SBA general revision Flashcards
1
Q
causes of severely low platelets
A
ITP, DIC, TTP, haematologial malignancy, HUS
2
Q
causes of modertely low platelets
A
HIT, drug-induced, EtOH, liver DZ, hypersplenism, viral infection, pregnancy, SLE/anti-PL S, B12 deficiency
3
Q
in DIC the clots are made of
A
fibrin
4
Q
before DIC the PT is
A
already ill with something else e.g. GNR bacteraemia, ITU, end stage liver DZ
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)
6
Q
DIC management
A
treat underlying cause, give platelets, cryoprecipitate (to boost fibrinogen), FFP (for PT, PTT, INR), RBC for schistocytosis
7
Q
fibrin clots in
A
DIC
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
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
10
Q
TTP is
A
thrombotic thrombocytopaenic purpura
11
Q
TTP clots are made of
A
hyaline
12
Q
mneumonic to remember TTP presentation
A
FATRN
13
Q
FATRN stands for
A
Fever, MAHA (microangiopathic heamolytic Anaemia), Thrombocytopaenia, Renal failure, Neuro symptoms
14
Q
with TTP the PT is originally
A
well
15
Q
TTP blood results
A
low platelets, +ve blood film for scistocytes
16
Q
TTP management
A
exchange transfusion, don’t give platelets (makes it worse)
17
Q
hyaline clots form in
A
TTP
18
Q
FATRN is a way of remembering
A
PT presentation in TTP
19
Q
a well PT who then develops low platelets may have
A
TTP
20
Q
low platelets, +ve blood film for scistocytes are the blood results of
A
TTP
21
Q
exchange transfusion, don’t give platelets (makes it worse) is the management of
A
TTP
22
Q
asymptomatic, v low platelts (single digits), purpura, petechiae, bleeding from mucosal sites, ?post-recent infection describes the presentation of
A
ITP
23
Q
ITP is
A
immune/idiopathic thrombocytopenia purpura
24
Q
presentation of ITP
A
asymptomatic, v low platelts (single digits), purpura, petechiae, bleeding from mucosal sites, ?post-recent infection
25
ITP diagnosis
diagnosis of exclusion, increased bleeding time, N blood film
26
ITP management
platelets (rule out TTP first), corticosteroids (reverse immune cause), IVIG, splenectomy, monoclonal Ab
27
diagnosis of exclusion, increased bleeding time, N blood film
ITP
28
platelets (rule out TTP first), corticosteroids (reverse immune cause), IVIG, splenectomy, monoclonal Ab is the management of
ITP
29
HUS is
haemolytic uraemic syndrome
30
HUS pathophysiology
toxin-mediated haemolysis, destruction of platelets, recent infectio with E. coli (specific strain, bloody diarrhoea)
31
HUS PT
recent diarrhoea, renal failure
32
HUS bloods
low platelets, increased bleeding time, signs of kidney failure, blood film +ve for schistocytes
33
HUS management
supportive
34
toxin-mediated haemolysis, destruction of platelets, recent infectio with E. coli (specific strain, bloody diarrhoea) describes the pathophysiology of
HUS
35
recent diarrhoea, renal failure then drop in platelets may suggest
HUS
36
low platelets, increased bleeding time, signs of kidney failure, blood film +ve for schistocytes is typical of
HUS
37
HIT is
heparin-induced thrombocytopaenia
38
pathophysiology of HIT
Abs to heparin cross react with platelets leading to theinr destruction
39
PT with HIT is
in hospital for an unrelated reason, receiving heparin, sudden drop in platelets
40
HIT management
stop heparin, bridge with alternative anticoagulant
41
drug causes of low platelets
quinine, diuretics, sulphonamides, aspirin, thiazide
42
viral causes of low platelets
EBV, HIV, hepatitis
43
Abs to heparin cross react with platelets leading to theinr destruction describes teh pathophysiology of
HIT
44
in hospital for an unrelated reason, receiving heparin, sudden drop in platelets may suggest
HIT
45
stop heparin, bridge with alternative anticoagulant is the management of
HIT
46
counselling is
6-12 sessions based on an acute event e.g. berevement
47
DBT is
dialectical behavioural therapy = explores opposite positions and looks at how they might exist together
48
IPT is
interpersonal therapy = identify + address problems regarding relationships + interactions with others
49
psychodynamic psychotherapy is
exploring how your unconscious thoughts (i.e. past experience) might affect the way you act today
50
CBT is generally used in the management of
anxiety, depression, panic attacks, phobias, OCD, PTSD
51
DBT is generally used in the management of
personality disorders
52
family therapy is generally used in the management of
CAMHS, ED, DV, drug + alcohol abuse
53
IPT is generally used in the management of
depression
54
6-12 sessions based on an acute event e.g. berevement describes
counselling
55
exploring opposite positions and looks at how they might exist together describes
DBT
56
identifies + addresses problems regarding relationships + interactions with others describes
IPT
57
exploring how your unconscious thoughts (i.e. past experience) might affect the way you act today describes
psychodynamic psychotherapy
58
psychodynamic psychotherapy is used in the management of
depression, schizophrenia
59
talking therapy for anxiety, depression, panic attacks, phobias, CD, PTSD
CBT
60
talking therapy for schizophrenia, depression
psychodynamic psychotherapy
61
talking therapy for personality disorders
DPT
62
talking therapy for CAMHS, ED, DV, drug + alcohol abuse
family therapy
63
talking therapy for depression
IPT
64
HF features
SOB, pik frothy sputum, bibasal crackles, low O2 sats, S3, PND, peripheral oedema
65
HF diagnosis depends on
previous MI or not
66
to diagnse HF in PT with previous MI
ECHO w/i 2/52
67
to diagnose HF in PT w/o previous MI
1. BNP
| 2. if BNP high ECHO w/i 2/52 if BNP low EECHO w/i 6/52
68
what is BNP
B-type natriuretic peptide = hormone produced by LV myocardium in respose to strain
69
BNP and prognosis in HF
the higher the BNP the worse the prognosis
70
factors that increase BNP
LVH, ischaemia, tachycardia, RV overload, hypoxaemia (inc PE), GFR <60, sepsis, DM, age >70, liver cirrhosis
71
factors that decrease BNP
obesity, diuretics, ACEi, B-blockers, ARB, aldosterone antagonists
72
SOB, pik frothy sputum, bibasal crackles, low O2 sats, S3, PND, peripheral oedema are features of
HF
73
ECHO w/i 2/52 in suspected HF for those who
have had a previous MI, or high BNP
74
ECHO w/i 6/52 in suspected HF for those who
have a low BNP
75
hormone produced by LV myocardium in respose to strain
