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SBA general revision Flashcards

1
Q

causes of severely low platelets

A

ITP, DIC, TTP, haematologial malignancy, HUS

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2
Q

causes of modertely low platelets

A

HIT, drug-induced, EtOH, liver DZ, hypersplenism, viral infection, pregnancy, SLE/anti-PL S, B12 deficiency

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3
Q

in DIC the clots are made of

A

fibrin

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4
Q

before DIC the PT is

A

already ill with something else e.g. GNR bacteraemia, ITU, end stage liver DZ

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5
Q

DIC blood results

A

low platelets, low fibrinogen, high D-dimer, high PT, high PTT, high INR, blood film +ve for schistocytes (fragmented RBCs)

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6
Q

DIC management

A

treat underlying cause, give platelets, cryoprecipitate (to boost fibrinogen), FFP (for PT, PTT, INR), RBC for schistocytosis

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7
Q

fibrin clots in

A

DIC

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8
Q

PT already ill with something else e.g. GNR bacteraemia, ITU, end stage liver DZ then get low platelets is likely to be

A

DIC

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9
Q

low platelets, low fibrinogen, high D-dimer, high PT, high PTT, high INR, blood film +ve for schistocytes (fragmented RBCs) is typical of

A

DIC

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10
Q

TTP is

A

thrombotic thrombocytopaenic purpura

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11
Q

TTP clots are made of

A

hyaline

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12
Q

mneumonic to remember TTP presentation

A

FATRN

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13
Q

FATRN stands for

A

Fever, MAHA (microangiopathic heamolytic Anaemia), Thrombocytopaenia, Renal failure, Neuro symptoms

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14
Q

with TTP the PT is originally

A

well

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15
Q

TTP blood results

A

low platelets, +ve blood film for scistocytes

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16
Q

TTP management

A

exchange transfusion, don’t give platelets (makes it worse)

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17
Q

hyaline clots form in

A

TTP

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18
Q

FATRN is a way of remembering

A

PT presentation in TTP

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19
Q

a well PT who then develops low platelets may have

A

TTP

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20
Q

low platelets, +ve blood film for scistocytes are the blood results of

A

TTP

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21
Q

exchange transfusion, don’t give platelets (makes it worse) is the management of

A

TTP

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22
Q

asymptomatic, v low platelts (single digits), purpura, petechiae, bleeding from mucosal sites, ?post-recent infection describes the presentation of

A

ITP

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23
Q

ITP is

A

immune/idiopathic thrombocytopenia purpura

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24
Q

presentation of ITP

A

asymptomatic, v low platelts (single digits), purpura, petechiae, bleeding from mucosal sites, ?post-recent infection

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25
Q

ITP diagnosis

A

diagnosis of exclusion, increased bleeding time, N blood film

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26
Q

ITP management

A

platelets (rule out TTP first), corticosteroids (reverse immune cause), IVIG, splenectomy, monoclonal Ab

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27
Q

diagnosis of exclusion, increased bleeding time, N blood film

A

ITP

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28
Q

platelets (rule out TTP first), corticosteroids (reverse immune cause), IVIG, splenectomy, monoclonal Ab is the management of

A

ITP

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29
Q

HUS is

A

haemolytic uraemic syndrome

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30
Q

HUS pathophysiology

A

toxin-mediated haemolysis, destruction of platelets, recent infectio with E. coli (specific strain, bloody diarrhoea)

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31
Q

HUS PT

A

recent diarrhoea, renal failure

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32
Q

HUS bloods

A

low platelets, increased bleeding time, signs of kidney failure, blood film +ve for schistocytes

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33
Q

HUS management

A

supportive

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34
Q

toxin-mediated haemolysis, destruction of platelets, recent infectio with E. coli (specific strain, bloody diarrhoea) describes the pathophysiology of

A

HUS

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35
Q

recent diarrhoea, renal failure then drop in platelets may suggest

A

HUS

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36
Q

low platelets, increased bleeding time, signs of kidney failure, blood film +ve for schistocytes is typical of

A

HUS

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37
Q

HIT is

A

heparin-induced thrombocytopaenia

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38
Q

pathophysiology of HIT

A

Abs to heparin cross react with platelets leading to theinr destruction

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39
Q

PT with HIT is

A

in hospital for an unrelated reason, receiving heparin, sudden drop in platelets

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40
Q

HIT management

A

stop heparin, bridge with alternative anticoagulant

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41
Q

drug causes of low platelets

A

quinine, diuretics, sulphonamides, aspirin, thiazide

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42
Q

viral causes of low platelets

A

EBV, HIV, hepatitis

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43
Q

Abs to heparin cross react with platelets leading to theinr destruction describes teh pathophysiology of

A

HIT

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44
Q

in hospital for an unrelated reason, receiving heparin, sudden drop in platelets may suggest

A

HIT

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45
Q

stop heparin, bridge with alternative anticoagulant is the management of

A

HIT

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46
Q

counselling is

A

6-12 sessions based on an acute event e.g. berevement

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47
Q

DBT is

A

dialectical behavioural therapy = explores opposite positions and looks at how they might exist together

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48
Q

IPT is

A

interpersonal therapy = identify + address problems regarding relationships + interactions with others

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49
Q

psychodynamic psychotherapy is

A

exploring how your unconscious thoughts (i.e. past experience) might affect the way you act today

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50
Q

CBT is generally used in the management of

A

anxiety, depression, panic attacks, phobias, OCD, PTSD

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51
Q

DBT is generally used in the management of

A

personality disorders

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52
Q

family therapy is generally used in the management of

A

CAMHS, ED, DV, drug + alcohol abuse

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53
Q

IPT is generally used in the management of

A

depression

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54
Q

6-12 sessions based on an acute event e.g. berevement describes

A

counselling

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55
Q

exploring opposite positions and looks at how they might exist together describes

A

DBT

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56
Q

identifies + addresses problems regarding relationships + interactions with others describes

A

IPT

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57
Q

exploring how your unconscious thoughts (i.e. past experience) might affect the way you act today describes

A

psychodynamic psychotherapy

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58
Q

psychodynamic psychotherapy is used in the management of

A

depression, schizophrenia

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59
Q

talking therapy for anxiety, depression, panic attacks, phobias, CD, PTSD

A

CBT

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60
Q

talking therapy for schizophrenia, depression

A

psychodynamic psychotherapy

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61
Q

talking therapy for personality disorders

A

DPT

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62
Q

talking therapy for CAMHS, ED, DV, drug + alcohol abuse

A

family therapy

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63
Q

talking therapy for depression

A

IPT

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64
Q

HF features

A

SOB, pik frothy sputum, bibasal crackles, low O2 sats, S3, PND, peripheral oedema

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65
Q

HF diagnosis depends on

A

previous MI or not

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66
Q

to diagnse HF in PT with previous MI

A

ECHO w/i 2/52

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67
Q

to diagnose HF in PT w/o previous MI

A
  1. BNP

2. if BNP high ECHO w/i 2/52 if BNP low EECHO w/i 6/52

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68
Q

what is BNP

A

B-type natriuretic peptide = hormone produced by LV myocardium in respose to strain

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69
Q

BNP and prognosis in HF

A

the higher the BNP the worse the prognosis

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70
Q

factors that increase BNP

A

LVH, ischaemia, tachycardia, RV overload, hypoxaemia (inc PE), GFR <60, sepsis, DM, age >70, liver cirrhosis

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71
Q

factors that decrease BNP

A

obesity, diuretics, ACEi, B-blockers, ARB, aldosterone antagonists

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72
Q

SOB, pik frothy sputum, bibasal crackles, low O2 sats, S3, PND, peripheral oedema are features of

