Wed Flashcards
unsafe swallow post stroke
nil by mouth with IV fluids and refer to SALT
first line investigation for stroke
CT
which lobe is broca’s area in
frontal
which lobe is wernicke’s area in
temporal
which artery is most common for thromboembolic infarcts
middle cerebral
post alteplase next step in acute stroke management
300mg aspirin for 2 weeks after alteplase
gram -ve are
diplococci and bacilli
diplococci
neisseia meningitidis and gonorrhoreae
baccili
bordatella
H influenzae
coliforms
pseudomonas
campylobactor
treatment for coliforms
gentamicin
gentamicin what type of antibiotic
aminoglyxosides
anaerobes
clostridium
bacteriocides
treatment for anaerobes
metronidazole
alpha hameolysis
strep pneumonia and viridans
partial
beta haemolysis
group A strep pyogens
group b
complete
gamma haemolysis
none
enterococcus
norovirus
1-2 days incubation
shellfish
crowds
E. coli
1-3 days incubation
feacal oral route
rotavirus , adenovirus
10h - 3 days incubation
fecal oral route
gastroenteritis in kids
listeria monocytogenes
1 day incubation
processed meats, soft cheese, pate
pregnancy
inflammatory diarrhea
fever, mucus stool , bloody stool
salmonella
1-3 days incubation
poultry
eggs
meat
fish
milk
petting zoos
inflammatory diarrhea
campylobactor
1-3 days incubation
poultry
meat
milk
animal contact
inflammatory diarrhea
shigella
1-3 days incubation
men who have sex with men
crowds
inflammatory diarrhea
CURB 65
for pneumonia
confusion
urea>7
RR>or equal 30
BP <90/60
age> or equal to 65
Community-Acquired Pneumonia pathogens
strep pneumonia and H. influenzae
klebsiella CAP
alcoholics or lung disease
candida
cottage cheese thick discharge
fungus
vaginal- thrush
Vulvovaginal Candidiasis complications
spread to groin, satelite regions
Vulvovaginal Candidiasis treatment
clotrimazole cream
bacterial vaginosis signs
thin grey discharge
clue cells
bacterial vaginosis treatment
metronidazole
medications risk factor for c diff
ppi - omeprazole
treatment for tb
isoniazid
rifampicin
ethambutol
pyrazinamide
2 months
isoniazid and rifampicin for extra 4 months
side effects of tb treatment for all meds
liver toxic
side effect of Isoniazid
Peripheral neuropathy
Vit B6 for this
side effect of Rifampicin
turns pee orange
Ethambutol side effect
visual
side effect of Pyrazinamide
Hyperuricaemia
Trigeminal neuralgia treatment
Carbamazepine
Cervical Spondylosis/myelopathy
age-related degenerative condition of the cervical spine
cervical osteoarthritis
myelopathy
injury to spinal cord by trauma degenerative disease or disc herniation
Cervical Spondylosis/myelopathy symptoms
upper limb paresis
neck pain
hand paresis
Cervical Spondylosis/myelopathy treatment
NSAIDS
surgery if this doesn’t work
screening for trisomy 21 types
Combined Test
Triple Test
Quadruple Test
Combined Test
Nuchal translucency using ultrasound scan
PAPP-A hormone - reduced
Beta-hCG hormone- raised
when is combined test done
11 and 13 weeks of pregnancy in the first trimester
triple test
Beta-hCG
AFP - reduced
uE3 - reduced
Quadruple Test
Beta-hCG
AFP - reduced
uE3 - reduced
Inhibin-A levels -raised
when to do triple test in pregnancy
16-18 weeks
first trimester
12 weeks
second trimester
13-26
what to give at pre term labour
corticosteroids- lung maturation
tocolytics- prevent contractions
penicillin- if infection
Ramsay Hunt Syndrome
shingles affecting the nerve supplying the outer ear
immunosuppression like methotrexate
Ramsay Hunt Syndrome symtoms
facial nerve palsy
painful ear with blisters
inflamed ear drum
Ramsay Hunt Syndrome treatment
Antiviral agents
Breast cyst
tender
moves
gets bigger and tender before period
phyllodes tumour
stretches skin
cancer of connective tissue
40+
stromal and epithelial fragments
‘leaf like’
fat necrosis of breast
after trauma
irregular lump
mastitis organism and treatment
staph aures
flucloaxcillin
Intraductal papilloma
growth in milk ducts
bloody discharge
Active second stage of labour
full cervical dilatation 10cm
active maternal pushing
can see baby
Passive second stage of labour
full dilatation
not active pushing
Latent first stage of labour
regular painful contractions
cervical changes- effacement
dilatation up to 4cm.