BNP
76
NYHA classification is used to stratify
HF
77
NYHA class I
no symptoms
78
NYHA class II
mild symptoms, slight limitation of physical activity
79
NYHA class III
marked limitation in physical activity, comfortable at rest
80
NYHA class IV
severe symptoms even at rest
81
acute management of HF includes
O2, CPAP, diuretics, vasodilators, morphine, mechanical circulatory assistance
82
long term management of HF
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
83
NYHA classification of no symptoms
I
84
NYHA classification of mild symptoms, slight limitation of physical activity
II
85
NYHA classification of marked limitation in physical activity, comfortable at rest
III
86
NYHA classification of severe symptoms even at rest
IV
87
O2, CPAP, diuretics, vasodilators, morphine, mechanical circulatory assistance are used in the acute management of
HF
88
1. ACEi, B-blockers
2. aldosterone antagonist (spiroolactone)/ARB (candesartan)/hydralazine with nitrates
3. digoxin if concurrent AF
is the guidance for management of
HF
89
causal agents of serotonin S
MAOi, SSRIs, ecstasy, amphetamines
90
features of serotonin S
hyperreflexia, myoclonus, rigidity, dilated pupils, tachycarida, hyperthermia, diaphoresis, altered mental state
91
management of serotonin S
stop offening drug, IV fluids, supportive, BZD
92
neuroleptic malignant S is causative agents
antipsychotics (typical and atypical)
93
neuroleptic malignant S features
males, w/i first 10/7 of starting/inreasing dose, pyrexia, hyporeflexia, rigidity, tachycardia, diaphoresis, raised ck
94
neuroleptic malignant S Mx
stop antipsychotic, IV fluids, BZD
95
serotonin S onset period
hours
96
neuroleptic malignant S onset period
hours - days
97
hyperreflexia, myoclonus, rigidity, dilated pupils, tachycarida, hyperthermia, diaphoresis, altered mental state are features of
serotonin S
98
males, w/i first 10/7 of starting/inreasing dose, pyrexia, hyporeflexia, rigidity, tachycardia, diaphoresis, raised ck are features of
neuroleptic malignant S
99
two types of stroke + % occurrence
ischaemin 85%, haemorrhagic 15%
100
subtypes of ischaemic stroke
thrombotic (from large vessels e.g. carotids), embolic (blood clot, air, fat, bacterial clump, AF)
101
subtypes of haemorrhagic stroke
intracerebral (w/i the brain), subarachnoid (on the surface of the brain)
102
rish factors for ischaemic stroke
age, HTN, smoking, hyperlipidaemia, DM, AF
103
risk factors for haemorrhagic stroke
age, HTN, AVM, anticoagulation therapy
104
stroke vs TIA
stroke symptoms last >24h, TIA <24h most <1h
105
Bamford/Oxford stroke classification
TACI, PACI, LACI, POCI
106
TACI is
total anterior circulation stroke affecting middle + ant cerebral a
107
TACI symptoms
ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia
108
PACI is
partial ant circulatory stroke, involves the smaller a of the ant circulation e.g. upper/lower division of MCA
109
PACI features
2 of: ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia
110
LACI is
lacunar infarct, involves perforating a around the internal capsule, thalamus and basal ganglia
111
LACI features
q of: ux weakness (+/ sensory deficit) of face + arm/arm + leg/all 3, pure sensory stroke, ataxic hemiplegia
112
POCI is
post circulation stroke, involves the vertebrobasilar a
113
POCI features
1 of: cerebellar/brainstem S, LOC, isolated HH
114
general symptom differences between haemorrhagic and ischaemic stroke
haemorrhagic > likely to have: reduces consciousness, headache, N, V, seizure
115
stroke Mx
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
116
TIA referral guidelines
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
117
location of stroke in amaurosis fugax
retinal/opthalmic a
118
AF post-stroke management
start warfarin 14/7 later
119
high cholesterol and stroke when to start statin
48h later
120
drug used for thrombolysis
altepase
121
secondary prevention of stroke management
clopidogrel 75mg lifelong
122
carotid a endarterectomy when stenosis
>70%
123
TIA Mx
300mg aspirin
124
secondary prevention post-TIA Mx
clopidogrel 75mg lifelong
125
types of AF
paroxysmal (spontaneoulsy stops, lasts <7/7), persistent, permanent (cannot be cardioverted)
126
symptoms of AF
palpitiations, SOB, CP
127
AF management options
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
128
risks of rhythm control in AF
highest risk of embolic stroke at point of cardioversion due to rhythm change
129
score to stratify stroke risk in AF
CHA2DS2VaS
130
CHA2DS2VaS and results
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
131
first line antiplatelets post NSTEMI
aspirin lifelong + clopidogrel/ticagrelor for 12/12
132
first line antiplatelet post STEMI
aspirin lifelong + clopidogrel/ticagrelor 1/12 if no/bare metal stent, 12/12 if drug-eluting stent
133
stroke affecting middle + ant cerebral a
TACI
134
ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia are symptoms of
TACI
135
stroke involving the smaller a of the ant circulation e.g. upper/lower division of MCA
PACI
136
2 of: ux hemiparesis +/ hemisensory loss of face, arm + leg, HH, higher cognitive dysfunction e.g. dysphasia are features of
PACI
137
stroke involving perforating a around the internal capsule, thalamus and basal ganglia
LACI
138
1 of: ux weakness (+/ sensory deficit) of face + arm/arm + leg/all 3, pure sensory stroke, ataxic hemiplegia are features of a
LACI
139
stroke involving the vertebrobasilar a
POCI
140
1 of: cerebellar/brainstem S, LOC, isolated HH are features of
POCI
141
retinal/opthalmic a stroke causes
amaurosis fugax
142
altepase is the drug used in
thrombolysis
143
clopidogrel 75mg lifelong for
post-stroke and TIA
144
CHA2DS2VaS is used to
stratify risk of stroke in AF
145
aspirin lifelong + clopidogrel/ticagrelor for 12/12 for
post-NSTEMI
146
aspirin lifelong + clopidogrel/ticagrelor 1/12 if no/bare metal stent, 12/12 if drug-eluting stent
post-STEMI
147
risk factors for developing schizophrenia
(in order) FH, black Caribbean, migration, urban environment, cannabis
148
diagnostic criteria for schizophrenia
1/12 of: delusions of control (passivity phenomenon), thought disorder (insertion/withdrawal/broadcast), persistent delusions (paranoid, perception), hallucinations (3rd person auditory)
149
negative symptoms in schizophrenia
