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FINALS: PASSMED/QUESMED > Random > Flashcards

Random Flashcards

1
Q

What is the FAST scan for?

A

Looking for free fluid in the abdomen and thorax

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2
Q

Reddening and thickening of nipple and areola suggests what?

A

Paget’s disease of the breast

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3
Q

What things would suggest amyloidosis?

A
  • Progressive weakness and SOB
  • Loss of renal function
  • Proteinuria
  • Hepatosplenomegaly
  • Middle aged patient
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4
Q

What are causes of postural hypotension?

A
  • Antihypertensive
  • Excessive alcohol
  • Hypovolaemia
  • Parkinsons/Multiple system atrophy
  • Diabetic neuropathy
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5
Q

What are management options for postural hypotension?

A
  • Education, high salt diet, bed tilts
  • Fludrocortisone/Midodrine
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6
Q

How do penicillin antibiotics work?

A

Inhibit cell wall synthesis

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7
Q

How do bacteria build up resistance to penicillin antibiotics and what class of drugs can be added to these to help tackle this?

A
  • Produce beta-lactamase
  • Beta-lactamase inhibitors can be added
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8
Q

What are some reversible causes of dementia?

A

B12 deficiency, normal pressure hydrocephalus, hypoglycaemia, hypothyroidism

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9
Q

What are the signs of Alzheimers on CT?

A
  • Cortical atrophy, ventricular enlargement, hippocampal atrophy
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10
Q

Risk factors for stress incontinence

A
  • Pregnancy
  • Childbirth
  • Obesity
  • Chronic constipation
  • Post menopause
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11
Q

Non-drug management of stress incontinence

A

Pelvic floor exercises, stop smoking, weight loss, avoid caffeine

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12
Q

How does duloxetine help with urge incontinence?

A

SNRI, so inhibits the reuptake of noradrenaline
(NA) at the synapse, meaning there is increased NA available, and this increases the tone of the internal urethral sphincter

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13
Q

What should be sent for all women with a suspected UTI with haematuria?

A

Urine MSU

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14
Q

Which antibodies are most useful for vit B12 deficiency?

A

Intrinsic factor antibodies

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15
Q

How to calculate risk ratio?

A

Incidence amongst exposed population / Incidence amongst non-exposed population

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16
Q

What is the medication of choice for anti-epileptic drugs in end of life?

A

Midazolam

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17
Q

Management of anti-freeze ingestion

A

Fomepizole

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18
Q

Which drugs can cause hyperkalaemia?

A
  • NSAIDS
  • ACE
  • Potassium sparing diuretics
  • LMWH
  • Ciclosporin
  • Beta blockers
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19
Q

Inheritance of hereditary haemorrhagic telangiectasia

A

Autosomal dominant

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20
Q

What should be avoided in patients with possibility of basal skull fracture?

A

Nasopharyngeal airway -> use orophyaryngeal

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21
Q

What should not be done in ABCDE with patients with potential C spine instability?

A

head tilt-chin life -> do jaw thrust instead

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22
Q

When does secondary syphillis signs present?

A

Around 4-6 weeks after primary painless ulcer (chancre)

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23
Q

dry eyes and mouth, urinary retention, hyperthermia and tachycardia. Hypotension and altered consciousness

A

TCA overdose

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24
Q

Amiodarone monitoring?

A

TFTs and LFTs every 6 months

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25
Q

What are the different stages of clinical tria;s?

A

Stage1 - safety assessment on health volunteers
Stage 2 assess efficacy in population affected
Stage 3 - RCT, large scale trial
Stage 4 -post marketing surveillance looking for long term effectiveness

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26
Q

Gram neg vs gram positive

A

Gram negative - stain pink (layer of peptidoglycan which prevents retaining stain)
Gram positive - purple

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27
Q

What LFT marker would be raised in prostate cancer?

A

ALP

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28
Q

How does aspirin poisoning cause on blood gases?

A

Respiraotry alkalosis then metabolic acidosis

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29
Q

What is the management of TCA overdose?

A
  • Activated charcoal if within 1 hour
  • Sodium bicarb if any arrhythmias/prolonged QRS/hypotension
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30
Q

Blue lines on gum margin?

A

Lead poisoning

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31
Q

Management of an anaphylactoid reactions to acetylcysteine?

A

Stop infusion and restart at lower rate

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32
Q

What is the management of intermittent testicular torsion?

A

Orchidopexy

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33
Q

What should be given to patients with Pseudomonas with CF?

A

Oral Ciprofloxacin

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34
Q

What is the recovery with minimal change?

A

Full recovery with later recurrent episodes potentially

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35
Q

How would mesenteric adenitis present?

A

Secondary to a viral infection

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36
Q

What should be measured prior to starting TB treatment?

A

LFTs

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37
Q

What are some side effects of steroids?

A
  • Osteoporosis
  • Weight gain
  • DM
  • Candida
  • Pancreatitis
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38
Q

Electrolyte abnormality with malignancy?

A

Hypercalcaemia

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39
Q

Risk of correcting hyponatraemia too quickly?

