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Fiona's Lists/Causes etc > Random Facts > Flashcards

Random Facts Flashcards

1
Q

Side Effects of Steroids

A 
Weight gain
Osteoporosis
Avascular necrosis (AVN)
Cataracts, glaucoma
Peptic ulcer disease (PUD)
Susceptibility to infection
Easy bruising
Acne
Hypertension
Hyperlipidemia
Hypokalemia
Hyperglycemia 
Mood swings
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2
Q

Bornholm disease/pleurodynia

A

Uncommon infection of intercostal muscles by Coxsackie B virus.

Causes severe stabbing chest pain. Pleuritic and worse with movement.

Associated with fever, malaise, and headaches.

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3
Q

Causes of Mononeuritis Multiplex

A

1) diabetes

2) vasculitis

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4
Q

2 diameters of NGT - their purpose

A

Smaller - for giving

Larger - for sucking

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5
Q

Steroid use in premature babies

A

Help to grow

Matures type 2 pneumocytes to reduce surface tension and aid breathing

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6
Q

What is the Ross procedure?

A

Diseasedaortic valveis replaced with the person’s ownpulmonary valve.
A pulmonaryallograft(valve taken from acadaver) is then used to replace the patient’s own pulmonary valve.

For common in children.

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7
Q

Chiari malformation

A

Structural defect where cerebellum +/- brain stem tissue extends into the foramen magnum

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8
Q

2 things to ask before interpreting ECG

A

1 - pain?
2 - HTN?
Most common cause of LVH is HTN.
Shows upas high voltages

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9
Q

When can you have ectopic rupture or D/C?

A

7-9 weeks.

Need the mass to be big enough either to cause rupture or to scrape.

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10
Q

Bacterial vs viral illness

A

Bacterial - constitutional symptoms

Viral - coryzal symptoms, esp sore throat, runny nose

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11
Q

What investigations to rule out SAH?

A

CT brain and then LP - rules out 99%
If still suspicious, do MRI.

LP preferably done within 24hrs .
Expect blood in all tubes.
4th tube looking for xanthochromia. Must be wrapped in foil.

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12
Q

Dimples of Venus correlate to?

A

Sacroiliac joints.

They directly overlie them.

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13
Q

How long can viral cough last for?

A

2-3 months

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14
Q

Therapeutic dose of clexane

for DVT

A

1.5mg/kg daily
or
1mg/kg bd

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15
Q

How can we clinically assess for jaw dislocation or #?

A

Look at alignment of teeth

Look for any hematomas in/under the gum

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16
Q

Iron tablets - what can they cause?

A

Black stools without the offensive smell

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17
Q

Intra-uterine hematoma

what are we worried about besides the baby?

A

Rh -ve mother
Rh +ve baby
Creation of Abs that attack the next baby

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18
Q

Iliac crest correlates to

A

L4-5 interspinal space

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19
Q

How to treat panadol OD?

A

N-Acetylcysteine as IV infusion or oral.

NAPQI (metabolite) accumulates within the body in OD.
NAPQI is conjugated by glutathione, but in excess, glutathione reserves are not sufficient. NAPQI interact with hepatic enzymes and damage liver.
Acetylcysteine acts to maintain or replenish depleted glutathione reserves in the liver and enhance non-toxic metabolism of acetaminophen.

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20
Q

Levels of Hb we can tolerate

before transfusion

A

70 - young

100 - old/other co-morbidities

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21
Q

Accessory pathway in wPw

A

Bundle of Kent

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22
Q

Why do we ask about amphetamine use in seizures?

A

Can cause arrhythmias and spasms

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23
Q

DVT, PE in young person

A

Think:

  • Prothrombotic state/coagulopathies
  • Left to Right heart shunts
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24
Q

Otolith catastrophe

A

Sudden ‘drop attacks’ in the context of Meniere’s disease.
During attacks, the patient falls to the ground in the absence of vertigo, loss of consciousness or malaise.
Late in the stage of Meniere’s.

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25
Q

What raises Lactate levels?

A

Anaerobic rest
Adrenaline - causes increases metabolic rate.
Diverts blood away from non essential organs. Anaerobic rest for those organs.