flat affect, anhedonia, alogia, avolition
150
general management of schizophrenia
PO antipsychotic + CBT
151
factors associated with poor prognosis in schizophrenia
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
152
AML is the most common
form of acute leukaemia in adults
153
features of AML
anaemia (pallor, lethargy), neutropaenia, thrombocytopenia (bleeding), splenomegaly, bone pain
154
CML is most commonly
associated with the Philadelphia ch (translocation -/- ch 9 + 22 leading to BCR-ABL)
155
CML presentation
anaemia (lethargy), weight loss, sweating, splenomegaly
156
ALL is the most common
childhood malignancy
157
features of ALL
anaemia (lethargy, pallor), neutropaenia (f/severe infections), thrombocytopaenia (easy bruising/petechiae), bone pain, splenomegaly, hepatomegaly, testicular swelling
158
CLL features
asymptomatic, anorexia, weight loss, bleeding, infections, lymphadenopathy
159
CLL on a blood film
smudge cells/smear cells
160
most common form of acute leukaemia in adults
AML
161
anaemia (pallor, lethargy), neutropaenia, thrombocytopenia (bleeding), splenomegaly, bone pain are features of
AML
162
associated with the Philadelphia ch (translocation -/- ch 9 + 22 leading to BCR-ABL)
CML
163
anaemia (lethargy), weight loss, sweating, splenomegaly are symptoms of
CML
164
most common childhood malignancy
ALL
165
anaemia (lethargy, pallor), neutropaenia (f/severe infections), thrombocytopaenia (easy bruising/petechiae), bone pain, splenomegaly, hepatomegaly, testicular swelling are features of
ALL
166
asymptomatic, anorexia, weight loss, bleeding, infections, lymphadenopathy are features of
CLL
167
smudge/smear cell on blood film suggests
CLL
168
tumour lysis S can occur in the Rx of
high grade lymphomas + leukaemia's
169
tumour lysis S is usually triggered by
chemo
170
pathophysiology of tumour lysis S
breakdown of tumour cells and subsequent release of chemicals from the cell leading to high K + high PO4 + low Ca
171
tumour lyiss S presentas as
AKI + high PO4 + high uric acid
172
chemo in high grade lymphomas + leukaemia's can trigger
tumour lysis S
173
hand foot and mouth DZ is caused by
coxsackie virus
174
clinical features of hand foot and mouth DZ
sore throat, fever, oral ulcers, vesicles on palms + soles
175
hand foot and mouth Mx
self limiting, hydration, analgesia
176
coxsackie virus causes
hand foot and mouth DZ
177
sore throat, fever, oral ulcers, vesicles on palms + soles are features of
hand foot and mouth DZ
178
immunisations for pertussis
2, 3, 4/12, preschool, pregnant women
179
bouts of coughing, worse at night/post-feed, V, central cyanosis, inspirtory whoop
whooping cough
180
pertussis Ix
per nasal swab culture, PCR, serology
181
pertussis Mx
PO macrolide (clarithromycin, azithromycin, erythromycin), 2/7 school exclusion
182
pertussis complications
subconjunctival haemorrhages, pneumonia, bronchiectasis, seizures
183
whooping courgh features
bouts of coughing, worse at night/post-feed, V, central cyanosis, inspirtory whoop
184
P450 inducers
phenytoin, carbamazepine, phenobarbitone, rifampicin, St John Wort, chronic EtOH intake, smoking
185
P450 inhibitors
ciprofloxacin, erythromycin, isoniazid, omeprazole, amiodarone, allopurinol, fluconazole, fluoxetine, sertraline, Na valproate, acute EtOH intake
186
Jarisch-Herxheimer reaction presentation
fever, rash, tachycardia
187
Jarisch-Herxheimer reaction occurs following
first dose ABx for syphilis
188
fever, rash, tachycardia post-first dose of ABx for syphilis
Jarisch-Herxheimer reaction
189
most common type of breast ca
invasive ductal carcinoma
190
breast ca risk factors
BRCA, 1st degree premenopausal relative, nuliparity, early menarche, late menopause, HRT, COCP, previous breast ca, not breastfeeding, ionising radiation, p53 gene mutations, obesity
191
breast ca screening f and ages
47-73, 3 yearly
192
4 main types of breast ca
invasive ductal carinoma (aka NST no special type), invasive lobar carcinoma, dudcal carcinoma in situ, lobar carcinoma in situ
193
tension headache presentation
recurrent, non-disabling, bx, tight band, not aggrevated by ADLs
194
cluster headache presentation
15min-2h duration, 1-2/d for 4-12/52, intense pain around eye, redness, lacrimation, lid swelling, limiting
195
temporal arteritis presentation
>60 y.o., rapid onset ux headache, jaw claudication, tender palpable temporal a
196
medication overuse headache
>15/7 per month, developed/wosened whilst taking medication (opoids, triptans)
197
migraine presentation
24-72h, ux, pulsating, aggrevated by ADLs, N/V, phono/photophobia
198
L ca types
small cell, non-small cell (squamous, adenocarcinoma, large cell)
199
small cell L ca features
central, ectopic ADH (hyponatraemia)/ACTH (Cushing's S) secretion, poor prognosos (usually mets at presentation)
200
squamous cell L ca features
central, PTHrP secretion (hypercalcaemia), clubbing
201
adenocarcinoma features
peripheral, most common in non-smokers
202
large cell L ca features
peripheral, anaplastic, poorly differentiated, poor prognosis, B-hCG secretion
203
recurrent, non-disabling, bx, tight band, not aggrevated by ADLs are features of
tension headache
204
15min-2h duration, 1-2/d for 4-12/52, intense pain around eye, redness, lacrimation, lid swelling, limiting are features of
cluster headache
205
>60 y.o., rapid onset ux headache, jaw claudication, tender palpable temporal a are features of
temporal arteritis
206
>15/7 per month, developed/wosened whilst taking medication are symptoms of
medication overuse headache
207
24-72h, ux, pulsating, aggrevated by ADLs, N/V, phono/photophobia are symptoms of
migraine
208
central, ectopic ADH (hyponatraemia)/ACTH (Cushing's S) secretion, poor prognosos (usually mets at presentation) are features of
small cell L ca
209
central, PTHrP secretion (hypercalcaemia), clubbing are features of
squamous cell L ca
210
peripheral, most common in non-smokers are features of
adenocarcinoma L ca
211
peripheral, anaplastic, poorly differentiated, poor prognosis, B-hCG secretion are features of
large cell L ca
212
causes of erythema nodosum
strep, TB, sarcoidosis, IBD, Bechet's, ca/lymphoma, penicillin, COCP, pregnancy
213
sarcoidosis is characterised by
non-caseating granulomas
214
features of acute sarcoidosis
erythema nodosum, bx hilar lymphadenopathy, swinging fever, polyarthralgia
