1. Beta blocker 2. if HR >100bpm still, add digoxin

FCM Flashcards by Katie Aitchison

First and second line treatment for oral thrush

Miconazole gel
Nystatin

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What cancer is associated with GORD?

Adenocarcinoma

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SVT management if haemodynamically unstable?

DC cardioversion

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Ix for suspected leukaemia?

Bone marrow aspirate

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Beta thalassaemia major vs minor

Major = symptoms in infancy; failure to thrive
Minor = mild anaemia in adulthood

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Complication of co-amoxiclav

Cholestatic hepatitis

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10-20y/o male with proximal tibial mass, painless; XR shows pedunculate lesion on the surface of the bone

Osteochondroma

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Where does amoebiasis come from and how do you treat it?

Diarrhoea; travel to LIC
Metronidazole then diloxanide

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Treatment for sciatica?

Paracetamol/NSAIDS
Codeine

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Treatment for bacterial meningitis GP vs. hospital

GP = IM ben pen
Hospital = IV cefotaxime

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AF; rate treatment

Beta blocker
if HR >100bpm still, add digoxin

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Treatment for STEMI

PCI

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Treatment of hyperparathyroidism and complication

Parathyroidectomy; aphonia due to damage to recurrent laryngeal nerve

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Treatment of venous eczema

Reduce leg swelling and potent topical steroid

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Salmon herald patch and Christmas tree distribution

Pityriasis rosea

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What drug can cause gynaecomastia?

Spironolactone

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UTI treatment in pregnancy

Nitrofurantoin until 3rd trimester
Amoxicillin in 3rd trimester
TRIMETHOPRIM IS CONTRAINDICATED

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What bacteria causes otitis externa

Staph aureus

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Migraine prophylactic treatment?

Propranolol
(Topiramate if contraindicated)

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Migraine attack treatment?

NSAIDs (paracetamol if pregnant)
Triptans

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Cluster headache prophylaxis?

Verapamil

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Cluster headache attack treatment?

O2 and sub cut triptan

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Which joint does gout commonly affect?

MTP joint

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Which joint does psuedogout commonly affect?

Knee

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What bacteria causes UTI?

E coli

What analgesia can cause urticarial rash?

NSAIDs

Tension headache, vomiting, tachycardia, tachypnoea, seizures, reduced GCS, cherry red skin

Carbon monoxide poisoning

AF and haemodynamically unstable?

DC cardioversion

Snowstorm appearance on TVUS

Molar pregnancy

Sepsis within 48 hours of birth - cause

Group B strep

1st line for fibrocystic disease of the breast

Supportive bra and avoid caffeine

Treatment for trichomonas

Metronidazole

Treatment for gonorrhoea

IM ceftriaxone

Unilateral deafness and vertigo

Acoustic neuroma

Asymptomatic jaundice

Gilbert's

What can EBV increase risk of?

Hodgkin's lymphoma

What bacteria causes prostatitis

E coli

What do you do if a baby has a hernia?

Observe, repair at 2 years if it hasn't closed spontaneously

Treatment for spinal cord compression

High dose dexamethasone

Treatment for microalbuminaemia

ACEi

Sudden onset blurry vision, reduction in visual acuity, visible drusen on fundoscopy

Macular degeneration

Treatment for CML

Oral imatinib

What CN causes down and out gaze

Occulomotor

Bleeding, bruising, organ ischaemia and failure

DIC

Treatment of essential tremor

Propranolol

White tongue, maculopapular rash on chest and back

Scarlet fever

What do you give in a intracerebral haemorrhage

Labetalol

When can you drive after a TIA

After 1 month

Treatment for apthous ulcers

Hydrocortisone Oro-mucosal tablets

What can shoulder dystocia cause?

