Year 3 Flashcards

1
Q

Prolapse + back pain

A

uterine prolapse

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2
Q

large tense uterus/ woody abdomen, bleeding and pain

A

placental abruption

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3
Q

clue cells, high vaginal pH >4.5

A

bacterial vaginosis

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4
Q

strawberry cervix

A

trichomonas vaginalis

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5
Q

PPH followed by pituitary failure

A

Sheehans syndrome

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6
Q

fetal distress and loss of engagement, previous c-section or surgery

A

uterine rupture

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7
Q

Statin should be avoided with?

A

grapefruit juice

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8
Q

Metronidazole avoid with?

A

alcohol

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9
Q

Warfarin avoid with?

A

cranberry juice

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10
Q

Calcium and thyroxine cause?

A

decreased absorption from the gut

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11
Q

Warfarin and NSAID cause?

A

bleeding

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12
Q

ACEi and spironolactone cause?

A

hyperkalaemia

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13
Q

Digoxin and verapamil cause?

A

digoxin toxicity

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14
Q

fluoexetine and phenelzine cause?

A

serotonin syndrome (hyperthermia, tremor, sweating, dilated pupils. late complications seizures and muscle breakdown)

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15
Q

Wernicke’s encephalopathy cause?

A

thiamine/B1 deficiency usually due to alcohol abuse can lead to irreversible Korsakoff’s syndrome

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16
Q

Triad in Wernicke’s?

A

ophthalmoplegia, ataxia, confusion

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17
Q

Delirium diagnosis?

A

fluctuating mental state + inattention + disorganised and/or altered level of consciousness

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18
Q

Triptans used for?

A

migraines or cluster headaches

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19
Q

Tripans contraindicated in?

A

IHD, uncontrolled HPT, with lithium, SSRI or ergot derivative drugs (cabergoline in PD)

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20
Q

Thunderclap headache

A

subarachnoid haemorrhage

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21
Q

What is PCKD risk factor for?

A

subarachnoid haemorrhage

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22
Q

Xanthochromic CSF in LP

A

subarachnoid haemorrhage

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23
Q

fresh blood in LP

A

traumatic tap

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24
Q

Lucid period after head trauma followed by sudden collapse or deterioration

A

extradural haemorrhage

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25
Q

Cogwheel rigidity

A

PD

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26
Q

Woody texture muscle swelling

A

duchenne or becker MD

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27
Q

raised CK

A

muscle destruction- muscular dystrophy

inflammatory- polymyositis

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28
Q

Toe walker, positive gowers sign

A

Muscular dystrophy

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29
Q

mask like expression

A

PD

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30
Q

fluctuating cognitive defect

A

LB dementia or delirium

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31
Q

REM disturbance

A

LB dementia or PD

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32
Q

Vivid visual hallucination normally of children and not threatening

A

LB dementia

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33
Q

acute onset, cognitive disturbance that fluctuates

A

delirium

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34
Q

personality/ behaviour changes then dementia

A

frontotemporal dementia (picks disease)

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35
Q

Memory and personality problems in someone with a history of CVD

A

vascular dementia

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36
Q

stepwise deterioration

A

vascular dementia

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37
Q

pain on loud noise

A

facial nerve palsy

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38
Q

Acute painful third nerve palsy

A

posterior communicating artery aneurysm

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39
Q

Myalgia + mypsitis + myoglobulinaemia/uria

A

rhabdomyolysis

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40
Q

What can rhabdomyolysis lead to?

A

DIC, ARF

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41
Q

inflammatory myopathy with poor response to steroids

A

inclusion body myositis

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42
Q

Weakness + frontal balding + cataracts + ptosis

A

myotonic dystrophy

onsets 30s, FH

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43
Q

leg symptoms plus midline shift

A

falcine herniation

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44
Q

back pain worse on coughing

A

slipped disc

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45
Q

headache worse on coughing

A

posterior fossa issue

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46
Q

saddle area numbness

BL sciatica, male sexual dysfunction +/- bowel and bladder symptoms

A

cauda equina

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47
Q

pleocytosis

A

rule out bacterial meningitis

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48
Q

migraine prophylaxis

A

1st line- propanolol, topiramate or amitriptyline

2nd- valproate, pizotifen, gabapentin, pregabalin (if drug doesnt work in 4 months try another)

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49
Q

injury to upper brachial plexus (c5-6 severed)

