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Year 6 > Random 2 > Flashcards

Random 2 Flashcards

1
Q

What is koebnerisation?

A

koebnerisation or the Koebner phenomenon occurs when new skin lesions occur on sites of previous trauma (e.g. scratches, stings or bites)

occurs in psoriasis (can also occur in vitiligo)

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2
Q

Cabergoline MoA

A

DA agonist

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3
Q

Octreotide MoA

A

somatostatin analogue

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4
Q

Which airway device can protect the airway from gastric contents?

A

only the tracheal tube can seal the trachea off and protect against aspiration

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5
Q

screening test for haemochromatosis

A

transferrin saturation

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6
Q

Fasting before surgery

A

2h for clear liquids
6h for solids

-> Standard national guidelines for elective patients with no
problems affecting gastric emptying. Too long a period of fasting is
unnecessary whilst residual solid food in the stomach poses a big risk ofaspiration/asphyxiation.

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7
Q

define discrimination

A

Discrimination is the unjust or prejudicial treatment of different categories of people.

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8
Q

Which test has the highest specificity for RA?

A

anti-CCP

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9
Q

Malaria with cerebral involvement - subtype?

A

Cerebral involvement makes falciparum more likely.

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10
Q

Which malaria parasite causes the most severe disease?

A

Plasmodium falciparum

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11
Q

anastamotic leak post surgery timeframe

A

would happen soon after surgery

-> if a patient is presenting with symptoms months later, this is most likely not the cause

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12
Q

maintainance fluid in someone with cardiac disease

A

20-25 ml/kg/24h

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13
Q

management of delirium

A
  1. Identify and manage possible underlying causes; effective communication and reorientation
  2. if agitated: try verbal de-escalation; low dose haloperidol is first line medication
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14
Q

Myasthenia gravis - how to monitor respiratory function?

A

FVC

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15
Q

first line initial treatment of sinus bradycardia

A

atropine IV

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16
Q

A 62 year old man develops acute pain, redness, swelling and warmth of his
right first metatarsophalangeal joint. He has a history of gout and
hypertension. His medications are allopurinol, amlodipine and ramipril.
His eGFR is >60 mL/min/1.73 m2
(>60).

Which is the most appropriate next step in his management?
A. Change allopurinol to febuxostat
B. Start naproxen
C. Stop allopurinol
D. Stop amlodipine
E. Stop ramipril

A

B

The patient has acute gout. The immediate
management would be to commence an NSAID.

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17
Q

Commonest organism in leg cellulitis

A

Streptococcus is the most common pathogen
in leg cellulitis (including in patients with diabetes).
-> strep pyogenes mainly

less commonly:
- staph A
- Pasteurella multocida

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18
Q

Main lymphatic drainage of the ovary?

A

para-aortic nodes

The iliac nodes are less frequently involved.

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19
Q

Presentation of uveitis

A

red eye
headache
visual disturbance
small pupil
pupil may be irregular
photophobia

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20
Q

How long does it take for prothrombin complex concentrate to reverse the anticoagulant effects of warfarin?

A

in minutes

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21
Q

Asystole - which med?

A

adrenline

the only recommended medication in asystole

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22
Q

What medication should all patients with metallic heart valves be on?

A

aspirin + warfarin

LMWH may be used for bridging

at the moment there is no place for DOACs (yet)

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23
Q

What would be the reason for normal sats in an unwell patients after a housefire?

A

carboxyhaemoglobin

Co bound to Hb

(affinity of CO is 200x that of O2)

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24
Q

stain in haemochromatosis

A

(Perl’s) Prussian blue

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25
Q

What is a boxers fracture?

A

break in the neck of the 5th metacarpal

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26
Q

describe a BCC

describe a SCC

A

BCC: pearly, rolled edges, ulceration, telangiectasia, pigmentation

SCC: firm, flesh coloured keratotic papules or plaques, smooth nodules, thick cutaneous horn and ulceration (faster growing)

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27
Q

describe eczema herpeticum

A
  • different than normal eczema
  • circular, depressed, ulcerated lesions
  • eroded
  • monomorphic punched out erosions 1-3 mm diameter

-> manage with aciclovir (children should be admitted for IV aciclovir)

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28
Q

Mx of airway burns

A

intubate ASAP!

this is because pts with burns damage to their airway can develop oedema very rapidly which is life threatening

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29
Q

constant leaking of urine spot dx

A

vesicovaginal fistula

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30
Q

Which substance is the primary factor facilitating platelet adhesoin?