Brachial plexus palsy

Treatment for angular stomatitis

Topical miconazole and hydrocortisone

Bipolar symptoms but psychotic in manic phase

Schizoaffective disorder

Fixed, split second hard sound

Atrial septal defect

Weak femoral pulses, systolic murmur below left scapula, tachypnoea, poor feeding, grey floppy baby

Coarctation of the aorta

Machine like murmur, SOB, poor feeding, recurrent LRTIs

Patent ductus arteriosus

First line treatment for menorrhagia

IUS

Haematuria, flank pain and palpable mass

Renal cell carcinoma

What is ketatitis and what can cause it

Infection of the cornea; often caused by contact lenses

12 year old, leg pain when exercising, limping, pain is dull and deep, feeling tired

Osteosarcoma

Treatment for PTSD

EMDR or trauma based CBT SSRI

Treatment for onychomycosis

1. Topical amorolfine 2. Oral terbinafine (if symptomatic or >2 nails)

Analgesia for renal colic

Diclofenac

Treatment for PCOS

COCP

Diarrhoea from crowded area e.g. prison

Shigella

Diarrhoea from contaminated water

Cholera

55y/o woman, progressive muscle weakness, frequent falls, difficulty standing up from seated, hand weakness

Polymyositis

Murmur with Marfan's

Mitral valve prolapse

Pink and brown papules

Kaposi's

Long term steroid use and exposure to lots of UV can cause...

Cataracts

Sharp tearing pain on defecation and fresh PR bleeding

Anal fissure

Treatments for anal fissure

1. Soften stool with IH 2. GTN ointment

Treatment for pityriasis rosea

Emolients

Medications following TIA

Aspirin for 2 weeks then clopidogrel

Treatment of PPH

IV syntocinon

Demithicone

For head lice

Slow growing, soft lump, non-tender, doughy consistency

Lipoma

Central punctum

Epidermoid cyst

Treatment given in PPROM

Corticosteroids and erythromycin

Pregnant woman, sudden back pain, regular contractions, painful bright red bleeding, pelvic tenderness, closed cervix

Abruptio placenta

Pregnant woman, painless vaginal bleeding

Placenta praevia

Treatment for acute delirium

Haloperidol Lorazepam if Parkinson's

Bronchiolitis causative organism

RSV

Croup causative organism

Parainfluenza virus

Epiglottitis causative organism

HiB

Treatment for vitiligo

Topical betnovate

Treatment for mastoiditis

IV broad spec ABx and admission

Treatment for tension PTX

Needle decompression

Treatment for spontaneous PTX

Needle aspiration

Medical management for OCD

SSRI

What can indapamide cause

Gout

Painful red eye, N&V, blurry vision, abnormal pupils, reduction in acuity

Acute closed-angle glaucoma

Crampy leg pain, worse when walking uphill; what is it and what can it cause

Claudication; arterial ulcers

Menieres disease attack and prevention

Attack = prochlorperazine Prevention = betahistine

Menieres Sx

Vertigo, tinnitus, hearing loss and pressure feeling

ABx given for sickle cell

Lifelong pen V (Erythromycin if allergic)

Vibrio cholerae - what food

Caused by oysters

Treatment for acute migraine in pregnancy

Paracetamol AVOID NSAIDS IN PREGNANCY

Treatment for pneumocystis

Co-trimoxazole

Treatment for molluscum

Self-limiting

Skin lesion, Hx of sun exposure, feels like sandpaper - what is it and how do you treat it

Actinic ketatosis; fluorouracil

Second line HTN treatment in Afro-Caribbeans

CCB+ARB

Causative organisms in septic arthritis 1. Normally 2. Young, unvaccinated child 3. Sexually active

1. Staph aureus 2. HiB 3. N. gonorrhoeae

Treatment for septic arthritis

IV clindamycin for 1 week then 4-6W of oral ABx

What treatment are you giving if DEXA scan results are

Bisphosphonates

Analgesia for OA

Paracetamol

Bacteria that causes osteomyelitis

Staph aureus

6 year old boy, painless limp, XR shows frog leg

Perthe's disease; cast brace

Fat 14 year old boy, painful limp, O/E external rotation of leg - what is it and how do you treat it?

SUFE; surgical fixation

Loss of vision like a curtain closing over the eye

TIA - GIVE 300mg ASPIRIN

Recurrent unilateral electric shock pain lasting a few seconds, triggered by brushing teeth, smoking and talking - what is it and how do you treat it?