A

HF

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73
Q

ECHO w/i 2/52 in suspected HF for those who

A

have had a previous MI, or high BNP

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74
Q

ECHO w/i 6/52 in suspected HF for those who

A

have a low BNP

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75
Q

hormone produced by LV myocardium in respose to strain

A

BNP

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76
Q

NYHA classification is used to stratify

A

HF

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77
Q

NYHA class I

A

no symptoms

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78
Q

NYHA class II

A

mild symptoms, slight limitation of physical activity

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79
Q

NYHA class III

A

marked limitation in physical activity, comfortable at rest

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80
Q

NYHA class IV

A

severe symptoms even at rest

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81
Q

acute management of HF includes

A

O2, CPAP, diuretics, vasodilators, morphine, mechanical circulatory assistance

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82
Q

long term management of HF

A
  1. ACEi, B-blockers
  2. aldosterone antagonist (spiroolactone)/ARB (candesartan)/hydralazine with nitrates
  3. digoxin if concurrent AF
    diuretics for fluid overload, but no evidence to suggest furosemide reduces mortality
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83
Q

NYHA classification of no symptoms

A

I

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84
Q

NYHA classification of mild symptoms, slight limitation of physical activity

A

II

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85
Q

NYHA classification of marked limitation in physical activity, comfortable at rest

A

III

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86
Q

NYHA classification of severe symptoms even at rest

A

IV

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87
Q

O2, CPAP, diuretics, vasodilators, morphine, mechanical circulatory assistance are used in the acute management of

A

HF

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88
Q
  1. ACEi, B-blockers
  2. aldosterone antagonist (spiroolactone)/ARB (candesartan)/hydralazine with nitrates
  3. digoxin if concurrent AF
    is the guidance for management of
A

HF

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89
Q

causal agents of serotonin S

A

MAOi, SSRIs, ecstasy, amphetamines

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90
Q

features of serotonin S

A

hyperreflexia, myoclonus, rigidity, dilated pupils, tachycarida, hyperthermia, diaphoresis, altered mental state

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91
Q

management of serotonin S

A

stop offening drug, IV fluids, supportive, BZD

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92
Q

neuroleptic malignant S is causative agents

A

antipsychotics (typical and atypical)

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93
Q

neuroleptic malignant S features

A

males, w/i first 10/7 of starting/inreasing dose, pyrexia, hyporeflexia, rigidity, tachycardia, diaphoresis, raised ck

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94
Q

neuroleptic malignant S Mx

A

stop antipsychotic, IV fluids, BZD

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95
Q

serotonin S onset period

A

hours

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96
Q

neuroleptic malignant S onset period

A

hours - days

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97
Q

hyperreflexia, myoclonus, rigidity, dilated pupils, tachycarida, hyperthermia, diaphoresis, altered mental state are features of

A

serotonin S

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98
Q

males, w/i first 10/7 of starting/inreasing dose, pyrexia, hyporeflexia, rigidity, tachycardia, diaphoresis, raised ck are features of

A

neuroleptic malignant S

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99
Q

two types of stroke + % occurrence

A

ischaemin 85%, haemorrhagic 15%

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100
Q

subtypes of ischaemic stroke

A

thrombotic (from large vessels e.g. carotids), embolic (blood clot, air, fat, bacterial clump, AF)

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101
Q

subtypes of haemorrhagic stroke

A

intracerebral (w/i the brain), subarachnoid (on the surface of the brain)

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102
Q

rish factors for ischaemic stroke

A

age, HTN, smoking, hyperlipidaemia, DM, AF

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103
Q

risk factors for haemorrhagic stroke

A

age, HTN, AVM, anticoagulation therapy

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104
Q

stroke vs TIA

A

stroke symptoms last >24h, TIA <24h most <1h

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105
Q

Bamford/Oxford stroke classification

A

TACI, PACI, LACI, POCI

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106
Q

TACI is

A

total anterior circulation stroke affecting middle + ant cerebral a

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107
Q

TACI symptoms

A

ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia

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108
Q

PACI is

A

partial ant circulatory stroke, involves the smaller a of the ant circulation e.g. upper/lower division of MCA

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109
Q

PACI features

A

2 of: ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia

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110
Q

LACI is

A

lacunar infarct, involves perforating a around the internal capsule, thalamus and basal ganglia

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111
Q

LACI features

A

q of: ux weakness (+/ sensory deficit) of face + arm/arm + leg/all 3, pure sensory stroke, ataxic hemiplegia

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112
Q

POCI is

A

post circulation stroke, involves the vertebrobasilar a

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113
Q

POCI features

A

1 of: cerebellar/brainstem S, LOC, isolated HH

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114
Q

general symptom differences between haemorrhagic and ischaemic stroke

A

haemorrhagic > likely to have: reduces consciousness, headache, N, V, seizure

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115
Q

stroke Mx

A
  1. ABCDE
  2. urgent CT/MRI head
  3. thrombolysis if thrombotic + w/i 4.5hrs, aspirin 300mg, supportive
    neurosurgical opinion if haemorrhagic, supportive, stop/reverse anticoagulants
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116
Q

TIA referral guidelines

A

crescendo TIA (i.e. multiple) admit + observation under specialist
TIA w/i 7/7 specialist assessment w/i 24h
TIA >7/7 ago specialist assessment w/i 7/7

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117
Q

location of stroke in amaurosis fugax

A

retinal/opthalmic a

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118
Q

AF post-stroke management

A

start warfarin 14/7 later

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119
Q

high cholesterol and stroke when to start statin

A

48h later

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120
Q

drug used for thrombolysis

A

altepase

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121
Q

secondary prevention of stroke management

A

clopidogrel 75mg lifelong

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122
Q

carotid a endarterectomy when stenosis

A

> 70%

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123
Q

TIA Mx

A

300mg aspirin

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124
Q

secondary prevention post-TIA Mx

A

clopidogrel 75mg lifelong

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125
Q

types of AF

A

paroxysmal (spontaneoulsy stops, lasts <7/7), persistent, permanent (cannot be cardioverted)

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126
Q

symptoms of AF

A

palpitiations, SOB, CP

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127
Q

AF management options

A

rate control: 1. B-blocker/rate limiting CaChB (diltiazem) 2. add B-blocker/diltiazem/digoxin
rhythm control aka cardioversion used in coexisting HF, first onset AF, or if reversible cause

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128
Q

risks of rhythm control in AF

A

highest risk of embolic stroke at point of cardioversion due to rhythm change

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129
Q

score to stratify stroke risk in AF

A

CHA2DS2VaS

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130
Q

CHA2DS2VaS and results

A

CHF, HTN, Age >75/>65, DM, Stroke/TIA, Vascular DZ, Sex (female)
0 = no R, 1 = consider in males, no Rx in females, 2 = offer anticoagulation

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131
Q

first line antiplatelets post NSTEMI

A

aspirin lifelong + clopidogrel/ticagrelor for 12/12

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132
Q

first line antiplatelet post STEMI

A

aspirin lifelong + clopidogrel/ticagrelor 1/12 if no/bare metal stent, 12/12 if drug-eluting stent

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133
Q

stroke affecting middle + ant cerebral a

A

TACI

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134
Q

ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia are symptoms of

A

TACI

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135
Q

stroke involving the smaller a of the ant circulation e.g. upper/lower division of MCA

A

PACI

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136
Q

2 of: ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia are features of

A

PACI

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137
Q

stroke involving perforating a around the internal capsule, thalamus and basal ganglia

A

LACI

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138
Q

1 of: ux weakness (+/ sensory deficit) of face + arm/arm + leg/all 3, pure sensory stroke, ataxic hemiplegia are features of a