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26
Q

Investigations when suspecting SBO

A

CT Abdo
With IV and oral contrast
Looking for transition point in oral contrast

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27
Q

Causes of ascites in a CLD patient

A
  1. further decompensation
  2. non compliance with medications
  3. hepatic vein thrombus
  4. malignancy causing a resistant ascites
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28
Q

Which murmurs become louder with Valsaver?

A

HOCM and click of MVP

all other murmurs become softer

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29
Q

Causes of low voltages on ECG?

A 
Pericardial effusion 
Dilated cardiomyopathy (walls are thinner)
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30
Q

How long do you have with testicular torsion to act?

A

Adult - 6hrs
Child - 12 hrs
(want to preserve function: spermatogenesis and hormone production)

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31
Q

Common causes of raised Aa gradient

A

V/Q mismatch

Right to left shunt (intrapulmonary or cardiac)

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32
Q

Which is more sensitive V/Q scan or CTPA?

A

CTPA will only tell you about PE’s that are proximal.

Need V/Q scan to look for more distal PE’s

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33
Q

Long term overdose of Insulin

A

Can have hypo-unawareness
Body gets use to stress response (adrenaline release).
Then get a blunted response to hypos

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34
Q

Side effects of Rifampicin

A

Red urine
Tears
Interacts with NOAC and warfarin (up regulates hepatic metabolism - CYP3A4 )

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35
Q

Relationship between rifampicin and flucloxacillin

A

Adding Rifampicin can lower the dose of flucloxacillin used.

Avoiding intra-hepatic cholestasis and allergies.

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36
Q

Vasopressors used commonly in anaesthetics

A

Ephedrine
Metaraminol

Rare cases: NA

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37
Q

Empirical one-off Rx for gonococcal urethritis

A

Ceftriaxone 500mg IM

Azithromycin 1g PO

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38
Q

Painless ulcer on penis?

A

Syphilis

Primary Chancre

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39
Q

What test can we do to determine pancreatic exocrine insufficiency?

A

Low levels of faecal pancreatic elastase

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40
Q

CREON?

A

Pancreatic Enzyme Replacement Therapy

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41
Q

Which part of duodenum do you get PUD?

A

1st part of duodenum

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42
Q

Test in Autoimmune pancreatitis

A

IgG4 - RAISED

accumulation of IgG4 in pancreas causing a mass –> blockage

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43
Q

Common causes of pancreatitis (clinically)

A 
GET
Autoimmune 
ERCP
Methotrexate
Prednisolone
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44
Q

Lipase levels in pancreatitis

A

> 1000

Below that, think:
renal colic, renal failure, gastritis, ovarian pathology

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45
Q

Contrast the pain location in Cholangitis and Biliary colic

A

Cholangitis - RUQ

Biliary colic - Epigastric

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46
Q

What does a drop >0.1 in PCV mean in someone receiving fluid resus?

A

Quite dehydrated as the pt is requiring lots of fluid resuscitation.

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47
Q

Why do Xray in Pancreatitis?

A

Looking for fat saponification and effusion around the pancreas

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48
Q

Diagnostic features of someone who does not clinically fit the picture of pancreatitis?

A

Epigastric pain and fat stranding around the pancreas.

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49
Q

How does ERCP cause pancreatitis?

A
  1. Backwash of contrast or pressure into the pancreatic duct

2. Repeat cannulation causing trauma

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50
Q

Management of someone with Pancreatitis

A

IVT
ADC
PPI
Analgesia

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51
Q

Normal wall thickness of gallbladder

A
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52
Q

Level of bilirubin at which you cannot perform CT IVC

A

Bilirubin >30

As the contrast, biliscopin will not be excreted.

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53
Q

Indications for CT IVC

A

Visualising bile leaks

Looking for stones

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54
Q

2 types of AAA

A

Suprarenal or Infrarenal.
Difficult to operate on suprarenal AAA as cannot reattach the arteries back onto the aorta. Will electively perform EVAR.
In emergency situations, tend to palliate.

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55
Q

RUQ USS

What do you look for?

A 
Liver
Gallbladder
Biliary tree
Kidneys
Pancreas
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56
Q

What do check in exam of #?

