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General Finals & SBA Review > Review of SBA books > Flashcards

Review of SBA books Flashcards

1
Q

Ix for CO poisoning?

A

Carboxyhaemoglobin levels

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2
Q

MEdication for polymyalgia rheumatica, think about side effects

A

Prednisolone

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3
Q

What Ix should you do for unprovoked DVT?

A

CT abdo pelvis looking for malignancy

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4
Q

Scaling skin over wounds =>

A

Psoriasis

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5
Q

First line medical management of prolactinoma

A

Cabergoline

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6
Q

Haemochromatosis features

A

HEPATOMEGALY
Tanned
Erectile dysfunction
Diabetes

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7
Q

How long do you need to stop eating/drinking before surgery

A

6hr no food

2hr no clear fluids

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8
Q

What can cocaine induce (ACS?)

A

Coronary artery spasm

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9
Q

Mx of coronary artery spasm

A

Nimodipin

Like SAH helping with spasm

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10
Q

Most common organism for malaria

A

Plasmodium falciparum

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11
Q

Painless scrotal lump
Well defined
Transilluminates

A

Epididymal cyst

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12
Q

Features of osteoarthritis

A

Assymetrical joint pain
Often base of thumb
X-ray shows LOSS
Treated with NSAIDs

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13
Q

How does atropine work?

A

It poisons the vagus nerve

Used in bradycardia to increase HR because reduces parasympathetic stimulation

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14
Q

Most likely causative organism in leg cellulitis

A

Streptococcus pyogenes

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15
Q

Swollen hard cord in the leg on background of varicose veins

A

Superficial thrombophlebitis

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16
Q

Treatment of superficial thrombophlebitis

A

Naproxen

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17
Q

Ix to consider in superficial thrombophlebitis

A

USS to exclude DVT

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18
Q

Which nerve, when damaged results in foot drop

A

Common peroneal nerve

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19
Q

Which nerve supplies sensation to the sole of the foot

A

Tibial nerve

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20
Q

Twitching in arm for 2 minutes, then stopped, felt weak for 1hr afterwards =>

A

Partial seizure

Can be precipitated by previous stroke -> damage

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21
Q

3 branches of the inferior mesenteric artery

A

Left colic
Sigmoid
Superior rectal artery

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22
Q

MEdical management of obstetric cholestasis (itching in pregnancy)

A

Ursodeoxycholic acid

Also the management for PBC

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23
Q 
Prominent headache
Nystagmus
N+V 
Can't walk straight 
Dx?
A

Cerebellar stroke

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24
Q

Treatment of venous ulcer ABPI >0.5

A

Compression stockings

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25
Q 
SMALL PUPIL 
Lacrimation
Red eye
Painful 
Hazy
A

Anterior uveitis

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26
Q 
DILATED PUPIL 
Lacrimation
Red-eye 
Painful 
Haloes 
Headache
A

Acute glaucoma

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27
Q

4H and 4Ts of MI

A

Hypoxia
Hypothermia
Hyper/hypokalaemia
HYPOVOLAEMIA

Tension pneumothorax
Tamponade
Toxins
Thrombosis

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28
Q

Differential for acutely painful scrotum in children

A

Testicular torsion

Hydatid of Morgani (embryological remnant, presents a bit more insidiously)

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29
Q

Fever
Epididymitis
+ve Prehn’s sign

A

Epidido-orchitis

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30
Q

What is Prehn’s sign

A

Pain relieved on elevation of the scrotum

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31
Q

Features of ALL

A 
Easy bruising 
Fatigue
Anaemia 
SOB 
Recurrent infections
Splenomegaly 
Pallor
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32
Q

What is benign rolandic epilepsy?

