WTFK Flashcards
what causes pataus?
trisomy 13
features of pataus?
microcephaly
small eyes
polydactyly
scalp lesions
what causes edwards?
trisomy 18
features of edwards?
micrognathia
low set ears
rocker bottom feet
overlapping of fingers
features of fragile X?
learning difficulties macrocephaly long face large ears macro-orchidism
features of prader-willi syndrome?
hypotonia
hypogonadism
obesity
what is DIDMOAD (AKA wolfram syndrome)?
autosomal recessive genetic disorder causing: diabetes insipidus diabetes mellitus optic atrophy deafness
PPIs can cause what electrolyte change?
hyponatraemia
what antidepressants can cause hyponatraemia?
citalopram
sertraline
bisphosphonates can cause indigestion, if someone has problems like that already how are bisphosphonates given?
may be given once yearly IV formulation
what T score defines osteoporosis?
< -2.5
which nerve root is affected in disc prolapse?
lower nerve root
what is carbamazepine and what else can it be used for?
anti-epileptic
can also be used for nerve pain
how long does it take to become nourished again after being fed in hospital for malnourishment and why?
around 25 days
takes a while for turnover (ie takes a while for albumin to come back up after being low in malnourishment)
analgesia in renal impairment?
oxycodone better than morphine but can still cause problems with accumulation if eGFR<30
what analgesia is used if eGFR <30?
alfentanyl
weber test?
tuning fork held in middle of forehead
what does it mean if sound is louder in one ear on weber test?
either of:
- sensorineural hearing loss in quieter ear
- conductive loss in louder ear
rinne test?
tuning fork held in front of ear and then on mastoid bone
what does it mean if air conduction louder than bone conduction on rinne test?
either normal or sensorineural loss
what does it mean if bone conduction louder than air conduction on rinne test?
conductive loss
what type of anaemia does cancer cause?
microcytic anaemia
how can ectopic pregnancy be managed medically?
methotrexate
first line management of hyperemesis gravidarum?
cyclizine
prochlorperazine
second line management of hyperemesis gravidarum?
ondansetron
metoclopromide
what other drugs can help with hyperemesis gravidarum?
thiamine supplements to replace loss
can give omeprazole/ranitidine to help with reflux or steroids
how platelets accumulate?
COX in platelets release thromboxane A2 which binds to GP iiia and iib receptors on other platelets and activates them
also release ADP which does same thing
aspirin vs clopidogrel/tricagrelor?
aspirin = COX inhibitor clopidogrel/tricagrelor = ADP receptor antagonist
what is cushings triad?
triad of symptoms in response to raised ICP
- bradycardia
- hypertension
- deep/irregular breathing
what is steal syndrome?
reduction in blood flow to the peripheries
due to an excess arterial blood being shunted into venous circulation
can be due to AVM or anastamosis (eg for dialysis)
what are the 3 trimesters in pregnancy?
1 = 1-12 weeks 2 = 13-28 weeks 3 = 29-40 weeks
how does oxytocin affect labour?
stimulates uterus to contract
what does oestrogen do in labour?
stimulates labour and uterine contractions by promoting prostaglandin production
how does progesterone affect labour?
inhibits uterine contractions by preventing formation of gap junctions and hindering contractibility of myocytes
where does signal for uterine contractions start?
pacemakers in tubal ostia
contraction waves from each ostia are synchronised and meet in the middle
what is tocolysis?
medication used to postpone labour
used when labour would result in premature delivery and/or risk foetal complications
can postpone delivery long enough to give glucocorticoids to help mature foetal lungs etc
what drugs are used for tocolysis?
terbutaline via s/c route
what does a strawberry cervix indicate?
trichomonas vaginalis
normal vaginal pH?
<4.5
commensal bacteria in vagina?
lactobacilli
metabolise glycogen to ensure acidic environment
features of moderate asthma attack?
peak flow 50-75% best
increasing symptoms
features of acute severe asthma attack?
peak flow >33-30% of best
resp rate 25 or more
hear rate 110 or more
inability to complete sentences
features of life threatening asthma attack?
peak flow <33% of best SpO2 <92% silent chest cyanosis poor resp effort arrhythmia exhaustion, altered consciousness PaO2 <8 normal PaCO2
features of near fatal asthma attack?
raised PaCO2 and/or requiring mechanical ventilation with raised inflation pressure
what group of antibiotics should be avoided in pregnancy?
tetracyclines (eg erythromycin, doxycyline, tetracycline etc)
how quickly should bHCG rise in pregnancy?
double every 48 hrs
who should have an OGTT done at 20-24 weeks in pregnancy?
previous macrosomnic baby
fam history of diabetes
obesity
family origin in area of high prevalence of gestational diabetes
first line broad spectrum antibiotic in pregnancy?
co-amoxiclav (clindamycin + gentamicin if pen allergic)
when is charcoal used to manage paracetamol overdose?
if <1 hour post ingestion and paracetamol level <150mg/kg
at what concentration is paracetamol overdose likely to cause toxicity?
> 75mg/kg of paracetamol taken in less than 1 hour
how do you know if acetylcysteine is needed in paracetamol overdose?
patients at risk of liver damage which is identified using plasma-paracetamol concentration related to time from ingestion (provided this time interval is not less than 4 hrs)
this value is plotted on treatment graph
when is acetylcysteine used in paracetamol overdose?
if value of plasma-paracetamol concentration is on or above “treatment line” on graph
if more than if patient ingested 150mg/kg or more of paracetamol and presenting within 8 hrs of ingestion and there is going to be a delay of 8 hrs or more after ingestion in obtaining paracetamol concentration
if presenting 8-24 hrs after ingesting more than 150mg/kg of paracetamol even is concentration not available
presenting >24 hrs after ingestion if they are clearly jaundiced or have hepatic tenderness or deranged LFTs
murmur in VSD?
soft systolic murmur loudest in lower left sternal edge
other presenting features of VSD?
palpable liver edge high HR low BP high resp rate slightly low SpO2
what do crescents on renal biopsy indicate?
rapidly progressive glomerulonephritis
how does slapped cheek (parovirus B19) affect blood?
causes reduction in RBCs due to haemolysis and reduced production of RBCs
why is reduced RBCs in slapped cheek only really a problem in kids or sickle cell patients?
RBCs last 120 days in adults
RBC turnover is much faster in kids so problematic
how is scarlet fever managed?
penicillin (IV??)
what causes scarlet fever?
group A strep
what cause molluscum contagiosum>
poxvirus
features of parkinsonism + autonomic disturbance (eg urinary incontinence, postural hypotension etc)?
multiple system atrophy
also often have cerebellar signs which can be more prominent than parkinsons signs
what NMJ disorder improves with exercise (unlike myasthenia gravis)?
lambert eaton syndrome
what is LEMS associated with?
small cell lung cancer
LEMS vs myasthenia gravis?
LEMS presents later in life
usually weakness of proximal limb muscles
initially improves with exercise
