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Phase 3a conditions list flashcards > Stuff I have got wrong in the past part 2 > Flashcards

Stuff I have got wrong in the past part 2 Flashcards

1
Q

What are some reasons for taking high dose folic acid (3)?

A
  • Taking AEDs
  • BMI > 30
  • FHx NTDs
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2
Q

Out of thrombectomy and thrombolysis which treatment should definitely be offered if an MRI shows salvageable tissue?

A

Thrombectomy always offered, CONSIDER thrombolysis

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3
Q

How should vaginal bleeding be managed in the first 6 weeks of pregnancy?

A

Send home for expectant management UNLESS abdo/ pelvic pain or cervical motion tenderness present … they then need emergency assessment

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4
Q

How should vaginal bleeding after 6 weeks pregnancy be managed?

A

Refer to hospital for TVUSS

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5
Q

How should VSDs be managed?

A

Most can be managed conservatively and monitored closely

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6
Q

What are the criteria for having your tonsils removed due to tonsillitis (3)?

A
  • 7 episodes in 1 year
  • 5 episodes per year for 2 years
  • 3 episodes per year for 3 years
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7
Q

What criteria should be monitored for methylphenidate (4)?

A
  • BP + pulse
  • Psychiatric symptoms
  • Appetite
  • Weight + height
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8
Q

When should the parameters be measured for people taking methylphenidate (3)?

A
  • Initiation of treatment
  • Dose adjustment
  • Every 6 months
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9
Q

What is classed as staggered overdose for paracetamol overdose?

A

First and last dose more than 1 hour apart

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10
Q

What is opisthotonus?

A

Type of acute dystonia causing involuntary flexing of muscles in back

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11
Q

What is the second line medication for OCD after SSRIs?

A

Clomipramine
not venlafaxine

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12
Q

What is the first and second line pharmacological treatment for PTSD?

A

1st = SSRIs/ venlafaxine
2nd = antipsychotics

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13
Q

When can venlafaxine be used first line (although sertraline is usually used first)?

A
  • GAD
  • Panic disorder
  • PTSD
    NOT used for OCD
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14
Q

What migraine medication can cause serotonin syndrome?

A

Triptans

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15
Q

What two signs indicate meningeal irritation and how do you elicit them?

A
  • Brudzinskis - neck flexed –> involuntary flexion of hips + knees
  • Kernigs - hips flexed, then knees straitened –> pain
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16
Q

What are two special signs/ tests are seen in MS?

A
  • Uhtoffs phenomena - worse after hot shower
  • Lhermittes sign - neck flexion –> electric shock sensations down spine
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17
Q

What is the most common cause of meningitis in adults?

A

S. pneumoniae

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18
Q

What tool is used to assess the risk of developing pressure sores for patients?

A

Waterlow score

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19
Q

What rash is pathological of secondary syphilis?

A

Condylomata lata - grey discs + rash on hands/ feet

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20
Q

How should antiretroviral drugs for HIV be taken?

A

Same time every day

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21
Q

How should patient be treated if they refuse a vulvovaginal and endocervical swab?

A

Order first catch urine, if they refuse this then empirically with Abx

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22
Q

What is the difference between lymphadenopathy in lymphgranuloma vereneum and syphilis?

A
  • Syphilis = non-painful
  • Lymphgranuloma vereneum = painful
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23
Q

What are the key explanations for health inequalities according to the black report (4)?

A
  • Artefact
  • Social selection
  • Materialist/ structural
  • Cultural/ behavioural
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24
Q

How long should substance use disorder go on before a diagnosis?

A

12 months, or 1 month if use is continuous

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25
Q

What is in the censor score (5)?

A
  • Age 3-15
  • Exudate/ swollen tonsills
  • Swollen LNs
  • Temp > 38
  • Cough absent
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26
Q

How should anaphylaxis be managed after giving two doses of IM adrenaline?

A

Fluid bolus + call for help

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27
Q

What is second line for diabetes management?

A
  • Sulfonylureas (e.g. gliclazide)
  • Heart disease/ CVD = SGLT-2 inhibitors (e.g. dapagliflozin)
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28
Q

How long should chronic fatigue syndrome last before a diagnosis?

A

3 months

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29
Q

What is a key side effect of colchicine use?

A

Diarrhoea

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30
Q

What is first line anticoagulant for AF and what is used in those with poor kidney function?

