All encompassing Flashcards

Question

Name a bigaunide? What is it used to treat?

Answer 1

Metformin. Type II DM.

Answer 2

- Bronchospasm (in aspirin sensitve pts) - Salicylate poisoning - Reye's syndrome ( v.rare but potentially fatal condition - liver and brain damage)

Answer 3

- SIRS (4 defining features) - Sepsis (SIRS as a result of infection) - Severe Sepsis (sepsis plus organ disorder) - Septic shock (sepsis plus hypotension despite adequate fluid resuscitation)

Answer 4

The probability that the person has the condition. = a / (a+b)

Answer 5

- Dyspnoea (asthma, COPD, PE, foreign body etc.)

Answer 6

- Rows = case/participants - Columns = variables - input data 2 (repitition is a way to remove human error)

Answer 7

Increased toxicity

Answer 8

Service evaluation

Answer 9

Replenish stores with hydroxycobalamin (B12), 1mg IM every other day for 2wks. Maintenance = 1mg IM every 3 months for life.

Answer 10

- Hypersensitivity

Answer 11

RR = the risk in the exposed group / the risk in the unexposed group

Answer 12

ICE them first **SEDATE** - **S**ymptoms (**physical** = hyperventilation, **palpitations**, chest **pain**, **sweating**, diarrhoea, loss of **sleep**, poor **conc**. Psychological = **agitation**, **irritable**, sense of impending doom) - **E**pisodic or continuous (if episodic then it's not GAD = persisent \>6 months) - **D**epression, **drinking** or **drugs** (caffeine & smoking) - **A**voidance or escape (groups of people, certain activities, phobias) - **T**riggers and timing - **E**ffect on **life**

Answer 13

- IN = NSAIDS & Abx - ATN = Lithium, contrast, gentamicin - Renal A stenosis = ACE-i - Glomerular damage = GOLD & NSAIDS

Answer 14

Dry - drusen = accumulation of pigment epithelial waste products

Answer 15

Atrial delay due to mitral stenosis or mitral regurg

Answer 16

- GI obstruction, perforation, haemorrhage - 3-4 days post GI surgery - phaeochromocytoma

Answer 17

A covariate which is affected by the exposure and affects the outcome. It is along the causal pathway and so must NOT be adjusted for.

Answer 18

Short-sightedness. They can't see distant objects. Most common refractive error of the lens.

Answer 19

Naloxone (100-400 micrograms) IV

Answer 20

- Males, obese, high chol, age, dec bile salts

Answer 21

- Oncholysis - Pitting

Answer 22

- group A beta haemolytic strep - TB - preggo - malignancy - IBD - chlamydia

Answer 23

Right ventricular hypertrophy. Extra heart muscles causes stronger positive signal picked up by the leads looking at the right side of the heart

Answer 24

ACEi or ARB (if the ACEi intolerance)

Answer 25

- microscopic haematuria is common

Answer 26

a false unshakeable belief despite evidence to contrary not held by others in same culture and held with intense personal conviction and certainty.

Answer 27

Anterior septal area = Little area

Answer 28

Mitral regurgitation

Answer 29

- Microvascular angina. There is a good hisotry of angina, but on angiography everything is normal.

Answer 30

- Angina, HT, HF, arrythmias - thyrotoxicosis - anxiety - prophylaxis of migraine - treatment of glaucoma (timolol)

Answer 31

- cimetidine, erythromycin, isoniazid, diltiazem inhibit metabolism of carb - OCP & warfarin = dec effect of these. - corticosteroids, phenytoin, ciclosporin = dec effect of carb

Answer 32

- Proportion of variation explained by the linear model - R^2 values range between 0 and 1 - value of one = perfect fit - Adding variables will always improve the fit thereby increase R^2

Answer 33

- falling bp - rising JVP on inspiration - muffled heart sounds Inidicator of cardiac tamponade/constrictive pericarditis

Answer 34

Low: RR=OR Increasing: RR Decreasing: RR changes whilst OR stays the same

Answer 35

Tinea/ringworm

Answer 36

Type 2 - boo hoo

Answer 37

Solid raised lesion \>5cm in diameter. (bigger version of a papule)

Answer 38

increase insulin sensitivity

Answer 39

DIABETES. Mark has diabetes.

Answer 40

Spearmans rank correlation coeff rho - one or both of the variables are ordinal - when the sample size is small

Answer 41

Salbutamol (beta 2 agonist)

Answer 42

Lack of Thiamine (B1) = can cause delirium

Answer 43

- usually monosymptomatic - unilateral optic neuritis - numbness and tingling in the legs - leg weakness - cerebellar dysfunction - GI disturbances

Answer 44

Hodgkins lymphoma

Answer 45

Salivary calculi

Answer 46

NSAIDS & Abx

Answer 47

Aorta (infrarenal) Iliac Femoral Popliteal

Answer 48

Aminosalicylate. Used in UC maintenance of remission.

Answer 49

- Hypoglycaemia - Wt gain

Answer 50

Women 16-24 yo Men 25-34 yo

Answer 51

Protstaglandin analogue and used to treat raised intraocular pressure seen in open angle glaucoma and ocular hypertension.

Answer 52

thiazide diuretics

Answer 53

- oral prednisolone, azathioprine and ciclosporin

Answer 54

- Erythromycin/Clarithromycin - inc risk of SE with antidepressants - dec effect of sublingual nitrates

Answer 55

- Other researchers/evaluators - Research funders - Clinical practitioners - Service users - Society

Answer 56

**- lymphadenopathy** **- night sweats** **- wt loss** - indigestion **- skin discolouration** **- papular rash** **- raised ICP** **- CN palsies**

Answer 57

Allergic eye disease

Answer 58

- RR, oxygen sats, chest expansion, tracheal deviation, percussion, air entry (auscultation) - consider ABG if indicated - Manage using oxygen 15L non rebreathe mask, ?thoracocentesis, resusitative thoracotomy, intubation.

Answer 59

COPD. Also a cause of asthma, lung cancer, pneumothorax.

Answer 60

Anti-convulsant. - Blocks voltage gated sodium channels so stops transmembrane movement of sodium and potassium - prevents spread of epileptic discharge

Answer 61

- pallor - Scars - Muscle wasting - Discolouration (haemosiderin) - ulcers - Hair loss (PVD) - Missing limbs/toes

Answer 62

Person, time and place

Answer 63

More likely to reject the null hypothesis. The use of Yates's continuity correction.

Answer 64

Pneumothorax. trachea may be deviated towards the affected side in a simple, spontaneous pneumothorax.

Answer 65

- GCA (jaw claudication, scalp tenderness, tender non pulsatile temporal artery) - Immediate referral to opthal and start steroids !

Answer 66

Asymmetrical

Answer 67

- Anticonvulsants for all types of epilepsy. - Inc GABA content in the brain by inhibiting GABA transaminase enzyme thereby stopping the re-uptake of GABA - also dec +ve aspartate - blocks voltage gated sodium channels

Answer 68

- Glass of water - Stethoscope - Piece of paper - Tendon hammer

Answer 69

- splenic rupture - meningitis - encephalitis - haemolytic anaemia - Myocarditis

Answer 70

- Caution in severe **pulmonary** or **CV** disease, **psych**, **endocrine**. - caution to susceptible **angle closure glaucom**a pts

Answer 71

- Bronchial muscle contraction - Mucosal swelling and inflammation - increase mucus production

Answer 72

Adrenaline

Answer 73

Loss of outer third of eyebrow hair

Answer 74

- Have you felt that life is not worth living? - Have you ever wished you could die? - Have you ever considered ways in which you could end your life? - Are you planning to end it all?

Answer 75

- Dryness, sweating - Exopthalmos (front, side, above) - Eye movements (H-test) - Lid lag - Mouth (undescended thyroid)

Answer 76

adenocarcinoma

Answer 77

Retinal detachment. The flashes of light are due to the retina being pulled off and stimulating neurons.

Answer 78

Benign paroxysmal positional vertigo

Answer 79

- **Diffuse** * Simple (physiological in puberty and preggo) * AI (firm diffuse - seen in graves and hashimoto's) * Thyroiditis (acute tenderness, swelling and severe pain) - **Nodular** * Multinodular * Single nodular * Fibrotic - **Tumours** * Adenomas * Lymphomas * Carcinomas

Answer 80

ROMANCE - reassure - oxygen - morphone - aspirin - nitrites - clopidogrel - enoxaprin

Answer 81

thyroglossal cyst. on swallowing it will not move. On protrusion of the tongue however, it will.

Answer 82

xi: logistic livedie age i.sex

Answer 83

aortic regurgitation

Answer 84

Microcytic, hypochromic

Answer 85

Whartnon's duct = exits under tongue

Answer 86

Papillary carcinoma

Answer 87

Mitral stenosis

Answer 88

- Facial burns - Neck wounds - Vomit - Epistaxis - head injury

Answer 89

- complete samples (+ no bias introduced by design. - potentially expensive) - unstratified random sampling (+ easy to design and conduct. - some groups may be underrepresented) - stratified random sampling (+ representative of population, unequal sampling of strata imrpoves power for rare strata. - pop may not easily be divisible into strata, partitions may not be known until after sampling)

Answer 90

- pre renal (majority of cases) = renal hypoerfusion so hypovolaemia, sepsis, heart failure renal artery stenosis, NSAIDS, ACEi. - Intrinsic = Acute tubular necrosis most common intrinsic cause. Due to ischaemia (hypo perfusion) or due to drugs. - Post renal = urinary tract obstruction

Answer 91

TOWARDS = POSITIVE

Answer 92

CONFOUNDERS

Answer 93

Two peaks of incidence = 15-30 and over 55 EBV

Answer 94

Iron def anaemia.

Answer 95

- Malignancy (breast lump, lungs, prostate, bowels, jaundice,) - GI (colon cancer, IBD, coeliac) - Endo (thyrotoxicosis) - Psychological (anorexia, depression, stress) - DM TI

Answer 96

- Smoking - ETOH - Bronchial obstruction - Bronchiectasis - Immunosuppression

Answer 97

- Decrease albumin - Normal protein

Answer 98

- inadequate collateral circulation - evidence of peripheral vascular disease - coagulopathy or high dose anticoag therapy

Answer 99

Many People Like To Nap Naked M = metformin P = potassium sparing diuretics L = lithium T = tetracyclines N = Nitrofurantoin N = NSAIDS + all the drugs that can cause Renal failure (NSAIDS, ACE-i, Abx, gentamicin, Gold, contrast, lithium)

Answer 100

Neural tube defects in the newborn

Answer 101

- Staph and strep - HPV, HSV, Herpes zoster - Tinea, candida and yeasts

Answer 102

Type I DM. There is no HLA assoc with type III

Answer 103

Seen in DM retinopathy. Dot = microaneurysm. Blot = haemorrhage

Answer 104

Parotid gland

Answer 105

All Sane Men Think That Pizza Is Italian

Answer 106

- Vomiting - Potassium depletion (diuretics) - Cushing's syndrome - Conn's syndrome (primary hyperaldosteronism)

Answer 107

- Give oxygen 15L/min via reservoir bag mask - sit pt up and attach monitorin - Use Look, Listen, Feel Look (RR, cyanosis, effort, chest injury, coughing) Listen (ability to complete full sentences, noisy breathing, coughing, percussion note, bilateral air entry, vescicular/bronchial breath sounds, creps, vocal resonance) Feel (pulse, trach deviation, chest expansion, surgical emphysema)

Answer 108

- Neisseria meningitidis - Streptococcal pneumoniae

Answer 109

Mitral stenosis

Answer 110

- review ABC - check pupils - AVPU/GCS - E4, V5, M6 - Glucose - Temp

Answer 111

- Gradual or sudden severe epigrastric or central abdo pain which radiates to the back, relieved on sitting on forward. Along with prominent vomiting.

