Year 3 Flashcards
Prolapse + back pain
uterine prolapse
large tense uterus/ woody abdomen, bleeding and pain
placental abruption
clue cells, high vaginal pH >4.5
bacterial vaginosis
strawberry cervix
trichomonas vaginalis
PPH followed by pituitary failure
Sheehans syndrome
fetal distress and loss of engagement, previous c-section or surgery
uterine rupture
Statin should be avoided with?
grapefruit juice
Metronidazole avoid with?
alcohol
Warfarin avoid with?
cranberry juice
Calcium and thyroxine cause?
decreased absorption from the gut
Warfarin and NSAID cause?
bleeding
ACEi and spironolactone cause?
hyperkalaemia
Digoxin and verapamil cause?
digoxin toxicity
fluoexetine and phenelzine cause?
serotonin syndrome (hyperthermia, tremor, sweating, dilated pupils. late complications seizures and muscle breakdown)
Wernicke’s encephalopathy cause?
thiamine/B1 deficiency usually due to alcohol abuse can lead to irreversible Korsakoff’s syndrome
Triad in Wernicke’s?
ophthalmoplegia, ataxia, confusion
Delirium diagnosis?
fluctuating mental state + inattention + disorganised and/or altered level of consciousness
Triptans used for?
migraines or cluster headaches
Tripans contraindicated in?
IHD, uncontrolled HPT, with lithium, SSRI or ergot derivative drugs (cabergoline in PD)
Thunderclap headache
subarachnoid haemorrhage
What is PCKD risk factor for?
subarachnoid haemorrhage
Xanthochromic CSF in LP
subarachnoid haemorrhage
fresh blood in LP
traumatic tap
Lucid period after head trauma followed by sudden collapse or deterioration
extradural haemorrhage
Cogwheel rigidity
PD
Woody texture muscle swelling
duchenne or becker MD
raised CK
muscle destruction- muscular dystrophy
inflammatory- polymyositis
Toe walker, positive gowers sign
Muscular dystrophy
mask like expression
PD
fluctuating cognitive defect
LB dementia or delirium
REM disturbance
LB dementia or PD
Vivid visual hallucination normally of children and not threatening
LB dementia
acute onset, cognitive disturbance that fluctuates
delirium
personality/ behaviour changes then dementia
frontotemporal dementia (picks disease)
Memory and personality problems in someone with a history of CVD
vascular dementia
stepwise deterioration
vascular dementia
pain on loud noise
facial nerve palsy
Acute painful third nerve palsy
posterior communicating artery aneurysm
Myalgia + mypsitis + myoglobulinaemia/uria
rhabdomyolysis
What can rhabdomyolysis lead to?
DIC, ARF
inflammatory myopathy with poor response to steroids
inclusion body myositis
Weakness + frontal balding + cataracts + ptosis
myotonic dystrophy
onsets 30s, FH
leg symptoms plus midline shift
falcine herniation
back pain worse on coughing
slipped disc
headache worse on coughing
posterior fossa issue
saddle area numbness
BL sciatica, male sexual dysfunction +/- bowel and bladder symptoms
cauda equina
pleocytosis
rule out bacterial meningitis
migraine prophylaxis
1st line- propanolol, topiramate or amitriptyline
2nd- valproate, pizotifen, gabapentin, pregabalin (if drug doesnt work in 4 months try another)
injury to upper brachial plexus (c5-6 severed)
Erb’s palsy
commonly due to shoulder dystocia
waiters tip
Erb’s palsy
injury to lower brachial plexus
Klumpkes palsy
Claw hand
Klumpkes palsy
positive simmonds test
achiles tendon rupture
anti ACh receptor antibody
myasthenia gravis
UMN and LMN symptoms with ocular sparing
motor neuron disease
third person auditory hallucinations
schizophrenia
mesocortical dopamine hypoactivity
negative and cognitive symptoms in schizophrenia
subcortical dopamine hyperactivity
psychosis
dopamine pathways in the brain
tuberoinfundibular (involved in prolactin release)
nigrostriatal (extrapyramidal motor movements)
subcortical & mesocortical (mesolibic system- motivation and reward)
mesolimbic Da blockade
depression
mesolimbic Da agonism
psychosis
atypical antipsychotic that causes most weight gain?
olanzapine
se of clozapine
agranulocytosis, cardiomyocitis and weight gain (second to olanzapine)
Clozapine rules to prescribe?
try two other anti-psych
consultant to prescribe