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Random things Flashcards

1
Q

Recommended daily calcium intake

A

at least 1300mg/day

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2
Q

antivirals for genital herpes

A

valaciclovir 500mg Q12H for 10 days; if rapid improvement can stopa t 5 days

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3
Q

treatment for genital warts

A
  1. imiquimod 5% cream, 3x per week until warts resolve (usuually 8-16 weeks)
  2. podophyllotoxin 0.5% paint, BD for 3 days, repeated weekly, until warts resolve (usually 4-6 weeks)
  3. leave them be
  4. cryotherapy
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4
Q

Supporting smoking cessation

A 
ask
assess
advise
assist
arrange follow up
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5
Q

Rotterdam criteria

A

if 2 present, PCOS diagnoses

  • history of oligo/anovulation
  • hyperandrogrenism
  • polycystic ovaries on USS (12 or more follicles 2-99mm, and/or increased ovarian volume)
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6
Q

live vaccines

A 
japanese encephalitis Imojev
MMR
varicella
MMRV
oral rotavirus
zoster
lBCG
typhoid (oral)
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7
Q

Testing for typhoid

A

Blood and stoop culture; serology not helpful

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8
Q

Medications that cause hyponatremia

A 
CARDISH
Chemotherapy
Antidepressants, antipsychotics, anticonvulsants, anti inflammatory drugs (cox2 inhibitors)
Recreational drugs - ecstasy
Diuretics
Inhibitors - ACEi, ssris
Sulfonylureas
Hormones desmopressin, oxytocin, hypnotics (temazepam)
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9
Q

Automatic high cv risk

A 
Diabetics >60
Atsi >74
Moderate or above Ckd (45)
Fh
Cholesterol >7.5
Bp >180/>110
Diabetes with microalbuminuria
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10
Q

TSH ranges for replacement

A 
<60 aim 0.5-2.5
> 60 aim 1-5
>80 aim 4-6
pregnancy
1st trimester 0.1-2.5
2nd trimester 0.2-3
third trimester 0.3-3
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11
Q

timing for pertussis PCR

A

up to 4 weeks of cough

serology can become positive after 2 weeks

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12
Q

LFT analyss cholestasis versus hepatocellular damage

A

cholestasis ALP >200 and ALP >3x ALT

hepatocellular damage ALT >200 and ALT >3x ALP

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13
Q

enzym inducing anti-epileptics

A

carbamazepine, phenobarbitone, phenytoin, primidone and topiramate (when 200mg or more a day)

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14
Q

gout MCS from joint aspirate

A

negative birefringence, needle shaped crystals, blue crystals

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15
Q

Who is at high risk of diabetes?

A 
AUSDRISK >12
>40yo and overweight
IFG
1st degree relative with diabetes
personal hx CV event
high risk ethnicity
history GDM
women with PCOS
antiphyscotics
ATSI
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16
Q

What testing do you have to do for patients who are at high risk of diabetes?

A

every 3 years FBG or HbA1c

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17
Q

Diabetes HbA1c

A

> 6.5

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18
Q

OGTT results

A

IFG 6.1-6.9 pre glucose
IGT >7.8-11 2hr after glucose
fasting >7 or 2hr >11.1 = diabetes

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19
Q

T score level for osteoporosis

A

<-2.5

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20
Q

Z score level

A

z score <-2 warrants invesitgation for secondary causes of bone loss; recommended in <50yo, premenopausal

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21
Q

testing for Addison’s disease

A

short synacthen test (aka ACTH stimulation test)

low morning serum cortisol

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22
Q

Hypoglycemia management

A

Rule of 15
BSL <4mmol/L
give 15g quick acting CHO (1/2 can non diet soda)
wait 15mins, then repeat
if not rising - repeat
provide long acting CHO if next meal >15mins away (i.e. tub of yoghurt)
test BSL every 1-2 hours for next 4 hours

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23
Q

severe hypoglycemia management

A

glucagon 1mg IM or subcut

IV fglucose 50% 20mL (10% in child)

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24
Q

Diabetes screening recommendation

A

screen everyone >40 with AUSDRISK every 3 years
ATSI >18yo annual blood test
high risk otherwise test every 3 years

