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Gen Med Flashcards

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1
Q

Multiple myeloma features (CRABBI)

A

Calcium: hypercalcaemia
Renal: light chain deposition within the renal tubules
Anaemia
Bleeding
Bones (pain)
Infection

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2
Q

Falsely low HbA1C reading causes

A

Sickle cell anaemia
G6PD
Beta thalassemia

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3
Q

Falsely high HbA1C reading causes

A

Splenectomy, iron-deficiency anaemia, B12 deficiency and alcoholism

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4
Q

Eradication of h pylori test

A

Urea breath test

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5
Q

Lhermitte’s sign

A

Tingling of fingers when neck is flexed
Indicates disease near the dorsal column nuclei of the cervical cord

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6
Q

Treatment of broad complex tachycardia

A

IV amiodarone

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7
Q

Enzyme inducers (CRAP GPs)

A

CRAP GPs :*

Carbemazepines
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

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8
Q

Enzyme inhibitors

A

SICKFACES.COM

Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole

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9
Q

Torsades de pointes causes

A

Hypothermia
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia

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10
Q

Bacterial otitis media most common cause

A

H. Influenzae

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11
Q

Dermatomyositis cause

A

Malignancy

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12
Q

What artery is affected in amarousis fugax

A

Opthalmic/retinal artery

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13
Q

Management of HF

A

1st line: ACEi/BB(Bisoprolol, Carvedilol)
2nd line Aldosterone antagonist(Spironolactone, Eplerenone), reduced EF= SGLT-2 inhibitor
3rd line: involve a specialist for
-Ivabradine(SR, HR>75+ EF<35%)
-Sacubitril-valsartan( EF <35%+ Symptoms despite ACEi/ARB)
-Digoxin( if coexistent AF)
- Hydralazine+Nitrate( in Afro-Caribbean)
-Cardiac resynchronization therapy( Widened QRS e.g. LBBB)

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14
Q

Trigeminal neuralgia management

A

Carbamezapine

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15
Q

Management of acute seizures

A

Buccal midazolam
Rectal diazepam

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16
Q

Cushing reflex

A

Bradycardia and hypertension with a wide pulse pressure

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17
Q

Bell’s palsy management

A

Oral steroids within 72hrs of onset

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18
Q

Posterior stroke signs

A

5Ds: dizziness, diplopia, dysarthria, dysphagia, dystaxia

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19
Q

Ulcerative colitis management

A

Mild/moderate
Proctitis: topical (rectal) aminosalicylate

proctosigmoiditis and left-sided ulcerative colitis: topical aminosalicylate -4 wks later-> add a high-dose oral aminosalicylate OR switch to a high-dose oral aminosalicylate and a topical corticosteroid —> oral aminosalicylate and an oral corticosteroid
Extensive disease: topical (rectal) aminosalicylate and a high-dose oral aminosalicylate

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20
Q

ACS take home meds

A

STAAB
Statin
Ticagrelor (or Clopidogrel)
Aspirin
ACEi
Beta blocker

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21
Q

Long term prophylaxis of cluster headaches

A

verpamil

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22
Q

Fundoscopy signs of acut angle closure glaucoma

A
  1. Optic disc cupping - cup-to-disc ratio >0.7 (normal = 0.4-0.7), occurs as loss of disc substance makes optic cup widen and deepen
  2. Optic disc pallor - indicating optic atrophy
  3. Bayonetting of vessels - vessels have breaks as they disappear into the deep cup and re-appear at the base
  4. Additional features - Cup notching (usually inferior where vessels enter disc), Disc haemorrhages
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23
Q

RA vs OA XR findings

A

OA (LOSS): Loss of joint space, Osteophytes, Subchondral cysts, Sclerosis
RA (LESS): Loss of joint space, Erosions, Subluxation, Extra-articular
Ostroporosis

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24
Q

Complications of MIs

A

1st 48 hours: Pericarditis
1-2wks: L ventricular free wall rupture (acute heart failure secondary to cardiac tamponade), VSD (acute heart failure associated with a pan-systolic murmur)
2-6wks: Dressler’s syndrome: fever, pain, pericardial effusion, raised ESR