A

Usually nocturnal twitching

Activity is in the rolandic fissure = motor

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33
Q

What might the EEG show in absence seizures

A

3 spike-wave cycles

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34
Q

Symptoms of a ventricular septal defect in infants

A

Poor feeding

Breathlessness

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35
Q

Chromosome 18 congenital disorder with features

A

Edwards
Rockerbottom feet
Small jaw
Bad at boxing

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36
Q

DDx for collapse in young child

A 
Reflex anoxic seizure 
Breath-holding spells 
Febrile convulsion
Epilepsy
Arrhythmia  
Head injury
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37
Q

Prolonged jaundice in infant, past 2 weeks probably indicates…

A

Biliary atresia

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38
Q

Features of Henoch Scholein Purpura

A

Abdominal pain
Joint pain
Rash on buttocks
Can get renal failure so make sure to check up on them

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39
Q

UTi <3mo what do you do?

A

Refer to paediatrician

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40
Q

What is first line Mx of constipation in kids?

A

Movicol

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41
Q

How do you confirm coarctation of the aorta?

A

MRI

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42
Q

What happens in pulsus alternans?

A

In congestive HF there is often blood left over in the ventricle from bad pumping
The heart has to work harder with the next pump
So you get an alternating strong and weak pulse

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43
Q

Why do you get hepatomegaly in RHF?

A

Vena cava isn’t cleared so backs up into the liver

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44
Q

Signs of LHF

A

Pulmonary oedema

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45
Q

Signs of RHF

A

Raised JVP

Peripheral oedema

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46
Q

Symptoms of hypercalcaemia

A

Abdominal pains
Depression
Polyuria and polydypsia
Constipation

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47
Q

Management of hypercalcaemia

A

Urgent fluid rescucitation

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48
Q

Causes of hypercalcaemia

A

Malignant

Hyperparathyroidism

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49
Q

Translocation in CML

A

BCR ABL

9:22

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50
Q

Which drug can target 9:22 translocation

A

Imatinib

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51
Q

What is the pathophysiology of thalassaemia major?

A

No B globin
Presents int he first year
May see frontal bossing

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52
Q

Which nodes might you see in osteoarthritis

A

Osler’s and Heberden’s

They are basically osteophytes

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53
Q

Ulcer for more than 3w, what should you do?

A

Biopsy it to make sure it isn’t carcinoma

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54
Q

Antibody associated with dermatomyositis

A

Anti-Jo1

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55
Q

Features of dermatomyositis

A

Raised CK
Weakness
Heliotrope rash

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56
Q

Long QT can predispose to which ventricular tachycardia?

A

Torsade de Pointes

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57
Q

Ix for cauda equina

A

Spinal MRI

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58
Q

Mx of shingles

A

Oral acyclovir

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59
Q

Features of coarctation of the aorta

A

Pulsus alternans

Radio-femoral delay

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60
Q

Management of chronic asthma

A 
SILLI!
SABA
ICS
Leukotriene 
LABA 
Increase doses
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61
Q

When is a retrograde urethrogram used?

A

To look for urethral injury or stricture

It may be useful in pt with repeated catheterization -> stricture formation

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62
Q

Symptoms of cholesteatoma

A 
Constant sound inside your ear (tinnitus)
Dizziness (or vertigo)
Ear infection.
Earache.
Feeling of "fullness" in one ear.
Fluid that smells bad and leaks from your ears.
Trouble hearing in one ear.
Weakness in half your face.
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63
Q

Features of glue ear

A

Peaks at 2yo
May have developmental (speech and language) delay
Also known as otitis media with effusion
Hearing loss is usually the presenting feature (glue ear is the commonest cause of conductive hearing loss and elective surgery in childhood)

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64
Q

What is Bowen’s disease?

A

Early skin cancer
Red patch on the skin
Scaly
Easily treatable

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65
Q

7day old infant with grossly distended abdomen, vomiting, bloody diarrhoea, fever, bile stained vomiting

A

Necrotising enterocolitis

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66
Q

What is a keratoacanthoma

A

Its a benign lesion that pops up like a little eruption on sun exposed areas
Can progress to SCC so best to excise

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67
Q

Test for Addisons’s disease

A

Short SynACTHen test

Cortisol should rise

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68
Q

Cause of recurrent UTIs in children

A 
Vesicauteric reflux (urine travelling the wrong way)
Can get dilation of the urethra on retrograde urogram
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69
Q