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25
Q

Graves disease antibodies

A

TSH receptor Ab positibe, TPO Ab often positive

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26
Q

Hashimoto’s thyroiditis abs

A

TPO antibodies +

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27
Q

Prep effectivness time frames

A

7 days to for receptive anal

21 days for receptive vaginal and IVDU

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28
Q

points about Prep

A

safe in pregnancy and breastfeeding
test within 7 days of starting for HIV
very effective as long as no missed pills
regular reviews - 30 days, then every 90 days
can impair renal function, BMD, liver function
SE - HA, nausea

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29
Q

complications of CF

A 
pancreatic exocrine insufficiency/steatorrhea
FTT
sinusitis
nasal polyposis
meconium ileus
diabetes mellitus
infertility
hyponatremic dehydration
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30
Q

COPDX

A 
case finding and confirm diagnoses/severity
optimise function
prevent deterioration
develop plan of care
manage eXacerbations
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31
Q

aspect of management

A 
pharmacotherapy
rehabilitiation programs
action plan
self management
co-morditities
exercise
vaccination
nutrition
smoking 
prascevns
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32
Q

severity in COPD

A

mild 60-80% FEV
moderate 40-59% FEV predicted
severe <40% predicted

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33
Q

pneumococcal vaccinations in at risk patients

A

1 dose 13 at diagnoses (at least 2 months after any previous dose 13)
1 dose 23 12 months after 12, or at 4yo (whichever is later)
2nd dose 23 at least 5 years later

or ATSI 13 at 50, then 23 1 yr later and 23 again 5 years later
non ATSI >70 = single 13

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34
Q

age zostavax

A

70-79

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35
Q

asthma stepwise management

A
  1. as needed SABA
  2. ICS + PRN SABA
  3. ICS + LABA
  4. consider referal; ICS + LABA (medium high dose)
  5. refer
    BAse decisions on last 4 weeks
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36
Q

good control of asthma

A

daytime symptoms <2 days per week
SABA needed <2 days per week
no night symptoms

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37
Q

ICS doses in adults

A

low budesonide 100-200
medium 500-800
high >800

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38
Q

aged 1-5 stepwise asthma

A
  1. SABA PRN
  2. ICS low dose or montelukast
  3. ICS low dose + montelukast or high dose ICS - consider referral
  4. referral for add ons
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39
Q

astham stepwish management in 6-11yo

A
  1. SABA PRN
  2. ICS low dose or montelukast
  3. ICS high paediatric dose,
    ICS/LABA low dose, ICS + montelukast - consider referral
  4. referral
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40
Q

SMART therapy

A

low dose budesonide-formoterol
rapihaler 100/3 2 puffs or turbuhaler 200/6 1 inhalation
when needed

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41
Q

acute asthma attack

A

adults 12 puffs slabutamol
8 puffs ipratropium
if severe do both, start oxygen to target sats 93-95%
if life threatening
2xsalbutamol nebs + 1x ipratropium neb
start oxygen
reassess within minutes; repeat doses in 20-30mins
add ons:
- IV magnesium sulfate 10mmol IV over 20 minutes
- steroids

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42
Q

acute asthma doses in kids

A 
1-5yo: 2-6 puffs slabutamol
6-11yo: 4-12 puffs
piratroprium 4 puffs in 1-5yo, 8 puffs >6yo
1/2 neb doses in >5yo
add ons:
- IV Mg So4 0.1mmol/kg
pred 1mg/kg
aim sats 95% in kids
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43
Q

consider adrenaline in asthma when…

A

?anaphylaxis as ddx

if unresponsive, cannot inhale bronchodilators, peri-arrest

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44
Q

kids >6yo steroid doses

A

fluticasoen (flixotiode) 100-200 is low dose, >200 high

budesonide (pulmicort) 200-400 low dose, >400 high dose

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45
Q

ddx splenomegaly

A 
Massive - CML
myelofibrosis
moderate - "PLTS"
portal HTN
lymphoma
leukemia
thalassemia
Mild
hemolytic anemia
EBH, IE
SLE
sarcoidosis infiltration
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46
Q

symptoms of nasopharyngeal carcinoma

A

neck mass
nasal obstruction with epistaxis
serous otitis media

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47
Q

red flags sinusitis

A 
unilateral
bleeding
cacosmia
menignism
altered neurology
frontal swelling
orbital involvement - diploplia, decreased VA etc
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48
Q

teen assessment

A 
Home
Education & employmen
Eating and exercise
Activities
Drugs and alcohol
Sexuality and gender
Suicide, depression & self harm
Safety
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49
Q

