bzzwords Flashcards
(489 cards)
1
Q
feltys syndrome
A
RA, splenomegaly, neutropenia
2
Q
stills
A
high fevers, joint pain, salmon rash
3
Q
tamoxifen SE
A
cataracts hotflush endometrial cancwr aches thromboembolism
4
Q
AAA sizes
A
> 4.4cm - 3 month rescan
3-4.4cm = 2 year rescan
5.5 = surgery
5
Q
first line anti hypertensive <55
A
ACEI
6
Q
pulseless patient with arthralgia
A
takayasu
7
Q
4 y/o with strawberry tongue, fever for 6 days that doesnt respond to antipyretics
A
kawasaki - tx with aspirin
8
Q
nelsons syndrome
A
remove adrenals in cushings patient then pituitary starts to produce ACTH
9
Q
vomiting, thoracic pain, subcut emphysema in alcohol abusers
A
boerhaave syndrome
- mackler triad described
10
Q
meigs syndrome
A
ovarian tumour (fibroma)
ascites
pleural effusion
11
Q
kartageners syndrome
A
primary ciliary dyskinesia
- dextrocardia, bronchiectasis, sinusitis, infertility
12
Q
shortening QT on ECG
A
hypercalcaemia
13
Q
prominent U waves on ECG
A
hypokalaemia
14
Q
small cell lung cancer syndromes
A
SIADH, ACTH, lambert eaton syndrome
15
Q
squamous cell lung cancer syndromes
A
PTH, TSH
16
Q
large cell lung cancer syndromes
A
bHCG
17
Q
radiofemoral delay, mid systolic murmur at the clavicle
A
coarctation of the aorta
- congenital narrowing of descening aorta
18
Q
cushings triad
A
irregular bleading, bradycardia, hypertension
= raised ICP
19
Q
becks triad
A
hypotensions, ditended neck veins, muffled heart sounds
= cardiac tamponade
20
Q
tx of acute promyelocytic leukaemia t(15;17)
A
alltrans retinoic acid
21
Q
caplans syndrome
A
RA + pneumoconiosis
22
Q
SE of ACEI
A
hyperkalaemia and dry cough
23
Q
SE of bendroflumethiazide
A
gout, impaired glucose tolerance, hyponatraemia
24
Q
SE of Ca channel blockers
A
headache, flushing, ankle oedema
25
tx of alcohol withdrawal
chlordiazepoxide
26
tx of SIADH where fluid restriction has failed
demeclocycline
27
tx of acute mania in pregnancy
olanzapine
28
gram positive diplococci
strep pneumonia
29
anaemia with raised ferritin and normal iron
anaemia of chronic disease
30
anaemia with raised reticulocytes and LDH
haemolytic anaemia
31
mcardles disease
pain after exercise and myoglobinuria
| - autosomal recessive glycogen stoarge disease
32
arthritis, spiking fevers and pink rash
stills disease
33
inferior MI and AR murmur
ascending aorta dissection
34
delay of femoral pulses in neonate
coarctation of aorta
35
erythema migrans
lyme disease
36
impalpable pulses
takayasu arteritis
37
tx of opioid respiratory depression
naloxone
38
varenicline
nicotine receptor partial agonist
39
CXR shows rib nothcing, weak pulses and radiofemoral delay
PDA
| - machine like murmur
40
se of BB
cold peripheries, bronchospasm, fatigue
41
se of doxazocin
postural hypotension
42
hernia that is unable to be reduced
incarcerated hernia
43
DEXA bone scan results
> -1 = normal
| -1 to -2.5 = osteopenia
44
anti-histone antibodies
drug induced lupus
| - due to procainamide and hydralazine
45
ASMA
autoimmune hepatitis
46
claudication, atrophy and impotence
leriche syndrome
| - atherosclerosis of abdo aorta/illiacs
47
arteritis in middle aged male with hep B
polyarteritis nodosa
48
pulsus paradoxicus
drop in BP during inspiration
| - cardiac tamponade
49
signet ring cell on CXR
bronchiectasis
50
alcohol withdrawal symptoms timings
6-12 hours = tremor, sweating, tachycardia, anxiety
36 hours = seizures
48-72 hours = delirium tremens - coarse tremor, confusion, delusions, auditory/visual hallucinations, fever, tachycardia
51
inferior MI and aortic regurg
aortic dissection
52
commonest murmur in pregnancy
mitral stenosis = mid-diastolic murmur
53
low platelets and high ALT/AST
dengue fever (from mosquitoes)
54
crescendo-descrescendo murmur in upper left sternal border with rib notching on CXR
coarctation of aorta
55
pansystolic murmur in lower left sternal border
VSD
56
machine like diastolic murmur in upper left sternal border
PDA
| - treat with indomethacin
57
ejection systolic murmur in upper left sternal border
pulmonary stenosis
58
ejection systolic murmur with fixed splitting of 2nd heart sound
ASD
59
tetralogy of fallot
| boot shaped cardiomegaly
VSD
overriding aorta
pulmonary stenosis
RVH
60
aorta from RV and pulmonary artery from LV with egg shaped cardiomegaly
TGA
61
neonate from Csection with failure to clear fluid from lungs
TTN
62
cyanosis within first days
TGA
63
cyanosis within first months
tetralogy of fallot
64
high fever > 5 days with red palms with desquamination + strawberry tongue
kawasaki
| - tx aspirin
65
parvovirus B12
slapped cheek
| - erythema infectiosum / 5th disease
66
coxsackie A16
hand, foot and mouth
67
jaundice > 14 days with increased conjugated bilirubin
biliary atresia
| - tx with kasai procedure (bypass blocked ducts)
68
tx of pertussis / whooping cough
clarithromycin
69
waxy yellow rash on soles of feet
keratoderma blenorrhagica
| - seen in reactive arthritis
70
trousseau sign
hypocalcaemia
| - carpal spasm if brachial artery occluded (BP cuff)
71
chvosteks sign
tapping parotid causes facial muscles to twitch
| - hypocalcaemia
72
PR bleeding and pain on feeding in neonate who was born prematurely
necrotising enterocolitis
| - treatment is supportive unless necrosis and then surgery is required
73
tetany and QT prolongation
hypocalcaemia
74
child crying with D+V and drawing legs towards chest. mass in RUQ and target sign on US.