A

Von Willebrand factor

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31
Q

What is the commonest complication of meningitis ?

A

sensorineural hearing loss

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32
Q

Oxybutynin MoA

A

competitive ACh R antagonist

-> anitmuscarinic

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33
Q

damage of which nerve causes winging of the scapula?

A

long thoracic nerve

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34
Q

sx of axillary nerve damage

A
  • loss of sensation over the deltoid area (patch)
  • pain
  • shoulder weakness (esp. when lifting arm up)
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35
Q

What electrolyte abnormality is seen in TURP syndrome?

A

hyponatraemia

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36
Q

Features of alcoholic cardiomyopathy

A
  • dilated cardiomyopathy (could cause MR)
  • can have pancytopenia

(Past Paper Question)

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37
Q

Features of Morton’s neuroma

A

associated with athletes, tight footwear

neuroma between 3rd and 4th toe is the commonest

causes sharp burning pain in the ball of the foot

thickening of the tissue around one of the nerves leading to your toes

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38
Q

Charcot’s triad

A

RUQ pain
fever
jaundice

-> ascending cholangitis

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39
Q

What does the SMA supply?

A

midgut
-> from the major duodenal papilla (of the duodenum) to the proximal 2/3 of the transverse colon

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40
Q

lower back pain, not related to movement, normal MSK exam… next Ix?

A

USS

could be a AAA

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41
Q

Herceptin fancy name

A

trastuzumab

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42
Q

hydatid of Morgagni

A

small embryological remnant at the upper pole of the testis.

(Torsion of the hydatid is of no consequence in itself except that it presents a similar picture to torsion of the testis which is a surgical emergency)

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43
Q

SJS vs TEN

A

now thought to be variants of the same condition
it is a rare, unpredictable reaction to medication

  • SJS: Stevens Johnson syndrome skin detachment <10% BSA
  • TEN: toxic epidermal necrolysis skin detachment >10% BSA (or >30% BSA )

Detachment between 10% and 30% of BSA is also known as SJS/TEN overlap syndrome

S comes before T in the alphabet so SJS is less surface than TEN

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44
Q

large binucleate cells with prominent nuclei dx?

What is another name for these cells ?

A

Hodgkin’s lymphoma

= Reed Sternberg cells

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45
Q

Describe what Reed Sternberg cells look like

A

large binucleate cells with prominent nuclei

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46
Q

What effect do benzodiazepines have on respiratory rate ?

A

reduce

you need a bigger dose but they can suppress the RR (sometimes they are used to intubate people)

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47
Q

Faget’s sign

A

relative bradycardia with fever

seen in typhoid fever

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48
Q

Management of BPH

A

1st line: alpha blocker
2nd line: 5 alpha reductase inhibitor

Surgical options include TURP

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49
Q

where is a thyroglossal cyst found?

A

midline

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50
Q

what is a cystic hygroma?

A

birth defect that appears as a sac-like structure with a thin wall that most commonly occurs in the head and neck area of an infant.

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51
Q

First line abx in cholera

A

doxycycline

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52
Q

Which common drug should you avoid when taking clarithromycin?

A

statins -> can accumulate

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53
Q

Summarise the different stages of clinical trials

A

0: exploratory studies, very small number of participants and aim to assess how a drug behaves in the human body.

I: safety assessment (determines SE prior to larger studies, conducted on healthy volunteers)

II: assess efficacy; involves a small number of patients affected by a particular disease. IIa is for optimal dosing and IIb for efficacy assessment

III: new treatment compared with current treatment, involves 100s- 1000s people often as part of a RCT

IV: Postmarketing surveillance (monitors for long-term effectiveness and SE)

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54
Q

smear cells diagnosis

A

CLL

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55
Q

medication that decreases the amount of urinary protein

A

ACE-i

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56
Q

management of amoebiasis / entamoeba histolytica

A

oral metronidazole

also agent for intraluminal cysts (diloxanide furoate)

(the disease can range from asymptomatic to mild diarrhoea to entamoebic dysentery)

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57
Q

commonest complication of meningitis

A

SN hearing loss

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58
Q

abx for meningitis

A

intravenous ceftriaxone but use cefotaxime if administering calcium- containing infusions.

