Year 4 Flashcards
From what week gestation can pregnancy-related blood pressure problems occur?
20
Give 2 things a women with endometriosis might mention during a history
- Dysmenorrhoea
- Deep dyspareunia
- Fertility problems
What is Meig’s syndrome associated with?
Benign ovarian tumour. Associated with ascites and pleural effusion
In Down’s syndrome is the bhCG high or low?
High
What screening is done for Down’s syndrome and when?
Nuchal translucency, done at 10-14 weeks
Double test for beta hCG and PAPP-A
What drugs facilitate delivery of the placenta and prevent PPH?
Oxytocin and ergometrine
What vitamin is teratogenic in high doses? What food type contains this and is thus not recommended in pregnancy?
Vitamin A. In liver.
Unopposed oestrogen therapy increases the risk of what kind of cancer?
Endometrial
How is chlamydia treated?
Azithromycin or doxycycline
When is the COCP contraindicated in postpartum women?
<6/52 postpartum and breastfeeding women
What is an absolute contraindication to the copper IUD?
PID
In premature ovarian failure what are the gonadotrophin levels (FSH & LH)? What is the estradiol level?
FSH & LH = high
oestradiol = low
What can be given prior to surgery to shrink fibroids?
GnRH analogues
What immunisations are offered to pregnant women?
Influenza and pertussis
When should progesterone levels be checked in a women’s cycle?
7 days before the end
What is normal variability in a CTG?
5-15bpm
If vagal manoeuvres fail to terminate supraventricular tachycardia what should be done next?
IV adenosine
Dry cough and erythema multiforme suggest what pathogen?
Mycoplasma
What haematological malignancy is associated with the Philadelphia chromosome - t(9:22) translocation?
CML
What abx should a patient who has had a splenectomy take daily?
Pen V
What 2 drugs should all patients who have heart failure take, according to NICE?
ACE inhibitor and B blocker
What drugs should be given in anaphylaxis?
Adrenaline 500mcg
Hydrocortisone 200mg
Chlorphenamine 10mg
What is the triad for normal pressure hydrocephalus?
Urinary incontinence
Dementia
Gait abrnomality
What test is best for diagnosing Addison’s?
Short ACTH test
Does gliclazide cause: weight gain? Weight loss? Is it weight neutral?
Weight gain
What diuretic can cause ototoxicity?
Loop diuretics, e.g. furosemide
Reactive arthritis (Reiter’s arthritis) is associated with what 3 conditions?
Chlamydia
Gonorrhoea
Gastroenteritis
Give 5 drugs that should be avoided in renal failure
Tetracycline Nitrofurantoin NSAIDS Lithium Metformin
What can be used to treat infective conjunctivitis?
Topical chloramphenicol
What is the most appropriate 1st line treatment for stable angina in a patient with heart failure?
Atenolol
What drugs should be used to manage angina?
B-blocker or CCB 1st line
Aspirin and statin to all patients if no contraindications
GTN to stop attacks
Give 4 features of aortic stenosis
Slow rising pulse
Narrow pulse pressure
ESM
Thrill
If patients cannot tolerate ACE inhibitor, e.g. due to dry cough, what medication can they be switched to?
A2RB, e.g. losartan
What is 1st line treatment for heart failure?
ACE inhibitor and B-blocker
What drugs should all patients be offered post MI?
Dual anti platelet therapy
ACEI
B blocker
Statin
Give 3 features of Conn’s syndrome
Low K+
Htn
Alkalosis (high HCO3-)
How much adrenaline should be given in cardiac arrest?
1mg
When is amiodarone given in cardiac arrest and how much?
After 3rd shock
300mg
What can precipitate guttate psoriasis?
Step infection
What drug is best for trigeminal neuralgia?
Carbamazepine
What is the mode of action of heparin?
Activates antithrombin 3
What is the compression and ventilation rate in newborn resus?
3:1
What drug is given in variceal haemorrhage?
Terlipressin
What is the Na, K and glucose like in an addisonian crisis? How should this be treated?
Hyponatraemia
Hypoglycaemia
Hyperkalaemia
Treat with hydrocortisone
What might be seen in fundoscopy in central retinal artery occlusion?
Cherry red spot on pale retina
What will St John’s wort do to the INR? What does cranberry juice do?
St John’s Wort - Reduce it
Cranberry juice - increase it
What does Anti-HBs and Anti-HBc imply in regards to Hep B serology?
Anti-HBs -> implies immunity
Anti-HBc -> implies previous or current infection
Where do lesions form in MEN1?
