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passmed qs > 17/06 > Flashcards

17/06 Flashcards

1
Q

diarrhoea with a long incubation period

A

amoebiasis

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2
Q

anchovy sauce liver abscess

A

amoebiasis

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3
Q

chloramphenicol adverse effect

A

aplastic anaemia

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4
Q

antibiotic causing long QT

A

macrolides especially erythromycin

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5
Q

undercooked or reheated rice, vomiting/diarrhoea within 6 hours

A

bacillus cereus

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6
Q

flaccid paralysis

A

botulism

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7
Q

painful genital ulcers associated with unilateral, painful inguinal lymph node enlargement
ulcers typically have a sharply defined, ragged, undermined border

A

chancroid

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8
Q

when should chalmydia testing be carried out

A

2 weeks after a possible exposure

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9
Q

profuse ‘rice water’ diarrhoea

A

cholera

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10
Q

GAS GANGRENE

A

c perfringens

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11
Q

spastic paralysis

A

tetanus

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12
Q

diarrhoea in immunocompromised/HIV

A

Cryptosporidiosis

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13
Q

Owl’s eye’ appearance due to intranuclear inclusion bodies

A

CMV

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14
Q

grey, pseudomembrane on the posterior pharyngeal wall

A

diptheria

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15
Q

only DNA virus that is single stranded

A

parvovirus

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16
Q

bradycardia, constipation and rose spots

A

typhoid

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17
Q

most common cause of viral meningitis

A

enteroviruses eg coxsackie, echovirus, rhinovirus

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18
Q

hairy leukoplakia

A

EBV infection

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19
Q

EBV malignancies

A

Burkitt’s lymphoma
Hodgkin’s lymphoma
nasopharyngeal carcinoma
HIV-associated central nervous system lymphomas

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20
Q

severe, haemorrhagic, watery diarrhoea
contaminated ground beef

A

e coli 0157 -> HUS

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21
Q

travellers diarrhoea

A

e coli

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22
Q

acute food poisoning due to toxin

A

Staphylococcus aureus, Bacillus cereus or Clostridium perfringens

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23
Q

prolonged non bloody diarrhoea

A

giardiasis

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24
Q

Bloody diarrhoea
Vomiting and abdominal pain

A

shigella

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25
Q

Severe vomiting
Short incubation period

A

staph aureus

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26
Q

flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody

A

campylobacter (can -> guillan barre)

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27
Q

multiple, non-keratinised warts

A

topical podophyllum

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28
Q

solitary, keratinised warts

A

cryotherapy

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29
Q

complication of giardisis

A

malabsorption and lactose intolerance

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30
Q

if needle refused in gonorrhea

A

oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose)

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31
Q

disseminated gonococcal infection

A

tenosynovitis
migratory polyarthritis
dermatitis

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32
Q

septic arthritis YA

A

gonorrhea

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33
Q

ground glass hepatocytes

A

HEP B

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34
Q

what does hep d coninfect with

A

hep b

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35
Q

severe hep pregnancy

A

hep E

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36
Q

most commonly affected valve in endocarditis

A

mitral

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37
Q

Distal transverse or descending colon cancer

A

left hemicolectomy

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38
Q

herpes gingivostomatitis

A

oral aciclovir, chlorhexidine mouthwash

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39
Q

kaposis sarcoma cause

A

HHV8

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40
Q

single or multiple ring enhancing lesions HIV
Thallium SPECT negative

A

toxoplasmosis

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41
Q

single or multiple homogenous enhancing lesions HIV
thallium SPECT positive

A

primary CNS lymphoma

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42
Q

widespread demyelination HIV

A

Progressive multifocal leukoencephalopathy (PML)

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43
Q

diagnosis of HIV

A

combination tests (HIV p24 antigen and HIV antibody)

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44
Q

HIV testing

A

testing for HIV in asymptomatic patients should be done at 4 weeks after possible exposure
after an initial negative result when testing for HIV in an asymptomatic patient, offer a repeat test at 12 weeks

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45
Q

glandular fever/infectious mononucleosis cause

A

EBV

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46
Q

sore throat, pyrexia and lymphadenopathy

A

infectious mononucleosis

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47
Q

differences in flu vaccine

A

children = intranasal live vaccine
adults and at risk groups = inactivated vaccine

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48
Q

tx of atypical pneumonia eg legionella

A

clari or erythromycin

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49
Q

patches of hypopigmented skin typically affecting the buttocks, face, and extensor surfaces of limbs
sensory loss

A

leprosy

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50
Q

sewage workers/farmers/vets/tropics

A

leptospiriosis -> serology

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51
Q

stage 1: small painless pustule which later forms an ulcer
stage 2: painful inguinal lymphadenopathy
may occasionally form fistulating buboes
stage 3: proctocolitis