A

LACI

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139
Q

stroke involving the vertebrobasilar a

A

POCI

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140
Q

1 of: cerebellar/brainstem S, LOC, isolated HH are features of

A

POCI

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141
Q

retinal/opthalmic a stroke causes

A

amaurosis fugax

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142
Q

altepase is the drug used in

A

thrombolysis

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143
Q

clopidogrel 75mg lifelong for

A

post-stroke and TIA

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144
Q

CHA2DS2VaS is used to

A

stratify risk of stroke in AF

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145
Q

aspirin lifelong + clopidogrel/ticagrelor for 12/12 for

A

post-NSTEMI

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146
Q

aspirin lifelong + clopidogrel/ticagrelor 1/12 if no/bare metal stent, 12/12 if drug-eluting stent

A

post-STEMI

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147
Q

risk factors for developing schizophrenia

A

(in order) FH, black Caribbean, migration, urban environment, cannabis

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148
Q

diagnostic criteria for schizophrenia

A

1/12 of: delusions of control (passivity phenomenon), thought disorder (insertion/withdrawal/broadcast), persistent delusions (paranoid, perception), hallucinations (3rd person auditory)

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149
Q

negative symptoms in schizophrenia

A

flat affect, anhedonia, alogia, avolition

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150
Q

general management of schizophrenia

A

PO antipsychotic + CBT

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151
Q

factors associated with poor prognosis in schizophrenia

A

male, strong FH, gradula onset, low IQ, premorbid Hx of social withdrawal, lack of obvious precipitant, no mood symptoms, initial poor response to Rx, young onset, predominantly -ve symptoms

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152
Q

AML is the most common

A

form of acute leukaemia in adults

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153
Q

features of AML

A

anaemia (pallor, lethargy), neutropaenia, thrombocytopenia (bleeding), splenomegaly, bone pain

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154
Q

CML is most commonly

A

associated with the Philadelphia ch (translocation -/- ch 9 + 22 leading to BCR-ABL)

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155
Q

CML presentation

A

anaemia (lethargy), weight loss, sweating, splenomegaly

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156
Q

ALL is the most common

A

childhood malignancy

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157
Q

features of ALL

A

anaemia (lethargy, pallor), neutropaenia (f/severe infections), thrombocytopaenia (easy bruising/petechiae), bone pain, splenomegaly, hepatomegaly, testicular swelling

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158
Q

CLL features

A

asymptomatic, anorexia, weight loss, bleeding, infections, lymphadenopathy

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159
Q

CLL on a blood film

A

smudge cells/smear cells

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160
Q

most common form of acute leukaemia in adults

A

AML

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161
Q

anaemia (pallor, lethargy), neutropaenia, thrombocytopenia (bleeding), splenomegaly, bone pain are features of

A

AML

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162
Q

associated with the Philadelphia ch (translocation -/- ch 9 + 22 leading to BCR-ABL)

A

CML

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163
Q

anaemia (lethargy), weight loss, sweating, splenomegaly are symptoms of

A

CML

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164
Q

most common childhood malignancy

A

ALL

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165
Q

anaemia (lethargy, pallor), neutropaenia (f/severe infections), thrombocytopaenia (easy bruising/petechiae), bone pain, splenomegaly, hepatomegaly, testicular swelling are features of

A

ALL

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166
Q

asymptomatic, anorexia, weight loss, bleeding, infections, lymphadenopathy are features of

A

CLL

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167
Q

smudge/smear cell on blood film suggests

A

CLL

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168
Q

tumour lysis S can occur in the Rx of

A

high grade lymphomas + leukaemia’s

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169
Q

tumour lysis S is usually triggered by

A

chemo

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170
Q

pathophysiology of tumour lysis S

A

breakdown of tumour cells and subsequent release of chemicals from the cell leading to high K + high PO4 + low Ca

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171
Q

tumour lyiss S presentas as

A

AKI + high PO4 + high uric acid

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172
Q

chemo in high grade lymphomas + leukaemia’s can trigger

A

tumour lysis S

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173
Q

hand foot and mouth DZ is caused by

A

coxsackie virus

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174
Q

clinical features of hand foot and mouth DZ

A

sore throat, fever, oral ulcers, vesicles on palms + soles

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175
Q

hand foot and mouth Mx

A

self limiting, hydration, analgesia

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176
Q

coxsackie virus causes

A

hand foot and mouth DZ

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177
Q

sore throat, fever, oral ulcers, vesicles on palms + soles are features of

A

hand foot and mouth DZ

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178
Q

immunisations for pertussis

A

2, 3, 4/12, preschool, pregnant women

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179
Q

bouts of coughing, worse at night/post-feed, V, central cyanosis, inspirtory whoop

A

whooping cough

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180
Q

pertussis Ix

A

per nasal swab culture, PCR, serology

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181
Q

pertussis Mx

A

PO macrolide (clarithromycin, azithromycin, erythromycin), 2/7 school exclusion

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182
Q

pertussis complications

A

subconjunctival haemorrhages, pneumonia, bronchiectasis, seizures

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183
Q

whooping courgh features

A

bouts of coughing, worse at night/post-feed, V, central cyanosis, inspirtory whoop

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184
Q

P450 inducers

A

phenytoin, carbamazepine, phenobarbitone, rifampicin, St John Wort, chronic EtOH intake, smoking

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185
Q

P450 inhibitors

A

ciprofloxacin, erythromycin, isoniazid, omeprazole, amiodarone, allopurinol, fluconazole, fluoxetine, sertraline, Na valproate, acute EtOH intake

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186
Q

Jarisch-Herxheimer reaction presentation

A

fever, rash, tachycardia

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187
Q

Jarisch-Herxheimer reaction occurs following

A

first dose ABx for syphilis

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188
Q

fever, rash, tachycardia post-first dose of ABx for syphilis

A

Jarisch-Herxheimer reaction

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189
Q

most common type of breast ca

A

invasive ductal carcinoma

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190
Q

breast ca risk factors

A

BRCA, 1st degree premenopausal relative, nuliparity, early menarche, late menopause, HRT, COCP, previous breast ca, not breastfeeding, ionising radiation, p53 gene mutations, obesity

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191
Q

breast ca screening f and ages

A

47-73, 3 yearly

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192
Q

4 main types of breast ca

A

invasive ductal carinoma (aka NST no special type), invasive lobar carcinoma, dudcal carcinoma in situ, lobar carcinoma in situ

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193
Q

tension headache presentation

A

recurrent, non-disabling, bx, tight band, not aggrevated by ADLs

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194
Q

cluster headache presentation

A

15min-2h duration, 1-2/d for 4-12/52, intense pain around eye, redness, lacrimation, lid swelling, limiting

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195
Q

temporal arteritis presentation

A

> 60 y.o., rapid onset ux headache, jaw claudication, tender palpable temporal a

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196
Q

medication overuse headache

A

> 15/7 per month, developed/wosened whilst taking medication (opoids, triptans)

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197
Q

migraine presentation

A

24-72h, ux, pulsating, aggrevated by ADLs, N/V, phono/photophobia

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198
Q

L ca types

A

small cell, non-small cell (squamous, adenocarcinoma, large cell)

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199
Q

small cell L ca features

A

central, ectopic ADH (hyponatraemia)/ACTH (Cushing’s S) secretion, poor prognosos (usually mets at presentation)

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200
Q

squamous cell L ca features

A

central, PTHrP secretion (hypercalcaemia), clubbing

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201
Q

adenocarcinoma features

A

peripheral, most common in non-smokers

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202
Q

large cell L ca features

A

peripheral, anaplastic, poorly differentiated, poor prognosis, B-hCG secretion

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203
Q

recurrent, non-disabling, bx, tight band, not aggrevated by ADLs are features of

A

tension headache

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204
Q

15min-2h duration, 1-2/d for 4-12/52, intense pain around eye, redness, lacrimation, lid swelling, limiting are features of

A

cluster headache

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205
Q

> 60 y.o., rapid onset ux headache, jaw claudication, tender palpable temporal a are features of

