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Last min FY > Everything > Flashcards

Everything Flashcards

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1
Q

Most common organisms in infective endocarditis and associations?

A
  • Saph aureus (most common) → western world + IVDUs
  • Strep viridans (20% cases) → poor dental hygiene
  • Staph epidermidis → indewlling lines, prosthetic valve (initially, then staph aureus after 2 months)
  • Strep bovis → colorectal cancer
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2
Q

Infective endocarditis - gold standard investigations?

A
  • TOE
  • Cultures
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3
Q

Does asymptomatic AF need treatment?

A
  • Not usually
  • Do CHADSVASC
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4
Q

How do you treat a patient who is shocked but fluid overloaded?

A

Inotropes → Noradrenaline

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5
Q

Treatment for Torsade de Pointes?

A

Magnesium IV

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6
Q

Investigation for unstable aortic dissection?

A

TOE

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7
Q

Investigation for stable aortic dissection?

A

CT Angio

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8
Q

How does posterior MI present on ECG?

A
  • ST Depression
  • Tall R waves in V1-2
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9
Q

What are the stages of postpartum thyroiditis?

A
  1. Thyrotoxicosis
  2. Hypothyroidism
  3. Normal

Treat symptoms (eg. with propranolol)

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10
Q

Which strains of HPV cause warts?

A

6 + 11

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11
Q

Which strains of HPV cause cervical cancer?

A

16 + 18

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12
Q

What impact does epidural anaesthesia have on BP?

A

Reduces BP in induced labour

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13
Q

Pleural Effusion: When should a chest drain be placed?

A

All patients with a pleural effusion in association with sepsis or a pneumonic illness require diagnostic pleural fluid sampling

  • if the fluid is purulent or turbid/cloudy a chest tube should be placed to allow drainage
  • if the fluid is clear but the pH is less than 7.2 in patients with suspected pleural infection a chest tube should be placed
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14
Q

When do you use NIV (BiPAP)?

A
  • IECOPD
  • T2RF
  • Respiratory acidosis
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15
Q

What is infective exacerbation COPD prophylaxis?

A

Azithromycin

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16
Q

When do use CPAP?

A
  • T1RF
  • Pulmonary oedema
  • Acute HF
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17
Q

What is important to give in acute life-threatening asthma?

A

Magnesium > theophylline

(O SHIT ME, but magnesium first)

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18
Q

What happens to the trachea in lung collapse?

A

It’s pulled towards the white out, ie. towards the collapsed lung

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19
Q

Types of aphasia

A
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20
Q

Myasthenia gravis vs Lambert-Eaton

A
  • Myasthenia → normal reflexes, anti-AChR abs
  • LEMS → areflexia, movement improves symptoms, anti-VGCC abs
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21
Q

Management for ascending cholangitis?

A

ERCP

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22
Q

Which pneumonia organism in IVDUs?

A

Staph aureus (also for influenza infection)

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23
Q

Osteomalacia bloods?

A
  • Low calcium + phosphate
  • Raised ALP
  • Low vit D

Sx → bone pain, fractures, muscle tenderness

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24
Q

Paget’s bloods?