A

LGV

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52
Q

causes of false negative mantoux

A

immunosuppression (miliary TB, AIDS, steroid therapy)
sarcoidosis
lymphoma
extremes of age
fever
hypoalbuminaemia, anaemia

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53
Q

metronidazole SEs

A

disulfiram-like reaction with alcohol
increases the anticoagulant effect of warfarin

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54
Q

pneumonia with erythema multiforme

A

mycoplasma -> serology

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55
Q

necrotising fasciitis T1

A

mixed anaerobes and aerobes

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56
Q

necrotising fasciitis T2

A

Streptococcus pyogenes

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57
Q

drug RF for nec fasc

A

SGLT2 inhibs

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58
Q

erythema infectiosum eg slapped cheek cause

A

parvivirus b19

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59
Q

splenectomy prophylaxis

A

pneumococcal, Haemophilus type b and meningococcal type C vaccines 2 weeks pre or post
annual flu
abx

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60
Q

chest infection cystic fibrosis

A

Pseudomonas aeruginosa

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61
Q

q fever from sheep or cattle

A

Coxiella burnetii

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62
Q

only double stranded RNA virus

A

Reoviridae

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63
Q

sepsis

A

life-threatening organ dysfunction caused by a dysregulated host response to infection

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64
Q

coagulase positive staph

A

staph aureus

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65
Q

coagulase negative staph

A

staph epidermidis

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66
Q

alpha (partial) haemolytic strep

A

strep pneumoniae
strep viridans

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67
Q

beta (complete) haemolytic strep

A

strep pyogenes
strep agalactiae
enterococcus

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68
Q

electrolyte effect of co-trimox

A

hyperkalaemia

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69
Q

syphillis

A

treponema pallidum

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70
Q

syphillis inc period

A

9-90 days

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71
Q

Positive non-treponemal test + positive treponemal test

A

active syphillis

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72
Q

Positive non-treponemal test + negative treponemal test

A

false positive syphillis result

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73
Q

Negative non-treponemal test + positive treponemal test

A

successfully treated syphillis

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74
Q

syphillis mx

A

IM bezathine penicillin

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75
Q

BV or trichomonas STI

A

trich

76
Q

abx interaction with methotrexate

A

trimethoprim

77
Q

sudden onset of high fever, rigors, nausea & vomiting Bradycardia
brief remission
jaundice, haematemesis, oliguria

A

yellow fever

78
Q

when to send culture in UTI

A

pregnat
male
F aged > 65 years
visible or non-visible haematuria
recurrent

79
Q

PE acute mx in pt at risk of bleeding

A

IV heparin

80
Q

renal stones invx

A

NON-CONTRAST CTKUB

81
Q

what glucose to use in unconscious hypoglycaemic pt

A

75ml of 20% by IV infusion

82
Q

T2DM CKD

A

sulphonylureas + DPP4s

83
Q

vestibular schwannoma invx

A

MRI of cerebellopontine angle

84
Q

poisoning presentation within 1 hr

A

activated charcoal

85
Q

when to give o2 in stemi

A

sats <94%

86
Q

SSRI use during third trimester

A

risk of persistent pulmonary hypertension of the newborn

87
Q

axillary freckles

A

nf1

88
Q

night blindness + tunnel vision

A

retinitis pigementosa

89
Q

black African or African–Caribbean taking a calcium channel blocker for hypertension, if they require a second agent

A

ARB eg losartan

90
Q

ptosis

A

CN III

91
Q

acute stress disorder tx

A

trauma focused CBT
benzos

92
Q

alcohol withdrawal tx

A

long-acting benzodiazepines e.g. chlordiazepoxide or diazepam
lorazepam if hepatic failure

93
Q

adults with anorexia tx

A

CBT-ED
Maudsley Anorexia Nervosa Treatment for Adults
specialist supportive clinical management

94
Q

kids with anorexia tx

A

anorexia focused family therapy

95
Q

typical antipsychotic examples

A

Haloperidol
Chlopromazine

96
Q

atypical antipsychotic egs

A

Clozapine
Risperidone
Olanzapine

97
Q

typical antipsychotics SEs

A

extrapyramidal SEs
hyperprolactinaemia

98
Q

atypical antipsychotics SEs

A

metabolic SEs
hyperprolactinaemia
clozapine - agranulocytosis, reduced seizure threshold

99
Q

acute dystonia

A

sustained muscle contraction (e.g. torticollis, oculogyric crisis)