215
features of insidious sarcoidosis
SOB, non-productive cough malaise, weight loss
216
Ix in sarcoidosis
CXR, ACE level, Ca, ESR, spirometry, tissue biopsy
217
non-caseating granulomas is chracteristic of
sarcoidosis
218
erythema nodosum, bx hilar lymphadenopathy, swinging fever, polyarthralgia are features of
acute sarcoidosis
219
SOB, non-productive cough malaise, weight loss are features of
insidious sarcoidosis
220
intussusception features
paroxysmal abdo colic, draw knees up, pallor, V, blood stined stools (red current jelly), sausage shaped mass in RIF
221
intussusception Ix
US (target lesion)
222
intussusception Mx
reduction by air insufflation under radiological guidance
223
paroxysmal abdo colic, draw knees up, pallor, V, blood stined stools (red current jelly), sausage shaped mass in RIF are features of
intussusception
224
TORCH screen consists of
toxo, rubella, CMV, HSV, HIV
225
method of inheritance of tuberous sclerosis
AD
226
cutaneous features of tuberous sclerosis
depigmented 'ash-leaf' spots which fluoresce under UV, Shagreen patches, butterfly distribution adenoma sebaceum, subungual fibromata, cafe au lait spots
227
neurological features of tuberous sclerosis
developmental delay, epilepsy, intellectual impairment
228
neurofibramatosis features
axillary/groin freckles, pheochromocytoma, iris hamartomas (Lisch nodules)
229
depigmented 'ash-leaf' spots which fluoresce under UV, Shagreen patches, butterfly distribution adenoma sebaceum, subungual fibromata, cafe au lait spots are features of
cutaneous tuberous sclerosis
230
axillary/groin freckles, pheochromocytoma, iris hamartomas (Lisch nodules) are features of
neurofibramatosis
231
Shagreen patches are
patches of roughened skin over the lumbar spine
232
patches of roughened skin over the lumbar spine are called
Shagreen patches
233
bronchiolitis is caused by
RSV
234
bronchiolitis features
coryzal symptoms, dry cough, SOB, wheeze
235
croup is caused by
parainfluenza virus
236
croup features
barking cough, stridor, fever, coryzal symptoms
237
croup Mx
dexamethasone (0.15mg/kg), high flow O2, nebulised adrenaline
238
RSV causes
bronchiolitis
239
coryzal symptoms, dry cough, SOB, wheeze are features of
bronchiolitis
240
parainfluenza virus causes
croup
241
barking cough, stridor, fever, coryzal symptoms are features of
croup
242
ASD murmur
ejection systolic
243
VSD murmur
pansystolic (harsh)
244
PDA murmur
continuous 'machine-like'
245
ToF murmur
ESM
246
coarctation of the aorta murmur
late systolic
247
Kleihauer test
determined proportion of foetal RBC in mother's circulation in the event of a sensitising event in a Rh- mother
248
give anti-D at
28/40, after birth/termination/miscarriage >12/40, ECV, APH, amnio/CVS/foetal blood sampling
249
test for anti-D at
booking 11-13/40
250
Coombe's test
direct Ab testing, do on cord blood after delivery from a Rh- mother
251
foetus affected by Rh incompatibility features
oedematous (hydrops fetalis), jaundice, anaemia, hepatosplenomegaly, HF, kernicterus
252
Mx of Rh DZ of the newborn
transfusion, phototherapy
253
determined proportion of foetal RBC in mother's circulation in the event of a sensitising event in a Rh- mother
Kleinhauer test
254
direct Ab testing, do on cord blood after delivery from a Rh- mother
Coombe's test
255
oedematous (hydrops fetalis), jaundice, anaemia, hepatosplenomegaly, HF, kernicterus are features of
Rh DZ of the newborn
256
pyloric stenosis presentation
2-4/52, projectile V 30' post-feed, constipation, dehydration, LUQ mass
257
pyloric stenosis Ix
US
258
pyloric stenosis Mx
Ramstedt pyloromyotomy
259
2-4/52, projectile V 30' post-feed, constipation, dehydration, LUQ mass features suggestive of
pyloric stenosis
260
Angelman S and Prader-Willi S
Prader-Willi if inherited from father
| Angelman if inherited from mmother
261
features of Prader-Willi
hypotonia, dysmorphic features, short stature, hypogonadism, infertility, LD, obesity, behavioural problems
262
hypotonia, dysmorphic features, short stature, hypogonadism, infertility, LD, obesity, behavioural problems are features of
Prader-Willi S
263
obstetric cholestasis presentation
pruitis, worse on palms, soles, abdo
264
risks associated with obstetric cholestasis
preterm birth
265
obstetric cholestasis Mx
IoL at 37/40, ursodeoxycholic acid, vit K
266
associations with cerebral palsy
LD, epilepsy, squint, hearing impairment
267
cerebral palsy causes
antenatal: cerebral malformation, congenital infection (rubella, toxo, CMV)
intrapartum: asphyxiation, trauma
postnatal: IVH, maningitis, head trauma
268
LD, epilepsy, squint, hearing impairment are associated with
cerebral palsy
269
somatisation disorder features
multiple ephysical symptoms, present for >2 years, refuses to accept reassurance from -ve test results
270
hypochondrial disorder features
persistent belief in presence of serious underlying disease e.g. cancer, refusal to acept reassuance from -ve test results
271
conversion disorder features
involves loss of motor/sensory function, PT indifferent about loss of function "la belle indifference"
272
dissociative disorder features
psychiatric symptoms e.g. amnesia, fuge, stupor, separating of certain memories from normal consciousness
273
dissociative identity disorder is
a new term for multiple personality disorder, is the most severe form of dissociative disorder
274
Munchausen's S aka
factitious disorder
275
factitious disorder features
intentional production of physical/psychological symptoms
276
malingering features
fraudulent simulation/exaggeratin of symptoms with the intention of finantial/other gain
277
multiple ephysical symptoms, present for >2 years, refuses to accept reassurance from -ve test results describes
somatisation disorder
278
persistent belief in presence of serious underlying disease e.g. cancer, refusal to acept reassuance from -ve test results describes
hypochondrial disorder
279
involves loss of motor/sensory function, PT indifferent about loss of function "la belle indifference" describes
conversion disorder
280
psychiatric symptoms e.g. amnesia, fuge, stupor, separating of certain memories from normal consciousness describes
dissociative disorder
281
factitious disorder aka
Munchausen's S
282
intentional production of physical/psychological symptoms describes