A

temporal arteritis

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206
Q

> 15/7 per month, developed/wosened whilst taking medication are symptoms of

A

medication overuse headache

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207
Q

24-72h, ux, pulsating, aggrevated by ADLs, N/V, phono/photophobia are symptoms of

A

migraine

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208
Q

central, ectopic ADH (hyponatraemia)/ACTH (Cushing’s S) secretion, poor prognosos (usually mets at presentation) are features of

A

small cell L ca

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209
Q

central, PTHrP secretion (hypercalcaemia), clubbing are features of

A

squamous cell L ca

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210
Q

peripheral, most common in non-smokers are features of

A

adenocarcinoma L ca

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211
Q

peripheral, anaplastic, poorly differentiated, poor prognosis, B-hCG secretion are features of

A

large cell L ca

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212
Q

causes of erythema nodosum

A

strep, TB, sarcoidosis, IBD, Bechet’s, ca/lymphoma, penicillin, COCP, pregnancy

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213
Q

sarcoidosis is characterised by

A

non-caseating granulomas

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214
Q

features of acute sarcoidosis

A

erythema nodosum, bx hilar lymphadenopathy, swinging fever, polyarthralgia

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215
Q

features of insidious sarcoidosis

A

SOB, non-productive cough malaise, weight loss

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216
Q

Ix in sarcoidosis

A

CXR, ACE level, Ca, ESR, spirometry, tissue biopsy

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217
Q

non-caseating granulomas is chracteristic of

A

sarcoidosis

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218
Q

erythema nodosum, bx hilar lymphadenopathy, swinging fever, polyarthralgia are features of

A

acute sarcoidosis

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219
Q

SOB, non-productive cough malaise, weight loss are features of

A

insidious sarcoidosis

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220
Q

intussusception features

A

paroxysmal abdo colic, draw knees up, pallor, V, blood stined stools (red current jelly), sausage shaped mass in RIF

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221
Q

intussusception Ix

A

US (target lesion)

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222
Q

intussusception Mx

A

reduction by air insufflation under radiological guidance

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223
Q

paroxysmal abdo colic, draw knees up, pallor, V, blood stined stools (red current jelly), sausage shaped mass in RIF are features of

A

intussusception

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224
Q

TORCH screen consists of

A

toxo, rubella, CMV, HSV, HIV

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225
Q

method of inheritance of tuberous sclerosis

A

AD

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226
Q

cutaneous features of tuberous sclerosis

A

depigmented ‘ash-leaf’ spots which fluoresce under UV, Shagreen patches, butterfly distribution adenoma sebaceum, subungual fibromata, cafe au lait spots

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227
Q

neurological features of tuberous sclerosis

A

developmental delay, epilepsy, intellectual impairment

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228
Q

neurofibramatosis features

A

axillary/groin freckles, pheochromocytoma, iris hamartomas (Lisch nodules)

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229
Q

depigmented ‘ash-leaf’ spots which fluoresce under UV, Shagreen patches, butterfly distribution adenoma sebaceum, subungual fibromata, cafe au lait spots are features of

A

cutaneous tuberous sclerosis

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230
Q

axillary/groin freckles, pheochromocytoma, iris hamartomas (Lisch nodules) are features of

A

neurofibramatosis

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231
Q

Shagreen patches are

A

patches of roughened skin over the lumbar spine

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232
Q

patches of roughened skin over the lumbar spine are called

A

Shagreen patches

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233
Q

bronchiolitis is caused by

A

RSV

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234
Q

bronchiolitis features

A

coryzal symptoms, dry cough, SOB, wheeze

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235
Q

croup is caused by

A

parainfluenza virus

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236
Q

croup features

A

barking cough, stridor, fever, coryzal symptoms

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237
Q

croup Mx

A

dexamethasone (0.15mg/kg), high flow O2, nebulised adrenaline

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238
Q

RSV causes

A

bronchiolitis

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239
Q

coryzal symptoms, dry cough, SOB, wheeze are features of

A

bronchiolitis

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240
Q

parainfluenza virus causes

A

croup

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241
Q

barking cough, stridor, fever, coryzal symptoms are features of

A

croup

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242
Q

ASD murmur

A

ejection systolic

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243
Q

VSD murmur

A

pansystolic (harsh)

244
Q

PDA murmur

A

continuous ‘machine-like’

245
Q

ToF murmur

246
Q

coarctation of the aorta murmur

A

late systolic

247
Q

Kleihauer test

A

determined proportion of foetal RBC in mother’s circulation in the event of a sensitising event in a Rh- mother

248
Q

give anti-D at

A

28/40, after birth/termination/miscarriage >12/40, ECV, APH, amnio/CVS/foetal blood sampling

249
Q

test for anti-D at

A

booking 11-13/40

250
Q

Coombe’s test

A

direct Ab testing, do on cord blood after delivery from a Rh- mother

251
Q

foetus affected by Rh incompatibility features

A

oedematous (hydrops fetalis), jaundice, anaemia, hepatosplenomegaly, HF, kernicterus

252
Q

Mx of Rh DZ of the newborn

A

transfusion, phototherapy

253
Q

determined proportion of foetal RBC in mother’s circulation in the event of a sensitising event in a Rh- mother

A

Kleinhauer test

254
Q

direct Ab testing, do on cord blood after delivery from a Rh- mother

A

Coombe’s test

255
Q

oedematous (hydrops fetalis), jaundice, anaemia, hepatosplenomegaly, HF, kernicterus are features of

A

Rh DZ of the newborn

256
Q

pyloric stenosis presentation

A

2-4/52, projectile V 30’ post-feed, constipation, dehydration, LUQ mass

257
Q

pyloric stenosis Ix

258
Q

pyloric stenosis Mx

A

Ramstedt pyloromyotomy

259
Q

2-4/52, projectile V 30’ post-feed, constipation, dehydration, LUQ mass features suggestive of

A

pyloric stenosis

260
Q

Angelman S and Prader-Willi S

A

Prader-Willi if inherited from father

Angelman if inherited from mmother

261
Q

features of Prader-Willi

A

hypotonia, dysmorphic features, short stature, hypogonadism, infertility, LD, obesity, behavioural problems

262
Q

hypotonia, dysmorphic features, short stature, hypogonadism, infertility, LD, obesity, behavioural problems are features of

A

Prader-Willi S

263
Q

obstetric cholestasis presentation

A

pruitis, worse on palms, soles, abdo

264
Q

risks associated with obstetric cholestasis

A

preterm birth

265
Q

obstetric cholestasis Mx

A

IoL at 37/40, ursodeoxycholic acid, vit K

266
Q

associations with cerebral palsy

A

LD, epilepsy, squint, hearing impairment

267
Q

cerebral palsy causes

A

antenatal: cerebral malformation, congenital infection (rubella, toxo, CMV)
intrapartum: asphyxiation, trauma
postnatal: IVH, maningitis, head trauma

268
Q

LD, epilepsy, squint, hearing impairment are associated with

A

cerebral palsy

269
Q

somatisation disorder features

A

multiple ephysical symptoms, present for >2 years, refuses to accept reassurance from -ve test results

270
Q

hypochondrial disorder features

A

persistent belief in presence of serious underlying disease e.g. cancer, refusal to acept reassuance from -ve test results

271
Q

conversion disorder features

A

involves loss of motor/sensory function, PT indifferent about loss of function “la belle indifference”

272
Q

dissociative disorder features

A

psychiatric symptoms e.g. amnesia, fuge, stupor, separating of certain memories from normal consciousness

273
Q

dissociative identity disorder is

A

a new term for multiple personality disorder, is the most severe form of dissociative disorder

274
Q

Munchausen’s S aka

A

factitious disorder

275
Q

factitious disorder features

A

intentional production of physical/psychological symptoms

276
Q

malingering features

A

fraudulent simulation/exaggeratin of symptoms with the intention of finantial/other gain

