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Year 3 Medicine > 2020 Paper > Flashcards

2020 Paper Flashcards

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1
Q

What is contact dermatitis?

A

Red, itchy, irritating skin after coming into contact with an allergen

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2
Q

What is Erythrasma?

A

Redness or brownness under the armpits, groin and in between the toes that is well demarcated and occasionally scaly with some superficial fissures

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3
Q

What are some key triggers of psoriasis?

A

Stress and smoking

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4
Q

What is flexural psoriasis?

A

Psoriasis located in the skin folds and genitals, the scaly overlayer is commonly lost leaving red and shiny skin below

  • Breast folds
  • Axilla
  • Groin
  • Natal cleft
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5
Q

What is the most common solid, benign renal mass?

A

Angiomyolipoma, it can present with retroperitoneal bleeding due to the vascularisation of the mass

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6
Q

What are the first and second line medical treatments for BPH?

A
  1. Tamsulosin (alpha blocker)
  2. Finasteride (5 alpha reductase inhibitor)

Tamsulosin tends to work more quickly and is more effective at reducing the discomfort LUTS

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7
Q

What is the presentation of mastitis?

A
  • Systemic symptoms
  • Generalised swelling and tenderness of the breast
  • Erythema and inflammation
  • Breastfeeding
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8
Q

What is the difference in presentation between mastitis and a breast abscess?

A

Mastitis will be generalised inflammation, whereas abscess will be a local area of inflammation walled off by an area of pus and will be a fluctuant (lump)

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9
Q

What is the classic presentation of haemorrhoids?

A

Painless PR bleeding, frank blood on the toilet paper and in the stool

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10
Q

What is the investigation of choice for haemorrhoids?

A

Proctoscopy

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11
Q

Which investigation is used to distinguish between IBD and IBS?

A

Faecal calprotectin (IBS also tends to improve post-defecation)

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12
Q

How does diverticulitis present?

A

Painful mass (usually in the left iliac fossa) with spiking temperatures

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13
Q

What is the histology of Barrett’s oesophagus?

A
  • Columnar epithelial cells
  • Goblet cells
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14
Q

What is the presentation of haemochromatosis?

A

Skin

  • Bronzing of the skin

Liver

  • Cirrhosis
  • Hepatocellular carcinoma

Pancreas

  • Diabetes mellitus

Heart

  • Arrhythmias

Pituitary

  • Hypopituitarism

Joints

  • Arthralgia
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15
Q

What are the features of peritonitis?

A
  • Rigitdity
  • Rebound tenderness
  • Guarding
  • Diffuse abdominal pain
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16
Q

What is the first line investigation for suspected perforation of peptic ulcer?

A

Erect chest x-ray to screen for subphrenic gas

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17
Q

What is the Parkinsonian triad?

A
  • Rigidity
  • Bradykinesia
  • Tremor
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18
Q

Which drugs improve morbidity and mortality of heart failure?

A

ACE inhibitors

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19
Q

What is the function of digoxin?

A

It’s a glycoside that is cardioprotective and is especially useful in atrial fibrillation and reduced left ventricular output

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20
Q

What is the gram stain of haemophilus influenzae?

A

Gram negative cocculobacillus

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21
Q

What is the gram stain of Klebsiella pneumoniae?

A

Gram negative bacillus

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22
Q

What is the gram stain of staphylococcus aureus?

A

Gram positive cocci in clusters

(strep pneumoniae gram positive diplococci)

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23
Q

What is a dermoid cyst?

A

A benign congenital cyst formed when the layers of skin don’t grow together properly

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24
Q

What are the eye symptoms of a cluser headache?