intussusception
- also get red currant jelly stool
- treat with air insufflation and 2nd line is surgery
75
green bile vomit in 6 month old
malrotation until proven otherwise
76
whipples triad
signs + symptoms of hypoglycaemia, glucose <2.5 and reversibility when given glucose
- suggests insulinoma
- C peptide levels dont fall on insulin administration
77
elevated pH, fishy smelling vaginal discharge
trichomonas vaginalis
| - metronidazole
78
child with meningism, odd behaviour and bilateral temporal lobe focus on MRI
HSV encephalitis
| - aciclovir IV
79
Stiffness and myalgia on exercise followed by a second wind with myoglobinuria after exercise
mcardles disease
| - glycogen storage disease
80
fair hair, eczema, musty smelling urine
PKU
81
peripheral rash, ulceration and reynauds
cryoglobulinaemia
82
fibrinoid necrosis surrounded by palisading epithelial cells
biopsy of rheumatoid nodules
83
CPR in neonates (<28 days)
3:1 ratio
84
child with learning difficulties, hepatosplenomegaly, jaundice, CP, growth delay and cataracts
CMV
85
neonate with blistering rash, lymphadneopathy, hepatosplenomegay, jaundice and encephalitis
HSV type 2
86
anti RNP antibody
mixed connective tissue disorder
87
knee pain with chrondrocalcinosis on Xray
pseudogout
88
upper limb bilateral loss of spinothalamic
syringomyelia
89
twisting knee and delayed swelling and locking
meniscal tear
90
twisting flexed knee and pop and instant swelling
ACL
91
child with increased head circumference, bulging fontanelle + sunsetting eyes
hydrocephalus
| - impaired upwards gaze
92
dementia, incontinence and disturbed gait
normal pressure hydrocephalus
| - weird, wet, wobbly
93
lumpy breasts that are warse around menstruation
fibroadenosis
94
tender breast lump with green discharge
mammary duct ectasia
| - dilation of large breast ducts
95
pagets disease of the nippple
eczematous changes associated with invasive ductal carcinoma
96
breast thickening with blood stained discharge
duct papilloma
97
knee injury followed by pain on going downstairs and muscle wasting
chondromalacia patellae
98
recurrent oral and genital ulcers, plus uveitis and diarrhoea
behcets
99
bilateral leg pain that gets better with rest and leaning forward
spinal stenosis
| - MRI to confirm
100
heberdens nodes and bouchards nodes
OA
101
Z shaped thumb + swanneck + boutonierre deformity
RA
102
muscle weakness with poor response to treatment, inclusion bodies on biopsy
inclusion body myositis
103
sitagliptin
DPP4 inhibitor
| - useful in obese patients - weight loss
104
exenatide
GLP-1 mimetic
105
acromegaly first Ix
IGF-1 levels
106
hypokalaemic metabolic alkalosis and impaired glucose tolerance
cushings
107
hyponatraemia and hyperkalaemia and weight loss
addisons
108
cognitive impairment, parkinsons, visual hallucinations
lewy body dementia
- SPECT scan
- Tx with acetylcholinesterase inhibitors such as donepezil and rivastigmine
109
weils disease / leptospirosis
fever, myalgia, subconjunctival haemorrhage, jaundice, headache and renal failure
- spread by rat urine
- tx with high dose benzylpenicillin or doxycycline
110
HIV with desaturation on exercise
pneumocystis pneumonia
- treat with co-trimoxazole
- CD4<200
111
chlamydia tx
doxycycline 100mg BD for 7 days OR
| azithromycin 1g stat followed by 200mg for 2 days
112
gonorrhoea tx
ceftriaxone 250mg IM as single dose
| - test of cure
113
gonorrhoea and chlamydia diagnosis
14 days post exposure NAAT
- first void urine in men
- high vaginal/ vulvovaginal swab in women
- rectal swab for MSM
114
induction of labour medication
vaginal misoprostol (prostaglandin)
115
post coital bleed during pregnancy
ectropion
116
Patient on COCP with diarrhoea and illness requiring antibiotics, 2 weeks later has lower abdo pain
urinary pregnancy test
117
severe RIF pain, bHCG negative
ovarian torsion
118
rate control in AF
BB (or digoxin)
119
heart failure managemet acutely
O2, furosemide, GTN, morphine
120
heart failure long term management
ACEI + BB
- then spironolactone
- furosemide if fluid overload
121
Tx of prolonged campylobacter
clarithromycin
122
AMA positive, ALP high, invasion of lymphocytes into ducts
PBC
123
red painful lesion on cheek
stauph aureus
124
lesion with stuck on appearance
seborrhoeic keratosis
| - reassure
125
woman taking carbamazepine becomes pregnant, what med should she take
5mg folic acid
126
old man with fluctuating confusion
chronic subdural haematoma
127
48y/o with change in behaviour and disinhibition
picks disease
128
22y/o post infection notices a mass at anterior aspect of SCM
branchial cyst
129
dendritic ulcer
herpes simplex keratitis
| - topical aciclovir
130
tall R waves on V1-2
posterior MI
131
management of PE with hypotension
thrombolysis
| - without hypotension = LMWH
132
Bilateral red eye and pain on reading with fluorescein stain showing punctate lesions on conjunctiva and cornea