277
Q

multiple ephysical symptoms, present for >2 years, refuses to accept reassurance from -ve test results describes

A

somatisation disorder

278
Q

persistent belief in presence of serious underlying disease e.g. cancer, refusal to acept reassuance from -ve test results describes

A

hypochondrial disorder

279
Q

involves loss of motor/sensory function, PT indifferent about loss of function “la belle indifference” describes

A

conversion disorder

280
Q

psychiatric symptoms e.g. amnesia, fuge, stupor, separating of certain memories from normal consciousness describes

A

dissociative disorder

281
Q

factitious disorder aka

A

Munchausen’s S

282
Q

intentional production of physical/psychological symptoms describes

A

factitious disorder

283
Q

fraudulent simulation/exaggeratin of symptoms with the intention of finantial/other gain describes

A

malingering

284
Q

IRIS stands for

A

immune reconstitution inflammatory S

285
Q

IRIS describes

A

an exaggerated immune response to a microorganism upon starting ARV

286
Q

an exaggerated immune response to a microorganism upon starting ARV desribes

287
Q

painful loss of vision causes

A

ACG, ischaemic neuropathy (arteritis vs not), papilloedema

288
Q

painless loss of vision causes

A

cataracts, AMD, POAG, CRVO, CRAO, detachment, DM

289
Q

Breslow thickness

A

used to describe the depth of a MM

290
Q

Breslow thickness >1mm

A

WLE + SLN biopsy

291
Q

used to describe the depth of a MM

A

Breslow thickness

292
Q

WLE + SLN biopsy of MM if Breslow thickness

293
Q

idiopathic intracranial HTN features

A

headache, blurred vision, papilloedema, enlarged blind spot, CNVI palsy

294
Q

risk factors for idiopathic intracranial HTN

A

obesity, female, pregnancy, COCP, steroids, vit A, Li

295
Q

neuroblastoma features

A

abdo mass, pallor, weight loss, bone pain, limp, hepatomegaly

296
Q

headache, blurred vision, papilloedema, enlarged blind spot, CNVI palsy are features of

A

idiopathic intracranial HTN

297
Q

obesity, female, pregnancy, COCP, steroids, vit A, Li are risk factors for

A

idiopathic intracranial HTN

298
Q

abdo mass, pallor, weight loss, bone pain, limp, hepatomegaly are features of

A

neuroblastoma

299
Q

early medical abortion

A

<9/40 mifipristone + misoprostol 48h later, can pass at home

300
Q

late medica abortion

A

> 9/40 serial misoprostol, inPT stay

301
Q

early surgical abortion

A

<15/40 vacume aspiration

302
Q

late surgical abortion

A

> 15/40 dilation + evacuation

303
Q

lichen sclerosus features

A

itch, elderly females

304
Q

lichen sclerosus Mx

A

topical steroids + emollients

305
Q

itch, elderly females describes

A

lichen sclerosus

306
Q

PCOS blood results

A

raised LH:FSH, prolactin + testosterone N/mildly elevated, ?imparied glucose tolerance

307
Q

raised LH:FSH, prolactin + testosterone N/mildly elevated bloods suggest

308
Q

HIV in pregnancy Mx

A

c/s if VL >50, PO ART to neonate when born, or triple therapy for 4-6/52 if high risk, no breastfeeding

309
Q

hep B in pregnancy Mx

A

vaccination + hep B IG at birth

310
Q

CADASIL is

A

an AD arteriopathy, most common cause of inherited stroke

311
Q

an AD arteriopathy, most common cause of inherited stroke describes

312
Q

cerebral toxo Rx

A

pyrimethamine + sulphadiazine

313
Q

candida symptoms

A

itch, cottage cheese discharge

314
Q

BV symptoms

A

fishy odeur, milky white discharge

315
Q

trichomonas symptoms

A

green frothy discharge

316
Q

pH candida, BV, trichomonas

A

candida <4.5 (N)

BV + trichomonas >4.5

317
Q

candida Mx

A

cotrimazole pessary/fluconazole PO

318
Q

BV Mx

A

PO metronidazole 5-7/7

319
Q

trichomonas Mx

A

PO metronidazole 5-7/7, treat partner

320
Q

itch, cottage cheese discharge are symptoms of

321
Q

fishy odeur, milky white discharge are symptoms of

322
Q

green frothy discharge are symptoms of

A

trichomonas

323
Q

DS screening at

324
Q

combined DS test is made up of

A

NT, PAPP-A, B-hCG

325
Q

quadruple DS test is offered when

A

high risk from the combined or too late for combined

326
Q

quadruple DS test is made up of

A

unconjugated oestradiol, total hCG, AFP, inhibin A

327
Q

NT, PAPP-A, B-hCG make up the components of the

A

conbined DS test

328
Q

unconjugated oestradiol, total hCG, AFP, inhibin A make up the

A

quadruple DS test

329
Q

extra precautions in pregnant obese women

A

VTE thromboprophylaxis, vit D supplementation, anaesthetic r/v, active management of 3rd stage (PPH risk)

330
Q

GDM risk factors

A

high BMI, previous macrosomic baby, previous GDM, DM FH, ethnicity

331
Q

GDM OGTT result

332
Q

placenta accretta

A

firm adhesion of the placenta to the uterine wall

333
Q

placenta increta

A

placenta extends through the full myometrium

334
Q

placenta percreta

A

placenta invades beyond the uterus

335
Q

firm adhesion of the placenta to the uterine wall describes

A

placenta accreta

336
Q

placenta extends through the full myometrium describes

A

placenta increta

337
Q

placenta invades beyond the uterus describes

A

placenta percreta

338
Q

gestation above which to give steroids

339
Q

imaging in pregnancy for suspected PE

340
Q

PPROM stands for

A

pretern pre-labour RoM

341
Q

PPROM Mx

A

10/7 ABx, steroids before 34/40, delivery 34-36/40

342
Q

10/7 ABx, steroids before 34/40, delivery 34-36/40 is the management of

343
Q

pregnancy physiology changes

A

increase in fibrinogen, factor VII, X, XII, 30% increase stroke V, haemodilutiondue to relative increase in plasma V leading to a reduction in [Hb]

344
Q

features of physiological murmurs in pregnancy

A

soft systolic flow murmur

345
Q

drug ised for the Mx of PE in pregnancy

A

enoxaparin

346
Q

placental abruption risk factors

A

previous abruption, smoking, IUGR, HTN, multiple pregnancies

347
Q

vasa praevia presentation

A

rare, occurs at time of RoM, painless bleed, foetal compromise

348
Q

HSV in pregnancy

A

c/s if delivery w/i 6/52, no evidence for acyclovir

349
Q

smoking, IUGR, HTN, multiple pregnancies are risk factors for

A

placental abruption

350
Q

rare, occurs at time of RoM, painless bleed, foetal compromise describes

A

vasa praevia

351
Q

chickenpox exposure in pregnancy Mx

A

check antibodies, give VZIG w/i 10/7

352
Q

when to stop insulin sliging scale post-delivery

A

once E+D, return to usual insulin regime

353
Q

risk of pregnancy with SLE

A

spontaneous miscarriage, foetal death, poreeclampsia, preterm delivery, foetal growth restriction

354
Q

spontaneous miscarriage, foetal death, poreeclampsia, preterm delivery, foetal growth restriction are risks of

A

being pregnant with SLE

355
Q

PUPP stands for

A

pruuritic urticarial papules and plaques or pregnancy

356
Q

PUPP presentaiton

A

> 34/40, starts on abdomen, in stretch marks with peri-umbilical sparing

357
Q

prurigo gestationis presentation

A

starts on trunk/upper limbs, abdo sparing

358
Q

> 34/40, starts on abdomen, in stretch marks with peri-umbilical sparing describes