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25
Anti-platelets advice for ACS and PCI
Aspirin (lifelong) & ticagrelor (12 months)
26
Generalized tonic-clonic management
males: sodium valproate females: lamotrigine or levetiracetam
27
Focal seizures management
first line: lamotrigine or levetiracetam second line: carbamazepine, oxcarbazepine or zonisamide
28
Absence seizures management
first line: ethosuximide second line: male: sodium valproate female: lamotrigine or levetiracetam
29
Myoclonic seizures management
males: sodium valproate females: levetiracetam
30
Tonic or atonic seizures management
males: sodium valproate females: lamotrigine
31
Features of anti-phospholipid syndrome
Clots - veno/ arterial thrombus L - livido reticularis O - obstetric miscarriage T - thrombocytopenia
32
Conditions that precipitate lithium toxicity
Hypomagnesaemia Hypercalcaemia Hypernatraemia Hypokalaemia
33
Scleritis vs episcleritis
Scleritis is painful Episcleritis is Pain free
34
Inferio-posterior infarct complications
Acute mitral regurg (acute hypotension and pulmonary oedema) AV block
35
Most common cause of death following an MI
V fib
36
Anti-emetic for intracranial causes of N+V
Cyclizine -> dex
37
UC vs Crohn's
UC: ileocaecal valve -> rectum continuous disease, no inflammation past submucosa, crypt abscesses, bloody diarrhoea, uveitis, CR cancer, Primary sclorsing cholangitis, pseudopolyps, LLQ tenderness Crohn's: Episcleritis, weight loss, mouth -> anus skip lesions, indlammation of all cells, goblet cells, bowel obstruction, non-bloody diarrhoea
38
Addison's + vomiting
Im hydrocortisone until vomiting stops
39
Lacunar stroke site
Basal ganglia, thalamus, internal capsule
40
Good prognosis in RA
RF -ve
41
1st line treatment of Lyme's disease
21 day course of doxycycline
42
Acute haemolytic reaction sx
Fever, abdo pain and hypotension post transfusion
43
Fever, abdo pain and hypotension post transfusion
Acute haemolytic reaction sx
44
Murmur man
Draw murmur man
45
Pre-endoscopy variceal haemorrhage meds
Terlipressin and Abx
46
Angina management
ABCD Aspirin+GTN Beta-blockers + Ca channel blocker (amlodipine) Ca channel blocker mono= Verapamil/diltiazem Nicorandil
47
Prophylaxis for contacts of patients with meningococcal meningitis
Oral cipro or rifampicin
48
Most likely cause of death in CK on haemodialysis
IHD
49
IgA nephropathy vs minimal change disease
Minimal change disease: nephrotic syndrome IgA nephropathy: nephritic syndrome
50
Management of minimal change disease
Oral corticosteroids
51
Renal transplant increases the risk of which cancers
SCC, cervical cancer, lymphoma
52
Discharge advice post-penuothorax
No sea diving for life Stop smoking No flying until 1 week post check x-ray
53
Antii-CCP
RA
54
ANCA
Vasculitides
55
Anti-Jo1
Poly/Dermatomyositis
56
Anti-dsDNA ANA
SLE
57
AntiRo/Anti-LA
Sjorgen's
58
Treatment for wilson's
Penicillamine
59
Monitoring tests for haemochormatosis
Ferritin and transferrin
60
Causes of raised prolactin
pregnancy prolactinoma physiological polycystic ovarian syndrome primary hypothyroidism phenothiazines, metoclopramide, domperidone
61
EGFR variables
CAGE Creatinine Age Gender Ethncity
62
AF electrical cardioversion, when to do
Haemodynamically unstable Elective
63
Elective cardioversion, onset <48 hrs ago
Rhythm OR rate control Rate control (Beta blockers or Ca channel blockers) Heparinize + rhythm control
64
Anticoag in AF if onset <48 hrs, post cardioversion
No anti coag if no risk of stroke (CHADVASC)
65
Elective cardioversion, onset >48hrs ago
Anticoag for 3/52 OR TOE to exclude thrombus -> cardiovert immediately Heparinize + cardiovert (electrical preferred_ Anticoag post electical cardioversion for 4 wks, then rv
66
AF pharmacological vcardioversion options
Amiodarone if structural heart disease Flecainide if no structural heart disease
67
What medication should be avoided in HOCM
ACE i
68
Tumour lysis syndrome electrolytes
Hyperkalaemia Hyperphosphatemia Hypocalcaemia
69
Prophylaxis for TLS
allopurinol /rasburicase
70
Hodgkin's lymphoma signs of poor prognosis
B symptoms Increasing age Male sex IV disease Lymphocyte depleted subtype
71
Sickle cell crises
Big spleen - mostly always sequestration crisis Limb pain - mostly haemolytic/ischaemic/vaso-occlusive crisis Hip pain - haemolytic/ischaemic/vaso-occlusive crisis (plus possible avascular necrosis head of femur) Parvovirus infection should result in an aplastic anaemia (with pancytopenia of all cell lines)