Mx of vesica-uteriric reflux

A 
Prophylactic antibiotics if young and getting repeated UTI 
If older (>5yo) can consider surgery to fix the problem
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70
Q

Mx of acute cholecystitis

A

IV antibiotics, let it settle, then operate selectively 6w later to remove the gallbladder

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71
Q

Difference between biliary colic and acute cholecystitis

A

Signs of infection = fever and raised inflammatory markers

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72
Q

Surgical Mx of BPH (very symptomatic)

A

Transurethral resection of the prostate

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73
Q

Drugs for BPH

A

Tamsulosin (a blocker, reduce smooth muscle tone and decrease bladder outflow resistance)
Finasteride inhibits conversion to active testosterone

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74
Q

Cut off for abdominal aortic aneurysm Dx

A

3cm

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75
Q

Cut off for surgery for AAA

A

5.5.cm

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76
Q

Monitoring for AAA 3cm

A

Yearly

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77
Q

Monitoring for AAA 4.7cm

A

3 monthly

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78
Q

Signs of infective tenosinovitis

A

A finger that’s red and inflamed
Difficult to move
Often after penetrating trauma (e.g. cut)
It’s the infection of the tendon sheath

The thumb and little finger share a union of tendon sheaths so you can get a horseshoe shaped pattern of inflammation

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79
Q

What are Kanavel signs?

A

Tenderness over the flexor sheath
Pain on passive extension
Flexed posture of the digit
Uniform swelling of the digit

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80
Q

Mx of infective tenosinovitis

A

IV antibiotics

Consider drainage

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81
Q

How many compartments of the hand

A

4

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82
Q

What is paronychia?

A

Infection of the nail

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83
Q

What is whitlow?

A

Herpes infection of the finger

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84
Q

Back pain improved by sitting =>

A

Spinal stenosis

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85
Q

Ix for spinal stenosis

A

Spinal MRI

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86
Q

X-ray changes of ankylosing spondylitis

A

Bamboo spine

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87
Q

HLA association for ankylosing spondylitis

A

HLA-B27

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88
Q

Features of Beurger’s disease

A

Young patient with features of intermittent claudication
Pulses are not palpable but the legs are nice and warm

Its a vasculitis

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89
Q

What is Volkmann’s contracture and what causes it?

A

Brachial artery injury leads to a fixed flexion deformity and shortening on the forearm
Often after use of a plaster cast

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90
Q

Antibody associated with PBC

A

AMA

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91
Q

Cancer associated with PSC

A

Cholangiocarcinoma

92
Q

What is gastroschisis?

A

Intestines out of the abdomen in a baby

No covering

93
Q

Where is a Morton neuroma most common?

A

Between the 3rd and 4th metatarsals

94
Q

Where is the pain typically in plantar fasciitis?

A

The heels

95
Q

What type of polyp is seen in IBD?

A

Pseudopolyp

Continuos waves of inflammation lead to lots of benign growths in the bowel

96
Q

What South American disease can cause dysphagia?

A

Chagas disease

97
Q

How does neurogenic shock cause low BP?

A

Loss of sympathetic tone

Blood pools in the peripheries

98
Q

Most aggressive type of thyroid cancer

A

Anaplastic

99
Q

Most common thyroid cancer

A

Papillary cancer

100
Q

Bloody nipple discharge =>

A

Intraductal papilloma

101
Q

1st line management of open fracture after splinting

A

IV antibiotics and debridement

102
Q

Which nerve should you assess after shoulder dislocation/relocation?

A

Axillary nerve (badge area)

103
Q

Which type of melanoma occurs on the palms/soles?

A

Acral letiginous melanoma

Can also occur under the nail!

104
Q

Most common form of melanoma and typical presentation

A

Superficial spreading

Usually from a pre-existing mole

105
Q

Do cystic hygromas transilluminate?

A

Yes

106
Q

Do branchial cysts transilluminate?