359
Q

rash starts on trunk/upper limbs, abdo sparing describes

A

prurigo gestationis

360
Q

diabetes in pregnany sugar control values

A

<5.5 pre-meal, <7.8 1h post-meal

361
Q

threatened miscarriage is

A

any bleeding <24/40

362
Q

bleeding after 24/40 is called

363
Q

missed miscarriage describes

A

loss of pregnancy w/o the passage of bood/clots, but loss of pregnancy related symptoms

364
Q

incomplete miscarriage describes

A

some retained products of conception

365
Q

incomplete misacrriage Mx optino

A

conservative, medical, Sx

366
Q

any bleeding <24/40 is called

A

threatened misacrriage

367
Q

loss of pregnancy w/o the passage of bood/clots, but loss of pregnancy related symptoms is called

A

missed miscarriage

368
Q

some retained products of conception and some passed is called

A

incomplete miscarriage

369
Q

extopic risk factors

A

previous ectopic, tubual Sx, IUS/D, PID, IVF

370
Q

c/s risks

A

1/1000 bladder injury, VTE, haemorrhage, increased still birth risk in subsequent pregnancies, placenta praevia, laceration to baby, infection

371
Q

Gillick competence is for people

372
Q

peripartum cardiomegaly features

A

develops in last 1/12 of pregnancy, SOB, tachycardia, tachopnea, signs of HF (cardiomegaly, pulmonary oedema)

373
Q

rish factors for peripartum cardiomegaly

A

multiple pregnancies, HTN in pregnancy, advanced maternal age

374
Q

develops in last 1/12 of pregnancy, SOB, tachycardia, tachopnea, signs of HF (cardiomegaly, pulmonary oedema) describes features of

A

peripartum cardiomegaly

375
Q

puerperal psychosis usualy presents

A

w/i first 2/52 of delivery

376
Q

risk factors for purperal psychosis include

A

c/s, emergency delivery, primiparity

377
Q

Apgar score includes

A

tone, colour, breathing, HR, reflex irritability

378
Q

Apgar score is measure at

A

1, 5, 10 mins

379
Q

Sheehan S aka

A

post partum pituitary gland necrosis

380
Q

Sheehan S presentation

A

not lactating, amenorrhoea

381
Q

Sheehan S is caused by

A

hypovolaemia, in prpegnancy the ant pit is hyperplastic therefore hypovolaemia may be sig enough to cause necrosis

382
Q

post partum pituitary gland necrosis aka

383
Q

not lactating, amenorrhoea may be signs of

384
Q

Listeria in pregnancy can lead to

A

miscarriage, stillbirth, preterm delivery

385
Q

toxo in pregnancy leads to

A

chorioretinitis, macro/microencephaly, convulsions, neurodevelopmental delay

386
Q

miscarriage, stillbirth, preterm delivery can be caused by

A

Listeria infection

387
Q

chorioretinitis, macro/microencephaly, convulsions, neurodevelopmental delay can be caused by

A

toxo infection

388
Q

haematocolpos can be caused by

A

inperforated hymen

389
Q

inperforated hymen can cause

A

haematocolpos

390
Q

risk factors for developing a hydatidiform mole

A

extremes of age, previous molar pregnancy, race

391
Q

hydatiforme mole presentation

A

unusual/heavy bleeding, larger than dates

392
Q

hydatiforme mole Ix

A

serial B-hCG (higher than usual), US (snowstorm appearance)

393
Q

unusual/heavy bleeding, larger than dates may be suggestive of

A

hydatiforme mole

394
Q

Bartholian glands are located

A

4 + 8-o’ clock on the labia minora

395
Q

Rx of bartholian cyst/abscess

A

marsupialisation

396
Q

marsupialisation involves

A

opening the abscess + suturing it open to prevent recurrence

397
Q

side effects of antimuscarinics

A

dry mouth, constipation, urinary retention

398
Q

first line medical Mx for urge incontinence

A

oxybutynin

399
Q

dry mouth, constipation, urinary retention are SE of

A

antimuscarinics

400
Q

oybutynin is 1st line for

A

urge incontinence

401
Q

risks of IVF pregnancies

A

ectopic, congenital abnormalities, multiple pregnancies, SGA, low birth weight

402
Q

PCOS criteria

A

anovulation/oligomenorrhoea, hyperandrogenism (physical/biochemical), 12+ folicles on US

403
Q

Asherman S can occur post

A

several surgical TOPs

404
Q

Asherman S comprises

A

uterine scar tissue + adhesions

405
Q

when to do a women’s bloods for fertility

A

d1-3 LH + FSH, mid-luteal progesterone (>30 suggests ovulation)

406
Q

uterine scar tissue + adhesions describes

A

Asherman S

407
Q

OSHH presentation

A

abdo pain, distension, V

408
Q

RMI is

A

risk of malignancy index used in ovarian ca

409
Q

RMI calculation

A

US features (1-5) x menopause (1 or 3) x ca125

410
Q

Turner’s S is associated with

A

lymphoedema of hands + feet as neonate, neck webbing, short stature, wide spaced nipples, congenital heart defects (coarctation)delayed/absent puberty, infertility

411
Q

diagnosis to rule out is delayed gross motor skills

A

MD, do a ck

412
Q

gross motor milestones in order

A

0, reflexes, head control, 3/12, rolls (front to back, then back to front), 6/12, sits, pulls to stand, walking, 1, runs, jumps, stairs 2 feet at a time, 2, trike, up stairs alternating feet, hops, downstairs alternating feet, 4, balances on 1 foot

413
Q

fine motore milestones in order

A

0, grasp reflex, 3/12, palmar grasp, reaching, transfering -/- hands, 6/12, pincer grip, 1, spoon, cup, 2 block, 4, block, scribbles, handedness, 6 blocks, fork, line, 2, undresses, toilet, circle, cross, square, buttons, 4, draws a person

414
Q

speech, language, hearing developmental milestones in order

A

0, suckles, startles, cooing, 3/12, babbles, 6/12, mama, dada, 1 word, 1, 5 words, 1-step command, body parts, 2-step command, 2-word phrase, 2, 3-4-word phrases, sentences, 4

415
Q

behavioural + social developmental milestones in order

A

0, fixes and follows, smiles, 3/12, object permenance, 6/12, 1, symbolic play, 2, sharing, empathy, role play, counting, 4, rules

416
Q

rule out in ambiguous genitalia e.g. bx undescended testes

417
Q

constitutional delay of puberty features

A

runs in families (male line)

418
Q

respirtory distress S is 2’ to

A

surfactant deficiency

419
Q

gastroschisis is

A

herniation of the bowel through a defect in the ant abdo wall

420
Q

inheritance pattern of Wilson’s DZ

421
Q

consequences of Wilson’s DZ

A

amber rings in iris, liver cirrhosis, neuro symptoms, renal involvement, cardiac complications, haemolytic anaemia

422
Q

1st line Mx of constipation in children

A

fluids, fibre, exercise

423
Q

UC is associated with

A

erythema nodosum, pyoderma gangrenosum, arthritis, spondylitis

424
Q

Crohn’s is associated with

A

oral ulcers

425
Q

cows milk protein allergy vs lactose intollerance

A

cows milk = switch to formula, eczema, V, D

lactose intollerance = post gastroenteritis, from 2 y.o.

