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Deepa's MSRA > Topics I'm not good at > Flashcards

Topics I'm not good at Flashcards

1
Q

T12-L1 give rise to which nerve?

A

T12-L1 give rise to iliohypogastric nerve.

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2
Q

L1-2 give rise to which nerve?

A

L1-2 give rise to genitofemoral nerve.

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3
Q

L2-4 give rise to which nerve?

A

L2-4 give rise to femoral nerve.

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4
Q

S2-4 give rise to which nerve?

A

S2-4 give rise to pudendal nerve.

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5
Q

L4-5, S1-3 give rise to which nerve

A

Sciatic nerve

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6
Q

Hypertensive retinopathy stages

A

I: Arteriolar narrowing and tortuosity. Silver wiring
II: AV nipping
III: Cotton-wool exudates
Flame and blot haemorrhages - ‘macular star’
IV: Papilloedema

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7
Q

Patau syndrome

A

Triosomy 13
P - Palate (cleft)
A - A-lot-of-fingers (polydactyly)
T - Tiny mouth (micrognathia)
A - Angry scalp lesions
U - Uveas are small (small eyes)

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8
Q

Edward’s syndrome

A

Trisomy 18
E - ears (low)
D - Dinky mouth
D - Dodgy feet (rockers)
Y - Fingers overlap (make a y shape)

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9
Q

Fragile X

A

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism

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10
Q

Noonan syndrome

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

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11
Q

Pierre-Robin syndrome*

A

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

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12
Q

Prader Willi Syndrome

A

Hypotonia
Hypogonadism
Obesity

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13
Q

William’s syndrome

A

Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

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14
Q

Cri du chat syndrome

A

Chromosome 5p
Characteristic cry due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism

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15
Q

Meniscal tear

A

Gives way & locks
Worse on straightening leg
Tender on joint line

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16
Q

Episcleritis

A

Diffuse redness
NO Pain
Blanches with eye drops

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17
Q

Scleritis

A

Redness, painful ++, pain worse on eye movement, reduced visual acuity
Rheumatoid

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18
Q

GET SMASHED

A

Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs: azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, sodium valproate

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19
Q

cephalohaematoma

A

Does not crosses suture lines
bleeding between the periosteum and the skull
2-3 days after delivery
Resolves

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20
Q

Caput succedaneum

A

Crosses suture lines
Few hours after delivery
Takes months to improve
Oedema of presenting part

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21
Q

Erythema infectiosum

A

5th disease or slapped cheek
Parvovirus B19
Lethargy, fever, headache
‘Slapped-cheek’ rash spreading to proximal arms and extensor surfaces
No school exclusion
pancytopaenia, aplastic crisis, hydrops fetalis

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22
Q

Measles

A

Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent

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23
Q

Mumps

A

Fever, malaise, muscular pain
Parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

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24
Q

Rubella

A

Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

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25
Q

Scarlet fever

A

Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
‘Strawberry’ tongue
Rash - fine punctate erythema sparing the area around the mouth (circumoral pallor)

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26
Q

Hand, foot and mouth disease

A

coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet

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27
Q

Angina management

A
  1. Beta blocker/ CCB
    - CCB monotherapy: verapamil/ diltizaem
    - if combo with B-b: amlodipine, modified-release nifedipine
  2. Add other of step 1
  3. a long-acting nitrate/ ivabradine/ nicorandil/ ranolazine
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28
Q

Erythema nodosum causes - SORE SHINS

A

SORE SHINS
Streptococci
OCP
Rickettsia
Eponymous (Bechets)

Sulfonamides
Hansen’s disease (leprosy)
IBD
NHL
Sarcoidosis

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29
Q

Ankylosing spondylitis features - the ‘A’s

A

Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis

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30
Q

Erythema multiforme

A

Target lesions
Herpes simplex virus (commonest cause)
idiopathic
Mycoplasma
Streptococcus
drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, OCP, nevirapine
SLE
sarcoidosis
malignancy

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31
Q

Anion gap

A

NA + K - bicarb - Cl
Normal is between 12-17

32
Q

Plasma osmolality

A

2Na + Urea + Glucose

33
Q

Bloody diarrhoea causes

A

SEECSY
Salmonella
E coli
Entamoeba
Campylobacter
Shigella
Yersinia

34
Q

Side effect of Methotrexate

A

Myelosuppression
Liver cirrhosis
Pneumonitis

35
Q

Side effect of Sulfasalazine

A

Rashes
Oligospermia
Heinz body anaemia
Interstitial lung disease

36
Q

Side effect of Leflunomide

A

Liver impairment
Interstitial lung disease
Hypertension

37
Q

Side effect of Hydroxychloroquine

A

Retinopathy
Corneal deposits

38
Q

Side effect of Prednisolone

A

Cushingoid features
Osteoporosis
Impaired glucose tolerance
Hypertension
Cataracts

39
Q

Side effect of Gold

A

Proteinuria

40
Q

Side effect of Penicillamine

A

Proteinuria
Exacerbation of myasthenia gravis

41
Q

Side effect of Etanercept

A

Demyelination
Reactivation of tuberculosis

42
Q

Side effect of Infliximab

A

Reactivation of tuberculosis

43
Q

Side effect of Adalimumab

A

Reactivation of tuberculosis

44
Q

Side effect of Rituximab

A

Infusion reactions are common

45
Q

Side effect of NSAIDs (e.g. naproxen, ibuprofen)

A

Bronchospasm in asthmatics
Dyspepsia/peptic ulceration

46
Q

Splenectomy puts you at increased risk of which bacteria?