Answer 112

- palpitations - chest pain - Breathlessness - cough - sputum - leg swelling

Answer 113

Pt lying on bed - tempt - joint lines (knee flexed, feeling for tenderness) - palpate collateral ligs and patello fem joint - measure quadriceps circum and compare - patella tap for large effusions and sweep test for small effusions - popliteal swellings

Answer 114

DANISH - D = dysdiadokinesis - A = apraxia - N = nystagmus - I = intention tremor - S = speech disturbances - H = Hypotonia

Answer 115

It measures existing practice against evidence based clinical standards

Answer 116

- cont or discrete - ordered variables

Answer 117

- Age - smoking - sun - diet - alcohol

Answer 118

Made in adrenal cortex. Mineralocorticoids. Electrolyte balance

Answer 119

- DM - Retinal detachment - ARMD - Trauma

Answer 120

Rhino-sinusitis

Answer 121

- Proteinuria - Oedema - Hypoalbuminaemia - hyperlipidaemia

Answer 122

Primary - anxiety - hypoxaemia - Pain/distress - salicylate toxicity - fever Secondary (metabolic acidosis)

Answer 123

- Common cold - influenza - Acute tonsillitis - Coryza less common = barotrauma, sinusitis, trauma of tymp membrane

Answer 124

Hyphaema (trauma, intraocular surgery)

Answer 125

Painless obstructive jaundice

Answer 126

- confirm identity of patient, date and time - PA or AP film - RIPE (rotation - check clavicles and spinous processes, inspiration - \>7 ribs, penetration, exposure) - A (airway - trachea central or deviated) - B (breathing - assess lung markings throughout lung fields - C (cardiac - evdince of cardiomegaly) - D (diaphragm - any signs of gas underneath) - E (Everything else - bones, soft tissue, lines, pacemakers)

Answer 127

- chronic = prevalence will be higher than incidence - incurable = prevalence inc at same rate as incidence - acute = incidence will be higher than prevalence

Answer 128

The size of a population at risk can vary over time: - individuals who are born or die - individuals who get and keep the disease - individuals who join or leave the study

Answer 129

No cure but slow progression

Answer 130

Chronic Hepatitis B infection

Answer 131

- adhesions - hernias - crohns - intersusception

Answer 132

Pleural effusion

Answer 133

- jaundice - hepatic encepahlopathy - fetor hepaticus (pear drops) - Asterixis - constructional apraxia

Answer 134

- Asthma - LVF (pink frothy sputum)

Answer 135

II, III, aVF

Answer 136

Sideroblastic anaemia (rare but in 20% of the elderly with a low MCV, without iron def, think of sideroblastic anaemia)

Answer 137

- Thyroid gland (each lobe) - Palpate whilst swallowing and then protruding their tongue - Lymphadenopathy - Tracheal deviation

Answer 138

Inspiration

Answer 139

- Distal tubule - Thiazide diuretics (bendroflumethazide) - Potassium sparing diuretics (spironalactone) - HTN, oedema, HF, ascites in liver cirrhosis - Addison's disease

Answer 140

- fever - sore throat - lymphadenopathy - splenomegaly - petechial haemorrhage

Answer 141

Underdiagnose

Answer 142

AMPLE - ALLERGIES - medication - PMHx - last meal - events

Answer 143

Doppler US probe (listen for flow in incompetent valves

Answer 144

- Detailed examination of whole body - Reassess - Prevent heat loss and maintain dignity

Answer 145

Risk of severe hyperkalaemia

Answer 146

Malignant otitis externa. (likely pseudomonas aeruginosa or anaerobes). 50% facial palsy.

Answer 147

- sweating - indigestion - diarrhoea - Nausea - trembling - dry mouth - palpitations

Answer 148

Hepatitis B

Answer 149

- anosmia - depression - dementia - mild urinary freq and urgency - visual hallucinations - sleep disturbances

Answer 150

- conn's syndrome - chronic kidney disease - cushing's syndrome

Answer 151

OR = case-control/trial studies looking at prevalence RR = cohort studies looking at incidence OR is used when outcome or exposure is low BUT OR is stable as outcome prev changes

Answer 152

Myelosuppression

Answer 153

- prophylaxis of embolism in AF, prosthetic heart valves, rheumatic heart disease - proph of DVT/PE - TIAs

Answer 154

Coeliac disease. Prolamin intolerance leading to villous atrophy and malabsorption.

Answer 155

- Cardiovascular exam - ABPI if indicated - lower limb neuro exam

Answer 156

- Generalised anxiety disorder (high level of background anxiety) - Panic attacks - Phobias

Answer 157

- Obsessive alcohol consumption - Increased tolerance - Narrowing of drinking repertoire - Withdrawal symptoms - Having to reinstate to alleviate withdrawal symptoms - Saliency (alcohol taking over form competing needs and responsibilities) - Continued drinking despite negative effects of alcohol on health

Answer 158

500mg of phenoxymethylpenicillin tds for 10 days

Answer 159

SE = Sd/route(n)

Answer 160

Systemic inflammatory repsonse syndrome. Temp 38 HR \>90bpm RR \>20breaths/min WCC 12

Answer 161

- Haematuria - Proteinuria - Hypertension - Low urine volume

Answer 162

normal findings

Answer 163

0.12 seconds. (3 small sqaures)

Answer 164

Duke criteria - postive blood cultures - endocardium involved + - predisposing factors - fever - vascular signs

Answer 165

- Pain - Discharge - Obstruction/congestion - Nose bleeds - Loss of smell

Answer 166

- How old are you? - What's your date of birth? - What's the year? - What is the time of day? Give address (42 west street) - Where are we? - Who is the current monarch? - What are the dates of the first world war? - Count backwards from 20 to 1 - Recognise two people - Can you remember the address?

Answer 167

- Stroke - Renovascular disease - limb ischaemia - HEART disease

Answer 168

- hepatic dysfunction - acute porhyria

Answer 169

The probability that the person does not have the condition. = d / (c+d)

Answer 170

- study planning - implementation - dissemination

Answer 171

mitral stenosis.

Answer 172

- BRADYKINESIA + (1 other) - Tremor (worse at rest) - Rigidity (inc tone) - Postural instability

Answer 173

- smoking - anxiety - tachycardia, haemorrhage, shock - hypokalaemia, pericarditis, MI - Bundle branch block - WPW

Answer 174

Nodular. - telangectasia - pearly rolled edge

Answer 175

1 - 1.25 mmol/L

Answer 176

- ABCDE approach - sit pt up - Oxygen 15L/min via reservoir mask - obtain IV access and take bloods - ABG - Salbutamol 5mg nebulised with oxygen (15-20min intervals) - Ipratropium bromide 500mcg nebulised with oxygen (4-6 hourly) - IV 200mg hydrocortisone - IV 2g magnesium sulphate over 20 mins - CXR to exclude infection and pneumothorax

Answer 177

Viral (rhinovirus, adenovirus, parainfluenzae)

Answer 178

Tinea capitis

Answer 179

- Sphenoid - Ethmoid - frontal - Maxillary

Answer 180

All (appearance & behaviour) Sane (speech) Men (mood) Think (thought process) That (thought content) Pizza (Perceptions) Is (insight) Italian (IQ)

Answer 181

Addison's disease (adrenal insufficiency)

Answer 182

Ann-Arbor stage 1 = localised single area of lymph nodes stage 2 = two adjacent areas of involvement - either above or below diaphragm stage 3 = areas in nodal areas both above and below diaphragm stage 4 = multiple nodal areas plus involvement of one or more extra nodal areas (liver lung)

Answer 183

Chlamydial

Answer 184

Enlarged virchows node.

Answer 185

- Sinus brady, AV block, SA block. - Caution with hypersensitivity, hepatic impairment, preggo

Answer 186

- prestige bias - recall bias - response bias

Answer 187

Blocks the beta receptors on the ciliary epithelium and therefore reduces aqueous humour production.

Answer 188

(true pos + true neg a+d)/(total)

Answer 189

HLA DR4/DR1 (assoc with inc severity)

Answer 190

- Observe for lid lag (follow movement of finger = hyper) - H-test testing for ocular palsy seen in Graves

Answer 191

Over diagnose

Answer 192

- Pleomorphic adenoma (benign, female) - Warthins tumour (adenolymphoma, benign, male)

Answer 193

In the morning

Answer 194

Menstruating women

Answer 195

Temperate climates. if adults migrate they take their risk with them. Children acquire the risk of where they settle.

Answer 196

Assoc with psoriasis. Scratch and gentle removal of scales cause capillary bleeding.

Answer 197

Aortic regurg. Duroziez's sign = to and fro murmur heard when the fem artery is auscultated and pressure applied distall. Quincke's sign = capillary pulsation in nail beds. De Musset's sign = head nod with each heartbeat.

Answer 198

Benign tumours of thyroid gland which produces excessive amounts of thyroid hormones. Always arise follicular cells of the thyroid.

Answer 199

AWAY from that lead

Answer 200

Longest = Hepatitis B avg 100 days Shortest = avg 28 days Hep A

Answer 201

- HTN - Rheumatic heart disease - MI/IHD - Thyrotoxicosis - Alcohol

Answer 202

- vertigo - Presyncope - Disequilibirum - Light headedness

Answer 203

- Tonsillitis

Answer 204

- CALL FOR HELP - oxygen via 15L reservoir mask - Basic airway manoeuvres (head tilt/chin lift, jaw thrust) - airway adjuncts (oropharyngeal airway or Guedel airway)

Answer 205

Elevation \>1mm = MI Depression = ischaemic myocardial tissue in the ventricles

Answer 206

Angina of recent onset (

Answer 207

- functional - theoretical (acceptable culture) - speculative

Answer 208

0.12 to 2 secs 3-4 small squares

Answer 209

Chronic liver disease

Answer 210

Women \> Men.

Answer 211

Lack of thiamine can lead to Wernicke's encephalopathy (opthalomoplegia, ataxia, confusion)

Answer 212

Unknown cause. Secondary causes include obstruction (DVT, fetus), valve destruction, constipation, arteriovenous malformation

Answer 213

- COPD/Asthma - Cardiogenic shock - Bradycardia - Hypersensitivity - Hyperthyroidism - Diabetes

Answer 214

- Suppurative infection caused from a haematogenous spread - or from direct spread from a penetrating trauma

Answer 215

Hypocalcaemia

Answer 216

- Infections (hepatitis) - Drugs (para overdose) - Vascular (Budd Chiari synd) - Others (alcohol, primary biliary cirrhosis, alpha 1 antitryp def)

Answer 217

- P wave preceding each QRS complex - look at whether they occur regularly

Answer 218

- Haematological (anaemia - SOBE, weakness, palpitations, angina, claud) - Endo (hypothyroid, DM) - Pscyh (depression) - malignancy - Chronic infection (TB) & addisons - Drugs

Answer 219

- permissions = governance - voluntary participation = consent - minimise risks and max benefits = ethics

Answer 220

- Arrhythmia - cerebellar syndrome

Answer 221

- chronic pain - GI problems - Nervous system problems - reproductive problems

Answer 222

Type I respiratory failure. PaCO2 could be normal or low.

Answer 223

Yellow and sticky

Answer 224

Assessment of risks to others? - have you ever thought about harming somebody else? - Are there people you know who would be better off dead?

Answer 225

- Kidney injury - Dehydration - GI bleed - increased protein breakdown (infection, trauma, malignancy)

Answer 226

RRAW - Rate - Rhythm - Axis - Waveform (various parts of the ECG)

Answer 227

- urinary incontinence or retention - faecal incontinence - saddle anaesthesia - unilateral or bilateral weakness in legs - hyperreflexia - wt loss

Answer 228

Linear model

Answer 229

- Financial problems - Divorce - Traffic violations & criminal offences - Job loss - Social isolation

Answer 230

- Age related = most common - Traumatic - Post inflam (recurrent uveitis) - Metabolic (DM)

Answer 231

- Temperature - Cap refill Pulses Arm = radial, radial radial delay, brachial, bp, carotid Legs = femoral, popliteal, post tib, dorsalis pedis Sensation - start distally

Answer 232

You would expect to see the most negative deflection in aVR. This is due to aVR looking at the heart in the opposite direction to the overall electrical activity.