A

Everything normal except raised ALP

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25
What are **associations** of **PBC**?
* Sjogren's * Rheumatoid * Systemic sclerosis * Thyroid disease
26
What are **associations** of **PSC**?
* IBD (UC \> Crohn's) * HIV
27
Features of **neuroleptic** **malignant** **syndrome**?
* Pyrexia * Muscle rigidity * HTN, tachycardia, tachypnoea * Agitated + Confused Ix → raised CK, AKI, leukocytosis
28
Which **analgesics** should be avoided in those who have resp disease undergoing major surgery?
Opioids
29
How do you manage **epistaxis**?
* **Minor bleeding** → silver nitrate + cautery * **Profuse bleeding** → anterior pack
30
What do the results of **high-dose dexamethasone suppression** test indicate?
* ACTH + Cortisol suppressed? → **pituitary** * Just cortisol suppressed? → **adrenal** * Neither suppressed? → **ectopic**
31
In whom is primary hyperparathryoidism commoner in?
Older females
32
Which **diabetic** drug should you suspend during intercurrent illness?
* **Metformin** * Risk of lactic acidosis
33
What is the treatment for **alcoholic** **ketoacidosis**?
IV Thiamine + 0.9% Saline
34
Investigation for **PSC**?
* MRCP * Shows beaded appearance
35
In which part of the gut is ischaemic colitis most common in?
Splenic flexure
36
Investigations for haemochromatosis?
* Transferrin sats \> 50-55% * Low TIBC * MRI
37
Which investigation for **pancreatitis**?
USS
38
Clinical features of lymphogranuloma vereneum?
Proctitis + Lymphadenopathy
39
What should you do if a pt presents with unexplained petechiae and hepatosplenomegaly?
Urgent specialist assessment for leukaemia
40
Investigation for chlamydia?
NAAT
41
Parvovirus B19
* **Slapped cheek syndrome** * *Features* → red cell aplasia, anaemia + low reticulocyte count
42
Clinical features of **myeloma**?
* Hypercalcaemia * Proteinuria * Impaired renal fxn * Lower back pain
43
Treatment for non-displaced scaphoid fracture?
Cast 6-8 wks
44
What is Todd's paresis?
Focal seizures leading to post-ictal weakness
45
Treatment for cervical myelopathy?
Neurosurgery
46
Treatment of acute ischaemic stroke \< 4.5hrs?
Thrombolysis + thrombectomy
47
Eye palsies
* LR6 * SO4 * Rest 3
48
Which nerve supplies the triceps reflex?
* Radial nerve * C7
49
Features of idiopathic intracranial HTN?
* Obese young females * Headaches * Blurred vision
50
How does blepharitis present?
Bilateral grittiness worse in morning
51
Treatment for whooping cough?
Oral clarithromycin
52
Features of HUS?
* MAHA * Thrombocytopenia * Acute renal failure
53
Features of HSP?
* Purpuric rash - bum + legs * **NO** anaemia or thrombocytopenia * Can lead to nephritis (haematuria + proteinuria)
54
Asthma - should you do peak flow if \<5 yrs old?
* No, just bronchodilator test * Spacer is also better for asthma exacerbations in children than nebs
55
What are rolandic seizures?
* Centrotemporal region * Saliva, grunting, slurred speech
56
How do you treat **terminal** **restlessness** in palliative care?
Midazolam syringe driver
57
TCA overdose
* QRS Prolongation * Rx → IV bicarb
58
Features of delirium tremens?
* Confusion * Visual hallucinations * Tachycardia * Pyrexia
59
Wernicke's encephalopathy
* Thiamine deficiency * **Sx** → nystagmus / ophthalmoplegia / ataxia * **Rx** → thiamine
60
What is Korsakoff's ?
* Leads on from Wernicke's * Characterised by anterograde and retrograde amensia and confabulation
61
What is **minimal change disease** associated with?
* Atopy * Hodgkin's lymphoma
62
Testicular torsion or epididymitis?
Prehn's sign → in torsion, the elevation of the testis does not ease the pain compared to epididymitis
63
Rx epidydmo-orchitis?
* IM ceftriaxone + oral doxycyline
64
Arterial vs venous ulcers
* **Arterial** → toes, heel, painful, cold, low ABPI * **Venous** → ankle, painless, brown pigment, oedema
65
Investigations for acute **pancreatitis**?
* Lipase \> amylase * Diagnosis can be made clinically + based on above * Early **USS** important, otherwise contrast CT
66
Investigations for chronic **pancreatitis**?
* Faecal elastase (if imaging inconclusive) * **CT** \> AXR
67
The one investigation of choice for **pancreatic** **cancer**?
* **High res CT** * Demonstrates 'double duct' sign (simulatenous dilatation of common bile and pancreatic ducts)
68
