Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Big Hitters and stuff you've got wrong > Flashcards

Big Hitters and stuff you've got wrong Flashcards

1
Q

what is the treatment for ascites secondary to liver cirrhosis

A

spironolactone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the treatment for hepatic encephalopathy

A

lactulose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

low saag indicates what

A

Low SAAG indicates a peritoneal cause of ascites, including tuberculous peritonitis and peritoneal mesothelioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

high saag indicates what

A

A high SAAG suggests a non-peritoneal cause of ascites, such as cirrhosis, Budd-Chiari syndrome, and nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the treatment for anterior uveitis

A

steroid eye drops with mydriatic eye drops

The steroid treats the underlying infection and the mydriatic eye drop dilates the pupil and reduces the pain

systemic steroids reserved for recurrent uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the treatment for dystonia secondary to antipsychotics

A

procyclidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how should you Start IV fluid resuscitation in children or young people

A

with a bolus of 20 ml/kg over less than 10 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what investigation do you need to do before starting anti-TNFα

A

a chest x ray to look for TB since these drugs can cause reactivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what antibiotic to treat human bites and animal bites

A

co-amoxiclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what should you do if metformin is not tolerated due to GI side effects

A

try a modified-release formulation before switching to a second-line agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what should you do with a patient’s oral analgesia if they switch to opiate PCA

A

stop all concomitant oral opiates but keep on things like paracetamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how should you treat acute heart failure not responding to treatment 40m IV furosemide

A

CPAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

preceding influenza predisposes to pneumonia caused by which bacteria

A

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you treat an inguinal hernia in infants

A

The high incidence of strangulation necessitates an urgent herniotomy be performed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the potassium requirement in maintenance fluids

A

1 mmol/kg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the features of wernicke’s encephalopathy

A

CAN OPEN
Confusion
Ataxia
Nystagmus
Ophthamoplegia
PEripheral
Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the criteria for urgent and elective EVAR

A

The three criteria for endoscopic vascular aneurysm repair surgery are:
• An asymptomatic aneurysm larger than 5.5 cm in diameter.
• An asymptomatic aneurysm which is enlarging by more than 1 cm per year.
• A symptomatic aneurysm. This is the only criteria, apart from emergency rupture, which requires urgent surgery rather than an elective procedure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the correct position for women who have had a cord prolapse?

A

on all fours, on knees and elbows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what form of contraception is UKMEC 3 (not forbidden but advised against) for wheelchair users

A

Wheelchair users (as this woman is due to below waist paralysis), due to immobility, are at higher risk of DVT and PE than the general population, and that risk will be further increased by talking the COCP.

It is currently UKMEC-3, which means it’s not forbidden, just advised against.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the only contraindication to circumcision on religious grounds

A

Hypospadias is the only contraindication to circumcision in infancy as the foreskin is used in the repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the treatment for a intertrochanteric (extracapsular) proximal femoral fracture

A

dynamic hip screw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how do you treat myxoedemic coma

A

Myxoedemic coma is treated with thyroxine and hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how do you treat thyrotoxic storm

A

Thyrotoxic storm is treated with beta blockers, propylthiouracil and hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

for a diagnosis of PTSD how long do symptoms need to be present for

A

one month

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the insulin infusion rate in DKA

A

0.1 unit/kg/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what should you also prescribe if someone is on an SSRI and an NSAID

A

lansoprazole - there is increased GI risk if SSRI and NSAID are combined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is the first choice SSRI in a patient with a history of cardiovascular disease

A

sertraline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the number one cause of painless massive GI bleeding requiring a transfusion in children between the ages of 1 and 2 years?

A

meckel’s diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the causes of upper and lower GI bleeding in newborns, from 1 month to 1 year, from 1 year to 2 years and 2 years + (but in children)

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  • what scoring system is used to judge whether someone will spontaneously go into labour?
  • A score of _____ or less suggests that labour is unlikely to start without induction?
    *
A

The Bishop’s score is used to predict whether induction of labor will be required.