Answer 233

Myelosuppression - inc infection risk, overwhelming neutropenic sepsis

Answer 234

Cortisol. Glycogen and lipid metabolism. Made in adrenal cortex

Answer 235

- symptoms of anaemia - **Lemon** tinge to skin (pallor + jaundice (haemolysis)) - **Neuropsych** (irritable, depression, psychosis) - **Neuro** (Parasthesiae, peripheral neuropathy, SCDSC)

Answer 236

- conduction defects and not by increased mass of the left ventricle

Answer 237

HIDEMAP-H H - hypoxia I - Infection D - drugs E - endocrine M - metabolic A - alcohol withdrawal P - psychosis H - head injury

Answer 238

- Hypoglycaemia

Answer 239

- clinically unimportant/irrelevant variables - variables that are too difficult/costly to collect - variables that require invasice or potentially sensitive measurement

Answer 240

- Asymptomatically - Palpitations - dyspnoea - chest pain - faintness

Answer 241

Survival function = as the chance of survival until a certain time Hazard function = as the chance of instantaneous failure at any one time

Answer 242

- nasal obstruction (nasal tumour, nasal polyps, foreign body) - infection in neighbouring tissue (tonsils, adenoids) - URTI - pre-existing rhinitis

Answer 243

- amiodarone, cimetidine, OCP, warfarin, rifampicin, nifedipine. THERE ARE FRICKING LOADS! Just think P450.

Answer 244

- Amiodarone (anti-dysrhythmic) - supraventricular/ventricular arrhythmias & tachyarrythmias assoc with Wolf-Parkinson White syn. - Nausea & vomiting, bradycardia, **thyroiditis**, **photosensitivity**, pulmonary fibrosis, sleep disturbances - Beta blockers, phenytoin, warfarin, digoxin, diltiazem

Answer 245

Prospective: pros = record ALL variables, using BEST techniques and applied consitently. ALL participants provide data on ALL variables. Cons = time and resource intensive. collect more variables than you need. Retrospective: pros = data already there. quick and not resource intensive Cons = can not chose which variables are measured or number of participants. no role in level of missingness

Answer 246

- ciclosporin

Answer 247

Adenocarcinoma. - fungating - malignant ulcers - infiltrating carcinoma

Answer 248

- Drusen - atrophy - scarring and pigmentation - haemmorhages

Answer 249

- Warfarin - Aspirin - all other anticoagulants

Answer 250

Nausea, abdo pain, diarrhoea. NOT hypoglycaemia

Answer 251

Acute pancreatitis. In assoc with fever, grey-turner's sign

Answer 252

Atrial delay due to mitral stenosis or mitral regurg

Answer 253

- Fever - Dyspnoea - Cough - Purulent sputum - Haemoptysis - malaise - Rigors

Answer 254

DEPRESSION - D = **depressed** mood E = **energy los**s P = **pleasure lost** R = retardation E = **eating habits changed/wt loss** S = **sleep disturbances (early morning waking)** S = suicidal thoughts I = I'm a failure (low self esteem) O = Only me to blame (pessimism) N = no concentration Screen for: - Mania - Anxiety - Delusions - hallucinations

Answer 255

Oxytocin and Vasopressin (ADH)

Answer 256

Wet macular degeneration. Aim to minimise angiogenesis to stabilise vision.

Answer 257

- Age \> 75 - CKD - cardiac failure - liver disease - PVD - DM - Nephrotoxins (iodinated contrasts, gentamicin, NSAIDs, ACE-i) - Hypovolaemia & sepsis

Answer 258

Intrinsic factor in the stomach

Answer 259

- Disturbed central vision (scooter, blurring, distortion) - Difficulty appreciating detail (reading fine print, recognising faces)

Answer 260

Sjogren syndrome

Answer 261

- Painless enlargement of a group of lymph nodes - night sweats - unexplaine dwt loss - splenomegaly - hepatomegaly - non specific pain

Answer 262

Uveitis. HLA-B27

Answer 263

- Polyuria - Polydipsia - Prone to infection - blurry vision - No loss of feeling or pins and needles in your legs - mood - Lethargy - exlcusion of UTI

Answer 264

Mitral stenosis

Answer 265

Extra-pyramidal SE: acute dystonic reactions - rarely galactorrhoea, cardiac conductive abnormalities, drowsiness

Answer 266

- Optic disc (cupping, pallor, splinter haemorrhages) - Raised intraocular pressure - RAPD if asymp adv glaucoma

Answer 267

- Aminoglycosides (gentamicin) - Salicylates (aspirin) - Loop diuretics (furosemide)

Answer 268

Rheumatoid arthritis

Answer 269

Pearson correlation coefficient R. Value r lies between -1 & 1. R =1 = perfect positive correlation. R = -1 = perfect neg correlation. R = 0 = no correlation. R

Answer 270

Acute otitis media

Answer 271

Pulmonary renal syndrome. Anti-GBM Abs bind to kidney glomerular membrane and lung alveolar membrane and cuase a type II hypersensitivity reaction. HLA DR2 assoc Serology = anti glomerular basement membrane Abs of IgG can be found in good pastures. definitive diagnosis is made on renal biopsy as it shows a classic linear staining on direct immunofluorescence. Presenting symptoms: cough, intermittent haemoptysis, haematuria.

Answer 272

rise in bicarb

Answer 273

xi: regress weight height age i.sex (just need to tell stata which variables are categorical)

Answer 274

- Recent wt loss (malignancy) - Recent foreign travel (TB)

Answer 275

- Skin turgor - HR, CRT, BP, JVP - sunken eyes - mucosal membranes - auscultate chest, abdo distension, urine output - haemorrhage, burns - confusion

Answer 276

- K+ sparing diuretics - NSAIDS - ACE-i - Trimethoprim

Answer 277

Loperamide. Acts on opioid receptors in myenteric plexus. Inhibits peristalsis by inhibiting Ach release.

Answer 278

- Liver cirrhosis - Pancreatitis - Liver cancer - Peptic ulcer disease - Hypertension etc.

Answer 279

- Neoplastic polyps - IBD - FAP - HNPCC - smoking - previous cancers - low fibre diet

Answer 280

Ventricular repolarisation

Answer 281

Glomerular damage

Answer 282

PE. Along with immobility, leg fractures, preggo, thrombophilia.

Answer 283

- Constant or episodic? - Duration? - Triggers? - Assoc symptoms (pain, hearing loss, tinnitus, n&v)

Answer 284

Vestibular neuronitis

Answer 285

Firm diffuse goitre

Answer 286

- Stroke - Renovascular disease - limb ischaemia - HEART disease

Answer 287

- thrombosis in situ - cardiac emboli - atherothromboembolism - CNS bleeds

Answer 288

21-hydroxylase adrenal autoantibodies. - Get a CXR/AXR for signs of TB

Answer 289

Fatality = number of cases who die / number of cases with disease Cause specific mortality = number of cases with disease who die / total number of any cause deaths

Answer 290

- Rate - Rhythm (regular or irregular)

Answer 291

A missing variable. Use a proxy variable.

Answer 292

- hypovolaemia (CRT, pulse, bp, JVP, skin turgor, pulm oedema, periph oedema, urine output, wt) - palpable bladder? - signs of vasculitis (wt loss, fever, rash, uveitis, haemoptysis, joint swelling) - bruits

Answer 293

PE. Looks at the risk factors and a score \>3 = probable chance of getting a PE

Answer 294

- methotrexate, ciclosporin, mycophenolate, retinoids (acetretin)

Answer 295

- Dihydropyridines (amlodipine - vascular resistance and arterial pressure lowering) - Non-dihydropyridines (verapamil - mycordial selective) - Benzothiapine (diltiazem - somewhere between amlodipine and verapamil = vasodilatory and cardiac depression)

Answer 296

- whether they get dizzy/LOC on standing from a lying position - recently started on or change their anti-hypertensive medication

Answer 297

- Infections (hepatitis) - Drugs (para overdose) - Vascular (Budd Chiari synd) - Others (alcohol, primary biliary cirrhosis, alpha 1 antitryp def)

Answer 298

- Present of heart block - wolf parkinson white syndrome

Answer 299

- Nausea - Abdo discomfort - Dark stools - Constipation

Answer 300

- Diabete Mellitus - Hypertension - chronic glomerulonephritis disease

Answer 301

- N&V + the usual - Stevens-Johnson syn. & toxic epidermal necrolysis - hypersensitivity reactions

Answer 302

- Infection (meningitis - fever, rash, photophobia, neck stiffness. abscess) - Inflammatory (Tension headache - late in day, assoc with stress. Cluster headache - painful attacks around one eye, lacrimation, occurs 2xday for 1-3mnths. GCA - throbbing scalp pain, jaw claudication) - Vascular (stroke, TIA, SAH - think about assoc motor/sensory weakness) - Trauma (head injury) - Raised ICP (worse in morning, leaning forward, coughing) - Extracranial (Glaucoma - pain around eye, swollen red eye. Sinusitis - congestion, facial pain leaning forward. Scleritis - burning pain to temple) - Drugs (nitrates, analgesia overuse, caffeine)

Answer 303

Log rank test or Cox proportional hazards modelling

Answer 304

- Liver cirrhosis - Non-alcohol fatty liver disease - hepatocellular carcinoma - Wilsons disease

Answer 305

Sinonasal cancer

Answer 306

Rheumatoid arthritis

Answer 307

- chronic plaque psoriasis - guttate, seborrhoeic, flexural, pustular, erythrodermic

Answer 308

Asterixis (CO2 retention flap)

Answer 309

Both. Ethmoidal arteries = internal carotid. Maxillary and facial arteries = external carotid

Answer 310

Rasagiline. (alternative to dopamine agonists in the treatment of PD). SE = postural hypotension and AF

Answer 311

GET SMASHED G = gall stones E = ethanol T = trauma S =steroids M = mumps A = autoimmune S = scorpion venom H = hyperlipidaemia, hypothermia, hypercalcaemia E = ERCP D = drugs

Answer 312

Stimulates receptors to produce intracellular cAMP. Dec in intracellular cAMP leads to bronchodilatation.

Answer 313

- inhibits phospholipase A2 activity which dec arachidonic acid production - arachidonic acid is a precursor for prostaglandins and leuktorien synth (inflam). so by dec arach acid = anti inflamm effect. - dec B and T lymphocyte response to antigens = immunosuppressive effect

Answer 314

Increases insulin secretion

Answer 315

Pupulation = every member of a defined group of interest Sample = subset of a population, intended to be representative of that population, from which we can explore the population by inference

Answer 316

Retinal vein occlusion

Answer 317

- Location (midline, ant triangle, post triangle) - Size (width, depth, height) - Shape (well defined) - Consistency (Smooth, rubbery, hard, nodular, irregular) - Temperature - Overlying skin changes (erythema, ulceration etc.) - Fluctuance - Transillumination

Answer 318

- TIA/stroke - Parkinsons - Seizure - Vasovagal

Answer 319

- megaloblastic = B12 def (dietary, malabsorption, congenital), folate def, cytotoxic drugs - non megaloblastic = alcohol, preggo, hypothyroidism, reticulocytosis

Answer 320

- women = legs - men = trunk

Answer 321

- Hypertension - Smoker - female - Family history

Answer 322

- Lithium - Contrast - gentamicin

Answer 323

Some Certain Silly Compounds Annoyingly Inhibit Enzymes, Grrrr.

