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Year 6 > Random > Flashcards

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1
Q

which substance overdose is linked to hyponatraemia

A

MDMA

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2
Q

what are features of MDMA overdose

A

neurological: agitation, anxiety, confusion, ataxia
cardiovascular: tachycardia, hypertension
hyponatraemia
this may result from either syndrome of inappropriate ADH secretion or excessive water consumption whilst taking MDMA
hyperthermia
rhabdomyolysis

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3
Q

what is the main side effect of giving oral magnesium

A

diarrhoea

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4
Q

What formula is used to calculate IV fluid needs after a burn

A

parkland formula

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5
Q

most common causes of epididymitis

A

chlamydia/ gonorrhoea for younger sexually active
e coli for older

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6
Q

what metabolic disorder does prolonged diarrhoea cause

A

metabolic acidosis with hypokalaemia
normal anion gap

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7
Q
A
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8
Q

what cell is primarily affected in MS

A

oligodendrocytes

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9
Q

what is the management for paralytic ileus

A

NG tube + IV fluids

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10
Q

what is the treatment for spinal cord compression

A

high dose oral dexamethasone before surgery
surgery to decompress but if too elderly and multiple lesions, beam radiotherapy

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11
Q

pain worse after eating (ulcer)

A

gastric

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12
Q

what can you give for gout if you cant use colchicine or nsaids

A

steroids

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13
Q

treatment for supraspinatus tendinopathy

A

physio

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14
Q

what pain medication can you not give postoperatively if the patient has respiratory disorders

A

opioids

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15
Q

in SIADH, where is water reabsorbed more

A

collecting duct

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16
Q

which airway device protects from aspiration of stomach contents

A

tracheal tube

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17
Q

which airway device is used in cardiac arrest

A

i-gel (supraglottic) airway

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18
Q

what do you do before CTPA

A

chest xray

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19
Q

what should you do for all thyroid nodules

A

US

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20
Q

how do you assess lung function in myasthenia gravis

A

FVC

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21
Q

if symptomatic gallstones disease but gallstone is in gallbladder and not common bile duct, what do you do

A

laparoscopic cholecystectomy - would be ERCP if in common bile duct

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22
Q

what is initial management of superior vena cava obstruction

A

dexamethasone

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23
Q

what is management for superficial thrombophlebitis

A

oral NSAID

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24
Q

what type of drug is oxybutinin

A

anti cholinergic

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25
Q

what are typical features of anastomotic leak

A

abdominal pain, fever, tachycardia, and often features of peritonitis.

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26
Q

what are features of atelectasis

A

Low-grade fever, reduced oxygen saturation, and diminished breath sounds (often bibasal).
Commonly occurs within the first 48 hours after surgery.

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27
Q

what are features of lumbar spinal stenosis

A

Symptoms triggered by walking:
Weakness and numbness after walking ~100 meters are classic for neurogenic claudication.

Relieved by leaning forward:
Flexion of the lumbar spine increases the canal diameter, reducing nerve compression.

Ability to cycle without symptoms:
Differentiates LSS from vascular causes like peripheral arterial disease.

Weakness of hip flexion bilaterally:
Indicates nerve root compression affecting the lumbosacral region (L2–L4).

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28
Q

how do you manage small bowel obstruction (due to adhesions)

A

conservative management - NG tube and IV fluids and aspiration of stomach contents

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29
Q

what is the purpose of cricoid pressure when breathing oxygen from a face mask before induction of anaesthesia

A

prevents the passage of gastric contents into the airway

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30
Q

what are indications of an oropharyngeal airway

A

Unconscious patients without a gag reflex (e.g., during anesthesia or in an unresponsive trauma patient).
Temporary support in airway obstruction or to facilitate bag-valve-mask ventilation.

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31
Q

what are contraindications for oropharyngeal airway

A

Conscious or semi-conscious patients (risk of vomiting or laryngospasm).

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32
Q

what are indications of nasopharyngeal airway

A

Semi-conscious patients with intact gag reflex.
Situations where an OPA is contraindicated (e.g., trismus or oral trauma).

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33
Q

what are contraindications of nasopharyngeal airway

A

Basal skull fracture or severe nasal trauma (risk of intracranial placement).

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34
Q

what are indications of supraglottic airway devices (i-gel or laryngeal mask)

A

Elective airway management during anesthesia.
Rescue airway device in difficult intubation scenarios.
Short-term ventilation in emergencies.