Risk factors for open angle glaucoma

A 
increased age
black
family history
diabetes
HTN
myopia (near sightedness)
steroid use
prior vitreous surgery
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50
Q

medication classes and examples for open angle glaucoma

A

topical beta blockers - timolol
topical prostaglandins - latanoprost
alphra adrengeric agonists - brimonidine
topical carbonic anhydrase inhibitors - dorzolamide

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51
Q

tests before starting immunosuppression

A

Hep B/C, MMRV serology, quantiferon tuberculosis

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52
Q

red flag system breast cancer

A
  1. two relatives on same side
  2. first degree relative
  3. relative <50
    1 flag = moderate risk, no action
  4. flags = consider referral; annual mammograms from 40yo maybe if 1st degree relative with breast can <50
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53
Q

managament missed OCP

A

<24hrs take as usual
>24hours or missed more than one pills - take as usual and add extra protection for 7 days
if <7 pills left in packet - skip sugar pills and add 7 days condoms
if missed >1 pill missed in first seven days or new pack, or start the pack >7 days late - consider emergency contraception, + condoms 7 days

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54
Q

uliprsital acetate cautions

A

reduced effect on BMI >30 (but better than LNG EC)
use up to 120hours
delay hormonal contraception for 5 days (or reduced UPA effectiveness)

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55
Q

acronym for enquiring about abuse

A

WHO LIVES
listen closely with empathy and without judgement
Inquire about needs and concerns
Validate and show you understand and believe them
Enhance safety, discuss a plan to protect themselves
Support with referrals and follow up

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56
Q

antibodies in Post partum thyroiditis

A

TPO Ab high titre, normal ESR

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57
Q

Graves disease Abs

A

TSH R Ab +. TPO Ab often+ also

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58
Q

different causes of vertigo based on duration

A

seconds - BPPV
mins -hrs Menieres, vestibular migraine
days - vestibular neuritis
days - weeks : CVA, vertebrobasilar insufficiency

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59
Q

HINTS exam - peripheral if

A

+ (abnormal) head impulse test
no nystagmus, or nystagmus that is unidirectional and horizontal
NO vertical skew

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60
Q

Menieres treatment

A

low sodium diet 2-3g/day
avoid caffeine
hydrochlorothiazide
referral to auidologist for hearing aid
referral to exercise pysiology for vestibular rehab program
referral to ENT for iutnratympanic injection, + pressure therapy, surgery

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61
Q

vitiligo treatment

A

avoid sunburn
cosmetic camouflage
does not need treatment
mometasone 0.1% furoate 0.1% cream TOP
if face/body folds: pimecrolimus 1% cream TOP BD for 3 months
OR for not on face
calcipotriol+betamethasone dipropionate 5+500microg/g ointment TOP daily for 3 months

62
Q

vitiligo treatment

A
63
Q

red flags bowel cancer risk screening levels

A

4 flags = moderate risk
2nd degree relative any age = 1 flag
1st degree relative >55 = 2 flags
first degree relative <55 = 4 flags

64
Q

moderate risk bowel cnacer screening

A

iFOBT every 2 yrs from 40-49
colonoscopy every 5 years from 50-74yo
aspirin 2.5 years from 50-70

65
Q

bipolar 2

A

Depression + hypomania, no need for manic episode

66
Q

contact tracing time frame gonorrhea

A

2 months

67
Q

contact tracing chlamydia

A

6 months

68
Q

contact tracing syphilis

A

primary - 3 months + duration of symptoms
secondary - 6 months + duration of symptoms
early latent syphilis - 12 months

69
Q

contact tracing hep B/C

A

6 months prior to onset of acute symtpoms

70
Q

management hyphaema

A 
manage bleeding tendency
eye shield over eye
elevate pt's head to 30degree
maintain be drest
cyclopegia if not globe ruputre
control N/V agghressively
managfe pain - TOP and orals
opthalmology
71
Q

fundoscopy finding in retinal vein occlusion

A

sunset storm

72
Q

fundoscopy finding in retinal artery occlusion

A

cherry red spot + pale fundus

73
Q

ddx papilledema

A

malignant HTN
rasid ICP (eg, tumor, IIHT, CVST)
optic neuritis
optic nerve tumour

