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Year 4 part 2 > SAQ facts > Flashcards

SAQ facts Flashcards

1
Q

What causes epigastric pain in appendicitis

A

Irritation of the visceral peritoneum which contains no somatic nerve endings at T10

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2
Q

What causes right iliac fossa pain later on in appendicitis

A

Irritation of the parietal peritoneum which does contain somatic sensation - localises the pain

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3
Q

Define diverticulosis

A

The outpouching of mucosa through the muscle wall

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4
Q

Define diverticular disease

A

Sympatic diverticulum

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5
Q

Define a hernia

A

Protrusion of a structure through the wall of cavity in which it’s usually contained

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6
Q

What causes an indirect inguinal hernia

A

Patent processus vaginalis

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7
Q

What is an obstructed inguinal hernia

A

Where GI contents cannot pass through that segment of the tract

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8
Q

What is the first line investigation of suspected appendicitis in women

A

Pregnancy test

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9
Q

What are howel jolly bodies

A

RBCs in which the nuclear remnant is still seen

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10
Q

Name two emergencies seen in acute pancreatitis

A

ARDS, DIC

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11
Q

Name two chronic complications of acute pancreatitis

A

Chronic pancreatitis
Pancreatic necrosis

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12
Q

How can we distinguish between small lbowel and large bowel on an X-Ray

A

Large bowels - look for haustrations

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13
Q

Components of gallstones

A

Bile salts, bile pigments, cholesterol and phosphlipids

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14
Q

Name tow types of gallstones

A

Pigment stones and cholesterol stones

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15
Q

What is Murphy’s sign

A

Two fingers are put under the RUQ - should cause pain.

Repeated in LUQ, if it does not cause pain - test is positive

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16
Q

What ligament separates the liver

A

Falicofrm ligament

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17
Q

When is a head tilt contraindicated

A

In head injuries where cervical spine injury is possible

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18
Q

If circulation is an issue in A-E, how many cannulas should be inserted

A

Two wide bore cannulas

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19
Q

What three structures typically break together in the knee

A

LCL
MCL
Medial meniscus

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20
Q

Why does the medial meniscus break with the LCL and MCL

A

Because it’s attached to the MCL tightly

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21
Q

What test is used to check for meniscal tears

A

McMurray’s

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22
Q

Where are autografts taken for ligament damaged in the knee

A

Hamstrings tendon

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23
Q

What criteria is used to classify intracapsular fractures

A

Graden criteria

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24
Q

What arteries supply to femoral head

A

Cervical vessels in the joint capsule , ligament tires, intramedullary bessels

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25
Q

What part of the arm does collet’ fractures affect

A

Radisu

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26
Q

What part of the bone does collet fractures affect

A

Metaphyses

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27
Q

What displacement and angulation is seen in a collet’ fracture

A

Dorsal displacement and angulation

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28
Q

Smiths’ vs Colles’ fractures

A

Smith’s sees a solar displacement and angulation

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29
Q

How should a collet’ fracture be followed up

A

Repeat X-Rays to see if reduction is adequate

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30
Q

Surgical management of colles fractures

A

Open reduction and internal fixation

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31
Q

How long does it take for collet’ fractures to resolve

A

6-8 weeks

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32
Q

Explain the mechanism of compartment syndrome

A

Swelling of healing tissues exceeds the space confined by the facia - this increases pressure in the compartment which compresses arteries and nervous supply = ischaemia

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33
Q

Two things to prevent compartment syndrome

A

Elevate the leg + use a back slab (allows injuries to swell)

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34
Q

Two benefits of a ‘box splint’

A

Limits bleeding and reduces NV compromise

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35
Q

What artery is affected if a STEMI is seen in the anterior leads

A

LAD

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36
Q

What defines a lateral lead MI

A

aVL, I, V5, V6

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37
Q

What artery is affected in a lateral lead MI

A

Left circumflex artery

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38
Q

Name two enzymes that are associated with MIs

A

Troponin and CK-MB

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39
Q

Examination findings in pulmonary oedema

A

Wheezing
Inspiratory crackles
Dullness to percussion

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40
Q

How does aspirin work

A

Inhibits Cox-2, causes reduced production of thromboxane 2 = less platelet aggregation

