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Phase 3a conditions list flashcards > Stuff I have got wrong in the past > Flashcards

Stuff I have got wrong in the past Flashcards

1
Q

What two bacteria are most significant for those with CF and are the reasons they should not interact?

A
  • Pseudomonas aeruginosa
  • Burkholderia cepacia (contraindication to lung transplant in CF)
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2
Q

When should infantile colic resolve by?

A

6 months

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3
Q

What is the triad of features seen in shaken baby syndrome?

A
  • Retinal haemorrhage
  • Subdural haematoma
  • Encephalopathy
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4
Q

When can a child legally consent to sex and the doctor is not required to contact safeguarding?

A

13

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5
Q

What medications can be used to close a PDA (3)?

A
  • Indomethacin
  • Ibruprofen
  • Paracetamol
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6
Q

What must be done before giving indomethacin to a neonate for PDA?

A

Echo to rule out duct dependant CHD

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7
Q

PPROM definition?

A

Rupture of membranes before 37 weeks and before labour
does not have to be a specific time period before labour

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8
Q

What is prolonged rupture of membranes?

A

Amniotic sac ruptured more than 24 hours before labour
note prelabour rupture of membranes simply means before labour

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9
Q

What are the sepsis six?

A
  • Blood cultures
  • Urine output
  • Fluids
  • Antibiotics
  • Lactate
  • Oxygen
    consider inotropic support e.g. epinephrine
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10
Q

What is pituitary apoplexy and how does it present (3)?

A

Sudden enlargement of a pituitary tumour:
* Sudden onset headache
* Visual field defects
* Evidence of pituitary insufficiency (e.g. hypotension)

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11
Q

What time period after going to hospital should deaths be reported to the coroner?

A

If death occurs within 24 hours

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12
Q

What law allows treatment of a patient for emergency treatment?

A

Common law
this supersedes MCA/ MHA in an emergency

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13
Q

What sort of memory loss does depression cause?

A

Global memory loss

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14
Q

How should neuropathic pain be managed (3)?

A
  1. Try one of amitriptyline, gabapentin/ pregabalin, duloxetine
  2. Stop original drug, try another
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15
Q

How should MS be diagnosed?

A

MRI WITH contrast

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16
Q

When should bleeding whilst taking a progesterone only pill be investigated?

A

If it lasts beyond 3 months

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17
Q

How is measles diagnosed (2)?

A
  • If rash began within 3 days = PCR
  • If rash began more than 3 days ago = serology
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18
Q

How should a sickle cell crisis be managed (4)?

A
  • Fluid
  • Analgesia
  • Oxygen
  • Abx
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19
Q

What are the different types of perineal tears (6)?

A
  • 1 = superficial, no muscle involvement
  • 2 = injury to perineal muscle, not sphincter
  • 3a = <50% external anal sphincter
  • 3b = >50% external anal sphincter
  • 3c = internal anal sphincter
  • 4 = rectal mucosa
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20
Q

How should perineal tears be managed (3)?

A
  • Nothing = 1st
  • Suture on ward by midwife = 2nd
  • Repair in theatre = 3/4th
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21
Q

What medication can improve the success of ECV?

A

Terbutaline

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22
Q

What nerve is often injured in a neck of fibular fracture?

A

Common fibular nerve

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23
Q

What drug can be given for the active management of the third stage of labour?

A

Oxytocin
ergometrine sometimes used as an alternative

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24
Q

When should urine cultures be sent in adults as opposed to relying on urine dipstick (4)?

A
  • Over 65
  • Visible/ non visible haematuria
  • Men
  • Pregnant women
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25
Q

What is jugular foramen syndrome?

A

Paralysis of CN 9, 10 and 11

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26
Q

What does a fluctuant breast mass suggest (2)?

A
  • Cyst
  • Abscess - refer to surgeons to drain
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27
Q

How should PID be managed with antibiotics (3)?

A
  • Ceftriaxone
  • Metronidazole
  • Doxycycline
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28
Q

What are the signs/ symptoms of rickets (5)?

A
  • Bowed legs (genuflects varum)
  • Stunted growth
  • Bone pain
  • Frontal bossing
  • Harrisons sulcus - indentation roughly along line of 6th rib (also seen in asthma)
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29
Q

What is Cushing’s reflex (3)?

A
  • Bradycardia
  • Hypertension
  • Irregular breathing
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30
Q

What is variance?

A

Standard deviation ^ 2

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31
Q

What is likelihood ratio for a positive test?

A

sensitivity/ (1 - specificity)

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32
Q

What is the likelihood ratio for a negative test?