Trigeminal neuralgia; carbemazapine

If a pt has a migraine and asthma AND PREGNANT, what drug do you give for prophylaxis

Amitriptyline

Treatment for status epilepticus GP vs hospital

GP = buccal midazolam/rectal diazepam Hospital = IV lorazepam

Time frame to treat Bell's palsy and what do you give

Prednisolone; within 72 hours - for 10 days

Treatment for tonic clonic seizures? What if they're pregnant?

Sodium valproate; lamotrigine

Overweight female, generalised headache that's worse in the mornings and when coughing - what is it and how do you treat it?

Idiopathic intracranial hypertension; LP and weight loss

Patient has a fall, temporary loss of consciousness, fluctuating changes in cognition, CT scan shows crescent-shape - what is it?

Subdural haematoma

Treatment for myasthenia gravis

Steroids + anti cholinesterase inhibitors (e.g. pyridostigmine)

What kind of seizure - sudden jerking of limb, trunk or face

Myoclonic

EtOH drinker, nystagmus, confusion and ataxia - what is it and how do you treat it?

Wernicke's encephalopathy; IV pabrinex

Treatment for Alzheimer's: - Mild-moderate? - Moderate-severe?

1. Donepazil 2. Memantine

Treatment of hyperparathyroidism if not eligible for surgery

Alendronate and cinacalet

Obese man, chronic cough and constipation - what type of hernia?

Direct inguinal hernia

6 month old baby, bulge into scrotum - what type of hernia?

Indirect inguinal hernia

Treatment of hepatic encephalopathy

Lactulose

Cherry red spot on fundoscopy

Central retinal vein occlusion

Morning headaches, vomiting, raised intracranial pressure

Glioblastoma

Management of cardiac tamponade

Pericardiocentesis

Adult female, low Hb, schistocytes on blood film

TTP

Child, recent viral illness normal blood smear

ITP

Pearly papule with rolled edge

Basal cell carcinoma

Clawing of the hand with sensory loss of 5th and half of 4th finger

Ulnar nerve compression

Enlarged scaly pink plaque that's friable and bleeds easily

Squamous cell carcinoma

Recent infection that causes red lumps on legs - what is it and what bacteria causes it?

Erythema nodosum; strep pyogenes

Retinitis in immunocompromised patient; what causes it and what is seen on fundoscopy?

CMV; cottage cheese with ketchup

What rash can doxycycline cause

Erythema multiforme

What is slapped cheek (2)

Erythema infectiosum / parvovirus B19

Rash from exposure to infrared

Erythema ab igne

Rash caused by Lyme disease

Erythema migrans

Treatment of hypercalcaemia

IV fluids and IV furosemide

Patient with Hx of sickle cell, sudden onset floaters in eyes, painful vision loss, can only see hazy red out of affected eye; fundoscopy reveals a poor view of the fundus

Vitreous haemorrhage

Cradle cap - what is it and how do you treat it?

Sebhorraeic dermatitis; 1. Olive oil and brush out the flakes 2. Topical miconazole 1%

Treatment of bowel obstruction

Insert an NG tube

Treatment of Kawasaki disease

IVIG and high dose aspirin

Painful arc 60-120 degrees

Rotator cuff injury

Treatment for cat/dog/human bites

Co-amoxiclav

Treatment for impetigo

5 days fusidic acid and good hygiene

Dysuria, pain at base of penis, tender and boggy prostate - what is it and how do you treat it?

Prostatitis; ciprofloxacin

Menopausal woman with no uterus?

Oestrogen only

Menopausal woman with only urogenital Sx?

Low dose vaginal oestrogen

What Sx can hypomagnesia cause

Seizures, muscle cramps and tremors

Patient with metabolic acidosis and tinnitus - what did they overdose on?

Aspirin

Treatment of blepharitis

1. Chloramphenicol 2. Fusidic acid

1st line treatment of trigger finger

Splinting

When do you review an undescended testes in newborn

6 months

PMS treatment

Lifestyle changes and COCP

Pregnant woman with a well-defined hyperpigmentation in a symmetrical pattern on the face

Melasma

Pt bitten by dog abroad, unable to swallow water and has parasthesia around the wound - what is it?

