Random Facts Flashcards
What is the treatment for oral lichen planus?
Betamethasone
Where is Melatonin produced?
Pineal gland
What is Otosclerosis?
Autosomal dominant condition with unilateral hearing loss and an otherwise normal ear examination
What ABPI warrants referral to vascular surgery?
< 0.8
What is the criteria for prescribing Orlistat?
BMI > 30 or BMI > 28 with associated risk factors
What should be investigated in patients with vitiligo?
Other autoimmune conditions -> TFTs etc
What is the common presentation for twins?
Both twins vertex
Which HTN medication is most likely to precipitate lithium toxicity?
Thiazide diuretics e.g. Bendroflumethazide
What does bone conduction > Air conduction suggest?
Conductive deafness
What does air conduction > bone conduction suggest?
Sensioneural deafness
What commonly develops after trauma to the breast?
Fat necrosis of the breast
Which Abx is assoicated with ventricular tachycardia (torsades de pointas)
Erythromycin
Aortic Dissection vs MI?
AD will have most pain at onset then decrease, MI pain builds from onset
Pericarditis signs?
- Pleuritic chest pain radiating to arm
- SOB
- Hx of recent illness
Treatment of pericarditis?
NSAIDs
Mechanism of N-acetylcysteine?
Replenishes body stores of glutathione
What is used to reverse heparin?
Protamine
How to calculate units?
Units = strength (ABV) x volume (ml) ÷ 1000
First line investigation for angina?
CT coronary angiography
Blood in the white of the eye with coughing sneezing and eye trauma with no tears or discharge?
Subconjunctival haemorrhage
How does travellers diarrhoea present?
Within 12-24 hours of exposure with crampy abdominal pain and profuse watery diarrhoea
Electrolyte abnormalities seen in referring syndrome?
Hypophosphataemia, hypomagnesaemia, hypokalaemia
What is rheumatic fever?
- Recent strep infection
- Arthritis, Chorea, Rash on trunks
What criteria is used to assess rheumatic fever symptoms?
Jones criteria
Management of rheumatic fever
- Penicillin Abx
- Analgesia
Atopic dermatitis vs psoriasis?
Dermatitis affects the flexors whilst psoriasis affects the extensors
Lichen sclerosus vs Lichen planus?
LS is more common in post menopausal women and will have itching and pain whereas LP will usually not have pain
Nasopharyngeal carcinoma red flags?
- Unilateral nasyl polyp
smooth, firm, painless, mobile lump?
Fibroadenoma
Which diuretic can cause gynaecomastia?
Spirinolactone
Pain worse on pronation of the forearm?
Medial epicondylitis - golfers elbow (Putt - Pronation)
Oral morphine:subcut ratio
2:1
Definition of polypharmacy?
A single patient taking 5 or more medications daily
Stages of AKI?
1: Creatinine is 1.5-1.9 times higher than baseline/ urine output < 0.5ml/kg for > 6 consecutive hours
2: Creatinine is 2-2.9 times higher than baseline/ urine output < 0.5ml/kg for > 12 consecutive hours
3: Creatinine is >3 times higher than baseline / urine output < 0.5ml/kg for > 24 consecutive hours/
anuria for > 12 hours
What is urea breath test used to diagnose?
H pylori
Management of H pylori?
PPI + Clarithromycin + Metronidazole/Amoxicillin
COPD management if steroid responsive?
Step 1: SABA or SAMA
● Step 2: SABA + LABA + ICS (if they were originally on SAMA, discontinue and start SABA)
● Step 3: SABA + LABA + ICS + LAMA
COPD management if not steroid responsive?
Step 1: SABA or SAMA
Step 2: SABA + LABA + LAMA (if they were originally on SAMA, discontinue and start SABA)
Fraser guidelines criteria
He/she has sufficient maturity and intelligence to understand the nature and implications of the proposed treatment
He/she cannot be persuaded to tell her parents or to allow the doctor to tell them
He/she is very likely to begin or continue having sexual intercourse with or without contraceptive treatment
His/her physical or mental health is likely to suffer unless he/she received the advice or treatment
The advice or treatment is in the young person’s best interests.
Breast cancer risk factors?
Increased hormone exposure
Early menarche or late menopause
Nulliparity or late first pregnancy
Oral contraceptives or Hormonal Replacement Therapy
Susceptibility gene mutations) - BRCA
Previous radiotherapy treatment
Guidelines for breast cancer referral
They are ≥30 with an unexplained breast mass (regardless of whether there is pain present or not)
They are ≥50 or older presenting with nipple discharge, retraction or other concerning symptoms.
What is error of inherited thinking?
a working diagnosis is handed over and accepted without pause for
consideration
What is error of overattachment?
conducting tests to confirm what we expect or want to see
and not ruling out other causes
What is error of bravado?
typically working above competence in a show of
over confidence that is not safe
Components of Seedhouse ethical grid?
Core rationale
Deontological layer
Consequential layer
External considerations
C/I to Heparin?