dry eyes sicca
133
overdose with hyperreflexia, tachycardia, pupils dilated
TCA overdose
| - treat with IV bicarbonate
134
drug withdrawal after 48 hours causing irritability, sweating, and dilated pupils that react to light
diazepam - benzo
135
elderly patient that behaviour has changed following a change in their carer
adjustment disorder
136
electrolyte in refeeding syndrome
hypophosphataemia
137
test for SIADH
urine : serum osmolality
138
cervical smear shows dyskaryosis, what type of cancer
SCC
139
amenorrhoea > 12 months wanting HRT
continuous combined HRT
140
menstrual irregularity and periods of amenorrhoea
cyclical combined HRT
141
T2DM patient with proteinuria on urinalysis, what Ix
urinary albumin:creatinine ratio (ACR)
142
Male smoked with haematuria, abdo pain and loin mass
RCC
143
20 y/o moved from afghan and has pelvic fracture. bloods show increased PTH and ALP. decreased Ca. what Ix
vitamin D - low
| osteomalacia
144
what Ix for suspected achilles rupture
US
145
what drugs cause pancytopenia in patients on methotrexate
co-trimoxazole and trimethoprim
146
muscle aches and stiffness with raised ESR
PMR
147
secondary care of mild psoriasis
UVB + PUVA
| systemic therapy - methotrexate
148
stage 1 of labour
latent - 0-3cm dilated with contractions
| active - 3-10/fully dilated
149
systemic vasculitis symptoms + HepB without pulmonary symptoms/signs
polyarteritis nodosa
150
history of chornic alcohol abuse presents with confusion ataxia and ophthalmoplegia
treat with pabrinex - IV vitB/C
- this is wernickes encephalopathy due to thiamine deficiency
- treat to prevent korsakoff syndrome
151
Tx of PPROM
erythromycin and steroids
152
features of argyl roberston pupil
pupilary reflex absent
| accomodation reflex present
153
holmes adie pupil
dilated pupil that slowly responds to light
| - can be associated with absent knee reflex
154
marcuss gunn pupil
RAPD
155
burning around eye with erythematous blistering rash in trigeminal distribution
herpes zoster ophthalmicus
| - hutchisons sign on top of nose shows ocular involvement
156
brown pigmentation of iris
latanoprost treatment
| - prostaglandin analogue
157
Tx of primary open glauecoma that causes pupil constriction, blurry vision and headache
pilocarpine
158
flashes of light and floaters in peripheral vision
vitreous detachment
159
immunofluorescence shows linear IgG + complement along the basement membrane
bullous pemphigoid
| - autoimmune with antibodies against hemidesmoses at the DEJ
160
immunofluorescence shows chicken wire deposits of IgG within the epidermis
pemphigus vulgaris
| - autoimmune with antibodies against desmoglein 3
161
munro abscesses, hyperkeratotic stratum corneum, parakeratosis, absence of granular layer, thickened prickle cell layer
psoriasis
162
monomorphic punched out lesions
eczema herpeticum
| - HSV - emergency admission and tx with IV aciclovir
163
potency of topical steroids
hydrocortisone then eumovate then betnovate then dermovate
164
itchy scale rash at forehead and nasolabial folds
seborrhoeic dermatitis
| yeast infection - treat with ketoconazole
165
skin test used for contact dermatitis
skin patch
| - type IV
166
skin test used for food and pollen allergies
skin prick
167
when is RAST used
when skin prick is not suitable ie eczematous skin or patient taking antihistamine
168
acne rosacea treatment
topical metronidazole then add oral antibiotics then isotretinoin
169
Tx of telangiectasia and rhiopyma in acne rosacea
laser therapy
170
acne vulgaris treatment
topical retinoid then benzyl peroxidase then antibiotics (topical then oral) then COCP then oral retinoids (isotretinoin aka roaccutane)
171
target lesion
erythema multiforme
| - due to hypersensitivity triggered by infection
172
blister than breaks down to form necrotic ulcer
pyoderma gangrenosum
| - seen in IBD or RA
173
necrobiosis lipoidica
seen in diabetics
| - firm waxy yellow plaques on anterior shin
174
thickened brown hyperpigmented velvety skin in flexural areas
acanthosis nigricans - seen in diabetes, addisons or maliganncy
175
stuck on appearance
```
seborrhoeic keratosis (basal cell papilloma)
- reassure or cryotherapy/curretage
```
176
hyperpigmented firm papule with pain/itch associated with trauma or insect bite
dermatofibroma
177
deficinecy in porphyria cutanea tarda
uroporphyrinogen decarboxylase deficinecy
178
deficinecy in erythropoetic protoporphyria
ferrochelatase
179
deficiency in acute intermittent porphyria
porphobilinogen (PBG) deaminase
180
itchy pearly pink papules with umbilicated centre in child
molluscum contagiosum
| - pox virus
181
slapped cheek
parvovirus B12
| - erythema infectiosum
182
hand foot and mouth
coxsackie virus
183
diagnosis and management of dermatophyte infection
skin scraping or nail clipping
- topical clotrimazole, miconazole.