A

No

107
Q

Test for myasthenia gravis

A

Tensilon test

108
Q

Initial management of acute glaucoma

A

Topical pilocarpine

109
Q

Bone cancer that shows periosteal elevation in Codman’s triange. Usually around the knee

A

Osteosarcoma

110
Q

Ix for bone cancer

A

BIOPSY

111
Q

Features of a psoas abscess

A

Fever
Flank pain
Pain on straight leg raise
Raised inflammatory markers

112
Q

Mx of psoas abscess

A

Incision and drainage

IV antibiotics

113
Q

Nerve damaged in carpal tunnel syndrome

A

Median nerve

114
Q

Congenital peripheral oedema (non-pitting) most likely is…

A

Milroy disease

Dysfunctional lymphatic system (failure of lymph nodes to develop)

115
Q

What type of aneurysm can angioplasty cause in the femoral artery?

A

A false aneurysm

116
Q

Tumour marker in ovarian carcinoma

A

CA125

117
Q

Which type of bone cancer shows ‘onion skin’ periosteal reaction?

A

Ewing sarcoma

118
Q

What is Rigler’s triad?

A

Gas in the biliary tree
Gallstones
Bowel obstruction

Triad for gallstone ileus

119
Q

Which skin lesion has a ‘stuck on’ appearance?

A

Seborrhoiec keratoses

120
Q

How do you Ix carcinoid syndrome?

A

24hr urinary 5-HIAA

121
Q

Hernia above the inguinal ligament that on covering the midpoint, still appears, most likely Dx

A

Direct inguinal hernia

122
Q

Ix and Mx of hydrocele

A

Transilluminates
Cant palpate the testis
Ix = USS
Mx = rule out sinister then give scrotal support or surgery if required

123
Q

Features of De Quervain’s thyroiditis

A

Viral infection
Initial hyperthyroid phase followed by a hypothyroid phase
Smooth enlarged thyroid
Young woman

124
Q

Which syndrome is associated with a port wine stain?

A

Sturge Weber syndrome

125
Q

Purulent vaginal discharge
Suprapubic and LIF pain
Dx?

A

PID

126
Q

Patient has cast removed and hand is very red, swollen and tender as well as sweating over the area
Dx??

A

Sudeck atrophy

Sympathetic stimulation is the cause

127
Q

Mx of sudeck atrophy

A

Physiotherapy

128
Q

Which test will be positive in an ACL tear?

A

Lachman’s test

129
Q

Symptoms of a flail chest

A

Breathless

Part of the chest is not moving how it should

130
Q

Management of a flail chest

A

Analgesia and ventilatory support

131
Q

Fluorescein and blue light reveals a dendritic ulcer on the eye, Dx?

A

Herpes keratitis

132
Q

Green discharge from the nipple =>

A

Duct ectasia

133
Q

RF for duct ectasia

A

Smoking

134
Q

Cause of lots of bilious vomiting in 1 day old infant

Mother had polyhydramnios while pregnant

A

Duodenal atresia

135
Q

Signs of a sciatic nerve injury

A

Weakness of the whole leg

Loss of sensation throughout, only spared areas are the medial leg and upper thigh

136
Q

Ix for ?urethral stricture

A

Cystoscopy

Urethrogram

137
Q

RF for urethral stricture

A

Recurrent STI
Surgery
Recurrent catheterisation

138
Q

Infant, unwell with jaw pain
Now has unilateral generalised swelling of the testis
Dx?

A

Mumps orchitis

139
Q

Mx of small pilonidal sinus

A

Antibiotics

140
Q

Mx of large pilonidal sinus

A

Excised

141
Q

Features of pilonidal sinus

A

Perianal pain at lower natal cleft
Contains hair
Press and get some discharge

142
Q

Mx of ?TIA

A

Aspirin and specialist review in <24hr

143
Q

What causes popeye muscle?

A

Proximal rupture of the biceps

144
Q

Where does the bicep join in the arm?

A

The radial tuberosity

145
Q

Features of impingement syndrome

A

Painful arc

Positive Neer’s test

146
Q

Features of a March fracture

A

Neck of the 2nd or 3rd metarsal

Often in runners/soldiers (marching)

147
Q

Name of slow growing ulcer in previously damaged skin

A

Marjolin ulcer

148
Q

Dx and Mx of a Marjolin ulcer

A

Biopsy and excision

149
Q

DDx for retrosternal pain on eating

A

GORD
Oesophageal spasm
Cancer (if other features like dysphagia and FLAWS)

150
Q

What is lymphoedema praecox?

