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Year 4 things I forgot > Revison > Flashcards

Revison Flashcards

1
Q

What is lithium use in pregnancy associated with

A

Epsteins anomoly

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2
Q

To check a women is ovulating which hormone would you measure and when

A

Progesterone on day 21 (If normal cycle length)

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3
Q

First line treatment for HG in pregnancy

A

First-line treatment is with anti-histamines that also have anti-emetic effects such as cyclizine, prochlorperazine or promethazine

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4
Q

4 causes of neonatal hypotonia

A

Hypothyroidism
Sepsis
Prader Wili
Werdnig-Hoffman disease (spinal muscular atrophy type 1)

(maternal benzos)

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5
Q

30 F with PCOS with PV bleeding

A

Very high risk uterine cancer as not shedding

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6
Q

Over 40 with new onset IBS

A

do a CA125

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7
Q

Medication used to suppress lactation in breastfeeding women

A

Cabergoline

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8
Q

When do you give an levongesterol double dose

A

BMI over 26

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9
Q

Can statins be used in pregnancy

A

NO

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10
Q

Anti-emetic to use in hypercalacemia or poor renal function

A

Haloperidol

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11
Q

If breast cancer ER+ve pts have bone mets. How to treat?

A

Still use hormonal therapy not radiotherapy

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12
Q

Performance status scale

A

0 normal. 4 bedridden.

0 = normal, 1 = symptomatic & ambulatory cares for self, 2 = ambulatory >50% time, 3 = ambulatory <50% time nursing care required, 4 = bedridden

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13
Q

Treatment for DUKES:C

A

Surgery then chemo

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14
Q

Two not ‘medical’ tests for meningitis

A

Kernigs and brudzinkis

Kernigs - cannot extend Knee
Brudzinkis - when patients neck is flexed, there legs will too

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15
Q

When doing the cover test for a squint which eye moves

A

The one with the squint. Away from where the squint is.

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16
Q

What is topical podophyllum used for?

A

Multiple non keritinized warts

Crirytherapy if kerintinized

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17
Q

After a patient has a catheter ablation, do they still need to take apixiban

A

Yes risk of stroke is same

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18
Q

First line treatment for black T2DM with HTN

A

ARBs

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19
Q

CF change in nose

A

Nasal polopys

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20
Q

Pre eclampsia definition

A

> 140/90 and proteinuria or organ dysfunction

After 20 weeks

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21
Q

How long after emergency contraception should women not take hormonal contraception

A

Levongesterol - as normal

Upistral - 5 days

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22
Q

After what age should enuresis stop

A

5 years

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23
Q

Hb cut off for iron in pregnancy

A

115 for non pregnant women
110 in early pregnancy
105 in late pregnancy
100 post partum

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24
Q

When may heparin be used in a PE

A

In patients bleeding or very high bleeding risk

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25
Q

What ctkub in stones

A

unenhanced

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26
Q

When starting new anti HTN what is acceptable creatine rise

A

less than 30%

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27
Q

What should T2 DM pts with HF receive

A

SGLT-2 inhibitor

-liflozin

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28
Q

Greatest risk factor for TPPN

A

C Section

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29
Q

Causes of a raised AFP in pregnancy

A

Abdominal wall defect

Neural tube defect

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30
Q

Why deliver babies in mums with obstetric cholestasis at 37 weeks

A

Increased risk of still birth

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31
Q

What is hypospadiasis associated with

A

Undescended testicles

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32
Q

When can you feel a carotid pulse in a child

A

Over 12 months

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33
Q

How long before conception does methotrexate be stopped

A

6 months for men and women

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34
Q

Best imaging for adenomyosis

A

MRI

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35
Q

Causes of U waves on ECG

A

Hypokalaemia

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36
Q

ECG changes in hypokalaemia

A

Flat T waves
U waves (bump after T)
Long PR

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37
Q

Key side effect of ondansetron

A

Constipation

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38
Q

How to treat patients under 65 with AF differently

A

Rhythm control by shock

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39
Q

Morphine to diamorphine conversion

A

1/3rd

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40
Q

When is rivastigmine used and what is a contraindication

A

Alzheimer’s

Bradycardia

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41
Q

3 key drugs used in chronic ETOH management

A

Disulfram
Acamprosate
naltrexone

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42
Q

How does disulfram work

A
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43
Q

What contraception can a patient taking carbamazepine have

A

non hormonal

COCP and POP UKMEC3
Implant UKMEC2

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44
Q

What age do you adjust development mile stones from in babies born prem

A

40 weeks

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45
Q

How to manage Seborrhoeic dermatitis in children

A

Cradle cap
Baby oil and baby shampoo
Hydrocortisone if needed

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46
Q

Rubella in pregnancy complications

A

PDA
Congenital cataracts
Sensorineural deafness

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47
Q

Which antibiotic may you be concerned in prescribing in women who are on COCP/ POP