A score of 5 or less suggests that labour is unlikely to start without induction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

If angina is not controlled with a beta-blocker, a _______ blocker should be added

A

calcium channel blocker

not verapamil or diltiazem (contraindicated with B blockers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the first line treatment for SVT

A

The first-line management of SVT is vagal manoeuvres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the treatment of choice for all patients with a displaced hip fracture

A

Hemiarthroplasty or total hip replacement

lean towards total hip replacement if they are young and can take it and if they have a history of hip osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

when should you advise women to stop taking their HRT/COCP before surgery

A

28 days before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

how does osteomalacia or vit d deficiency show on bloods

A

low calcium, phosphate and vitamin D levels

combined with

a raised alkaline phosphatase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the first line and second line treatment for prolactinomas

A

Dopamine agonists (e.g. cabergoline, bromocriptine)

Surgery is performed for patients who cannot tolerate or fail to respond to medical therapy. A trans-sphenoidal approach is generally preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the treatment of gonorrhoea

A

Intramuscular ceftriaxone stat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how does gonorrhoea look down a microscope?

A

Gram negative diplococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what causes a cavitating pneumonia in the upper lobes, mainly in diabetics and alcoholics

A

Klebsiella pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Blood stained discharge from the nipple is most likely to be associated with _____

A

duct papilloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how does duct ectasia present

A

green-brown discharge and an abscess with puss discharging from the nipple. The latter will also be associated with red, swollen, warm skin of the breast.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

does nephrotic syndrome cause bleeding or clotting and why

A

Nephrotic syndrome is associated with a hypercoagulable state due to loss of antithrombin III via the kidneys.

The most common site of thrombosis is the renal vein but patients are also at risk of deep vein thromboses and pulmonary embolisms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

when is platelet transfusion indicated

A

Platelet transfusion is appropriate for patients with a platelet count < 30 x 109 and clinically significant bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what can CLL, classically, transform into

A

Richter’s transformation; a transformation of CLL into a fast-growing diffuse large B cell non-Hodgkin’s lymphoma which occurs in 2-10% of people with CLL (Cancer Research UK) and carries a poor prognosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

three differentials for fever in a previously well patient post-op

A
  • physiological reaction to surgery
  • thromboembolism
  • infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

when is hand preference abnormal

A

Hand preference before 12 months is abnormal - it could be an indicator of cerebral palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

how can you determine whether the position of an NG tube is safe

A
  • aspirate
    • If aspirate obtained has a pH <5.5, the NG tube is safe to use.
    • If aspirate >5.5, request a chest x-ray to confirm the position of the NG tube.
  • If no aspirate can be obtained, the following manoeuvres can be used:
    • Turn the patient on to their left side
    • Inject 10-20ml air
    • Offer a drink (if safe swallow) or mouth care (if nil by mouth) and re-check aspirate in 15-20 minutes
    • Advance or withdraw the NG tube by 10-20 cm
  • If an aspirate can still not be obtained, request a chest x-ray to confirm the position of the NG tube.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what scoring system for pancreatitis and what does it include

A
  • The Modified-Glasgow Score can be used to stratify patients by risk of severe pancreatitis. A score of ≥3 suggests a significant increase in likelihood of severe pancreatitis. These patients may benefit from intensive care.
    • P - PaO2 <8kPa
    • A - Age >55-years-old
    • N - Neutrophilia: WCC >15x10(9)/L
    • C - Calcium <2 mmol/L
    • R - Renal function: Urea >16 mmol/L
    • E - Enzymes: LDH >600iu/L; AST >200iu/L
    • A - Albumin <32g/L (serum)
    • S - Sugar: blood glucose >10 mmol/L
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

why does pancreatitis cause hypocalcaemia

A

Lipase from pancreatic cells breaks down mesenteric and peripancreatic fat. This results in the liberation of free fatty acids that bind calcium, decreasing the circulating concentration. Approximately 55% of patients had some degree of hypocalcemia at presentation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what is the treatment for widened QRS or arrhythmia in tricyclic overdose

A

IV bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the first line treatment of threadworms

A

oral Mebendazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

how can you manage acute flares of rheumatoid arthritis

A

Intramuscular steroids such as methylprednisolone are used to manage the acute flares of rheumatoid arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

is the ulcer in syphillis most likely to be painless or painful

A

painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is the definition of a staggered paracetamol overdose and how should these patients be treated