A

Osmotic demyelination/central pontine demyelination

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40
Q

Risk of correcting hypernatraemia too quickly?

A

Cerebral oedema

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41
Q

Treatment for human/animal bites?

A

Co-amoxiclav

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42
Q

Management of asymptomatic bacteruria in catheterised patient?

A

Nothing
If symptoms, treat with 7 day course

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43
Q

BRCA2 mutation is associated with what?

A

Prostate cancer in men

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44
Q

Most common and early symptom with neoplastic spinal cord compression?

A

Back pain

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45
Q

PET scans deomstrate what?

A

Glucose uptake

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46
Q

What can be used to suppress N+V in intracranial tumours?

A

Dexamethasone

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47
Q

How to test for exogenous insulin?

A

Measure c-peptide, this would not be in exogenous insulin

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48
Q

What are core requirements of DOLS?

A
  • Avoid if possible
  • In patients best interest
  • Only for immediate intervention required
  • For as short a time period as possible
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49
Q

Erectile dysfunction management when sildenafil is C/I?

A

Intracavernosal prostaglandins

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50
Q

Painless jaundice + weight loss + lump under skin

A

Think pancreatic cancer -> lump is Trousseau sign of malignancy

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51
Q

multiple ring enhancing lesions in someone with HIV?

A

Toxoplasmosis infection -> administer sulfadiazine with folate

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52
Q

How to calculate serum osmolality

A

Serum osmolality is 2 x(Na) + Urea + glucose

53
Q

Which neuropathic pain agent is the one of choice in patients with renal disease?

A

Amitriptyline

54
Q

How to help oral candida caused by steroid inhalers?

A

Take ICS using large volume spacer

55
Q

Rash with folliculitis on chest?

A

Sign of late HIV infection

56
Q

pale cream coloured nodules on both
elbows and medial aspects of the upper eyelids

A

Xanthomas -> Hyperlipidaemia

57
Q

What is the most severely impaired part of cognition in dementia?

A

Short term memory

58
Q

What makes c diff so difficult to destroy?

A

Spore formation - they are resistant to environmental stressors and persist for months

59
Q

When is bariatric surgery indicated?

A

BMI > 40 or BMI > 35 with comorbidities such as diabetes and HTN

60
Q

When can orlistat be given?

A
  • BMI > 35 or >28 with specific risk factors
61
Q

What must be lost when commencing orlistat?

A

Minimum 5% of body weight within the first 3 months of starting

62
Q

What is zolpidem?

A

A non-benzo hypnotic/sedative associated with falls

63
Q

Which member of MDT can conduct initial assessment of pressure ulcers?

A

District nurses

64
Q

What is the most common organism for diarrhoea in HIV patients?

A

Cryptosporidium parvum

65
Q

What abnormality would be seen with EBV on blood cells?

A

Abnormal lymphocytosis

66
Q

What are examples of AIDS defining illnesses?

A
  • Cervical cancer
  • Non Hodgkins
  • CMV retinitis
  • HIV related encephalopathy
  • Cerebral toxoplasmosis
  • Recurrent pneumonia
67
Q

Why is plasmodium vivax prone to reactivation following initial infection?

A

It enters a dormant stage as liver hypnozoites whereas plasmodium falciparum does not

68
Q

Gonorrhoea management if patient is refusing injection

A

oral cefixime + oral azithromycin

69
Q

Treatment of asymptomatic bacterial vaginosis?

A

Nothing

70
Q

What is the features of disseminated gonococcal infection?

A
  • Tenosynovitis: trouble moving finger from bent position to straight
  • Migratory polyarthritis
  • Dermatitis: often rash around thighs
71
Q

What is the management of shingles?

A
  • oral Antivirals within 72 hours of onset
72
Q

What can cause a false positive syphillis test?

A

‘SomeTimes Mistakes Happen’
SLE, TB, Malaria, HIV

73
Q

Bilateral breast pain?

A

Think hormonal changes -> ?pregnany test

74
Q

Management of QRISK > 10%

A
  1. Lifestyle modifications
  2. Statin consideration
75
Q

All patients with a new diagnosis of anaphylaxis

A

Refer to allergy clinic

76
Q

What will reactive arthritis show on gram staining?

A

No organism growth

77
Q

Management of plantar fasciitis

A

Rest, stretching and weight loss if overweight

78
Q

Tumour lysis syndrome electrolytes

A

Hyperuricaemia
Hyperkalaemia
Hyperphosphatemia
Hypocalcaemia

79
Q

syphilitic gumma is a sign of what?

A

Tertiary syphillis

80
Q

fever, rash and tachycardia, but there is crucially no wheeze and no hypotension

A

Jarisch-Herxheimer reaction -> treat with paracetamol

81
Q

Chemotherapy patients are at increased risk of what?

A

Gout

82
Q

MSM should be offered what?

A

Hep A vaccine

83
Q

How to calculate serum osmolarity?

A

(2 x Na) + Urea + Glucose

84
Q

People who test positive for MRSA should be offered what?

A

Nasal mupirocin + Chlorhexidine wash

85
Q

What is refractory anaphylaxis?