72
How soon can you re-administer adrenaline in anaphylaxis
5 minutes
73
Cushing's triad
Bradycardia Irregular breathing Hypertension + widening pulse pressure
74
Migraine acute management
triptain+NSAID/triptan+paracetamol
75
76
Causes of digoxin toxicity
Low: hypoK, hypoMg, hypoalbumin? Hypothermia/thyroidism Potassium: drugs that cause hypoK (thiazides/loop diuretics) Can: hyperCa, acidosis, hyperNa Hurt/Heart: common heart drugs: amiodatone, diltiazem, verapamil, spiro
77
Causes of psoriasis exacerbation
BLANQ Beta blockers Lithium NSAIDs ACEi Quinine Infliximab
78
Short QT interval causes
Hypercalcaemia Hyperkalaemia
79
Psoriasis management
Potent steroid + vitamin D analogue BD vit D analogue Potent steroid OR coal tar
80
Psoriasis management
Potent steroid + vitamin D analogue BD vit D analogue Potent steroid OR coal tar
81
Allergic reactions types
ACID Anaphylaxis Cell mediated Immune complex Delayed
82
Anti emetics in raised intracranial pressure
Cyclizine Dex
83
Why are irradiated blood products used
Depleted T-cell lymphocytes to avoid transfusion associated host vs graft disease
84
Goodpasture’s syndrome triad
Diffuse pulmonary haemorrhage, glomerulonephtitud and anti GBM antibodies
85
Autosomal recessive vs dominant
Dominant is structural, except Gilbert’s, hyperlipideamia Recessive is enzyme/metabolic related, except ataxias
86
Anorexia features
All low Gs and Cs are raised: GH, glucose, salivary glands, cortisol, cholesterol, carotinaemia
87
Wernicke’s encephalopathy
COAT Confusion Oculomotor dysfunction Ataxia Thiamine treatment
88
Korsokoff’s syndrome
CART (cart them off it’s incurable) Confabulation Anterograde and Retrograde amnesia Temperament altered
89
HHT 4 main diagnostic criteria
Epistaxis Telangectasia Visceral lesions FHx
90
When to refer to specialist for molluscum contagiosum
patients with HIV Eyelid margins or ocular region lesions
91
Adverse effects of adenosine
Chest pain FLushing
92
Who to avoid adenosine in and why
Asthmatics -> bronchospasm
93
Witnessed cardiac arrest on monitor
3 successive shocks followed by CPR
94
Draw ALS algorithm
ALS
95
What can make clopidogrel less effective
Omeprazole
96
Hypokalaemia ECG
in hypok U have no Pot and no T, Long PR and long QTH
97
Hypothermia ECG
Brr Just Freeze Little Atriums Bradycardia J waves (hump at end of QRS) First degree HB Long QT Arrthmias
98
Acute HF with shock management
Ionotropes Vasopressors mechanical circulatory assistance
99
Hypercalcaemia ECG
Short QTs love milk
100
HTN flowchart
HTN
101
ECHO findings of HOCM
MR SAM ASH Mitral regurg Systolic ant motion Asymmetric hypertrophy
102
HOCM ECG
BIG QRS, Small Q, Twisted ST
103
HOCM management
ABCD Amiodarone Beta blockers Cardioverted defib Dual chamber pacemaker
104
HOCM drugs to avoid
ACEis, Nitrates, ionotropes
105
Valve affected in Infective endocarditis
mitral valve
106
Valve affected in Infective endocarditis in IVDU
tricuspid valve
107
Bradycardia management
IV Atropine 500 mcg (can have up to 3mg) Trancutaneous pacing isoprenaline/adrenaline infusion titrated to response Transvenous pacing
108
Acromegaly testing
IGF1 first -> OGTT to confirm if levels raised
109
Management of acromegaly
Octreotide
110
Addison's features
ADRENALS Aldosterone deficiency Dark skin Refractory hypotension Electrolyte imbalance (Hyponatraemia, hyperkalaemia) No energy Appetite loss Low sodium Shock risk
111
Addison's investigation
Short synchathen test
112
Cushing's syndrome
Excess steroid production Hyperaldosteronism Hypokalaemic metabolic acidosis
113
Management of cardiogenic shock post MI
inotropes or an intra-aortic balloon pump
114
Arrythmia associated with inferior MI
AV node block
115
Left ventricular rupture post MI
Ischemic damage weakens the myocardium, leading to aneurysm formation, persistent ST elevation, and risk of thrombus formation.
116
Min amount of time to observe anaphylaxis for
6 hours
117
Weber's stroke
Midbrain stroke, ipsilateral CN III palsy and contralateral hemiparesis
118
Lateral medullary strokr
Wallenburg (ice-burg): loss of temp and facial paralysis
119
What can precipitate wernicke's encephalopathy in thiamine deficiency
Glucose infusion
120
Cryoprecipitate ingredients
Fibrinogen VWF 13, 8

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