A

defined as an overdose taken over >1 hour

they should be given NAC immediately

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is the most common mechanism for ankle sprain

A

Inversion of the foot is the most common mechanism of ankle sprain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

how can you treat chronic symptoms of vestibular neuronitis

A

Vestibular rehabilitation exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what cancer do people with PSC go on to get

A

20% of them get cholangiocarcinoma, a cancer of the biliary tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

vision worse on going down the stairs indicates

A

4th nerve palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

how do you manage patients >= 75 years following a fragility fracture,

A

Start alendronate in patients >= 75 years following a fragility fracture, without waiting for a DEXA scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are the two ALS adrenaline doses

A
  • anaphylaxis: 0.5mg - 0.5ml 1:1,000 IM
  • cardiac arrest: 1mg - 10ml 1:10,000 IV or 1ml of 1:1000 IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

complete heart block after an MI would indicate that which artery was affected

A

right coronary artery

62
Q

what is the first line investigation for acromegaly

A

Serum IGF-1 levels

63
Q

90% of genital warts are caused by which HPV viruses

A

HPV 6 & 11

64
Q

prophylactic treatment of bleeding oesophageal varices

A

non-cardioselective B blocker such as propanolol

Transjugular intrahepatic portal shunt (TIPS) for varices that are resistant to other prophylactic treatments such as propranolol and repeat endoscopic banding

65
Q

what is the second investigation you do for acromegaly

A

if a patient is shown to have raised IGF-1 levels, an oral glucose tolerance test (OGTT) with serial GH measurements is suggested to confirm the diagnosis

66
Q

preceding influenza infection predisposes to pneumonia caused by what organism

A

staphylococcus aureus

67
Q

what is the inheritance pattern of Hypertrophic obstructive cardiomyopathy

A

autosomal dominant

68
Q

what is the antibiotic for otitis media

A

amoxicillin

69
Q

how does acute alcohol intake affect risk of hepatotoxicity following paracetamol overdose

A

acute alcohol intake is not associated with an increased risk of developing hepatotoxicity and may actually be protective

70
Q

how should women with HIV deliver

A
  • vaginal delivery is recommended if viral load is less than 50 copies/ml at 36 weeks, otherwise caesarian section is recommended
  • a zidovudine infusion should be started four hours before beginning the caesarean section (not necessary if vaginal delivery)
  • zidovudine is usually administered orally to the neonate if maternal viral load is <50 copies/ml. Otherwise triple ART should be used. Therapy should be continued for 4-6 weeks.
71
Q

what sort of antibiotics can cause torsades des pointes

A

Macrolides such as clarithromycin can cause QT interval prolongation and therefore may trigger polymorphic ventricular tachycardia, particularly in patients with an underlying channelopathy.

72
Q

what is the most common adverse effect of the progesterone only pill

A

Progestogen-only pill: irregular vaginal bleeding is the most common adverse effect

73
Q

All patients with peripheral arterial disease should take _______ and _______

A

All patients with peripheral arterial disease should take clopidogrel and atorvastatin

74
Q

what is the empirical antibiotic of choice in neutropenic sepsis

A

Piperacillin with tazobactam (Tazocin) is the empirical antibiotic of choice for neutropenic sepsis

75
Q

in what skin presentation do you see a herald patch?

A

Pityriasis rosea

76
Q

what is the treatment for a unstable patient in VT

A

synchronised cardioversion

77
Q

what are the conditions required for lactational amenorrhoea to be a reliable form of contraception

A

Lactational amenorrhoea is a reliable method of contraception as long as amenorrhoeic, baby <6 months, and breastfeeding exclusively

78
Q

what steroid do you give ladies who are at risk of preterm labour

A

dexamethasone

79
Q

Bilious vomiting on the first day of life is likely due to _______

A

intestinal atresia

80
Q

what’s the rash like in scarlet fever

A

sandpaper rash

81
Q

what are the indications for thoracotomy in haemothorax

A

Indications for thoracotomy in haemothorax include >1.5L blood initially or losses of >200ml per hour for >2 hours

82
Q

Orthostatic hypotension can be diagnosed when there is:

A
  • a. A drop in systolic BP of 20mmHg or more (with or without symptoms)
  • b. A drop to below 90mmHg on standing even if the drop is less than 20mmHg (with or without symptoms)
  • c. A drop in diastolic BP of 10mmHg with symptoms
83
Q

what is the investigation of choice for reflux nephropathy

A

Micturating cystography is the investigation of choice for reflux nephropathy

84
Q

what are the blood test results in osteoporosis

A

Osteoporosis is commonly associated with normal blood test values (e.g. normal ALP, normal calcium, normal phosphate, normal PTH)

85
Q

when is breast cancer screening offered

A

Breast cancer screening is offered to all women aged 50-70 years (mammogram every 3 years)

86
Q

how is local anaesthetic toxicity treated

A

Local anesthetic toxicity can be treated with IV 20% lipid emulsion

87
Q

what is the antibiotic for GBS prophylaxis in pregnancy

A

IV Benzylpenicillin is the antibiotic of choice for GBS prophylaxis

88
Q

which drugs trigger haemolysis in G6PD deficiency

A

G6PD deficiency: sulph- drugs: sulphonamides, sulphasalazine and sulfonylureas can trigger haemolysis

89
Q

what biochemical abnormality does cushing’s cause

A

Cushing’s syndrome - hypokalaemic metabolic alkalosis

90
Q

what is the firstline investigation for pre-term, pre-labour rupture of membranes

A

Careful speculum examination to look for pooling of amniotic fluid in the posterior vaginal vault is the first-line investigation for preterm prelabour rupture of the membranes

91
Q

can you have erythromycin during pregnancy

A

yes

92
Q

can pregnant patients have clarithromycin

A

no - especially not in the first trimester

93
Q

indications for thrombolysis with alteplase in PE

A
  • Massive PE causing right heart failure associated with hypotension and a low bleed risk
  • Non-massive PE with the patient deteriorating after initial anticoagulation (without hypotension and with a low bleeding risk).
94
Q

absolute contraindications to thrombolysis

A
  • Structural intracranial disease
  • Prior intracranial haemorrhage
  • Active bleeding
  • Ischaemic stroke less than 3 months ago
  • Recent spinal or brain surgery
  • Recent brain injury
  • Recent head trauma with fracture
  • Bleeding diathesis (such as antiphospholipid syndrome and haemophilia).
95
Q

how long does the mirena coil last

A

5 years

96
Q

how long does the copper IUD last

A

5-10 years depending on the type

97
Q

what is the reversal agent for dabigatran

A

Idarucizumab

98
Q

what is the treatment for rosacea

A
  • mild/moderate: topical metronidazole
  • severe/resistant: oral tetracycline
99
Q

if patients are going to start taking long term steroids what should you do about their bone protection

A
  • bone protection should start immediately
    • if Ca2+ and vit D are replete then the first step alendronate
    • if they’re Ca2+ and vit D deficient then these should be replaced before bisphosphonates are started
100
Q

what are the stages of CKD

A
101
Q

what is the treatment for pernicious anaemia

A

life long IM hydroxocobalamin injections - loading dose and then repeated at 2-3 monthly intervals.

102
Q

how do you calculate a breakthrough dose with morphine

A

Breakthrough dose = 1/6th of daily morphine dose

103
Q

what is the investigation of choice for prostate cancer

A

multiparametric MRI

104
Q

whatis the routine with which you should take hydrocortisone in addison’s

A

hydrocortisone dose is split with the majority given in the first half of the day

105
Q

what is the investigation of choice in renal colic

A

Non-contrast CT-KUB is the imaging of choice in suspected renal colic

106
Q

are you more likely to have weight loss in crohns or UC

A

crohns

107
Q

extra intestinal features of Crohns and UC

A
  • Crohn’s
    • gallstones
    • oxalate renal stones
  • Ulcerative colitis
    • PSC
  • Both
    • Arthritis
    • Pyoderma Gangrenosum
    • Erythema Nodosum
    • Uveitis (mostly UC)
108
Q

draw the Crohn’s and UC venn diagram

A
109
Q

describe the histology found in crohn’s and UC

A
  • crohn’s
    • inflammation in all layers from mucosa to serosa
    • increased goblet cells
    • granulomas
  • UC
    • no inflammation beyond submucosa
    • crypt abscesses (formed by neutrophils)
110
Q

describe the endoscopic appearance of Crohn’s and UC

A
  • Crohn’s
    • Deep ulcers
    • Skip lesions
    • “cobblestone appearance”
  • UC
    • Pseudopolyps
111
Q

grade severity of ulcerative colitis

A
  • mild:
    • <4 stools/day
  • moderate:
    • 4-6 stools per day
  • severe
    • >6 stools per day and features of severe systemic upset
112
Q