A
  • Resp/Cardio problems despite 2 doses of IM adrenaline
  • Expert help for IV adrenaline should be considered
86
Q

2nd line Abx for MRSA

A

Teicoplanin/Linezolid

87
Q

When is sterilisation following a vasectomy confirmed?

A

After semen analysis shows azoospermia

88
Q

Why should metformin be stopped before coronary angio?

A

Risk of lactic acidosis

89
Q

What is used to suppress N+V with intracranial tumours?

A

Dexamethasone

90
Q

When are NG tubes safe to use?

A

When pH <5.5 on aspirate
If >5.5, check placement

91
Q

Widened QRS or arrhythmia in tricyclic overdose

A

Give bicarb

92
Q

Patients who take a staggered paracetamol overdose (over >1 hour) should receive what?

A

N-acetyl-cysteine immediately regardless of paracetamol level

93
Q

Chickenpox exposure in immunosuppressed?

A

Give immunoglobulins if not immune

94
Q

Rheumatic fever can occur after what?

A

Post strep throat infection

95
Q

Most common site of bone mets?

A

Spine

96
Q

Side effects of chemo drugs?

A

Cisplatin - Ototoxicity/Nephrotoxicity
Cyclophosphamides - Haemorrhagic cystitis
Bleomycin - Lung fibrosis

97
Q

Radiation to the pelvis can cause what?

A

Radiation proctitis

98
Q

Radiation + difficulty swallowing + hoarseness

A

Radiation induced laryngeal oedema

99
Q

What are the 4 end of life medications?

A
  1. Morphine for pain
  2. Hyoscine hydrobromide/Hyoscine butylbrombide/Glycopyrronium for secretions
  3. Haloperidol for N+v
  4. Midazolam for restlessness
100
Q

Which cancers spread transcoelomic?

A
  • Spread through peritoneal cavity and onto surface of organs covered by peritoneum
  • Ovarian
  • Mesothelioma
101
Q

What is the most common spread of cancer mets?

A

Haematogenous

102
Q

What is a common electrolyte imbalance seen in cancer patients?

A

Hypercalcaemia

103
Q

WHO Pain ladder

A
  1. Non-opioids e.g. paracetamol, NSAIDs
  2. Weak opioids e.g. codeine, tramadol, dihydrocodeine
  3. Strong opioids e.g. morphine, oxycodone, buprenorphine, fentanyl
104
Q

S/E of opoids

A
  • Constipation
  • Drowsiness
  • Dry mouth
  • Hallucinations
  • N+V
  • Risk of falls
  • Erectile dysfunction
105
Q

What is the preferred opioid in those with renal impairment?

A

Oxycodone -> mainly metabolised by liver

106
Q

When would you make dose adjustments in those taking paracetamol?

A
  • Renal impairment
  • Weight <50kg
107
Q

What can be considered for local neuropathic pain relief in those who do not want to take oral treatments?

A

Topical capsaicin cream

108
Q

What is the most common cause of SVC obstruction?

A

Non small cell lung cancer

109
Q

What is the drug of choice as first line for breathlessness in palliative care?

A

Morphine -> relieves dyspnoea and distress

110
Q

BRCA2 can increase the risk of what cancers in men?

A
  • Breast
  • Prostate
111
Q

What will the neutrophil count be in neutropenic sepsis?

A

<0.5

112
Q

Thyroid nodule which does not take up iodine?

A

Papillary/Follicular carcinoma

113
Q

Different types of variables

A

Continuous - range of values
Categorical - category
Discrete - specific value
Nominal - those with no specific order

114
Q

WHO performance status

A

0 - normal
1 - restricted in strenuous activity
2 - can do self care and up and about for more than 50% of waking hours
3 - in bed/chair for >50% of day
4 - completely disabled and confined to bed/chair

115
Q

Most common organism causing line infection?

A

Staph epidermidis

116
Q

NICE reccommended tests for falls?

A
  • Turn 180 test
  • Timed up and Go test
117
Q

Management of opioid induced constipation?

A

Osmotic + Stimulant

118
Q

What class of drug is allopurinol?

A

Xanthine oxidase inhibitors

119
Q

What age patients should have further investigations for secondary causes of HTN?

A

<40

120
Q

What position should patients with anaphylaxis be encouraged to adopt?

A

Flat with legs raised to maximise venous return to heart

121
Q

All patients with CD40 count <200 require what?

A

Anti-retroviral therapy
Co-trimoxazole

122
Q

Baby born to mother infected with Hep B?

A

Give Hep B vaccine + HepB immunoglobulins

123
Q

Colicky pain in malignancy with bowel obstruction?

A

Use antimuscarinic e.g. hyoscine butylbromide

124
Q

Doxorubicin can cause what?

A

Cardiotoxicity -> cardiomyopathy

125
Q

What is a risk factor for post op nausea and vomiting?

A

Female

126
Q

Beta blocker overdose?

A

Atropine if bradycardic and unstable
Then Glucagon

127
Q

How to convert codeine to morphine?

A

Divide by 10

128
Q
A

FINALS: PASSMED/QUESMED (22 decks)

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