426
Q

Kawasaki DZ features

A

fever, blanching erthematous rash, bx non-purulent conjunctivitis, cervical lymphadenopathy, red tongue, cracked lips

427
Q

consequences of CMV infection in pregnancy for the baby

A

deafness, IUGR, hydrocephalus, thrombocytopaenia

428
Q

herniation of the bowel through a defect in the ant abdo wall describes

A

gastroschistisis

429
Q

amber rings in iris, liver cirrhosis, neuro symptoms, renal involvement, cardiac complications, haemolytic anaemia describe

A

Wilson’s DZ

430
Q

fever, blanching erthematous rash, bx non-purulent conjunctivitis, cervical lymphadenopathy, red tongue, cracked lips describes

A

Kawasaki’s

431
Q

erythema multiforme description

A

target lesions

432
Q

causes of erythema multiforme

A

drugs (penicillin), infection (atypical pneumo), idiopathic

433
Q

erythema migrans is caused by

A

Lyme’s DZ

434
Q

SCID blood results

A

low t cells, low b cells, low immunoglobulins

435
Q

DiGeorge S features

A

cleft pallet, cardiac abnormalities (TOF, VSD), thymic hypoplasia, mid-facial hypoplasia, hypocalcaemia

436
Q

DiGerege S diagnosed by

437
Q

Wiskott-Aldrich S mode of inheritance

A

X-linked recessive

438
Q

Wiskott-Aldrich presenation

A

eczema, thrombocytopaenia, recurrent infections, petechiae, bruising

439
Q

SCID presents

A

v early in life, may be fatal by 3 y.o.

440
Q

Lyme’s DZ skin manifestation

A

erythema migrans

441
Q

low t cells, low b cells, low immunoglobulins blood results suggest

442
Q

cleft pallet, cardiac abnormalities (TOF, VSD), thymic hypoplasia, mid-facial hypoplasia, hypocalcaemia are features suggestive of

A

DiGeorge S

443
Q

eczema, thrombocytopaenia, recurrent infections, petechiae, bruising is suggestiev of

A

Wiskott-Aldrich

444
Q

test for cf

A
  1. newborn blood spot 2. sweat test
445
Q

most common type of cardiac defect

446
Q

symptoms of HF in neontes

A

SOB, sweaty, growth restriction, failure to thrive, hepatosplenomegaly, cyanosis

447
Q

when does the ductus arteriosis closes

A

hours - days post-birth

448
Q

cardiac abnormalities that manifest once the ductus arteriousis closes

A

ToF, pulmonary atresia, tricuspid atresia, TGA

449
Q

reopen the ductus arteriosis with

A

prostaglandins

450
Q

cardiac abnormalities associated with DS

A

ToF, ASD, VSD, AVSD

451
Q

WPW on ECG

A

delta wave (slanting upstroke of R), short PR,

452
Q

Kawasaki Mx

A

high dose aspirin, IVIG

453
Q

Eisenmenger’s S describes

A

when a VSD turns from a L-R shunt to a R-L

454
Q

SOB, sweaty, growth restriction, failure to thrive, hepatosplenomegaly, cyanosis are symptoms of

A

HF in neonates

455
Q

delta wave (slanting upstroke of R), short PR, are seen on ECG in

456
Q

when a VSD turns from a L-R shunt to a R-L describes

A

Eisenmenger’s S

457
Q

low rumbling murmur heard above the nipple line is called

A

venous hum (N finding in children)

458
Q

posterior urethral valves presentation

A

enarged, palpable bladder

459
Q

posterior urethral valves Ix

A

micturating cystourethrogram

460
Q

HbSS crisis Mx

A

analgesia (morphine), rewarming, ABx, O2, IV fluids, transfulsion if required

461
Q

haemophillia mode of inheritance

462
Q

haemophilia A is due to a deficiency of

A

factor VIII

463
Q

haemophilia B is due to a deficiency of

464
Q

long term sequelae of childhood ca Rx

A

2’ ca, educational difficulties, growth, infertility

465
Q

when to do a MRI with a port wine stain

A

if it’s in the trigeminal distribution

466
Q

strawberry naevi present

A

in 1st month

467
Q

course of a strawberry naevi

A

get larger before it regresses by 5y

468
Q

molluscum contagiosum is caused by

469
Q

erythema toxicum appearance

A

erythematous base with small pustules in the newborn period

470
Q

erythematous base with small pustules in the newborn period describes

A

erythema toxicum

471
Q

features of Kleinfelter’s S

A

tall stature, small testicular V, delayed puberty, gynaecomastia

472
Q

Kleinfelter’s karyotype

473
Q

features of Marfan’s S

A

myopia, lens dislocation, arachnodactly, arm span > height, hypermobility, aortic arch abnormalities, mitral valve prolapse, chest wall deformity

474
Q

precocious puberty ages

A

<8 for girls, <9 for boys

475
Q

tall stature, small testicular V, delayed puberty, gynaecomastia are features of

A

Kleinfelter’s S

476
Q

47XXY is the karyotype of

A

Kleinfelter’s S

477
Q

myopia, lens dislocation, arachnodactly, arm span > height, hypermobility, aortic arch abnormalities, mitral valve prolapse, chest wall deformity are features of

A

Marfan’s

478
Q

growing pains are usually more troublesome at

479
Q

SUFE Mx

A

Sx fixation

480
Q

grenstick # describes

A

one side of the bone buckes and the other side is intact

481
Q

Colles # describes

A

of ulnar + radius, distal end slides back + shortens it

482
Q

Salter-Harris # describes

A

a Colles # that occurs through the growth plate

483
Q

one side of the bone buckes and the other side is intact describes

A

greenstick #

484
Q

of ulnar + radius, distal end slides back + shortens it describes

485
Q

a Colles # that occurs through the growth plate describes

A

Salter-Harris #

486
Q

osteogenesis imperfecta mode of inheritance

A

AD, variable penetrance

487
Q

DDH risk factors

A

breech, first born, FH, clubbed foot, oligohydramnios, macrosomia

488
Q

DDH Mx

A

US at 6/52, ortho referral, harness for 6/52

489
Q

breech, first born, FH, clubbed foot, oligohydramnios, macrosomia are risk factors for

490
Q

features of HIE

A

poor feeding, altered tone, seizure activity, irritability, hyperventillation

491
Q

SE of Na valproate

A

increased apetite, weight gain, hair loss, liver failure

492
Q

memory loss causing inability to orientate oneself

A

topographical

493
Q

memory loss causing inability to recall personal life events

A

autobiographical

494
Q

memory loss causing inability to remember how to do things e.g. ride a bike

A

proceedural

495
Q

memory loss causing inability to recall facts

496
Q

topographical memory loss describes

A

inability to orientate oneself

497
Q

autobiographical memory loss describes

A

inability to recall personal life events

498
Q

proceedural memory loss describes

A

inability to remember how to do things e.g. ride a bike

499
Q

schemantic memory loss describes

A

inability to recall facts

500
Q

perseverence describes

A

answering the 1st Q correctly then using the same answer for all subsequent Q’s

501
Q

perseverence is seen in

502
Q

confabulation describes

A

false memories occur, giving wrong answers, trying to cover up deficit, invents fantastical stories

503
Q

confabulation is seen in

A

organic brain damage e.g. alcholism

504
Q

affect illusion describes

A

mood influences the illusion e.g. frightened + see dressing gown as person

505
Q

completion illusion describes

A

lack of attention to stimulus therefore incorrect interpretation e.g. misreading in book

506
Q

pareidolic illusions

A

shapes being seen in other objects e.g. images in the clouds

507
Q

extracampine hallucination describes

A

hallucination beyond range of sensation

508
Q

functional hallucination describes

A

hallucination only when external stimulus present in same modality e.g. hearing voices when hearing classical music

509
Q

hypnagogic hallucinations describe

A

hallucinations when going to sleep

510
Q

hypnopompic hallucination describe

A

hallucinations when waking up

511
Q

reflex hallucinations describe

A

hallucination only when external stimulus present in different modality e.g. hearing voices when child looks at them

512
Q

answering the 1st Q correctly then using the same answer for all subsequent Q’s describes

A

perseverence

513
Q

false memories occur, giving wrong answers, trying to cover up deficit, invents fantastical stories describes

A

confabulation

514
Q

mood influences the illusion e.g. frightened + see dressing gown as person describes