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41
Q

What is a capture beat on an ECG

A

Normal QRS complexes among VT signs

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42
Q

What part of the heart chamber is affected in I, II, aVF leads

A

Inferior

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43
Q

Signs of digoxin toxicity on an ECG

A

reverse tick pattern
ST Depression
T-wave inversion

V5-V6

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44
Q

How does cholesterol function

A

Inhibits HMG-CoA reductase - which stops cholesterol synthesis

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45
Q

Two signs of ypercholesterolaemia

A

Xanthelasmata and Corneal arcus

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46
Q

Name two drugs that can be used in pulmonary oedema

A

Furosemide and GTN/nitrates

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47
Q

At what BP should treatment for hypertension be definite

A

Over 160/100 mmHg

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48
Q

What criteria is used to check for Infective endocarditis

A

Dukes criteria

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49
Q

What first line investigation wouild you do for anyone with abdominal pain (gynecology)

A

Uriner Beta HCG - rule out a pregnancy!

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50
Q

How is methotrexate given

A

IM

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51
Q

Bedside investigations for HG

A

Urine dipstick to look fo rketones (starvation)

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52
Q

How should HG be managed

A

IV Thiamine and prochlorperazine

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53
Q

Two conservative management of menorrhagia

A

Mirena coil and endometrial albation

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54
Q

Describe CIN

A

CIN is the premalignant condition in qhixh abnormally dividing cells invade the epithelial layer but not the basement membrane

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55
Q

Management of CIN III

A

Large loop excision of the transition zone

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56
Q

How to check for cervicla mets

A

CT

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57
Q

Name two characteristic signs of Endometriosis on examination

A

Uterosacral liagemnt nodules
Fixed retroverted uterus

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58
Q

Two risk factors of endometriosis

A

FH
Smoking

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59
Q

What is seen in a clotting profile of someone with a placental abruption

A

Hypofibrinogemia: as placental damage causes thromboplastin to be released into circulation = DIC. Fibrinogen gets used up

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60
Q

Risk Factors of a placental Abruption

A

IGR
Previous Abruption
Smoking
Cocaine
Hypertension
Pre-Eclampsia

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61
Q

Define antepartum haemorrhage

A

Bleeding from the genital tract after 24 weeks’ gestation

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62
Q

Risk Factors of placenta praaevia

A

Twin/Multiple Pregnancy
Age
Scarred Uterus

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63
Q

Symptoms of Pre-Eclampsia

A

Nausea, vomiting, headaches, brisk reflexes, oedema

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64
Q

Name three causes of CAP

A

S. pneumoniae, h. influenzae, m. pnuemoniae

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65
Q

IN which condition is bronchial breathing seen in

A

Consolidation

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66
Q

Two differentials that can be mistaken for pneumonia

A

Pleural effusions

Pneumothoraxes

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67
Q

Why is RIPE given in TB

A

To combat multidrug resistance

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68
Q

How long is RIPE given for Tb meningitis

A

12 months

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69
Q

Two complictaions of bronchiectasis

A

Pneumoia and pneumothoraxes

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70
Q

What test is used to check for superior vena cava onstruction

A

Pemburton’s test

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71
Q

Name two causes of extrinsic allergic alveolitis

A

Farmer’s lung
Bird fancier’s lung

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72
Q

Two findings on an X-Ray for pulmonary fibrosis

A

Honeycomb lung and reticulnodular shadowing

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73
Q

Symptoms of exterinsic allergic alveolitis

A

4-6 hours after being exposed to the allergen, they develop a fever and dry cough