Pituitary
Parathyroid
Pancreas
When is murphy’s sign seen?
Acute cholecystitis
How many people with Hep C become chronically infected?
80-85%
What can be used to distinguish between IBS and IBD in primary care?
Faecal calprotectin -> it’s released in the bowel in response to inflammation
What drug is often 1st line in treatment for hepatic encephalopathy?
Lactulose. Reduces production and absorption of ammonia from the GI tract
Describe some signs and symptoms of PBC
Lethargy, pruritis. Increase in gamma GT and ALP.
M rule -> IgM, anti-Mitochondrial abs, Middle-aged women
What bacterium causes amebiasis?
E. histolytica.
Metronidazole to treat
Give some features of Kawasaki disease
Strawberry tongue, high fever resistant to anti-pyretics, red cracked lips, red palms and soles, conjunctival infection.
What is a complication of Kawasaki disease?
Coronary artery aneurysm. Do an echo
What causes Roseola infantum? Give an example history
HHV-6
High fever, maculopapular rash starting on chest and spreads
How is croup managed?
Oral steroids, regardless of severity
Herald patch and blisters/red spots on trunk describes what infection?
Pityriasis rosea
What is 1st line treatment for Raynauds?
Nifedipine (CCB)
Which nerve is implicated in a saturday night palsy? (cannot extend wrist)
Radial
Dermatitis herpetiformis is associated with what autoimmune condition?
Coeliac’s
IgA autoimmune skin condition
What blood abnormalities can amiodarone cause?
TFT abnormalities - either hypo or hyper
Isolated unilateral hemiplegia with NO speech or visual defects suggests a lesion where?
Lacunar infarct
Amiodarone and nitrofurantoin can both cause what side effect?
Pul. fibrosis
When is anti-D prophylaxis given to rhesus -ve women?
28 and 34 weeks
What antibody is positive in someone with anti-phospholipid syndrome?
Anti-cardiolipin
Which condition is associated with long bleeding time and long APTT, von Willebrand disease or Haemophilia?
von Willebrand disease
Where is the mutation in polycythaemia rubra vera?
JAK2
Splenomegaly, hyper viscosity, pruritus, plethoric appearance
In which haem malignancy are Bence-Jones proteins seen?
Multiple myeloma.
High ESR and osteoporosis are suggestive of this
What organism is most likely to be responsible in an infective exacerbation of COPD?
H. influenzae
What is the most common opportunistic infection in someone with AIDS?
PCP (Pneumocystis jiroveci)
Co-trimoxazole
Pneumonia in an alcoholic, what organism?
Klebsiella
Tonsillitis, what organism most likely?
Step. pyogenes
Central line infections, what organism?
Staph. epidermidis
Pneumonia following an episode of flu, what organism most likely?
Staph aureus
What is the auto antibody for SLE?
anti ds DNA
What is the auto antibody for Sjogrens?
anti-Ro and anti-La
What is the auto antibody for Wegner’s?
c-ANCA
URTI, LRTI, saddle nose deformity
What is the auto antibody for RA?
anti-CCP,
rheumatoid factor
What is the auto antibody for dermatomyositis?
anti-Jo1
What organism is most likely to cause meningitis in a newborn?
Group B strep
What organism is most likely to cause meningitis in infants/children?
Strep. pneumoniae
What organism is most likely to cause meningitis in young adults?
N. meningitidis
What organism is most likely to cause meningitis in older adults?
S. pneumoniae
In what syndrome might you see an isolated raised unconjugated bilirubin with no associated symptoms?
Gilbert’s
What is the inheritance pattern for Ehler-Danlos? What is it characterised by?
Autosomal dominant
Joint hyper mobility, elastic skin, easy bruising, aortic regurg.
What anti sickness medication must be avoided in parkinson’s?
Metoclopramide, dopamine antagonist
In what type of patients can HONK occur and what is it?
Newly diagnosed T2DM.
Hyperosmolar non ketotic coma. Dehydration and renal failure, severely high glucose
What antibiotic can lower the seizure threshold in someone with epilepsy?
Ciprofloxacin
Which type of testicular might have a raised bhCG?
Teratomas
What is the most common type of lung cancer in non smokers?
Lung adenocarcinoma
What organism causes syphilis? How can it be managed?
T. pallidum, a spirochaete. Benzylpenicillin to treat
Barrett’s oesophagus is premalignant for what?
Adenocarcinoma
What vaccine is given to people with Coeliac’s disease and why?
Pneumococcal as it’s associated with hyposplenism