74
Q

fundoscopy finding hypertensive retinopathy

A 
AV nicking
copper wiring
cotton wool patchy
retinal hemorrhage
optic disc swelling
hard exudate
75
Q

diabetic retinopathy fundoscopy findings

A 
microaneurysms
dot and blot haemorrhages
cotton wool spots
neovascularisation - at disc esp
* if treatment will have evidece of photocoagulation
hardf exudates
76
Q

treatment for bacterial keratitis if delayed referral or vision threatened

A

ciprofloxacin 0.3% eye drops 1-2 drops into affected eye, every 15mins for 6 hrs; then hourly for 48hours then every 4 hours until healed

77
Q

RFs macular degeneration

A 
smoking
increased age
family history
caucasion
obesity
CV disease
78
Q

cirrhosis on excam

A

spider naevi
palmar erythema
gynaecomastia
splenomegaly

79
Q

cirrhosis on pathology tests

A

thrombocytopenia
low albumin
prolonged PT/INR
AST:PLT ratio >1.0

80
Q

treatment of keratosis pilaris

A

urea 10% cream TOP 1-2 BD after bathing

alpha-hydroxy acids (lactic acid 10-20%) TOP nocte

81
Q

causes of skin hyper-pigmentation

A 
addisons disease
cushing syndrome
ectopic ACTH syndrome
hyperthyroidism
haemochromatosis
cirrhosis of the liver
porphyria
chronic kidneyt failure
malnutrition/malabsorption
pregnancy
82
Q

ABCDE melanoma

A 
Asymmetry
Border
Color
Diameter >6mm
Evolving
83
Q

non pharm treatment of rosacea

A 
minimise factors that cuase flushing
low irritant skin care products and sunscreen
use emollient soap free cleanser
green tinted foundation
avoid topical corticosteroids
84
Q

rosacea pharm treatment

A
  1. metronidazole 0.75% gel once or twice daily 6-12 weeks
    if severe
  2. doxycycline 50-100mg PO for up to 8 weeks, repeat as required; consider minocycline if doxy not tolerated or inadequate response
85
Q

flushing ddx

A 
menopause
rosacea
emotional stress
hot/spicy food or beverages
high fever
alcohol
exercise
wind
hot baths
drugs - eg. CCBs, tamoxifen, opioids
food additives
neurologicla disorder - eg PArkinsons
carcinoid syndrome
paeochromocytoma
systemic mastocytosis
86
Q

type of tinea

A 
cruris - groin
pedis - foot
corporis - body
manuum - hands
capitis - scalp
87
Q

causes erythema nodosum

A 
sarcoidosis
strep infection
hep B infection
TB
chlamydia
IBD - Crohn's
drugs - OCP
88
Q

disease associated with granuloma annulare

A

diabetes

89
Q

pityriasis rosacea

A

herald patch
salmon pink scaly eruption
christams tree pattern
if itchy betamethasone valerate 0.02% cream TOP once daily

90
Q

pityriasis types

A

rosea - christmas tree pattern
vesicolor- patchy yeast
alba - white

91
Q

treatment pityriasis versicolor

A

miconazole 2%shampoo once daily leave for 10mins then wash off for for 10 days
econazole 1% solution TOP to wet skin, leave povernight for 3 nights
if unresponsive fluconazole 400mg PO STAT

92
Q

non pharm management elevated choldesterol

A

reduce saturated and trans fat
use monosaturated and polyunsaturated fats to replace saturated fats
improve soluble fiblre intake
plant sterols enriched diary products

93
Q

target HbA1c

A

7% usually, but can be individualised

94
Q

Psychosis signs and symtpoms

A 
alogia/poverty of content
thought blocking
loosening of association
tangentiality
clanging
word salad
perseveration
95
Q

psychosis signs

A

delusions
hallucinations
thought disorgnaisation
agitation/aggression

96
Q

types of delusions

A 
persecutory
grandiose
erotomanic
somatic
delusions of reference
delusions of control
97
Q