Answer 324

- Malnutrition - liver disease - Preggo

Answer 325

- Aortic stenosis - Postural hypotension - Arrhythmia

Answer 326

regress weight height age

Answer 327

Acne vulgaris

Answer 328

Hyperopia.

Answer 329

Increase in ACTH which cross reacts with melanin receptors

Answer 330

Metabolised to NO which causes coronary artery/systemic vein vasodilatation

Answer 331

ALT sources = LIVER. AST sources = liver, skeletal muscle, heart, pancreas, kidneys

Answer 332

RA + splenomegaly + neutropenia

Answer 333

Only influences the outcome

Answer 334

- a non linear relationship between 2 variables - outliers present - there are distinct sub groups - onr or both of the variables is not normally distributed - one or both variables is non-numeric

Answer 335

- excision - mohs micrographic surgery - radiotherapy

Answer 336

Based on clinical presentation and the attacks must last \>1 hr and there must be \>30days between attacks. - MRI abnormality

Answer 337

Chlamydial

Answer 338

- size of sample - level of confidence requried - variability of characteristics being studied (he greater the variability of the characteristic, the greater the standard deviation which increases the standard error and so increases the width of the confidence interval.)

Answer 339

Hyper = more prone to AF which can cause dyspnoea Hypo = pleural effusions

Answer 340

- S.aureus - Pseudomonas - Proteus

Answer 341

Haemolysis

Answer 342

n-1. (n = sample size)

Answer 343

- ischaemia - anxiety - tachycardia - digoxin toxicity - Haemorrhage, hypokalaemia, myocarditis - Coronary artery insuff - MI

Answer 344

Furosemide. Inhibits sodium and potassium reabsorption.

Answer 345

Terminal ileum

Answer 346

- Dyspnoea (SOB) - Fatigue (if pt presents saying "i'm tired all the time", have anaemia as a differential - Palpitations - Faintness - Headache

Answer 347

- Otalgia - Discharge - Hearing loss - Tinnitus - Vertigo - Dizziness

Answer 348

- Duration - how many lumps? - Size change - skin changes - Painful - Assoc symptoms

Answer 349

- bronchoconstriction - fatigue - Bradycardia - cold extremities

Answer 350

- CV disease - hyperthyroidism - DM - hypokalaemia

Answer 351

HYPOGLYCAEMIA. Wt gain

Answer 352

Specificity - true negatives. = d / b + d = true negatives / false positives + true negatives

Answer 353

3.5-5 mmol/L

Answer 354

Retinal vein occlusion

Answer 355

- Suppression of allergic/inflamm disorders - IBD - asthma - rheumatoid disease - Immunosuppression

Answer 356

Hyperventilation

Answer 357

Case-control

Answer 358

Gliclazide. Type II DM.

Answer 359

Alcohol dependence screening. - Cut down - Angry/annoyed - Guilty - Eye opener

Answer 360

- Chronic pain - Problems with GIT - Problems with nervous system - Problems with reproductive system

Answer 361

- macula oedema - retinal haemorrhages - vitreous haemorrhages - neovascularisation

Answer 362

Thumb sign

Answer 363

Group A Beta Haemolytic strep

Answer 364

Otitis externa.

Answer 365

- Intro (WIPE) - Check understanding - Explain what it is * Invasive procedure which allows doctor to view the lining of your oesophagus, stomach and the first part of your small intestine. * Involves passing a flexible tube through the mouth, down the oesophagus and into the stomach. The tube is about the width of the index finger. - reason for it * accurate way to diagnose and sometimes treat conditions that have been causing you problems * visualisation of any abnormalities * Painless biopsies which help in the diagnosis - Procedure details * Prep (clear fluids 8hr before, NBM 4 * During (either sedated (GA not recommended - (midazolam IV)) or unsedated with a throat spray of local anaesthetic (lidocaine) * After (if under GA then accompanied for 24 hrs. Go home within 2-4 hrs. DO NOT drive, operate machinery, drink alcohol, sign legal docs for 24 hours) - Risks and benefits * Sore throat (very common but short lived) * Perforation and haemorrhage (rare but serious, need to stay in hospital) * Reaction to sedative drugs * Risk of damage to teeth and dental bridge work * Alternate = barium meal but does not allow for tissue diagnosis

Answer 366

The likes of confounders and competing exposures which undermine the associations between the two main variables. (we can eliminated these though aslong as we identify- DAG, and measure them)

Answer 367

- Nasal endoscopy - CT paranasal sinuses - Microbiology

Answer 368

BUFALO - Blood cultures prior to Abx administration - U = urine output (catheter) - F = fluids to treat hypotension/clinical shock - A = broad spectrum Abx - L = Serum lactate and Hb - O = 15L/min oxygen via reservoir bag

Answer 369

Acute mastoiditis. - Earache, - Profuse creamy discharge - conductive deafness - Pinna is looking like elephant ears - Pt looks v unwell. Pyrexial.

Answer 370

IV cefotaxime

Answer 371

- the mean effect is greater - variation in the effect is smaller - your sample is bigger (you can calculate your sample size and adjust in order to make sure your CI are stat significant. e.g if n = 49 CI (-0.1 to 2) and n = 50 (CI 0.1 to 2) then you could say that \>50 = sufficent power to produce a significant result. If CI does not include zero then it is significant at p

Answer 372

Non-hodgkins lymphoma

Answer 373

- **red** **reflex** = comment on **opacification** like **cataracts** - **Optic** **disc** (**colour**, **contour**, **cupping**, size, shape) - **Vessels** (**A-V nipping** (HTN), **copper** wiring, narrowing of A., **neovascularisation**) - **Retinal** background (**dot** and **blot** haemorrhages, **flame** and **spinter** haemorrhages, hard and soft **exudates**, microaneurysms, **cotton wool spots**) - **Macula** (**drusen**, haemorrhages, hard exudates) & then **foveal reflex**

Answer 374

yes if needed.

Answer 375

- deflection in lead one to become more positive - deflection in lead three to more negative LEFT axis deviation = leaving each other

Answer 376

Hyperinflation

Answer 377

- Exopthalmos (look from front, side and above) = graves - Lid retraction (more sclera visible than normal) - Periorbital swelling (hypo) - Madarosis (hypo) - Conjunctival chelosis (hyper)

Answer 378

Hodgkins lymphoma

Answer 379

Chronic Hepatitis B infection

Answer 380

Acute anterior uveitis

Answer 381

Tension headache

Answer 382

- Tonic clonic seizures - partial seizures - Trigeminal neuralgia (second line treatment is phenytoin) - proph of bipolar disorder unresponsive to lithium

Answer 383

- Diuretics

Answer 384

Hepatocellular carcinoma

Answer 385

Small artery vasculitis (ANCA positive). - lesion in URT, lungs and kidneys. - symptoms = nasal obstruction, cough, haemoptysis, pleuritic chest pain. possible eye signs like scleritis, uveitis, retinitis. - CXR showing multiple nodular masses

Answer 386

- Is it both legs? - Any pain? - Any skin changes? - Is there oedema elsewhere? - trauma (surgery..) - Preggo? - Mobile? - Medication (HRT/OCP)? - Any skin pitting?

Answer 387

Pus in the eye

Answer 388

non selective beta blocker used to treat open angle glaucoma.

Answer 389

Osteoarthritis. DIP.

Answer 390

- inherited disroder affecting young men. - dorsal columns affected so loss of vibration and proprioception - deep tendon reflexes absent

Answer 391

- external validity (stratified and random sampling) - confounding (adjustment or random sampling)

Answer 392

Young = ant Elderly = starts to move more posteriorly

Answer 393

Autoimmune disease. Usually occurs secondary to RA. - xerostomia - keratoconjunctivitis sicca

Answer 394

- Hepatitis A - Hepatitis C - Hepatitis A - Hepatitis C - Hepatitis C

Answer 395

- Note clarity, particles and colour before removing the lid of container - remove the lid of container and check odour - check multistix container is intact and in date. DO NOT use if stored in humid environment or if out of date - Remove a strip from container and replace lid - dip test strip into urine and wet all test zones - do not leave in urine for more than one second - remove strip from urine and drag edge on container to remove excess urine - replace lid - take note of time and compare test zones against those on multisite container at appropriate time - Note any abnormalities - dispose of waste appropriately (urine down sluice, container into clinical waste bin, fold test strip inside gloves as you remove them) - wash hands - record results

Answer 396

Pars tensa

Answer 397

- Aura (migraine) - Nausea - Vomiting - Photophobia (migraine) - Neck stiffness (meningitis, SAH) - LOC (SAH) - Fever (meningitis) - Rhinorrhoea (cluster)

Answer 398

Inhaled steroid

Answer 399

- renal failure

Answer 400

- Dry skin and lips - hepatotoxic? - teratogenic

Answer 401

Linear regression Logistic regression (most likely a binary outcome)

Answer 402

Type 2 resp failure with metabolic compensation from raised bicarb. PaO2 could be normal or low

Answer 403

Fisher's exact test. If the contingency table fails to meet the conditions required for chi squared.

Answer 404

Iodine def

Answer 405

- dyspepsia - wt loss - vomiting - dysphagia - anaemia

Answer 406

Inc statin conc and therefore inc risk of rhabdomyolysis

Answer 407

Left side = bleeding/mucus/mass on PR, tenesmus, altered bowel habit/obstrcution. RIght side = wt loss, anaemia, abdopain. Either side = abdo mass, haemorrhage, perforation

Answer 408

Bell's palsy

Answer 409

Flumazenil

Answer 410

- Encephalitis - Septicaemia - Malaria - Dengue & tetanus

Answer 411

- Blurred vision - Increased pigmentation of iris - darkening of eyelid skin colour - darker, thicken eyelashes

Answer 412

Opposite the 2nd upper molar. (parotid duct)

Answer 413

Lobar pneumonia

Answer 414

- Longer = complex originated in ventricles - Shorter = complex is supraventricular in origin

Answer 415

Koebner phenomenon. Linear eruption arising at the side of trauma. See in psoriasis

Answer 416

Relative afferent pupillary defect

Answer 417

Pneumonitis, oral ulcers & hepatotoxicity

Answer 418

- systemic infection - hypersensitivity - osteoporosis - glaucoma - recent MI - preggo - vaccines

Answer 419

Generalised anxiety disorder Panic attacks Phobias

Answer 420

- Anti-convulsant - Partial seizures, primary/secondary generalised tonic-clonic seizures - lennox gestaut syndrome seizures - trigeminal neuralgia

Answer 421

- Barret's oesophagus - Smoking - GORD - Obesity

Answer 422

- Cotton wool spots - Dot and blot haemorrhages - hard exudates - microaneurysms

Answer 423

Correcting sample statistics to make them: - better estimates of the true population - comparable to other samples/populations with different baseline characteristics

Answer 424

Digoxin. Inhibits sodium/potassium pump to inc intracellular sodium conc which inhibits sodium/calcium pump. Dec calcium pumped out of cell = inc force of contraction. Also inc vagal activity and reduced HR/AV node conduction. - HF, and supraventricular arrhythmias (AF)

Answer 425

Pernicious anaemia

Answer 426

It measures the number of cases that exist at a specified time point in a population at risk

Answer 427

Weaker on inspiration. Asthma, PE, Tension pneumothorax, COPD. Abnormally large dec in systolic blood pressure and pulse wave amplitude during inspiration.

Answer 428

- Type 1 resp failure - Hypotension - Pleural effusion - Empyema - Lung abscess - AF

Answer 429

- retinopathy - neuropathy - nephropathy

Answer 430

overproduction of IGF1 from the liver. Stimulates overgrowth of tissues and alters blood glucose and lipid metabolism. Symptoms of acromegaly

Answer 431

Inspiratory sound due to partial obstruction of upper airways

Answer 432

KIDNEYS - secrete hydrogen ions into urine and reabsorb bicarb from urine.