A
  • 1st line = DOAC (e.g. apixaban)
  • CKD = warfarin
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31
Q

What is the definition of postural hypotension in terms of BPs?

A
  • Drop in 20 mmHg systolic
    or
  • Drop in 10 mmHg diastolic
  • Within 3 minutes of standing
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32
Q

What two medications can treat postural hypotension?

A

1st = Midodrine
2nd = Fludrocortisone

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33
Q

What immunoglobulin is raised in hay fever/ asthma/ eczema?

A

IgE

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34
Q

How is cradle cap (seborrhoeic dermatitis) treated (3)?

A
  1. Emollient + brushing
  2. Topical anti fungal shampoo
  3. Topical steroids
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35
Q

What is erythema infectiosum?

A

Slapped cheek

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36
Q

What is a sandal gap associated with?

A

Downs syndrome

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37
Q

What are the features of potters syndrome (4)?

A
  • Low set ears
  • Twisted body/ skeletal malformation
  • Flattened nose
  • Pulmonary hypoplasia (respiratory distress)
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38
Q

What are some criteria for assisted withdrawal (with chlordiazepoxide) for alcohol use disorder (2)?

A
  • Audit > 20
  • Drink more than 15 units per day
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39
Q

What is the most common cause of a painful third nerve palsy?

A

Posterior communicating artery aneurysm

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40
Q

If a woman is using lactational amenorrhoea as a form of contraception is it recommended for her to take the POP or not?

A

Yes POP is recommended even with lactational amenorrhoea

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41
Q

If a preterm woman is in labour and she is 4cm dilated what medications should she be given (2)?

A
  • Betamethasone (mature lungs)
  • Benzylpenicllin (indicated in preterm births)
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42
Q

How would GBS appear under the microscope?

A

Positive coccus

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43
Q

How should labour be managed after 3 pulls using an instrumental delivery?

A

Convert to LSCS

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44
Q

Can you take amiodarone whilst breastfeeding?

A

No, and not during pregnancy either

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45
Q

What is Galeazzis test?

A

Used to indicate whether leg length shortening is due to tibia or femur

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46
Q

What medication other than SSRIs can be helpful in treating those with anorexia nervosa?

A

Mirtazapine

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47
Q

What are some normal laboratory findings/ changes from normal in pregnancy (3)?

A
  • Increased urinary protein
  • Reduced serum creatinine
  • Reduced serum urea
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48
Q

How long should symptoms of PTSD go on before a diagnosis can be made?

A

1 month

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49
Q

What is the second line medication for ADHD after methylphenidate?

A

Lisdexamfetamine

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50
Q

What heart defect is associated with Williams syndrome?

A

Supravalvular aortic stenosis

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51
Q

How is meningitis treated in those over and under 3 months?

A
  • Over = ceftriaxone + dexamethasone
  • Under = cefotaxime + amoxicillin
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52
Q

Is a meningococcal septicaemia rash raised?

A

No it is flat on skin

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53
Q

When does volvulus usually present?

A

Before 1 month

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54
Q

What are the signs/ symptoms of lithium toxicity (5)?

A
  • Corse tremor
  • Hyper-reflexia
  • Acute confusion
  • Polyuria
  • Seizures
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55
Q

What are the 3 drugs used for alcohol dependance and what do they do?

A
  • Disulfiram - unpleasant symptoms if alcohol consumed
  • Acamprosate - reduces desire
  • Naltrexone - reduces pleasure
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56
Q

What are the important blood tests to do in those taking lithium (4)?

A
  • TFTs
  • eGFR
  • U&Es
  • Lithium level
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57
Q

What is a lilliputian hallucination?

A

Seeing lots of small people

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58
Q

What is the most common type of hallucination in delirium tremens?

A

Tactile hallucinations

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59
Q

What is the most common type of hallucination in delirium?

A

Visual

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60
Q

Which nerves are affected in erbs palsy?

A

C5-6

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61
Q

When are cervical cerclage and vaginal progesterone used in preterm labour?

A
  • Cerclage = when cervical length < 25mm AND previous preterm birth
  • Vaginal progesterone = ONLY when cervical length < 25mm
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62
Q

When should serum progesterone be measured in those having trouble conceiving?

A

7 days before end of cycle

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63
Q

What are the criteria for prescribing antibiotics in mastitis (2)?

