Recall May Part 1 2024 Flashcards
What is the surgery indication for a popliteal artery aneurysm?
Diameter > 2.5 cm
What is the surgery indication for splenic and renal artery aneurysms?
Diameter ≥ 2 cm
What is the preferred investigation for a primary brain tumor?
MRI
What stage is Duke C3 in colorectal cancer (CR) and what surgery is indicated?
Duke C3 (local lymph node involvement); Full colectomy
What enzyme is related to the efficacy and metabolism of allopurinol?
Cytochrome P450 (CPY 450)
What genetic testing is recommended before starting allopurinol in certain populations?
HLA-B*5801 screening
What imaging is used for anterior and lateral neck masses versus posterior neck masses?
Anterior and Lateral Neck: Ultrasound; Posterior Neck: CT for high malignancy suspicion
What is the likely cause of toddler diarrhea?
Lactose intolerance
How do the histories of appendicitis and mesenteric adenitis typically differ?
Mesenteric Adenitis: Long history of symptoms; Appendicitis: Acute presentation
What hormone level is indicative of a prolactinoma?
Prolactin > 4000
What initial management step is recommended for SVT with a heart rate > 200 and < 200?
> 200: Consider electrical shock if unstable; <200: Use Valsalva maneuver; if ineffective, consider adenosine
How does the location and pain of lymph nodes indicate infection or non-infection?
Painless Below Ligament: Likely non-infected; Painful: Likely infected
Which nodes are located above and below the inguinal ligament?
Above Inguinal Ligament: Inguinal nodes; Below Inguinal Ligament: Femoral nodes
What follow-up procedure is indicated for HPV types 16 and 18 in cervical cancer screening?
Colposcopy
What are common causes of nocturia in men?
BPH (Benign Prostatic Hyperplasia) and prostate cancer
What mnemonic helps remember the causes of acute pancreatitis, and which two causes are specifically mentioned?
“I GET SMASHED” - Steroids and Scorpion can cause pancreatitis”
• I: Idiopathic (unknown cause) • G: Gallstones • E: Ethanol (alcohol) • T: Trauma • S: Steroids • M: Mumps (and other infections) • A: Autoimmune disease • S: Scorpion sting • H: Hypercalcemia / Hyperlipidemia • E: ERCP (Endoscopic Retrograde Cholangiopancreatography) • D: Drugs (certain medications)
What is a common symptom of temporal arteritis?
Headache in 70-80% of patients
What are the symptoms and treatment for salivary duct issues related to chewing problems and high temperature?
Chewing Problem: Obstruction (sialolithiasis); High Temperature: Sialadenitis (infection); Treat bacterial infection with ceftriaxone
What type of fractures are indicated by horizontal and vertical patterns in orbital fractures?
Horizontal: Zygomatic fractures; Vertical: Orbital fractures
What are the initial and best investigations for mesenteric ischemia, and associated findings?
Initial: X-ray (thumbprinting sign); Best: CT angiography; Associated: Lactic acidosis, AF on ECG
What are the typical early and late post-operative complications related to stents?
Early: Stent cardiac tamponade; Late: Stent thrombosis (e.g., 5 days)
How do TSH levels differ in secondary hypothyroidism and subclinical hypothyroidism?
Secondary Hypothyroidism: TSH normal, issues outside thyroid; Subclinical Hypothyroidism: Elevated TSH, normal T3/T4
What is the recommended change in antipsychotic medication for schizophrenia with delusions?
Stop haloperidol, start quetiapine
What is the initial and best investigation for suspected PE in pregnant women?
Initial: ECG if no VQ scan available; Best: CTPA
How do ACL and meniscus injuries typically present regarding swelling?
ACL: Immediate swelling; Meniscus: Swelling later
What is the first step in the infertility workup?
Test sperm before evaluating the woman
What type of fluid is recommended for isotonic loss?
Isotonic fluid
What is the treatment progression for motor and vocal tic disorders?
Motor Tic: Start with psychotherapy, then risperidone; Vocal Tic: Consider Tourette’s
What asthma medication is recommended for children over 5 years?
Fluticasone
What is the management for renal masses based on size?
<1 cm: Observe; <4 cm: Partial nephrectomy; 4-7 cm: Total nephrectomy; >7 cm: Radical nephrectomy; Biopsy required if ≥3 cm
What is essential for glucose control in diabetes before driving?
Ensure normal glucose levels
What is the next best step and subsequent investigation for chronic elbow pain in a carpenter?
Next Best: MRI; Then: Ultrasound
What is a known side effect of long-term ACE inhibitor use?
Angioedema
What is the initial and confirmation step for neonatal sepsis management?
Initial: Blood culture; Confirmation: Lumbar puncture after blood culture
What medications are used for remodeling in heart failure?
