniazid - TB
P: Phenytoin - seizures
P: Procainamid - arrhythmia

anti-histone antibodies positive

50
Q

diabetes management algorithm:

A

Remember BP targets

< 80 –> 140/90 (clinic), 135/85 (home)
> 80 –> 150/90 (clinic) , 145/85 (home)

51
Q

High-dose dexamethasone suppression test with a pituitary adenoma: results

A

Cortisol: suppressed
ACTH: suppressed

52
Q
A

MLA Content (25 decks)

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