A
  • Conjunctival injection
  • Lacrimation
  • Eyelid swelling

There is NO loss of vision, however there can be visual disturbance in migraine

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25
What would fundoscopy show in benign intracranial hypertension?
Papilloedema
26
Are tension headaches pulsatile?
NO
27
Why is temporal arteritis an emergency?
Because it can lead to ischaemia of the retinal arteries leading to irreversible blindness
28
What is the inheritance pattern of neurofibromatosis?
Autosomal dominant
29
What is the difference in presentation between neurofibromatosis type 1 and 2?
Neurofibromatosis type 1: * Axillary freckling * Cafe au lait spots on the chest and back (\>=6) * Renal artery stenosis * Lisch nodules * Phaeochromocytoma Neurofibromatosis type 2: * Bilateral vestibular schwannomas * Meningiomas * Glioblastomas
30
What is the only condition that will lead to a painful thyroid goitre?
De Quervain's thyroiditis (sub-acute thyroidits)
31
What is MR angiography used for?
MR angiography is used for imaging the carotid arteries and intracranial vessels
32
Which drug causes cholestatic hepatitis?
Co-amoxiclav
33
What are the most common areas for a fragility fracture?
The neck of femur, spine and wrists
34
What is a skeletal survey?
A series of x-ray scans of all the bones in the body, commonly used for mutliple myeloma where the bones demonstrate punched out lesions
35
What's seen in the urine of multiple myeloma patients?
Bence Jones proteins
36
What DEXA scan score would indicate osteoporosis?
t= -2.5
37
What is the diagnostic test for AAA?
Abdominal ultrasound
38
Which AAA patients should CT angiography be offered to?
\>5.5cm or query rupture
39
Where are inguinal hernias usually located?
Superior and medial to the pubic tubercle
40
Where are femoral hernias usually located?
Inferior and lateral to the pubic tubercle
41
How long after surgery do incisional hernias occur?
3-6 months
42
What is sephena varix?
Dilation of the saphenous vein due to an incompetent valve proximal to the saphenofemoral junction
43
Why is there tachypnoea in DKA?
Attempt of correcting the metabolic acidosis
44
What is one of the side effects of Carbamazepine?
Hyponatraemia Presentation: * Coma * Somnolence * Cerebellar symptoms
45
What is the presentation of ecstasy overdose?
Hyperactivation of the sympathetic nervous system
46
What is the most common presentation of alcoholic liver disease on FBC?
Thrombocytopaenia
47
What is the most important investigation for suspected thyroid malignancy?
Fine needle aspiration and cytology
48
When are Calcitonin levels ascertained in the thyroid context?
If there is query medullary thyroid cancer
49
What is physiologic jaundice?
Jaundice that occurs days after birth due to increased rate of haemolysis and reduced hepatic clearance in new-borns 2-3 days after birth
50
How are Warfarin's effects monitored?
Via INR
51
How many days prior to surgery should Warfarin be stopped?
3-5 days prior to surgery, unless there are contra-indications such as life threatening emboli
52
If warfarin cannot be stopped 3 days prior to surgery, what actions should be taken?
An INR of less than 2.5 should be achieved and heparin therapy should be given
53
How can lymphoma present on chest x-ray?
Bilateral hilar lymphadenopathy
54
How does mesothelioma tend to present on x-ray?
* Pleural thickening * Plerual effusion * Tumour tends to be peripheral
55
What is retrograde ejaculation?
Ejaculation from the penis into the bladder, commonly as a consequence of TURP`
56
What is the most common malignancy in men 20-40?
Testicular
57
What is the first line investigation for intestinal obstruction?
Supine abdominal x-ray
58
What is IV crystalloid?
IV crystalloid is fluid containing electrolytes eg. NaCl saline
59
What is a Sengstaken-Blakemore tube?
A tube inserted into the oesophagus with a balloon inflated in order to reduce variceal bleeding (commonly in oesophageal varices)
60
What is orthostatic proteinurea?
Abnormal amount of protein passed in the urine when the patient is upright and a normal amount of protein passed when the patient is supine
61
Which organs are most commonly affected by primary amyloidosis?
Kidenys
62
Does amyloidosis cause nephrotic or nephritic syndrome?
Amyloidosis causes nephrotic syndrome
63
What is the most common symptom of interstitial nephritis?
Fever
64