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35
Q

what are contraindications for supraglottic airway devices

A

High risk of aspiration (e.g., full stomach or regurgitation).
Airway obstruction below the glottis.

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36
Q

what are indications of endotracheal tube

A

Airway protection from aspiration (e.g., reduced consciousness or vomiting).
Mechanical ventilation (e.g., in respiratory failure or during major surgery).
Severe airway obstruction (e.g., due to trauma, swelling, or burns).
Administration of specific anesthetic gases.

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37
Q

what are indications of tracheostomy tube

A

Long-term ventilation (>7–10 days).
Upper airway obstruction (e.g., tumor, trauma, or edema).
Facilitation of airway clearance in chronic conditions (e.g., neuromuscular diseases).
Reduced dead space for ventilation in severe respiratory failure.

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38
Q

what are contraindications of tracheostomy tube

A

Active infection or unstable neck anatomy (relative contraindications).

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39
Q

what are indications of cricothyroidotomy (emergency airway)

A

“Cannot intubate, cannot ventilate” scenarios.
Severe upper airway obstruction (e.g., foreign body or trauma).

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40
Q

what are contraindications of cricothyroidotomy

A

Pediatric patients (prefer needle cricothyroidotomy due to anatomy).

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41
Q

urine culture shows mixed growth of organisms with no leucocytes

A

contaminated sample

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42
Q

what is the management of painful eyes with loss of acuity

A

emergency assessment

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43
Q

what does triple assessment of breast mean

A

Clinical examination, breast imaging and core biopsy

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44
Q

CSF fluid analysis for bacterial meningitis

A

High pressure, raised protein, excess neutrophils

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45
Q

bacterial vs viral meningitis

A

viral meningitis -
rash
upper resp symptoms
mild course

bacterial -
rapid deterioration

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46
Q

what is average life expectancy

A

82 years

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47
Q

Chadvasc score

A

Risk factor Points
C Congestive heart failure 1
H Hypertension (or treated hypertension) 1
A2 Age >= 75 years 2
Age 65-74 years 1
D Diabetes 1
S2 Prior Stroke, TIA or thromboembolism 2
V Vascular disease (including ischaemic heart disease and peripheral arterial disease) 1
S Sex (female) 1

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48
Q

can an F1 consent for a surgical procedure

A

No, should ask someone higher to do it

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49
Q

what is pre diabetes in HbA1c

A

41-48 (5.9% - 6.5%)

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50
Q

diagnostic scan for vestibular schwannoma

A

MRI or internal acoustic meatus

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51
Q

What is the initial investigation in IBD

A

stool cultures before faecal calprotectin

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52
Q

how would a rotator cuff tear be different to adhesive capsulitis in terms of active and passive movement

A

rotator cuff tear has weakness and pain during active movement while nothing during passive movement
adhesive capsulitis has reduced passive and active movement

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53
Q

how would subacromial bursitis differ to adhesive capsulitis in terms of movement

A

subacromial bursitis does not lead to significant stiffness or reduced passive range of motion like adhesive capsulitis does
subacromial bursitis also presents with pain

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54
Q

patient has acute abdomen following abdominal surgery eg abdominal tenderness, reduced sounds, reduced lung breaths. what is diagnostic investigation

A

CT abdomen

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55
Q

what can happen if you give oxygen in ACS if breathing is fine and oxygen sats are normal

A

increases mortality

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56
Q

urea:creatinine ratio for pre renal, renal and post renal AKI

A

pre renal - >20
renal and post renal 10-20 (urea and creatinine rise proportionally
normal - 10-20

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57
Q

‘lens shaped haemorrhage’

A

lemon shaped, convex, extradural

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58
Q

diagnostic test for norovirus

A

PCR

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59
Q

if a lady presents with red hard breast and doesnt improve with 2 weeks of antibiotics, what should you do

A

fast track breast appointment
could be something else other than mastoiditis

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60
Q

what are features of contrast nephropathy

A

A common complication of angiographic procedures using iodinated contrast.
It typically manifests as an acute rise in creatinine levels 48–72 hours post-procedure.
This patient’s creatinine has risen significantly (from 104 µmol/L to 210 µmol/L), consistent with this timeline.
Risk factors include chronic kidney disease (CKD), diabetes, and concurrent use of nephrotoxic drugs (e.g., ramipril).

