year 2 passmed Flashcards by zoe coyne

what are the ottawa rules for ankle x-ray

An ankle x-ray is required only if there is any pain in the malleolar zone and any one of the following findings:

bony tenderness at the lateral malleolar zone
bony tenderness at the medial malleolar zone
inability to walk four weight bearing steps immediately after the injury and in the emergency department

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how often is methotrexate taken

weekly

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how quickly do patients with PMR respond to steroids

dramatically quickly

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which antibiotic if prescribes with methotrexate could cause bone marrow suppression

trimethoprim

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what does a patient need to have to confirm a diagnosis of diffuse systemic sclerosis

systemic fibrosis

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what does this patient have

ankylosing spondylitis

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which type of osteomyelitis are sickle cell patients prone to

salmonella osteomyelitis

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how long does the morning stiffness last in osteoarthritis

less than 30 mins

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if the biopsy is normal in a potential giant cell arteritis patient, do you stop prednisolone

skip lesions may occur

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which SLE drug is safe to use in pregnancy

azathioprine

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if syndesmophytes are found on plain radiograph of the spine what does this indicate

ankylosing spondylitis

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what does spondylolisthesis mean

displacement of one spinal vertebra over the other

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what should patients with anti phospholipid syndrome who haven’t had a thrombosis before be started on

low dose aspirin

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patients who are allergic to what drug may also be allergic to sulfasalazine

aspirin

co-timoxazole

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causes of trigger finger

rheumatoid arthritis

- diabetes

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what does a positive simmonds sign mean

achilles tendon rupture

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which hypersensitivity reaction is anaphylaxis

type 1

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what does joint aspiration of gout show

needle-shaped negatively birefringent monosodium urate crystals under polarised light

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early x-ray findings of rheumatoid arthritis

juxta-articular osteoporosis
loss of joint space
soft-tissue swelling

JLS!!!!!

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late x-ray findings os rheumatoid arthritis

periarticular erosion

- subluxation

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Knee pain and swelling, typically after exercise
Knee catching, locking and/or giving way: more constant and severe symptoms are associated with the presence of loose bodies
Feeling a painful ‘clunk’ when flexing or extending the knee - indicating the involvement of the lateral femoral condyle

diagnosis?

osteochondritis dissecans

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if a patient presents with an auricular haematoma what is done first

referral to ENT

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if a patient presents with a unilateral polyp what is the first thing that should be done

urgent referral to ENT

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side effect of azathioprine

myelosuppression

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how long should you wait after taking methotrexate before having a baby

6 months

first line treatment for tonsillitis

Phenoxymethylpenicillin

where does webers lateralise to

affected ear

side effect of gentamicin

sensorineural hearing loss

what causes viral warts in rheumatoid arthritis

secondary to immunosuppression from etanercept treatment | -nothing should be done tho

halos around lights

closed angle glaucoma

what diseases can cause angular cheilitis

crohns and UC

what does pyoderma gangrenosum present as

an enlarging blister usually on the shins

what does erythema multiforme present as

many target lesions over 24 hours

what is lupus vulgaris

a type of cutaneous tuberculosis

what does lichen planus present as

a violaceous, polygonal, papular eruption that is commonly pruritic -it can form plaques

what does lichen sclerosus present as

itchy white spots seen on vulvas and penises

what does drusen affecting the fovea suggest

ARMD

does a thyroglossal cyst protrude when the patient sticks their tongue out

yes

histology of a SCC of the skin

lesion containing irregular masses of anaplastic epidermal cells proliferating down to the dermis with keratin pearls

what is an eye manifestation of giant cell arteritis

anterior ischaemic optic neuritis

if a patient with psoriasis is on oral steroid and vit D analogue what is the next step in management

stop the steroid and do twice daily vit D analogue

in bullous pemphigoid, which adhesive structure is disrupted by autoimmune mechanisms