factitious disorder
283
fraudulent simulation/exaggeratin of symptoms with the intention of finantial/other gain describes
malingering
284
IRIS stands for
immune reconstitution inflammatory S
285
IRIS describes
an exaggerated immune response to a microorganism upon starting ARV
286
an exaggerated immune response to a microorganism upon starting ARV desribes
IRIS
287
painful loss of vision causes
ACG, ischaemic neuropathy (arteritis vs not), papilloedema
288
painless loss of vision causes
cataracts, AMD, POAG, CRVO, CRAO, detachment, DM
289
Breslow thickness
used to describe the depth of a MM
290
Breslow thickness >1mm
WLE + SLN biopsy
291
used to describe the depth of a MM
Breslow thickness
292
WLE + SLN biopsy of MM if Breslow thickness
>1mm
293
idiopathic intracranial HTN features
headache, blurred vision, papilloedema, enlarged blind spot, CNVI palsy
294
risk factors for idiopathic intracranial HTN
obesity, female, pregnancy, COCP, steroids, vit A, Li
295
neuroblastoma features
abdo mass, pallor, weight loss, bone pain, limp, hepatomegaly
296
headache, blurred vision, papilloedema, enlarged blind spot, CNVI palsy are features of
idiopathic intracranial HTN
297
obesity, female, pregnancy, COCP, steroids, vit A, Li are risk factors for
idiopathic intracranial HTN
298
abdo mass, pallor, weight loss, bone pain, limp, hepatomegaly are features of
neuroblastoma
299
early medical abortion
<9/40 mifipristone + misoprostol 48h later, can pass at home
300
late medica abortion
>9/40 serial misoprostol, inPT stay
301
early surgical abortion
<15/40 vacume aspiration
302
late surgical abortion
>15/40 dilation + evacuation
303
lichen sclerosus features
itch, elderly females
304
lichen sclerosus Mx
topical steroids + emollients
305
itch, elderly females describes
lichen sclerosus
306
PCOS blood results
raised LH:FSH, prolactin + testosterone N/mildly elevated, ?imparied glucose tolerance
307
raised LH:FSH, prolactin + testosterone N/mildly elevated bloods suggest
PCOS
308
HIV in pregnancy Mx
c/s if VL >50, PO ART to neonate when born, or triple therapy for 4-6/52 if high risk, no breastfeeding
309
hep B in pregnancy Mx
vaccination + hep B IG at birth
310
CADASIL is
an AD arteriopathy, most common cause of inherited stroke
311
an AD arteriopathy, most common cause of inherited stroke describes
CADASIL
312
cerebral toxo Rx
pyrimethamine + sulphadiazine
313
candida symptoms
itch, cottage cheese discharge
314
BV symptoms
fishy odeur, milky white discharge
315
trichomonas symptoms
green frothy discharge
316
pH candida, BV, trichomonas
candida <4.5 (N)
| BV + trichomonas >4.5
317
candida Mx
cotrimazole pessary/fluconazole PO
318
BV Mx
PO metronidazole 5-7/7
319
trichomonas Mx
PO metronidazole 5-7/7, treat partner
320
itch, cottage cheese discharge are symptoms of
candida
321
fishy odeur, milky white discharge are symptoms of
BV
322
green frothy discharge are symptoms of
trichomonas
323
DS screening at
11-13/40
324
combined DS test is made up of
NT, PAPP-A, B-hCG
325
quadruple DS test is offered when
high risk from the combined or too late for combined
326
quadruple DS test is made up of
unconjugated oestradiol, total hCG, AFP, inhibin A
327
NT, PAPP-A, B-hCG make up the components of the
conbined DS test
328
unconjugated oestradiol, total hCG, AFP, inhibin A make up the
quadruple DS test
329
extra precautions in pregnant obese women
VTE thromboprophylaxis, vit D supplementation, anaesthetic r/v, active management of 3rd stage (PPH risk)
330
GDM risk factors
high BMI, previous macrosomic baby, previous GDM, DM FH, ethnicity
331
GDM OGTT result
2h >7.8
332
placenta accretta
firm adhesion of the placenta to the uterine wall
333
placenta increta
placenta extends through the full myometrium
334
placenta percreta
placenta invades beyond the uterus
335
firm adhesion of the placenta to the uterine wall describes
placenta accreta
336
placenta extends through the full myometrium describes
placenta increta
337
placenta invades beyond the uterus describes
placenta percreta
338
gestation above which to give steroids
>24/40
339
imaging in pregnancy for suspected PE
V/Q scan
340
PPROM stands for
pretern pre-labour RoM
341
PPROM Mx
10/7 ABx, steroids before 34/40, delivery 34-36/40
342
10/7 ABx, steroids before 34/40, delivery 34-36/40 is the management of
PPROM
343
pregnancy physiology changes
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
features of physiological murmurs in pregnancy
soft systolic flow murmur
345
drug ised for the Mx of PE in pregnancy
enoxaparin
346
placental abruption risk factors
previous abruption, smoking, IUGR, HTN, multiple pregnancies
347
vasa praevia presentation
rare, occurs at time of RoM, painless bleed, foetal compromise
348
HSV in pregnancy
c/s if delivery w/i 6/52, no evidence for acyclovir
349
smoking, IUGR, HTN, multiple pregnancies are risk factors for
placental abruption
350
rare, occurs at time of RoM, painless bleed, foetal compromise describes
vasa praevia
351
chickenpox exposure in pregnancy Mx
check antibodies, give VZIG w/i 10/7
352
when to stop insulin sliging scale post-delivery
once E+D, return to usual insulin regime
353
risk of pregnancy with SLE
spontaneous miscarriage, foetal death, poreeclampsia, preterm delivery, foetal growth restriction
354
spontaneous miscarriage, foetal death, poreeclampsia, preterm delivery, foetal growth restriction are risks of
being pregnant with SLE
355
PUPP stands for
pruuritic urticarial papules and plaques or pregnancy
356
PUPP presentaiton
>34/40, starts on abdomen, in stretch marks with peri-umbilical sparing
357
prurigo gestationis presentation
starts on trunk/upper limbs, abdo sparing
358
>34/40, starts on abdomen, in stretch marks with peri-umbilical sparing describes
PUPP
359
rash starts on trunk/upper limbs, abdo sparing describes
prurigo gestationis
360
diabetes in pregnany sugar control values
<5.5 pre-meal, <7.8 1h post-meal
361
threatened miscarriage is
any bleeding <24/40
362
bleeding after 24/40 is called
APH
363
missed miscarriage describes
loss of pregnancy w/o the passage of bood/clots, but loss of pregnancy related symptoms
364
incomplete miscarriage describes
some retained products of conception
365
incomplete misacrriage Mx optino
conservative, medical, Sx
366
any bleeding <24/40 is called
threatened misacrriage
367