A

antibiotic alters the P450 enzyme system, for example, rifampicin

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48
Q

FBS pH range which is abnormal

A

Less than 7.25 -7.20 borderline

Less than 7.20 abnormal

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49
Q

Most common site of breast cancer

A

Upper outer quadrant

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50
Q

How do you manage patients with a GCS of 14 2 hours post head injury

A

CT within 1 hour

GCS <15 after 2 hours
GCS <13 on initial assessment

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51
Q

A patient vomits twice after a head injury how do you manage

A

CT

More than one vomiting episode after a head injury -> CT

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52
Q

What is injured in Erbs palsy

A

C5 C6

Waiters tip arm

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53
Q

ES murmur louder on inspiration ->

A

Pulmonary stenosis

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54
Q

When is clarithromycin given in pregnancy

A

It is not - increased risk of miscarriage

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55
Q

What diluent do you use in syringe driver

A

Water for injection

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56
Q

Common doses for PRN anticipatory drugs

A

Midazolam : 5mg
Levomepromazine: 6.25mg
Hyoscine hydrobromide: 20mg

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57
Q

How many days must a death be registered in

A

5 days

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58
Q

Where are the initial changes in the brain in Altzhimers

A

Temporal lobe

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59
Q

What emergency contraception cannot be used in pts with asthma

A

Ulipristal acetate

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60
Q

two main side effects of miterazapine

A

sedation and increased appetite

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61
Q

mx of chlamydia in pregnancy

A

Azithromycin

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62
Q

Most common organism in catheter associated UTIs

A

E coli

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63
Q

BV gram stain

A

Mixed gram positive and negative bacteria

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64
Q

What can help reverse cervical mild dyskariosis

A

Stopping smoking

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65
Q

Management of women with a thin cervix (less than 25mm)

A

Vaginal progesterone

Between 16 and 24 weeks

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66
Q

most common cause of death in early pregnancy

A

ruptured ectopic

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67
Q

Where should you press when performing Barlows test

A

Lesser trochanter

68
Q

repeated flexion of head/arms/trunk followed by extension of arms

A

Infantile spasms

69
Q

Why would you be worried if T21 child starting rugby

A

Risk of atlanto-axial instability

70
Q

Therapy in personality disorder

A

DBT

71
Q

Important Acetylcholinesterase inhibitors contraindication

A

Bradycardia
Upper GI bleed

Use metamanine instead (glutamate blocker of NMDA receptor)

72
Q

Patient is taking lots of lorazepam, how do you help them cut down

A

Switch to diazepam then slowly reduce

Longer half life and easy to titrate

73
Q

How many people are needed for a MHA assesment and what must they have

A

3

AMHP
2 doctors: 1 section 12, 1 prior knowledge of patient

74
Q

How to test for capacity

A

2 stage:

Disorder of mind or brain
AND
Unable to make a decision because of …

75
Q

What is an SNRI

A

Serotonin and noradrenaline reuptake inhibitor

76
Q

Does of IM adrenaline in a 5 year old

A

150mcg

77
Q

Does of IM adrenaline in a 11 year old

A

300mcg

150 if under 6
300 6-12
500 (adult dose) greater than 12

78
Q

What is Potters syndrome

A

Consequence of oligohydraminos

Clubbed feet, pulmonary hypoplasia and cranial abnormalities

79
Q

Clubbed feet, pulmonary hypoplasia and cranial abnormalities

A

Potters syndrome

Oligohydraminos

80
Q

In what condition are TAU proteins found

A

???