UC: how to induce remission in mild to moderate proctitis

A
  • topical rectal aminosalicylate (mesalazine)
  • if remission not achieved in 4 weeks add oral aminosalicylate
  • if remission not achieved in 4 weeks add oral or rectal corticosteroids
113
Q

UC: how to induce remission in mild to moderate proctosigmoiditis & left sided disease

A
  • rectal aminosalicylate (mesalazine)
  • if no improvement in 4 weeks then add oral mesalazine
  • OR switch to oral mesalazine with rectal corticosteroid
  • if remission still not achieved then oral mesalazine and oral corticosteroids
114
Q

UC: how to induce remission in mild to moderate extensive disease

A
  • topical aminosalicylate with oral aminosalicylate
  • if remission not achieved in 4 weeks then stop topical treatments and start oral mesalazine and oral corticosteroids
115
Q

how do you induce remission in severe ulcerative colitis

A
  • these patients should always be treated in hospital
  • IV steroids are first line
116
Q

how do you maintain remission in UC

A
  • following mild to moderate flare
    • proctitis and proctosigmoiditis
      • rectal mesalazine +/- oral mesalazine
    • left sided and extensive disease
      • low dose oral mesalazine
  • following a severe flare
    • oral azathioprine or oral mercaptopurine
117
Q

crohn’s management

A
  • STOP SMOKING
  • inducing remission
    • 1st line: glucocorticoids
    • 2nd line: mesalazine
      • azathioprine or mercaptopurine can be used as add ons but not as a monotherapy
    • 3rd line: infliximab
  • maintaining remission
    • 1st line: azathioprine or mercaptopurine
    • 2nd line: methotrexate
  • surgery
118
Q

what is the glasgow blatchford score for

A

it is for use before endoscopy to establish whether the patient can be treated as an outpatient

119
Q

what is the rockall score for

A

it is for after endoscopy in upper GI bleed patients to establish their risk of re-bleeding and mortality

120
Q

things included in glasgow blatchford

A
  • urea
  • Hb
  • systolic BP
  • pulse >100
  • melaena
  • syncope
  • hepatic disease
  • cardiac failure

patients with a score of 0 may be considered for early discharge

121
Q

managment of upper GI bleed

A
  • resuscitation
    • ABC
    • platelet transfusion if actively bleeding and platelets less than 50
    • FFP if INR >1.5
    • prothrombin complex if patient taking warfarin and actively bleeding
  • endoscopy immediately after resuscitation
    • non-varicael bleed
      • don’t give PPI until after endoscopy
    • varicael bleed
      • terlipressin and abx
      • band ligation
      • injection if N-butyl-2-cyanoacrylate
      • TIPS if bleeding not controlled by above measures
122
Q

diseases associated with PBC

A

sjorgens

rheumatoid arthritis

systemic sclerosis

thyroid disease

123
Q

management of PBC

A
  • ursodeoxycholeic acid slows disease progression
  • pruritis: cholesytramine
  • fat soluble vitamin supplementation
  • liver transplant
    • recurrence in graft is rare
124
Q

how do you diagnose PBC

A
  • AMA M2 subtype = sensitive + specific
  • imaging with RUQ US or MRCP
125
Q

how do you grade C.diff

A
  • mild
    • WCC Normal
  • moderate
    • WCC <15
    • 3-5 loose stools per day
  • severe
    • WCC >15
    • AKI
    • Temp >38.5
  • life threatening
    • hypotension
    • partial or complete ileus
    • toxic megacolon
126
Q

management of first episode of non-life threatening C.diff

A
  • first line: oral vancomycin for 10 days
  • second line: oral fidaxomycin
  • third line: oral vancomycin +/- IV metronidazole
127
Q

