Year 4 Flashcards

1
Q

From what week gestation can pregnancy-related blood pressure problems occur?

A

20

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2
Q

Give 2 things a women with endometriosis might mention during a history

A
  • Dysmenorrhoea
  • Deep dyspareunia
  • Fertility problems
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3
Q

What is Meig’s syndrome associated with?

A

Benign ovarian tumour. Associated with ascites and pleural effusion

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4
Q

In Down’s syndrome is the bhCG high or low?

A

High

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5
Q

What screening is done for Down’s syndrome and when?

A

Nuchal translucency, done at 10-14 weeks

Double test for beta hCG and PAPP-A

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6
Q

What drugs facilitate delivery of the placenta and prevent PPH?

A

Oxytocin and ergometrine

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7
Q

What vitamin is teratogenic in high doses? What food type contains this and is thus not recommended in pregnancy?

A

Vitamin A. In liver.

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8
Q

Unopposed oestrogen therapy increases the risk of what kind of cancer?

A

Endometrial

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9
Q

How is chlamydia treated?

A

Azithromycin or doxycycline

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10
Q

When is the COCP contraindicated in postpartum women?

A

<6/52 postpartum and breastfeeding women

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11
Q

What is an absolute contraindication to the copper IUD?

A

PID

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12
Q

In premature ovarian failure what are the gonadotrophin levels (FSH & LH)? What is the estradiol level?

A

FSH & LH = high

oestradiol = low

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13
Q

What can be given prior to surgery to shrink fibroids?

A

GnRH analogues

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14
Q

What immunisations are offered to pregnant women?

A

Influenza and pertussis

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15
Q

When should progesterone levels be checked in a women’s cycle?

A

7 days before the end

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16
Q

What is normal variability in a CTG?

A

5-15bpm

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17
Q

If vagal manoeuvres fail to terminate supraventricular tachycardia what should be done next?

A

IV adenosine

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18
Q

Dry cough and erythema multiforme suggest what pathogen?

A

Mycoplasma

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19
Q

What haematological malignancy is associated with the Philadelphia chromosome - t(9:22) translocation?

A

CML

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20
Q

What abx should a patient who has had a splenectomy take daily?

A

Pen V

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21
Q

What 2 drugs should all patients who have heart failure take, according to NICE?

A

ACE inhibitor and B blocker

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22
Q

What drugs should be given in anaphylaxis?

A

Adrenaline 500mcg
Hydrocortisone 200mg
Chlorphenamine 10mg

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23
Q

What is the triad for normal pressure hydrocephalus?

A

Urinary incontinence
Dementia
Gait abrnomality

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24
Q

What test is best for diagnosing Addison’s?

A

Short ACTH test

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25
Q

Does gliclazide cause: weight gain? Weight loss? Is it weight neutral?

A

Weight gain

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26
Q

What diuretic can cause ototoxicity?

A

Loop diuretics, e.g. furosemide

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27
Q

Reactive arthritis (Reiter’s arthritis) is associated with what 3 conditions?

A

Chlamydia
Gonorrhoea
Gastroenteritis

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28
Q

Give 5 drugs that should be avoided in renal failure

A
Tetracycline
Nitrofurantoin
NSAIDS
Lithium
Metformin
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29
Q

What can be used to treat infective conjunctivitis?

A

Topical chloramphenicol

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30
Q

What is the most appropriate 1st line treatment for stable angina in a patient with heart failure?

A

Atenolol

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31
Q

What drugs should be used to manage angina?

A

B-blocker or CCB 1st line
Aspirin and statin to all patients if no contraindications
GTN to stop attacks

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32
Q

Give 4 features of aortic stenosis

A

Slow rising pulse
Narrow pulse pressure
ESM
Thrill

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33
Q

If patients cannot tolerate ACE inhibitor, e.g. due to dry cough, what medication can they be switched to?

A

A2RB, e.g. losartan

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34
Q

What is 1st line treatment for heart failure?

A

ACE inhibitor and B-blocker

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35
Q

What drugs should all patients be offered post MI?

A

Dual anti platelet therapy
ACEI
B blocker
Statin

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36
Q

Give 3 features of Conn’s syndrome

A

Low K+
Htn
Alkalosis (high HCO3-)

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37
Q

How much adrenaline should be given in cardiac arrest?

A

1mg

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38
Q

When is amiodarone given in cardiac arrest and how much?

A

After 3rd shock

300mg

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39
Q

What can precipitate guttate psoriasis?

A

Step infection

40
Q

What drug is best for trigeminal neuralgia?

A

Carbamazepine

41
Q

What is the mode of action of heparin?

A

Activates antithrombin 3

42
Q

What is the compression and ventilation rate in newborn resus?

A

3:1

43
Q

What drug is given in variceal haemorrhage?

A

Terlipressin

44
Q

What is the Na, K and glucose like in an addisonian crisis? How should this be treated?

A

Hyponatraemia
Hypoglycaemia
Hyperkalaemia
Treat with hydrocortisone

45
Q

What might be seen in fundoscopy in central retinal artery occlusion?

A

Cherry red spot on pale retina

46
Q

What will St John’s wort do to the INR? What does cranberry juice do?

A

St John’s Wort - Reduce it

Cranberry juice - increase it

47
Q

What does Anti-HBs and Anti-HBc imply in regards to Hep B serology?