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59
Q

statin adjustments with muscle pain and raised CK

A

> 5x ULN -> stop
<5x ULN -> reduce

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60
Q

Mx of PE in severe renal impairment (eGFR <15/min)

A

LMWH instead of DOAC (double check this at MDT)

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61
Q

what is erythema multiforme associated with?

A

herpes simplex

MYCOPLASMA PNEUMONIAE

fungal infections

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62
Q

complications of mycoplasma pneumoniae

A

erythema multiforme
cold AIHA (cold agglutinins IgM may cause haemolytic anaemia/thrombocytopaenia)

can also lead to meningitis, pericarditis, myocarditis, hepatitis, pancreatitis, acute glomerulonephritis, bullous myringitis (tympanic membrane)

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63
Q

Management of SBP

A

IV cefotaxime

also offer prophylactic oral ciprofloxacin or norfloxacin in people with cirrhosis and ascites with protein 15g/L or less until ascites has resolved

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64
Q

features of WPW on ECG

A

short PRi
slurred upstroke of QRS (delta wave)
widened QRS b

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65
Q

management of WPW

A

definitive: radiofrequency ablation of the accessory pathway

medical: amiodarone, flecainide, sotalol**

**avoid if pt also has AF

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66
Q

Name an LTRA

A

montelukast

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67
Q

tiotropium drug class

A

LAMA

long acting muscarinic antagonist

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68
Q

Which electrolyte abnormalitites do you see in refeeding syndrome?

A

hypophosphataemia
hypokalaemia
hypomagnesaemia (may predispose to torsades de pointes)

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69
Q

What causes U waves on ECG? How are they described?

A

small deflection immediately following the T-wave

most common: severe hypokalaemia, bradycardia

but also: hypocalcaemia, hypomagnesaemia, hypothermia, raised ICP….

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70
Q

Barthel index

A

score done after stroke to assess ability to do ADLs, how dependent/independent someone is

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71
Q

score for risk of pressure ulcers

A

waterlow

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72
Q

meds for focal seizures

A

lamotrigine o levetiracetam are 1st line

second line: carbamazepine, oxcarbezepine or zonisaide

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73
Q

meds for generalised tonic clonic seizures

A

male: sodium valproate
female: lamotrigine or levetiracetam

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74
Q

Which CCBs should be used in angina?

A

rate limiting

e.g. diltiazem or verapamil (if used as monotherapy)

if used in combination with a beta blocker, then use a longer acting dihydropyridine CCB like amlodipine or MR nifedipine

75
Q

Which CCBs are ND and dihyrdopyridine?

A

ND: diltiazem, verapamil (rate limiting)

D: amlodipine, nifedipine

76
Q

Which cardiac marker rises 1st after MI?

A

myoglobin

(rises after 30 minutes)

77
Q

Management of BV in pregnancy

A

oral metronidazole

BV increases the risk of preterm labour, low birth weight, chorioamnionitis and late miscarriage -> treat!

78
Q

Bacteria described as curved rod - dx and mx?

A

campylobacter

give clarithromycin

79
Q

Management of normal pressure hydrocephalus

A

ventriculoperitoneal shunting

10% of pts with shunts expereince significant complications such as seizures, infection and intracerebral haemorrhgaes.

80
Q

CK in PMR

A

normal

81
Q

MS hypersensitivity type

A

IV (cell mediated)

82
Q

Abx for prostatitis

A

ciprofloxacin

(or another quinolone)

83
Q

Tamsulosin drug class

A

alpha blocker

84
Q

finasteride drug class

A

5 alpha reductase inhibitor

85
Q

Mx of acute closed angle glaucoma

A
  • eye drops (direct parasymphatomimetic e.g. pilocarpine), beta blocker (e.g. timolol) and alpha 2 agonist (e.g. apraclonidine)
  • IV acetazolamide (reduces aqueous secretions)
  • some guidelines use topical steroids to reduce inflammation
  • Laser irridiotomy is the DEFINITIVE management
86
Q

mx of PE in a hemodynamically unstable patient

A

thrombolysis

87
Q

rash in adults incl palms and soles with lymphadenopathy - likely to be syphilis

A

syphilis

88
Q

mx of chlamydia in pregnancy

A

azithromycin 1g stat is the drug of choice

can also use erythromycin or amoxicillin

discuss the benefits and risks of the treatment with the patient

89
Q

Which fungus most commonly causes athletes foot?