Which 3 features characterise **acute liver failure**?
* Jaundice * Confusion * Coagulopathy
69
Bloods for **refeeding** **syndrome**?
* Hypophosphataemia * Hypokalaemia * Hypomagnesaemia * Abnormal fluid balance
70
Most common causes of **liver cirrhosis** (3)
* NAFLD / NASH * Alcohol * HCV + HBV
71
Investigation of choice for **liver** **cirrhosis**?
**Fibroscan** *aka* **transient elastography**
72
**Ascites** treatment?
* Fluid restrict + low salt diet * **Spironolactone**
73
Treatment for **hepatic encephalopathy**?
Lactulose
74
PBC
* Non-caseating granulomas * Middle aged females * *Ix* → **AMA**, IgM *Rx* → symptom management, ADEK, ursudeoxycholic acid, transplant
75
**Wilson's** investigation (1) + treatment (1)?
* Ix* → Reduced serum **caeruloplasmin** * Rx* → **penicillamine**
76
**Budd-chiari** triad?
* RUQ pain * Hepatomegaly * Ascites
77
Screening for HCC?
* Ultrasound * AFP Only for high risk groups
78
Who needs surgery for **bowel** **obstruction**?
* Closed loop obstruction * Obstructing neoplasm * Strangulation/perforation → sepsis, peritonitis * Failure of conservative Mx (up to 72hr)
79
CAP Abx
* *Mild or Moderate* → **Amoxicillin** * *Severe* → **Co-amoxiclav + clarithromycin**
80
Types of lung cancer
* **Small cell** → SIADH, ACTH, central, LEMS * **Squamous cell** → PTHrP, hilar * **Adenocarcinoma** → small airways
81
**Lofgren's** syndrome is a specific presentation of sarcoidosis. What's the Lofgren's triad?
* Ertyhema nodosum * Bilateral hilar lymphadenopathy * Polyarthralgia
82
Gold standard diagnosis of **sarcoidosis**?
* Histology from **biopsy** * Done by bronchosocopy w/ USS guided biopsy of mediastinal lymph nodes * Shows non-caseating granulomas + epithelioid cells
83
Industrial lung diseases
* **Coal-workers pneumoconicosis** → progressive dyspnoea, chronic bronchitis / CXR: upper zone fibrotic masses * **Silicosis** → quarrying, sand-blasting / upper zone reticular shadowing + egg shel calcification of hilar nodes * **Asbestosis** → demolition, ship building / basal fibrosis, pleural plaques / CXR: pleural effusions / do biopsy
84
Brain abscess features
* Headche * Fever * Focal neurology
85
Labyrinthitis vs Vestibular neuronitis?
Both present after viral illness, associated w/ vertigo, nausea and vomiting and both treated w/ prochlorperazine * **Lab** → hearing loss, faster onset, associated w/ ramsay-hunt syndrome * **Vest** → no hearing loss
86
**Systemic** **sclerosis** antibodies
* **Scleroderma** → ANA * **Diffuse** → anti-scl70 * **Limited** → anti-centromere
87
Hip # Management
* **Displaced intracapsular** → arthroplasty * **Undisplaced intracapsular** → internal fixation + cannulated screw * **Intertrochanteric** → DHS * **Subtrochanteric** → intramedullary nail
88
Urethral trauma
* **Bulbar** rupture (most common) → retention / perineal haematoma / bloody meatus * **Membranous** rupture → prostate displaced upwards *Ix* → ascending urethrogram
89
What is the most common **benign** intracranial tumour?
Meningioma
90
Most common type of malignant brain tumour?
Astrocytoma
91
In which brain tumours is **raised** **ICP** common earlier on in?
Posterior fossa tumours
92
Myotomes
93
Management of neutropenic sepsis?
* **Abx immediately** → Tazocin * Do _not_ wait for WBC * G-CSF in some patients
94
Which diabetic drug in CKD?
Gliptins (DPP4 inhibitor)
95
**Shoulder** **pathologies** according to age?
* **40-70** → adhesive capsulitis * **\> 70** → rotator cuff tear or glenohumeral OA
96
**Subacromal bursitis** features
* Occupational or athletic hx of lifting/moving things
97
Urge (OAB) incontinence treatment
1. **Bladder training 6 weeks** 2. **Anticholinergics** → oxybutynin, tolterodine, darifenacin 3. Mirabegron 4. Botulinum toxin A injections 5. Sacral nerve stimulation + agumentation cystoplasty
98
CTG: Baseline **bradycardia** and **tachycardias**
* **Bradycardia** indicates **(severe) fetal distress** due to placental abruption/uterine rupture/fetal hypoxia * **Tachycardia** indicates prematurity / hypoxia / fetal distress / maternal pyrexia / exogenous b-agonists
99
CTG: Decelerations
* **Early** → physiological * **Late** → fetal distress * **Variable** → cord compression, oligohydramnios

Last min FY (3 decks)

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