19/06 Flashcards
(135 cards)
1
Q
upper vs lower GIB
A
ligament of Treitz
2
Q
metastatic bone pain
A
analgesia
bisphosphonates
radiotherapy
3
Q
BRCA2 assoc men
A
prostate cancer
4
Q
ITP tx
A
prednisolone
5
Q
iron deficiency anaemia
A
hypochromic microcytic anaemia
high TIBC
low ferritin and transferrin
6
Q
anaemia of chronic disease
A
low TIBC
low transferrin
high ferritin
7
Q
ITP invx
A
antiplatelet autoantibodies (usually IgG)
bone marrow aspiration to rule out leukaemia
8
Q
decreased haptoglobin
A
intravascular haemolysis
9
Q
abdo and neuro signs
blue lines on gums
A
lead poisoning
10
Q
ovaries lymph drainage
A
para-aortic lymphatics via the gonadal vessels
11
Q
uterine fundus lymph drainage
A
para-aortic nodes
inguinal nodes
12
Q
body of uterus lymph drainage
A
iliac lymph nodes
13
Q
cervix lymph drainage
A
external iliac nodes
presacral nodes
internal iliac nodes
14
Q
methotrexate anaemia
A
macrocytic megaloblastic
15
Q
‘chocolate’ cyanosis
A
Methaemoglobinaemia
16
Q
myelodysplasia progression
A
acute myeloid leukaemia (AML)
17
Q
unobtainable bone marrow biopsy - ‘dry tap’ therefore trephine biopsy needed
A
myelofibrosis
18
Q
myeloma imaging
A
whole body MRI
19
Q
monoclonal IgM paraproteinaemia
A
waldenstroms macroglobulinaemia
20
Q
most common inherited bleeding disorder
A
vWF
21
Q
tumour lysis syndrome electrolytes
A
high potassium
high phosphate
low calcium
22
Q
clinical features of tumour lysis syndrome
A
increased serum creatinine
cardiac arrhythmia or sudden death
seizure
23
Q
essential thrombocytosis mx
A
hydroxyurea (hydroxycarbamide) is widely used to reduce the platelet count
interferon-α is also used in younger patients
low-dose aspirin may be used to reduce the thrombotic risk
24
Q
sideroblastic anaemia
A
deposits of iron in the mitochondria that form a ring around the nucleus called a ring sideroblast
25
basophilic stippling of red blood cells
ringed sideroblasts
sideroblastic anaemia
26
sickle cell diagnossi
haemoglobin electrophoresis
27
long term mx sickle cell
hydroxyurea
28
sickle cell crisis reduced reticulocyte count
aplastic crisis
29
sickle cell crisis increased reticulocyte count
sequestration crisis
30
post thrombotic syndrome tx
compression stockings
31
polycythaemia vera mx
aspirin
venesection
hydroxyurea
32
when to offer a platelet transfusion
count <30 if active bleeding
count <10 if no active bleeding or planned procedure
33
highest risk of bacterial contamination blood product
platelets
34
patients with acute, severe, symptomatic hyponatraemia (< 120 mmol/L)
hypertonic saline (3%)
35
stress incontinence
duloxetine
36
?angina invx
Contrast-enhanced CT coronary angiogram
37
when should abx be given in AOM
>4 days or not improving
Systemically unwell but not requiring admission
Immunocompromised or high risk of complications
< 2 years old with bilateral otitis media
Otitis media with perforation and/or discharge in the canal
38
sinusitis symptoms >10 days
intranasal steroids
39
most common cause tonsilitis
strep pyogenes
40
what does everything need to be above for a normal audiogram
20dB line
41
+ve dixhallpike manouvre BPPPV
rotatory nystagmus
42
neck lump anterior and lateral to SCM muscle
branchial cyst
43
foul-smelling, non-resolving discharge
cholesteatoma
44
chronic sinusitis mx
avoid allergen
intranasal corticosteroids
nasal irrigation with saline solution
45
bilateral high-frequency hearing loss
presbycusis
46
'flamingo tinge' tympanic membrane
otosclerosis
47
ototoxic drugs
aminoglycosides eg gent
furosemide
aspirin
48
ear wax tx
ear syringing and ear drops
olive oil
sodium bicarbonate 5%
almond oil
49
mx of epistaxis
pinch soft part of nose and lean forward for 20 mins
naseptin (unless peanut soy or neomycin allergy)
cautery if bleed is visible
nasal packing
ligation of the sphenopalantine artery in theatre
50
gingival hyperplasia drug causes
phenytoin
ciclosporin
calcium channel blockers
51
gingivitis mx (before dentist)
oral metronidazole for 3 days
chlorhexidine or hydrogen peroxide mouth wash
simple analgesia
52
tx of glue ear
grommets
adenoidectomy
53
ludwigs angina
progressive cellulitis that invades the floor of the mouth and soft tissues of the neck
tx - IV abx and airway mx
54
malignant otitis externa biggest RF
diabetes
55
malignant otitis externa cause
Pseudomonas aeruginosa
56
acute attacks menieres
buccal or intramuscular prochlorperazine
57
prevention menieres
betahistine and vestibular rehabilitation exercises
58
nasal polyps mx
refer to ENT
topical steroids can shrink size
59
Unilateral serous otitis media
?nasopharyngeal carcinoma