A

fungi from the genus trichophyton

90
Q

1st line mx of athletes foot

A

topical terbinafine or imidazole or undecenoate

91
Q

which nerve is responsible for wrist extension and finger extension?

A

radial nerve

92
Q

motor function of median nerve

A

pronation of the forearm
flexion of the wrist
flexion of the digits

93
Q

motor function of the ulnar nerve

A

majority of intrinsic hand muscles

anterior forearm:
flexes the ring and little fingers at the DIP
flexes and adducts the hand at the wrist

94
Q

Sx of parietal lobe seizures

A

paraesthesia

95
Q

sx of occipital lobe seizures

A

floaters/flashes

96
Q

frontal lobe seizure sx

A

head/leg movements
posturing
post-ictal weakness (Todd’s paresis)
Jacksonian march

97
Q

temporal lobe seizure signs

A

may be with or without impaired awareness

aura occurs in most patients (this is actually a focal seizure that then progresses to a generalised seizure in tonic clonic - fun fact)

  • seizures usually last around 1 min
  • automatisms (e.g. lip smacking, grabbing, plucking) are common
98
Q

status epilepticus - what do you give if IV loraz 2x did not suffice?

A

IV phenytoin

99
Q

First line for myoclonic seizures in females

A

levetiracetam

(taM -> Myoclonic)

100
Q

first line for tonic/atonic seizuers in females

A

lamotrigine

AmoT - A/T

101
Q

Which medication for absence seizures?

A

ethosuxamide (in males and females)

AbsencE -> ethosuxamide

102
Q

acute alcohol intake and risk of hepatotoxicity in paracetamol OD

A

interestingly, acute alcohol intake reduces the risk of hepatotoxicity

chronic alcohol intake increases the risk

103
Q

male with focal seizures mx

A

lamotrigine or levetiracetam

both in males and females

104
Q

Summarise anti-epileptic mx in males and females

A

Males: Sodium valproate for everything except:
- focal: lamotrigine/levetiracetam
- absence: ethosuxamide

Females: lamotrigine/levetiracetam for everything except:
- absence: ethosuxamide
- in myoclonic levetiracetam > lamotrigine
- in tonic /atonic LevetiAceTam > lamotrigine

105
Q

What is juvenile myoclonic epilespy?

A

classically associated with seizures in the morning or following sleep deprivation

typically affects teenage girls and includes a combination of absence seizures, generalised tonic clonic seizures and myoclonic seizures

106
Q

stopping antiepileptic meds

A

can be considered if seizure free for >2y and done over 2-3 months

107
Q

features of acute interstitial nephritis

A

fever
rash
arthralgia
eosinophilia
mild renal impairment
HTN

108
Q

causes of acute interstitial nephritis

A
  1. Drugs (commonest!)
    - penicillin
    - rifampicin
    - NSAIDs
    - allopurinol
    - furosemide

Systemic disease (SLE, sarcoidosis, Sjogrens)

Infection (Hanta virus, staphylococci)

109
Q

Haemolytic uraemic syndrome

A

generally seen in young children

triad:
- AKI
- microangiopathic haemolytic anaemia
- thrombocytopaenia

E coli 0157:H7 is the textbook cause

other causes:
- HIV infection
- pneumococca linfection
- rare: SLE, drugs, cancer

mx: supportive
(plasma exchange in severe cases)

110
Q

What is the commonest site of pressure ulcers?

A

sacrum

111
Q

Which fluid avoid in acidosis?

