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AMK style questions > Thurs revision > Flashcards

Thurs revision Flashcards

1
Q

What drug may patients who are allergic to aspirin also react to?

A

Sulfasalazine

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2
Q

What is reactive arthritis?

A

an arthritis that develops following an infection where the organism cannot be recovered from the joint.

‘Can’t see, pee or climb a tree’

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3
Q

What is the management for reactive arthritis?

A

symptomatic: analgesia, NSAIDS, intra-articular steroids
sulfasalazine and methotrexate are sometimes used for persistent disease
symptoms rarely last more than 12 months

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4
Q

Persistent fever lasting >5 days which has not responded to paracetamol, injected conjunctiva, dry and swollen mucosal linings around the mouth and red, swollen hands and feet are features of what?

A

Kawasaki disease

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5
Q

What is the treatment of choice for kawasaki disease?

A

high-dose aspirin alongside intravenous immunoglobulin

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6
Q

What are the components of CHA2DS2-VASc?

A

C Congestive heart failure 1

H Hypertension (or treated hypertension) 1

A2 Age >= 75 years 2
Age 65-74 years 1

D Diabetes 1

S2 Prior Stroke, TIA or thromboembolism 2

V Vascular disease (including ischaemic heart disease and peripheral arterial disease) 1

S Sex (female) 1

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7
Q

What is the threshold for treatment on a CHA2DS2-VASc score?

A

0 No treatment

1 Males: Consider anticoagulation
Females: No treatment (this is because their score of 1 is only reached due to their gender)

2 or more Offer anticoagulation

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8
Q

What treatment is indicated for non pregnant women with an uncomplicated UTI?

A

3 days trimethoprim or nitrofurentoin

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9
Q

What is first line for pregnant women with a UTI that are symptomatic?

A

nitrofurantoin (should be avoided near term)

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10
Q

What is second line for pregnant women with a UTI that are symptomatic?

A

amoxicillin or cefalexin

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11
Q

What is first line for pregnant women with a UTI that are asymptomatic?

A

nitrofurantoin (should be avoided near term), amoxicillin or cefalexin (7 days)

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12
Q

What is first line treatment for men with a UTI?

A

trimethoprim or nitrofurantoin 7 days

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13
Q

What is the recommended treatment for acute pyelonephritis?

A

broad-spectrum cephalosporin or a quinolone (for non-pregnant women) for 10-14 days

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14
Q

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

A

Aortic dissection

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15
Q

Which of the following medications makes clopidogrel less effective?

Allopurinol

Amiodarone

Metronidazole

Omeprazole

Trimethoprim

A

Omeprazole

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16
Q

What medication(s) should be administered to patients with resolved TIA symptoms, awaiting specialist review within 24 hours?

A

Aspirin

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17
Q

What medication(s) should be administered to patients after a TIA who have been reviewed by a specialist, for their initial 21 days when at high risk of further events?

A

Aspirin + Clopidogrel

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18
Q

What medication(s) should be administered to patients
after a TIA for long-term secondary prevention after 21 days?

A

Clopidogrel

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19
Q

When should a carotid endarctectomy be considered?

A

After a stroke or TIA in the carotid territory and if the stenosis > 50%

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20
Q

What is the protein content of transudate?

A

Transudate is < 30g/L protein

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21
Q

What is the protein content of exudate?

A

Exudate is > 30g/L protein

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22
Q

What are the causes of a transudative pleural effusion?

A

heart failure (most common transudate cause)
hypoalbuminaemia
liver disease
nephrotic syndrome
malabsorption
hypothyroidism
Meigs’ syndrome

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23
Q

What are the causes of an exudative pleural effusion?

A

infection:
- pneumonia (most common exudate cause),
- tuberculosis
- subphrenic abscess

connective tissue disease:
- rheumatoid arthritis
- systemic lupus erythematosus

Neoplasia
- lung cancer
- mesothelioma
- metastases

pancreatitis
pulmonary embolism
Dressler’s syndrome
yellow nail syndrome

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24
Q

What is the treatment of choice for Chlamydia trachomatis in pregnancy?

A

Azithromycin, erythromycin or amoxicillin

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25
Q

What is the first line treatment indicated for non pregnant adults with Chlamydia trachomatis?

A

Doxycycline

26
Q

What is the recommended treatment regime for pubic lice?

A

Malathion lotion or permethrin cream.

Both should be applied to the whole body and washed off after 12 hours. The patient should be advised to reapply the treatment 7 days after initial application to ensure that lice emerging from surviving eggs are eradicated.

27
Q

What is the treatment of choice for Trichomonas vaginalis?