A

Idiopathic lymphoedema (non-pitting!)

151
Q

Features of ulnar nerve damage

A

Wasting of the hand (except the thenar eminence)
Clawing of ring and little finger
Loss of power to splay the fingers

152
Q

What is Erb’s palsy?

A

Upper brachial plexus injury
Often after traumatic injury
Upper = C5 and C6 injury! (because brachial plexus is C5-T1, makes sense)
You lose sensation over the lateral forearm and arm

153
Q

What is Klumpke’s palsy?

A

Lower brachial plexus injury
C8-T1!
Present with a clawed hand and sensory loss of ulnar border of forearm and the hand

154
Q

Which incision for ?abdominal internal bleeding?

A

Midline laparotomy

155
Q

What are Langer’s lines?

A

Lines on the body that if you cross you get worse scarring, just makes sense

156
Q

Which class of shock do you first have a drop in blood pressure?

A

Class 3

157
Q

Where do you find neuropathic ulcers?

A

Glove and stocking distribution

Areas that get regular minor trauma (e.g. around edge of shoes)

158
Q

What is necrobiosis lipoidica?

A

Like pyoderma gangrenosum of diabetes

Pyoderma gangrenosum = shin ulcer in IBD

159
Q

Diagnosis of Meckel diverticulum

A

99Technetium scan

160
Q

What is a pharyngeal pouch also known as?

A

Zenker diverticulum

161
Q

What is a laryngocele?

A

A pocket of air in the trachea

Like a pharyngeal pouch in the trachea instead

162
Q

What is a fistula?

A

Abnormal connection between 2 epithelial surfaces

163
Q

How do you Ix a fistula

A

MRI scan

164
Q

Mx of anal fistulae

A

Depends on its relationship to puborectalis
If below, it can be laid open
If it passes through it, laying it open would be too higher risk of faecal incontinence, so these have a seton inserted

165
Q

What is a haematocele?

A

Trauma to testis -> swelling

Takes a while to go away but Mx should be supportive usually

166
Q

Painful, swollen testicle with a bit of a fever =>

A

Orchitis

167
Q

Most common cause of orchitis

A

Viral

168
Q

Most common cause of epididymo-orchitis

A

STI

Give antibiotics

169
Q

Signs thats +ve in epididymo-orchitis

A

+vs Prehn’s sign

170
Q

Eczema over nipple with lump underneath =>

A

Paget’s disease

171
Q

1st line Ix for swallowed object

A

Chest, neck and abdominal x-rays

172
Q

Polyuria
Polydipsia
High sodium
Low glucose

Dx?

A

Conn’s syndrome

173
Q

The physiology behind Conn’s syndrome

A

Excess aldosterone

Swapping out potassium for more sodium

174
Q

Dx of Conn’s syndrome

A

Renin: aldosterone

Aldosterone should be raised compared to renin

175
Q

Initial management of Conn’s syndrome

A

Spironolactone

176
Q

Key Ix for melaena

A

OGD

177
Q

What delineates the upper GI tract from the lower?

A

Ligament of Treitz

178
Q

Which rash appears as bumps in a circle, usually in diabetics and clears up after around a year

A

Granuloma annulare

179
Q

How do you Dx congenital adrenal hyperplasia?

A

Levels of 17-hydroxyprogesterone

ACTH stimulation test

180
Q

Presentation of CAH

A

Precocious puberty
Tall
Pubertal features

181
Q

Presentation of impetigo

A

Blisters that itch and bleed

Superficial golden-yellow crust

182
Q

Mx of impetigo

A

Start with hydrogen peroxide if very limited infection

Can progress to fusidic acid

183
Q

What type of tumour in the neck that can be moved left and right but not up and down?