Rabies

What antihypertensive can cause ankle swelling?

CCB - amlodipine

What bacteria causes folliculitis? And what about if the pt. has been in a hot tub recently?

1. Staph aureus 2. Pseudomonas aeruginosa

What is a side-effect of azithromycin?

LQTS

Treatment of DKA (which fluids)

0.9% saline

What bacteria can cause schistocytes on blood smear

E coli

Treatment for acute cholecystitis?

IV co-amoxiclav

Treatment of hyperparathyroidism if not eligible for surgery

Alendronate and cinacalet

Treatment for agoraphobia?

CBT with graded exposure therapy

Young boy, facial swelling then whole body swelling

Minimal change

Old man, urinary incontinence, abnormal gait, dementia

Normal pressure hydrocephalus

Patient with recurrent sinus infections now has fever, sudden onset headache, peri-orbital swelling and diplopia

Cavernous sinus thrombosis

Treatment of giant cell arteritis

Prednisolone

Photosensitive malar rash in the shape of a butterfly, fatigue, fevers, muscle pain - what is it and how do you treat it?

SLE, do anti-dsDNA, give NSAIDs and prednisolone

What electrolyte abnormality can be caused by losartan?

Hyperkalaemia

Postpartum woman, new pain at the base of thumb

De Quervain's tenosynovitis

15 year old, intermittent high fevers, rashes, hepatosplenomegaly, lymphadenopathy, anaemia, leukocytosis

Juvenile rheumatoid arthritis

Hyperpigmentation, fatigue, weakness, hypotension

Addison's

Unvaccinated child, fever, sore throat, grey-white membrane in oropharynx that bleeds when scraped

Diphtheria

Elderly patient dehydrated, has hypernatraemia - how do you treat it, and what happens if you don't do it slowly?

5% dextrose; too quickly may cause cerebral oedema, then seizure/coma/death

Patient with previous head trauma, now has polydipsia, polyuria and hypernatraemia - what is the condition?

Diabetes insipidus

Treatment for Addisonian crisis?

IV hydrocortisone and IV normal saline

What electrolyte imbalance can be caused by PPIs?

Hyponatraemia and hypomagnesia

What 3 results will you see in tertiary hyperparathyroidism?

Raised calcium Raised PTH Raised phosphate (or CKD)

9 year old, palpable non-tender, mobile, fluid-filled lump on the midline of the neck; moves upwards on swallowing and protrusion of the tongue

Thyroglossal cyst

Patient with magical thinking and dressing oddly

Schizotypal PD

Treatment for OCD

CBT+ERP (+SSRI)

Patient is on statin and you're prescribing a macrolide - what do you do?

Withhold the statin

Treatment for intermittent claudication

1. Lifestyle advice and exercise programme 2. Naftidrofuyl

What murmur can occur after an inferior MI?

Mitral regurgitation

Treatment for asystole

Adrenaline (It's non-shockable!)

Young ish female, smoker, CP on rest and at night - ECG shows ST elevation when she has the chest pain - what is it and how do you treat it?

Prinzmetal angina; CCB

Which bacteria in infective endocarditis?

Staph aureus

Sudden onset tearing chest pain, mediastinal widening - what is it and how do you treat it?

Aortic dissection; morphine+beta blockers -> surgery asap

What bacteria causes Scarlet fever?

Strep A

Flu-like Sx, sandpaper rash, strawberry tongue

Scarlet fever

Painless red eyes, swollen hands and feet, cracked lips, strawberry tongue

Kawasaki disease

Anaemia, hand/feet swelling, delayed puberty, frequent infections

Sickle cell anaemia

Frothy urine, oedema, proteinuria and haematuria

Glomerulonephritis

Microaneuyrisms, blot haemorrhages, neovascularisation

Diabetic retinopathy

Retinal haemorrhage, papilloedema

Hypertensive retinopathy

Peripheral loss of vision, 'halos' around lights

Glaucoma

Treatment of open angle glaucoma

Prostaglandin analogue eye drops

If patient is B12 deficient and folate deficient, which do you treat first

B12

What causes Cushings disease

Pituitary tumour

Rash from face to trunk, lymphadenopathy and red petechiae in mouth

Rubella

Recent LRTI, swinging fevers, night sweats, weight loss and chest pain

Empyema

Normocytic anaemia and raised bilirubin

Haemolytic anaemia

Which nerve can get damaged by shoulder dislocation

Axillary nerve

What needs to be given for life after gastric bypass

B12

Bilateral thigh pain, better when stooping or sitting

Spinal stenosis

Patient with active cancer, undergoing chemotherapy, temperature 38'C - what will their neutrophil count be? What do you treat them with?