loss of pregnancy w/o the passage of bood/clots, but loss of pregnancy related symptoms is called
missed miscarriage
368
some retained products of conception and some passed is called
incomplete miscarriage
369
extopic risk factors
previous ectopic, tubual Sx, IUS/D, PID, IVF
370
c/s risks
1/1000 bladder injury, VTE, haemorrhage, increased still birth risk in subsequent pregnancies, placenta praevia, laceration to baby, infection
371
Gillick competence is for people
16
372
peripartum cardiomegaly features
develops in last 1/12 of pregnancy, SOB, tachycardia, tachopnea, signs of HF (cardiomegaly, pulmonary oedema)
373
rish factors for peripartum cardiomegaly
multiple pregnancies, HTN in pregnancy, advanced maternal age
374
develops in last 1/12 of pregnancy, SOB, tachycardia, tachopnea, signs of HF (cardiomegaly, pulmonary oedema) describes features of
peripartum cardiomegaly
375
puerperal psychosis usualy presents
w/i first 2/52 of delivery
376
risk factors for purperal psychosis include
c/s, emergency delivery, primiparity
377
Apgar score includes
tone, colour, breathing, HR, reflex irritability
378
Apgar score is measure at
1, 5, 10 mins
379
Sheehan S aka
post partum pituitary gland necrosis
380
Sheehan S presentation
not lactating, amenorrhoea
381
Sheehan S is caused by
hypovolaemia, in prpegnancy the ant pit is hyperplastic therefore hypovolaemia may be sig enough to cause necrosis
382
post partum pituitary gland necrosis aka
Sheehan S
383
not lactating, amenorrhoea may be signs of
Sheehan S
384
Listeria in pregnancy can lead to
miscarriage, stillbirth, preterm delivery
385
toxo in pregnancy leads to
chorioretinitis, macro/microencephaly, convulsions, neurodevelopmental delay
386
miscarriage, stillbirth, preterm delivery can be caused by
Listeria infection
387
chorioretinitis, macro/microencephaly, convulsions, neurodevelopmental delay can be caused by
toxo infection
388
haematocolpos can be caused by
inperforated hymen
389
inperforated hymen can cause
haematocolpos
390
risk factors for developing a hydatidiform mole
extremes of age, previous molar pregnancy, race
391
hydatiforme mole presentation
unusual/heavy bleeding, larger than dates
392
hydatiforme mole Ix
serial B-hCG (higher than usual), US (snowstorm appearance)
393
unusual/heavy bleeding, larger than dates may be suggestive of
hydatiforme mole
394
Bartholian glands are located
4 + 8-o' clock on the labia minora
395
Rx of bartholian cyst/abscess
marsupialisation
396
marsupialisation involves
opening the abscess + suturing it open to prevent recurrence
397
side effects of antimuscarinics
dry mouth, constipation, urinary retention
398
first line medical Mx for urge incontinence
oxybutynin
399
dry mouth, constipation, urinary retention are SE of
antimuscarinics
400
oybutynin is 1st line for
urge incontinence
401
risks of IVF pregnancies
ectopic, congenital abnormalities, multiple pregnancies, SGA, low birth weight
402
PCOS criteria
anovulation/oligomenorrhoea, hyperandrogenism (physical/biochemical), 12+ folicles on US
403
Asherman S can occur post
several surgical TOPs
404
Asherman S comprises
uterine scar tissue + adhesions
405
when to do a women's bloods for fertility
d1-3 LH + FSH, mid-luteal progesterone (>30 suggests ovulation)
406
uterine scar tissue + adhesions describes
Asherman S
407
OSHH presentation
abdo pain, distension, V
408
RMI is
risk of malignancy index used in ovarian ca
409
RMI calculation
US features (1-5) x menopause (1 or 3) x ca125
410
Turner's S is associated with
lymphoedema of hands + feet as neonate, neck webbing, short stature, wide spaced nipples, congenital heart defects (coarctation)delayed/absent puberty, infertility
411
diagnosis to rule out is delayed gross motor skills
MD, do a ck
412
gross motor milestones in order
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
fine motore milestones in order
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
speech, language, hearing developmental milestones in order
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
behavioural + social developmental milestones in order
0, fixes and follows, smiles, 3/12, object permenance, 6/12, 1, symbolic play, 2, sharing, empathy, role play, counting, 4, rules
416
rule out in ambiguous genitalia e.g. bx undescended testes
CAH
417
constitutional delay of puberty features
runs in families (male line)
418
respirtory distress S is 2' to
surfactant deficiency
419
gastroschisis is
herniation of the bowel through a defect in the ant abdo wall
420
inheritance pattern of Wilson's DZ
AR
421
consequences of Wilson's DZ
amber rings in iris, liver cirrhosis, neuro symptoms, renal involvement, cardiac complications, haemolytic anaemia
422
1st line Mx of constipation in children
fluids, fibre, exercise
423
UC is associated with
erythema nodosum, pyoderma gangrenosum, arthritis, spondylitis
424
Crohn's is associated with
oral ulcers
425
cows milk protein allergy vs lactose intollerance
cows milk = switch to formula, eczema, V, D
| lactose intollerance = post gastroenteritis, from 2 y.o.
426
Kawasaki DZ features
fever, blanching erthematous rash, bx non-purulent conjunctivitis, cervical lymphadenopathy, red tongue, cracked lips
427
consequences of CMV infection in pregnancy for the baby
deafness, IUGR, hydrocephalus, thrombocytopaenia
428
herniation of the bowel through a defect in the ant abdo wall describes
gastroschistisis
429
amber rings in iris, liver cirrhosis, neuro symptoms, renal involvement, cardiac complications, haemolytic anaemia describe
Wilson's DZ
430
fever, blanching erthematous rash, bx non-purulent conjunctivitis, cervical lymphadenopathy, red tongue, cracked lips describes
Kawasaki's
431
erythema multiforme description
target lesions
432
causes of erythema multiforme
drugs (penicillin), infection (atypical pneumo), idiopathic
433
erythema migrans is caused by
Lyme's DZ
434
SCID blood results
low t cells, low b cells, low immunoglobulins
435
DiGeorge S features
cleft pallet, cardiac abnormalities (TOF, VSD), thymic hypoplasia, mid-facial hypoplasia, hypocalcaemia
436
DiGerege S diagnosed by
FISH
437
Wiskott-Aldrich S mode of inheritance
X-linked recessive
438
Wiskott-Aldrich presenation
eczema, thrombocytopaenia, recurrent infections, petechiae, bruising
439
SCID presents
v early in life, may be fatal by 3 y.o.