100
Q

ACUTE DYSTONIA mx

A

procyclidine

101
Q

akathisesia

A

severe restlessness

102
Q

tardive dyskinesia

A

late onset of choreoathetoid movements
eg chewing and pouting of jaw

103
Q

antipsychotic risk in elderly pts

A

> risk of VTE and stroke

104
Q

clozapine monitoring

A

initally weekly FBC

105
Q

baseline monitoring antipsychotics

A

FBC, U+Es, LFTs
lipids, wt
fasting blood glucose, prolactin
BP, ECG, CV risk assessment

106
Q

antipsychotic with best SE profile, particularly for hyperprolactinaemia

A

aripirprazole

107
Q

benzos MOA

A

enhance the effect of the inhibitory neurotransmitter GABA by increasing the frequency of chloride channels

108
Q

withdrawal of benzos

A

dose should be withdrawn in steps of about 1/8 of the daily dose every fortnight

109
Q

FREQuently BEnd - DURing BARbeque

A

benzodiazipines increase the frequency of chloride channels
barbiturates increase the duration of chloride channel opening

110
Q

type I bipolar

A

mania and depression

111
Q

type II bipolar

A

hypomania and depression

112
Q

mania

A

severe functional impairment or psychotic symptoms for 7 days or more

113
Q

hypomania

A

decreased or increased function for 4 days or more

114
Q

antidepressant of choice in bipolar

A

fluoxetine

115
Q

2nd line mood stabiliser

A

valproate

116
Q

duration of symptoms for bulimia diagnosis

A

at least once a week for three months

117
Q

bulimia mx

A

bulimia-nervosa-focused guided self-help for adults
CBT ED

118
Q

bulimia mx kids

A

bulimia focused family therapy

119
Q

charles bonnet syndrome

A

persistent or recurrent complex hallucinations occurring in clear consciousness
visual impairment

120
Q

cotard syndrome

A

pt believes that they (or in some cases just a part of their body) is either dead or non-existent

121
Q

declerambaults syndrome aka erotomania

A

pt, often a single woman, believes that a famous person is in love with her

122
Q

factors favouring depression over dementia

A

short history, rapid onset
biological symptoms
pt worried about poor memory
reluctant to take tests, disappointed with results
mini-mental test score: variable
global memory loss

123
Q

less severe depression

A

PHQ-9 score of < 16

124
Q

more severe depression

A

PHQ-9 score of ≥ 16

125
Q

depression tx

A

guided self-help
group CBT
group behavioural activation (BA)
individual CBT
individual BA
group exercise
group mindfulness and meditation
interpersonal psychotherapy (IPT)
SSRIs
counselling
short-term psychodynamic psychotherapy (STPP)

126
Q

more severe depression first line mx

A

individual CBT and an anti-depressant

127
Q

depression screening qs

A

‘During the last month, have you often been bothered by feeling down, depressed or hopeless?’
‘During the last month, have you often been bothered by having little interest or pleasure in doing things?’

128
Q

depression scales

A

HAD
PHQ9
DSMIV

129
Q

Switching from citalopram, escitalopram, sertraline, or paroxetine to another SSRI

A

the first SSRI should be withdrawn before the alternative SSRI is started

130
Q

Switching from fluoxetine to another SSRI

A

withdraw then leave a gap of 4-7 days before starting a low-dose of the alternative SSRI

131
Q

Switching from a SSRI to a tricyclic antidepressant (TCA)

A

cross-tapering

132
Q

Switching from citalopram, escitalopram, sertraline, or paroxetine to venlafaxine

A

cross-tapering

133
Q

Switching from fluoxetine to venlafaxine

A

withdraw and start slowly

134
Q

iliac claudication

A

buttock pain

135
Q

femoral claudication

A

calf pain

136
Q

absolute CI to ECT

A

raised ICP

137
Q

anxiety mx

A

education about GAD + active monitoring
individual non-facilitated self-help or individual guided self-help or psychoeducational groups
cognitive behavioural therapy or applied relaxation or drug treatment
highly specialist input e.g. Multi agency teams

138
Q

drug tx anxiety

A

sertraline

139
Q

insomnia tx if severe daytime impairment

A

hypnotics - short-acting benzodiazepines or non-benzodiazepines (zopiclone, zolpidem and zaleplon)

140
Q

lithium adverse effects

A

nausea/vomiting, diarrhoea
fine tremor
nephrotoxicity: polyuria, secondary to nephrogenic diabetes insipidus
thyroid enlargement, may lead to hypothyroidism
ECG: T wave flattening/inversion
weight gain
idiopathic intracranial hypertension
leucocytosis
hyperparathyroidism and resultant hypercalcaemia

141
Q

mild OCD

A

CBT + ERP
+ SSRI

142
Q

mod OCD

A

SSRI or intensive CBT
?clomipramine

143
Q

severe OCD

A

2ndary care for assessment

144
Q

orthello syndrome

A

pathological jealousy where a person is convinced their partner is cheating on them without any real proof. This is accompanied by socially unacceptable behaviour linked to these claims.