Answer 433

Small squares = 0.04 seconds Large square = 0.2 seconds 5 large squares = 1 second 300 large squares = 1 minute

Answer 434

- Sleep disturbances - Diarrhoea - Inability to concentrate - Headache - Sexual dysfunction - Loss of appetite

Answer 435

Seen in MS in Optic neuritis - vision worsens on exercise, eating a hot meal or in hot baths

Answer 436

Exactly 90 degrees to that lead

Answer 437

- Sore non sticky red eye - Abnormal corneal epithelium in dendrite pattern which stains with fluorescein.

Answer 438

Freq = number of cases/events expressed as if they were counts Rel freq = these counts expressed as percentage of total number of counts

Answer 439

"can you place your hands out in front of you" Place paper on back of hands and observe for fine tremor

Answer 440

Lumbar puncture

Answer 441

Some (sodium valproate) Certain (ciprofloxacin) Silly (sulphonamide) Compounds (cimetidine) Annoyingly (antifungals, amiodarone) Inhibit (isoniazid) Enzymes (erythromycin), Grrrr (grapefruit juice).

Answer 442

Hydrocortisone 1% Eumovate Betnovate C Dermovate

Answer 443

Well's score. \>3 = treat as DVT

Answer 444

GI carcinoma. RED FLAG

Answer 445

- Normal (Gaussian) distibution and its Z statistic of 1.96 - Student's t distribution

Answer 446

Alcohol excess

Answer 447

OR = the odds that an event will occur/the odds of an event not occuring

Answer 448

Nephrotic = loss of a lot of protein Nephritic = loss of a lot of blood

Answer 449

Atrovent = ipratropium bromide. - BPH, bladder outflow obstruction (precipitates urinary retention) - Angle-closure glaucoma

Answer 450

- Muscle pains - Hair loss - Itching Also nausea, vomiting, diarrhoea, abdo pain

Answer 451

Monoarthritis

Answer 452

Apply the log of the OR and then find the exponential of it

Answer 453

- Atheroma - trauma - Infection (infective endocarditis, tertiary syphillis) - Connective tissue disorders (marfans = josh, ehlers danlos) - Inflammatory disorders (takayasu's aortitis)

Answer 454

- GI disturbances - Xanthospia (colour vision def - yellow in vision) - Arrhythmias

Answer 455

Vesicle = raised clear fluid filled lesion Bulla \> 0,5cm

Answer 456

- Moisture (sweaty = hyper, dry = hypo) - Thyroid acropachy (phalangeal bone overgrowth) - Palmar erythema (hypo) - Oncholysis (hyper)

Answer 457

Aortic regurg

Answer 458

Amaurosis fugax

Answer 459

Age related macular degeneration

Answer 460

DM retinopathy. Ischaemic changes.

Answer 461

- Blurred vision - Burning or stinging in the eye less common include those of cardiovascular and respiratory SE similar to those of other beta blockers

Answer 462

- Kidney failure - Thrombocytopenia - Haemophilia - Hypertension

Answer 463

- poor birth outcomes - Macrosomia (birth wt above 90th percentile)

Answer 464

Tinea capitis

Answer 465

Make the sputum less thick

Answer 466

- Thyroxine for life - Calcium (due to the potential of resection of the parathyroid glands as well) - Vit D

Answer 467

Glucagon like peptide analogue - DPP4 inhibitor. Type II DM.

Answer 468

Type 1 - oh what fun

Answer 469

Somatisation

Answer 470

- dermatitis - IV injections - open wounds - renal failure - DM

Answer 471

- rate (fast = hyper, slow = hypo) - Rhythm (irregular AF = hyper)

Answer 472

Primary prevention

Answer 473

- Antidepressants (SSRI, tricyclic) - antipsychotics - MAOIs

Answer 474

Acute angle closure glaucoma

Answer 475

- loss to follow up = intention to treat - omitted variable bias = prori hypothesis and primary data collection - attributional bias = priori design

Answer 476

Immunity due to hep B vaccination

Answer 477

- serum amylase and lipas - AXR - LFTS (looking at ALT and ALP) before doing a USS for gallstones - ABG to monitor oxygenation and acid-base

Answer 478

- Infliximab - etanercept - adalimunab

Answer 479

During preggo the placenta produces vasopressinase which breaks down vasopressin. GDI is caused by overproduction of vasopressinase by the placenta causing a lack of functional vasopressin.

Answer 480

- H.influenzae - Strep pneumoniae, - Group A strep

Answer 481

Erythema migrans rash. Lyme disease is a tick borne infection caused by Borrelia burgdorferi.

Answer 482

parainfluenza virus

Answer 483

- Cardiovascular (**MI**, **angina**, **pericarditis**, arrhythmias, **aortic dissection**) - Respiratory (pneumonia, **pneumothorax**, **PE**) - Other (**Reflux**, **Anxiety**, rib fracture, costocondritis)

Answer 484

- Salbutamol is the blue reliever inhaler so you take this during an attack to relieve your symptoms. You may get a tremor or a fast heart rate by using this. - Steroid inhaler (beclomethasone) is the brown preventer inhaler and you use it every morning and night to prevent an attack. Make sure to rinse your mouth after use. You may experience a dry mouth, hoarse voice or thrush from using this but that's why it's important to wash your mouth out. - Dry powder or breath activate inhalers can be used as a reliever or preventer depending on the drug inside.

Answer 485

Descriptive/inductive (producing evidence)

Answer 486

- SEIZURES (tonic clonic, focal, status epilepticus) - Secondary treatment for trigeminal neuralgia (after carbamazepine)

Answer 487

COPD exacerbation

Answer 488

Graves' disease & Hashimoto's disease

Answer 489

- Renal Failure - Ototoxicity

Answer 490

Occlusion of retinal artery

Answer 491

- thiazide diuretics - calcium channel blockers (verapamil)

Answer 492

dopamine agonist used in the treatment of Parkinson's disease

Answer 493

Silver nitrate

Answer 494

Hep A = **Foecal oral route** (contaminated food or drinking water, person to person contact) Hep B = **Vertical** transmission (from mother to infant) or **horizontal** (unprotected sex, sharing of needles, bodily fluid transmission) Hep C = **IVDU** or sharing needles

Answer 495

- Mucociliary disorder (Kartagener's, CF) - Immunosuppressed.

Answer 496

Cluster headache

Answer 497

Tinea corporis

Answer 498

Asthma exacerbation

Answer 499

- Cataracts - Glaucoma - Macular degeneration

Answer 500

- Mennorrhagia - GI bleed

Answer 501

Addison's disease

Answer 502

- asthma, COPD - premature labour - used in treatment of hyperkalaemia

Answer 503

X-ray using contrast to look at salivary glands

Answer 504

Can be very serious - Periorbital cellulitis - orbital cellulitis - Periorbital abscess - epidural abscess (most common) - meningitis - encephalitis - subdural empyema

Answer 505

- Tachypnoea - Confusion - Fever \>39.5 - Increased vocal resonance - Dec chest expansion - Dull percussion note - Rusty coloured sputum

Answer 506

- hypertension - oedema - anaemia - renal bone disease - hyperkalaemia - hyperlipidaemia

Answer 507

- Colour (pallor) - tar staining - tendon xanthoma - gangrene

Answer 508

Osteoarthritis. Small bony nodules affecting the distal interphalangeal joints

Answer 509

- Dry - Wet

Answer 510

Multinodular goitre = can also cause laryngeal n. palsy.

Answer 511

- Introduction to pt - Check pt ID - Explain you need a mid stream sample of urine - wash hands and put on gloves and apron

Answer 512

- compre participants with complete and and missing data - create a missing category for missing measurements (reduce cont to categorical variables = losing info) - interpolate what the missing variable are likely to have been

Answer 513

Sertoli cells to produce androgen binding globulin which binds to testosterone to keep it at high concs in the seminiferous tubules.

Answer 514

10-18 mmol/L. If over 18 then indicates presences of an increase in unmeasured anions (e.g lactate, salicylate)

Answer 515

ADH (synthetic vasopressin)

Answer 516

- Headache - cold hands and feet - abnormal skin colour - leg pains

Answer 517

Pulmonary oedema

Answer 518

- Inspect around bed side for walking sticks, wheelchair, knee brace - Gait (normal heel strike-toe off, inc step, smooth, symmetrical, antalgia, festinance, waddling) - Inspect * Front (scars, swellings, asymmetry, valgus or varus deformities, quad wasting) * Side (hyperextension or flexion) * Back (popliteal swellings, like bakers cysts or pop aneursym)

Answer 519

Chi squared test. The number of expected values in each of the fours cells in the contingency table need to be greater than one. And in 3 of the 4 the expected value should be greater than 5.

Answer 520

De quervain's thyroiditis.

Answer 521

ACTH stimulation test. Synacthen test. Give ACTH and this should cause an increase in cortisol but in addison's due to the adrenal insuff, it doesn't.

Answer 522

- s. pneumoniae - H.influenzae - moraxella

Answer 523

Bladder cancer

Answer 524

Amiodarone (interferes with iodine absorption). Treatment for AF, atrial flutter, complex tachys.

Answer 525

bpm = 300/number of squares 3 squares = 100 bpm 4 squares = 75 bpm 5 squares = 60 bpm

Answer 526

- treat = insulin - contra-indicated = gliclazide, metformin.

Answer 527

- minimal change glomerulonephritis - focal segmental glomerulosclerosis - membranous glomerulonephritis secondary causes include DM, SLE, Heb B and C, malig

Answer 528

- itchy, erythematous, dry sclay patches - more common on flexor acpest of children and adults - acute lesion erythematous, vesicular and weepy - nail pitting, excoriations and lichenification follows.

Answer 529

mono or oligoarthritis

Answer 530

Measures the **number of new cases** that occur over a specified **time period** in a population at risk

Answer 531

**Do =** §\*Non-human subjects/material covered by the Animals (Scientific Procedures) Act 1986 §\*Service Evaluations involving vulnerable participants or ethically sensitive topics §Projects involving a new intervention – Experimental Research §Projects collecting new information on more than only service delivery – Non-Experimental Research **Do Not =** §Data/material already published/publicly available – Secondary Research §Projects on non-human subjects/materials – Non-Human Research\* §Projects using only existing service management data – Audit §Projects collecting new information only on service delivery – Service Evaluation\*

Answer 532

Acute hepatitis B infection

Answer 533

N-acetylcysteine

Answer 534

Hyperventilation (Kussmaul's respiration)

Answer 535

- Cardiac (**LVF =** frothy pink) - Respiratory (**LRTI** (yellow/green), **URTI**, **asthma** (nocturnal), **COPD** (clear/gray), pulmonary oedema (foamy pink), pleural effusion, **PE** (haemoptysis), allergy, **malignancy**, **TB,** CF) - Other (**PND**, **GORD**, Drugs (ACE-i))

Answer 536

- moisture (Swimming) - foreign objects (ear buds, finger nails) - Trauma - Skin conditions (eczema, psoriasis)

Answer 537

- MS - Tumour - Stroke - Chronic alcoholism - Iatrogenic (phenytoin, carbamazepine) - Friedereichs ataxia

Answer 538

renal failure risk

Answer 539

- Malleus - Incus - Stapes

Answer 540

- Gastro (**colon** **cancer**, **IBD**, **IBS**, **gastroenteritis**, **coeliac disease**, bowel obstruction, diverticulitis) - Thyroid (**Thyrotoxicosis**, **hypothyroidism**) - Drugs (**opiates**, iron, **Abx**)

Answer 541

- coefs of the exposure = m - the coefs of \_cons = b - R^2

Answer 542

- Antiemetic (dopamin antagonisT0 - Vomiting/Nausea & GOR - blocks dopamine receptors in chemoreceptor trigger zone of brain stem - dec pyloric sphincter tone = inc gastric emptying - Inc lower oesoph sphincter tone

Answer 543

Vesicle = clear fluid filled lesion Pustule = pus filled lesion

Answer 544

True - If we want to be more confident (95% confident rather than 90% confident) that our range of plausible values includes the true population value then it makes sense that the confidence interval has to be wider

Answer 545

Bleeding. monitor with INR.