A
  1. tenderness
  2. deformity
  3. swelling
  4. temperature
  5. abnormal mobility and crepitus
  6. loss of function
  7. neurovascular status
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57
Q

How to calculate the the eGFR

A

Cockcroft-Gault equation

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58
Q

Dose of suxemethonium

A

1-2mg/kg of TBW

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59
Q

Why might you get a derm consult in setting of ablative therapy (chemo)

A

Skin cancers may transform.
Any dormant malignancies may activate.
Thus should get a skin check for things like SCCs etc.

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60
Q

Which type of leukaemia are more likely to cause splenomegaly?

A

Monocytic/monoblastic

Acute erythroid

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61
Q

Why might you inspect skin in acute leukaemia?

A

Looking for skin infiltrates (leukaemic deposits in skin which look like papules)
Also known as chloromas
More common in myeloid > lymphoid

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62
Q

Valganciclovir used for?

A

CMV prophylaxis

Do serology to check status.

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63
Q

Why check CMV serology status?

A

When giving blood products - do they need CMV-ve products?

Do they have dormant CMV? Must check before we immunosupress for fear of activation.

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64
Q

What can be used to treat oral thrush?

A

Amphotericin B mouth lozenges

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65
Q

Why worry about oral mucosa in leukaemic pts?

A

Because of the combo of neutropenia + chemo:
high risk of candida infections
mouth pain
nutrition also affected

Therefore do regular inspection of the mouth.

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66
Q

Why start allopurinol in someone with Leukaemia?

A

Large tumour burden –> hyperuricemia –> may precipitate gout
Also help prevent tumour lysis syndrome

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67
Q

What parameters do you look at for tumour lysis monitoring?

A

LDH
Urate
Potassium
eGFR

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68
Q

What type derangement can thiazide diuretics cause?

A

increase BSL

hyperuricaemia

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69
Q

Who do we need to dose adjust Clexane in?

A

Renal impairment

Obese or small ppl

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70
Q

In who do we need to monitor clexane?

with anti-factor Xa levels

A

renal impairment

someone who has a propensity to bleed from a site (PUD)

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71
Q

Difference in Mx in someone with proximal or distal DVT

A

Proximal - greater risk of PE

Distal - may not treat medically if small and not really symptomatic but are close to hospital and sensible.

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72
Q

3 type of Myeloproliferative disorders

A
  1. Polycythemia Rubra Vera
  2. Myelofibrosis
  3. Essential thrombocythemia

Commonly associated with JAK2 mutation

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73
Q

1 cause of acquired anti-thrombin deficiency

A

Nephrotic syndrome

The MW of the protein is such that it can leak.

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74
Q

Why might morphine be used in APO?

A

Dilates the abdominal great veins and decreases preload.

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75
Q

What is entorox used for?

A

Analgesic gas - used commonly in paeds

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76
Q

Someone bleeding profusely?

A

Direct pressure on bleeding vessel

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77
Q

What predisposes a Pathological #?

A

Osteoporosis
Bone tumours
Paget disease
Osteogenesis imperfecta

78
Q

Which Ca’s most commonly go to bone?

A

Breast
Prostate
Bowel

79
Q

Contraindication in tranexamic acid use

A

Lowers seizure threshold.

Avoid in epilepsy

80
Q

What 2 drugs when given too quickly can cause ototoxity?

A

Frusemide IV

Gentamicin IV

81
Q

Side effects of morphine in anaesthetics

A

Broncho-constriction

Vasodilation (via histamine release)

82
Q

Time for IV morphine to take effect?

A

10 mins

83
Q

Anti-emetic options

A

Metoclopramide
Ondansetron
Dexamethasone (prophylaxis)
Droperidol 1mg

84
Q

Side effect of Panadol IV

A

Drops blood pressure

85
Q

What can be used for Analgesia?

A 
Mg
Local anaesthetic
Panadol
NSAID
Opiate
TCAs
Gabapentin
Pregabalin
Tramadol
clonidine
86
Q

What are the 3 actions of Tramadol

A
  1. Partial agonist at mu receptors
  2. alpha agonist
  3. 5HT3 receptor
    (last 2 actions are in the descending pathways)
87
Q

What would monitors show if there was a large fat embolus?

A

Drop in CO2 that is expired

88
Q

Lung Primaries metastasise to?

A

Other parts of lung
Adrenals
Bone
Sometimes liver

89
Q

Which Cancers metastasise to bone?