A

SHiN SKiS : Encapsulated bacteria
Streptococcus pneumonia
Haemophilus influenzae type B (HIB)
Neisseria meningitidis
Group B Strep
Klebsiella pneumonia
Salmonella typhi

46
Q

Splenectomy vaccines/ Abx

A

Pneumococcal
HIB
Meningococcal
Influenza (annual)
Oral phenoxymethylpenicillin prophylaxis

46
Q

Complications post MI

A

DARTHVADER
Death
Arrtyhymia
Rupture
Tamponade
Heart failure
Valvular disease
Aneurysm
Dressler’s syndrome
Recurrence
Cardiogenic shock

46
Q

Acute mitral regurgitation

A

More common with infero-posterior infarction and may be due toischaemia or papillary muscle rupture. Acute hypotension andpulmonary oedemamay occur. early-to-mid systolic murmur. Vasodilator therapy but often require emergency surgical repair.

47
Q

Bradyarrhythmias

A

AV block post inferior MI

47
Q

Cardiogenic shock

A

If EF reduces too much due to ischaemia -> cardiogenic shock. Or after left ventricular free wall rupture as listed below. Inotropic support and/or an intra-aortic balloon pump.

47
Q

Left ventricular aneurysm

A

Persistent ST elevationand left ventricular failure. Thrombus within the aneurysm increasing the risk of stroke. Patients are therefore anticoagulated.

48
Q

Left ventricular free wall rupture

A

in 3% of MIs and occurs around 1-2 weeks after. acute heart failure secondary to cardiac tamponade (raised JVP, pulsus paradoxus, diminished heart sounds). Urgent pericardiocentesis and thoracotomy

49
Q

Pericarditis

A

Pericarditis in the first 48 hours following a transmural MI is common(c. 10% of patients). The pain is typical for pericarditis (worse on lying flat etc), a pericardial rub may be heard and a pericardial effusion may be demonstrated with an echocardiogram.

50
Q

Dressler’s syndrome

A

Dressler’s syndrometends to occur around2-6 weeksfollowing a MI- underlying pathophysiology autoimmune reaction against antigenic proteins formed as the myocardium recovers. It is characterised by a combination offever,pleuritic pain, pericardial effusion and a raised ESR. It is treated with NSAIDs.

51
Q

Tachyarrhythmias

A

VF and VT. VF -> Death

52
Q

Ventricular septal defect

A

first week and is seen in around 1-2% of patients. acute heart failure associated with a pan-systolic murmur. An echocardiogram excludes acute MR which presents in a similar fashion. Urgent surgical correction needed.

53
Q

C diff treatment

A
  1. PO Vancomycin 10 days
  2. Retreatment: fidaxomicin
  3. PO Vanc +- IV Met
53
Q
A
54
Q

Most common cause septic arthritis

A

Staph Aureus

55
Q

Serotonin syndrome

A

Alternated mental status
NM hyperactivity - profound shivering, tremor, teeth grinding, hyperreflexia
Autonomic instability: Tachy, fever, high BP, D&V

56
Q

Neuroleptic malignant syndrome

A

Treating with dopamine antagonists or withdrawal of dopamine agoinsts
Hyperthermia, muscle rigidity, altered mental status, sympathetic nervous system lability, hypermetabolism, high CK

57
Q

Reed Sternberg cells

A

Hogkin’s Lymphoma

58
Q

Philadelphia chromosome

A

CML

59
Q

Corneal abrasion

A

Chloramphenicol

60
Q

Herpes Simplex Keratitis

A

topical aciclovir

61
Q

Conjunctivitis

A

Clean with cooled boiled water
Chloramphenicol drops

62
Q

Chlamydia

A
  1. PO Doxy 7 days
  2. if doxycycline contraindicated : azithromycin (1g stat, then 500mg OD for 2 days)
  3. if pregnant then azithromycin, erythromycin or amoxicillin
63
Q

Trichomonas

A

PO metronidazole 5-7 days
or one-off dose of 2g metronidazole

64
Q

Gonorrhoea

A
  1. single dose of IM ceftriaxone 1g
  2. PO stat dose of cefixime 400mg + azithromycin 2g
65
Q

Bacterial vaginosis

A

PO metronidazole 5-7 days or single oral dose of metronidazole 2g
Topical clindamycin can also be used

66
Q

Scleroderma

A

Systemic: anti scl-70anti-topoisomerase
Limited (CREST): Anti-nuclear and anti-centromere

67
Q

Cushing’s syndrome: Investigations

A
  1. overnight (low-dose) dexamethasone suppression/
    24 hr urinary free cortisol/ bedtime salivary cortisol
  2. High-dose dexamethasone suppression test
68
Q

steeple sign x ray

A

croup

69
Q

thumbprint sign xray

A

epiglottis

Deepa's MSRA (2 decks)

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