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Things you just need to know Flashcards

1
Q

AKI definition

A

Creatinine > 26 umol/L within 48hrs
Creatinine > 1.5 x baseline
Decreased urine volume < 0.5 mL/kg/hr for 6 hrs

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2
Q

AAA screening recommendations

A

Invitation to screening at 65 y/o
Normal - no rescan
3-5cm - rescan every 6 months
>5cm - rescan every 3 months

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3
Q

CHA2DS2-Vasc score

A 
Congestive HF 1
HTN 1
Age >75 2
DM 1
Stroke/TIA 2
Vascular disease 1
Age 65-74 1
Female sex 1
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4
Q

Asthma attack

A

ABCDE resus
High flow O2
Salbutamol nebs (5mg, initially continuous then 2-4 hourly)
Ipratropium bromide (0.5 mg QDS
Steroid therapy (100-200 mg hydrocortisone followed by 40 mg oral prednisolone for 5-7 days)
If no improvement, IV magnesium sulphate, IV aminophylline, IV salbutamol)
Discharge when PEFR >75% predicted and stable for 24 hrs

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5
Q

Chronic asthma management

A
  1. Inhaled SABA prn (e.g. salbutamol)
  2. 1 + regular ICS (e.g. beclomethasone)
  3. 2 + LABA, then increase steroid dose
  4. Increase inhaled steroid dose, add leukotriene antagonist/theophylline/oral BA
  5. Add regular oral steroids, maintain high-doses and seek specialist care
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6
Q

Calculating plasma osmolality

A

2Na + 2K + glucose + urea

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7
Q

Diagnosing diabetes

A

HbA1c 48mmol/mol (6.5%) or more

FBG >6.9 mol/L (>125 mg/dL)
RBG >11.1 mmol/L (>200 mg/dL)
OGTT >11.1 mmol/L (>200 mg/dL)

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8
Q

LP results: cloudy CSF, high neutrophils, low lymphocytes, high protein, low glucose

A

Bacterial meningitis

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9
Q

LP results: clear CSF, low neutrophils, high lymphocytes, high protein, normal glucose

A

Viral meningitis

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10
Q

LP results: fibrinous CSF, low neutrophils, high lymphocytes, high protein, low glucose

A

TB meningitis

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11
Q

Cerebellar signs

A 
Dysdiadocokinesia
Ataxia
Nystagmus
Intention tremor
Speech changes
Hyperreflexia
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12
Q

Bacterial meningitis

Gm +ve cocci, elderly

A

Streptococcus pneumoniae

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13
Q

Bacterial meningitis

Gm -ve diplococci

A

Neisseria meningitides

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14
Q

Bacterial meningitis
Cheese consumption
Alcoholic

A

Listeria monocytogenes

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15
Q

Bacterial meningitis
Child
Unvaccinated

A

Haemophilus influenzae

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16
Q

Bacterial meningitis
Neonate
Extended labour, infection in previous pregnancy

A

Group B streptococcus

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17
Q

Bacterial meningitis

Late neonatal infection

A

E coli

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18
Q

Bacterial meningitis

Chronic infection

A

Mycobacterium TB

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19
Q

Infective endocarditis buzzwords

A 
Prosthetic valve
Dental procedure
New onset murmur
Right heart
Indwelling catheter
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20
Q

Bone marrow failure with Auer rods

A

Acute myeloid leukaemia

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21
Q

Bone marrow failure in children

A

Acute lymphoblastic leukaemia

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22
Q

Bone marrow failure with Philadelphia chromosome

A

Chronic myeloid leukaemia

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23
Q

Bone marrow failure with smear cells and warm agglutinins

A

Chronic lymphocytic leukaemia

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24
Q 
Painless lymphadenopathy
Reed-Sternberg cells
Binucleate lymphocytes
Pain after alcohol
Single group of nodes
A

Hodgkin’s lymphoma

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25
Q

Painless lymphadenopathy

Multiple groups of nodes

A

Non-Hodgkin’s lymphoma

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26
Q

Bone marrow failure without splenomegaly

Ringed sideroblasts

A

Myelodysplasia

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27
Q

Bone marrow failure with massive splenomegaly

Dry bone tap

A

Myelofibrosis

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28
Q

Increased calcium, renal failure, anaemia, bone lesions

Bence-Jones proteins (dense band)

A

Multiple myeloma

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29
Q

Plethoric face, headache, aquagenic pruritis

A

Polycythaemia vera

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30
Q

Normal Sodium levels

A

135-145

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31
Q

Normal Potassium levels

A

3.5-4.5

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32
Q

Normal urea levels

A

2-7

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33
Q

Normal CRP

A

0.5-10

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34
Q

Normal Ca levels

A

2.2-2.6

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35
Q

Lung cancer
Male, smoker
Found central at proximal bronchi
Spreads locally with late mets