A

saline

more acidic than Hartmann’s

112
Q

vocal resonance in empyema and pneumonia

A

reduced in empyema

increased in pneumonia

113
Q

Features of Vitamin B12 deficiency

A

macrocytic anaemia
sore tongue and mouth
neurological disorders
- loss of proprioception and vibration sensation
- distal paraesthesia
mood disturbance

you see the neuro features more in B12 than in folate deficiency

114
Q

drug induced interstitial nephritis - when after abx do you get it?

A

it is rare!

would not appear before 4-7 days of abx exposure

115
Q

classic location for venous ulcers

A

medial and lateral malleolus

116
Q

features of nephrotic syndrome

A

hypoalbuminaemia
proteinuria
oedema
hypercholesterolaemia

117
Q

Urine sodium clinical significance

A

useful to differentiate renal vs extrarenal cases of sodium loss in hypovolaemic hyponatraemia

Values >20mmol/L -> suggest renal sodium loss.

Useful to help confirm SIADH (>40mmol/L)

118
Q

zolendronate route of administration

A

IV only

reserved for those who do not tolerate oral bisphosphonates

119
Q

what causes flashes in retinal detatchment

A

the separating vitreous will tug on the surface of the retina and create a mechanical depolarization of the axons running through the nerve fiber layer of the retina -> this leads to flashing lights

120
Q

What is atelectasis

A

common post op complication
basal alveolar collapse can lead to respiratory difficulty

caused when airways become obstructed by bronchial secretions

presents as dyspnoea about 72h post op

-> upright positioning and chest PT to manage

121
Q

management of SBO due to adhesions

A

drip and suck - conservative management

  1. IV fluids + NG tube

this is successful in 65-80% pts

if not successful, get surgeons involved

IV abx are NOT indicated in cases managed conservatively

122
Q

blood test findings in DIC

A

thrombocytopenia
prolonged PT and APTT
low plasma fibrinogen
elevated D-dimer

may have microangiopathic abnormalities on blood smear

123
Q

Why cricoid pressure pre intubation?

A

to prevent gastric contents in a patient who is not fasted or has abdominal problems from passing higher up and obstructing the airway

124
Q

pericardial effusion on ECG

A

low voltage complexes on ECG

125
Q

risks of exercising despite exertional chest tightness

A

indicates a high likelihood if IHD

vigorous exercise runs the risk of a significant ischaemic event e.g. MI or arrythmia

126
Q

dose of steroid in malignant spinal cord compression

A

16 mg IV dexamethasone

followed by 8 mg BD

127
Q

how to differentiate lithium toxicity from neuroleptic malignant syndrome?

A

lithium toxicity:
- confusion
- coarse tremor
- jerking leg movements
-> may be precipitated by dehydration secondary to D&V

NMS:
- fever
- rigors
- autonomic lability (HTN, tachycardia, tachypnoea)
- agitated delirium with confusion

128
Q

management of primary biliary cirrhosis

A
  1. ursodeoxycholic acid (increased elimination of retained bile acids and reduces toxicity)
  2. colchicine or methotrexate can be used in pts who don’t respond to UDCA

also manage sx :
- pruritus (e.g. colestyramine)
- metabolic bone disease: calcium and vit D
- portal HTN: b-blockers, banding of varices, TIPS

Liver transplant in end stage

129
Q

who gets PBC?

A

middle aged women most commonly

9:1 (f:m)

associated with other AI diseases, may have Sjogrens, Raynauds, arthritis

129
Q

sx of PBC

which ix?

A

fatigue, may have no signs

later: jaundice, pale stool, dark urine, hepatomegaly, xanthomas, ascites, signs of liver disease

may be found incidentally on bloods with
- raised ALP
- raised cholesterol

AMA-M2 +ve

liver biopsy to diagnose

130
Q

pathophys of PBC with PSC

A

PBC: inflammation and progressive destruction of the small and medium intrahepatic bile ducts leading to chronic cholestasis -> cirrhosis
-> most commonly in middle aged women (9:1)
-> AMA-M3

PSC: progressive inflammation and fibrosis of intrahepatic and extrahepatic bile ducts
-> more common in males (2:1), associated with UC
-> associated with increased risk of cancer (cholangiocarcinoma)
-> pANCA

131
Q

Mx of PSC

A
  • no curative treatment

-sx control: e.g. cholestryramine for pruritus, fat soluble vitamins for deificiency, calcium and vit D,
- UDCA may be used (but evidence not as strong as for PSC)
- stenting to relieve obstruction
- liver transplantation for end stage disease

132
Q

+ve markers in
- PSC
- PBC
- AIH

A

PSC: p-ANCA

PBC: AMA-M2

AIH type 1: SMA, ANA

AIH type 2: LKM1, ALC1

133
Q

meds in VT/VF alongside defib

A

adrenline 1mg
amiodarone 300 mg IV

134
Q

pt with fall and head injury, on DOAC, GCS14

what next?