nail infection = oral terbinafine
athletes foot = topical terbinafine
184
patient with hypopigmentation following holiday
pityriasis versicolour
- yeast infection by melassezia
- treat with topical antifungal - selenium sulphide or ketoconazole
185
bullseye appearance rash
erythema chronicum migrans - lyme disease
(borrelia burgdoferi)
- treat with doxycycline
186
painful nodule on ear
chondrodermatitis nodularis helicis
187
pigmentation of nail bad affecting proximal nail fold
acral lentiginous melanoma - this is hutchisons sign
188
asymptomatic flat scaly rash which has a coral red fluorescence on woods light
erythrasma - tx with topical miconazole or oral erythromycin
189
cluster headache tx
hyperbaric O2 and subcut triptan. verapamil as prophylaxis
190
plucking of clothes, smacking of lips, aura and feelings of de-ja vu
temporal lobe seizure
191
motor abnormalities and jacksonian movements
frontal lobe seizures
192
cape like loss of temperature with preservation of fine touch and proprioception
syringomyelia
| - patient burns hands without realising
193
symmetrical tremor with parkinsonism
drug induced parkinsonism
194
ipsilateral CN III palsy with contralateral weakness of upper and lower limb
webers syndrome
195
tremor worse when arms outstretched and better with alcohol
essential tremor
- aut dom
- propranolol first line
196
seizure which began affecting right hand before involving entire right arm and progressing to LOC with entire body shaking
jacksonian march - frontal lobe
197
On completing a full neurological exam it is found that he cannot feel pain or temperature sensation on his right side. He has weakness and loss of light touch sensation on his left side
brown sequard syndrome - complete hemisection of spine
198
hypertension and bradycardia
cushings reflex
| - late sign of raised ICP
199
management of ischaemic stroke >4.5hrs
aspirin 300mg for 2 weeks then clopidogrel 75mg long term
| - statin should also be started
200
management of ischaemic stroke <4.5hrs
alteplase (thrombolysis) - if no contraindications
201
smiths fracture with weakened opposition of thumb
median nerve
202
loss of axillary sensation after axillary node clearance
intercostobrachial
203
supracondylar fracture with difficulty of pronation
median nerve
204
diabetes insipidus and visual disturbance
craniopharyngioma
205
CSF circulation
```
lateral ventricles (via foramenof Munro) --> 3rd ventricle --> cerebral aqueduct (via sylvius aqueduct) --> 4th ventricle then subarachnoid space
- reabsorbed into venous system via arachnoid granulations
```
206
most common complication following meningitis
sensorineural hearing loss
207
antiemetic for parkinsons patient
domperidone (doesnt cross BBB)
208
collapse following laughing
cataplexy
209
african with pericardial calcification, fatigue, chest pain on exertion and SOB
TB causing constrictive pericarditis
210
rise in JVP on inspiration
kussmaul sign
| - constrictive pericarditis
211
narrow pulse pressure, slow rising pulse
aortic stenosis
| - if symptomatic tx with valve replacement, otherwise observe
212
common drugs that cause hyponatraemia
SSRI and diuretics
213
management of stable patient with AF for 3 days and HR of 120
bisoprolol and oral anticoagulant for 3 weeks followed by pharmaco cardioversion
214
RBBB + left anterior/posterior hemiblock + 1st degree heart block
trifascicular block
215
anaphylaxis dose for adult
0.5ml adrenaline
200 IM hydrocortisone
10mg chlorphenamine
216
tx for symptomatic bradycardia
IV atropine
217
high pitched early diastolic murmur that is blowing in nature
aortic regurg
| - collapsing pulse and bobbing head, wide pulse pressure
218
mid-late diastolic murmur that is rumbling in character
mitral stenosis
219
child with sore throat, chorea, rash and polyarthralgia
```
rheumatic fever (Strep pyogenes)
- rash is erythema marginatum
```
220
young female with short PR and wide QRS complx with slurred upstroke
ablation of accessary pathway
221
abnormally large drop in BP during inspiration
pulsus paradoxus
222
what is cor pulmonale
RV hypertrophy and right heart failure due to pulmonary arterial hypertension
223
AF + abdo pain + rectal bleeding
ischaemic colitis
| - thumbprinting, lactic acidosis and CT scan to confirm
224
treatment of hepatic encephalopathy
lactulose (to remove ammonia)
225
treatment of ascites
spironolactone
226
most common cause of infective exacerbation of COPD
H.influenzae
227
h.pylori eradication tx
amox + met + PPI (7 days)
228
signet ring cells
gastriccancer
229
periumbilical discolouration (cullen) and flank discolouration (grey-turner)
acute pancreatitis
230
itching in middle aged woman with raised AMA
primary biliary cirrhosis
231
triad of sudden abdo pain, ascites, and tender hepatomegaly
budd chiari syndrome
232
coffee bean sign
sigmoid volvulus
233
first step of management of pleural effusion
perform pleural aspiration (under US) to find cause of effusion
234
diagnostic marker for carcinoid syndrome
5-HIAA
- carcinoid syndrome occurs when mets are present in liver and release serotonin into systemic circulation causing flushing, diarrhoea, bronchospasm, hypotension etc
235
long term risk of PPI
osteoporosis due to malabsorption of magnesium and Calcium
236
pansystolic murmur in lower left sternal border
VSD
237
diastolic machinary murmur in upper left sternal border
PDA
238
ejection systolic murmur in the upper left sternal border
pulmonary stenosis
239
sore throat and pustules on hands and feet
coxsackie - hand, foot and mouth
240
32 y/o female with symmetrical polyarthritis and proteinuria
SLE
241
female with dactylitis and DIP
psoriatic
242
man with sternal pain and multiple lytic lesions - what Ix
protein electrophoresis - myeloma
243
what form of therapy is becks triad
CBT
244
what is freudans theory
psychoanalytical
245
surfer who has gradual unilateral hearing loss
exocitosis
246
what fruit interferes with statins
grapefruit
247
hearing loss after getting off plane
tympanic perforation
248
colposcopy shows ulcerated malignant lesion with discharge
lletz - large loop excisional biopsy of the transformation zone
249
man dragged out river - what shock is going on
hypothermia - mixed metabolic and respiratory acidosis
250
someone on SABA + ICS and using SABA 4 times / day , what next
LABA
251
what happens in bullous pemphigoid
immunofluorescence shows IgG and C3 at the dermoepidermal junction
252
elbow replacement then tingling in ring finger and positive fromments test
cubital tunnel syndrome
| - fromments test is picking up paper test
253
painful hip and leg is shortened, adducted, and internally rotated.