A

Squamous cell carcinoma

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36
Q

Lung cancer
Female, non-smoker
Peripheral
Early mets

A

Adenocarcinoma

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37
Q 
Lung cancer
Smoking
Aggressive, early mets
Found centrally in proximal bronchi
Paraneoplastic syndromes (e.g. SiADH)
A

Small cell carcinoma

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38
Q 
Lung cancer
Male
Gynaecomastia (beta HCG)
Peripherally
Late mets
A

Large cell carcinoma

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39
Q 
Lung cancer
Found in apex
Horner's syndrome
Hoarse voice
Pancoast syndrome - wasting of arm muscles, pain, paraesthesia, paresis
A

Pancoast tumour

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40
Q

Paraneoplastic syndromes

A 
SiADH
Cushing syndrome
Hypoglycaemia
Hypercalcaemia
Carcinoid syndrome
Lambert-Eaton Myasthenia syndrome
Acanthosis nigricans
Dermatomyositis
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41
Q

Complications of AKI

A 
Metabolic acidosis
Hyperkalaemia
Uraemia
Fluid overload
Hyperphosphataemia
Hypocalcaemia
HTN
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42
Q

Pre-renal causes of AKI

A 
IMPAIRED PERFUSION
Cardiac failure
Sepsis
Blood loss
Dehydration
Vascular occlusion
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43
Q

Renal causes of AKI

A

Glomerulonephritis
Small vessel vasculitis
Acute tubular necrosis - drugs, toxins, prolonged hypotension
Interstitial nephritis - drugs, toxins, inflammatory disease, infection

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44
Q

Post-renal causes of AKI

A 
Urinary calculi
Retroperitoneal fibrosis
Benign prostatic enlargement
Prostate cancer
Cervical cancer
Urethral stricture/valves
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45
Q

AKI with brown cell casts in urine

A

Acute tubular necrosis

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46
Q

AKI with white cell casts in urine, infective

A

Acute interstitial nephritis

Pyelonephritis

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47
Q

AKI with eosinophilia, immune/non-infective

A

Acute hypersensitivity

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48
Q

Hypoalbuminaemia
Oedema
Lipid abs
Proteinuria

A

Nephrotic syndorme - HOLP

Structural (nephrosis)

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49
Q 
Proteinuria
Haematuria
Azotemia
Red cell casts
Oliguria
HTN
A

Nephritic syndrome - PHAROH

Inflammation (nephritis)

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50
Q

Previous UTI
Fever
Proteinuria, +leucocytes +nitrates
Normal also US

A

Acute interstitial nephritis

51
Q

Ejection systolic murmur

A

Aortic stenosis

52
Q

Early diastolic murmur

A

Aortic regurg

53
Q

Mid diastolic murmur

A

Mitral stenosis

54
Q

Pansystolic murmur

A

Mitral regurg

55
Q

Aortic equivalent

A

Pulmonary

56
Q

Mitral equivalent

A

Tricuspid

57
Q

Machinery murmur

A

Patent ductus arteriosus

58
Q

HTN treatment ladder

1st line <55 yrs

A

ACEis (e.g. ramipril)/ARBs (e.g. losartan)

59
Q

HTN treatment ladder

1st line >55 yrs/black

A

CCBs (e.g. amlodipine)

60
Q

HTN treatment ladder

2nd line

A

ACEi + CCB

61
Q

HTN treatment ladder

3rd line

A

ACEi + CCB + thiazide like diuretic (e.g. indapemide)

62
Q

HTN treatment ladder

Final step

A

B blocker/alpha blocker

63
Q

WHO pain ladder

Step 1

A

Non-opioid +/- adjuvant (e.g. paracetamol, NSAIDs)

64
Q

WHO pain ladder

Step 2

A

Weak opioid +/- adjuvant (e.g. tramadol/codeine)

65
Q

WHO pain ladder

Step 3

A

Strong opioid +/- adjuvant (e.g. morphine)

66
Q

Staph abx

A

Flucloxacillin, vancomycin, gentamicin

67
Q

Enterococcus abx

A

Ampicillin, gentamicin

68
Q

Strep abx

A

Benzylpenicillin, gentamicin

69
Q

Defining a lump

A 
Size, shape, skin, situation
Colour, contour, consistency
Tethering, transillumination, temperature, tenderness
Fluctuant
Pulsatile
Expansile
Reducible
70
Q

Treatment of MI

MONARCH BARS

A 
Morphine
Oxygen
Nitrates
Aspirin
Reperfusion (thrombolysis/PCI)
Clopidogrel
Heparin

Beta blocker
ACEi
Risk factors
Statin

71
Q

Complications of MI

A 
Death
Arrhythmia
Rupture
Tamponade
Heart failure
Valve disease
Aneurysm
Dressler's syndrome
Emboli
Recurrence
72
Q