PTSD versus ASD

A

1 month is cut off

98
Q

screened for in heelprick test

A 
phenylketonuria
congenital hypothyroidism
cystic fibrosis (only detects 95%)
galactosemia
other rare disorders of metabolism
99
Q

causes jaundice in neonates

A

early - sepsis, hemolysis (blood extravasation, isoimmunisation)
within 2 weeks - BM jaundice, brusing, spesis, dehydration, physiological
>2 weeks - sepsis, hemolysis (G6PD), dehydration, hypothyroidism
hepatitis
biliary atresia

100
Q

anti-HBc

A

total hep B core Ab: indicates exposure to Hep B ()previous or ngoing)

101
Q

anti-HBs

A

Hepatitis B surface antibody: immunity; either immunised or previous infection with recovery

102
Q

igM antiHBc

A

IgM antibody to hep B core antigen = acute infection

103
Q

Hep B sAg

A

Hep B surface antigen = high levels during acute or chronic Hep B, indicates person is infectious

104
Q

examination questions

A

ensure general comfort/explain steps
inspection
palpation
adequate exposure

105
Q

reasons for DMMR

A 
5 or more regular medications
>12 doses of medication per day
recent significant changes to medications
narrow theraputic range of meds
symptoms suggestive of SEs
sub-optimal response to treatment
suspected non-compliance
difficulty managing meds becuase of language/literacy
cnogitive difficulties
attends a number of doctors
recent DC from hospital
106
Q

sodium intake in heart failure

A

<2g/day

107
Q

CAUSES OF thyrotoxicosis

A

toxic multi-nodular goitre
toxic adenoma
exogenous thyroid hormone
subacute thyroiditis/de Quervain thyroiditis

108
Q

treatment of mania first line meds

A
  1. olanzapine 10-15mg PO daily

1. risperidone 2mg PO daily

109
Q

IgM

A

acute, then usually reduces

110
Q

IgG

A

takes time to develop and then persists

111
Q

diagnostic criteria in PTSD

A

need all of A
A. exposure to event
B. intrusion symptoms - at least once i./e. flashbacks
C. avoidance
D. negative alterations in cognition - at least 2; persistent guilt, disassociative amnesia
E. alteration in arousal/reactivity - at least 2 of - hypervigilance, irritable
F. duration of distrubance > 1/12
G. causing impairment/significant distress
H. Not attributable to substances

112
Q

Lithium monitoring

A

serum lithium every 3-6 months
electrolytes and eGFR 3-6 months
TSH 6-12 months
Ca every 12 months - screen for hyperparathyroidism

113
Q

causes hyponatremia - hypervolemia

A

heart failure, renal failure, liver cirrhosis, nephritic syndrome

114
Q

evolemia causes hyponatremia

A 
SIADH - drugs, malignancy
hypothyroidism
psychogenic polydipsia
pain
nausea
115
Q

hypovolemic causes hyponatremia

A 
vomiting/diarhea
burns
thiazides
hypopituitarism
adrenal insufficivnency
116
Q

ddx schizophrenia

A

schizophreniform - >1/12, but <6/12
Schizoaffective disorder - major mood episodes also
delusional disorder - not criterai for schizophrenia disease
brief psychtic episode < 1 month
schizotypal personatlity disrder - “persavive pattern”
major depressive disorder with psuychotic features
bipolar depression with psychotic features

117
Q

medical ddx psychosis

A 
delirium - electrolytes
endo - thyroid
hepatic/uremic encephaloptahty
SLE, MS
acute intermittent porphyria
dementia with Lewy bodies
space occupying lesions
vit B12 def
118
Q

first generation antipsychotics

A

chlorpomazine

haloperidol

119
Q

2nd generation antipsychotics

A 
ariprazole/abilify
cloazpine
olanzapine
quetiapine
risperidone
paliperidone
120
Q

side effects of antipsychotics

A

pseudoparkinsonism
acute dystonia
akathisia
tardive dyskinesia

121
Q

delirium pharmacological management

A
  1. hapoeridol 0,5mg PO STAT
  2. olanzapine 2.5mg PO STAT
  3. risperidone 0.5mg PO STAT
    if IM - haloperidol 0.5mg IM, olanzapine 2.5mg IM
122
Q

drugs to avoid in parkinsons

A

haloperidol

metoclopramide

123
Q

drugs that cause delirium

A 
anticholinergics
benzos
opioids
steroids
NSAIDs
dopaminerdis - levodopa
soltalol/propanolol
alcohol, drugs
124
Q

anticholinergic drugs

A 
sedating antihistmaines - doxylamine
oxybutyning
antipsychostics
TCAs - endep
benztropine
prochlorperazine
hyoscine hydrobromide
125
Q

delirium prevention

A 
hydration, nutrition
pain relief
sleep
visual/heaqring mimpairment
avoid restraints
lighting
quiet
singlew rooms
clock and calendar
family
126
Q

improving medication compliance

A 
webster pack
eudcation re outcome of poor ocmpliance
HMR
home visit nurse
subsidies for medications
involve appropriate nurses - AHW, diabetic educator
involve family with permission
127
Q