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74
Q

Two risk factor for obstructive sleep apnea

A

Enlarged tonsils

Enlarged Adenoids

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75
Q

ECG findings in cor pulmonale

A

Right axis deviation

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76
Q

Lifestyle changes for sleep apnoae

A

Lose weight, stop alcohol intake

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77
Q

What is seen under a biopsy for sarcoidosis

A

Non-caseating granulomas

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78
Q

Extra pulmonary manifestations of sarcoidosis

A

Erythema nodosum
Anterior Uveitis
Neuropathy
hepatosplenomegaly

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79
Q

Two peices of advice to tell someone starting on steroids

A

Bring a steroid card at all times
Do not stop taking it suddenly

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80
Q

Management of a persistent pleural effusion

A

Pleurodesis with lac, bleomycin and tetracycline

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81
Q

Where should a pleural tap be done; above or below the rib

A

Above the rib to avoid hitting the neurovascular bundle under the rib

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82
Q

Two reasons we would check a renal USS in AKI

A

To check renal size and exclude obstruction

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83
Q

Two causes of ckd

A

Hypertension
Glomerulonephirtis
PCKD
Pyelonephritis

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84
Q

What is stage 5 CKD

A

< 15

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85
Q

Symptoms of stage 5 ckd

A

Pallor
uraemic tinger
Hypertension

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86
Q

Calcium levels in tertiary Parathyroidism

A

HIgh

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87
Q

What test would you order to check for rhabdomyolysis

A

Urinary myoglobin

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88
Q

Three features of hyperkalaemia

A

Tall tented t waves
Broad qrs complexes
Flat p waves

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89
Q

How is Calcium gluconate given

A

10ml of 10% IV over 5 minutes

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90
Q

Management of granulomatosis with polyarthritis

A

Steroids

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91
Q

Define nephrotic syndrome

A

Proteinuria (>3 g/24 hours) AND hypoalbuminaemia (<30g)

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92
Q

Most common cause of nephrotic syndrome in adults

A

Membranous nephropathy

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93
Q

Dietary management of nephrotic syndrome

A

Salt restirtcion and normal protein intake

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94
Q

Two complictaions of nephrotic syndrome

A

Thromboembolism and Hyperlipidaemia

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95
Q

How to calculate serum osmolality

A

positive cations * 2 + glucose + urea

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96
Q

What is a consequence of overcorrection of low sodium ions

A

Central pontie myelynolysis

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97
Q

Three ways to prevent urinary tract infections

A

Wipe front to back
Cranberry juice
Urinate after sexual intercourse

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98
Q

Name two contraindications to a renal biopsy

A

Abnormal coagulation studies

CKD with small kidneys

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99
Q

Three complications of a renal biopsy

A

Infections

Haematuria

Right flank pain

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100
Q

What histological finding would be found in IGA nephropathy

A

C3 deposits and IgA deposits

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101
Q

three signs of rheumatoid arthritis on an x ray

A

Juxtaarticular erosions
Loss of joit space
Soft tissue swelling

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102
Q

how to nsaids work

A

COX inhibitors - causes less prostaglandins to be released so reduces inflammation

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103
Q

Two x-ray findings in gout

A

Soft tissue swelling and periarticular erosions (happens later on)

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104
Q

Where is pseudogout typically found

A

Knee, hips and wrists

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105
Q

Two causes for pseudogout

A

Hypothyoridisjm and hyperparathyroidism

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106
Q

What murmur is heard in Ankylosing Spondylitis

A

Aortic Regurgitation

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107
Q

6 signs of Acromgealy

A

HIGH blood pressure
Bitemproal hemianopia
Prognathism
Headaches
Voice changes
Frontal bossing

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108
Q

Why is an OGTT done in acromgealy

A

An increase in glucose will stop GH production - does not happen in acromegaly

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109
Q

Where does the thyroid gland originate embryologically

A

Foramen caecum

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110
Q

Where is ADH produced

A

Posterior pituitary gland

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111
Q

Where is IGF-1 produced

A

Anterior pituitary gland

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112
Q

What is the oral glucose tolerance test

A

A 300ml drink containing 75g of glucose is taken/ A pre drink glucose level is taken and a post drink after 2 hours is taken

After 2hours: 11.1 mmol/l = diabetes

Before drinking: Over 7 = diabetes

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113
Q

Name two ways DKAs occur physiologically

A

More gluconeogenesis by the liver and lipolysis of fatty tissues

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114
Q

What should people on steroids be advised

A

How to convert dose changes during intercurrent illness, carry a steroid card and bring an ampoule of hydrocortisone when oral itake is limited