hemidesmosome

treatment for scabies

topical permethrin

which drug can cause acne vulgaris

isoniazid

what is changed about levothyroxine in pregnancy

dose increased

what is elevated in the blood results for polymyositis

creatine photokinase and aldolase

which arteritis is the pulseless one

takayasu's

what is skiers thumb

a complete or partial tear of the UCL of the thumb

which nerve is associated with tear formation

intermediate nerve

what does positive anti-endomysial antibody mean

coeliac

blood results for pseudohypoparathyroidism

elevated PTH low calcium high phosphate

if someone has right homonymous superior quadrantanopia where is the lesion

left temporal lobe optic radiation

first line treatment for a pregnant woman with conjunctivitis

topical fusidic acid eye drops | -chloramphenicol contraindicated in pregnancy

treatment for actinic keratoses

5-flourouracil cream

treatment for actinic keratoses

5-flourouracil cream

which type of collagen is affected in alport syndrome

type IV

what causes oslers nodes

infective endocarditis

treatment for moderately severe eczema

regular diprobase ointment and once daily betamethasone valerate 0.025% plus 10 days oral flucloxacillin

what is found on biopsy in diabetic nephropathy

kimmelstein-wilson nodes

treatment for patients with rheumatoid arthritis who have not responded to two DMARDs

biologics | infliximab

in a suspected osteosarcoma, what is first line management

order a whole body bone scan, CT chest, and MRI of the entire femur

which thyroid cancer tends to affect young patients and has a good prognosis

papillary

which thyroid cancer has the worst prognosis

anaplastic

what would explain these abdo x-ray findings

medullary sponge kidney

what does the long head of the biceps brachii tendon attach to

the supraglenoid tubercle of the scapula

side effect of bisphosphonates

oesophagitis (most common) | osteonecrosis of jaw (less common)

if psammoma calcification is found on biopsy of a thyroid lump, what is the diagnosis?

papillary cancer

what does the patient have if they have a negative anterior drawer test but the test in painful

ACL injury

testosterone effect on fertilisation

increases infertility | -exogenous testosterone suppresses GnRH and so FSH and LH

intrinsic hand muscle wasting suggests that the lesion is where

what is fat embolism syndrome

an acute respiratory disorder caused by embolized fat globules that may enter the bloodstream as a result of acute long bone fractures or intramedullary instrumentation

what can cause sensory problems and reduction in grip and pinch strength in the hand

ulnar neuropathy

if a patient gets an intertrochanteric fracture and gets a dynamic hip screw for it, then a few months there the hip screw is backed out slightly what does this suggest

trochanteric bursitis from the metal work

if a patient with T2DM on metformin and gliclazide is getting surgery and needs to fast, what changes should be made to their medication

omit gliclazide and continue metformin

what drug can cause hyponatraemia

bendroflumethiazide

what causes the hyponatraemia in SIADH

increased water absorption in collecting duct

investigation for osteomalacia

serum 25-OH cholecalciferol

floaters in eye

retinal detachment

first thing to do in a patient with a painful eye and loss of visual acuity

refer to opthalmology department as an emergency

which anatomical structure in most likely to be affected in an orbital blowout fracture

inferior rectus muscle at fracture site

which nerve is responsible for closing the lids

facial (7th)

does otosclerosis result in conductive or sensorineural hearing loss

conductive

abdo thrusts or chest thrusts in a conscious choking baby

chest

what needs to be done in children with UTIs

abdo ultrasound

preterm baby with vomiting, lethargy and abdo distension

necrotising enterocolitis

when would jaundice due to haemolysis present

within 24 hours of birth

what jaundice is pathological

jaundice in first 24 hours of life

causes noisy breathing in baby with fever, cough, reduced oral intake

bronchiolitis

who gets kawasaki disease

children younger than 5

what are the 5 principal clinical features of kawasaki disease

- bilateral conjunctival injection - changes in the lips and oral cavity - cervical lymphadenopathy - extremity changes - polymorphous rash

what medication improves survival in chronic congestive heart failure

ACEis

what is the test for glandular fever (epstein barr)

monospot test