Year 4 Passmed Incorrect Qs 4 Flashcards
Erectile dysfunction
Factors favouring an organic cause (3)
Factors favouring a psychogenic causes (7)
ORGANIC
Gradual onset of symptoms
Lack of tumescence
Normal libido
PSYCHOGENIC
- Sudden onset of symptoms
- Decreased libido
- Good quality spontaneous or self-stimulated erections
- Major life events
- Problems or changes in a relationship
- Previous psychological problems
- History of premature ejaculation
Talk me through stepwise COPD management
- SABA or SAMA
2a. If atopy LABA + ICS (B for Bloody asthma!)
2b. No atopy LABA + LAMA
- LAMA + LABA + ICS
Urinary problems in a male with previous Gonorrhoea think what?
urinary stricture
STEM: muddy brown casts in the urine =
Acute tubular necrosis
Management of lactational mastitis?
First line-
If it doesn’t resolve in… -
1)
2)
First line- Conservative, encourage continue breast feeding, analgaeisia, ensure good positioning when breastfeeding.
If doesn’t resolve in 12-24hrs- Antibiotics
1) oral flucloxacillin (500mg four times a day for 14 days) or erythromycin if penicillin allergic.
2) Second-line choice is co-amoxiclav.
What is Ludwig’s Angina
Why so life threatening?
Rare infection of the floor of the mouth and soft tissues of the neck- usually after tooth extraction
Can cause rapid deterioration with airway compromise within minutes and requires urgent airway management and aggressive surgical treatment therefore 999 emergency call
Premenstrual syndrome
What is it?
Emotional symptoms (4)
Physical symptoms (2)
PMS describes the emotional and physical symptoms that women may experience in the luteal phase of the normal menstrual cycle- only occurs in the presence of ovulatory menstrual cycles - it doesn’t occur prior to puberty, during pregnancy or after the menopause.
Emotional symptoms include:
anxiety
stress
fatigue
mood swings
Physical symptoms
bloating
breast pain
Management of PMS Premenstrual sydrome
Mild
Mod
Severe
Mild- Lifestyle, sleep exercise, ref freq meals 2-3 hrly complex carbs
Mod- COCP
Severe- SSRI continually or in luteal phase
Difference between strangulated and incarcerated inguinal hernias
Incarcerated- they are irreducible, but no pain or any other symptoms are present (predisposes them to become strangulated)
Strangulated- where the blood supply to the herniated tissue becomes compromised risking ischaemia and necrosis, leading to pain
ENT How do you differentiate clinically between Viral labyrinthitis, Vestibular neuronitis, Meniere’s disease and BPPV
Viral labyrinthitis
- post-viral
- sudden onset horizontal nystagmus
- hearing affected and tinnitus
- nausea, vomiting
- vertigo
Vestibular neuronitis
- Also post-viral
- Also horizontal nystagmus
- Also N+V and vertigo
- BUT no hearing affected or tinnitus
Meniere’s disease
- More chronic and reoccuring than acute
- Again classic 3 of vertigo, tinnitus and hearing loss though
- STEM fullness feeling in ear
BPPV
- vertigo brought on by movement
- v short episodes
- no hearing disturbances or tinnitus or nystagmus
STEM Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes
silicosis
Slipped Upper Femoral Epiphysis
What moments are restricted?
Surgical management?
- Int rotation of leg in flexion
- Internal fixation- typically a single cannulated screw placed in the centre of the epiphysis
What is the genetic inheritance pattern on sickle cell?
Sickle cell disease is an autosomal recessive condition
Paeds suspected meningitis what Abx used in >3 monthns and <3 months?
What if recent travel outside of uk?
< 3 months- ceftriaxone + amoxacillin (listeria)
> 3 months ceftriaxone (IV 3rd gen cephlasporin)
addition of vancomycin to the 3rd generation cephalosporin is indicated when there has been recent travel outside of the UK.
6 month old baby presenting with bilious vomiting associated with signs of obstruction (distended abdomen and absent bowel sounds), what are you thinking?
intestinal malrotation
