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1
Q

supra abdominal pain referred to the back

A

pancreatitis

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2
Q

unable to move swollen index finger

A

tendon sheath infection

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3
Q

flexion at the PIP joint with extension at the DIP joint

A

swan neck

RA

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4
Q

Nerve in ankle jerk

A

S1

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5
Q

Biggest risk for PTSD?

A

Rape

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6
Q

CN for raising the eyebrow

A

CN VII, facial nerve

frontalis muscle

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7
Q

CN for muscles of mastication

A

CN V. 3

trigeminal, mandibular branch

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8
Q

orphan annie eyes

A

papillary thyroid cancer

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9
Q

Cheif cells in stomach secret what?

A

pepsinogen

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10
Q

Parietal cells secrete what?

A

HCl acid and IF

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11
Q

What happens to pepsinogen in precence of HCl

A

converted to pepsin

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12
Q

Knee jerk

A

L3/4

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13
Q

Foot drop

A

common fibular nerve

L4-S1

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14
Q

contraception in breast cancer

A

NOT COCP or POP

IUD

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15
Q

green nasal discharge

A

sinusitits

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16
Q

demylinaiton of the mid brain

A

holmes

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17
Q

barking cough

A

croup

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18
Q

lateral gaze palsy

A

CN6

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19
Q

ptosis

20
Q

eye pain on movement

A

MS- optic neuritis

21
Q

What are aids defining illnesses?

A

opportunistic infections that do not normally occur in immunocompenent individuals

22
Q

What is the CD4 count for AIDS?

23
Q

Give examples of AIDS defining illness?

A

Pneumocytic pneumonia (fungal infection)
toxoplasmosis (parasite)
karposis sarcoma
mycobacterium TB

24
Q

What is AIDS?

A

acquired immunodeficient syndrome

25
Q

What are the main symptoms of pneumocystis pneumonia and how do you diagnose it?

A 
fever
non productive cough
weight loss 
night sweats
XRay- widespread pulmonary infiltrates
low O2 sats
26
Q

What are the key symptoms of ectopic pregnancy?

A 
amenorrhoeic for 6-8 weeks
severe pain
bleeding
shoulder tip pain
cervical excitation
haemodynamically unstable, hypotension
27
Q

What causes shoulder tip pain?

A

internal bleeding irritating the diaphragm

28
Q

Shoulder tip pain

A

ectopic prgnancy

29
Q

When do you give expectant management in ectopic pregnancy?

A

low risk
no symptoms or mild symptoms and small or cant be found pregnancy
<200 hCG and decline mass

30
Q

What happens in expectant management?

A

take serum hCG levels until undetectable

31
Q

What are the worrying consequences of undiagnosed ectopic pregnancy?

A

rupture of plantation site

intraperitoneal bleeding

32
Q

What are the investigations of ectopic pregnancy?

A

positive pregnancy test

TVUS showing no intrauterine pregnancy

33
Q

If TVUS cant confirm intrauterine pregnancy what other tests might be considered and what would be the expected results?

A

serum hCG- <50% increase in level over 24hrs or plateau

34
Q

How can you use serum hCG to differentiate between a normal pregnancy, ectopic and failing pregnancy/miscarriage?

A

Normal pregnancy hCG should be increasing by >50% each day
Ectopic pregnancy hCG increases by <50% each day or plateaus
Failing intrauterine pregnancy/miscarriage dhCG decreases steadily

35
Q

What is recommended if you cant distinguish between a failing pregnancy/miscarriage and an ectopic pregnancy?

A

dilation and curettage

determines the presence or absence of trophoblastic tissue

36
Q

What is recommended if you cant distinguish between a failing pregnancy/miscarriage and an ectopic pregnancy?

A

dilation and curettage

determines the presence or absence of trophoblastic tissue

37
Q

How do you treat moderate risk or failed expectant management of ectopic pregnancy?

A

methotrexate bum injection
serum hCG until undetectable
use contraception for at least 3 months

38
Q

What are moderate risk ectopic pregnancies?

A

haemodynamically stable

hCG <5000

39
Q

What is methotrexate and how does it work?

A

folic acid atagonists that disrupts rapidly dividing trophoblast cells

40
Q

How do you treat ruptured ectopic pregnancy or failed medical managment?

A

haemodynamically unstable
surgery
post surgery methotrexate (if still detectable hCG)
anti D IG

41
Q

What is the apgar score?

A

measure of physical condition of a newborn

42
Q

APGAR?

A

activity (muscle tone): floppy, flexed arms and legs, moving
pusle: none, <100, >100
grimace (reflex irratibility): none, grimace, sneezes/coughs and pulls away
Apearance: blue/pale, pink core and blue extremities, pink
Respiration: none, slow/irregular, crying

43
Q

what makes up the axiliary nerve?

A

fibers from C5 and C6

44
Q

Consequence of damage to axiliary nerve and when does this commonly occur?

A

loss of sensation over badge area
paralysis of deltoid and teres minor- flat shoulder deformity
dislocations of shoulder can damage the nerve

45
Q

What makes up the musculocutaneous nerve?

46
Q

Carpal tunnel syndrome?

A

median nerve

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