golfer’s elbow The medial humeral epicondyle is the bony origin for wrist flexors. Injury to the wrist flexors causes medial epicondylitis (golfer’s elbow).

Extras Flashcards by Sarah Oussena

Microcytic Anaemia

Lead Poisoning

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Confirmed decreased temp. What do you get with hypothermia (<32 degrees) characteristically?

J-waves on ECG

(also known as Osborn wave, camel-hump sign, late delta wave, hathook junction, hypothermic wave,[1] K wave, H wave)

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30yo with Hodgkins. Gets mantel radiotherapy. What cancer is she most likely to get?

Lung

secondary cancer depends on location of radiotherapy = mantle (chest = lung or breast in women under 30)
neck = thyroid
chemo = blood cancers

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Woman, 24hrs of eye pain, now presents with complete paralysis of L eye (no movements) ptosis, and loss of sensation in division 1 of trigeminal nerve. What is the cause?

Internal carotid sinus aneurysm in cavernous area (CN3, 4, 5 (1 and 2) and 6)

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Girl, aspirin o/d, takes large amount, 5 hr ago, is in abdo pain, tinnitus and vomiting. >500mg in blood (above treatment level). pH is 7.00. What do you wanna do?

IV NaHCO3

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If someone has cellulitis, what do you need to cover?

Strep A = Necrotising fascitis = strep pyogenes

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HIV low CD4 count [70], he can’t swallow, and he has retrosternal chest pain. How do you treat this complication of HIV?

Fluconazole (candidiasis)

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HF. Shes already on metoprolol, ACE-I, spironolactone and diuretic. What do you do relieve her angina?

Digoxin

1st: β-B + ACEi + loop diuretic
2nd = spironolactone
3rd = digoxin
4th = cardiac resynchronisation

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What opens at 2nd part of duodenum at major ampulla?

CBD (bile duct and pancreatic duct)

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coeliac diagnosis?

Duodenal biopsy

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4/12 old child. Unwell, coughs until vomits. Increased RR and temp etc. Which organism?

Bordatella pertussis

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Had OGD, multiple ulcers in duodenum and gastric. PPI for 8/52 and H pylori –ve. They still have ulcers on repeat OGD. Cause?

Gastrinoma

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Levodopa/Carbidopa/Benserazide?

Stops peripheral metabolism of levodopa

Levodopa changes into dopamine in the brain, helping to control movement.

Carbidopa prevents the breakdown of levodopa in the bloodstream so more levodopa can enter the brain

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Pregnant lady with essential hypertension. How do you control it?

Methyldopa

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Cisplatin side effect?

irreversible sensorineural hearing loss = vestibular neuropathy

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Hirsuitism. Drug?

Phenytoin

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Microdeletion on chromosome 22q11. Non-mendelian inheritance. Affects T-lymphocytes?

DiGeorge

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18 yo with priapism (painful erection) and leg ulcers

sickle cell disease

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Haemophilia A has minor op. Treatment?

Factor 8

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Emergency angiography: 3 vessel disease. Treatment?

CABG

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Mesothelioma suspected. Diagnosis?

USS guided pleural biopsy

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Ophthalmia Neonatorum. Cause?

gonococci (n. gonorrhoeae) typically manifests in the first 5 days
chlamydia trachomatis produces conjunctivitis 3 days to 2 weeks after delivery.

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lateral epicondylitis

tennis elbow
The lateral humeral epicondyle is the bony origin for wrist extensors.
Injury to the wrist extensors causes lateral epicondylitis

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medial epicondylitis

golfer’s elbow
The medial humeral epicondyle is the bony origin for wrist flexors.
Injury to the wrist flexors causes medial epicondylitis (golfer’s elbow).

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Pregnant UTI. Mx?

Cephalexin

thionamides

inhibiting the TPO enzyme - its involved in the synthesis of the T4

Management of thyroid storm?

Propranolol, antithyroid drugs, Lugol’s iodine and hydrocortisone sodium succinate e. g. potassium iodide (= lugol's iodine) and thionamides * Inhibit proteolytic cleavage of T3 and T4 Iodine reduces the synthesis ofthyroid hormone

Malaria management?

* **P falciparum** is: 1st line _IV artesunate_ * 2nd line _Doxy + Quinine_ or ACT * **Non falciparum** is _ACT_ 1st line or _chloroquine_ 1st line. * **Vivax** or **Ovale** add in _primaquine_ to get rid of the *hypnozoites* in the liver

propylthiouracil

* helps to prevent peripheral conversion of T4 into T3 * but MAIN mechanism of proylthiouracil is that it inhibits TPO

PPI s/e?

C difficile

* erythematous raised patches * adherent keratotoic scales * follicular plugging * **atrophic scarring**

Discoid Lupus

Pulse in co-arctation of the aorta?