A

affect illusion

515
Q

lack of attention to stimulus therefore incorrect interpretation e.g. misreading in book describes

A

completion illusion

516
Q

shapes being seen in other objects e.g. images in the clouds describes

A

parelolic illusion

517
Q

hallucination beyond range of sensation desribes

A

extracampine hallucinations

518
Q

hallucination only when external stimulus present in same modality e.g. hearing voices when hearing classical music describes

A

functional hallucination

519
Q

hallucinations when going to sleep describes

A

hypnagogic hallucination

520
Q

hallucinations when waking up describes

A

hypnopompic hallucination

521
Q

hallucination only when external stimulus present in different modality e.g. hearing voices when child looks at them describes

A

reflex hallucination

522
Q

autochthonous delusion describes

A

a delusion that occurs out of the blue

523
Q

autoscopy desribes

A

sensation of seeing oneself

524
Q

delusional atmosphere aka

A

delusional mood

525
Q

delusional atmosphere describes

A

state of perplexity/bewilderment when sufferers feel that st is going on but w/o being able to state exactly what

526
Q

delusional memory describes

A

recall of an event interpreted with delusional meaning

527
Q

a delusion that occurs out of the blue is called

A

autochthonous delusion

528
Q

sensation of seeing oneself describes

529
Q

state of perplexity/bewilderment when sufferers feel that st is going on but w/o being able to state exactly what describes

A

delusional atmosphere

530
Q

recall of an event interpreted with delusional meaning describes

A

delusional memory

531
Q

logoclonia describes

A

repeating the last sylable of a word

532
Q

logoclonia is seen in

533
Q

repeating the last sylable of a word describes

A

logoclonia

534
Q

PTSD symptoms have to be present for at least

535
Q

clanging describes

A

when words are used based on thier similarities in sound

536
Q

when words are used based on thier similarities in sound describes

537
Q

medical Mx of delirium

A

low dose haloperidol

538
Q

Hebephrenic schizophrenia describes

A

predominance of thought disorder + affective symptoms (factuous + childlike), social withdrawal is common

539
Q

Hebephrenic schiophrenia aka

A

disorganised schizophrenia

540
Q

residual schizophrenia describes

A

late-stage schizophrenia where +ve symptoms replaces with -ve ones

541
Q

simple schizophrenia describes

A

no overt psychotic symptoms

542
Q

predominance of thought disorder + affective symptoms (factuous + childlike), social withdrawal is common describes

A

Hebephrenic schizophrenia

543
Q

disorganised schizophrenia aka

A

Heberphrenic schizophrenia

544
Q

late-stage schizophrenia where +ve symptoms replaces with -ve ones describes

A

residual schizophrenia

545
Q

no overt psychotic symptoms describes

A

simple schizophrenia

546
Q

clozapone causes (risk)

A

agranulocytosos/neutropenia

547
Q

Mx of tardive dyskinesia

A

reduce dose of antipsychotic

548
Q

schizoaffective disorders describes

A

schizophrenia + affective disorder e.g. mania, both present in same episode

549
Q

schizotypal dosirder describes

A

eccentric behaviours + beliefs that may mimic schizophrenia but w/o psycosis

550
Q

schizophrenia + affective disorder e.g. mania, both present in same episode descries

A

schizoaffective disorder

551
Q

eccentric behaviours + beliefs that may mimic schizophrenia but w/o psycosis describes

A

schizotypal disorder

552
Q

dysthymia describes

A

chronic low grade mood disorder

553
Q

cyclothymia describes

A

persistent instability of mood

554
Q

hypomania describes

A

elevated mood that interferes with ADLs but not severely + no psychotic symptoms

555
Q

core features of depression

A

low mood, anhedonia, anergia

556
Q

biological symptoms of depression include

A

change in apetite, weight change, sleep change, loss of libido, diurnal variation in mood

557
Q

psychological features of depression

A

guilt, hopelessness, suicidal ideation

558
Q

chronic low grade mood disorder describes

559
Q

persistent instability of mood describes

A

cyclothymia

560
Q

elevated mood that interferes with ADLs but not severely + no psychotic symptoms describes

561
Q

agaraphobia describes

A

fear of situations that one might not be able to escape from, avoidance of these situations

562
Q

social phobia describes

A

fear of particular social situations e.g. pubic speaking

563
Q

Charles Bonnet S describes

A

complex visual hallucinations the occur in people with severe visual impairment e.g. AMD, insight is retained

564
Q

mneumonic to remeber factors that comprise personality

565
Q

OCEAN stands for

A

openness, conscienciousness, exraversion, agreeableness, neuroticism

566
Q

antisocial personality disorder describes

A

emotionally cold, no remorse, forensic Hx

567
Q

dependent personality disorder usually comes to attention

A

once partner dies

568
Q

schizoid personality disorder describes

A

isolated, aloof, emotionally detached, few friends/relationships

569
Q

anakastic personality disorder describes

A

preoccupied by rules and schedules, perfecionist, overly pedantic, rigid, stubborn, difficult

570
Q

anakastic personality disorder aka

A

OC personality disorder

571
Q

histrionic personality disorder describes

A

overly dramatic displays, occasional DSH, attention seeking

572
Q

EUPD

A

intense + unstable relationships, go to great lengths to avoid being abandoned

573
Q

complex visual hallucinations the occur in people with severe visual impairment e.g. AMD, insight is retained describes

A

Charles Bonnet S

574
Q

emotionally cold, no remorse, forensic Hx describes

A

antisocial PD

575
Q

isolated, aloof, emotionally detached, few friends/relationships describes

A

schizoid PD

576
Q

preoccupied by rules and schedules, perfecionist, overly pedantic, rigid, stubborn, difficult describes

A

anakastic PD

577
Q

overly dramatic displays, occasional DSH, attention seeking describes

A

histrionic PD

578
Q

intense + unstable relationships, go to great lengths to avoid being abandoned describes

579
Q

Wernike’s encephalopathy triad

A

ataxia, confusion, opthalmoplegia

580
Q

characteristics fo Korsakoff’s

A

amnesia with N consciousness

581
Q

ca most likelt to metastasise to the spine

A

breast, prostate, L, thyroid, renal

582
Q

Rx of ca induced hypercalcaemia

A

fluids, bisphosphonates (pamidronate)

583
Q

Rx of acute hypercalcaemia

A

fluids (only use bisphosphonates if ca induced)

584
Q

three most common causes of hypercalcaemia

A

ca, hyperparathyroidism, sarcoid

585
Q

adjuvent therapy describes

A

post-Sx Rx

586
Q

neoadjuvent therapy describes

587
Q

radical therapy describes

A

Rx with curative intent

588
Q

CEA is a tumour marker for

589
Q

AFP is a tumour marker for

590
Q

B-hCG is a tumour marker for

A

seminomas, teratomas, choriocarcinomas

591
Q

CA19-9 is a tumour marker for

A

pancreatic

592
Q

post-Sx Rx for ca is called

593
Q

pre-Sx Rx for ca is called

A

neo-adjuvent

594
Q

Rx with curative intent for ca is called

595
Q

tumour marker for CRC is

596
Q

tumour marker for HCC is

597
Q

tumour marker for seminomas/teratomas/choriocarcinomas is

598
Q

tumour marker for pancreatic ca is

599
Q

oesophageal ca types + locations

A

upper2/3 = SCC, lower 1/3 = adenocarcinoma, risk factor = GORD

600
Q

small cell L ca is sensitive to

601
Q

ca which may cause SIADH

A

L, prostate, thymus, pancreatic, lymphoma

602
Q

SIADH results

A

low serum osmolality, high urinary osmolality

603
Q

symptoms of SIADH

A

confusion N, irritability

604
Q

initial Rx of SIADH

A

fluid restriction

605
Q

low serum osmolality, high urinary osmolality suggests

Medicine (30 decks)

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