A

Anti-HBs -> implies immunity

Anti-HBc -> implies previous or current infection

48
Q

Where do lesions form in MEN1?

A

Pituitary
Parathyroid
Pancreas

49
Q

When is murphy’s sign seen?

A

Acute cholecystitis

50
Q

How many people with Hep C become chronically infected?

A

80-85%

51
Q

What can be used to distinguish between IBS and IBD in primary care?

A

Faecal calprotectin -> it’s released in the bowel in response to inflammation

52
Q

What drug is often 1st line in treatment for hepatic encephalopathy?

A

Lactulose. Reduces production and absorption of ammonia from the GI tract

53
Q

Describe some signs and symptoms of PBC

A

Lethargy, pruritis. Increase in gamma GT and ALP.

M rule -> IgM, anti-Mitochondrial abs, Middle-aged women

54
Q

What bacterium causes amebiasis?

A

E. histolytica.

Metronidazole to treat

55
Q

Give some features of Kawasaki disease

A

Strawberry tongue, high fever resistant to anti-pyretics, red cracked lips, red palms and soles, conjunctival infection.

56
Q

What is a complication of Kawasaki disease?

A

Coronary artery aneurysm. Do an echo

57
Q

What causes Roseola infantum? Give an example history

A

HHV-6

High fever, maculopapular rash starting on chest and spreads

58
Q

How is croup managed?

A

Oral steroids, regardless of severity

59
Q

Herald patch and blisters/red spots on trunk describes what infection?

A

Pityriasis rosea

60
Q

What is 1st line treatment for Raynauds?

A

Nifedipine (CCB)

61
Q

Which nerve is implicated in a saturday night palsy? (cannot extend wrist)

A

Radial

62
Q

Dermatitis herpetiformis is associated with what autoimmune condition?

A

Coeliac’s

IgA autoimmune skin condition

63
Q

What blood abnormalities can amiodarone cause?

A

TFT abnormalities - either hypo or hyper

64
Q

Isolated unilateral hemiplegia with NO speech or visual defects suggests a lesion where?

A

Lacunar infarct

65
Q

Amiodarone and nitrofurantoin can both cause what side effect?

A

Pul. fibrosis

66
Q

When is anti-D prophylaxis given to rhesus -ve women?

A

28 and 34 weeks

67
Q

What antibody is positive in someone with anti-phospholipid syndrome?

A

Anti-cardiolipin

68
Q

Which condition is associated with long bleeding time and long APTT, von Willebrand disease or Haemophilia?

A

von Willebrand disease

69
Q

Where is the mutation in polycythaemia rubra vera?

A

JAK2

Splenomegaly, hyper viscosity, pruritus, plethoric appearance

70
Q

In which haem malignancy are Bence-Jones proteins seen?

A

Multiple myeloma.

High ESR and osteoporosis are suggestive of this

71
Q

What organism is most likely to be responsible in an infective exacerbation of COPD?

A

H. influenzae

72
Q

What is the most common opportunistic infection in someone with AIDS?

A

PCP (Pneumocystis jiroveci)

Co-trimoxazole

73
Q

Pneumonia in an alcoholic, what organism?

A

Klebsiella

74
Q

Tonsillitis, what organism most likely?

A

Step. pyogenes

75
Q

Central line infections, what organism?

A

Staph. epidermidis

76
Q

Pneumonia following an episode of flu, what organism most likely?

A

Staph aureus

77
Q

What is the auto antibody for SLE?

A

anti ds DNA

78
Q

What is the auto antibody for Sjogrens?

A

anti-Ro and anti-La

79
Q

What is the auto antibody for Wegner’s?

A

c-ANCA

URTI, LRTI, saddle nose deformity

80
Q

What is the auto antibody for RA?

A

anti-CCP,

rheumatoid factor

81
Q

What is the auto antibody for dermatomyositis?

A

anti-Jo1

82
Q

What organism is most likely to cause meningitis in a newborn?

A

Group B strep

83
Q

What organism is most likely to cause meningitis in infants/children?

A

Strep. pneumoniae

84
Q

What organism is most likely to cause meningitis in young adults?

A

N. meningitidis

85
Q

What organism is most likely to cause meningitis in older adults?

A

S. pneumoniae

86
Q

In what syndrome might you see an isolated raised unconjugated bilirubin with no associated symptoms?

A

Gilbert’s

87
Q

What is the inheritance pattern for Ehler-Danlos? What is it characterised by?

A

Autosomal dominant

Joint hyper mobility, elastic skin, easy bruising, aortic regurg.

88
Q

What anti sickness medication must be avoided in parkinson’s?

A

Metoclopramide, dopamine antagonist

89
Q

In what type of patients can HONK occur and what is it?

A

Newly diagnosed T2DM.

Hyperosmolar non ketotic coma. Dehydration and renal failure, severely high glucose

90
Q

What antibiotic can lower the seizure threshold in someone with epilepsy?

A

Ciprofloxacin

91
Q

Which type of testicular might have a raised bhCG?

A

Teratomas

92
Q

What is the most common type of lung cancer in non smokers?

A

Lung adenocarcinoma

93
Q

What organism causes syphilis? How can it be managed?

A

T. pallidum, a spirochaete. Benzylpenicillin to treat

94
Q

Barrett’s oesophagus is premalignant for what?

A

Adenocarcinoma

95
Q

What vaccine is given to people with Coeliac’s disease and why?

A

Pneumococcal as it’s associated with hyposplenism