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115
Q

Management of prolactinomas

A

Cabergoline

Or Surgery/Radiotherapy

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116
Q

A diabetic woman comes into the clinic complaining of vomiting, what’s ahppening

A

Autonomic gastroparesis (a typce of neuropathy)

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117
Q

What is the first sense to go in diabetic neuropathy

A

Vibration senses

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118
Q

Signs of iron deficiency anaemia

A

Tacchycardia
Pale conjunctiva
Ejection Systolic murmur

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119
Q

Why does sickle cell anaemia present later (6 months)

A

Due to foetal haemoglobin - does not get replaced by adult beta chains until 6 months of age

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120
Q

Name four complications of multiple myeloma

A

Hypercalcaemia
Spinal cord compression
Hyperviscocity
Acute Renal Failure

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121
Q

Chronic vs Acute Leukamia on a blood film

A

Chronic: Will show mature white cells

Acute: Will show immature blast cells

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122
Q

How is imatinib given

A

Orally

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123
Q

Name an acute cause of a transfusion reaction

A

Acute haemolytic reaction

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5
Perfectly
124
Q

Name a late onset complication of blood transfusions

A

Infections

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125
Q

Define am assive blood transfusion

A

Transfusion of the entire patient’s blood volume over 10 units of blood within 24 hours

126
Q

What is the main cause of a blood transfusion reaction

A

Giving the wrong blood product to the wrong patient

127
Q

How to manage a an acute haemolytic reatcion after stopping the transfusion

A

Send the product back to be cross-matched again - check if it is the correct product given

128
Q

What is an acute presentation of haemophilia

A

COmpartment Syndrome

129
Q

In which condition is a cobblestone appearance seen in

A

Crohn’s

130
Q

Which condition in IBD has a transmural affect

A

Crohn’s

131
Q

Pharmacology of infliximab

A

TNF alpha blocker - stops inflammation

132
Q

Name two complications of crohn’s disease

A

Fistulas and GI cancers

133
Q

What sign would I be looking for on an erect chest x ray to look for peptic ulcer perforation

A

Pneumperitoneum = free air under the diaphragm

134
Q

Increased gastrin levels = what syndrome

A

Zollinger-Ellison syndrome (pancreatic gastrinoma)

135
Q

Define GORD

A

Excessive movement of aicd from the stomach into the oesophagus through the gastro-oesophageal junction

136
Q

Gold standard test for diagnosing reflux

A

pH manometry

137
Q

What two infections can someone with Hepatitis B be co-infected with

A

Hep C and D, HIV

138
Q

Two risk factors for hepatitis B

A

Occupation health workers + Sex workers

139
Q

Name two cancers associated wit coealiac’s

A

GI T-cell lymphoma + Gastric carcinoma

140
Q

Name two autoimmune conditions associated with coeliac’s

A

Hypothyroidism + T1DM

141
Q

Why is lactulose given for hepatic encephalopathy

A

Because more bowe movements = less nitrogen producing bacteria in teh gut

142
Q

Sign of SAH on a CT head

A

Mixing of blood with the CSF in the interhemispheric fissures

143
Q

What is kernig’s sign

A

SHows meningeal irritation, bend hip and knee to 90 degrees and extends = pain

144
Q

Most comon cause of a stroke

A

Carotid artery atherosclerosis

Needs a carotid endarterectomy

145
Q

Define a seizure

A

Transient abnormal electrical activity in the brain that leads to disruptive symptoms

146
Q

What two structures are damaged to causes homonymous hemianopia

A

Visual cortex and optic radiation

147
Q

Name the three layers of the meninges

A

Dura mater, arachnoid mater and pia mater

148
Q

What needs to be prescribed with Levo-dopa

A

Peripheral dopa-decarboxylase inhibitor to reduce peripheral breakdown - causes less side effects

