Recall Flashcards by Shanxi Jen

Zieve syndrome?

Seen in severe ETOH excess
- haemolytic anaemia + jaundice + deranged LFTs + deranged lipids

Tx: alcohol abstinence

How well did you know this?

Not at all

Perfectly

What medications may lead to Li toxicity by reducing urinary clearance?

NSAIDs, thiazides, ACEi

How well did you know this?

Not at all

Perfectly

Type of seizures associated with epigastric aura and early oral automatism?

Temporal lobe seizures

How well did you know this?

Not at all

Perfectly

2nd line management for migraine prophylaxis? (If pt unable to take propranolol or anitriptyline)

Candesartan

How well did you know this?

Not at all

Perfectly

SLE treatment?

Hydroxychloroquine

How well did you know this?

Not at all

Perfectly

Effect of haemodialysis on HbA1c?

May falsely lower bc of reduced red cell life span with HD

How well did you know this?

Not at all

Perfectly

Loffler syndrome?

Eosinophilic pneumonia 2’ ascaris lumbricoides

> tropical areas such as Central America
generally self limiting and resolves within 2/52 of onset

How well did you know this?

Not at all

Perfectly

Weight gain + painful hepatomegaly + ascites + jaundice within 12 days of haematopoietic stem cell transplant?

veno-occlusive syndrome (aka sinusoidal obstructive syndrome)

> usually low Plt, high transaminases, imaging of liver showing hepatic venous congestion (nutmeg liver)

How well did you know this?

Not at all

Perfectly

Diagnosis of veno-occlusive syndrome (aka sinusoidal obstructive syndrome)?

Liver biopsy

How well did you know this?

Not at all

Perfectly

Ix of lambert Eaton syndrome assoc w malignancy?

Anti VGCC ab
Nerve conduction studies: variation of muscle action potentials

How well did you know this?

Not at all

Perfectly

Atypical pneumonia + farmer + transaminitis + blood culture negative endocarditis?

Q fever
- coxiella burnetii

How well did you know this?

Not at all

Perfectly

Management of Q fever?

Doxycycline

How well did you know this?

Not at all

Perfectly

What antibiotic may lead to theophylline toxicity (n+v, palpitations, acidosis with hypok)?

Ciprofloxacin
> CYP1A2 inhibitor > causing increased theophylline levels

How well did you know this?

Not at all

Perfectly

Empirical management of infective endocarditis in IVDU?

Flucloxacillin
> because most likely organism is staph aureus

How well did you know this?

Not at all

Perfectly

Empirical management of infective endocarditis in IVDU?

Flucloxacillin
> because most likely organism is staph aureus

How well did you know this?

Not at all

Perfectly

Difference between stage 3 and 4 diabetic nephropathy?

Stage 3: microalbuminuria (3-300mg/ day)

Stage 4: significant proteinuria with urine dip positive proteinuria. >300mg/day

How well did you know this?

Not at all

Perfectly

Family history of renal stones + radioopaque stones?

Cystinuria

Tx: hydration + urinary alkalinisation

How well did you know this?

Not at all

Perfectly

Functional B12 deficiency 2’ illicit drug use (NO inhalation)?

B12 levels may be normal -> still have SACD

-> serum methylmalonic acid and homocysteine levels high

How well did you know this?

Not at all

Perfectly

Management of poly myalgia rheumatica?

Prednisolone

How well did you know this?

Not at all

Perfectly

What is WPW?

AVRT
- re entry via accessory pathway not the AV node
So it’s a atrioventricular re-entry tachycardia

How well did you know this?

Not at all

Perfectly

Common drug causes of transaminitis?

Sodium valproate
Methotrexate
Amiodarone
Statins
Paracetamol

How well did you know this?

Not at all

Perfectly

Common drug causes of bullous pemphigoid?

Furosemide
Captopril
Penicillamine and other penicillin derivatives

How well did you know this?

Not at all

Perfectly

Management of severe leptospirosis?

IV penicillin

How well did you know this?

Not at all

Perfectly

management of cannabis induced psychosis?

atypical antipsychotic e.g. risperidone

How well did you know this?

Not at all

Perfectly

management of severe bleeding while on warfarin?

PCC

management of a solitary hot nodule if no features of malignancy e.g. thyroid adenoma?

radioiodine > high level of effectiveness + does not carry the morbidity assoc w partial thyroidectomy

management of psychosis in Parkinson's patients?

clozapine or quetiapine - usually ppl use quetiapine first because clozapine would require FBC monitoring

1st line mx of Guillain barre?

IVIG

cause of bronchiectasis + very low levels of nasal nitric acid (<250 ppb)

Primary ciliary dyskinesia

what medication can you use for Restless legs syndrome if you do not want to use ropinirole because of Parkinson's disease?

gabapentin

management of cystine stones?

can use penicillamine - urinary alkalisation + potassium citrate

management of aortic root dilation in Marfans when elective surgery is recommended (>50mm)?

valve-sparing aortic root replacement

management of lewy body dementia ?

donepezil

how to diagnose non classical CAH?

