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1
Q

what is courvoisier’s law

A

in a patient with a painless enlarged GB + mild jaundice the cause is unlikely to be stones
It is more likely to be malignancy of pancreas or biliary tree

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2
Q

What is the garden classification

A

for classification of NOF #s:
1- incomplete stable
2- complete, non displaced
3- complete, partially displaced
4- complete, completely displaced

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3
Q

What is gartland classification for?

A

supracondylar fracture in children

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4
Q

What is salter- harris classification for

A

fractures about the groeth plate in children

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5
Q

WHat is the weber classification for

A

ankle fractures about the syndesmoses

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6
Q

What is the most common reason for the total hip replacement

A

aseptic loosening of the hip replacement

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7
Q

Expected LFTS in hepatocellular disease

A

ALT raised at least 2 fold
Normal ALP
ALT/ALP at least 5

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8
Q

Expected LFTS in cholestatic disease

A

ALT normal
ALP raised at least 2 fold
ALT/ALP less than 2

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9
Q

Expected LFTS in mixed hepatocellular and cholestatic disease

A

ALT and ALP raised at least 2 fold
ALT/ALP = 2-5

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10
Q

Why do asthma symptoms worsen at night and early morn

A

Circaidian variations in airway tone and reactivity

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11
Q

What’s the rule for CT and LP in SAH

A

If CT negative and done within 6 hours of symptoms , then consider an alternate dx
If CT negative and done 6 hours past symptoms, then can do LP

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12
Q

What is the MC site of metatarsal stress fractures

A

2nd metatarsal shaft

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13
Q

What is used as a first line agent to treat focal seizures

A

lamotrigine

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14
Q

What is the difference on CT b/w chronic and acute subdural hematoma

A

CHronic - hypodense
Acute- hyperdense
- both crescent collections around brain concavity. not limited by suture lines

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15
Q

What vessel is damaged and where does bleeding occur in subdural hemorrhage

A

briding veins - convex and venous sinuses

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16
Q

benzos for terminating seizures based on route

A

midazolam-> mouth
lorazepam-> line/IV
Diazepam -> PR

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17
Q

Aus rules for seizure termination

A

midaz/diaz 10mg IV if can get IV access w/in 5 min
If cant get access 10mg IM midaz or 5-10mg buccal/ intranasal midaz

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18
Q

Which Abs are more useful/ diagnostic for ix B12 def

A

intrinsic factor Abs

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19
Q

Duration of irrigation for chemical injury on skin

A

20min

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20
Q

how much fluid is given in burns <10% TBSA

A

Maintenance fluids

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21
Q

How much fluid is given in burns >10% TBSA

A

Parkland formula
4ml/kg/%TBSA - gives total in 24 hours- half of which is given in the first 8 hours and the other half in the next 16 hours

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22
Q

What is the MCC of lower GI bleeding

A

Diverticular disease

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23
Q

Which side of diverticular disease is more likely to cause sig bleeding

A

right

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24
Q

what heart thing is associated with angiodysplasia

A

aortic stenosis

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25
Indications for colectomy in UC flare
unresponsive to medical mng signs of perforation, progressive dilation, worsening toxicity
26
When to start IV cyclosporin and infliximab in UC flare
failure to respond to IV CS after 3-5 days
27
what is venous guttering
collapse of superficial veins due to reduced arterial inflow
28
mgn of CLTI- chronic limb threatning ischemia
urgent vascular imaging -> CT angio Revascularisation- either endovascular or open surg RF mods: smoking cessation, antiplatelet, mng CV comorbids
29
What feature of chronic limb threathening ischemia indicated an immediately threatened limb requiriung urgent revascularisation
loss of motor function
30
Diagnostic criteria of chronic limb threatneing ichemia
at least 2 weeks of: rest pain, ulceration or gangrene
31
When does callus formation on XR appear
2-3 weeks after fracture
32
List some common causes of bronchiectasis
post inf: severe pneumonia, TB, childhood inf Immunodef: IgA def, hyper IgM syndrome CF Allergic bronchopulmonary aspergillosis Primary ciliary dyskinesia CT disorders
33
Most common cause of central retinal artery occlusion
Embolus from atherosclerotic carotid artery
34
Examination findings of acute angle closure glaucoma
seen in ant chamber: cloudy cornea, shallow ant chamber, mid dilated unreactive pupil
35
mng of central retinal artery occlusion
urgent evaluation for carotid endarterectomy
36
what anatomical variant can preserve some vision in central retinal artery occlusion
cilio-retinal artery
37
Which imagin modality is preferred for drainage of pelvic abscess
CT
38
When is ultrasound guided drainage considered
fluid colllections within GIT or adjacent if CT drainage of pelvic failed
39
fluid resus guidelines in septic shock
immediate fluid resus with 30ml/kg of crystalloid in the first 3 hours
40
mng of an incidental finding of porcelain GB
Yearly follow up with USS
41
What is the time period for a late DVT following total hip arthroplast
up until at least 35d post surgC
42
CI to suing fondaparinux in DVT ppx
increased bleeding risk so: elderly, renal impairment, <50kg
43
Which clin f of GORD is less likely to be controlled by PPIS
regurgitation
44
when should an endoscopy be ordered for pts with GORD
Red flags- dysphagia, odonophyagia, GI bleeding, wt loss, fatigue Diagnostic uncertainty symptoms not responsive to initial treatment long stnading troublesome symptoms symtpoms in older people- esp asian pop preop assessment detect and mng baretts esophagu
45
what is food protein induced enterocolitis syndrome
non IgE medicated food allergy
46
Clin f of food protein induced enterocolitis sydnrome
vomits, lethargy, diarrhea 1-4 hours after ingestion of trigger
47
Indications for long term oxygen therapy
PO2 of 7.3-8kPa and one of: secondary polycythemia, peripheral edema, pulm htn
48
Which opiod may work on neuropathic pain
tramadol
49
What is the first line med for eclampsia
magnesim sulphate
50
When can pt resume their hormonal contraception after taking levonorgestrel
immediately
51
FOlic acid recommendation in not high risk preg:
400mcg 3mo before up to 12weeks GA
52
What are the SSRIS of choice in breastfeeding women
sertraline paroextine
53
At what BP for pregnant women should they be admitted and observed
>160/110
54
How to manage unscheduled bleeding after impanon insertion
3mo of COCP
55
When to offer anti-D prophylaxis in abortion
rhesus D negative and abortion is after 10+0 weeks GA
56
mng of SCFE
Ortho- in situ fixation with cannulated screw
57
How long are suboptimal Sp02 readings expected from a healthy neonate
up to 10 min
58
Preferred method of induction of labour if bishop score >6
amniotomy + IV oxytocin infusion
59
Diagnostic criteria/ suspicion for whooping cough
acute cough at least 14d without apparent cause with at least one of: paroxysmal cough, inspiratory whoop, post-tussive vomiting, undiagnosed apneic attacks in young infants
60
Define a small PTX
<15% Less than a 2cm rim b/w outer lung margin and chest wall at level of hilum
61
what does hyponatremia 7-10d after transsphenoidal surgery indicate
SIADH
62
What is the treatment of SIADH
Daily fluid restriction
63
Features of hyperkalemia on ECG
Peaked T waves , broad QRS
64
Features of digoxin toxicity on ECG
Junctional rhytm/regular ventricular response plus Af
65
For how long should DAPT be continued after drug eluting cardiac stents are inserted
6-12mo
66
Dx of: wt loss, smoking, ETOH, painless bilateral pedal edema over the last 2 days and on CT: retroperitoneal mass
lymphoma
67
what med is used for prevention of variceal bleeding
Noncardioselective betablocker-> propanolol
68
Pneumonia causative organism in pts with preceding influenza
staph aureus
69
Def cholesteatoma
collections of stratified squamous epithelium in the middle ear- can be congenital or acquired
70
RFs for COPD
Smoking Air polluition, occupational exposure, exp to wood smoke or other biomass fuel Alpha 1 antitrypsin def Age, FH atopy, male, hx of childhood resp inf, low socioeconomic status
71
Dx test of choice for suspected legionella
urinary antigen
72
What meds can cause tinnitus
NSAIDS benzos TCAS ABX
73
Examples of hypertonic fluids
3% Normal saline
74
Def acute cholecystitis
Inflammation of GB - gs IN CYSTIC DUCT

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