149
Q

What lesions would be foundin the brain of someone with parkinson’s

A

Lewy Body

150
Q

What is the triad for parkinson’s

A

Bradykinesia, Rigidity and Unilateral pill-rolling tremour

Postural instability

151
Q

What surgery is indicated for bladder tumours T1

A

Trans urethral resection of the bladder tumour

152
Q

What treatment is indicated for T2/T3 bladder tumours

A

Radical cyctsectomy

153
Q

Sensitivty vs positive predictive value

A

Sensitivtity: True positives/ True positives/False negatives

Positive Predictive Value: True positives/ False positives

154
Q

What would a low PPV mean for a patinet

A

They would have to udnergo invasive treatment for conditions they don’t have

155
Q

What medications are given prior to a prostate biopsy and why

A

Metronidazole and ciprofloxacin as gut flora may enter the prostate and cause infections

156
Q

Two consequences of orchidectomy

A

Infertility and delayed puberty/stunted puberty

157
Q

Two characteristics of a renal mass on examination

A

MOves up and down with respiration and able to get above the mass

158
Q

Four risk factors of renal cancer

A

Age
Male
Smoking
Obesity

159
Q

Why do we get loin pain in kidney stones

A

Visceral nerve supply to the ureter and kidneys follows a similar course to the somatic nerve supply of th egonads . Brain intereprets these interchangeable

160
Q

What causes ureteric colics

A

Spasming caused by peristalsis to push the stones down - causes local ischaemia and pain

161
Q

When is stenting of the ureters contraindicated

A

If there are signs of infection

162
Q

Name trhee anatomical sturtcures that are most prone to stones

A

Renal pelvis, Pelvic-ureteric junction and vesico-ureteric junction

163
Q

T1 dermatome sensation?

A

Inner arm to the medial epicondyle

164
Q

Dermatome of the umbilicus

A

T10

165
Q

Dermatome at the level of the nipple

A

T4

166
Q

Dermatome of the middle and lateral aspect of the anterior thigh

A

L2

167
Q

Dermatome supplying the medial malleolus

A

L4

168
Q

Dermatome supplying the perineum

A

S4/5

169
Q

Myotome of shoulder shrugs

A

C4

170
Q

Myotome for finger abduction

A

T1

171
Q

Myotome for hip flexion

A

L2

172
Q

Myotome for wrist extension

A

C6

173
Q

Myotome for shoulder abduction

A

C5

174
Q

Myotome for elbow extension

A

C7

175
Q

Myotome for elbow flexion

A

C5

176
Q

Myotome for wrist flexion

A

C7

177
Q

Myotome for finger flexion and thumb extension

A

C8

178
Q

Myotome for Knne Extension

A

L3

179
Q

Myotome for big toe extension

A

L5

180
Q

Myotome for ankle dorsiflexion

A

L4

181
Q

First line treatment of a generalised tonic clonic seizure

A

Valproate in men

Lamotrigine in women

182
Q

First line medication in absence seizures

A

Sodium valproate in men, Ethosuxamide in women

Ethosuxamide second line in men

183
Q

First line management of myoclonic seizures

A

Sodium valproate

184
Q

First line management of infantile spasms

A

High dose prednisolone and vigabatrin

185
Q

First line management of focal seizures

A

Carbamazepine or lamotrigine NOT valproate

186
Q

When should someone with Chron’s be admitted to hospital

A

> 8 stools a day and systemically very unwell

187
Q

Drug to induce remission in crohn’s

A

Prednisolone

If untolerated: 5-ASA

188
Q

What is added to predniosolone in crohn’s disease if not working

A

Add azathioprine

Infliximab is last line really

189
Q

What medication is used to maintain remission in Crohn’s

A

Azathioprine or mercaptopurine

190
Q

What myotome can causefoot drop

A

L5

191
Q

What nerve root causes difficulty with walking on toes

A

S1

192
Q

Nerve root for bicep jerk

A

C5/6

193
Q

Nerve root for tricep jerk

A

C7/8

194
Q

Nerve root for supinator jerk

A

C5/6

195
Q

What abbreviated mental test score suggets confusion

A

<6

196
Q

What are two complications of TURP surgery

A

TURP syndrome
Retrograde ejaculation

197
Q

Two complication of taking gout the prostate

A

Erectile Dysfunction
Urinary incontinence

198
Q

Two risk factors of stress incontinence

A

Obesity and Childbirth

199
Q

Four lifestyle changes to stop stress incontinence

A

Stop alcohol, caffeine, smoking cessation and weight loss. Avoid drinking at night time

200
Q

A long term complication of raised intravesicular pressure of the bladder

A

Bladder diverticulum

201
Q

Surgical management of a urethral stricture

A

Urethroplasty

202
Q

Two complictaions of a urethral stricture

A

Stones and UTIs

203
Q

Two causes of a urethral stricture

A

Gonorrhoea and catheters.