Neutropenic sepsis - <0.5, initiate sepsis 6 (give BS ABx e.g. tazocin) and then filgastrim

Treatment of acute pancreatitis

Fluids, analgesics and antiemetics

Soft stool and going a few times a day, but only passing small amounts - which laxative do you prescribe?

Senna

Old patient with dementia, chronic constipation - what GI can it cause and how do you treat this?

Sigmoid volvulus; flatus tube

What is the cause of 70% of small bowel obstructions?

Previous abdominal surgery

What GI condition can co-amoxiclav cause?

Cholestasis

Treatment for tension PTX

Needle decompression

What can the scarring from GORD cause?

Benign oesophageal stricture

Most common cause of raised Virchow's node

Gastric cancer

RUQ pain after ERCP, relieved by leaning forward

Acute pancreatitis

Positive RPR test

Syphilis

What is the timeframe for adjustment disorder

Within 3 months of a stressful life event

Drugs to stop in AKI

Diuretics ACEi and ARB Metformin NSAIDs

Friable cervix with cobblestone appearance, dyspareunia and post coital bleeding

Chlamydia

Slit lamp: shallow anterior chambers and corneal epithelial oedema

Acute closed-angle glaucoma

Treatment for tension PTX

Needle decompression

Patient with spontaneous PTX (primary and secondary)

1. Tall young male 2. Middle aged pt with COPD

Patient with tension PTX (x3)

Ventilated, trauma or Marfan's

What type of cancer in colorectal cancer

Adenocarcinoma

When do you assess a pt for LTOT

Patient is stable and has <92% ORA

Smoker, clubbing - which lung cancer

Squamous cell

Smoker, SIADH - which lung cancer

Small cell

Non-smoker, gynaecomastia - which lung cancer

Adenocarcinoma

What causes stoney dullness

Pleural effusion

Cerumen impaction - treatment algorithm (3)

1. Ear drops e.g. oil 2. Ear irrigation 3. Microsuction

Test for peripheral vertigo

Head impulse test

What can leukoplakia become

Squamous cell carcinoma

Which TB med causes orange secretions

Rifampacin

Which TB med causes peripheral neuropathy

Isoniazid

Os closed, mild bleeding, little pain - what type of miscarriage?

Threatened (often 6-9 weeks)

Os open, heavy bleeding, painful - what type of miscarriage?

Inevitable

Os closed, pain and bleeding with clots, empty uterus - what type of miscarriage?

Complete

Os open, pain, bleeding, products of conception are partially expelled - what type of miscarriage?

Incomplete

Os closed, gestational sac with dead foetus without clinical features

Missed (silent)

Crohn's treatment 1 and 2

1. Oral prednisolone 2. Mesalazine

Complications of Crohn's

Fissures, fistulas and strictures

Most common location for Crohn's

Terminal ileum

Most common location for UC

Rectum

Complications of UC

Toxic megacolon and strictures

Treatment of UC

Topical ASA (mesalazine)

Pregnant woman, *painless* **bright red** blood

Placenta praevia

Pregnant woman, painful dark red blood

Placental abruption

What is a pterygium

White, wing-shaped growth across the eye, caused by exposure to UV and being in a dry, dusty environment

Blood tests in menopause

High FSH, high LH and low oestrogen

Floaters, flashers, painless vision loss starting in the periphery , blurred vision

Retinal detachment

Hx of HTN, sudden painless loss of vision in one eye, cherry red spot

Central retinal artery occlusion

Central loss of vision

Macular degeneration

Peripheral loss of vision and halos around lights

Glaucoma

Which bronchus would an inhaled foreign object go down

Right

Drug that is positively inotropic, negatively chronotropic

Digoxin

New York HF scale 1-4

1. no symptoms 2. mild sx 3. symptomatic except at rest 4. sx at rest

Which CCBs are non-dihydropyridines

Verapamil and diltiazem

H pylori and allergic to amoxicillin - what do you give!