A

Erb’s palsy

commonly due to shoulder dystocia

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50
Q

waiters tip

A

Erb’s palsy

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51
Q

injury to lower brachial plexus

A

Klumpkes palsy

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52
Q

Claw hand

A

Klumpkes palsy

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53
Q

positive simmonds test

A

achiles tendon rupture

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54
Q

anti ACh receptor antibody

A

myasthenia gravis

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55
Q

UMN and LMN symptoms with ocular sparing

A

motor neuron disease

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56
Q

third person auditory hallucinations

A

schizophrenia

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57
Q

mesocortical dopamine hypoactivity

A

negative and cognitive symptoms in schizophrenia

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58
Q

subcortical dopamine hyperactivity

A

psychosis

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59
Q

dopamine pathways in the brain

A

tuberoinfundibular (involved in prolactin release)
nigrostriatal (extrapyramidal motor movements)
subcortical & mesocortical (mesolibic system- motivation and reward)

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60
Q

mesolimbic Da blockade

A

depression

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61
Q

mesolimbic Da agonism

A

psychosis

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62
Q

atypical antipsychotic that causes most weight gain?

A

olanzapine

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63
Q

se of clozapine

A

agranulocytosis, cardiomyocitis and weight gain (second to olanzapine)

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64
Q

Clozapine rules to prescribe?

A

try two other anti-psych

consultant to prescribe

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65
Q

monitoring clozapine?

A

once a week for first 6 months
every 2 weeks for next 6 months
every four weeks after
one month after stopping

66
Q

limbic system functions

A

M2OVE

motivation, memory, olfaction, visceral afferents, emotion

67
Q

brain changes in schizophrenia

A

reduced frontal lobe/grey matter, enlarged lateral ventricles, reduced grey matter in temporal cortex

68
Q

pressure of thought

A

alot of varied ideas

characteristic of mania or schizophrenia

69
Q

poverty of thought

A

lack/absence of thoughts

70
Q

thought blocking

A

abrupt and complete interruption of stream strongly ass with schizophrenia

71
Q

flight of ideas

knightsmove thinking

A

moving from one topic to the next with a link unlike knightsmove where no link appears seen in bipolar during manic phase

72
Q

treatment of EPSE

A

procyclidine

73
Q

amygdala

A

involved in the normal response to threat

74
Q

PFC

A

dampens down the amygdalas response to threat-with less connections is less effective

75
Q

management of ocd

A

SSRI, SSRI, TCA or SSRI, SSRI or TCA (chlomipramine is the TCA of choice)
CBT

76
Q

learning disabilities

A
borderline 70-80
mild 50-69
mod 35-49
sev 20-34
profound <20
77
Q

becks triad

A

negative feelings about self, world and future

78
Q

SE of NMDA antagonists

A

psychotic symptoms

79
Q

treating alcohol withdrawal

A

chlordiazepoxide

80
Q

alcohol withdrawal seizures

A

occur within 48hrs

81
Q

delirium tremens after alcohol withdrawal

A

48-72hrs

82
Q

eosinophilic inclusions

A

lewy bodies seen in LBD and PD

83
Q

risk of hypertensive crisis in which drugs

A

MAOIs

84
Q

treatment of hypertensive crisis

A

phentolamine infusion

85
Q

when to avoid TCAs

A

cardiac problems or patients with suicidal intent

86
Q

USS snowstorm appearance or frogspawn when expelled

A

hydatidiform mole

87
Q

antepartum haemorrhage in patient with succenturiate lobe or valementous insertion

A

vasa praevia

88
Q

maternal blood and no fetal distress

A

ante partum haemorrhage MUST EXCLUDE placenta before doing vaginal exam

89
Q

fetal blood and sudden fetal distress

A

vasa previa (need to treat with c section)

90
Q

placenta accreta (doughy abdomen)

A

placenta on the myometrium commonly post endometrial ablation (always give contraception) c section with/without hysterectomy needed

91
Q

schistocytes

A

intravascular haemolysis

92
Q

pepper pot skull

A

myeloma

93
Q

rouleux formation

A

myeloma

94
Q

reed sternberg cells

A

hodgkins lymphoma

95
Q

philadelphia chromosome (chromosome translocation between 9 & 22)

A

chronic myelois leukemia

96
Q

atypical lymphocytes

A

EBV (mononucleosis)