A 
Breast 
Prostate
Lung 
Melanoma
Thyroid
Kidney
90
Q

1st line therapy for TB

A

Isoniazid
Rifampicin
Pyrazinamide
Ethambutol

91
Q

Regimen for HAART

A

2 NRTI + PI

2 NRTI + NNRTI

92
Q

Where does breast Ca metastasise to?

A

Bone
Liver
Lung

93
Q

Which diuretics precipitate gout?

A

Loop
Thiazides

Reduce urate excretion by both directly and indirectly increasing urate reabsorption and decreasing urate secretion

94
Q

Most common cause of LLQ pain?

A

Diverticulitis

95
Q

Midgut ends where?

A

2/3 along transverse colon

96
Q

Ligamentous injury or fracture?

A

Test vibration - hurts bad in fracture. Not so much in ligament injury.
Change in position also does not change fracture pain.

97
Q

What sign may you see radiologically with pneumoperitoneum?

A

Rigler’s sign

When air is present on both sides of the intestine –> get a double wall sign.

98
Q

Femoral hernias more common in…

A

little old ladies

99
Q

Toxic megacolon

A

dilated bowel with translocation of material

100
Q

Differentiate LB and SB radiologically

A

Location
Diameter
Haustra vs Valvulae Conniventes (plicae circulares)

101
Q

Lower abdo pain in female.

DDx

A 
Appendicitis
Diverticulitis
Cyst rupture
Retrograde menstruation
Ectopic
PID
102
Q

Location of pain for fore/mid/hind gut?

A

Foregut - epigastric
Midgut -periumbilical
Hindgut - lower abdomen

103
Q

Describe Shenton’s line

A

Shenton’s line is formed by the medial edge of the femoral neck and the inferior edge of the superior pubic ramus.
Help to pick NOFs

104
Q

Bechets triad

A

Apthous ulcers
Genital ulcers
Uveitis

105
Q

Dark urine DDx

A

Myoglobinuria (rhabdo)
Haemoglobinuria (Hemolysis)
Hyperbilirubinemia

106
Q

How would hemolysis show in blood?

A

haptoglobin low

107
Q

Primaries that metastasise to lung

A

breast
pancreas
kidney
skin

108
Q

Expected CO2 formula for compensation for metabolic acidosis

A

HC03 x 1.5 + 8 +/- 2

109
Q

Do the following causes alkalosis or acidosis?
Liver failure
Renal failure
Sepsis

A

Liver failure - alkalosis (loop diuretics, aldosterone)
Renal failure - acidotic
Sepsis - acidotic (shock, lactic acid build up)

110
Q

Normal Anion gap?

A
111
Q

For every drop of 0.1 in pH, how much does K go up by?

A

0.5 increase

112
Q

Rigors imply?

A

Sepsis

Think bacteria, influenza, HIV, vasculitis

113
Q

Would you expect to see radiological changes in septic arthritis

A

Not in acute setting.

If after several weeks, may see osteopenia

114
Q

What does decreased haptoglobin suggest?

A
  1. intravascular hemolysis: with increased reticulocyte count and a decreased haemoglobin and hematocrit.
  2. extravascular hemolysis: haptoglobin can be normal and the reticulocyte count is increased
115
Q

Prophylaxis for vatical bleeding

A
  1. propranolol

2. band ligation

116
Q

2 benefits if ascitic fluid analysis

A
  1. diagnose Spont Bact. Peritonitis (pmn count > 250)

2. diagnose portal hypertension (SAAG > 11 g/L)

117
Q

how does portal hypertension manifest?

A
  1. ascites +/- SBP

2. vatical +/- bleeding

118
Q

Ddx for upper GI bleed

A 
– Peptic ulcer disease
– Varices
– Esophagitis
– Mallor-Weiss tear
– Other: cancer, angiodysplasia/AVM
119
Q

Causes of Cushing’s syndrome

A
  1. anterior pituitary adenoma (cushion’s disease)
  2. paraneoplastic (SCC of lung)
  3. primary adenoma/carcinoma of adrenals
  4. iatrogenic
120
Q

3 antidotes to know?

A
  1. NAC - for paracetamol OD
  2. Flumazenil - benzodiazepine GABA receptor antagonist
  3. Naloxone - opioid antagonist
121
Q

Back pain and fever?