posterior hip dislocation
254
treatment of anterior uveitis
topical steroids
| - urgent ophthalmology review
255
first line for acute angle glaucoma
IV acetazolamide
256
woman with TAH BSO for endometriosis has hot flushes and night sweats aged 45
oestrogen only HRT
257
tx of girl with acne wanting contraception
dianette (COCP_)
258
bilateral red eye in neonate
chlamydial conjunctivitis
259
lesion on leg with firm hard centre
dermatofibroma
| - often history of trauma
260
leg ulcers with ABPI >0.8
graduated compression
261
leg ulcers with ABPI 0.4
refer to vascular surgeon
262
psoriasis pathophysiology
hyperproliferation of keratinocytes
263
Who must you inform when detaining emergency mental health act
mental health officer
264
who can help to explain schizophenia to parents
community mental health nurse
265
who helps old man wanting to move into care home
social care
266
patient in accident, what law can you use to treat them
common law
267
who appeals a detention order for patients with mental health condition
advocacy worker
268
haematuria in someone back from abroad
schistosomiasis
269
what is the cause of bleeding in woman taking NSAIDs for hip replacement develops bleeding
acute erosive gastritis
270
what ECG feature in hypothermia
J waves
271
Woman who has angina pain with history of severe left knee osteoarthritis
myocardial perfusion scan
272
sweating, palpitations, hypertension
urinary metanephrines for phaeochromocytoma
| this has replaced urinary catecholamines
273
65 year old lady vacant pauses, distracted. Last for several hours, recovers in less than 24hours
partial status epilepticus
274
child with abdominal pain and joint pain and then has purpuric rash down buttocks to thighs feeling slightly unwell
HSP
275
born and then 20 mins later short of breath and needing oxygen fast resp rate
transient tachypnea of the newborn
276
scan for someone with prostate cancer and back pain
technetium bone scone
277
patient on IV co-amoxiclav and clari for severe pneumonia whose obs have been stable for 48 hours . what tx
step down to oral doxycycline
278
Someone who is being treated with iv fluclox for endocarditis.. results come back and sensitive to this… obs are now stable
stay on same IV regimen as this is a deep seated infection
279
pyrexic 35 year old with tonic colonic fits in the last 48 hours
viral encephalitis
| - HSV - IV aciclovir
280
30 year old smoker wants contraception that must be oral. Previous arterial disease.
POP
281
woman had palps, dizzy. When she came to see you she was anxious and hyperventilating and then collapse
hypocapnia
282
142. Person was on olanzapine and had developed a dry mouth – which NT/receptor was responsible for this effect
ACh
283
PTSD treatment
eye movement desensitisation reprocessing EMDR
284
woman hearing things but knew they were inside her head
pseudohallucination
| - in perception in MSE
285
person with contact lenses and has red eye and pain
bacterial keratitis / corneal ulcer
286
white spider web pattern in mouth
drug induced lichen planus
287
painful yellow ulcer with red halo
aphthous ulcer
288
what hormone triggers testosterone production
LH
289
where is sperm stored
epidiymis
290
corpus luteum secretes
progesterone
291
man has compartment syndrome of extensor part of lower leg – which structure most be affected
deep fibular nerve
292
what disease has a degenerated NBM
alzheimers
293
what is the heritability of schizophrenia
80%
294
what part of MSE
man wants to kill himself - thought content
man has flight of ideas - thought form
man picked up phone during interview - behaviour
couldnt complete MMSE - cognition
295
In which part of the brain are changes most likely to be found in early Alzheimer’s disease?
temporal lobe
296
treatment of gout in CKD
oral prednisolone
297
MSM with proctitis and lymphadenopathy
lymphogranuloma venereum
298
tx for severe pneumonia
co-amoxiclav and doxycycline
299
HDU/ITU pneumonia tx
co-amoxiclav and clarithromycin
300
marjolins ulcer
malignant transformation to a SCC of a non-healing ulcer
301
tx for uncomplicated venous ulcer
graduated compression bandaging
302
mild to very potent steroid
mild - hydrocortisone
moderate - modrasone clobetsaone butyrate - eumovate
potent - betnovate - betomethasone valerate
very potent - dermovate - clobetasone proprionate
303
chickenwire deposit of IgG
pemphigus vulgaris
| - mucosal involvement and nikolsky +ve
304
sub-epidermal bullae with granular IgA in dermal papillae
dermatitis herpetiformis
| - associated with coeliac - tTG
305
50 y/o Turkish man with 3 year history of liver cirrhosis 2ry to Hep C presents with ulcer + pleuritic chest pain + SOB. O/E: has multiple purpuric rashes, + large leg ulcer. Blood tests reveal elevated urea + creatinine, + urine dip is positive for protein and blood. Diagnosis?
cryoblobulinaemia
- Nephritic/Nephrotic pic – membranoproliferatuve glomerulonephritis
- Cryoglobulinaemia commonly secondary to Hep C
Purpura + gangrene
- PE = increased risk of thrombus
306
what study - group of individuals who differ with respect to one or more factors are followed, to determine how these factors affect outcomes
prospective cohort
307
what study - individuals with a given outcome along with a suitable control group and looks back retrospectively at how many individuals from both groups had the exposure(s) of interest.
case-control study
308
what study - measures prevalence in a population at a given point in time.
cross sectional study
309
what study - tests the effects of a specific intervention or interventions against a control group
randomised clinical trial
310
what study - begins after the outcome has occurred and looks back at the exposure of interest.