A

Metronidazole

28
Q

If ST elevation is seen in leads II, III, aVF, what is the most likely affected coronary artery?

A

RCA (inferior myocardium)

29
Q

If ST elevation is seen in leads V1-2, what is the most likely affected coronary artery?

A

Proximal LAD (septal myocardium)

30
Q

If ST elevation is seen in leads V 3-4, what is the most likely affected coronary artery?

A

LAD (anterior myocardium)

31
Q

If ST elevation is seen in leads V 5-6, what is the most likely affected coronary artery?

A

Distal LAD/ LCx/ RCA (myocardial apex)

32
Q

If ST elevation is seen in leads I and aVL, what is the most likely affected coronary artery?

A

LCx (lateral myocardium)

33
Q

If ST elevation is seen in leads V7-V9, with reciprocal ST depression V1-3, what is the most likely affected coronary artery?

A

RCA/ LCx (posteriolateral myocardium)

34
Q

What are the rules surrounding warfarinised patients and emergency surgery?

A

If surgery can wait for 6-8 hours - give 5 mg vitamin K IV
If surgery can’t wait - 25-50 units/kg four-factor prothrombin complex

35
Q

Barrett’s oesophagus can predispose to what malignancy?

A

Adenocarcinoma of the oesophagus

36
Q

Patient presents with red eye, photophobia, small pupil, reduced visual acuity and pus in the anterior chamber. What is the most likely diagnosis?

A

Anterior uveitis

37
Q

The following features are seen in which disease?

flushing (often the earliest symptom)
diarrhoea
bronchospasm
hypotension
right heart valvular stenosis

A

Carcinoid syndrome - seretonin secreting tumor

38
Q

‘onion skin’ appearance on X-ray is suggestive of what?

A

Ewings sarcoma

39
Q

Which of the following medications can lower seizure thresholds?

Co-amoxiclav

Nitrofurantoin

Cefixime

Trimethoprim

Ciprofloxacin

A

Ciprofloxacin

40
Q

What side effects are associated with metformin?

A

Gastrointestinal side-effects
Lactic acidosis

41
Q

What side effects are associated with sulfonylureas?

A

Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)

42
Q

What side effects are associated with glitazones?

A

Weight gain
Fluid retention
Liver dysfunction
Fractures

43
Q

What side effects are associated with gliptins?

A

Pancreatitis

44
Q

Empagliflozin, dapagliflozin and canagliflozin are examples of which class of drug?

A

SGLT2 inhibitors

45
Q

Sitagliptin, saxagliptin and alogliptin are examples of which class of drug?

A

DPP4 inhibitors

46
Q

Exenatide, liraglutide and dulaglutide are examples of which class of drug?

A

GLP-1 analogues (incretin)

47
Q

Gliclazide is an example of which class of drug?

A

Sulfonylurea

48
Q

What is the best initial treatment regime for someone with T2DM?

A

Metformin first line
+SGLT-2 inhib if patient has pre-existing CVD, heart failure or QRISK > 10%

49
Q

What is second line in T2DM?

A

add sulfonylurea, pioglitazone, DPP4 inhib or SGLT2 inhib

50
Q

What is third line in T2DM?

A

Triple therapy with metformin + 2x 2nd line drugs
Consider insulin therapy

51
Q

What is the first line management for patients with COPD?

A

a short-acting beta2-agonist (SABA) or short-acting muscarinic antagonist (SAMA)

52
Q

What is second line for COPD if the patient does not exhibit steroid responsiveness?

A

add a long-acting beta2-agonist (LABA) + long-acting muscarinic antagonist (LAMA)

if already taking a SAMA, discontinue and switch to a SABA

53
Q

What is second line for COPD if the patient exhibits steroid responsiveness?

A

LABA + inhaled corticosteroid (ICS)

54
Q

What is third line therapy for COPD?

A

triple therapy i.e. LAMA + LABA + ICS

if already taking a SAMA, discontinue and switch to a SABA

55
Q

How is cor pulmonale managed?

A

use a loop diuretic for oedema, consider long-term oxygen therapy

56
Q

What can be used to reverse dystonia that may be induced by haloperidol?

A

Procyclidine

57
Q

If C. difficile does not respond to first-line vancomycin, what should then be administered?

A

oral fidaxomicin

58
Q

What antibiotic is first line for c.diff infections?

A

Vancomycin

59
Q

Which diabetic drug is useful in the management of obese type 2 diabetics?

A

DPP4 inhibitors eg a ‘gliptin’

60
Q
A

AMK style questions (8 decks)

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