screening test for gestational diabetes
75g 2-hour Oral glucose tolerance test (OGTT)
24-28 weeks
treatment for gestational
if fasting glucose <7 then lifestyle modifications for 1-2 weeks
then metformin
> or equal to 7 then insulin
goal fasting glucose for gestational diabetes
5.3
folate
b9
Cervical ectropion
young people
pregnancy
COCP
high levels of oestrogen trigger an enlargement of the cervix, causing eversion of the endocervical canal, which appears as a red ring
parkinsons tremor
at rest
3-5Hz
Schizophrenia
positive and negative symptoms
postive symptoms
hallucinations- speaking to someone not there
delusions
thought disorders
control issues
broadcasting of thoughts
negative symptoms
alogia- speaking less
anhedonia- lack of interest and pleasure in things used to
avolition- lack of motivation
types of Schizophrenia
paranoid
catatonic
Hebephrenic
residual
simple
Catatonic Schizophrenia
motor
waxy flexibility- resistance to being moved
Hebephrenic Schizophrenia
disorganized thinking, emotions, and behavior.
Residual Schizophrenia
Residual symptoms persist after a major episode.
Simple Schizophrenia
gradual decline in functioning without prominent positive symptoms.
Schizophrenia acute management
sedatives
lorazepam, promethazine, or haloperidol
Schizophrenia medication when resistant to 2 antipsycotics
clozapine
treatment of oestrogen-receptor-positive breast cancer in premenopausal women.
Tamoxifen
treatment of HER2 breast cancer
Trastuzumab
vaccine for tb
BCG
most common cause of food poisoning
gram stain
Campylobacter jejuni
gram -ve rods
second most common cause of food poisoning
gram stain
Salmonella enteritidis
-ve
TNM staging
Small tumours under 2cm in size score T1
N1 if less than 4 close nodes affected
more than 9= N3
tertiary Syphilis or neurosyphilis
Argyll Robertson pupil
pupil is constricted and does not react to light but does react to the accommodation reflex
only happens when left untreated
meningitis treatment
2g of IV ceftriaxone twice daily
IV amoxicillin/chloramphenicol age extremes for listeria coverage
viral encephalitis= IV aciclovir
Ductal carcinoma pathology
irregular
large nuclei
Lobular carcinoma pathology
small
round
uniform
Mammary-duct ectasia
dilation and thickening of the lactiferous ducts
blockage of the ducts
accumulation of fluid.
Mammary-duct ectasia symptoms
thick, sticky green or yellow nipple discharge with nipple inversion
most common type of vulval cancer
SSC
Intracranial haemorrhages
extradural haemorrhage
subdural haemorrhage
subarachnoid haemorrhage
extradural haemorrhage
trauma to pterion
CT- biconvex haematoma
acute severe headache and contralateral hemiplegia
trauma to the pterion causes
tearing of the middle meningeal artery.
SUBDURAL HAEMORRHAGE
gradually increasing headache and confusion
CT- crescent-shaped haematoma
RF for subdural haemorrhage
age
alcoholism
anticoagulation
SUBARACHNOID HAEMORRHAGE
acute severe headache - back of head
CT- white centre of brain
causes traumatic or spontaneous
cause of spontaneous subarachnoid haemorrhage
damage to circle of willis
uterine fibroids
benign tumour of endometrium
uterine leiomyomas,
uterine fibroids symptoms
menorrhagia- heavy periods
dysmenorrhoea- painful periods
mass
infertility if v big
management of small uterine fibroids
NSAIDs
anti-fibrinolytics- transamenic acid
Levonorgestrel-releasing intrauterine system (Mirena).
management of big uterine fibroids
myomectomy
viral meningitis on lumbar puncture and pathogen
Lymphocytes and slightly raised protein- CSF
enterovirus
bacterial meningitis pathogens and lumbar puncture
Streptococcus pneumoniae
Neisseria meningitidis
Haemophilus influenzae
raised protien, low glucose , clear
bacterial meningitis treatment
IV ceftriaxone
risk factors for haemorraghic stroke
age
male
haemophilia
anti-coagulation
sympathomimetic drugs - cocaine and amphetamines for ADHD
mumps
parotid swelling
measles
conjunctivitis and grey (Koplik spots) mouth
Acute fatty liver of pregnancy
nulliparous women
vomiting, and jaundice
management- delivery
Methaemoglobinaemia
accumulation of methaemoglobin
haemoglobin unable to bind oxygen
Methaemoglobinaemia symptoms
cyanosis
SoB
headache
dizziness
fatigue
Methaemoglobinaemia treatment
o2
methylene blue
ascorbic acid supplementation