Metronidazole, clarithomycin and omeprazole

Diverticular disease vs. diverticulosis

DD - pain, blood, bowel changes D - incidental finding of outpouches, no inflammation

HELLP syndrome

H - haemolysis EL - elevated liver enzymes LP - low platelets

What drug can't be taken if having cataract surgery

Tamsulosin

What drug should a pregnant woman not touch

Finasteride

How long until POP works

48 hours

BP target after a stroke

130/80mmHg

What can sodium valproate do to INR

Raise it

When can you drive after your first seizure

6 months

What can lithium do to thyroid

Hypothyroidism

What would histology from thyroid cancer show?

Papillary

Male, >60, wakes up at night with back pain regularly

Multiple myeloma

Intrinsic factor is involved in the transportation and absorption of what?

B12

Lack of dopamine, starts with bradykinesia

Parkinsons

Which drug - modulates cellular keratinisation and inflammatory procresses

Adapalene

Worst skin change to have on mole

Irregular shape

A 39-year-old female teacher presents with a burning sensation affecting her arms and legs. She thinks she is becoming colour blind, as she can no longer discern the colour of the red pen she uses for marking.

A 28-year-old white woman who has smoked 1 pack per day for the last 10 years presents with subacute onset of cloudy vision in one eye, with pain on movement of that eye. She also notes difficulty with colour discrimination, particularly of reds. She was treated for a sinus infection 2 weeks ago and, on further history, recalls that she had a 3-week history of unilateral hemibody paraesthesias during examination week in university 6 years ago. She occasionally has some tingling on that side if she is overly tired, stressed, or hot.

Baby, ejection systolic murmur, low oxygen sats, cyanosed

Tetralogy of Fallot

Which leads do you see LBBB/RBBB in?

V1 and V6

Haemophilia A&B = which factors? And which is more common?

A = 8 B = 9 (A = more common)

CT chest shows honeycombing

Asbestosis and IPF

Two drugs that can cause pulmonary fibrosis

Methotrexate and nitrofurantoin

SIADH values

High urine osmolality, low serum osmolality, low Na

Treatment for nephrotic syndrome (+minimal change)

Prednisolone

Gold standard Ix for bronchiectasis

High resolution CT chest

How much protein = pre-eclapsia

More than or qual to 0.3g in 24 hours

Treatment for aortic dissection

IV labetolol

Ix for phaeochromocytoma

24hr catecholamine collection

Ix for Cushing's

1 = 24hr urinary free cortisol GOLD = overnight dexamethasone suppression test

Ix for Addison's

GP - 8-9am cortisol GOLD = ACTH stimulation test

Ix for Conn's

Renin:aldosterone

Ix for SLE (sensitive vs specific)

Sensitive = ANA Specific - Anti-dsDNA

Ix for Sjogren's

Anti-Ro and Anti-La antibodies

GCA treatment

Prednisolone

Trigeminal neuralgia = electric shocks on face, what is the treatment

Carbemazepine

Ix for Osgood Schlatters

Knee XR

Tumour marker for colon cancer

CEA

T2DM + heart failure/ACS

Metformin + SGLT-2 inhibitor (flozin)

2nd line and 3rd line for T2DM

Gliptin (DPP4) Gliclazide

Three drugs that can cause agranulocytosis

Clozapine Carbimazole Methotrexate

Treatment for Addisonian crisis

IV hydrocortisone

Other name for Conn's

Primary hyperaldosteronism

Other name for Addison's

Primary adrenal insufficiency

Cardiac drug that can cause thyroid issues

Amiodarone

First-line for PCOS

COCP

Treatment for eclamptic seizure

IV magnesium sulphate

At how many weeks can gestational HTN be diagnosed?

20 weeks

FCM Flashcards

(308 cards)