Beta-blockers, ACE inhibitors, spironolactone, SGLT2 inhibitors
What is the likelihood of renal stones <7 mm passing naturally?
Likely to pass naturally
What is an alternative treatment for osteoporosis when bisphosphonates are contraindicated?
Strontium
What is the first-line treatment for surgical menopause? Or menopause
Hormone Replacement Therapy (HRT)
What knee injury triad
Knee Injury Triad
involves ACL, medial meniscus, and MCL?
What is the treatment for cat scratch disease with and without systemic symptoms?
With Systemic Symptoms: Cephalexin; Otherwise: Flucloxacillin
What drugs can cause postural hypotension?
Thiazide diuretics, nitrates, SSRIs, and CCBs
Which diuretic has less impact on hyperlipidemia?
Indapamide
What are the recommended treatments for hypertension in pregnancy for simple and emergency cases?
Simple: Methyldopa; Emergency: Labetalol
What is the management strategy for hypertension by age and ethnicity?
> 55 Years: Diuretics; <55 Years: ACE inhibitors; African Descent: Diuretics for <55 years
What is the survival expectation for TGA with VSD and ASD?
Survival more than one day
How do the recovery times for vasovagal syncope and HOCM compare?
Vasovagal: Recovers within minutes; HOCM: Longer recovery, family history
What is the treatment for SVT in patients with asthma?
Verapamil
What imaging modalities are used for diagnosing an aortic aneurysm?
X-ray, CT, Echo
What is a known complication of cyclophosphamide?
Painful hematuria
What symptom confirms delirium tremens?
Visual hallucinations (seeing insects on the wall)
Why is diazepam preferred in pregnancy for certain conditions?
Longer half-life, fewer doses needed
What condition is associated with anti-histone antibodies?
Drug-induced lupus, systemic lupus erythematosus (SLE)
At what ages are FOBT and CRC screenings recommended for categories 1 and 2?
- No family history: No relatives with colorectal cancer.
- One first-degree relative (e.g., parent, sibling) diagnosed at age 60 or older: Slightly above average risk.
- One first-degree relative diagnosed before age 60.
- One first-degree relative plus one or more second-degree relatives (e.g., grandparent, aunt/uncle) diagnosed at any age.
- Two first-degree relatives diagnosed at any age.
- Two first-degree relatives plus one second-degree relative, with one diagnosed before age 50.
- Two first-degree relatives plus two or more second-degree relatives diagnosed at any age.
- Three or more first-degree relatives diagnosed at any age.
- Include both sides of the family.
- Verify family history information as patients’ reports may be inaccurate.
- Update family history regularly.
- Screening: iFOBT every two years from age 45 to 74.
- Aspirin: Consider low-dose (100 mg) daily from age 45 to 70.
- Screening: Colonoscopy every five years from age 50 or 10 years younger than the earliest diagnosis, up to age 74.
- Aspirin: Consider low-dose (100 mg) daily from age 45 to 70.
- Screening: Colonoscopy every five years from age 40 or 10 years younger than the earliest diagnosis, up to age 74.
- Aspirin: Consider low-dose (100 mg) daily from age 45 to 70.
- Referral: Consider referral to a family cancer clinic.
By simplifying the categories and screening recommendations, this information should be easier to understand and follow.
Category 1: Age 60; Category 2: Age 50
Organised screening by iFOBT is recommended for the asymptomatic (average risk) population from 50 years of age every two years (A) until 74 years of age with repeated negative findings.- racgp
What is the initial management for Perthes disease?
Crutches, physiotherapy
What is the first-line treatment for alcohol dependence?
Naltrexone; Second-line: Acamprosate
What is the initial management for uterine atony?
Uterine massage and oxytocin
What blood loss defines post-partum hemorrhage (PPH) for vaginal delivery and C-section?
Vaginal Delivery: >500 mL; C-section: >1000 mL
What is the next step after antibiotics for empyema management?
Intercostal drainage (chest tube)
What is the best investigation for eosinophilic esophagitis?
Endoscopy with biopsy
What are common symptoms of tinea pedis?
Itching, scaling, skin cracks
What is the first-line treatment for tinea?
Terbinafine 1% cream
What characteristic rash is associated with scabies?
Raised papules, burrows
What management steps are taken for developmental dysplasia of the hip (DDH) based on age?
0-6 Months: Pavlik harness with traction; 3-18 Months: Closed or open reduction, pelvic cast; >18 Months: Open reduction
What are the management steps for a Bartholin cyst?
Persistent: Incision with catheterization; Recurrent: Marsupialization; Abscess: Incision and drainage
What are the initial and best investigations for a femoral aneurysm?
Initial: Ultrasound; Best: CT angiography
When should a caval filter be considered?
Repeated PE
What criteria diagnose SIADH?
Hyponatremia, low serum osmolality (<275 mOsm/kg), urine osmolality >100 mOsm/kg