A

(1 - sensitivity)/ specificity

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33
Q

Hazard ratio vs incidence rate ratio?

A
  • Hazard ratio compares the risk over time periods
  • Incidence rate ratio simply compares the incidence at different time points
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34
Q

Should patients with cystic fibrosis be allowed to interact with PPE?

A

No they should never be allowed to interact under NO circumstances

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35
Q

What is the hawthorne effect?

A

Change in behaviour due to the knowledge that it is being studied

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36
Q

What nerves are affected in vestibular schwannomas?

A

5, 7, 8

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37
Q

What medication is used for delirium tremens in those with liver failure?

A

Lorazepam

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38
Q

What is raised in the newborn blood spot test in children with cystic fibrosis?

A

Immunoreactive trypsinogen

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39
Q

How should pre-elampsia be managed by a GP?

A

Emergency secondary care assessment

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40
Q

What causes webers syndrome?

A

Occlusion in the branches of the posterior cerebral artery that supply the midbrain

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41
Q

How does webers syndrome (branches of posterior cerebral artery that supply the midbrain) present (2)?

A
  • Ipsilateral CN 3 palsy
  • Contralateral weakness of upper + lower extremities
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42
Q

What causes Wallenberg syndrome (lateral medullary syndrome)?

A

Posterior inferior cerebellar artery occlusion

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43
Q

What causes lateral pontine syndrome?

A

Anterior inferior cerebellar artery occlusion

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44
Q

How does Wallenbergs (PICA) present (4)?

A
  • Ipsilateral facial pain + temp loss
  • Contralateral limb pain + temp loss
  • Ataxia
  • Nystagmus
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45
Q

How does lateral pontine syndrome present (AICA) (3)?

A
  • Same as Wallenbergs +++
  • Ipsilateral facial droop
  • Deafness
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46
Q

What neurological condition can cause fluctuating levels of consciousness?

A

Subdural haemorrhage

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47
Q

What is the presentation of a hydrocele?

A

Fluctuant mass in groin area
fluctuant differentiates it from hernia

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48
Q

What is the most common cause of painless massive GI bleed in 1-2 year olds?

A

Meckles diverticulum

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49
Q

What is the most common cause of mesenteric adenitis?

A

Yersinia enterocolitica

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50
Q

How is CJD definitively diagnosed?

A

Brain biopsy

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51
Q

What should indicate the need for antibiotics in women breastfeeding who have mastitis (3)?

A
  • No improvement after 12-24 hours of expressing/ breastfeeding
  • Nipple fissure
  • Systemically unwell
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52
Q

How is whooping cough investigated (2)?

A
  • Nasal swab + culture = first line
  • Nasal swab + PCR = more sensitive
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53
Q

What medication is used to suppress breastfeeding?

A

Cabergoline (dopamine receptor agonist)

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54
Q

What is often the most significant sign of congestive heart failure in infants?

A

Hepatomegaly

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55
Q

What is a radial scar?

A

Benign breast condition causing scaring of the breast in a star shaped pattern (due to sclerosis of breast ducts)

56
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease

57
Q

What is confabulation?

A

Memory gaps are filled with false fabricated memories

58
Q

How should abnormal vaginal bleeding be investigated in postmenopausal women (3)?

A
  • TVUSS
  • Colposcopy
  • Biopsy
59
Q

How should premenopausal women be investigated for abnormal vaginal bleeding (4)?

A
  • TVUSS
  • Chlamydia test
  • Colposcopy
  • Biopsy
60
Q

What is cataplexy?

A

Sudden and transient loss of muscle tone caused by strong emotions e.g. laughing

61
Q

How is spasticity due to MS treated (2)?

A

Baclofen or gabapentin

62
Q

What is the bone marrow finding in those with ALL?

A

Blast cell predominance
note ALL causes pancytopenia - even WCC can be low

63
Q

What are the combined test results for downs?

A
  • Raised BhCG
  • Increased NT
  • Decreased PAPP-A
64
Q

What are the quadruple test results for Downs?

A
  • Raised BhCG
  • Raised inhibit A
  • Decreased AFP
  • Decreased E3
65
Q

How does a bartholins cyst present and what is the management?

A

Painless fluctuant lump on labia major
manage with warm salt water baths

66
Q

What is usually the most significant risk factor for candidasis?

A

COCP
also DM, recent Abx

67
Q

When is spinal stenosis pain/weakness usually worse?

A

Walking downhill

68
Q

What type of biopsy should be used for most breast lumps?

A

Core needle biopsy
fine is not used very frequently nowadays

69
Q

Which antipsychotic has the highest rate of prolactinaemia?