Alzheimer’s

81
Q

What is herpes virus 3

A

VZV

Chickenpox

82
Q

How does Aminophylline work

A

Phosphodiesterase inhibitor

83
Q

Second line pharmacological treatment in ADHD

A

Atomoxetine

Noradrenaline reuptake inhibitor

84
Q

2 key dx of a child with an early hand preference

A

CP

Spastic hemiplegia

85
Q

What is Jarisch-Herxheimer Reaction

A

Reaction to giving Benzathine benzylpenicillin to patient with syphillis

86
Q

Medical treatment of syphillis

A

Benzathine benzylpenicillin

87
Q

Which antibody class is generally seen in an acute infection

A

IgM

IgG later on

88
Q

Difference between rickets and osteomalacia

A

Rickets in children

89
Q

chorioretinitis, hydrocephalus, and intracranial calcifications dx

A

Congenital toxoplasmosis

90
Q

What is cushings triad

A

Increased blood pressure, bradycardia and irregular breathing

91
Q

Malignant hyperthermia treatment

A

Dantrolene

Active cooling

92
Q

What is “blue dot sign” associated with

A

Torsion of eppidimayl appendage

93
Q

What is Amstel criteria used for

A

BV

94
Q

Anaesthetic agent with anti epileptic properties

A

Thiopentone

95
Q

Anaesthetic agent to use in HF

A

Etomidate

96
Q

What would you use for a haemodynamically stable and unstable RSI

A

Stable: Thiopentone (fastest)
Unstable: Ketamine (increase in HR/ BP)

(Etomidate alternative as does not drop BP)

97
Q

When is amiodarone given in ALS

A

After 3 shocks

98
Q

When is adrenaline given in ALS

A

Every 3-5 mins (every 2 shocks)

99
Q

What is the sux reversal agent

A

There is not one!

100
Q

Where is pelvic binder placed

A

Under clothes

At level of greater trochanter

101
Q

When may a J wave be present and in what does it look like

A

Spike after QRS

Hypothermia

102
Q

ECG changes in hypothermia

A

Everything prolonged (PR QRS QT)
Bradycardia
J waves

Makes sense that everything slows down

103
Q

When can Sux not be used

A 
Increased ICP IOP gastric pressure
Hyperkalemia
Hyperthermia
Severe burns
MND
104
Q

Features of severe asthma

HR
RR
PEFR
One other

A

HR > 110 (125 in over 5s)
RR > 25 (30 in over 5s)
33-55%
Cannot complete full sentences

105
Q

First line drug for Alzheimer’s side effects

A

Acetylcholinesterase inhibitor (increase ach)

Diarrhoea, nausea, bradycardia, hypersecretions, bronchoconstriction

106
Q

Parovirus B19 in first half of pregnancy ->

A

Hydrop fetalis (profound anaemia)

107
Q

How many weeks after miscarriage/ termination is a PT done

A

3

108
Q

What are chorid plexus cysts associated with

A

T18

Edwards

109
Q

How to objectify obesity in kids

A

BMI on a age and gender percentile chart

110
Q

How to treat a child who has become bradycardic and stopped breathing

A

CPR 5+ 15:2

111
Q

What test is Galleazi used for

A

In DDH to see if shortening of tibia or femur

112
Q

Difference between acreta, increta and percreta

A

How deep placenta invades (alphabetical order)

Aceta: deeply to uterine wall
Increta: uterine muscle
Percreta: through whole uterus