ACTH stimulation test - levels of 17OH progesterone will rise > 10

do you test for resolution of h pylori if symptoms have resolved?

first line mx of SLE with lupus nephritis?

mycophenolate mofetil

management of intractable nausea and vomiting, or agitation and distress in a pt in last few days of life?

levomepromazine

raised AFP and testicular tumour?

teratoma

what may precipitate scleroderma renal crisis?

steroids

what may precipitate scleroderma renal crisis?

steroids

HLA assoc w TEN?

HLA B1502

what may give rise to pacemaker induced VT?

undersensing of ventricular and atrial beats - may result in a stimulus being given when ventricular ectopic is also present > could precipitate VT

first line rate control for AF even if they have COPD?

bisoprolol - no evidence that BBs make COPD worse

Pacemaker: failure to capture

Failure to pace

failure to sense/ underspending

what may cause palpitations in myotonic dystrophy?

atrial tachyarrhythmias e.g. AF

management of Transthyretin (TTR) amyloidosis?

tafamidis >stabilises amyloid tetramers, reduces progression to cardiomyopathy and neuropathy

what may be given to reduce size of tumour prior to acromegaly surgery?

octreotide - somatostatin analogue

what may be given to reduce size of tumour prior to acromegaly surgery?

octreotide - somatostatin analogue

management of Addisons disease during labour?

convert steroids to IV hydrocortisone 100mg Q6H

choice of blood sugar control in NASH?

GLP1 agonists e.g. liraglutide/ semaglutide - can help w weight loss - has been shown in trials to slow NASH progression

best investigation to assess for iron deficiency anaemia?

percentage of hypo chromic red cells - >6% indicating IDA

management of poly myalgia rheumatica like symptoms 2' renal cell carcinoma? (these usually do not respond to steroids)

nephrectomy

management of diabetic macular oedema? - usually can see circle of hard exudates

anti-VEGF e.g. ranibizumab, aflibercept, bevacizumab 2nd line: focal laser photocoagulation

management of diabetic macular oedema? - usually can see circle of hard exudates

anti-VEGF e.g. ranibizumab, aflibercept, bevacizumab 2nd line: focal laser photocoagulation

best test to differentiate between ectopic and pituitary ACTH?

high dose dexamethasone test - would usually suppress pituitary ACTH not ectopic

first line mx for invasive aspergillosis infection in immunocompromised pt?

voriconazole 2nd line: amphotericin

transverse femoral fracture + long time on bisphosphonate?

remember risk of atypical femoral fracture with prolonged use of bisphosphonate

how can you test for sulfonylurea abuse?

urinary sulfonylurea testing

management of paracetamol OD if also had anaphylaxis to NAC?

restart NAC at slower dose and cover with steroids/ antihistamines

mx of CLL related AIHA?

steroids

recent SAH + new NPH?

post SAH aqueduct obstruction

first line medication to give pregnant people for constipation?

bulk forming laxative e.g ispaghula husk

management of systemic sclerosis ILD?

mycophenolate mofetil

choice of pacemaker in AV node block without AF?

DDDR (dual chamber rate modulated pacing) > record both atrial and ventricular rates and can pace either PRN

management of erythrodermic psoriasis?

ciclosporin +/- systemic steroids for rapid relief

Chronic allograft rejection causing obstructive picture in lung transplant?

bronchiolitis obliterans > tx w azithromycin first

oral abx option to cover for hospital acquired pseudomonas infection?

oral levofloxacin

delayed prosthetic joint infection + gram positive bacteria?

propionibacterium acnes

what common medications cause cholestatic joundice?

augmentin, clarithromycin, flucloxacillin, trimethoprim

mx of choice of legionella pneumonia?

levofloxacin, azithromycin

bats/ caves : infective diseases?

Marburg virus Histoplasmosis: mild (itraconazole), severe (hypoxia/ SOB- Amphotericin)

Theophylline OD within last few hrs?

Activated charcoal!!

Theophylline OD within last few hrs?

Activated charcoal!!

continuous murmur following pregnancy

mammary souffle > flow murmur from increased flow through internal mammary artery

initial treatment of Lambert eaton myasthenic syndrome?

3,4-diaminopyridine

what monoclonal antibody can you use in advanced metastatic melanoma?

pembrolizumab (PD1 receptor)

what antibiotic do you also use in tetanus infection after giving tetanus Ig?

metronidazole

most effective management of achalasia?

`heller's laparoscopic myotomy - for patients with good functional status. symptom relief in up to 90%

small bowel pneumotasis in coeliac disease?

inflammation of small bowel mucosa with passage of intraluminal gas into small bowel wall `. can be normal + no need to do anything

mx of methamphetamine psychosis?

BZD e.g. diazepam

Ciprofloxacin inhibits?

CYP 1A2

what structure implicated in hidradenitis suppurativa?

apocrine glands

management of duodenal ulcer on endoscopy + H pylori positive?

H pylori eradication + re test for h pylori at 4-8 wks

high grade dysplasia + Barrett's oesophagus mx?

refer for oseophagectomy