A
  • Symptoms do not improve after 12-24 hours of breastfeeding
  • Nipple fissure present
    fluclox first line
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64
Q

What is a haematoclopos?

A

Accumulation of blood in the vagina usually due to imperforate hymen

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65
Q

What is the most common cause of hyperandrogegism in postmenopausal women?

A

Ovarian hyperthecosis - luteinised theca cell nests in ovaries

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66
Q

What are the 5 signs of heart failure on X-ray?

A
  • Alveolar bat wing oedema
  • Kerley B lines
  • Cardiomegally
  • Dilated upper lobe vessels
  • Pleural effusion
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67
Q

What is the flow of CSF through to the subarachnoid space?

A

Lateral ventricles –> foramen on monro –> third ventricle –> cerebral aqueduct –> fourth ventricle –> foramina of luschka & magendie –> SAS

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68
Q

What autoantibodies are found in primary biliary cholangitis?

A

Anti mitochondrial antibodies

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69
Q

What two drugs are important in hyperthyroidism?

A
  • Carbimazole - reduce thyroid levels
  • Propanolol - symptomatic relief
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70
Q

What medication can be used to provide relief from stomach cramps of those with IBS?

A

Buscopan

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71
Q

How is DKA managed in the emergency setting?

A
  • IV bolus 0.9% NaCl 10ml/kg given over 15 minutes
  • Insulin at 0.1 units/kg/h
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72
Q

What causes molluscum contagiosum?

A

Poxvirus

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73
Q

What is conduct disorder?

A

Persistent behaviours that violate the right of others in people under 18

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74
Q

What is oppositional defiant disorder?

A

Angry, irritable mood and argumentative, but without the severe aggression seen in conduct disorder

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75
Q

What are some contraindications for donepezil (2)?

A
  • Pelvic ulcers
  • Bradycardia
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76
Q

What features suggest a worse prognosis for MS (3)?

A
  • Male
  • Older
  • Motor signs at onset
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77
Q

How is a missed miscarriage managed medically?

A
  1. Mifepristone
  2. Misoprostol (48 hours later)
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77
Q

How is an incomplete miscarriage managed medically?

A

Misoprostol

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77
Q

How should a bishop score of more than 6 be managed?

A

Amniotomy AND IV oxytocin

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78
Q

How should a bishops score of 6 or less be managed?

A

Vaginal prostaglandin E2 OR oral misoprostol

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79
Q

What medication should be avoided in those with myasthenia gravis?

A

Beta blockers

80
Q

When can antiepileptic medications be stopped and how long a period should they be stopped over?

A

Seizure free for 2 years, stopped over a course of 2-3 months

81
Q

How is epiglottitis managed (2)?

A
  1. Secure airway
  2. IV antibiotics (cefuroxime)
82
Q

What are the doses of adrenaline used for anaphylaxis depending on the age of the child (3)?

A
  • Under 6 = 150 micrograms
  • 6-12 = 300 micrograms
  • Over 12 = 500 micrograms
83
Q

What is the inheritance of Charcot Marie tooth?

A

Autosomal dominant

84
Q

How should cervical ectropion be investigated if the GP is unsure of the diagnosis?

A

Urgent colposcopy
smears are never used when there are symptoms

85
Q

What should the first step to investigated jaundice almost always be?

A

Conjugated and unconjugated bilirubin

86
Q

In the acute management of delirium tremens what should be the first line management?

A

Oral lorazepam

87
Q

What medications are risk factors for idiopathic intracranial hypertension (5)?

A
  • Tetracyclines
  • Steroids
  • COCP
  • Retinoids
  • Lithium
88
Q

What criteria is used to grade tumours in prostate cancer?

A

Gleason criteria

89
Q

What is the first line for acute stress reaction?

A

Trauma focused CBT

90
Q

When should labour be induced in women who have PROM?

A

After 24 hours, provided they are beyond 37 weeks gestation

91
Q

According to ICD-11 what are the criteria for a diagnosis of mild depression?

A

2/3 key symptoms and 2/7 of the remaining for more than 2 weeks

92
Q

What are some negative symptoms of schizophrenia (4)?

A
  • Anhedonia
  • Alogia
  • Avolition
  • Blunted affect
93
Q

What sign may be seen on x-ray of those with bronchiolitis?