440
Lyme's DZ skin manifestation
erythema migrans
441
low t cells, low b cells, low immunoglobulins blood results suggest
SCID
442
cleft pallet, cardiac abnormalities (TOF, VSD), thymic hypoplasia, mid-facial hypoplasia, hypocalcaemia are features suggestive of
DiGeorge S
443
eczema, thrombocytopaenia, recurrent infections, petechiae, bruising is suggestiev of
Wiskott-Aldrich
444
test for cf
1. newborn blood spot 2. sweat test
445
most common type of cardiac defect
VSD
446
symptoms of HF in neontes
SOB, sweaty, growth restriction, failure to thrive, hepatosplenomegaly, cyanosis
447
when does the ductus arteriosis closes
hours - days post-birth
448
cardiac abnormalities that manifest once the ductus arteriousis closes
ToF, pulmonary atresia, tricuspid atresia, TGA
449
reopen the ductus arteriosis with
prostaglandins
450
cardiac abnormalities associated with DS
ToF, ASD, VSD, AVSD
451
WPW on ECG
delta wave (slanting upstroke of R), short PR,
452
Kawasaki Mx
high dose aspirin, IVIG
453
Eisenmenger's S describes
when a VSD turns from a L-R shunt to a R-L
454
SOB, sweaty, growth restriction, failure to thrive, hepatosplenomegaly, cyanosis are symptoms of
HF in neonates
455
delta wave (slanting upstroke of R), short PR, are seen on ECG in
WPW S
456
when a VSD turns from a L-R shunt to a R-L describes
Eisenmenger's S
457
low rumbling murmur heard above the nipple line is called
venous hum (N finding in children)
458
posterior urethral valves presentation
enarged, palpable bladder
459
posterior urethral valves Ix
micturating cystourethrogram
460
HbSS crisis Mx
analgesia (morphine), rewarming, ABx, O2, IV fluids, transfulsion if required
461
haemophillia mode of inheritance
X-linked
462
haemophilia A is due to a deficiency of
factor VIII
463
haemophilia B is due to a deficiency of
factor IX
464
long term sequelae of childhood ca Rx
2' ca, educational difficulties, growth, infertility
465
when to do a MRI with a port wine stain
if it's in the trigeminal distribution
466
strawberry naevi present
in 1st month
467
course of a strawberry naevi
get larger before it regresses by 5y
468
molluscum contagiosum is caused by
pox virus
469
erythema toxicum appearance
erythematous base with small pustules in the newborn period
470
erythematous base with small pustules in the newborn period describes
erythema toxicum
471
features of Kleinfelter's S
tall stature, small testicular V, delayed puberty, gynaecomastia
472
Kleinfelter's karyotype
47XXY
473
features of Marfan's S
myopia, lens dislocation, arachnodactly, arm span > height, hypermobility, aortic arch abnormalities, mitral valve prolapse, chest wall deformity
474
precocious puberty ages
<8 for girls, <9 for boys
475
tall stature, small testicular V, delayed puberty, gynaecomastia are features of
Kleinfelter's S
476
47XXY is the karyotype of
Kleinfelter's S
477
myopia, lens dislocation, arachnodactly, arm span > height, hypermobility, aortic arch abnormalities, mitral valve prolapse, chest wall deformity are features of
Marfan's
478
growing pains are usually more troublesome at
night
479
SUFE Mx
Sx fixation
480
grenstick # describes
one side of the bone buckes and the other side is intact
481
Colles # describes
of ulnar + radius, distal end slides back + shortens it
482
Salter-Harris # describes
a Colles # that occurs through the growth plate
483
one side of the bone buckes and the other side is intact describes
greenstick #
484
of ulnar + radius, distal end slides back + shortens it describes
Colles #
485
a Colles # that occurs through the growth plate describes
Salter-Harris #
486
osteogenesis imperfecta mode of inheritance
AD, variable penetrance
487
DDH risk factors
breech, first born, FH, clubbed foot, oligohydramnios, macrosomia
488
DDH Mx
US at 6/52, ortho referral, harness for 6/52
489
breech, first born, FH, clubbed foot, oligohydramnios, macrosomia are risk factors for
DDH
490
features of HIE
poor feeding, altered tone, seizure activity, irritability, hyperventillation
491
SE of Na valproate
increased apetite, weight gain, hair loss, liver failure
492
memory loss causing inability to orientate oneself
topographical
493
memory loss causing inability to recall personal life events
autobiographical
494
memory loss causing inability to remember how to do things e.g. ride a bike
proceedural
495
memory loss causing inability to recall facts
semantic
496
topographical memory loss describes
inability to orientate oneself
497
autobiographical memory loss describes
inability to recall personal life events
498
proceedural memory loss describes
inability to remember how to do things e.g. ride a bike
499
schemantic memory loss describes
inability to recall facts
500
perseverence describes
answering the 1st Q correctly then using the same answer for all subsequent Q's
501
perseverence is seen in
dementia
502
confabulation describes
false memories occur, giving wrong answers, trying to cover up deficit, invents fantastical stories
503
confabulation is seen in
organic brain damage e.g. alcholism
504
affect illusion describes
mood influences the illusion e.g. frightened + see dressing gown as person
505
completion illusion describes
lack of attention to stimulus therefore incorrect interpretation e.g. misreading in book
506
pareidolic illusions
shapes being seen in other objects e.g. images in the clouds
507
extracampine hallucination describes
hallucination beyond range of sensation
508
functional hallucination describes
hallucination only when external stimulus present in same modality e.g. hearing voices when hearing classical music
509
hypnagogic hallucinations describe
hallucinations when going to sleep
510
hypnopompic hallucination describe
hallucinations when waking up
511
reflex hallucinations describe
hallucination only when external stimulus present in different modality e.g. hearing voices when child looks at them
512
answering the 1st Q correctly then using the same answer for all subsequent Q's describes
perseverence
513
false memories occur, giving wrong answers, trying to cover up deficit, invents fantastical stories describes
confabulation
514
mood influences the illusion e.g. frightened + see dressing gown as person describes
affect illusion
515
lack of attention to stimulus therefore incorrect interpretation e.g. misreading in book describes
completion illusion
516
shapes being seen in other objects e.g. images in the clouds describes
parelolic illusion
517
hallucination beyond range of sensation desribes
extracampine hallucinations
518
hallucination only when external stimulus present in same modality e.g. hearing voices when hearing classical music describes
functional hallucination
519
hallucinations when going to sleep describes
hypnagogic hallucination
520