97
Q

auer rods

A

acute myeloid leukemia

98
Q

Bence-jones proteins

A

multiple myeloma

99
Q

itchy after hot bath

A

polycytheamia rubra vera

100
Q

translocation of info between 8 and 14

A

burkitts lymphoma

101
Q

african kid history of EBV and tumour in face/jaw

A

burkitts

102
Q

alcohol makes it worse

A

hodgkins lymphoma

103
Q

haemarthrosis

A

haemophilia

104
Q

bleeding into joint

A

secondary haemostasis problem

105
Q

reduced level of factor IX

A

haemophilia B/christmas disease

106
Q

young boy reduced levels of factor VIII and increased APTT

A

haemophilia A

107
Q

congo red staining

A

amyloid deposition of biopsied tissue in myeloma and AA amyloidosis

108
Q

schillings test

A

b12 deficiency

109
Q

smudge cells (immature leukocytes)

A

CLL

110
Q

JAK-2 mutation

A

PRV or essential thrombocythemia

111
Q

NBT test

A

Chronic granulomatosis disease

112
Q

positive schumms test

A

intravascular haemolytic anaemia

113
Q

hair on end skull xray

A

major beta thalassemia

114
Q

bite cells, blister cells and heinz bodies

A

G6PD deficiency

115
Q

russell bodies

A

chronic inflammation

116
Q

schistocytes

A

intravascular haemolysis

117
Q

avoid what with simvustatin

A

grapefruit juice

118
Q

suspected meningitis treatment

A

benzylpenicillin

119
Q

gram negative stains what colour

A

pink

120
Q

when do you do IVF

A

unexplained infertility, female infertility or mild male factor

121
Q

When do you do ICSI

A

(intracytoplasmic sperm injection) male infertility

122
Q

definition of infertility

A

after two years of trying

but can go to the GP after 1 year

123
Q

tests for infertility

A

female- mid progesterone level (are they ovulating), HSG (tube patency), STI screnn, transvaginal US
male- semen analysis

124
Q

day 21 progesterone

A

ovulation test

125
Q

pregnancy test

A

measure HCG

126
Q

iron side effect

A

makes stools black

127
Q

who typically gets ALL

A

younger people

128
Q

CML treatment

A

imatinib

129
Q

anemic old person first and 2nd Ix

A

sigmoid colonscopy

endoscopy (check for chronic bleed)

130
Q

warfarin test

A

measure INR

131
Q

heparin test

A

measure prothrombin

132
Q

pneumococcal meningitis treatment in child

A

penicililin

133
Q

HiB meningitis prophylaxis

A

rifampicin

134
Q

cause of neonatal conjuncitivitis

A

gram positive cocci- group B strep

135
Q

lithium SE

A
underactive thyroid
dry mouth
shaky
weight gain
BLOOD TEST 5 day after starting
136
Q

genital warts treatment

A

podophylin

137
Q

secretions of seminal vesicles

A

fructose rich fluid, prostaglandin, fibrinogen

138
Q

se metoclopramide

A

restless, insomnia, fatigue, depression, parkinsonism

139
Q

se sodium valproate

A

stomach irritation, unsteady, tremor, weight gain

140
Q

se carbamazepine

A

n and v, dizzy, headache, confused, double vision

141
Q

se iamortigine

A

SJS caution during pregnancy and breastfeeding

142
Q

cloazapine se

A

agranulocytosis

143
Q

se atypical antipsychotics

A

weight gain esp olanzapine

144
Q

tpical antipsychotis se

A

tardive dyskinesia

145
Q

acute closed angle glaucome

A

mid dilated pupil

146
Q

hemisection of posterior spinal cord

A

will leave some motor function since anterior corticospinal tracts intact

147
Q

Ix orbital cellulitis

A

CT

148
Q

green frothy baginal discharge

A

trichomoniasis treat with metronidazole

149
Q

pregnant women with diabetes collapses first test

A

blood glucose

150
Q

dizzy turning in bed and gets up disappears over minutes

A

BPPV

151
Q

abdo pain radiating to back with hx of gall stones

A

pancreatitis

152
Q

ruq pain radiating to shoulder

A

gall bladder

153
Q

RUQ pain and elavated LFT and fever

A

hepatitis

154
Q

frontotemporal dementia

A

behaviour and language change

155
Q

lewy body disease

A

hallucinations and parkinsonism

156
Q

motor neuron disease

A

amyotrophic lateral sclerosis

157
Q

chorea

A

purposeless movements that fit and flow appearing restless

158
Q

foot drop

A

L5

159
Q

path of trigeminal nerve

A

travels into parotid gland and branches afterwards

160
Q

poor vision and floaters

A

retinal detachment

161
Q

vertical diplopia when walking down stairs

A

SO4 palsy