113
Q

Painless lesion on penis with panful lymph nodes

A

Lymphogranuloma Venereum

114
Q

What type of hypersensitivity reaction is asthma

A

1

115
Q

Type of lung cancer that most commonly causes SVCO

A

Small cell

Bulky and central, causes lymphadenopathy

116
Q

If ACR is >70 what is BP target

A

130/80

If below its 140/90

117
Q

Why may you stop naproxen in a pt with HF

A

NSAIDs can worsen HF

118
Q

What anti T2DM drug is contraindicated in HF

A

Piaglitizone

119
Q

What is Barthel index

A

Measure performance/ capability of ADLs

120
Q

What is cockroft gault significance to medicine

A

Creatine clearance calculation

121
Q

When should patients on a ACEI have their UEs checked

A

After 1-2 weeks
After every increase
Yearly

122
Q

What monitoring should be done on DOACs

A

FBC annually

123
Q

Two cancers associated with Li-Fraumeni Syndrome

A

Sarcoma and leukaemia

124
Q

Which BRCA is associated with prostate cancer in men

A

2

125
Q

3 PNP syndromes associated with small cell

A

ADH
ACTH
Lambert eaton

126
Q

3 PNP syndromes associated with squamous cell

A

PTH
HPOA
Ectopic TSH

127
Q

2 PNPs associated with adenocarcinoma

A

Gynaecomastia

HPOA

128
Q

Metabolic picture in Addisons

A

Increased testosterone
Increased potassium
Low sodium

Addisons picture

129
Q

What are sanctuary sites and where are two commons ones

A

CNS and testicles

Sites where chemotherapy does not reach

130
Q

How is haemophilia inherited

A

x linked recessive

131
Q

Which investigation monitors the response of lymphoma to chemo

A

PET scan

132
Q

What is double bubble sign associated with

A

Duodenal atresia

133
Q

Main complication of Reyes syndrome

A

Liver failure (biopsy for dx) and cerebral oedema

134
Q

What is a trachelectomy and when can it be used

A

Removal of cervix

Offered in very early stage cancer

135
Q

How does the tremor of lithium change in toxicity

A

Fine tremor is normal but can become coarse in toxicity

136
Q

What is agoraphobia

A

Fear of public spaces

137
Q

Why should nitrofuratonin not be used in 3rd trimester

A

Risk of haemolytic anaemia if child has G6PD deficiency

138
Q

3 main courses of a G6PD crisis

A

Broad beans, infections and anti-malarials

139
Q

What are Heinz bodies seen in

A

G6PD

140
Q

What type of drug us duloxetine

A

SNRI

141
Q

Two signs of primary syphillus

A

Painless genital ulcer (chancre) that lasts 3-8 weeks

Local lymphadenopathy

142
Q

3 types of tertiary syphillus

A

Neurosyphilis
Aortic aneurysms
Gummatous lesions (large ugly perforating skin lesions)

143
Q

What is condylomata lata

A

Grey like warty rash associated with secondary syphilis

144
Q

What is a Argyll-Robertson pupil

A

Change in neurosyphilis

Called the prostitues pupil because it accommodates but does not react

145
Q

Type of sexual psychiatric disorders (3)

A

Hypoactive sexual desire disorder: SSRIs, enjoys sex once having it
Sexual aversion: disgust at the thought of sex
Female sexual aversion disorder: dont want sex, dont enjoy sex

146
Q

Three main tests for Syphilus and when are they each used

A

RPR and VDRL (cardiolipin) = active infection
TPHA (antibody) = immunity

PCR can be used from chancre

147
Q

What is Vaginismus

A

Tightening of vagina in response to fear or sex

148
Q

Treatment and prophylaxis of cluster headaches

A

Triptans and high flow O2

Verapamil and short course of steroids to break cycle

149
Q

Treatment and prophylaxis of migraines

A

NSAIDS, triptans

Propanolol, topiramate (teratogenic), ?B12 suplimentation

150
Q

How does Riluzole work and what is it used for

A

Stops stimulation of glutamate receptor

ALS - MND

151
Q

Close contact of meningitis prophylaxis

A

Oral ciprofloxacin (or rifampicin)

152
Q

What is Fleischners sign and what is it associated with

A

Enlarged pulmonary artery, massive PE

153
Q

How do you reverse DOAC, heparin and warfarin

A

Warfarin: vitamin K +/- beriplex (prothrombin complex)
Heparin: protamine
DOAC: beriplex (prothrombin)
dabigatran can be treated with idaruczimab

154
Q

What does clopidogrel inhibit

A

P2y12

155
Q

pharmacological cardioversion in pts with structural heart disease

A

Amiodarome

flecainide in those without

156
Q

Cells seen highest in fungal/ TB LP

A

Monocytes
Glucose low
Protein low

157
Q

First and second line in PTSD

A

Before 1 month - active monitor

1st: combat focused CBT
2nd: if 1-3 months EMDR (eye movement)

158
Q

First line treatment of OCD

A

CBT with exposure-response prevention

SSRI if severe (fluoxetine in body dysmorphia)

159
Q
A

Confirm presence of bacteriuria with second culture and begin culture dependent antibiotic

160
Q

Polyhydramnios is usually diagnosed at an AFI of >24cm (or 2000ml+). Oligohydramnios is usually diagnosed with an AFI of <5cm (or under 200ml).

A
161
Q

Polyhydraminos is most commonly idiopathic but can be caused by xyz

A
162
Q

trigeminal neuralgia 1st mx

A

carbamezapine

163
Q

What type of drugs are selegiline, rasagiline, or safinamide

A

MAO-B inhibitors (do not react with thyrosine)

164
Q

What type of drugs are Pramipexole and Ropinirole

A

Synthetic dopamine

165
Q

When is hypospidasis surgery performed

A

12 months

166
Q

“normal” APGAR score

A

Over 7

Year 4 things I forgot (7 decks)

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