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WTFK Flashcards

1
Q

what causes pataus?

A

trisomy 13

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2
Q

features of pataus?

A

microcephaly
small eyes
polydactyly
scalp lesions

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3
Q

what causes edwards?

A

trisomy 18

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4
Q

features of edwards?

A

micrognathia
low set ears
rocker bottom feet
overlapping of fingers

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5
Q

features of fragile X?

A 
learning difficulties
macrocephaly
long face
large ears
macro-orchidism
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6
Q

features of prader-willi syndrome?

A

hypotonia
hypogonadism
obesity

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7
Q

what is DIDMOAD (AKA wolfram syndrome)?

A 
autosomal recessive genetic disorder causing:
diabetes insipidus
diabetes mellitus
optic atrophy
deafness
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8
Q

PPIs can cause what electrolyte change?

A

hyponatraemia

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9
Q

what antidepressants can cause hyponatraemia?

A

citalopram

sertraline

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10
Q

bisphosphonates can cause indigestion, if someone has problems like that already how are bisphosphonates given?

A

may be given once yearly IV formulation

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11
Q

what T score defines osteoporosis?

A

< -2.5

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12
Q

which nerve root is affected in disc prolapse?

A

lower nerve root

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13
Q

what is carbamazepine and what else can it be used for?

A

anti-epileptic

can also be used for nerve pain

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14
Q

how long does it take to become nourished again after being fed in hospital for malnourishment and why?

A

around 25 days

takes a while for turnover (ie takes a while for albumin to come back up after being low in malnourishment)

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15
Q

analgesia in renal impairment?

A

oxycodone better than morphine but can still cause problems with accumulation if eGFR<30

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16
Q

what analgesia is used if eGFR <30?

A

alfentanyl

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17
Q

weber test?

A

tuning fork held in middle of forehead

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18
Q

what does it mean if sound is louder in one ear on weber test?

A

either of:

  • sensorineural hearing loss in quieter ear
  • conductive loss in louder ear
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19
Q

rinne test?

A

tuning fork held in front of ear and then on mastoid bone

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20
Q

what does it mean if air conduction louder than bone conduction on rinne test?

A

either normal or sensorineural loss

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21
Q

what does it mean if bone conduction louder than air conduction on rinne test?

A

conductive loss

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22
Q

what type of anaemia does cancer cause?

A

microcytic anaemia

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23
Q

how can ectopic pregnancy be managed medically?

A

methotrexate

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24
Q

first line management of hyperemesis gravidarum?

A

cyclizine

prochlorperazine

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25
second line management of hyperemesis gravidarum?
ondansetron | metoclopromide
26
what other drugs can help with hyperemesis gravidarum?
thiamine supplements to replace loss | can give omeprazole/ranitidine to help with reflux or steroids
27
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
28
aspirin vs clopidogrel/tricagrelor?
``` aspirin = COX inhibitor clopidogrel/tricagrelor = ADP receptor antagonist ```
29
what is cushings triad?
triad of symptoms in response to raised ICP - bradycardia - hypertension - deep/irregular breathing
30
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)
31
what are the 3 trimesters in pregnancy?
``` 1 = 1-12 weeks 2 = 13-28 weeks 3 = 29-40 weeks ```
32
how does oxytocin affect labour?
stimulates uterus to contract
33
what does oestrogen do in labour?
stimulates labour and uterine contractions by promoting prostaglandin production
34
how does progesterone affect labour?
inhibits uterine contractions by preventing formation of gap junctions and hindering contractibility of myocytes
35
where does signal for uterine contractions start?
pacemakers in tubal ostia | contraction waves from each ostia are synchronised and meet in the middle
36
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
37
what drugs are used for tocolysis?
terbutaline via s/c route
38
what does a strawberry cervix indicate?
trichomonas vaginalis
39
normal vaginal pH?
<4.5
40
commensal bacteria in vagina?
lactobacilli | metabolise glycogen to ensure acidic environment
41
features of moderate asthma attack?
peak flow 50-75% best | increasing symptoms
42
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
43
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 ```
44
features of near fatal asthma attack?
raised PaCO2 and/or requiring mechanical ventilation with raised inflation pressure
45
what group of antibiotics should be avoided in pregnancy?
tetracyclines (eg erythromycin, doxycyline, tetracycline etc)
46
how quickly should bHCG rise in pregnancy?
double every 48 hrs
47
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
48
first line broad spectrum antibiotic in pregnancy?
co-amoxiclav (clindamycin + gentamicin if pen allergic)
49
when is charcoal used to manage paracetamol overdose?
if <1 hour post ingestion and paracetamol level <150mg/kg
50
at what concentration is paracetamol overdose likely to cause toxicity?
>75mg/kg of paracetamol taken in less than 1 hour
51
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
52
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
53
murmur in VSD?
soft systolic murmur loudest in lower left sternal edge
54
other presenting features of VSD?
``` palpable liver edge high HR low BP high resp rate slightly low SpO2 ```
55
what do crescents on renal biopsy indicate?
rapidly progressive glomerulonephritis
56
how does slapped cheek (parovirus B19) affect blood?
causes reduction in RBCs due to haemolysis and reduced production of RBCs
57
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
58
how is scarlet fever managed?
penicillin (IV??)
59
what causes scarlet fever?
group A strep
60
what cause molluscum contagiosum>
poxvirus
61
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
62
what NMJ disorder improves with exercise (unlike myasthenia gravis)?
lambert eaton syndrome
63
what is LEMS associated with?
small cell lung cancer
64
LEMS vs myasthenia gravis?
LEMS presents later in life usually weakness of proximal limb muscles initially improves with exercise

Year 4 (83 decks)

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