Answer 546

Chronic suppurative otitis media.

Answer 547

Hodgkins lymphoma

Answer 548

Haemophilus influenzae

Answer 549

Hodgkins & non-Hodgkins

Answer 550

Tylosis (seen in oesophageal cancer)

Answer 551

Enhances hypoglycaemic effect

Answer 552

Dopamine precursor. Used to treat PD and parkinsonism

Answer 553

reactive hyperaemia - legs first returns to pink then become red. due to arteriolar dilatation in order to remove build up of metabolic waste.

Answer 554

- constipation - hernia - adhesions - tumour

Answer 555

Emphysema & Bronchitis

Answer 556

- Cardiac (**MI**, angina, **aortic stenosis**, **CCF**, VSD) - Respiratory (**asthma**, **COPD**, **pneumonia**, **PE**, **pneumothorax**, **pulmonary** **fibrosis**, pulmonary oedema, pleural effusion, TB) - Other (**anaemia**, overdose of opioids, thyroid, DKA)

Answer 557

- CBT - self help (lifestyle, education) - medication (benzodiazapines, SSRIs, antihistamines)

Answer 558

- Cholesterol stones (large and often solitary) - Pigment stones (small and irregular) - Mixed stones (faceted made up of all constituents) Most common

Answer 559

Tremor & coma

Answer 560

Publication bias = prior registration and meta analysis

Answer 561

- Pulse oximetry - ABG (pH, PaO2, PaCO2, bicarb & base excess) - Portable CXR

Answer 562

Non-hodgkins lymphoma

Answer 563

Sensitivity = picks up the true positives. = a / a + c = true positives / true positives + false negatives (total number who have tested postive according to gold standard)

Answer 564

Angina that occurs on lying down. Impaired LV function due to severe CAD.

Answer 565

- Audit - Service evaluation - Research

Answer 566

- DAG (able to summarise all causal relationships between your known/available variables)

Answer 567

- Peripheral (**BPPV**, **viral labyrinthitis**, vestibular neuritis, menieres disease, **acoustic neuroma**) - Central (v**ertobasilar insufficiency**, head injury, **MS**, epilepsy, tumour, migraine, **stroke**) - Infection (**COM**, Ramsay Hunt syn.) - Drugs (**gentamicin**, **alcohol**, salicylates)

Answer 568

- Thalassaemia (inherited disorder - alpha and beta types) - Sideroblastic anaemia

Answer 569

45% rectum. 25% sigmoid. 15% caecum.

Answer 570

mean - 1.96 \* SE to mean + 1.96 \* SE - remember SE = sd/root of n

Answer 571

loss of function in the protein fillaggrin

Answer 572

- gradual vision loss (can be rapid in DM) - Glare (esp at night) - Blurred, lazy vision - Halos - Monocular diplopia signs - reduced VA - reduced red reflex - poor view of fundus due to cloudy lens

Answer 573

- reversibly inhibits HMG CoA reductase which is the rate limiting eznyme in chol synth. - liver responds by inc LDL receptor expression to inc LDL uptake

Answer 574

125-145 mmol/L

Answer 575

Subconjunctival haemorrhage (asymptomatic)

Answer 576

pH 7.8 = death!

Answer 577

- 20% prevalence Risk factors: - birth, loss, divorce, illness, jobs - endo problems (dexa suppression test abnor in 1/3) - lack of intimate relationships Yes there is a genetic element (higher concordance in identical twins)

Answer 578

- Sensorineural - Conductive

Answer 579

- UV exposure, pre-malignant skin condition (actinic keratoses), chronic inflammation, immunosuppression, genetics.

Answer 580

- Inhibits platelet aggregation by preventing activation of gp11b/IIIa. - SE = dyspepsia, abdo pain, diarhhoea, bleeding

Answer 581

- Gallstones - Alcohol

Answer 582

- Based on history Treat using: - psychological treatment (behavioural therapy) - manage co-morbib condiitons (alcohol, anxiety, psychotic symps, eating disorders, dementia) - antidepressants (tricylic = amitriptyline. SSRIs = sertraline, citalopram, fluoxetine. MAOIs = Phenelzine) - ECT - Admission

Answer 583

Anterior Uveitis

Answer 584

- Disturbed central vision (scooter, blurring, distortion) - Difficulty appreciating detail (reading fine print, recognising faces)

Answer 585

- Vascular (postural hypotension, aortic stenosis, arrhythmia, ruptured AAA - Neurological (stroke, epilepsy, PD, head injury, vasovagal - emotional, fear, pain, nausea, pallor, sweat LOC 2 mins. intracranial haemorrhage, MS) - Drugs (alcohol, polypharmacy) - Others (hypoglycaemia, anaemia) - Postural instability

Answer 586

Acute Carbon dioxide retention

Answer 587

Varicose veins

Answer 588

- established cirrhosis - ++ alcoholic liver disease

Answer 589

- temperature - thyroid acropachy - moisture of skin - palmar erythema - tremor - pulse (rate and rhythm)

Answer 590

- Septic signs (fever, wt loss, rigors, night sweats, anaemia, splenomegaly, clubbing, malaise) - New or changing murmur - Oslers nodes, janeway lesions, roth spots

Answer 591

LOOK - for chest movements - paradoxical 'see-saw' pattern indiactes obstruction. - use of accessory muscles - misting of oxygen mask LISTEN - abnormal sounds - snoring, choking, gurgling, stridor - silence FEEL - airflow on inspiration and expiration

Answer 592

DELIRIUM - **Disordered** thinking (slow and irrational) - **Euphoric** (angry, depressed) - **Language** impaired - **Illusions** - **Reversal** of **sleep** cycle - **Inattention** - **Unaware** - **Memory** deficits

Answer 593

Nephritic syndrome.

Answer 594

Sodium bicarbonate

Answer 595

- Gastro (Oesophageal **varicies**, Haemorrhagic **peptic ulcer**, Proximal polyp/**cancer**, Haemorrhagic infective **gastroenteritis**, **IBD**, IBS, distal colon cancer, **Diverticular** haemorrhage, **haemorrhoids**, **anal fissures**)

Answer 596

Subacute combined degeneration of the spinal cord

Answer 597

Sialadenitis

Answer 598

CRAPS out drugs - C = carbamazepine - R = rifampicin - A = bArbituates - P = phenytoiin - S = st johns wort

Answer 599

Infective endocarditis

Answer 600

- Anti-depressants - Diuretics - Lithium

Answer 601

V/Q mismatch

Answer 602

the angle at which a limb develops pallor during the buerger's test indicating limb ischaemia.

Answer 603

- Dyspnoea - redcued conciousness - tachycardia - tachypnoea - cyanosis - accessorry muscles for ventialtion - confusion

Answer 604

- BLOOD LOSS (menorrhagia or GI bleed) - Poor diet in babies and children - Malabsorption = coeliac disease is a cause of refractory IDA - Tropical (hookworm)

Answer 605

- Respiratory (**Pneumonia**, **PE**, **Lung** **tumour**) - Others (Prolonged **coughing**, Mitral stenosis, TB, laryngeal carcinoma, Aspergillosis)

Answer 606

- Fluid management - Blood glucose - check potassium - Give insulin and dextrose together

Answer 607

During the last month, have you been bother by... - ..feeling down, depressed or hopeless? - having a persistent sadness of low mood? - have little interest in doing things of pleasure? - having fatigue? Have you felt like this for more than 2 weeks?

Answer 608

Tinea manuum

Answer 609

Labyrinthitis

Answer 610

- pattern of joint involvement - symmetry - morning stiffness \>30mins - pain, swelling, warmth, erythema, loss of function

Answer 611

- Heart failure

Answer 612

- Biliary tract - Bone - Less so in placenta, SI & kidneys

Answer 613

Oesophageal cancer

Answer 614

- Ciclosporin = inc risk of myositis - Fibrates = inc risk of myopathy - Warfarin = inc effects of warfarin - Clarithromycin = inc risk of myopathy and rhabdomyolysis

Answer 615

- Anaesthetics (inc risk of dysrhthmias) - MAOIs (risk of HTN crisis)

Answer 616

Rheumatic heart disease

Answer 617

y = y axis m = gradient x = x axis b = y-intercept E = residual part N(0, variance). Where N(0, variance) is the normal distribution of the residual with mean zero and a variance of whatever). As variance increases, the amount of noise increasse so less of the variation in the data is explained by the model. Variance = standard dec squared

Answer 618

- Bar chart - continuous variables or for ordinal categorical variables

Answer 619

Cardiac - Cyanotic congenital heart disease - Infective endocarditis - Atrial myxoma Resp - Lung cancer - Pulmonary fibrosis - Chronic pulmonary suppuration (bronchiectasis, empyema) - CF GI - IBD - Liver cirrhosis - Coeliac disease Endo - Thyrotoxicosis

Answer 620

Leads I, II, III.

Answer 621

- Conjunctivitis - Corneal abrasions - Acute iritis - Scleritis - Acute glaucoma - sub conjunctival haemorrhage

Answer 622

Categorical (**nominal -** male/female and **ordinal -** score) Numerical (**discrete** and **continuous**)

Answer 623

- Parotid - Submandibular - Sub lingual

Answer 624

Catecheloamines. Adrenaline.

Answer 625

- Deviated uvula (away from abscess) - Hot potato voice

Answer 626

Beta-blockers

Answer 627

- call for helo - removal of trigger - IM or IV adrenaline - maintain airway patency - management of bronchospasm and CV collapse

Answer 628

Type II DM. \>80% concordance with identical twins

Answer 629

Lead 1 would become more negative and the deflection in lead III would be more positive. Right axis deviation = reaching towards

Answer 630

- Salbutamol - Insulin - Diuretics

Answer 631

- Pretibial myxoedema - Proximal myopathy - Ankle reflexes bilaterally (when they stand up out of chair, get them to rest a knee on the chair to elicit ankle reflex)

Answer 632

mitral stenosis.

Answer 633

When we are not certain what happened to people before the time at which they entered the study. Common example is when people already have the disease of interest when the study starts

Answer 634

- Cough +/- sputum production - Dyspnoea - Haemoptysis - Fever - Chest pain - Fever/night sweats

Answer 635

Trigeminal neuralgia

Answer 636

- Dyspnoea - Fatigue - palpitations - faintness - headache

Answer 637

- Tachycardia - S1 Q3 T3 (rare but indicative of PE)

Answer 638

Inactivates COX. and dec thromboxane synthesis. CI = peptic ulcer, haemophilia, active bleeding

Answer 639

Posterior Epistaxis. (less common than anterior epistaxis). Bleeding from the sphenopalatine arteries.

Answer 640

- ciprofloxacin (and other quinolones) - phenytoin (dec effect of pred) - rifampicin (dec effect of pred) - coumarins (enhance or reduce anticoag effect) - amphotericin ( inc risk of hypokal)

Answer 641

- Rise in serum creatinine \> 26 micromol/L within 48 hours OR - Rise in serum creatinine \>1.5 baseline within 1 week OR - urine output

Answer 642

- Arrhythmias - Seizures

Answer 643

- Institutional - Government

Answer 644

- Perform flexion and extension both actively and passively (can you move your heel towards your bottom please?) - lift both legs by feet and note any hyperextension - Special tests * Ant/post drawer tests (flex pts knee at 90degrees, rest forearem on shin and elbow on foot, pull and push tibia) * Collateral ligs (extend knee fully, hold pts knee in one hand and lower portion of leg in other hand. attempt to bend lower leg medially = lat collateral lig and then laterally = med collateral lig)

Answer 645

Glandular fever. EBV.