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61
Q

most common cause of unilateral smelly discharge from nose of a child

A

foreign body

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62
Q

what investigation would you do to help diagnose sarcoidosis

A

x-ray - ACE levels may be raised but high false negative and positive rates

63
Q

lump on parotid gland present for 30 years but suddenly grows in size over last 3 months. No pain but slight weakness. adenoma or carcinoma

A

carcinoma

64
Q

what are phosphate and ALP levels typically in osteomalacia

A

phosphate low
ALP high

65
Q

what artery is affected in amaurosis fugax

A

internal carotid artery/retinal/ophthalmic
same side blindness

66
Q

what asthma/copd drug is contraindicated in prostatic enlargement

A

LAMA

67
Q

what muscle group is affected if trendelenburgs test is positive

A

abductors

68
Q

what is given before large volume paracentesis for ascites

A

albumin

69
Q

cause of mumps

A

RNA paramyxovirus

70
Q

cause of rubella

A

togavirus

71
Q

semi dilates non reacting pupil, severe headache, reduced visual acuity, red eye, hazy cornea

A

AACG

72
Q

small irregular pupil, blurred vision, red eye, pain

A

anterior uveitis

73
Q

irregular pupils with no response to light but a response to accommodation

A

Argyll robertson pupil

74
Q

dilated pupil that is slowly reactive to accommodation but poorly reactive to light

A

holmes adie pupil

75
Q

common cause of keratitis in contact lens users

A

pseudomonas

76
Q

reduced visual acuity, red desaturation, RPAD, pain on movement, central scotoma

A

optic neuritis

77
Q

swollen rock hard eye with RPAD

A

orbital compartment syndrome

78
Q

test for optic neuritis

A

MRI with contrast

79
Q

red swollen eye, severe pain (especially with eye movements), visual disturbance, drowsiness

A

orbital cellulitis

80
Q

examination in orbital cellulitis

A

ct with contrast

81
Q

floaters, flashers, curtain coming down

A

vitreous detachment

82
Q

treatment for primary open angle glaucoma

A

selective laser trabeculoplasty ->
prostaglandin analogues ->
beta blocker, carbonic anhydrase etc eye drops

83
Q

insidious peripheral vision loss with reduced visual acuity

A

primary open angle glaucoma

84
Q

red eye pain and visual loss after surgery

A

endophthalmitis

85
Q

night blindness and peripheral vision loss

A

retinitis pigmentosa

86
Q

transient vision loss lasting <24 hours

A

transient monocular vision loss

87
Q

painless visual loss with red hues and floaters

A

vitreous haemorrhage

88
Q

what scan is done to rule out retinal detachment

A

US

89
Q

what should you do for all thyroid nodules

A

US

90
Q

what is seborrhoeic dermatitis caused by

A

malessezia furfur

91
Q

What are features of transient global amnesia

A

sudden onset retrograde and anterograde amnesia
confusion
clear consciousness
unaffected motor skills
resolution of symptoms within 24 hours

92
Q

what rheumatological condition involving the hands does alcohol consumption increase the chances of

A

dupuytrens contracture

93
Q

champagne bottle legs

A

charcot marie tooth

94
Q

difference between charcot marie tooth type 1 and 2

A

type 1 is demyelinating and type 2 is axonal

95
Q

what are features of folliculitis

A

very itchy red rash with pustules around hair follicles

96
Q

what is needed for the development of foetal lungs

A

amniotic fluid

97
Q

what can oligohydramnios lead to in the foetus

A

foetal pulmonary hypoplasia

98
Q

what is a garden 1 type fracture

A

incomplete, undisplaced fracture

99
Q

what is a garden 2 type fracture

A

complete undisplaced fracture

100
Q

what is a garden type 3 fracture

A

complete, displaced fracture

101
Q

what is the most common cause of cancerous axillary lymphadenopathy

A

breast cancer

102
Q

diagnostic test for renal artery stenosis

A

MRA with contrast

103
Q

unilateral small kidney and persistent hypertension

A

renal artery stenosis

104
Q

what are features of sick sinus syndrome

A

alternating bradycardia and tachycardia

105
Q

pericarditis symptoms with elevated troponin

A

myopericarditis

106
Q

which side of the brain are brocas and wernickes areas located

A

left side
brocas - Left lower frontal gyrus
wernickes - Left superior temporal gyrus
conduction aphasia - Left arcuate fasciculus

107
Q

management of goodpastures

A

plasma exchange
steroids

108
Q

what is meant by subchondral sclerosis

A

Increased bone density beneath the cartilage

109
Q

what is a common cause of nephrotic syndrome in sickle cell

A

FSGS

110
Q

what is the treatment for kaposis sarcoma

A

antiretroviral therapy

111
Q

most common cause of hypothyroidism

A

iodine deficiency

112
Q

where is the most common site of lesion for obstructive hydrocephalus

A

cerebral aqueduct

113
Q

what is a common side effect of dopamine agonists to do with mood

A

causes impulsivity

114
Q

what is triad of feltys syndrome

A

rheumatoid arthritis, splenomegaly, neutropenia

115
Q

most common cause of central retinal vein occlusion

A

carotid artery doppler

116
Q

isolated high protein on CSF fluid analysis

A

Guillian barre

117
Q

what investigation is used for sjogrens syndrome

A

schirmers test

118
Q

what type of allergic reaction is hypersensitivity pneumonitis

A

type 3

119
Q

how do you change corticosteroid control for surgery

A

switch to IV hydrocortisone and stop fludrocortisone

120
Q

what should you use for mild labour pain in the second stage of labour

A

inhaled nitric oxide (entonox)

121
Q

what should you use for severe labour pain in the second stage of labour

A

IM pethidine

122
Q

what cause of keratitis is linked to poor contact lens hygiene

A

acanthamoeba keratitis

123
Q

what is management for large bowel obstruction due to volvolus

A

sigmoidoscopic decompression followed by flatus tube insertion

124
Q

what to do for infective exacerbation of COPD

A

give amoxicillin, doxycycline or clarithromycin

125
Q

management for atelectesis

A

chest physio and pain management

126
Q

when cant you use DOAC for AF

A

moderate mitral stenosis
creatinine clearance <15

127
Q

which cause of sudden vision loss is linked to diabetes

A

vitreous haemorrhage

128
Q

how do you treat vitreous haemorrhage

A

vitrectomy

129
Q

what drug cant you use alongside sildenafil

A

nitrates

130
Q

what are risk factors for subdural haematoma

A

alcohol and old age

131
Q

what should be done for persistent molluscum contagiosum in an adult

A

check for HIV

132
Q

where do neuropathic ulcers tend to present

A

pressure points eg heel

133
Q

how is VTE prophylaxis given

A

LMWH - unless egfr < 30
IV unfractionated heparin if renal failure

134
Q

what does hoovers sign assess and when is it used

A

raise her right leg against resistance whilst keeping it straight. He places his hand under the left heel as she does this, and feels pressure under his hand.

differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension

135
Q

what investigation do you do for testicular cancer

A

US

136
Q

how do you monitor LMWH including dalteparin

A

no routine monitoring but can use anti Xa levels

137
Q

how do you monitor unfractionated heparin

A

APTT

138
Q

How do you help irregular periods whilst using nexplanon

A

add a COCP alongside the nexplanon for 3 months

139
Q

what is a common complication of panretinal photocoagulation

A

decrease in night vision

140
Q

how do you manage paracetamol overdose if they present after 24 hours but still show jaundice/hepatic tenderness and have ALT above normal limit

A

NAC

141
Q

when is liver transplant required for paracetamol overdose

A

pH<7.3

or all 3 of:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

142
Q

if someone has a rib fracture but normal analgesia isnt enough, what can be given

A

regional nerve block

143
Q

what is most sensitive test for SLE

A

ANA

144
Q

what is most specific test for SLE

A

anti smith

145
Q

macrocytic anaemia with raised GGT

A

alcoholic cause

146
Q

what is the management for severe peripheral arterial disease

A

endovascular revascularisation -
percutaneous transluminal angioplasty +/- stent
done if stenosis <10cm, aortic iliac disease and high risk patients

surgical revascularisation -
surgical bypass
stenosis >10cm, multifocal lesions, lesions of common femoral artery, purely infrapopliteal disease

147
Q

do you send an MSU for UTI with haematuria in a women

A

yes

148
Q

what electrolyte abnormalities precipitate digoxin toxicity

A

hypokalaemia
Hypomagnesaemia
Hypercalcaemia
Hypernatraemia

149
Q

differences between small bowel and large bowel obstruction presentation

A

SBO - vomiting (bilious) , crampy central/upper abdo pain, constipation
LBO - lower abdo pain, absolute constipation, distention, sometimes bleeding

150
Q

what is management of lithium toxicity

A

IV fluids with isotonic saline
if severe, haemodialysis

151
Q

what is used to stage hodgkins

A

PET/CT

152
Q

what is conservative management for post lumbar puncture headache

A

caffeine and fluids

153
Q

fluctuating cognition with features of parkinsonism

A

lewy body

154
Q
A

Year 6 (24 decks)

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