A

Hyperinflation

94
Q

What criteria would prompt admission to hospital for bronchiolitis (5)?

A
  • Apnoeas
  • RR>70
  • Sats < 92
  • Grunting
  • Central cyanosis
95
Q

How can bronchiolitis be confirmed?

A

Nasopharyngeal aspirate + PCR

96
Q

What is the period after a head injury before the patient deteriorates known as?

A

Lucid phase

97
Q

How do penicillin Abx work?

A

Beta lactam antibiotics - inhibit cell wall synthesis

98
Q

How do bacteria develop resistance to beta lactic antibiotics (penicillins)?

A

Beta lactamase production

99
Q

What tool is recommended to assess for delirium by NICE, and what is included in it?

A

4AT - alertness, 4-AMT, attention, acute course?

100
Q

What is the order of antiemetics for use in hyperemesis gravidarum (4)?

A
  1. Antihistamines (cyclizine)
  2. Chlorpromazine
  3. Ondansetron/ metoclopramide
101
Q

What are some features of atypical depression (3)?

A
  • Mood reactivity - improves with positive events
  • Hyperphagia
  • Leaden paralysis - heavy feeling in limbs
102
Q

What is a complication of urethritis?

A

Urethral strictures

103
Q

What is the first line medication for severe Alzheimers?

104
Q

What is a side effect of memantine?

A

Constipation

105
Q

What emerging blood test is most sensitive to bacterial sepsis?

A

Procalcitonin

106
Q

What nuclei are within the midbrain?

A
  • CN 3 = occulomotor
  • CN 4 = trochlear
107
Q

What nuclei are within the pons?

108
Q

What nuclei are within the medulla?

109
Q

Which cranial nerve decussates?

110
Q

What are some examples of dopamine agonists (3)?

A
  • Ropinirole
  • Bromocriptine
  • Apomorphine
111
Q

What treatment is offered after a stroke if the patient has more than 70% stenosis of their carotid artery?

A

Carotid endarterectomy

112
Q

What is the earliest a pregnant uterus can be palpated?

113
Q

What blood tests are routinely offered to pregnant women (4)?

A
  • FBC
  • Group + save
  • Rubella immunity
  • HIV/ syphilis serology
114
Q

What is increased nuchal translucency suggestive of other than downs, Edwards and pataus?

A

Other congenital defects e.g. CHD

115
Q

What are the features of all miscarriages?

A
  • Missed = no Sx, Os closed, foetus dead
  • Threatened = Os closed, painless light bleeding
  • Inevitable = Os open, heavy bleeding with clots + pain
  • Incomplete = Os open, painful bleed
  • Complete = empty uterus, painful bleed, os closed
116
Q

What are some features of Alzheimers on an MRI (4)?

A
  • Cerebral atrophy
  • Hippocampal atrophy
  • Ventricular enlargement
  • Sulcal widening
117
Q

What are some reversible causes of dementia (3)?

A
  • Hypothyroidism
  • NPH
  • B12 deficiency
118
Q

When is it recommended not to fly in twin and singleton pregnancies?

A
  • Twin > 37 weeks
  • Singleton > 32 weeks
119
Q

Which symptoms are less common in drug induced parkinsons disease?

A

Rigidity and resting tremor

120
Q

What tool is used to differentiate strokes from stroke mimics?

121
Q

What is relative risk?

A

Risk of event happening: risk of not happening

122
Q

How is myasthenia graves diagnosed?

A

Antibody screen

123
Q

How should exposure to chickenpox during pregnancy be managed (2)?

A
  • Measure VZV Igs if immunity unknown
  • Give acyclovir day 7-14, or within 24 hours of rash, if more than 20 weeks
    I don’t think VZV Ig are given any more
124
Q

What is the first line treatment for all eczema?

A

Emollients

125
Q

Is any pain at all felt with a varicocele?

A

None at all

126
Q

What are some side effects of topical corticosteroids (4)?

A
  • Thinning of skin
  • Striae
  • Acne
  • Telangiectasis
127
Q

How does acamprosate, naltrexone and disulfiram work (3)?

A
  • Disulfiram = increases levels of acetaldehydes
  • Acamprosate = reduces cravings by enhancing GABA transmission
  • Naltrexone = opioid antagonist to reduce pleasure
128
Q

What are some causes of drug induced psychosis (5)?