A

Risperidone

70
Q

What tool is used to assess whether medications should be discontinued?

A

STOPP tool

71
Q

Can aspirin be taken whilst breastfeeding?

A

NOOOOO

72
Q

What are the ranges for a diabetes diagnosis (3)?

A
  • FBG > 7.0
  • HbA1C > 48 (or equal to)
  • RPG > 11.1
73
Q

How does gliclazide (sulfonylurea) cause hypoglycaemia?

A

Increases pancreatic beta cell insulin production + release independent of blood glucose level

74
Q

What legislation allows patients who lack capacity to be made to do something/ not allowed to do what they want??

A

Deprivation of liberties safeguard

75
Q

What are the 3 most common presentations of OCD (3)?

A
  • Hand washing
  • Fear of harm
  • Perfectionism/ arranging things
76
Q

How does lymphogranuloma vereneum present?

A

Small PAINLESS ulcer in genital area
doxycyline = first line

77
Q

What is a differential for croup if symptoms do not improve with treatment?

A

Bacterial tracheitis

78
Q

How is chorea in huntingtons treated?

A

Tetrabenazine

79
Q

What is baclofen?

A

Muscle relaxant often used for MS and muscle spasms in palliative care

80
Q

What bloods should be done before starting lithium (5)?

A
  • FBC
  • U&Es
  • Ca2+
  • eGFR
  • TFTs
81
Q

What are the percentages that fall within 1,2,3 standard deviations?

A
  • 1 = 68.3
  • 2 = 95.4
  • 3 = 99.7
82
Q

How long is the driving ban for a first unprovoked seizure?

A

6 months and must notify DVLA

83
Q

What are the common causes of otitis media (7)?

A
  • Bacterial = s. pneumoniae, h. influenziae, s. pyogenes
  • Viral = RSV, rhinovirus, adenovirus, influenza virus
84
Q

What are the first and second line Abx for otitis media (2)?

A
  1. amoxicillin
  2. clarythromycin
85
Q

What other questions should be asked to a pregnant women presenting with shortness of breath (5)?

A
  • Headache
  • Oedema
  • Reduced foetal movements/ SOB
  • N+V
  • Abdo/ epigastric pain
86
Q

What are some side effects of levodopa and dopamine agonists (5)?

A
  • Confusion
  • Postural hypotension
  • Dry mouth
  • Psychosis
  • Dyskinesia
87
Q

What side effects are a higher risk in those taking dopamine agonists compared to dopamine agonists (and answer for the other way round as well)?

A
  • Da agonists = psychosis, impulse control disorders,
  • Levodopa = on-off phenomena, motor symptoms e.g. chorea
88
Q

What are some examples of dopamine agonists (2)?

A
  • Ropinirole
  • Bromocriptine
89
Q

What is an example of MAO-Bi?

A

Selegiline

90
Q

What are some examples of COMT inhibitors?

A

Entacapone

91
Q

What follow up should be arranged for a first seizure in a child?

A

Urgent (<2 weeks) referral to a paediatric neurologist

92
Q

What advice should be given to children having seizures (3)?

A
  • Don’t have a bath or swim
  • Take caution with heights
  • Call ambulance after 5 mins of seizure
93
Q

What are two tests recommended by NICE to investigate a patient who has had a fall (2)?

A
  • Timed up and go test
  • Turn 180 test
94
Q

How should acute asthma be managed (5)?

A
  1. Oxygen
  2. Nebulised salbutamol
  3. Nebulised ipatropium bromide
  4. IV hydrocortisone
  5. IV MgSO4, aminophylline or salbutamol
95
Q

What medication is typically used in end of life care for agitation?

A

Midazolam

96
Q

What is important to monitor in those on venlafaxine?

A

BP - as it can cause hypertension

97
Q

What is the most common cause of an incidentally found abdominal mass in a healthy child?

A

Wilms tumour (nephroblastoma)
usually in younger children <5

98
Q

How is constipation managed in children?

A
  1. Movicol disempaction regimen (+ Senna if not effective after 2 weeks)
  2. Movicol maintenance regimen
99
Q

How should all patients with antepartum haemorrhage be managed by a GP?

A

Urgent admission to hospital

100
Q

How can an invasive ductal carcinoma be differentiated from an invasive lobular carcinoma (2)?

A
  • Ductal (most common) = discrete lump
  • Lobular = thickened area of breast
101
Q

How can severe lithium toxicity be managed?

A

Haemodialysis

102
Q

What sign is seen on USS in ectopic pregnancy and ovarian torsion?