Crohn’s test

A

Faecal calprotectin

73
Q

H pylori test

A

Urease breath test

74
Q

Coeliac test

A

Anti-endomysial abs

Anti-transglutaminase abs

75
Q

Liver cancer marker

A

Alpha fetoprotein

76
Q

Ovarian cancer marker

A

CA125

77
Q

Breast cancer marker

A

BRCA1/2

CA15-3

78
Q

Liver/pancreas/gallbladder cancer marker

A

CA19-9

79
Q

Testicular cancer marker

A

B HCG

80
Q

Prostate cancer marker

A

PSA

81
Q

B symptoms

A

Fever, night sweats, weight loss

82
Q

Sepsis 6

A 
Blood cultures
Urine output
Fluids
Antibiotics
Lactate
Oxygen
83
Q

Antiphospholipid antibodies

A

Anticardiolipin

84
Q

EBV + ampicillin

A

Widespread maculopapular rash

85
Q

Dense/patchy consolidation +/- bronchograms

A

Pneumonia

86
Q

Ground glass shadowing

A

Alveolitis

87
Q

Complete absence of lung markings

A

Pneumothorax

88
Q

Dense pacification with meniscus/fluid level

A

Pleural effusion

89
Q

Fluffy opacification (bilateral and lower zones)

A

Pulmonary oedema

90
Q

Patches of defined and varying consolidation

A

Mets

91
Q

Large mass in perihilar region

A

Lung cancer

92
Q

Hyperinflation (>6 ant ribs), flattened hemidiaphrams, increased bronchovascular markings

A

COPD

93
Q

Reticulonodular shadowing

A

Interstitial lung disease/fibrosis

94
Q

Perihilar lymphadenopathy

A

Sarcoidosis

95
Q

Heart failure CXR signs

A 
Alveolar oedema
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels
Effusion
96
Q

Batwing sign

A

Pulmonary oedema

97
Q

CURB-65 score

A 
Pneumonia
Confusion
Urea
Resp rate
BP
Age >65
98
Q

Post abdo exam

A 
Full history
Basic obs
External genitalia exam
Examine hernial orifices
DRE
Urinalysis
Stool sample
99
Q

Post cardio exam

A 
Full history
Basic obs
Urinalysis
12 lead ECG
Fundoscopy
100
Q

Post neuro exam

A 
Full history
Basic obs
Full neurological examination
GALS screen
Nerve conduction studies
Head CT
101
Q

Post breast exam

A

Imaging - mammography (>35), US (<35)

Biopsy - FNA, core biopsy

102
Q

Basic obs

A

Oxygen sats, temperature, RR

103
Q

Post respiratory exam

A 
Full history
Sputum
Peak flow
O2 sats
Temperature
CXR
Blood gases
ABG
104
Q

Post thyroid exam

A

Full history
Basic obs
TFTs
ECG

105
Q

PR exam

A 
Full history
Basic obs
Stool sample and culture
Abdo exam
PSA, FBC, haematinics, faecal occult blood
CXR
Colonoscopy
106
Q

After peripheral vascular exam

A 
Full history
Cardiovascular exam
Lower limb near exam
ABPI
Venous doppler US
107
Q

After AMTS

A

Full history
Full collateral history
MMSE
Head CT

108
Q

ABCD2 score

A 
Stroke risk post TIA
Age
BP
Clinical features (weakness, speech disturbance)
Duration of TIA
DM
109
Q

Child-Pugh score

A 
Prognosis of cirrhosis
Bilirubin
Serum albumin
PT
Ascites
Hepatic encephalopathy
110
Q

GCS

A

Eyes - AVPU
(alert, voice, pain, un)
Speech - ACISU
(alert, confused, inappropriate, sounds, un)
Movement - ALWFEU
(alert, localises, withdraws, flexion, extension, un)

111
Q

Wells score

A

DVT/PE scoring

112
Q

FUNDHIPS BPH

A 
Frequency
Urge incontinence
Nocturia
Dribbling
Hesitancy
Incomplete voiding
Poor Stream
113
Q

CKD definition

A

> 3 months GFR <60mL/min/1.73m2

114
Q

SLE serology marker

A

ANA

115
Q

Wegener’s serology marker

A

C-ANCA

116
Q

Goodpasture’s serology marker

A

Anti-GBM

117
Q

Nephrotic syndrome triad

A

Proteinuria, hypoalbuminaemia, oedema

118
Q

Gout crystals

A

Needle shaped

Negative birefringence

119
Q

Pseudogout crystals

A

Rhomboid shaped

Positive birefringence

120
Q

Gout crystal composition

A

Urate

121
Q

Pseudogout crystal composition

A

Calcium pyrophosphate

122
Q

Order of loss of pit hormones

A 
Go Look For The Adenoma Please
GH
LH
FSH
TSH
ACTH
P
123
Q

Kernig’s sign

A

Pain on knee extension when hips are flexed

124
Q

Bordzinski’s sign

A

Pain on flexion of the neck

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