A

Epidural abcess until proven otherwise

Can cause paralysis if ignored

122
Q

Treatment for toxoplasmosis

A

sulphadiazine + pyremethamine

123
Q

Cushing reflex

A

Impending herniation

Increased BP
Bradycardia
Cheyne stokes breathing

124
Q

Wernicke’s encephalopathy

A

Vitamin B1 deficiency (thiamine)

ataxic gait
encephalopathy (confusion)
oculomotor deficiency

125
Q

Normal pressure hydrocephalus triad

A

urinary incontinence
gait disturbance
dementia

126
Q

Side effect of tetracycline in breastfeeding

A

Stains teeth

127
Q

Insulin use post MI

A

Improves survival in hyperglycaemia setting.
Sliding scale 24hrs post
3months insulin subcut

128
Q

Delirium tremens

A

Most severe form of ethanol withdrawal
Confusion, hallucinations
high mortality

129
Q

Neuropathy distinctions

A

Diabetic: peripheral sensory
B12: Vibration and proprioception
CIDP: large fibre and areflexia
Syringomyelia: pain and temp in UL

130
Q

Anti-endomysial Abs

A

Coeliac disease

131
Q

Sign of hyperventilation

A

Carpal spasm

132
Q

hypogonadotrophic hypogonadism and anosmia

A

Kallman’s syndrome

Failure of migration of the olfactory neurones and GnRh neurones during development.

133
Q

Phenytoin side effects

A

peripheral sensory neuropathy
cerebellar ataxia
hirsutism
gum hypertrophy

134
Q

Neural tube defects

A

Valproate

Supplement with folate!

135
Q

CLL and immunodeficiency

A

CLL is commonly complicated by panhypogammaglobulinaemia

136
Q

Seroconversion illness HIV

A

widespread macular rash
pharyngitis
generalised lymphadenopathy

137
Q

Amoidarone induced hypothyroidism

A

amiodarone induced hypothyroidism which inhibits the peripheral conversion of T4 to T3.

138
Q

Hypercalcemia seen in…

A

multiple myeloma, hyperparathyroidism and hyperthyroidism

139
Q

Upper lobe fibrosis

A

Ankylosing spondylitis

140
Q

How to differentiate Myasthenia from Lamber Eaton?

A

Weakness tends to improve after a few minutes of muscular contraction, and absent reflexes return in Lambert eaton whereas in MG, muscles fatigue with use.

141
Q

Valsava

A

First ask if you can do one - pt may be unstable

  1. breath in and push against my hand that’s flat ons stomach
  2. squat
  3. reinforcement
  4. syringe
  5. blow out of nose that’s squeezed closed
142
Q

What should you do in a pt with AF on examination?

A

take radial pulse and auscultate heart at the same time.

Not all contractions may be transmitted into a pulse

143
Q

Major side effect of verapamil

A

constipation

144
Q

Amiodarone effect on warfarin

A

increases effective dose

145
Q

2 antibodies to look for in scleroderma

A

anti-centromere

anti-topoisomerase (Scl 70)

146
Q

Fluorinated Steroid

A

Also has prefix beta
Avoid on face
Can cause steroid rosacea

147
Q

methotrexate crepitations

A

coarse creps in mid zone

148
Q

MLH1 and MSH mutations are important in which syndrome?

A

Lynch

Hereditary nonpolyposis colorectal cancer

149
Q

Alcohol binge LFT pic

A

AST and GGT rise

150
Q

Oxygen saturation 90

A

PaO2 = 60mmHg

151
Q

Von Willebrand features

A

autosomal dominant

affects APTT

152
Q

Haemophilia inheritance

A

X linked recessive

153
Q

MRSA

A

Healthcare workers

154
Q

Courvoisier’s Sign

A

enlarged, palpable gallbladder in patients with obstructive jaundice caused by tumors of the biliary tree or by pancreatic head tumors

155
Q

Pneumocystis features

A

symptoms progress over month

cough is optional

156
Q

Sigmoid volvulus

A

RIF pain

157
Q

Sign of portal hypertension in cirrhosis

A

splenomegaly

158
Q

Skin reactions in radiotherapy last for?