A. C spine immobilisation
B. CXR
C. CT head
D. IV prothrombin complex
E. IV vit K

A

A. C spine immobilization

this is because in trauma patients the sequence is

Airway
C-spine

135
Q

which TB abx causes red secretions?

A

rifampicin

136
Q

where are paneth and goblet cells geerally found?

A

in the small intestine

137
Q

typical ABG in acute T2RF

A

hypoxaemia
CO2 retention
acidosis

138
Q

features of post streptococcal glomeruloephritis

A

7-14 d post strep A infection

  • haematuria
  • fatigue
  • proteinuria (+/- oedema)
  • headache
  • malaise
  • HTN

bloods may show a raised anti-streptolysin O titre (confirms recent streptococcal infection)
- low C3

139
Q

anion gap formula

A

(Na+ + K+) - (Cl- + HCO3-)

normal is 10-18 mmol/L

140
Q

What investigation for Addisons?

A

plasma cortisol and ACTH

141
Q

can a pt have septic arthritis with a -ve gram stain?

A

yes

50% WILL BE POSITIVE

142
Q

key difference cholangitis and cholecystitis

A

in cholangitis you get jaundice and the cholestatic LFTs and GGT would be up

143
Q

TCA posioning wihtin 30 mins mx?

A

activated charcoal

144
Q

Pt with T2DM and CKD not controlled on mteformin - which drug should you add ?

A

Sitagliptin (DPP4 inhibitor)

SGLT2 inhibitors are not licensed - however known to be beneficial

145
Q

route of administration of GLP-1 analogues

A

sc injection (e.g. liraglutide)

given weekly or daily

146
Q

When would you repeat U&Es in a Creatinine raise rather than stoppingthe medicatrion?

A

if the patient has a <30% increase in serum creatinine

-> at this level no indication to change treatment, repeat renal function in 2-4 weeks instead

147
Q

what is frozen shoulder?

A

= adhesive capsulitis

presents with dull shoulder pain
the pain often disturbs sleep
followed by stiffness and loss of shoulder mobility
unlikely in pts <40yo or >70yo -> more likely to be rotator cuff tear or glenohumeral OA

subacromial bursitis or rotator cuff tendinopathy often complain of activity related symptoms

148
Q

Pt with acute abdomen following abdo surgery - what ix?

A

CT scan (usually with contrast)

this will provide diagnostic information and help plan further management

149
Q

does furosemide help reduce hyperkalaemia?

A

yes

150
Q

tamoxifen effect on VTE risk

A

increases VTE risk

151
Q

Horner syndrome

A

miosis (small pupil)
partial ptosis
facial anhidrosis

results from interruption of the ipsilateral SNS supply to the head, eye and enck

most cases are idiopathic but some conditions such as brainstem stroke, carotid dissection and neoplasms are occasionally identified as the cause.

152
Q

APTT and platelets in anti-phospholipid syndrome

A

paradoxically prolonged

+ low platelets

153
Q

NNT formula

A

1/ARR

154
Q

How do you calculate likelihood ratio?

A

Likelihood ratio for a positive test result = sensitivity / (1 - specificity)

155
Q

alternative to oral metronidazole in BV

A

topical clindamycin 2%

156
Q

which antibiotic to close contacts of someone with meningitis?

A

ciprofloxacin oral

157
Q

abx for legionella

A

Macrolides such as clarithromycin are used to treat Legionella

158
Q

Organisms causing post splenectomy sepsis

A

Streptococcus pneumoniae
Haemophilus influenzae
Meningococci

159
Q

Mx of hiccups in palliative care

A

chlorpromazine or haloperidol

160
Q

good first line anti-emetic for intracranial causes of N&V

A

Cyclizine is a good first line anti-emetic for intracranial causes of nausea and vomiting

161
Q

which chemo agent causes haaemorrhagic cystitis?