What is the first line managment of perianal abscess?
Incision and drainage
65
Which patients with peri-anal abscesses should be given broad spectrum antibiotics?
* Immunocompromised * Elderly * Patients showing signs of related cellulitis * Cardiac valvular disease * Diabetes
66
What is the post-surgical care of peri-anal abscesses?
Salt baths and analgesia
67
What is the difference between peri-anal and peri-rectal abscess management?
Peri-anal abscesses can be drained in office (surgery, clinic etc) whereas peri-rectal abscesses need to be drained in an opperating theatre where there is adequate access to anaesthetics
68
What is the most common cause of osteomalacia?
Vitamin D deficiency
69
What does anticonvulsant therapy increase the risk of? (particularly carbamazepine and phenytoin)
Catabolism of vitamin D and decreased Ca2+ absorption Carbamazepine can also induce hyponatraemia
70
What does a diagnosis of Sjorgen's syndrome require?
3/4 of: * Positive anti-Ro and anti-La antibodies * Objective ocular involvement eg positive Schirmer's test * Objective salivary gland involvement eg. salivary gland scintigraphy * Salivary gland histopathology
71
What is Schirmer's test?
A strip of paper is placed inside the lower eyelid and the moisture length measured \<5mm within 5 minutes is a postive test Normal is 15mm within 5 minutes
72
What is the ideal INR for patients with AF taking Warfarin?
Between 2-3
73
What is the WHO pain ladder?
74
Measurement of which parameter is the most effective in measuring iron levels?
Ferritin
75
How long do cluster headaches typically last for?
15 mins- 3 hrs
76
What is the definition of significant hyperkalaemia?
K+ \>6mmol/L
77
What tends to exacerbate essential tremors?
Movement
78
What is the most common location for obstruction in acute cholecystitis?
Cystic duct
79
What is the most common cause of acute pancreatitis?
Gallstones, followed by alcohol
80
What is the traid for Budd Chiari syndrome?
* Hepatomegaly * Abdominal pain * Ascites Blood clots blocking drainage from the liver
81
What is a cherry red fovea a sign of?
Central retinal artery occlusion
82
What is typical for a history of allergic bronchopulmonary aspergillosis?
* Bronchiectasis * Eosinophilia
83
How is eosinophilic granulomatosis with polyangiitis distinguished from allergic bronchopulmonary aspergillosus?
Eosinophilic granulomatosis with polyangiitis often includes sinusitis, whereas sinusitis is not present in ABPA
84
Which dermatological sign can present with pneumocystis jerovecii?
Kaposi's sarcomas
85
Which antibodies are positive in PBC?
Anti-mitochondrial
86
What is the difference on neurological examination between myaesthenia gravis and lambert eaton myaesthenic syndrome?
Reflexes will be preserved in myaesthenia gravis, however they will be diminished/ absent in LEMS
87
Which leukocytes are markedly raised in a bacterial infection compared to viral?
Neutrophils
88
Where is acanthosis nigricans commonly found?
* Vulva * Groin * Umbilicus * Axillae * Mammary folds * Nape of the neck * Elbows * Knuckles
89
What are the symptoms of anastamotic leak?
* Abdominal pain * Prolonges ileus * Delayed bowel movements * Delayed passage of flatus * Faeculent drainage * Prurulent drainage Usually 5-7 days post operatively
90
What is the presentation of atelectasis?
* Dysponea * Tachycardia * Febrile One of the most common complications following surgery: * Basal actelectasis following abdo surgery
91
What should be suspected in a patient with a catheter, fever but no urinary signs?
UTI
92
What is the first line investigation in suspected hepatobiliary disease?
Abdominal ultrasound
93
What should be done if an ultrasound scan is normal, but there is clinical suspicion of pancreatic cancer?
Pancreas-specific CT
94
What are plasma tumour markers generally used for?
Guidance in treatment rather than diagnosis
95
What is acute rheumatic fever?
An autoimmune disease following a group A strep infection, typically 2-3 weeks after an URTI has been cleared
96
What are the 5 manifestations of rheumatic fever?
* Carditis (most common) * Arthritis (most common) * Chorea * Subcutaneous nodules * Erythema marginatum
97
Why is raised urea a risk in pneumonia?
Water deprevation developes rapidly in patients with pneumonia therefore urea is an indicator of dehydration

Year 3 Medicine (22 decks)

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