204
Q

What lymph node is specific to tonsilitis

A

Jugulodiagastric lymph node

205
Q

Define vertigo

A

The room is spinning in a certain direction

206
Q

Pathophysiology of BPPV

A

Displacement of otolith in th esemicircular canals. Heavier otolith causes abnormal movement of the endolymph

207
Q

Name three ways we can manage BPPV

A

Cyclizine + Hyoscine Hydrobromide

Reassurance
Reduce alcohol intake
betahistine

208
Q

Two parts of the ear drum

A

PArs flaccida and pars tensa

209
Q

What is a positive rinne’s test

A

AIR conduction > bone conduction

210
Q

Main differential of a vestibular schwannoma

A

Meningioma

211
Q

Define a paranasal sinus

A

An air filled cavity in the facial bones that connects to the nasal cavity

212
Q

Name two causes of sinusitis

A

Infections and swimming

213
Q

Namme two management methods for sinusitis

A

Decongestants and analgesia

214
Q

What gland in the face usually has tumours

A

Parotid glands

215
Q

Most common type of parotid gland tumour

A

Pleomorphic adenomas

216
Q

Name three causes of parotid gland inflammation

A

Parotitis, mumps and duct blockages

217
Q

What ives preferance to EVAR over a open repair for an AAA

A

EVAR if there are multiple comorbdities

218
Q

Disadvantages of EVAR

A

Long term follow up needed and high reintervention rate

219
Q

Name the three layers oft he blood vessel wall

A

Intima, media, externa and aventitia

220
Q

Someone gets black digits following an open repair fo their AAA, what is this

A

Cholesterol embolism from surgery

221
Q

Critical limb ischaemia vs acute limb ischaemia

A

Critical limb ischaemia is a gradual form of PAD - happens at rest/night

Acute limb ischaemia is a sudden onset of symptoms

222
Q

How long can tissue go without recieving blood supply

A

6 hours

223
Q

What is pre-clinical trial

A

Animal testing

224
Q

What is a phase 0 trial

A

Small group of volunteers to assess pharmacokinetics (not comon)

225
Q

What’s a phase 1 trial

A

Helathy volunteers to find dosing

226
Q

What’s a phase 2 trial

A

Tetsing of drug on large group of patients to check for safety

227
Q

What’s a phase 3 trial

A

Final testing to check effectiveness again to compare between existing interventions

228
Q

If a 95% confidence interval includes 1. something, what does this mean

A

There is NO signfiicant increase or decrease in the prevalence

229
Q

What is the strongest type of interventional trial

A

Randomised control trial

230
Q

Define risk ratio

A

Probability of an event in an exposed group compared to the probability occuring in the non-exposed group

231
Q

In what studies can an odds ratio be the only way to calculate something

A

Case-control and cross-setcional studies

232
Q

Define a cohort study

A

Where one group is exposed to a certain risk factor and the other is not to establish a link in a health related outcome

Usually prospective

233
Q

Define case-control study

A

Examines the association between an outcome and an exposure to a risk factor

234
Q

Name four of the bradford hill criterions

A

Strength
Consistency
Specificty
Temporarilty
Biologic Gradient
Plausibility
Coherence
Analogy