145
Q

cluster A PDs

A

odd or eccentric
Paranoid
Schizoid
Schizotypal

146
Q

cluster B PDs

A

dramatic, emotional or erratic
Antisocial
Borderline (Emotionally Unstable)
Histrionic
Narcissistic

147
Q

cluster C PDs

A

anxious and fearful
Obsessive-Compulsive
Avoidant
Dependent

148
Q

mx PDs

A

dialectal behaviour therapy

149
Q

PTSD tx

A

trauma-focused CBTor eye movement desensitisation and reprocessing therapy

150
Q

PTSD drugs

A

venlafaxine or a SSRI

151
Q

pseudohallucinations

A

hallucinations but the person knows not real eg when grieving

152
Q

brief psychotic disorder

A

symptoms <1 month

153
Q

risk of developing schizophrenia

A

monozygotic twin has schizophrenia = 50%
parent has schizophrenia = 10-15%
sibling has schizophrenia = 10%
no relatives with schizophrenia = 1%

154
Q

RF schizophrenia

A

FAMILY HISTORY
black carribean ethnicity
migration
urban environment
cannabis use

155
Q

schneiders first rank symptoms

A

auditory hallucinations
thought disorders
passivity phenomena
delusional perceptions

156
Q

passitivity phenomena

A

bodily sensations being controlled by external influence
actions/impulses/feelings - experiences which are imposed on the individual or influenced by others

157
Q

poor prognosis schizophrenia

A

strong family history
gradual onset
low IQ
prodromal phase of social withdrawal
lack of obvious precipitant

158
Q

section 2

A

admission for assessment for up to 28 days, not renewable
tx can be given

159
Q

section 3

A

admission for treatment for up to 6 months, can be renewed
tx can be given

160
Q

section 4

A

72 hour assessment order in an emergency, often changed to section 2

161
Q

section 5(2)

A

a patient who is a voluntary patient in hospital can be legally detained by a doctor for 72 hours

162
Q

section 5(4)

A

similar to section 5(2), allows a nurse to detain a patient who is voluntarily in hospital for 6 hours

163
Q

section 17a

A

Supervised Community Treatment (Community Treatment Order), pt recalled to hosp if dont comply with tx

164
Q

SSRI post MI

A

sertraline

165
Q

citalopram and escitalopram issue

A

prolonged QT

166
Q

SSRI interaction

A

NSAIDs - co prescribe PPI
triptans - inc risk of serotonin syndrome
MAOs -“’
warfarin - use mirtazapine instead

167
Q

how should SSRIs be reviewed

A

after 1 week in pts <25
normally after 2 wks

168
Q

how should SSRIs be stopped

A

gradually over 4 wks except fluoxetine

169
Q

SSRI use first trim

A

small increased risk of congenital heart defects

170
Q

paroxetine preg

A

AVOID as inc risk of congenital malformations

171
Q

SNRIs

A

venlafaxine and duloxetine

172
Q

SSRI electrolyte abnormality

A

hyponatraemia

173
Q

problem with Z drugs

A

inc risk of falls in the elderly

174
Q

Low serum calcium, low serum phosphate, raised ALP and raised PTH

A

osteomalacia

175
Q

what drugs can cause malignant hyperthermia

A

Volatile liquid anaesthetics
the -FLURANES
halothane

176
Q

when should nitrous oxide be avoided

A

?pneumothorax

177
Q

which iv anaesthetic agent has anti-emetic effects

A

propofol

178
Q

IV anaesthetic used if haemodynamic instability

A

Etomidate

179
Q

anaesthetic for trauma (doesnt cause a drop in BP)

A

ketamine

180
Q

IO access site

A

anteromedial aspect of the proximal tibia

181
Q

mx of malignant hyperthermia

A

dantrolene

182
Q

muscle relaxants

A

-IUMS

183
Q

which muscle relaxant is the only DEpolarising neuromuscular blocker

A

suxamethonium

184
Q

The muscle relaxant of choice for rapid sequence induction for intubation with the exception of eye injuries

A

suxamethonium

185
Q

what can lead to post-op ileus

A

deranged electrolytes

186
Q

OAB

A

oxybutynin aka antimuscarinic

187
Q

which abx reacts with statins

A

clarithromycin/erythromycin

passmed qs (18 decks)

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