Radio-**Femoral** delay

Patient with symptoms and blood results suggestive of HIV encephalitis. How would you treat him?

sulfadiazine and pyrimethamine (toxoplasma gondii)

Young female undergoes cervical screening. 6 weeks later her results show “moderate dyskariosis” and “viral wart”. You are a GP (i think?). What would you do next?

Consistent with CIN II. Refer for urgent colposcopy(within 2 weeks)

Patient presents in A&E with a 3 day history of pyrexia and rigors. There is no other finding on examination. What would you culture: a. CSF b. blood c. sputum d. urine e. faeces

Urine (urosepsis = rigors)

42 y/o male returns from Thailand. He has a 2 week history of painless genital ulceration. Which investigation is required?

**treponeme-specific antibody test** ## Footnote *The direct fluorescent antibody test for T pallidum is easier to perform than dark-field microscopy. It detects antigen and, thus, does not require the presence of motile treponemes. It is the most specific test for the diagnosis of syphilis when lesions are present.*

19 y/o female, has smelly, foamy, yellow-green vaginal discharge with petechia on cervix. Partner is asymptomatic. How would you treat her?

metronidazole (treatment for this woman with Trichomonas Vaginalis)

Children Asthma managment?

1. SABA 2. SABA + ICS 3. SABA + ICS + LTRA 4. SABA + ICS + LABA 5. SABA + MART

A 65 y/o male smoker is due for elective THR. How would you reduce risk of thromboembolic disease?

LMWH + TED Stockings

Kussmaul's sign

* paradoxical rise in jugular venous pressure (JVP) on inspiration * constrictive pericarditis * restrictive cardiomyopathy

pseudomembranous colitis

C Diff

An old male has a 2 year history of chest pain (heartburn?) after eating food. This has been controlled with antacids until recently when he has found that antacids have a “reduced effect”. He is likely to have?

GORD (a?, i think he still has GORD and needs PPI/H2-blockers now etc?)

Recurrent UTI. Ix?

**Cystoscopy** should be performed to exclude bladder pathology and to detect urethral narrowing

A 50 y/o female with heart failure suffers from urinary incontinence. This is pronounced when she coughs or laughs. Reduction of diuretic therapy has made no difference to her incontinence. [In the question you are informed that she is not pregnant, nor does she have any pelvic masses.] She also states that she experiences incontinence when standing from a lying/sitting (?) position. What is the likely diagnosis?

Genuine Stress Incontinence

An old male with diabetes present complaining of hand pain at night relieved by shaking etc. What is the likely cause?

Carpal Tunnel Syndrome

An old lady with rheumatoid arthritis presents with gradual reduction in **visual acuity**. What is the likely cause?

steroid induced glaucoma

Which one of the following finding would support PCOS as opposed to Cushings syndrome?

increased serum free testosterone levels

A patient has chronic renal failure. Which one of the following is not a feature? a. polycythaemia b. pruritus c. hyperpigmentation d. polyuria

polycythaemia

What drug decreases admissions and mortality in HF?

ACE-I

Neuropathic Ulcer

tend to occur on the sole of the foot or over pressure points

COPD on 60% Oxygen. Increased PaCO2. What do you do?

Decreased FiO2

Zollinger-Ellison?

* gastrin secreting tumour = gastrinoma * increased gastric acid * recurrent peptic ulcers * MEN1 * abdo pain, heartburn (pyrosis), diarrhoea

Woman, getting radiotherapy to breast, develops fixed mass in upper outer quadrant of L breast?

Fat Necrosis

ARF vs CRF?

Best way to differentiate is renal ultrasound - most patients with CRF have **bilateral small kidneys** _Exceptions_ * autosomal dominant polycystic kidney disease * diabetic nephropathy * amyloidosis * HIV-associated nephropathy Other features suggesting CRF rather than ARF **hypocalcaemia** (due to lack of vitamin D)

Baby with lichenification to extensor services. Family have asthma and hayfever. Whats diagnosis?

Atopic Dermatitis (eczema)

Bladder outflow obstruction diagnosed on ultrasound. Next appropriate step?

Catheterise

uy has arm#, has plaster cast put on. Hrs later arm is blue. What do you do?

Cut plaster cast all the way

70yo Woman with RA has been on pred for 7 months. On 10mg pred. What SINGLE  thing do you do to protect her from osteoporosis?

bisphosphonates

Day 2 post op from bowel surgery. Has been having good urine output (20-30ml per hr). BP: 160/70, Now past 2hrs no urine output, what do you do?

Flush Catheter

69yr old lymphadenopathy, fevers, night sweats. Biopsy: homogenous lymphocytes/lymphoid cells?

NHL

stony dull percussion

pleural effusion

Had cataract surgery prev. Gradual loss of vision like **curtain** coming down. Now reduced to hand movements in L eye?

Retinal Detachment

Old man at home now presents with bleeding gums and is badly dressed. Diagnosis?

Scurvy Vitamin C Deficiency