retrospective cohort
311
which airway device provides protection for the lungs from regurgitated stomach contents
tracheal tube
312
what is the treatment of a prolactinoma
cabergoline
313
what is the screening test for haemochromatosis
transferrin saturation
314
mass that transilluminates and is separate and can get above the testis
epididymal cyst
315
what is the most common pathogen in leg cellulitis
strep pyogenes
316
what age do you give vitamin D supplements
6 months to 5 years
317
what is the cause of polyuria in diabetes
osmotic effects of glucose
318
olanzapine causes dry mouth due to which NT
ACh
319
head lagging and dysphonia
MG`
320
treatment of lewy body dementia
ACh-ase inhibitors
321
femoral nerve block affects what muscles
hip flexors and knee extensors
322
deep dyspareunia, fixed retroverted uterus
endometriosis
323
contact lens wearer has pain and decreased VA
corneal ulcer / keratitis
324
physiological change of ageing
heterogenicity
325
what are the risks of imperforate hymen
endometriosis due to retroverted uterus
326
patient who was in a coma after a motorcyle crash has ca2+ influx and excitotoxicity.
diffuse axonal injury
327
induction of ovulation in hyperprolactinaemia
bromocriptine
328
child throwing cereal in morning, absence seizures at school
JME - juvenile myoclonic epilepsy - early morning seizures and then absences
329
SE of acarbose
flatulence
330
MOA of metformin
AMPK and reduced gluconeogenesis
331
risk of saline
hyperchloraemic metabolic acidosis
332
statin use
```
primary prevention - atorvastatin 20mg OD
secondary prevention (post MI) - atorvastatin 80mg OD
```
333
Thyrotoxicosis with tender goitre
subacute (De Quervain's) thyroiditis
334
small testes, infertility, gynaecomastia, above average height and a lack of secondary sexual characteristics.
Klinefelters syndrome
335
hypercalcaemia ECG
short QT
336
MOA of thrombolysis
activate plasminogen to form plasmin
337
Hypochloraemic hypokalaemic metabolic alkalosis
pyloric stenosis
338
seizure was lip smacking and post-ictal dysphasia
temporal seizure
339
young man with night blindness and tunnel vision
retinitis pigmentosa
340
large radiolucent lesion in the head of the humerus extending to the subchondral plate with a soap bubble appearance
giant cell tumour
341
boy has a fracture and Xray shows a lytic lesion with onion type periosteal reaction
ewing sarcoma
342
microcephaly, polydactyly and cleft lip/palate
patau (13)
343
micrognathia, rockerbottom feet, overlapping fingers, low ears
edwards (18)
344
stroke with left sided leg weakness
right anterior cerebral artery
345
Middle aged adult with insidious onset dementia and personality changes
picks disease - fronto-temporal dementia
346
what test can be used to assess if fetaland maternal blood have been mixed
Kleihauer
347
A 28-year-old woman presents with abdominal pain, vomiting andjaundice. On examination she has tender hepatomegaly and ascites.She has a history of recurrent miscarriages.
budd-chiari syndrome
348
A 35-year-old man presents with an insidious onset ofhepatosplenomegaly with marked pigmentation on the forehead andhands. He is anaemic and has a history of pathological fractures.
gauchers disease
349
A 24 year old presents with nausea, malaise and jaundice. Hereturned 3 weeks ago from a holiday abroad. On examination he has amoderate hepatosplenomegaly and tender cervical lymphadenopathy.He has dark urine and pale stools.
hep A
350
A 22-year-old man presents with a lump on the scalp. Examinationreveals a smooth, spherical, tense lump. A small punctum can be seenon the surface
sebaceous cyst
351
A 33-year-old man presents with a swelling on the upper arm that has been growing slowly for a number of years. Examination revealsa soft, compressible, non-tender, lobulated mass.
lipoma
352
A 28-year-old man presents with a painless swelling on the dorsumof the right hand. Examination reveals a smooth, spherical, tense,1.5 cm swelling. The overlying skin can be drawn over it.
ganglion
353
A 29-year-old man presents with two mobile fusiform-shaped lumps on the forearm. Each swelling feels like firm rubber and causes tingling in the hand on pressure.
neurofibroma
354
A 65-year-old woman presents with a rapidly growing lump just below the eye. Examination reveals a 2 cm smooth, round, skin-coloured lump with a black central core. The lump is freelymobile over subcutaneous tissues.
keratoacanthoma
355
A 26-year-old man presents after surgery with a reducible lump inthe left groin above and medial to the pubic tubercle. The lump is notcontrolled after reduction by pressure over the internal inguinal ring.
direct inguinal hernia
356
A 40-year-old man presents with a swelling in the right groin thatdescends into the scrotum. It can be controlled after reduction bypressure over the internal inguinal ring.
indirect inguinal hernia
357
A 55-year-old woman presents with a soft lump in her left groin.There is an expansile cough impulse and a fluid thrill is felt when percussing lower down the leg
saphena varix
358
A 60-year-old smoker complains of a throbbing lump in his rightgroin. Examination reveals an expansile pulsation in the mass.
femoral aneurysm
359
A 25-year-old man presents with a testicular swelling that hasincreased in size over the last couple of months. The swelling is fluctuant and the underlying testis impalpable.
hydrocele
360
A 45-year-old man presenting with a scrotal swelling is worried thathe is growing a third testicle. On examination there is a smooth fluctuant swelling within the scrotum. Both left and right testes arepalpable
epididymal cyst
361
vitamin C deficiency
scurvy
362
A 25-year-old African man presents with symmetrical dermatitis onsun-exposed skin, diarrhoea and depression. He has recently been onanti-TB treatment.
pelagra due to isoniazid treatment
363
A 41-year-old HIV-positive man presents with decreased visual acuity.Fundoscopy shows a ‘mozarrella and tomato pizza’ appearance.
CMV
| - IV ganciclovir
364
A man says that his depressed partner has taken an overdose. She isdrowsy and hypotensive with signs of respiratory depression. There isno response to naloxone.
benzodiazebines
| - reverse with flumazenil
365
40-year-old depressed man is brought to A&E with dilated pupils,blurred vision and seizures. On examination he is tachycardic and hisECG shows wide QRS complexes
TCA
| - treat with bicarbonate
366
A 65-year-old man complains of flushing, headache and ankleswelling after starting new medication for hypertension.
Nifedipine
367
A 21-year-old woman treated with medication for migraine developsacute dystonia.
metoclopramide
368
A 35-year-old man on treatment for depression complains of a severethrobbing headache soon after his evening meal. Blood pressure ismarkedly raised
phenelezine
369
drug SE of haemorrhagic cystitis
cyclophosphamide
370
A 25-year-old man on treatment for seizures complains of acne andgum hypertrophy.
phenytoin
371
definition of neutropenic sepsis
Sepsis + neutrophil < 0.5,
| or < 1.0 if chemotherapy given within last 21 days
372
stroke due to atherosclerosis
clopidogrel
373
stroke due to cardioembolic disease
start warfarin / NOAC
374
The radial, ulnar, median nerve quick test:
make a fist = median
thumbs up = radial
starfish = ulnar
Thenar sensation = median nerve, Hypothenar sensation = ulnar nerve, 1st web space sensation = radial nerve
375
temporal seizure causing weakness
todds palsy
376
treatment of partial seizures
carbamazepine or lamotrigene
377
initial treatment of status epilepticus
Lorazepam 4mg IV or Midazolam 10mg buccally or Diazepam 10mg IV
378
A 43 YEAR OLD PATIENT CAME HIM WITH HIS WIFE. SHE REPORTED VACANT EPISODES WITH LIP SMACKING WHICH LAST APPROXIMATELY 2 MINUTES. HE IS CONFUSED AFTERWARDS. WHAT IS YOUR DIAGNOSIS?
temporal lobe epilepsy
379
Ix for diabetes insipidus
water deprivation test
380
Ix for SIADH
fluid restriction
381
bradycardia + hypertension =
cushing reflex = raised ICP
382
angina management
angina + statin
BB or CCB
nitrate
383
3y/o undergoing surgery becomes bradycardic and hypotensive during surgical traction, what mx
atropine
| - bradycardia is due to oculocardiac reflex
384
71 y/o develops AF at 150bpm. BP is 125/70. She has COPD. what mx
amiodarone
| - BB contraindicated due to COPD
385
65 y/o undergoing THR. PMH of ischaemic heart disease. intra-operatively becomes hypotensive (70/35) with a pulse of 85. what mx
metaraminol - alpha agonist
386
lady with ovarian mets has irregular bowel movements with no colic. what antiemetic will help
metoclopramide
387
patient for surgery with history of GORD, what airway
endotracheal tube
388
diagnosis of polycystic ovaries
12/more 2-9mm follicles
Increased ovarian volume >10ml
Unilateral/bilateral
389
PMH of TB presents ith haemoptysis an CXR shows round opacity
aspergilloma
390
hyperinflation with flattened hemidiaphragms and hyperlucent lungs
COPD
391
pansystolic at apx radiates to axilla
mitral regurg - displaced apex and splitting of 2nd heart sound
392
rumbing mid diastolic heard best on expiration on left side
mitral stenosis- opening snap
393
early diastolic heard bet when leaning forward and expiring
aortic regurg
| - displaced apex, collapsing pulse and head nodding
394
LV failure and new early- mid diastolic murmur post MI
acute mitral regurg secondary to papillary muscle rupture
395
mitral valve obstruction, systemic embolisation and B symptoms
atrial myxoma triad
396
psych drug causing long QT
citalopram
397
tx after stroke
aspirin 300mg for 2 weeks then clopidogrel lifelong
398
ROM + painless bleed + fetal bradycardia
vasa previa
399
tx of acute cholecystitis
IV antibiotics and early lap cholecystectomy
400
management of hyperemesis gravidarum
promethazine
401
management of ectopic with fetal heartbeat
surgical management
402
CVS vs amniocentesis
CVS = 12 weeks, placenta sample , 2% risk
| amnio - >15 weeks,amniotic fluid sample, 1% risk
403
kawasaki tx
aspirin high dose + single dose of IVIG
404
TOP managment
oral mifepristone (antiprogesterone) + vaginal misoprostol (prostaglandin)
405
most common malignant ovarian tumour
serous cytsadenoma
406
alcohol withdrawl timings
6-12 hours = symptoms
36 hours = seizures
72 hours = delirium tremens
407
short PR
WPW
408
ST depression
ischaemia
409
PR depression
pericarditis
410
young athletic female presents with sudden onset lower back pain and prominent back
spondylolisthesis
411
60 y/o with rapid cognitive decline and myoclonic jerk
creutzfelt jakob disease -- diagnose with LP and EEG
412
abdo pain, tenderhepatomegaly and ascites
budd chiari syndorme
| - occlusion of heaptic vein
413
hypothermia, hyporeflexia, bradycardia and seziures
myxoedemic coma
414
pneumonia after influenza
staph aureus
415
pneumonia, fever, dry cough, normocytic anaemia, erythema multiforme
mycoplasma
416
pneumonia on a boat, deranged LFT, hyponatraemia
legionella - urinary antigen
| - treat with levofloxacin or clarithromycin
417
frank haematuria in 24 week pregnant lady with history of C.section
placenta percreta
418
meningitis prophylaxis for contacts
ciprofloxacin
419
dibaetic nephropathy screening
early morning ACR (albumin creatinine ratio)
420
failure to respond to short synacthen test
addisions
421
5 y/o with abdo pain and bloody diarrhoea and target sign on US
intususception
| - tx with reduction using fluroscopy with air
422
child with knee pain after exercise and intermittent swelling and lokcing
osteochondritis dissecans
423
rotavirus risk after 14 weeks
intussusception
424
Thrombocytopenia, retinitis, periventricular calcification on CT
congential CMV
425
chorioretinitis, tram-like calcification on CT, hydrocephalus
congenital toxoplasmosis
426
Bony prominence, saddle nose, rhinitis, skin bullae, abnormal teeth
congenital syphilis
427
still born, non immune hydrops fetalis
congenital parvovirus
428
jaundice, sensorineural deafness, cataracts/glaucoma, meningoencephalitis
congenital rubella
429
skin scarring, limb hypoplasia, neurological and eye lesions
congenital VZV
430
4month history of high spiking fever, arthralgia, salmon pink rash
stills disease / juvenile idiopathic arthritis
431
abortion timings
<9 weeks for medical, <13 weeks for dilation and suction, >15 weeks dilation and evacuation
432
learning difficulties, macrocephaly, large ears and macro-orchidism
fragile X
433
bleeding after dental treatment
vWF deficiency
| - most common inherited bleeding disorder
434
most common iherited thrombophilia
factor V leidine (actiavted protein C resistance
435
6 month old with repeated flexion of head/arms/trunk followed by extension of arms
infantile spasm / west syndrome
| - dramatic hypsarrhythmia appearance on EEG – poor prognosis – linked with tuberous sclerosis – treat with vigabatrin
436
bilateral high frequency hearing loss
presbycusis
437
slow rising pulse
AS
| - also narrow pulse pressure , heaving apx and 4th heart sound
438
1st line treatment for severe falciparum malaria.
IV artesunate
439
sensory loss over sole of foot, weak plantar flexion and inversion
tibial nerve - l4-s3
440
loss of sensation in dorsal first web space
radial nerve
| - humeral shaft fracture
441
spike and wave at 3Hz
absence seizure
442
photosensitive polyspike and wave
JME - juvenile myoclonic epilepsy - morning myoclonic and day time absences
443
temporary weakness post seizure in a
todds palsy
| - associated with jacksonian seizure - twitching movements which spread
444
triad of encepahlopathy, jaundice and coagulopathy
liver failure
445
baby with retinal haemorrhages, encephalopathy and subdural haematoma
shaken baby syndrome
446
treatment of MRSA
vancomycin
447
treamtnt of cellulitis
IV flucloxacillin (vancomycin if allergic)
448
treatment of severe community acquired pneumonia
IV co-amoxiclav and doxy
| if in ITU coamox + clarithro
449
stepping down from amox, met, gent in abdo sepsis
cotrimox and met
450
treatment of pyelonephritis
amox + gent IV
451
palliative resp secretions
hyoscine butylbromide
452
antihypertensive causing ankle swelling
calcium channel blocker
453
offensive 'fishy', thin, grey vaginal discharge. Testing the discharge shows the pH to be > 4.5 and clue cells are present
bacterial vaginosis - metronidazole
454
patient with anaemia, dark urine and jaundice has urine positive for Hb and haemosiderin with low haptoglobins and raised methaemalbumin
G6PD (intravascular haemolysis) with heinz bodies and aut recessive
455
long QT
hypocalcaemia
456
short QT
hypercalcaemia
457
shoulder injury after seizure with lightbulb sign and medial rotation
posterior dislocation
458
tx of hypotension in anaesthesia
ephedrine (a+b agonist) or metaraminol (a agonist)
459
antidepressant in young gun
fluoxetine
460
antidepressant post mi
sertraline
461
overdose causing prolongd QT and anticholinergic
TCA - treat with IV bicarbonate
462
abdo pain, ascites, hepatomegaly
budd chiari formation (occlusion of hepatic veins)
463
penumothorax tx
<2cm – no treatment. >2cm = aspiration, repeat aspiration, chest drain
464
chlamydia tx
doxyxycline 100mg BD for 7 days
465
SVT tx
vagal maneouvres ten adenosine 6 then 12 then 12
466
bradycardia tx
atropine 500mcg
467
MI secondary prevention
atorvastatin 80mg OD, aspirin 75mg OD + ticagrelor or clopidogrel, ACEI 10mg OD, propranolol 80mg BD
468
acne tx
topical retinoidbenzyl peroxide topical Abx oral Abx COCP Roaccutane
469
psoriasis tx
emollientsvitD analogues dithranol coal tarPUVA/UVB methotrexate
470
tx of carcinoid syndrome
somatostatin analogue - octreotide
471
itchy, solid, pearly pink papules with umbilicated centre
molluscum contagiosum – pox virus
472
AK management
sun avoidance, 5-FU cream, topical diclofenac or topical imiquimod
473
vomiting in parkinsons
domperidone
474
where is lesion for huntington
caudat nucleus and putamen
| (35 CAG repeat on chromosome 6
475
righthanded woman ignores the stimuli on her left side
right parietal lobe lesion
476
woman falls to the ground after hearing some bad news
vasovagal syncope -
477
blackouts and falls, preceded by palpitations
stokes adams attack
478
donald duck voice and laughing inappropriately
pseudobulbar palsy
479
CN VII, IX, X, XI palsy
bulbar palsy
480
what is used to prevent tumour flare up initially in prostate Ca
cyproterone acetate (anti androgen)
481
displaced, volume-overloaded apex. Soft S1, pansystolic murmur at apex radiating to axilla
mitral regurg
482
tapping apex beat, loud S1, mid-diastolic murmur loudest at the apex in expiration lying on the left side
mitral stenosis
483
collapsing pulse, wide pulse pressure, ‘pistol-shot’ sound heard over femoral arteries
aortic regurgitation
484
slow rising pulse, narrow pulse pressure, heaving apex beat and fourth heart sound
aortic stenosis
485
bilateral high pitch hearing loss
presbycusis
486
6 month old with repeated flexion of head/arms/trunk followed by extension of arms
west syndrome - infantlile spasm - hypsarrhythmia on EEG - poor prognosis and tuberous sclerosis - treat with vigabatrin
487
most comon inherited throbophilia
factr V leiden - activate protein C resistance
488
bleeding following dental treatment
vWF deficency
489
normocytic anaemia, leukopenia and thrombocytopenia
aplastic anaemia