A
  • Anti-malaria drugs
  • Steroids
  • Da agonists
  • Levodopa
  • Recreational drugs
129
Q

How do SSRIs affect benzodiazepines?

A

Increase plasma levels

130
Q

What simple tests should be done on someone with hyperemesis gravidarum (4)?

A
  • FBC
  • U&E
  • LFT
  • Urinalysis
131
Q

What is hypospadias?

A

Where the opening to the urethra is on the underside of the penis

132
Q

What is in the hormonal patch for contraception?

A

Oestrogen AND progesterone

133
Q

What are some common conditions/ things that should be screened for in pregnancy (8)?

A
  • Bacteriuria
  • HIV
  • Syphilis
  • Anaemia
  • Hep B
  • Congenital abnormalities/ triremes
  • Pre-eclampsia risk factors
  • Blood group
134
Q

What is an important investigation to do in patients with menorrhagia but no suspicion of an underlying cause?

135
Q

What antibiotic should be used to manage STIs if there are just general symptoms and no definitive diagnosis scan be made?

A

Azithromycin - it covers both gonorrhoea and chlamydia

136
Q

How should all malignancies causing compression on nerves be managed initially?

A

High dose dexamethasone

137
Q

What is the time course of symptoms of MS?

A

Develop over hours to days, resolve over weeks to months

138
Q

What is a contraindication to joint aspiration (4)?

A
  • Overlying infection
  • Bacteraemia
  • Inaccessible joint
  • Prosthetic joint = relative - should be done in theatre by orthopaedic surgeon
139
Q

What is second line to allopurinol for prophylaxis against gout?

A

Febuxostat

140
Q

What is the first line management of symptomatic cholelithiasis?

A

Laparoscopic cholecystectomy

141
Q

What is raised more in alcoholic liver disease - AST or ALT?

A

AST raised more!!!

142
Q

What is first line management for the symptoms of BPH?

A

Tamsulosin

143
Q

What is a common complication of prostatitis?

A

Urinary retention

144
Q

What are some common causes of COPD exacerbations (3)?

A
  • H. influenziae
  • S. pneumoniae
  • Moraxella catarrhalis
145
Q

What is relative risk reduction?

A

Ratio of risk of experimental group : risk in control group

146
Q

What visual field defect does a parietal lesion cause?

A

Contralateral inferior quadranopia

147
Q

What visual field defect does a temporal lesion cause?

A

Contralateral superior quadranopia

148
Q

What causes upper and lower bitemporal hemianopia?

A
  • Lower = craniopharyngeoma
  • Upper = pituitary tumour
149
Q

What is Todds palsy?

A

Temporary weakness following a seizure

150
Q

What airway should be used to manage a patient having a seizure?

A

Nasopharyngeal airway

151
Q

Does hyperthyroidism cause menorrhagia or amenorrhoea?

A

Amenorrhoea
hypothyroidism = menorrhagia

152
Q

What are the stages of clinical trials?

A

1 = test on healthy volunteers
2 = small number of those with disease (efficacy and adverse effects)
3 = large number with disease
4 = after regulatory approval

153
Q

What is the most important management for acute delirium tremens and the most important for Wernicke-korsakoff syndrome?

A
  • DT = oral lorazepam
  • Wernicke - Korsakoff = IV thiamine
154
Q

What is the most serious long term health risk for those with turners syndrome?

A

Aortic dissection/ dilatation

155
Q

What are the layers of the abdomen cut through in a C-section?

A

Anterior rectus sheaf –> rectus abdominis muscle –> transversalis fascia –> extraperitoneal connective tissue –> peritoneum –> uterus

156
Q

What should you do to the SSRI dose before starting ECT?

A

Reduce the dose to the minimum amount

157
Q

What is the first line management for acute stress disorder?

A

Trauma focused CBT

158
Q

What contraception methods can a trans man take?

A

All except COCP + patch as this interferes with testosterone

159
Q

What physical health problem is a differential for baby blues?

A

Post partum thyroiditis

160
Q

When do symptoms of postpartum psychosis usually begin?

A

First 2 weeks

161
Q

What is cervical ectropion?

A

Growth of endocervical cells - glandular columnar cells, outside of the external os where squamous cells usually are

162
Q

What features are suggestive of hypernatraemic dehydration (5)?