235
Q

Name two advantage sof a cross-sectional study

A

Multiple outcomes can be studied

Can be used to generate hypotheses

Cheap and easy

236
Q

Name two disadvantages of cross-sectional studies

A

Do not show causality
Chances of recall bias

237
Q

Advantage of meta analysis

A

Increases statistical power and reliability of data

238
Q

Disadvantage of meta analyses

A

Cannot control biases introduced in separate studies

239
Q

Role of a RCT

A

To determine causality

240
Q

How can we improve an RCT value

A

Meta analysis - increases stiatsical power

241
Q

What is a type I error

A

incorrect rejection of th enull hypothesis if it’s true

242
Q

What is a type 2 error

A

failure to reject th enull hypothesis when it is false

243
Q

At what p value do we reject the null hypothesis

A

p< 0.05

244
Q

What is the intention to treat analysis

A

Analysing the resuls with the patient in their allocated group - even if they leave halway throuogh

245
Q

How to adjust for confounding factors

A

Multivariable analysis

246
Q

Define a power of a study

A

The ability of a study to detect a difference bwtee study groups if such a difference exists

247
Q

Name two structures that can be damaged in a carotid endarterectomy

A

Hypoglossal nerve and internal jugular vein

248
Q

Two complications of carotid endarterectomy

A

MIs and strokes

249
Q

Define an ulcer

A

Abnormal break in the epithelial surface

250
Q

Management of ulcer infections

A

Broad spectrum antibiotics + debridement of dead tissue

251
Q

What mechanical intervention can be given for people recurrently suffering from DVTs

A

Inferior Vena Cava Filter

252
Q

Two complications of DVTs

A

PEs and CHronic venous insufficiency

253
Q

Name trhee parts of virchow’s triad

A

Hypercoagulable state, endothelial wall damage and flow stasis

254
Q

Risk factors for varicose veins

A

Obesity and pregnancy

255
Q

Two skin changes seen in venous ulcers

A

Lipodermatosclerosis and Ulcers

256
Q

Two lifestyle changes to improve varicose veins

A

Support stockings + Weight loss

257
Q

Two complication of varicose veins

A

Ulcers and bleedings

258
Q

What nerve may be damaged in surgical management of venous ulcers

A

Saphenous nerve - loss of pain in medial and anterior aspect of the calf

259
Q

What causes varicose veins

A

Valve insufficiency

260
Q

Name two treatments other than Emolients and topical steroids for eczema

A

Ciclosporin and oral steroids

261
Q

Two features of eczema

A

Scaly, erythematous excoriations

262
Q

Two features of plaque psoriasis

A

Well demarcated, scaly plaques

263
Q

Two tests for phemigoid vulgaris

A

Biopsy and auto antibody screen

264
Q

What can precipitate phemigoid vulgaris

A

Auto immune an ddrug induced

265
Q

Managedment of phemigoid vulgaris

A

Steroids

266
Q

Risk factors for melanomas

A

Lenigo maligna + family history

267
Q

What is moh’s micrographic surgery

A

Done to take out BCCs

268
Q

Differentials of Basal cell carcinomas

A

Amenolitic melanoma + Actinic Keratosis

269
Q

What causes acne pathophysiology

A

Increased produtcion of sebum due to blockage of the pilosebaceous follicles

270
Q

Differentials for squamous cell carcinomas

A

BCCs, keratocanthoma and pyogenic granuloma

271
Q

Where should you inspect on the body otehr than the SCC lesion itself

A

Lip and Ear - lymph nodes

272
Q

What strain of virus causes shingles

A

Human herpes virus 3 (VZV)

273
Q

Describe the waterlow pressure score

A

Grade I: Non-blanching erythema over intact skin

Grade II: Partial thickness loss

Grade III: Full thickness loss extending into fat

Grade IV: Extensive destruction with involvement of muscle an dtissues

274
Q

Symptoms of lichen sclerosus

A

Itching, constipation and dyspareunia

275
Q

Gold tsnard invetsigation for lichen sclerosus

A

Biopsy

276
Q

Management of lichen sclerosis

A

TOpical steroids and emiolients

277
Q

Paired vs unpaired student t test

A

Paired t test compares study subjects at 2 different times vs unpaired t test which compared two different groups of study subjects

278
Q

When is an embolectomy firtst line in acute critical limb ischaemia versus thrombolysis with heparin

A

When motor symptoms have gone

279
Q

What is a paradoxical embolus

A

A complication of DVT where it moves through the inferior vena cava and into the left circulation to cause infarcts in the lower leg

