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passmed notes > sunday 21st > Flashcards

sunday 21st Flashcards

1
Q

what would characteriscally casue loss of DCML eg vibration first

A

b12 deficiency

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2
Q

what tumour is caused by secondary hyperparathyroid

A

browns tumour of the bone

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3
Q

management of bone disease in CKD

A
  1. reduce phosphate intake
  2. phophate binders - calcium carbonate/sevelamar
  3. vit D supps
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4
Q

anamia in CKD predisposes to what heart pathology

A

lv hypertrophy

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5
Q

test used for proteinuria in daibetics

A

ACR

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6
Q

hypertension management in CKD

A

ACEI
Furosemide

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7
Q

examples of potassium sparing diuretics

A

eplerenone spironolactone

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8
Q

treatment of preotienuria in CKD

A

ACEI
SGLT-2

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9
Q

treatment of arotic stenosis

A

symptomatic = valve replacement
asymptomatic but valvular gradient > 40 mmHg and with features such as lV dysfunction then consider surgery

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10
Q

is fasiculations an UMN or LMN sign

A

LMN

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11
Q

how to work out serum osmolality

A

2x sodium + glucose+urea

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12
Q

what is seen in HHS - symps and findings

A

polyuria, polydipsia, confusion, dehydrated , lethargy, N&V

hyerglycaemia >30
serum osmol>320
hypovolaemia

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13
Q

complications of HHS

A

hyperviscosity therefor MI and stroke give VTE prophylaxis

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14
Q

rescue therpay for exacerbations of neuropathic pain

A

tramadol

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15
Q

criteria for liver trasnplant post paracetamol overdose

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

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16
Q

management of torsades

A

iv mag sulphate

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17
Q

treatment of barrets oseophagus

A

high dose PPI
if dysplasia 1st line - radiofrequency ablation

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18
Q

Symptoms of ADPKD

A

loin pain
haematuria
palpable masses
HTN
recurrent UTI
renal stones

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19
Q

first investigation in acute limb ischaemia

A

handheld dopller

20
Q

medications for individuals with PAD

A

Clopidogrel and atorvastaton

21
Q

investigations for varicose veins

A

venous duplex ultrasound: this will demonstrate retrograde venous flow

22
Q

treatment of varcisoe veins

A

compression stockings
endothermal ablation:
foam sclerotherapy:
surgery: ligation or stripping

23
Q

management of takayasu

A

steroids

24
Q

types of gastric adenocarcinoma and associations

A

intestinal - angry ulcer
diffuse - dignet ring type

25
Q

tx of gatroparesis

A

metroclopamide - pro-kinetic

26
Q

dyspahgia to both liquids and solids

A

achalasia

27
Q

treatment of achalasia

A

pneumatic balloon dilatation
heller myomectomy

28
Q

investigation of ahcalsia

A

oesophageal manometry

29
Q

h.pylori type of bug e.g gram stain

A

gram neg curvillinear rod

30
Q

screening test for latent TB

A

mantoux test

31
Q

diagnosis of TB including first line and gold standard

A

CXR
Sputum smear (i.i zheils neelsen) - need 3
Sputum culture - gold standard

32
Q

prophylaxis of peripheral neuropathy in wilson adn with isonizaid

A

pyridoxine

33
Q

retinopathy is hydroxychloroquine adn ethambutol

A

HCQ- bulls eye retinooathy
ethambutol - opttic neurtitis

34
Q

tb drugs and side effects

A

rifampicin - orange secretions , hepatitis
isonizaid- periph neuro
pyrazinamide 0 gout, arthralgia, heaptitis
ethambutol- optic neuritis

35
Q

where doe sTB reaction generally occur in lung

A

apex

36
Q

treatemtn of latent TB

A

3 months of Rifampicin and isonizaid
OR
6 month isonaizde

37
Q

what is given in sus meningitis if in GP

A

IM Benpen

38
Q

sign of raised ICP

A

focal neurological signs
papilloedema
continuous or uncontrolled seizures
GCS ≤ 12

39
Q

when should LP be delayed in meningitis

A

signs of sepsis or rash
severe resp or cardio compromise
significant bleeding risk
signs of rasied ICP

40
Q

management of suspected meningitis

A

IV access - bloods and culture
LP
IV ABX
< 3 months: cefotaxime + amoxicillin (or ampicillin)
3 months - 50 years: cefotaxime (or ceftriaxone)
> 50 years: cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin) for adults
IV dexamethasone - dont give if rash/septic or <3 months

41
Q

when shoudl dexamethasone be avoided in meningitis

A

in septic shock, meningococcal septicaemia, or if immunocompromised

42
Q

prophylaxis of meningitis who its given to

A

ciprofloxacin or rifampicin for close contacts in the previous 7 days

43
Q

how is meningitis tested for if LP contraindicated

A

PCR

44
Q

what is seen in diff type of LP in menigitis with regards to white cells

A

bacteria- polymorphs
virla, Tb, fungi - lymphocytes

45
Q

most common cause of bacterial meningits in over 60s

A

strep pneumonia

passmed notes (18 decks)

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