A
  • Jittery movements
  • Increased muscle tone
  • Hyperreflexia
  • Convulsions
  • Drowsiness
163
Q

What is the risk of developing schizophrenia if a monozygotic twin is affected?

164
Q

What neuropathic pain medication is contraindicated in open angle glaucoma?

A

Amitriptyline

165
Q

How should antisocial personality disorder be managed?

A

Group based CBT

166
Q

What is a breath holding spell/ reflex anoxic seizure?

A

A seizure following sudden pain/ strong emotion

167
Q

How is a reflex anoxic seizure managed?

A

Reassurance

168
Q

What is the most likely cause of a smooth palpable lump that grows very fast in a 40-60 year old woman?

A

Phyllodes tumour

169
Q

Who should cases of child abuse be discussed with?

A

Senior or safeguarding lead

170
Q

What does the DCML carry?

A

Proprioception and fine touch

171
Q

What does the spinothalamic tract carry?

A
  • Laterally = pain + temperature
  • Anteriorly = crude touch
172
Q

How long should MgSO4 continue for after giving birth?

A

24 hours after last seizure/ delivery

173
Q

What time period does an appeal against a section 2 need to be made within?

174
Q

What causes micrognathia and rocker-bottom feet?

A

Edwards syndrome
patau = microcephaly + small eyes

175
Q

What is thought blocking?

A

When a patient suddenly stops talking or the thought process suddenly stops

176
Q

What type of MS are disease modifying treatments used for?

A

Relapsing remitting

177
Q

What is the first and second line investigation for asthma in children (5-15)?

A
  1. Fractional exhaled nitric oxide (FeNO)
  2. Bronchodilator reversibility with spirometry
178
Q

How is constipation in adults treated (first and second line)?

A
  1. Bulk forming laxatives (e.g. ispaghula)
  2. Osmotic laxatives (e.g. macrogol - movicol)
179
Q

How is CTG affected in Chorioamnionitis?

A

Foetal tachycardia

180
Q

What is the difference between bulimia nervosa and anorexia nervosa (2)?

A
  • Bulimia = binge eating and then purging
  • Anorexia = significant restriction of food intake and intense fear of weight gain
181
Q

What is seen on xray of those with respiratory distress of the newborn?

A

Ground glass appearance

182
Q

Other than prematurity what are some risk factors for respiratory distress of the newborn (3)?

A
  • Male
  • Diabetic mother
  • C-section
183
Q

What are some examples of AIDs defining illnesses (7)?

A
  • Pneumocystis pneumonia
  • Oesophageal candidasis
  • HIV encephalopathy (dementia)
  • Toxoplasmosis
  • Progressive multifocal leukoencephalopathy
  • Kaposi sarcoma
  • CMV retinitis
184
Q

How is essential tremor often inherited?

A

Autosomal dominant

185
Q

What does whooping cough look like under the microscope?

A

Gram negative coccobacillus

186
Q

How should suspected bone malignancies be managed in children by the GP?

A

Urgent X-ray within 48 hours

187
Q

When can hormonal contraception be taken after emergency contraception?

A
  • Levonorgestrel = immediately after
  • Ulipristal acetate = after 5 days
188
Q

How soon should an ultrasound be done for babies born in breech?

A

Within 6 weeks for DDH

189
Q

How does NAC work?

A

Glutathione metabolises NAPQI, NAC helps replenish the glutathione stores in the liver and break down the toxic metabolite NAPQI

190
Q

What is a complex febrile seizure (3)?

A
  • Lasts longer than 15 minutes
  • Recurrence within 24 hours
  • Focal seizure (rather than generalised)
191
Q

When do febrile seizures typically occur?

A

6 months - 5 years

192
Q

What medication is used in the management of IIH?

A

Acetazolamide

193
Q

When should oxygen be offered to those with bronchiolitis?

A

If sats are below 90%

194
Q

How is Guillain barre syndrome managed (2)?

A
  1. IV Ig
  2. Plasmapheresis
195
Q

What are the MRI findings in huntingtons disease?

A

Atrophy of caudate nucleus and putamen

196
Q

What is a long term side effect of levodopa (2)?

A
  • Dyskinesia
  • On-off phenomena
197
Q

What organisms commonly cause PID (3)?

A
  • Chlamydia
  • Gonorrhoea
  • Micoplasma genitalium

Phase 3a conditions list flashcards (31 decks)

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