Answer 646

0 to infinity

Answer 647

Multinodular goitre

Answer 648

Clinical audit

Answer 649

Physiological changes (puberty or preggo)

Answer 650

Lichenification. Eczema

Answer 651

Yes it can. Research is designed to generate new, generalisable knowledge.

Answer 652

A - Alveolar oedema (Bat wings) B - Kerley B lines (interstitial oedema - outer margins) C - Cardiomegaly D - Dilated upper lobe vessels E - Pleural Effusions

Answer 653

Blood is not mixed with sputum in a PE. Along with Trauma and bleeding into lung cavity.

Answer 654

- occurs when people in the study to do not reach a failure before the end of the study

Answer 655

Mitral regurg

Answer 656

Buerger's test - pt supine - stand at bottom of bed and raise both legs to 45 degrees for 2-3 mins. - observe for pallor (emptying of superficial veins) - healthy leg should remain pink even at 90 - after 3 mins ask pt to swing legs over side of bed - observe for reactive hyperaemia (goes pink then red)

Answer 657

- Full neck examination - TFTs - USS

Answer 658

- Meningism (photophobia, neck stiffness, Kernig's sign) - seizures - petechial rash (non blanching) - Dec in conscious level

Answer 659

Candidiasis

Answer 660

Hallucination

Answer 661

Alpha gliadin

Answer 662

- Alzheimers (60%) - Vascular (more sudden onset than AD) - Lew body (shares many features wioth AD & PD) - Others (huntingtons, metabolic disorders (alcohol. vitb12), hypothyroidism, psych)

Answer 663

- Bone marrow depression - AV conduction abnormalities - Porhpyrias

Answer 664

- Pneumonia - Malignancy

Answer 665

- Diarrhoea - Steatorrhoea - Wt loss - Abdo pain - Nausea & vomiting - Bloating

Answer 666

inflammation of salivary gland

Answer 667

macrocytosis

Answer 668

Secondary form of pericarditis that occurs as a complication of MI. Consists of fever, pleuritic pain, pericarditis and/or pericardial effusion.

Answer 669

- hyperkalaemia (tall tented T waves) - Myocardial ischaemia (hyper acute MI)

Answer 670

Angina without provocation. Usually at rest due to coronary artery spasm

Answer 671

Ranitidine

Answer 672

Autoimmunity

Answer 673

Aortic stenosis

Answer 674

- Inability to concentrate - Poor sleep - constant worry - irritable - feeling depressed - tired

Answer 675

Acute hepatitis B infection

Answer 676

Neck flexion that causes electric shocks in trunk and limbs. +ve in MS and cevrical spondylosis, cord tumours and Subacute combined degeneration of spinal cord

Answer 677

- **Memory loss** (short term memory loss) - Decline in **cognitive function** (language impairment, planning, difficulty performing complex tasks) - **Challenging behaviours** (depression, anxiety, incontinence, aggression, wandering, psychosis, dis-inhibition)

Answer 678

- Lactic acidosis - Ketoacidosis - Poisoning - Acute or chronic kidney disease

Answer 679

- 10% 10ml Calcium gluconate (cardio protective) - Insulin and dextrose - Salbutamol nebs (pushes K+ back into cells)

Answer 680

Spoon shaped nails. iron def anaemia

Answer 681

B12 def, pernicious anaemia

Answer 682

Immunity via natural infection

Answer 683

- jaundice - hepatic encepahlopathy - fetor hepaticus (pear drops) - Asterixis - constructional apraxia

Answer 684

Spasm of jaw muscles keeping it closed aka lockjaw

Answer 685

- symmetrical posterior column loss so sensory and LMN signs - symmetrical corticospinal trat loss so motor and UMN signs - Classic triad of extensor plantars, absent knee jerks, absent ankle jerks.

Answer 686

Old (orientation) Tired (time) Psychiatrists (Place) Persevere (person) At (attention - observe for distractions) Creating (concentration - test using sequencing exercises) Mnemonic (memory - working, short and long term) Learning (language) - Codswallop (construction - apraxia)!

Answer 687

- Squamous cell carcinoma (middle third of oesoph) - Adenocarcinomas (lower third)

Answer 688

- confusion - flapping tremor - drowsiness - bounding pulse - headache - warm extremities

Answer 689

- drug/toxin induced hepatitis - viral hepatitis - liver ischaemia

Answer 690

- Pneumonia - PE - Pneumothorax - Pulmonary oedema - Acute asthma - COPD

Answer 691

Peripheral myopathy

Answer 692

tinea pedis with tinea unguium

Answer 693

Cervical lymph nodes. Enlarged, painless, non tender, rubbery superficial lymph nodes.

Answer 694

Hyponatraemia

Answer 695

- Aortic stenosis! - LRTI - Exacerbation of asthma - PE

Answer 696

Anaemia, Loss of wt, Anorexia, Recent onset of progressive symptoms, Maleana, swallowing difficulty

Answer 697

- abdo pain - nausea - ankle oedema - dizziness - constipation

Answer 698

HIDEMAP-H - Hypoxia (pneumonia, anaemia, MI) - Infection (URTI/LRTI, UTI, malaria, wounds) - Drugs (opiates, sedatives, anticonvulsants) - Endocrine (hyper/hypothyroid, addison's and cushing's, DKA) - Metabolic (uraemia, liver failure, hyper/hypo natraemic/glycaemic, malnutrition) - Alcohol withdrawal - Pyschosis - head injury

Answer 699

GI neoplasms, esp colorectal Ca.

Answer 700

21-28mmol/L. BE +/- 2

Answer 701

Vomited. (bright red, alkaline and frothy = coughed up)

Answer 702

- Xerostomia (dry mouth) - karatoconjunctivitis sicca (dry eyes)

Answer 703

COMT inhibitor. Parkinson's disease

Answer 704

Area in the anterior inferior part of the nasal septum where four arteries anastomose - 90% of epistaxis

Answer 705

Sub mandibular

Answer 706

Glucagon like peptide analogue - DPP4 inhibitor. Type II DM.

Answer 707

\>12 wks. Acute

Answer 708

- Coeliac disease - Chronic pancreatitis - Crohn's disease

Answer 709

Epiglottitis

Answer 710

Well's score. \>3 = treat as DVT

Answer 711

- Non hodgkins lymphoma - Hodgkins lymphoma

Answer 712

- Audiogram - MRI if tumour suspected

Answer 713

Thyroid acropachy

Answer 714

- Infection (**cholecystitis**, **cholangititis**, hepatitis, **pancreatitis**, **gastroenteritis**, **appendicitis**, **peritonitis**, diverticulitis, **pyelonephritis**, pneumonia) - Inflammatory (**PUD**, GORD, **IBD**, IBS, coeliac, **renal colic**, endometriosis) - Vascular (ruptured **AAA**, **MI,** **mesenteric ischaemia**) - Malignancy (gastric Ca. colorectal Ca) - Mechanical (**bowel obstruction**, **hernia**, ectopic **preggo**)

Answer 715

Rhinosinusitis

Answer 716

V5, V6, Leads I, aVL & aVR

Answer 717

duodenum/ prox jejunum

Answer 718

- Observational (selective sampling) = cross sectional analytical, case-control, cohort - Experimental (selective exposure) = trials

Answer 719

Via the trabecular meshwork in the angle formed by the iris and cornea.

Answer 720

- coma - severe hyperglycaemia - Kussmaul respiration (deep gasping breaths) - breath smells of pear drops - cerebral oedema - severe abdo pain

Answer 721

Lipodermatosclerosis

Answer 722

- Introduction (WIPE) - Check for current understanding of condition and inhaler treatments - Initial explanation (type of inhaler, purpose and when to use + inhaler contains set dose of medication and the aim is to get it into the lungs + you release the drug by twisting/clicking the device) - Steps of use * Check expiration * Shake vigorously * remove cap and check inside is clean * Stand it up right * Place index finger on top and thumb underneath * Breath out completely * Seal mouth well around mouthpiece * Simultaneously press down and breath in deeply and slowly * Hold breath for 10 seconds * Breathe out slowly * Replace cap * Repaet after 1 min if required - Demonstration and observation - Other advice (seek emergency help if symptoms are sevre or not being relieved by inhaler, see GP if suffering SE or using reliever \> 3 x /wk, any questions?

Answer 723

- IM adrenaline injection - Give anti-histamines later

Answer 724

The passage of large volumes of dilute urine

Answer 725

- Sialolithiasis (obstruction) - Dehydration - Mumps - surgery - trauma - AI disease

Answer 726

Addison's disease

Answer 727

Reactive arthritis - AI condition which develops due to an infection in another part of the body. - inflammatory arthritis - urethritis - conjunctivitis

Answer 728

Viral labyrinthitis

Answer 729

- information bias = priori hypotheiss and prospective data collection - observer bias = blinded, indepedant and objective - recall/response/prestige bias = blinded

Answer 730

- post inflam hyperpigmentation, scarring, deformity, socail effects

Answer 731

- comment on behaviour (appear irritable or apathetic) - comment on body habitus - comment on clothes for current time of year

Answer 732

Cardioselective = Atenolol & bisoprolol Nonselective = Propanolol, carvedilol

Answer 733

- recent, sudden onset of middle ear inflammation and effusion - Signs of middle ear effusion (bulging of tympanic membrane, otorrhoea, fluid air level behind membrane) - Signs and symptoms of middle ear inflammation (red tympanic membrane, otalgia)

Answer 734

Type II respiratory failure

Answer 735

- looking for signs of shock - HR, BP, CRT, JVP, ausculation of heart sounds, volume status, urine output, ECG external haemorrhage - Manage using IV access (warm fluid replacement or blood replacements) - catheter

Answer 736

- Fluconazole/miconazole = inc hypoglycaemic effect - chloramphenicol, coumarins, NSAIDs

Answer 737

- N & V - Abdo pain - insomnia - agitation - postural hypotension - palpitations Rarely reddish discolouration of bodily fluids, psych symptoms

Answer 738

Towards that lead

Answer 739

- UV, male, immunosuppression, age, skin type I, previous history of skin cancer, sun burn.

Answer 740

- no psoas show due to inc in retroperitoneal fluid

Answer 741

- COPD - Exhaustion - Flail chest injury - Opiate toxicity - Obstructive sleep apnoea

Answer 742

LV enlargement

Answer 743

Ramsay Hunt syndrome

Answer 744

Mycotic aneurysm

Answer 745

- Thoracocentesis (cannula) - Later on put in chest drain

Answer 746

Guys (Gentamicin) With (warfarin) Large (Lithium) Dongles (digoxin) Totally (theophylline) Make (methotrexate) Perfect (phenytoin) Internet (insulin) Connections (ciclosporin)

Answer 747

- benign paroxysmal positional vertigo (episodes lasting around 30 seconds, evoked by head turning. Rotational vertigo) - Viral labyrinthitis (severe vertigo and hearing disturbances, preceded by URTI, may have tinnitus, otalgia, N&V, fever) - Vestibular neuritis (lasts several days, preceded by URTI, rotational vertigo and vomiting, several episodes a year) - Meiniere's disease (classic triad of vertigo, hearing loss and tinnitus)

Answer 748

- calcium channel blockers

Answer 749

Quinsy = peritonsilar abscess

Answer 750

Surgery around the parotid gland. frey syndrome.