A
  • Torsion = whirlpool sign
  • Ectopic = bagel sign
103
Q

What are some side effects of atypical antipsychotics (4)?

A
  • Hyperprolactinaemia
  • Weight gain
  • Dyslipidaemia
  • Impared glucose tolerance
104
Q

What is the difference between section 135 and 136?

A
  • 135 = allows police to enter a persons home and take them to place of safety
  • 136 = allows police to take someone in public place to place of safety
105
Q

Give two examples of questionnaires used in the diagnosis of depression?

A
  • PHQ-9
  • HADS (hospital anxiety and depression scale)
106
Q

What is the first, second and third line investigations for endometrial cancer?

A
  1. TVUSS
  2. Pipelle biopsy
  3. Hysteroscopy
107
Q

How are stage 1 and 2 endometrial cancer treated?

A

Total abdominal hysterectomy with bilateral salpingo-oophrectomy
(+/- radiotherapy if higher risk disease)

108
Q

What are the criteria of the health belief model (4)?

A
  • Believe they are susceptible to the condition
  • Believe in serious consequences
  • Believe taking action reduces susceptibility
  • Believe benefits of action outweigh costs of acting/ not acting
109
Q

What is the AED used for tonic clonic seizures?

A
  • Male = valproate
  • Female = lamotrigine or levetiracetam
110
Q

What is the AED used for focal seizures (1st + second)?

A
  1. Lamotrigine or levetiracetam
  2. Carbemazepine
111
Q

What is the AED used for absence seizures (1st + second)?

A
  1. Ethosuximide
  2. Male = valproate; female = lamotrigine or levetiracetam
112
Q

What is the AED used for myotonic seizures?

A
  • Male = valproate
  • Female = levetiracetam
113
Q

What is the AED used for atonic seizures?

A
  • Male = valproate
  • Female = lamotrigine
114
Q

How should meckels diverticulum be investigated?

A

Technetium scan

115
Q

What is the equation for power?

A

1 - probability of a type 2 error

116
Q

What is a type 1 error?

A

The null hypothesis is rejected when it is true

117
Q

What is a type 2 error?

A

The null hypothesis is accepted when it is false

118
Q

How could bells palsy affect taste?

A

Ipsilateral loss of tase in anterior 2/3rds of tongue

119
Q

What antibiotics are used for a brain abscess?

A

Ceftriaxone + metronidazole

120
Q

What type of cancer does PCOS increase the risk of?

A

Endometrial cancer

121
Q

What is probably the strongest risk factor for completed suicide?

A

Previous suicide attempt

122
Q

What is miosis vs mydriasis?

A
  • Miosis = constricted pupil
  • Mydriasis = dilated pupil
123
Q

What is nocturnal enuresis?

A

Bedwetting in a 5 year old or older

124
Q

What is the management of nocturnal enuresis (5)?

A
  • Investigate underlying cause
  • General advice
  • Reward system
  • Enuresis alarm
  • Desmopressin (short term)
125
Q

How should GBS be managed during pregnancy?

A

IV benzylpenicillin during labour + delivery

126
Q

What medications can cause ototoxicity (hearing loss + vertigo) (2)?

A
  • Loop diuretics (e.g. furosemide)
  • Aminoglycoside (e.g. gentamicin)
127
Q

Which vitamins are fat soluble and therefore deficient in CF?

A

DEAK

128
Q

What is a contraindication for live vaccines e.g. MMR?

A

Immunosuppression e.g. ALL

129
Q

How is epiglottits managed?

A

Urgent assessment by anaesthetist
(steroids/ adrenaline are not given)

130
Q

How is TCA toxicity treated?

A

Sodium bicarbonate

131
Q

What is cerebellitis?

A

Sudden onset of ataxia following a viral illness e.g. chickenpox

132
Q

What is it known as when a child is stubborn and argumentative?

A

Oppositional defiant disorder

133
Q

What should be given to children with nephrotic syndrome as prophylaxis?

A

Penicillin V
(prophylaxis against infection as children with oedema are susceptible)

134
Q

What is the most common cause of meconium ileus?

A

CF (90% of cases)

135
Q

What is the management for very elevated levels of unconjugated bilirubin?

A

Exchange transfusion

136
Q

What is the treatment pathway for severe asthma attack (6)?

A
  1. Oxygen
  2. Salbutamol
  3. Ipratropium bromide
  4. Oral pred/ IV hydrocortisone
  5. Escalate
  6. IV salbutamol/ MgSO4/ aminophylline
  7. Intubate/ CPAP
137
Q
A

Phase 3a conditions list flashcards (29 decks)

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