60
nasopharyngeal carcinoma mx
radiotherapy
61
otitis externa tx
topical antibiotic or a combined topical antibiotic with a steroid
62
pleomorphic adenoma tx
surgical excision
63
ramsay hunt syndrome tx
oral aciclovir and corticosteroids
64
horizontal nystagmus
vestibular neuronitis
65
vestibular neuronitis/vestibular neuronitis drug tx
prochlorperizene or an antihistamine
66
what meds should be stopped in c diff
opiods
67
raised AFP and HCG
non-seminomatous testicular cancer
68
murmur turners syndrome
bicupsid aortic valve - ejection systolic murmur
69
H pylori test post eradication
urea breath test
70
rectal tumours
anterior resection
71
complication of fluid resus in young pt DKA
cerebral oedema
72
where can a gallstone block that does NOT cause jaundice
cystic duct
73
medical mx of a miscarriage
vaginal misoprostol
74
symptoms of mania in primary care
URGENT referral to CMHT
75
symptoms of hypomania in primary care
ROUTINE referral to CMHT
76
bilous vomiting first day
intestinal atresia
77
medical abortion
mifepristone followed by prostaglandins
78
GBS prophylaxis
benzypenicillin
79
drug that can precipitate digoxin toxicity
thiazides eg indapamide
80
cushings biochem abnormality
hypokalaemic metabolic alkalosis
81
anaphylactoid reaction to Nacetylcysteine
stop infusion and consider at a slower rate
82
if at the time of diagnosis of GDM, the fasting glucose level is >= 7 mmol/l
insulin
83
long saphenous vein superficial thrombophlebitis
USS to exclude DVT
84
IM B12
IM hydroxocobalamin
85
oral codeine to morphine
divide by 10
86
symptom control in bronchiectasis
inspiratory muscle training + postural drainage
87
severe flare UC tx
IV steroids
88
AACG predisposing factors
hypermetropia (long-sightedness)
pupillary dilatation
lens growth associated with age
89
AACG invx
tonometry
gonioscopy
90
AACG definitive mx
laser peripheral iridotomy
91
DRY ARMD
drusen
92
wet ARMD
choroidal re-vascularisation
93
dry ARMD tx
zinc with anti-oxidant vitamins A,C and E
94
wet ARMD tx
anti-VEGF
95
HLAB27 aka ank spond
eye
anterior uveitis
96
cataracts old age
nuclear
97
cataracts steroid use
subscapular
98
proliferative diabetic retinopathy
99
pre-proliferative diabetic retinopathy
100
DIABETIC RETINOPATHY TX
panretinal laser photocoagulation
intravitreal VEGF injections
101
IBD, rheumatoid arthritis
eye
episcleritis
102
not painful red eye with mobile injected vessels
episcleritis
103
dendritic corneal ulcer
herpes simplex keratitis
104
herpes zoster ophthalmicus tx
oral antiviral treatment for 7-10 days
105
holmes adie pupil
dilated
106
Anhidrosis of the face, arm and trunk
Stroke
Syringomyelia
Multiple sclerosis
Tumour
Encephalitis
107
Anhidrosis of the face
Pancoast's tumour
Thyroidectomy
Trauma
Cervical rib
108
No anhidrosis
Carotid artery dissection
Carotid aneurysm
Cavernous sinus thrombosis
Cluster headache
109
hypertensive retinopathy
110
bacterial conjuncitivitis
purulent discharge
111
viral conjunctivitis
serous discharge
112
keratitis contact lens user
Pseudomonas aeruginosa
113
persistent watery eye in a newborn
nasolacrimal duct obstruction - teach pts to massage duct
114
orbital cellulitis invx
CT with CONTRAST
115
sudden appearance of flashes and floaters
posterior vitreous detachment
116
primary open angle glaucoma tx
selective laser trabeculoplasty
prostaglanding eye drops
117
peripheral visual field loss
glaucoma
118
Dense shadow that starts peripherally progresses towards the central vision
retinal detachment
119
uncorrected squint leads to
amblyopia
120
painful red eye
scleritis
121
night blindness and tunnel vision
Retinitis pigmentosa
122
retinal detachment sight RF
myopia
123
small, fixed oval pupil, ciliary flush
anterior uveitis
124
Investigating suspected PE: if the CTPA is negative
consider a proximal leg vein ultrasound scan if DVT is suspected
125
cannot get above the swelling
inguinal hernia
126
can get above the swelling
hydrocele
127
LP finding guillan barre
elevated protein with normal white cell count
128
indapamine
thiazide
129
mild-moderate flare of distal ulcerative colitis
rectal aminosalicylates
130
secondary prevention post MI
ACEi
Beta Blocker
Cholesterol lowering agent (Statin)
Dual antiplatelet therapy
131
pyloric stenosis
Hypochloremic, hypokalaemic metabolic alkalosis
132
cytotoxic agent pulmonary fibrosis
bleomycin
133
lynch syndrome/HNPCC
development of bowel cancer (among other cancers) with little formation of adenomatous polyps
134
when would you thrombolyse in PE
hypotension
135
small bowel overgrowth syndrome
hydrogen breath test