hallucinations when waking up describes
hypnopompic hallucination
521
hallucination only when external stimulus present in different modality e.g. hearing voices when child looks at them describes
reflex hallucination
522
autochthonous delusion describes
a delusion that occurs out of the blue
523
autoscopy desribes
sensation of seeing oneself
524
delusional atmosphere aka
delusional mood
525
delusional atmosphere describes
state of perplexity/bewilderment when sufferers feel that st is going on but w/o being able to state exactly what
526
delusional memory describes
recall of an event interpreted with delusional meaning
527
a delusion that occurs out of the blue is called
autochthonous delusion
528
sensation of seeing oneself describes
autoscopy
529
state of perplexity/bewilderment when sufferers feel that st is going on but w/o being able to state exactly what describes
delusional atmosphere
530
recall of an event interpreted with delusional meaning describes
delusional memory
531
logoclonia describes
repeating the last sylable of a word
532
logoclonia is seen in
PD
533
repeating the last sylable of a word describes
logoclonia
534
PTSD symptoms have to be present for at least
1/12
535
clanging describes
when words are used based on thier similarities in sound
536
when words are used based on thier similarities in sound describes
clanging
537
medical Mx of delirium
low dose haloperidol
538
Hebephrenic schizophrenia describes
predominance of thought disorder + affective symptoms (factuous + childlike), social withdrawal is common
539
Hebephrenic schiophrenia aka
disorganised schizophrenia
540
residual schizophrenia describes
late-stage schizophrenia where +ve symptoms replaces with -ve ones
541
simple schizophrenia describes
no overt psychotic symptoms
542
predominance of thought disorder + affective symptoms (factuous + childlike), social withdrawal is common describes
Hebephrenic schizophrenia
543
disorganised schizophrenia aka
Heberphrenic schizophrenia
544
late-stage schizophrenia where +ve symptoms replaces with -ve ones describes
residual schizophrenia
545
no overt psychotic symptoms describes
simple schizophrenia
546
clozapone causes (risk)
agranulocytosos/neutropenia
547
Mx of tardive dyskinesia
reduce dose of antipsychotic
548
schizoaffective disorders describes
schizophrenia + affective disorder e.g. mania, both present in same episode
549
schizotypal dosirder describes
eccentric behaviours + beliefs that may mimic schizophrenia but w/o psycosis
550
schizophrenia + affective disorder e.g. mania, both present in same episode descries
schizoaffective disorder
551
eccentric behaviours + beliefs that may mimic schizophrenia but w/o psycosis describes
schizotypal disorder
552
dysthymia describes
chronic low grade mood disorder
553
cyclothymia describes
persistent instability of mood
554
hypomania describes
elevated mood that interferes with ADLs but not severely + no psychotic symptoms
555
core features of depression
low mood, anhedonia, anergia
556
biological symptoms of depression include
change in apetite, weight change, sleep change, loss of libido, diurnal variation in mood
557
psychological features of depression
guilt, hopelessness, suicidal ideation
558
chronic low grade mood disorder describes
dysthymia
559
persistent instability of mood describes
cyclothymia
560
elevated mood that interferes with ADLs but not severely + no psychotic symptoms describes
hypomania
561
agaraphobia describes
fear of situations that one might not be able to escape from, avoidance of these situations
562
social phobia describes
fear of particular social situations e.g. pubic speaking
563
Charles Bonnet S describes
complex visual hallucinations the occur in people with severe visual impairment e.g. AMD, insight is retained
564
mneumonic to remeber factors that comprise personality
OCEAN
565
OCEAN stands for
openness, conscienciousness, exraversion, agreeableness, neuroticism
566
antisocial personality disorder describes
emotionally cold, no remorse, forensic Hx
567
dependent personality disorder usually comes to attention
once partner dies
568
schizoid personality disorder describes
isolated, aloof, emotionally detached, few friends/relationships
569
anakastic personality disorder describes
preoccupied by rules and schedules, perfecionist, overly pedantic, rigid, stubborn, difficult
570
anakastic personality disorder aka
OC personality disorder
571
histrionic personality disorder describes
overly dramatic displays, occasional DSH, attention seeking
572
EUPD
intense + unstable relationships, go to great lengths to avoid being abandoned
573
complex visual hallucinations the occur in people with severe visual impairment e.g. AMD, insight is retained describes
Charles Bonnet S
574
emotionally cold, no remorse, forensic Hx describes
antisocial PD
575
isolated, aloof, emotionally detached, few friends/relationships describes
schizoid PD
576
preoccupied by rules and schedules, perfecionist, overly pedantic, rigid, stubborn, difficult describes
anakastic PD
577
overly dramatic displays, occasional DSH, attention seeking describes
histrionic PD
578
intense + unstable relationships, go to great lengths to avoid being abandoned describes
EUPD
579
Wernike's encephalopathy triad
ataxia, confusion, opthalmoplegia
580
characteristics fo Korsakoff's
amnesia with N consciousness
581
ca most likelt to metastasise to the spine
breast, prostate, L, thyroid, renal
582
Rx of ca induced hypercalcaemia
fluids, bisphosphonates (pamidronate)
583
Rx of acute hypercalcaemia
fluids (only use bisphosphonates if ca induced)
584
three most common causes of hypercalcaemia
ca, hyperparathyroidism, sarcoid
585
adjuvent therapy describes
post-Sx Rx
586
neoadjuvent therapy describes
pre-Sx Rx
587
radical therapy describes
Rx with curative intent
588
CEA is a tumour marker for
CRC
589
AFP is a tumour marker for
HCC
590
B-hCG is a tumour marker for
seminomas, teratomas, choriocarcinomas
591
CA19-9 is a tumour marker for
pancreatic
592
post-Sx Rx for ca is called
adjuvent
593
pre-Sx Rx for ca is called
neo-adjuvent
594
Rx with curative intent for ca is called
radical
595
tumour marker for CRC is
CEA
596
tumour marker for HCC is
AFP
597
tumour marker for seminomas/teratomas/choriocarcinomas is
B-hCG
598
tumour marker for pancreatic ca is
CA19-9
599
oesophageal ca types + locations
upper2/3 = SCC, lower 1/3 = adenocarcinoma, risk factor = GORD
600
small cell L ca is sensitive to
chemo
601
ca which may cause SIADH
L, prostate, thymus, pancreatic, lymphoma
602
SIADH results
low serum osmolality, high urinary osmolality
603
symptoms of SIADH
confusion N, irritability
604
initial Rx of SIADH
fluid restriction
605
low serum osmolality, high urinary osmolality suggests
SIADH