TIME acronym for ulcer management

A

Tissues, Infectionm, Moisture, Edge

128
Q

ABI measurements

A

<0.5 arterial disease, >0.9 venous diease

129
Q

hydrogels - examples and use

A

solosite; increase wound moisture, use in dry, scabbed, necrotic wounds

130
Q

film dressings - example and use

A

opsiyte/tegarderm - don’t absorb or create moisture, but can keep moistuyre in; use if nil to low level exudate

131
Q

hydrocolloid dressing - example and use

A

eg duoderm/comfeel; give soft moisture bed; use in low to moderate exudate

132
Q

abdorbent fibre/hydroactive polymners/polyurethane foams - eg and uses

A

eg. kaltostat, use in high exudating wounds to manage moisture without maceration

133
Q

medications for dementia

A

donepezil
galantamine
rivastigmine
memantine

134
Q

causes of abnormal uterine bleeding

A 
PALM-COEIN
Polyp
Adenomyosis
Leiomyoma
Malignancy and hyperplasia
Coagulopathy
Ovulatory dysfunction
Endometrial
Iatrogrenic
Not yet classified
135
Q

topical treatment lichen sclerosus

A

betamethasone diproprionate 0.05% in optimized vehicle BD until itch resolves then wean

136
Q

complications of snake bites

A

coagulopathy
neurotoxicity - ptosis first sign
myotoxicity - rhabdomyolysis
acute kidney injry

137
Q

treatment of meningitis pehospital transfer

A

ceftriaxone 50mg.kg p to 2g; IM or IV

138
Q

breast cancer red flags risk categories

A 
1 = avg risk
2 = moderate risk = annual mammogram >40yo, if relatives diagnosed <50yo
139
Q

breast cancer red flags

A

2 relatives with breast cancer on same side of family
first degree relative
relative <50yo

140
Q

levonorgestrel emergency contraception

A

1.5mg PO ASAP
within 96 hours
if BMI >26 or 70kg consider 2x dose
interacts with liver inducers - give 2x dose

141
Q

Ulipristal acetate

A 
30mg PO STAT
within 5 days
decreased effect if BMI >30/>85kg
don't 2x dose
interacts with liver enzymes
stop OCP for 5/7
don't give with steroids
142
Q

Implanon true name

A

Etonogestrel implant 68mg subdermally

143
Q

normal PR interval

A

3-5 small squares

120-200msec

144
Q

normal QRS

A

2.5 small squares

70-100msec

145
Q

QTc

A

M <440msec

F <460msec (12 small sqauers)

146
Q

pathological Q wave

A 
first negative defelction after P wave
needs to be 
>1 small square wide
>2mm deep
leads V1-V3 25 % QRS depth
147
Q

Rheumatic fever diagnostic criteria - how many required

A

initial - needs 2 major OR 1 major and 2 minor
AND evidence of step pyogenese infection
recurrent - 2 major, or 1 major + 1 minor, or 3 minor

148
Q

Major manifestations of acute rheumatic fever

A 
carditis
polyarthritis or aseptic monoarthritis
chorea
erythema marginatum
subcutaneous nodules
149
Q

minor manifestations of acute rheumatic fever

A 
high risk pt -
monoarthralgia
fever >38
ESR/CRP >30
prolonged PR
all others
polyarthralgia
fever >38.5
ESR >60, CRP >30
prolonged PR
150
Q

sensitivity

A

= true +/true positive + false negative (i.e. everyone with diease)

151
Q

specificity

A

true negatives/false positives + true negatives (i.e. all those who do not have disease)

152
Q

haemochromatosis genotypes

A

C282Y - homo righ risk

H63D

Gp Exam Study (5 decks)

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