Bacterial endocarditis
Mode of Action of Salmeterol?
Stimulation of G protein-coupled receptors
Gastric cancer
Dysphasia, palpable mass, ascites
Acne vulgaris
- Chronic inflammation in the pilosebaceous units
- Tx includes ben peroxide, isotretinoin, topical retinoids, oral COCP
BPH management?
Alpha blocker - Tamsulosin - smooth muscle relax
5-alpha reductase inhibtors - Finasteride - inhibits testosterone conversion to reduce prostate size
TURP - surgical treatment
Conjunctivitis?
- Inflammation of conjunctiva
- Red eyes, itchy, discharge
- Purulent discharge if bacterial
- Chloramphenicol/Fusicidic acid eye drops to treat
Polymyalgia rheumatica?
- Inflammatory condition which causes pain, stiffness, pelvic girdle and neck
- Associated with GCA
- Raised inflammatory markers
- Treat with steroids
Psoriasis?
- Dry, flaky skin lesions which are raised/rough plaques commonly over extensor surfaces of elbows/knees/scalp
- Topical steroids, vit D, tacrolimus, phototherapy
Sinusitis
- Recent VURTI
- Congestion, discharge, facial pain, headache
- Tenderness, discharge, fever
- Nasal endoscopy/CT scan
- Nasal spray + Abx
Urticaria/Hives
- Release of histamine by mast cells
- Triggered by something e.g allergies, meds, viral infection
- Antihistamines to treat
Anal Fissure
- Tears of the squamous lining of the distal anal canal
- Constipation, IBD, STIs all risk factors
- Painful, bright red bleeding
- Treated with analgesia, lubricants
- Chronic treated with topic GTN
Hiatus Hernia
- Hernia of part of the stomach above the diaphragm
- Obese patients
- Heartburn, chest pain, dysphagia
- Barium Swallow/detected incidentally on endoscopy
- Tx with PPI, Weight loss, Surgery
Varicose Veins
- Common, dilated superficial veins
- Visual appearance, itching, throbbing
- Weight loss, regular exercise, compression stockings
- Some patients may need specialist intervention
Folliculitis
- Inflammation of hair follicle, usually after infection
- Erythematous papules around hair follicles
- Treated conservatively, sometimes give Abx if cultures positive
Diverticulitis
- Infection of diverticulum
- RF: Age, lack of fibre, obesity
- Intermittent abdo pain, bloating, change in bowel habit
- Fever, tachycardic, guarding, rigidity, rebound tenderness
- CT is best imaging
- Tx with Abx, fluids, analgesia
Bursitis
- Inflammation of the bursa
- Localised pain, tenderness and swelling
- Tx is physical excercise, rest and analgesia, with steroid injections if needed
- Septic needs Abx and aspiration
Causes of microcytic anaemia?
- Iron deficiency
- Thalassaemia (loss of globin)
- Sideroblastic anaemia (loss of heme)
- Anaemia of chronic disease
TIBC vs Ferritin
TIBC - Transferrin level which is iron transport protein
Ferritin - Amount of storage iron
These always oppose each other
Causes of iron defiency anaemia?
- Decreased intake
- Decreased absorption
- Increased demand
- Increased iron loss
IDA specific signs
- Pica
- Koilonychia
- Atrophic glossitis
- Angular stomatitis
- Brittle hair
- High TIBC
Beta Thalassemia major features?
- Chipmunk facies
- Crew cut appearance of skull
- Hepatosplenomegaly (increased haemolysis)
- Target cells on blood film
- Tx with blood transfusions
- Normal iron studies
Sideroblastic anaemia features?
- Basophilic stippling
- Ringed sideroblasts
Megalobastic Macrocytic anaemia?
- Vit B12 and Folate deficiency
Non-megalobastic macrocytic anaemia?
- Liver disease
- Alcoholism
- Hypothryoidism
Pernicious anaemia
- Autoantibodies attack parietal cells in fundus
- B12 cannot be absorbed properly
- IF antibodies specific for diagnosis
Sickle cell trait
- one Hb S gene
- Asymptomatic
- Sometimes painless gross haematuria, recurrent UTI
Sickle cell anaemia Px?
- Bone pain crisis most common)
- Dactylitis
- Acute chest syndrome (pain, distress, hypoxia0
- Priapism
- Strokes/MI
How many days of Abx do men require for UTI?
7 days
If >65 and on long term steroids, what should be given?
Bisphosphonates
Anti-TPO are in what condition?
Hashimotos
TRAb antibodies are part of what?
Graves
2nd line for gout?
Febuxostat
AST raised more than ALT?
Alcoholic liver disease
ALT raised more than AST?
Hepatitis/Alcoholic fatty liver disease
Predominantly raised ALP?
Cholestatsis
Only ALP raised?
Bone breakdown
What can precipitate acute angle-closure glaucoma?
TCAs
First line for rate control in AF?
Beta-blockers or Verapamil