A

cyclophosphmide

162
Q

Which chemo agent causes lung fibrosis?

A

bleomycin

163
Q

Which chemo agent that is used in the management of lymphoma causes peripheral neuropathy?

A

vincristine

164
Q

where in the lung is adenocarcinoma generally?

A

causes peripheral lesions

165
Q

What causes Hyaline casts in urine?

A

loop diuretics

e.g. furosemide

166
Q

Mx of anterior uveitis

A

urgent referral to specialist

Anterior uveitis is most likely to be treated with a steroid (drops) + cycloplegic (mydriatic) drops

167
Q

Herpes zoster ophthalmicus (HZO)

A
  • reactivation of the varicella-zoster virus in the area supplied by the ophthalmic division of the trigeminal nerve.

-> ~10% of case of shingles.

168
Q

What do pilocarpine eye drops do?

A

CONSTRICT the pupil

immediate management of acute angle-closure glaucoma

by causing the pupil to constrict allowing for drainage of aqueous humour.

169
Q

Why should contact lens wearers be sent to opthal ASAP with red eye?

A

Contact lens wearers who present with a red painful eye should be referred to eye casualty to exclude microbial keratitis

170
Q

Summarises the CKD stages

A

CKD stage GFR range
1 Greater than 90 ml/min, with some sign of kidney damage on other tests (if all the kidney tests* are normal, there is no CKD)

2 60-90 ml/min with some sign of kidney damage (if kidney tests* are normal, there is no CKD)
3a 45-59 ml/min, a moderate reduction in kidney function
3b 30-44 ml/min, a moderate reduction in kidney function
4 15-29 ml/min, a severe reduction in kidney function
5 Less than 15 ml/min, established kidney failure - dialysis or a kidney transplant may be needed

171
Q

Six of gastroparesis

A
  • erratic blood glucose control
  • bloating
  • vomiting
  • early satiety
172
Q

pupil in surgical CN III palsy

A

dilated (mydriasis)

173
Q

ipratropium drug class

A

SAMA

174
Q

Examples of LABAs

examples of SAMAs

A

LABA: Formoterol and salmeterol

SAMA: ipratropium

175
Q

Which one is Broca which Wernicke and which lobes are they?

A

Spoken word is heard at the ear. This passes to Wernicke’s area in the temporal lobe (near the ear) to comprehend what was said. Once understood, the signal passes along the arcuate fasciculus, before reaching Broca’s area. The Broca’s area in the frontal lobe (near the mouth) then generates a signal to coordinate the mouth to speak what is thought (fluent speech).

176
Q

Pneumothorax high risk features

A
  • haemodynamic instability
  • pronounced hypoxia
  • bilateral pneumothorax
  • pre-existing pulmonary pathology
  • > 50 years old with significant smoking history
  • haemothorax
177
Q

Diving and flying after pneumothorax

A

Diving -> permanently avoid unless had bilateral surgical pleurectomy and has normal lung function and chest CT scan postop.

Flying -> absolute contraindication; may fly 2 w post succesful drainage or 1w post check x-ray

178
Q

Which diabetic medication can be used by obese patients who are pre-diabtetic to help lose weight?

how is it given?

A

liraglutide (GLP-1 analogue)

-> once daily SC injections

179
Q

medial epicondylitis

A
  • pain and tenderness localised to the medial epicondyle
  • pain is aggravated by wrist flexion and pronation
  • symptoms may be accompanied by numbness / tingling in the 4th and 5th finger due to ulnar nerve involvement
180
Q

lateral epicondylitis

A
  • worsening symptoms when the wrist is extended and supinated as the wrist extensors are contracted, aggravating the point of their insertion at the lateral epicondyle of the humerus.
181
Q

Felty’s syndrome

A

splenomegaly + neutropenia in a patient with rheumatoid arthritis.

182
Q

Describe colles fracture

A

Colles’ - Dorsally Displaced Distal radius → Dinner fork Deformity

can be caused by FOOSH

183
Q

prevention of seizures in end of life care

A

buccal midazolam

Year 6 (37 decks)

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