280
Q

Management of placental abruption

A

Foetal distress: Emergency c section

No foetal distress < 36 weeks: Give steroids and admit

No foetal distress > 36 weeks: Deliver vaginally

281
Q

When is placenta praevia diagnosed

A

20 weeks for low lying

Then 32/36-37 weeks to confirm if elective c section is needed

282
Q

When are elective c-sections ordered for

A

38 weeks

283
Q

Contraindications for external cephalic version

A

Abnormal CTG
Antepartum haemorrhage
Previous c-section

284
Q

Contraindications for vaginal delivery for breech position

A

Macrosomic baby: >3,800g
Footling
<2000g
Foetal compromise
Previous C-section

285
Q

How should being small for gestational age be managed

A

Offer induction IF umbilical artery doppler is abnormal + steroids

286
Q

Define an informal patient

A

Someone who has voluntarily agreed to a treatment of mental illness and is not being detained against their will.

287
Q

Name three things that need to be measured at baseline for lithium:

A

ECG: for prolongued QT syndrome

TFTs

U&Es

288
Q

Why is the hospital anxiety depression scale

A

Diagnosis, monitors symptoms and for research of depression in hospitals

289
Q

Name two problems of teh HADS score

A

Culturally varied in scores/ can only be used in hospitals

290
Q

Delirium vs Dementia

A

Delirium: Organic cause of a fluctuating altered consciousness with conufsion and disorientation, as a result of memory loss

Dementia: Chronic deteriorating condition caused by the disease of the brain. This causes global cognitive dysfunction

291
Q

Name two components of the mini-mental state examination

A

Orientation to time

Orientation to place

292
Q

Name two ways we can manage delirium

A

MOderately lit and quiet rooms

Ensure calming non-agressive voice to orientate the patient

293
Q

Acamprosate mechanism of action

A

Gaba agonist

294
Q

Disulfiram mechanism of action

A

Blocks acetyl dehydrogenase which stops its breakdown into acetic acid - large amounts of alcohol in the blood can cause hangover like symptoms

295
Q

Define an auditory/visual hallucination

A

The perception of sounds or visions in the absence of a stimuli

296
Q

Define Delusions

A

A false held belief with strong convictions despite evidence against it - that goes against the person’s cultural or social norms.

297
Q

How can someone refuse to be sectioned? What can they do about it

A

Send in an appeal wihtin 14 days of detention

298
Q

diagnosis of bronchiolitis

A

Nasopharyngeal aspiration

299
Q

What two ways we can manage a hcild with bronchiolitis in hospitals

A

Oxygen and NG Tubes

300
Q

What is seen on an X-Ray for extreme bronchiolitis

A

Hyperinflation

301
Q

Management of severe croup if dexamethasone has not worked

A

Nebulised adrenaline for the wheeze

302
Q

What prenatal investigation can be done to check for heart defects

A

ECHOcardiogram

303
Q

What is seen on an X-Ray for IRDS

A

Ground glass shadowing

304
Q

What causes AF in mitral stenosis

A

Increased pressure in the left atrium causes it to enlargen - this resultselectrical remodelling of the left atrium due to stress resulting in AF

305
Q

Method of action of allopurinol

A

Xanthine Oxidase inhibitor - it stops the production of urice acid from xanthine, so it won’t build up and cause gout

306
Q

WHat is a QALY

A

A measure of the value of health outcomes. One QALY = 1 year of life in perfect health

307
Q

Two types of economic evaulations

A

BENEFIT-COST ANALYSIS
COST-EFFECTIVENESS ANALYSIS
Cost-utility analysis
Cost consequenct analysis

308
Q

Define efficiency in health economics

A

Measures whether health resources are being used to get the best value for its cost

309
Q

Define opportunity cost

A

It refers to the economic benefit which is relinquished while choosing one therapeutic alternative over the other

310
Q

Nmae 4 contraindications to thrombolysis

A

POssible aortic dissection
Active internal bleeding
High Blood pressure (180/100+)
Recent major surgery

Year 4 part 2 (10 decks)

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