A

up to 3 weeks

basal keratinocytes takes 3 weeks to generate new skin

159
Q

Low DLCO

A

Interstitial pulmonary fibrosis (restrictive)
Emphysema (obstructive)
Anaemia, pulmonary vasc disease (normal)

160
Q

Metacholine challenge test

A

diagnose asthma

161
Q

Normal DLCO

A

Chest wall disease

Neuromuscular disease

162
Q

Optic neuritis

A

RAPD
Central scotoma
More often normal fundus (otherwise can be pale or swollen optic disc)
Can have colour defects - but only if acuity also affected

163
Q

Fulminant Hepatitis

A

Hep B not Hep C

164
Q

Chylothorax

A

One of the rare complications of CABG
Nick the thoracic duct.
Get chyle in drainage once you begin to eat fatty foods

165
Q

ECG pattern in PE

A

SI QIII TIII pattern – deep S wave in lead I, Q wave in III, inverted T wave in III.

166
Q

What might you see on CXR of aortic dissection?

A

widened mediastinum

irregular aortic contour

167
Q

Riddle’s lobe

A

Anatomical variant of the right lobe of the liver

Tongue like projection - may look like hepatomegaly

168
Q

Dentate line

A

Divides the upper two thirds and lower third of the anal canal. Developmentally, this line represents the hindgut-proctodeum junction.

Superior rectal artery vs inferior rectal artery
Superior rectal vein vs inferior rectal vein
Visceral (inferior hypogastric plexus) vs. somatic (pudendal)

169
Q

Chilaiditi sign

A

Large bowel btw the liver and diaphragm

Appears as free gas with rugae underneath the diaphragm

170
Q

Portal venous gas

A

Accumulation of gas in the portal vein and its branches.
Harbinger of death
Gas found more peripherally

171
Q

Pneumobilia

A

Gas in biliary tree.

Gas found more centrally in liver

172
Q

4 types of calcification

A

Rim like - in wall of hollow viscus - e.g. cysts
Linear - in wall of tubular structures
Lamellar - stones
Amorphous - in solid organ

173
Q

SBO

A

Dilated loops of bowel
> 2.5-3cm
> 5 air fluid levels on erect film

Proximal to obstruction - first to dilate
Overtime, all parts dilate

174
Q

In ileus, what happens to the bowel?

A

Both small and large bowel are dilated

175
Q

Where is the largest diameter in bowel?

A

Caecum - 9cm but thinnest. >15cm: impending perforation
Small bowel 3cm
Colon - 6cm

176
Q

Imaging in LBO?

A

CT with rectal contrast

177
Q

Apple core lesion

A

Stenosing annular colorectal carcinoma

178
Q

Side effects of metronidazole

A

Severe nausea
Massive vomiting with alcohol consumption
Metallic taste in mouth

179
Q

Difference in Prinzmetal and normal angina on ECG?

A

ST elevation and more leads affected.
cf.
ST depression usually limited to one vascular territory.

180
Q

Considerations for MRI and previous SAH

A

Certain aneurysmal clips may be CI

181
Q

Things to consider in a splenectomy pt

A

Left shift in neutrophils and thrombocytosis
Increased risk of thrombosis
low dose Abs for prophylaxis

182
Q

Side effect go mycophenolate

A

Microangiopathic haemolytic anaemia

183
Q

Where else can you get cysts in PKD?

A 
liver 
spleen
pancreas
ovaries
lung
184
Q

Preop anaesthetic assessment of RA pt

A

Must image C-spine

Instability from RA

185
Q

Reiter’s triad for reactive arthritis

A

arthritis
uveitis
urethritis

186
Q

Behcet’s triad

A

mouth ulcers
genital ulcers
uveitis

187
Q

Most common cause of pneumoperitoneum

A

perforated peptic ulcer

188
Q

Dengue symptoms

A

Fever, violent headache, and severe pains in the muscles and joints following an incubation period of 5-8 days, and lasts about 4-7 days

189
Q

Troisier’s sign

A

Clinical finding of a hard and enlarged left supraclavicular node (Virchow’s node)

Virchow’s node: where the lymphatic drainage of most of the body (from the thoracic duct) enters the venous circulation via the left subclavian vein.

190
Q

Why does CKD increase CVD risk?

A

High PO4 leads to increased PTH levels.

Ca released binds to PO4 and together they deposit in vessel walls

191
Q

What do we use to treat Meniere’s?

A

Betahistadine

Increases bloodflow to vestibule

Fiona's Lists/Causes etc (6 decks)

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