VIA III Flashcards
What bacteria is associated with mesenteric adenitis?
yeseria
Criteria for Bariatric surgery?
BMI 35+ with comorbidity or
BMI 40+
What is the acute management of Cluster headache?
And long term?
100% o2 for 15min
and sumatriptan in the long term
What is a short synacthen test?
Stimulation test for deficiency of ACTH - Addison’s disease
Hyponatraemic + hyperkalaemic with weight loss, tiredness and nausea?
Addison’s disease
What is Addison’s disease?
Primary Adrenal insufficiency - decreased Cortisol and decreased Aldosterone
What is Conn’s syndrome?
Primary Hypothyroidism. Increased Aldosterone levels - leading to normal/low Na, increased fluid. The body loses hydrogen and hence the pH goes up.
Acute exacerbation of Gout caused by..?
90% caused by decreased renal clearance. Other causes include:
GORD + Constant heartburn and regurgitation and dysphasia. On gastroscopy you would see….
Barrett’s oesophagus
30 yo female + Unilateral blurring and acute pain + central scotoma + Right swollen disc
Optic Neuritis (MS)
Treatment of spontanenous Bacterial peritonitis?
Antibiotics - re-tap in 24 hours and neutrophil should have decreased by 50%.
You know its spontaneous bacterial peritonitis because the tap has neutrophils
If the tap didn’t have neutrophils therapeutic paracentesis would be first line.
What to avoid in Ventricular tachycardia?
Adenosine. Adenosine is given in SVT.
45yo man when to Africa two weeks ago - presenting fever, headache and maculopapular rash
HIV infection
How do you treat PCP ( Pneumocystis jirovecii)?
oral Co-trimoxazole
HIV is a DNA Virus?
T or F?
F - It is a retroviridae - works through reverse RNA transcriptase
Mixed upper motor neuron disease and lower motor neuron disease in the upper and lower limb
Motor neuron disease
Lower motor neuron signs in Upper limbs + Upper motor neuron signs in lower limb
Cervical cord compression
Signs of progressive bulbar palsy?
tongue fasiculations + difficulty swallowing and chewing
35 yo woman, two months post partum, 4 week history of joint pain, skin rash and fever. ESR: 40. Diagnosis?
SLE
RA wouldn’t have a rash.
Differentiating between discoid rash in SLE vs Eczema?
SLE would have other symptoms too
What is the genes affected by Coeliac?
HLA DQ2 and HLA DQ8
What do you see on histology with Coeliac?
The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened
Investigations for Coeliac?
anti-tTG, genetics screening, Anti-endomysial antibodies (IgA)
When do you transfuse bloods in anaemia?
Transfuse blood when iron is less than 70.
Woman young, fat with increased intracranial pressure (damage to retina and optic disc swelling)?
Idiopathic (Benign) Intracranial hypertension
Why does oral analgesics not work in people that have migraine’s whilst having it?
There is gastric stasis and hence orally it is not helpfull.
Triggers for Migraine?
CHOCOLATE
Chocolate
H
OCP
How to manage migraine?
PREVENTATIVE (avoid triggers) + paracetamol, metachlopramide + aspirin
Migraine diary
triptans (intranasal)??
How to differentiate between IgA (can be triggered after sickness) and Post-Streptococcal gN?
IgA is rapid - 24 hrs.
Post Streptococcus occurs 2 weeks after illness.
Abdominal pain + Purpura + GN symptoms
HSP
Severe complication of MDMA and Serrotonin syndrome?
Fever
Treatment of neuroepeleptical malignant syndrome?
Benzotropine
How to treat alcohol withdrawal tremor?
Diazapem
Cannabis intoxication?
Dry mouth, increased appetite, conjunctival injection, tachycardia
Pupillary constriction with which drug?
Opiod intoxication
Signs of neuroepeleptical malignant syndrome?
HARM
Serotonin syndrome? (3)
CAN:
CNS
Autonomic system (temperature),
Neuromuscular excitation`
In acidic environment (Stomach) what sort of substance is more easily able to be absorbed?
An acidic substance - because it has to be non-ionised to be absorbed.
Episodic impairment of consciousness?
Fluctuating mental state in old people
Chronic sub-dural haematoma
Crescent shaped haemorrhage
Subdural haematoma
Lemon shaped haemorrhage?
Epidural haematoma
Drugs causing infiltrative lung disease? (BAM)
Bleomycin
Amiodarone
Methotrexate
Ground glass appearance/ Honeycomb appearance on CT?
Infiltrative lung disease (pulmonary fibrossi)
Young man , 47, with osteoporosis (causing vertebral collapse).. how would you investigate?
Testosterone concentration?
ddx for testosterone deficiency?
- ## Genetic syndorme (Kleinfelter’s)-
Difference between primary and secondary polycthaemia?
Primary - renal cell carcinoma producing EPo
Secondary causes - due to a chronic disease
How do you check someone’s blood group
INDirect coombs test for cross matching to pick up on the antibodies!
When do you need FFP?
When coagulopathy problem?
How do you manage an asthamtic patient who quickly gets softer breath sounds?
immediate intubation!
Most frequent cause of blood stained nipple discharge?
Duct Papilloma
What is Paget disease?
DCIS of the nipple
Indian filed fashion of the breast
Invasive lobular breast cancer
Dengue fever presents with _______
back pain and myalgia and arthralgia
Mx of Malaria?
Chloroquinone
CA-125 is a marker for _____
Ovarian Cancer
CA-19-9 is tumour marker for __________
Pancreatic cancer
Organophosphate cause inhibition of ________
Acetylcholinesterase
Normal pressure hydrocephalus can occur be either idiopathic or secondary. Secondary is due to?
The secondary type of NPH can be due to a subarachnoid hemorrhage, head trauma, tumor, infection in the central nervous system, or a complication of cranial surgery.[1]
Most common cause of polyhydramnios?
Idiopathic polyhydramnios
or Gestational. So look at RF.
Severe oligohydramnios and no foetal bladder found
Renal Agenesis
How do you manage post menopausal bleeding due to and uterus procidentia?
Vaginal hysterectomy and repair
What is the gynaecologist preparing for by inserting ureteric stents before a hysterectomy?
Clamp and ligate uterine arteries
What additional steps have to be taken to remove the ovaries compared to a simple TAH
To ligate the infundibulopelvic ligaments
Complications in surgery after a women has had C-sections
Sharp dissection of he anterior lead (broad ligament) before reflecting onto the bladder
Bout of constipation, dehydration and serum potassium is low
Bartter syndrome