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Year 4 > WTFK > Flashcards

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
Q

second line management of hyperemesis gravidarum?

A

ondansetron

metoclopromide

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26
Q

what other drugs can help with hyperemesis gravidarum?

A

thiamine supplements to replace loss

can give omeprazole/ranitidine to help with reflux or steroids

27
Q

how platelets accumulate?

A

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
Q

aspirin vs clopidogrel/tricagrelor?

A 
aspirin = COX inhibitor
clopidogrel/tricagrelor = ADP receptor antagonist
29
Q

what is cushings triad?

A

triad of symptoms in response to raised ICP

  • bradycardia
  • hypertension
  • deep/irregular breathing
30
Q

what is steal syndrome?

A

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
Q

what are the 3 trimesters in pregnancy?

A 
1 = 1-12 weeks
2 = 13-28 weeks
3 = 29-40 weeks
32
Q

how does oxytocin affect labour?

A

stimulates uterus to contract

33
Q

what does oestrogen do in labour?

A

stimulates labour and uterine contractions by promoting prostaglandin production

34
Q

how does progesterone affect labour?

A

inhibits uterine contractions by preventing formation of gap junctions and hindering contractibility of myocytes

35
Q

where does signal for uterine contractions start?

A

pacemakers in tubal ostia

contraction waves from each ostia are synchronised and meet in the middle

36
Q

what is tocolysis?

A

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
Q

what drugs are used for tocolysis?

A

terbutaline via s/c route

38
Q

what does a strawberry cervix indicate?

A

trichomonas vaginalis

39
Q

normal vaginal pH?

A

<4.5

40
Q

commensal bacteria in vagina?

A

lactobacilli

metabolise glycogen to ensure acidic environment

41
Q

features of moderate asthma attack?

A

peak flow 50-75% best

increasing symptoms

42
Q

features of acute severe asthma attack?

A

peak flow >33-30% of best
resp rate 25 or more
hear rate 110 or more
inability to complete sentences

43
Q

features of life threatening asthma attack?

A 
peak flow <33% of best
SpO2 <92%
silent chest
cyanosis
poor resp effort
arrhythmia
exhaustion, altered consciousness
PaO2 <8
normal PaCO2
44
Q

features of near fatal asthma attack?

A

raised PaCO2 and/or requiring mechanical ventilation with raised inflation pressure

45
Q

what group of antibiotics should be avoided in pregnancy?

A

tetracyclines (eg erythromycin, doxycyline, tetracycline etc)

46
Q

how quickly should bHCG rise in pregnancy?

A

double every 48 hrs

47
Q

who should have an OGTT done at 20-24 weeks in pregnancy?

A

previous macrosomnic baby
fam history of diabetes
obesity
family origin in area of high prevalence of gestational diabetes

48
Q

first line broad spectrum antibiotic in pregnancy?

A

co-amoxiclav (clindamycin + gentamicin if pen allergic)

49
Q

when is charcoal used to manage paracetamol overdose?

A

if <1 hour post ingestion and paracetamol level <150mg/kg

50
Q

at what concentration is paracetamol overdose likely to cause toxicity?

A

> 75mg/kg of paracetamol taken in less than 1 hour

51
Q

how do you know if acetylcysteine is needed in paracetamol overdose?

A

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
Q

when is acetylcysteine used in paracetamol overdose?

A

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
Q

murmur in VSD?

A

soft systolic murmur loudest in lower left sternal edge

54
Q

other presenting features of VSD?

A 
palpable liver edge
high HR
low BP
high resp rate
slightly low SpO2
55
Q

what do crescents on renal biopsy indicate?

A

rapidly progressive glomerulonephritis

56
Q

how does slapped cheek (parovirus B19) affect blood?

A

causes reduction in RBCs due to haemolysis and reduced production of RBCs

57
Q

why is reduced RBCs in slapped cheek only really a problem in kids or sickle cell patients?

A

RBCs last 120 days in adults

RBC turnover is much faster in kids so problematic

58
Q

how is scarlet fever managed?

A

penicillin (IV??)

59
Q

what causes scarlet fever?

A

group A strep

60
Q

what cause molluscum contagiosum>

A

poxvirus

61
Q

features of parkinsonism + autonomic disturbance (eg urinary incontinence, postural hypotension etc)?

A

multiple system atrophy

also often have cerebellar signs which can be more prominent than parkinsons signs

62
Q

what NMJ disorder improves with exercise (unlike myasthenia gravis)?

A

lambert eaton syndrome

63
Q

what is LEMS associated with?

A

small cell lung cancer

64
Q

LEMS vs myasthenia gravis?

A

LEMS presents later in life
usually weakness of proximal limb muscles
initially improves with exercise

Year 4 (83 decks)

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