managment of recurrent episode of non-life threatening C.diff

A
  • within 12 weeks: oral fidaxomycin
  • after 12 weeks: oral vancomycin or fidaxomycin
  • if they’ve had more than two episodes then consider fecal transplant
128
Q

treatment of life threatening C.diff

A
  • oral vancomycin and IV metronidazole
  • surgical referral
129
Q

investigation for PSC

A
  • ERCP or MRCP: multiple biliary strictures and “beading”
  • p-ANCA may be positive
130
Q

complications of PSC

A

cholangiocarcinoma

increased risk of colorectal cancer

131
Q

difference of SAAG in ascites and what it means

A
  • SAAG >11
    • indicates portal hypertensio
      • most commonly liver disorders
      • also
        • right heart failure
        • constrictive pericarditis
        • budd chiari
        • portal vein thrombosis
  • SAAG <11
    • hypoalbuminaemia
      • nephrotic syndrome
      • severe malnutrition
    • malignancy
      • peritoneal carcinomatosis
    • infections
      • TB
    • other
      • pancreatitis
132
Q

managment of ascites

A
  • reduce dietary sodium
  • if sodium is low then restrict fluids
  • spironolactone
  • drainage of tense ascites with albumin cover
    • to protect against paracentesis induced circulatory dysfunction and mortality
  • abx for prophylaxis of SBP
  • TIPS
133
Q

grade hepatic encephalopathy

A
  • Grade I: irritability
  • Grade II: confusion and inappropriate behaviour
  • Grade III: incoherent restlessness
  • Grade IV: coma
134
Q

what are the LFT findings in alcoholic hepatitis

A

AST:LFT ratio is 2:1

135
Q

what is the treatment for alcoholic encephalopathy

A
  • lactulose
    • works by increasing the excretion of urea and increasing the metabolism of it by gut bacteria
  • rifaximin
    • modulates gut flora to decrease ammonia production
136
Q

what malignancy does coeliac predispose to

A

enteropathy associated T-Cell lymphoma

137
Q

what malignancy does chronic H.pylori infection predispose to?

A

MALT

138
Q

what is the investigation of choice for liver cirrhosis

A

transient elastography

139
Q

how do you diagnose malnutrition

A

unintentional weight-loss of >10% in 3-6 months

140
Q

SLE antibody

A

anti-dsDNA

141
Q

PSC antibody

A

p-ANCA

142
Q

Primary biliary cholangitis antibody

A

AMA M2 subtype is highly sensitive and specific

143
Q

what is the UC antibody

A

p-ANCA

144
Q

what is the wegener’s granulomatosis antibody

A

c-ANCA

145
Q

What are the coeliac antibodies

A

Anti-endomysial / gliadin / transglutamase

146
Q

what are the CREST / Scleroderma antibodies

A

anti-centromere

147
Q

what is the sjorgen’s syndrome antibody

A

anti-Ro and anti-La

148
Q

two typical antipsychotics

A

Haloperidol
Chlopromazine

149
Q

three atypical antipsychotics

A

Clozapine
Risperidone
Olanzapine

150
Q

side effects of antipsychotics

A
  • typical
    • extrapyramidal side effects
    • hyperprolatinaemia
  • atypical
    • metabolic effects
    • reduced swizure threshold
  • both
    • antimuscarinic: dry mouth, blurred vision, urinary retention, constipation
    • sedation, weight gain
    • impaired glucose tolerance
    • neuroleptic malignant syndrome: pyrexia, muscle stiffness
151
Q

extrapyramidal side effects

A
  • Parkinsonism
  • acute dystonia
    • sustained muscle contraction (e.g. torticollis, oculogyric crisis)
    • may be managed with procyclidine
  • akathisia (severe restlessness)
  • tardive dyskinesia (late onset of choreoathetoid movements, abnormal, involuntary, may occur in 40% of patients, may be irreversible, most common is chewing and pouting of jaw)
152
Q

causes of AF

A
  • AF affects Mrs SMITH
    • sepsis
    • mitral stenosis/regurge
    • IHD
    • thyrotoxicosis
    • HTN

Finals (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions