Clinical conditions bible Flashcards
(166 cards)
1
Q
PCOS triad
A
Hyperandrogenism
Anovulation
Cystic ovaries on US
2
Q
Cystic ovaries on US characteristics
A
12+ follicles 2-9mm
3
Q
PCOS associated conditions
A
T2DM
Obesity
4
Q
Ectopic pregnancy presents with
A
Abdominal/pelvic pain
Amenorrhea
Cervical motion tenderness
5
Q
Manage ectopic surgically
A
Laparoscopic salpingectomy
6
Q
Cystocele
A
Bladder into front vaginal wall
7
Q
Rectocele
A
Rectum into posterior vaginal wall
8
Q
Enterocele
A
Prolapse of posterior vaginal wall involving small bowel
9
Q
Urethrocele
A
Prolapse of lower anterior vaginal wall involving urethra only
10
Q
Vault prolapse
A
Top of vagina bulging down
11
Q
When do you get a vaginal vault prolapse?
A
Post hysterectomy
12
Q
Complete vaginal eversion AKA
A
Procidentia
13
Q
POP-Q is in relation to the
A
Hymen
14
Q
Nocturia is a sign of
A
OAB
15
Q
OAB?
A
Urinary urgency +/- incontinence with increased frequency/nocturia
16
Q
Overflow incontinence management?
A
Specialist
17
Q
Male vs female c/g test
A
VVS women
First pass urine male
18
Q
Manage chlamydia new guidelines
A
Doxy 7
19
Q
Gonorrhea infects what?
A
Mucus membranes
20
Q
Chlamydia infects
A
Male urethra and female endocervix/urethra
21
Q
Most common non-viral STI worldwide
A
Trichomoniasis
22
Q
What does trichomonad vaginalis look like?
A
Flagella
23
Q
Strawberry cervix
A
TV
24
Q
Test for trichomoniasis
A
Charcoal swab with microscopy
25
Manage TV
Metranidazole for 5-7 days
26
BV is caused by overgrowth of what?
Anaerobic organisms and loss of lactobacilli
27
BV test
High vaginal swab
28
Spriochete bacterium
Syphilis
29
How does syphilis spread?
Gets through skin and mucous membranes, replicates, disseminates throughout bloodstream and lymphatics
30
Can you give syphilis to baby?
Yes
31
How do you know if syphilis has been treated?
RPR value decreases 4 fold
32
Treat syphilis?
Parenteral IM benzylpenicillin
33
Candiadasis test
Charcoal swab
34
Charcoal swab
Thrush / BV / TV / Group B strep
35
Pupils with syphilis
Argyl-Robertson
36
Most common non-gonococcal urethritis
Mycoplasma genitalium
37
NAATS for non-gonococcal
HVS women
| First pass men
38
Treat non-gonococcal
Doxy 1 week
39
When is itch worse with crabs?
Night time
40
HIV primary infection undergoes __________, then what happens?
Seroconversion, flu like symptoms present
41
During seroconversion, the patient is not/is contagious
Is VERY contagious
42
What does viral load mean?
Number of copies of HIV RNA per ml of blood
43
"Undetectable viral load" AKA
50-100 copies / ml
44
HIV, CT shows multiple ring enhancing
Toxoplasmosis
45
Manage cyst premenopausal
<5cm
5-7cm
>7cm
Resolve in 3 cycles
Routine referral, yearly US
Consider MRI or surgery
46
Persisting or enlarging cysts require
Laparoscopy, ovarian cystectomy +/- oophorectomy
47
Meigs syndrome
Fibroma, pleural effusion, ascites
48
How do you treat ovarian torsion?
Laparoscopic surgery
49
PID is caused by
Gonorrhea, chlamydia, mycoplasma
50
How do you treat non-STI PID?
Ceftriaxone and doxycycline
51
What is FHC syndrome?
Perihepatitis
| Inflammation and infection of liver capsule resulting in adhesions between liver and peritoneum = RUQ pain
52
HPV produces what that inhibits P53?
E6 and E7
53
What can cervix look like in cervical cancer
Inflamed or friable !
54
Protective factor in endometrial cancer?
Smoking
55
Exam for endometrial cancer pathway
TVUS
Pipelle biopsy
Hysteroscopy with biopsy
56
GI tract in ovary tumour
Krukenberg - signet ring on histology
57
When do you give IV hydralazine?
Critical care with hypertension in pregnancy
58
Early vs late miscarriage
<13 weeks
| 13-24 weeks
59
Diagnose miscarriage
TVUS
60
Manual vs electric vacuum
LA
| GA
61
APH measurements
<50
50-1000
>1000 or shock
62
Placenta praaevia over internal os manage
C-section 36-37 weeks
63
Woody hard uterus
Placental abruption
64
Vasa previa delivery
C section
65
Asymptomatic vasa previa manage
Corticosteroids and Csection
66
Placenta accreta diagnosis via
Antenatal USS
67
PPH is prevented how?
Active manage
| Syntocinon IM/IV + tranexamic acid IV (C/S)
68
Continuous assessment in PPH chart
MOEWS chart
69
What is McRoberts manoeuvre?
Hyperflexion of hip to provide a posterior pelvic tilt to lift pubic symphysis up and out of way
70
Rubins manoeuvre
Reaching into vagina to apply pressure on posterior aspect of baby's shoulder to move it under pubic symphysis
71
Wood's screw
Performed during Rubins, hand into vagina
Pressure on posterior shoulder
Top shoulder is pushed forward and bottom backwards to rotate baby and help delivery
72
Manouvre to push baby back in so you can perform CS
Zavaneli
73
Cord prolapse most significant risk factor
Abnormal lie at 37 weeks
74
Cord prolapse treat
CS
75
Uterine fibroids are non/tender
Non tender
76
Fibroid management
<3cm IUS, COCP, NSAIDS
| >3cm myomectomy, uterine artery embolization
77
Endometriosis in myometrium
Adenomyosis
78
Endometriosis symptoms
Deep dyspareunia, dysmenorrhea, infertility
79
Confirm vulval lichen sclerosis
Vulval biopsy
80
Vulval lichen sclerosis treat
Clobetasol Propionate
81
Breast mouse or
Fibroadenoma
82
Do phyllodes tumours require intervention?
Yup - excision
83
BRCA breast cancer common mets
Lungs liver breast brain
84
DCIS usually seen on
Mammogram
85
LCIS seen in who? How do you detect?
Premenopausal women
| Not seen on mammogram - accidental finding
86
Manage LCIS once found
6 monthly exam and yearly mammogram
87
Tethering nipple
Pagets
88
Paeu d'orange
Inflammatory breast cancer
| Pitting oedema of breast
89
Diagnosis of breast cancers
<40 = US
>40 = mammogram
Core biopsy
90
Tumours of frontal lobe causes changes in
Personality/behaviour
91
Most common brain mets are from
Lung
92
Extradural tumours are
Secondary mets
93
Intradural tumours are
Meningiomas, schwannoma
94
Intramedullarly are
Astrocytoma, gliomas
95
Investigate meningioma
MRI +/- CTA
96
Acoustic neuromes gene
Tumour supressor gene on Ch 22
97
Schwanomma removed surgically typically by
Gamma knife radiotherapy
98
Craniopharyngiomas are seen in who?
5-14 year olds and 50-70 year olds
99
Does chemo work in craniopharyngiomas?
No
100
Primary CNS lymphomas are usually
Large B cell lymphomas
101
Test in CNS lymphomas
Test for HIV
102
Manage primary CNS lymphoma
Manage with chemo with radiotherapy
| Dexamethasone
103
Most common malignant CNS tumour in kids
Medulloblastoma
104
What do medulloblastomas arise from?
Cerebellar stem cells between brainstem and cerebellum
105
Medulloblastomas are _______ _______ _________ tumours
Malignant primitive neuroectodermal
106
How do medulloblastomas present?
Cerebellar signs and diplopia
107
Commonest benign tumour in kids?
Pilocytic ast rocytoma
108
What is meningitis?
Inflammation of Pia and arachnoid mater meninges of brain and spinal cord
109
Encephalitis
Inflammation of brain tissue itself
110
Neisseria meningitis causing meningitis mostly capsule group
B
111
Kernig's sign
Unable to fully extend at the knee when hip is flexed (spinal pain/resistance)
112
Brudzinski's sign
Patient's knees and hips flex involuntarily when neck is flexed
113
Post exposure prophylaxis of meningitis
Single dose ciprofloxacin or rifampicin
114
Silent stroke
Radiological or pathological evidence of infarction without history of dysfunction
115
Why would oral COMT be given in Parkinson's?
Given to improve compliance
116
Phenytoin causes what deficiency?
Folate
117
Diagnosis of GB by what criteria?
Brighton
118
Huntington's triad and other motor signs
Mental disturbance
Cognitive disturbance
Motor disturbance
Chroea, myoclonus, eye movement disorders, dysarthria, dysphagia
119
MG is a what type of sensitivity ?
II
120
What antibiotic is CI in MG?
Gentamicin --> reduce effectiveness of NMJ transmission, exacerbating symptoms
121
LEMS ________ muscle weakness
Prominal lower limb
122
Botulism causes
Rapid onset weakness without sensory loss
123
Monitor ICP with what?
Mannitol or hypertonic saline
124
How long do you need to have symptoms to diagnose shiz?
1 month and 6 months of functional decline
125
Atypical blocks 2 what
D2
| 5HT2a
126
What antipsychotic causes hyperprolactinaemia
Risperidone
127
How many ml of alcohol is a unit
10
128
3 screening for autism
3di
DISCO
ADOS
129
Inflated sense of self importance
Narcissism
130
Place of safety order
Used by police to transport psych patients when they are in public (135)
131
Emergency detention allows up to
72 hours
132
Short term is to what?
Administer psychiatric treatment
133
MI in elderly may present at ______ or ______
Syncope or delirium
134
Vd is what?
Amount given/amount in 1L of blood
135
High Vd is ______ and therefore ______ release from fatty stores
Lipophilic
| Slow
136
Axonal injury involves a reaction in
Cell body
137
________ degeneration of axon during injury
Anterograde
138
Acute neuronal injury when?
Hypoxia
| Ischemia
139
When does gliosis happen?
1-2 weeks
140
What infarcts do hypertensives get?
Lacunar
141
Presenilin 1 vs 2 chromosome
14
| 21
142
What can help stain Lew Body's
Ubiquitin
143
How many weeks does neural tube form?
4 weeks
144
Glial or ______ cells
Glue
145
What are grey matter in brain?
Somas, synapses, and cell bodies
146
What is inter ventricular foraemen also known as ?
Foramen of Munro
147
Basilar artery is from
Vertebral arteries
148
Ganglia vs nucleus
Ganglia outside CNS
| Nucleus in CNS
149
Cerebellar input cells
| Cerebellar output cells
Granular
| Purkinje
150
Aphasia definition
Inability to use language
151
Lacunar stroke comes into the ER with symptoms since this morning, what’s the management?
Urgent CT of the head and aspirin 300 MG within 24 hours if ischaemic stroke is confirmed
152
Wilson’s disease, ceruplasmin and 24 hour urinary copper levels
Low and high 
153
Three first line drugs for dementia
Galantamine
Rivastigmine
Donezepil
154
If someone is on sodium valproate and is continuing to have seizures, what do you do?
Withdraw drug
155
Unable to stand on your toes and ankle reflexes are reduced, which nerve root
S1
156
Another antibody for MG
Musk
157
You have given lorazepam to a patient, they have still been seizing for five minutes. What do you do?
Wait until 10 minutes have passed and give a second dose of lorazepam
158
A 67-year-old female is concerned about a tremor that she is developing in her hands. It is the same in both hands and worse when she’s using it. She thinks her mother had a similar
Benign, essential tremor
159
An 82-year-old female with type two diabetes and hypertension develops a wild flailing movements on one side of his body
Subthalmic stroke
160
A seven-year-old male notes he is losing his hand dexterity, an examination, you know what a tremor in the left hand, while he performs task with his right hand
Parkinson’s disease
161
79-year-old male with a history of previous strokes, has two episodes of shaking in one hand, each lasting less than two minutes no tremors a parent on examination between episode
Partial seizure
162
27-year-old female presents with gradual onset of a tremor in both hands, her family has noticed a change in her voice was variation in speed and volume
Wilson’s disease
163
52-year-old male has a daily headache, present and waking from sleep with Jesus through the day. This is associated with nausea and vomiting. It is worse on coffee.
Space occupying lesion
164
19 year old university student has headache. It is constant bilateral in reading to the front region and into his neck. He described it as a pressure sensation. He is worried as it is interfering with his revision for his upcoming exams.
Tension headache
165
18-year-old university student is brought into the hospital by her flat mate with a headache. It worse throughout the day and radiates into her neck. She is drowsy and febroile on examination.
Meningitis
166
20–year-olds wakes up with a unilateral headache. Throbbing, he is tired and photophobic. He has vomited twice.
Migraine