Answer 751

- rectal bleeding or a persistent change in bowel habit \>6 wks - iron def anaemia without an obvious cause - palpable abdo or rectal mass - recent onset of looser stools and or inc in freq of shitting \>6 wks

Answer 752

- Red = right wrist or shoulder - Yellow = left wrist or shoulder - Green = left ankle - Black = right ankle (earth electrode)

Answer 753

Look * front (scars, swellings, asymmetry, muscle wasting) * Side (scars, muscle wasting, alignment of shoudler girdle) * Back (scars, trapz bulk, scapula - elevated, depressed, winging) Feel * Joints and bones * start at sterno-clavicular joint * clavicle * acromio-clavicular joint * coracoid * acromion * head of humerus * spine of scapula * Muscle bulk of deltoid Move * Active (flexion, extension, abduction, adduction, internal and external rotation) * Passive movement (feeling for crepitus) Function * Hands behind head (ext rot and abd) * Hands as far up your back as you can (int rot and add) Special tests * **Impingement** (painful arc) - **abduction** of arm against light resistance = **supraspin** * **Internal** rotation against resistance (**subscapularis** muscle) - dorsum of hand on back, apply resistance and lift off * **External** rotation against resistance (**infraspin** and **teres** **minor**) - loss of power = tear. pain on forced ext rot = tendonitis.

Answer 754

- Look * Front (Scars, swelling, eyrthema, carrying angle) * Side (fixed flexion derformity, olecranon bursitis, scars, swelling, erythema) * Back (Rheumatoid nodules, psoriatic plaques) - Feel * Temperature * Palpate joint lines - Move (active and passive) * elbow flexion and extension * supination and pronation - Special tests * Medial epicondylitis (golfers) - flex elbow, supinate hand, ask pt to flex wrist against resistance * Lateral epicondylitis (tennis) - flex elbow, pronate hand, ask pt to extend wrist against resistance

Answer 755

Paradoxical breathing pattern, added noises such as snoring, gurgling

Answer 756

- Sudden deterioration, rash, urticaria - airway swelling, wheeze, CV collapse

Answer 757

Adrenaline (0.5 mls of 1:1000 IM)

Answer 758

- high flow oxygen - diuretics - nitrates - possibly non invasive ventialation

Answer 759

- hypovolaemic (dehydration, fluid loss and haemorrhage - reduced JVP) - Distributive shock (septic - bounding pulses, warm pt, anaphylactic) - Cardiogenic (MI, HF - increased JVP) - Obstructive (PE, tamponade, tension pneumothorax) - Neurogenic (spinal transection or brain stem injury)

Answer 760

- excess insulin - oral hypoglycaemics - alcohol - liver failure

Answer 761

Tetracyclin

Answer 762

-preggo & breat feeding. deposits in gorwing bone and lead to pemanent staining of teeth.

Answer 763

Milk products as these dec absorption of the drug

Answer 764

- Vancomycin & teicoplanin

Answer 765

Methotrexate, nitrofurantoin and amiodarone

Answer 766

Reversible oligospermia

Answer 767

ciclosporin, phenytoin and calcium channel blockers

Answer 768

- Transient arrhythmias that decrease CO sufficient to cause syncope. - recovery is quick = pt is usually pale with syncope and then becomes flushed on recovery

Answer 769

- Antihypertensive medication. Beta blockers, L-dopa and tricyclic antidepressants affect autonomic nervouse system

Answer 770

- Bronchiectasis - miliary tb - PE - fibrosis early - fibrosis late - mesothelioma

Answer 771

- staph/klebsiella - chlamydia psittaci infection - pneumocystis carinii pneumonoa - legionella infection

Answer 772

- Rifampicin - Isoniazid

Answer 773

- anaemia of chronic disease (malignancy, RA)

Answer 774

Glcuose 6 phosphate dehydrogenase def

Answer 775

- colorectal cancer - bladder cancer - head of pancreas cancer - Gastric cancer - bronchial cancer - prostate cancer

Answer 776

= Hodgkin's lymphoma - AML - CML

Answer 777

- Parkinson's disease - MS - Motor neuron disease - Huntington's disease

Answer 778

- Wernicke's encephalopathy - Brown-sequard syndrome - cauda equina syndrome - Korsakoff's syndrome - Guillain Barre syndrome

Answer 779

- wide based gait - shuffling small steps - high stepping/stamping gait - shuffling/festinant gait

Answer 780

- Neurosyphilis (argyll robertson pupil) - CNIII palsy - opiate overdose - tricyclic antidepressant overdose - Horner's syndrome

Answer 781

- Median nerve - radial nerve - common peroneal - ulnar nerve - tibial nerve - Erb's palsy

Answer 782

- Arthritis - anterior uveitis - apical lung fibrosis - aortic regurg

Answer 783

Behcet's disease

Answer 784

Metronidazole

Answer 785

Small bowel obstruction. Large bowel, vomiting appears later and is faeculent.

Answer 786

Anti-thyroid. Inhibits thyroid peroxidase which is needed for thyroid synth.

Answer 787

- Nausea & GI disturbances, taste disturbances, headache - rarely bone marrow suppression (agranulocytosis) - warn pts to tell doc immediately if sore thorat, mouth ulcers, bruising, fever, malaise, or non-specific illness develops.

Answer 788

- Propanolol - carbimazole - during a thyrotoxic crisis you could als prescribe hydrocortisone.

Answer 789

- Tablets should be swallowed whole with plenty of **water** while **sitting** or **standing** and taken on an **empty stomach** at **least 30 mins before** **breakfast** and should **remain** sitting or standing for 30 minutes after taking the tablet.

Answer 790

Bisphosphonate. - Used in post menopausal osteoporosis, osteoporosis and corticosteroid induced osteroporosis. - Abnormalities in oesophagus (strictures), hypocalacaemia, renal impairment and preggo - Oesophageal reactions, abdo discomfort, GI disturbances

Answer 791

- Antacids - calcium salts & iron salts

Answer 792

- ciprofloxacin, tetracyclin (dec absorption of Abx) - Diuretics (inc risk of hypercalcaemia)

Answer 793

Hypercalcaemia. Metastatic calcification. - Phenytoin/carbamazepin = inc Vit D requirements. Diuretics = inc risk of hypercalcaemia.

Answer 794

- Anticoags (inc risk of haemorrhage) - Ciclosporin (plasma conc of diclo inc by ciclo) - Methotrexate (reduceds excretion of metho so inc risk of toxicity

Answer 795

- Mimics endogenous opioids and acts on the opioid receptors in the dorsal horn, the periaqueductal grey matter and the midline raphe nuclei.

Answer 796

- Severe respiratory depression (COPD, asthma attack( - Head injury or raised ICP - paralytic ileus or other undiagnosed acute abdo

Answer 797

- mild-mod pain - diarrhoea - cough suppression

Answer 798

- Antihistamines = inc sedative effects - MAOIs = possible CNS excitation or depression

Answer 799

- mild to mod pain & pyrexia - alcohol dependence, hepatic or renal impairment - Rare skin reactions like SJS, TEN, blood disorders. LIVER damage. Indications: - Phenytoin & carbamazepine = inc metabolism rate - Metoclopramide = inc rate of absorption

Answer 800

- aspirin Treat usiing multiple doses of oral activated charcoal. If moderate, give sodium bicarb. If severe haemodialysis.

Answer 801

- cocaine, amhetamine and tricylics = dilate - heroin = constrict

Answer 802

Amiodarone.

Answer 803

- Coxsackie Virus

Answer 804

- Intro - "I've been asked to come talk to you about a recent medication you've been started on - is this okay?" - "I understand you've just been diagnosed with AF/have got a DVT post op, is that right?" - Explain AF or DVT (inc risk of Stroke or PE) - Signpost (explain warfarin and why it's needed. Treatment, SE, advice) - Warfarin is a drug which thins your blood and makes it less likely to clot. It'll help dissolve your current clot and prevent it from going to your lungs. You'll need to take it for 3-6 months (PE), lifelong (AF) every day. The aim of warfarin is to get the blood consistency just right just that it doesn't clot too much or bleed too much. For that we'll need to do regular blood tests called INR - every day for a week, then every week for 3 weeks, then once a month for 3 months. Yellow warfarin book for you to record your INR levels. - SE (notice any unusual bleeding, black stools, coughing or vomiting up blood you must let your doc know) - Do you take any current regular medication? (CYP450 crap). If on OCP STOP, as it inc risk of clotting but also interferes with warfarin. Need alt contraceptive though as warfarin and preggo are bad) - Food and alcohol. Do you drink alcohol? Do you drink cranberry juice, eat lots of spinach? Advise is to drink no more than a pint a day, no binge. Don't eat lots of spinach, liver etc. ADVICE: Contact sports STOP due to inc risk of bleeding. Any procedure you must let your doc or dentist know. Stay mobile though.

Answer 805

- Acute angle closure glaucoma - Haloes, triggered by low illumination

Answer 806

- Urological * **cystitis** * **Urethritis** * **Pyelonephritis** * **BPH** * Bladder **calculus** * **Prostatitis** Other * **Anxiety** * Preggo * Drugs (**diuretics**)

Answer 807

Urological * **Bladder** cancer * Urethral **trauma** * **UTI** * Urethritis * **Calculi** * Glomerulonephritis * **BPH/prostate cancer** * Schistosomiasis Other * **IE** * **Drugs** (sulphonamides, cyclophosphamide, NSAIDs) * **Menstruation** * Strenuous exercise

Answer 808

Endocrine * DM * Diabetes insipidus * Cushing's syndrome Urological * Chronic kidney disease Drugs (diuretics, alcohol, tetracyclines, lithium)

Answer 809

- **Stress** incontinence (**incompetent** sphincter = small losses with effort like **coughing** or **exersion**) - **Urge** incontinence (Detrusor instability = idiopathic, cystitis. or **hyperreflexia** = **MS, CVA, spinal cord injury**. Urge to pass followed by uncontrollable bladder emptying) - **Overflow** (**Prostatic** hypertrophy, stricture or stone. Dribbling and poor stream) - **True** (**fistula** between bladder and vag or urethre = cont urine leak) - Mixed

Answer 810

Urological * **BPH** * Urethral **stricture** * **Bladder neck obstruction (**calculus, **tumour)** * **UTI** * **CONSTIPATION** * Prostatitis * Genital herpes * Pelvic mass Neuro (**MS, spinal cord compression**) Drugs (**anticholinergics**)

Answer 811

Enteropathic arthritis (symmetrical arthritis of lower limb joints, early morning stiffness)

Answer 812

Hypovolaemic * Diuretics * Addison's disease * Kidney failure * Diarrhoea and vomiting * Burns Oedematous * CCF * Nephrotic syndrome Euvolaemic * Hypothyroidism * SIADH

Answer 813

Normovolaemia - excess IV crystalloids Hypovolaemia - Fluid loss (vomiting/diarrhoea, burns) - DIabetes insipidus - Osmototic diuresis (DKA) or hypoaldosteronism

Answer 814

Physiological neonatal jaundice. - Haemolytic anaemia - hereditary spherocytosis - ineffective erythropoiesis

Answer 815

Hepatic and post hepatic jaundice

Answer 816

Colour of urine and stool = Normal ALP = normal AST/ALT = normal Bilirubin = normal or inc Conjugated = normal

Answer 817

Colour = **dark urine** but **normal stool colour** ALP = raised AST/ALT = raised Bilirubin = raised Conjugated = raised **Unconjugated bili = raised**

Answer 818

**Colour = dark urine and pale stools** ALP: raised ALT/AST: raised Bilirubin: raised Conjugated: raised **Unconjugated: normal**

Answer 819

- acute or chronic hepatitis - cirrhosis - primary biliary cirrhosis - alcoholic liver disease

Answer 820

- GALLSTONES in the bile duct - Carcinoma of the head of the pancreas - pancreatitis - parasites Shit ton of others

Answer 821

2 abx + 1 PPI (amoxicillin and clarithromycin) + omeprazole

Answer 822

UC. Crohns disease = normocytic/normochromic anaemia of chronic disease

Answer 823

- CD - UC - UC - CD - CD - CD - CD - CD - UC - CD

All encompassing Flashcards

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