A

Chemodectoma

184
Q

Reiter’s syndrome other name and Sx

A

Reactive arthritis

Can’t see (conjunctivitis)
Can’t pee (urethritis)
Can’t climb a tree (arthritis

185
Q

What is Kussmaul’s sign?

A

Rise in JVP on inspiration

186
Q

Which type of hernia might you get post-surgery

A

Incisional hernia

187
Q

Most common type of hiatus hernia

A

Sliding (95%)

188
Q

Sx of hiatus hernia

A

Dysphagia
Night cough
Acid reflux

189
Q

Tests for developmental dysplasia of the hip

A

Ortolani (posterior pressure)

Barlow (anterior pressure)

190
Q

Mx of DDH

A

Pavlik harness

191
Q

Catheter to use when passing clots

A

3 way catheter

192
Q

Mx of ascending cholangitis

A

ERCP

193
Q

Complications of ERCP

A

Pancreatitis

Perforation of the bile duct

194
Q

Ix for ?ichaemic colitis/mesenteric angina

A

Mesenteric angiography

195
Q

Scoring system for prostatic carcinoma

A

Gleason scoring

196
Q

Rest pain, ABPI = ?

A

<0.5

197
Q

Bowel obstruction with Hx of Crohn’s =>

A

Stricture formation

198
Q

Which side is classically associated with Crohn’s

A

RIF

199
Q

Swinging fever
Jaundice
Just been abroad
Dysentry

Dx?

A

Amoebic liver abscess

200
Q

Management of acute limb ischaemia

A 
Analgesia 
Call vascular surgeons 
Oxygen 
IV fluids 
IV heparin

Surgical options = embolectomy (if say from A fib)
Thrombolysis if acute on chronic

201
Q

Management of an anal fissure

A

Topical GTN (improve blood supply)
Analgesia
Stool softener

202
Q

Analgesia of choice in back pain

A

NSAID

203
Q

1st line Mx of UC to induce remission

A

Mesalazine

204
Q

Drug for acute attacks of UC

A

Steroids

205
Q

At what level does the spinal cord end?

A

L2

206
Q

What drug do you give post-menopausal women with breast cancer?

A

Anastrazole = aromatase inhibitor

207
Q

Ex and Ix for achilles tendon rupture

A

Ex = Simmonds test (feet of the bed)

Ix = MRI

208
Q

Symptoms of hyperthyroid with a thyroid bruit =>

A

Graves disease

209
Q

SALTER HARRIS criteria are…

A 
Straight along the growth plate = I
Above = II
Lower = III
Through the growth plate = IV
Rammed (compressed) = V
210
Q

What does the tibial nerve supply?

A

The sole of the foot
Flexion of the toes
Ankle jerk

211
Q

Analgesia to use for digits

A

Nerve block using lidocaine only

212
Q

Max dose of lidocaine

A

3mg/kg

213
Q

Management of a young patient with a NOF fracture intracapsular

A

Cannulated screw or dynamic hip screw

214
Q

Mx of myxoedema coma

A

IV thyroxine

215
Q

What to measure if ?insulinoma? Sx of dizziness when they don’t eat, may be putting on weight

A

C-peptide levels

216
Q

Hernia that straddles the inferior epigastric vessles

A

Pantaloon

217
Q

Imaging for young patient with a breast lump

A

USS

218
Q

Lump on the leg that disappears when lying down
Non-pulsatile
Bluish

A

Saphena varix

219
Q

Pain in knee, feels like its locking, young patient

A

Osteochondritis dissecans

220
Q

Mx of osteochondritis dissecans

A

Arthroscopic removal

221
Q

Surgery for tumours close to the anal verge (<8cm)

A

Abdominoperineal resection (think of research!)

222
Q

Surgery for achalasia

A

Heller myotomy

223
Q

How long for upper limb fractures to heal?

A

6 weeks

224
Q

How long for lower limb fractures to heal?

A

12 weeks

225
Q

Treatment for a well-demarcated, red hot area on the face

A

IV antibiotics for erysipelas

226
Q

Difference between erysipelas and cellulitis

A

Erysipelas is well demarcated

General Finals & SBA Review (8 decks)

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