high yield Q's Flashcards
1
Q
reed sternberg cells
A
hodgkins lymphoma
2
Q
smudge cells
A
CLL
3
Q
auer rod
A
AML
4
Q
rouleux formation
A
myeloma
5
Q
lytic bone lesions
A
myeloma
6
Q
muddy brown casts
A
acute tubular necrosis
7
Q
what is the most common cause of pancreatitis
A
gallstones
alcohol
8
Q
how is cancer definitively diagnosed
A
biopsy
9
Q
what type of laxative is laxido
osmotic
stimulant
A
osmotic laxative
10
Q
when is a FIT test used
A
when there is suspicion of bowel cancer but pt does not meet 2ww
11
Q
what is the most common cause of diarrhoea
A
rotavirus
12
Q
what organism is responsible for causing diarrhoea with vomiting
A
nora virus
13
Q
what medication might you give a pt with diarrhoea
A
loperamide
14
Q
give an eg of an abx that can cause c.diff infection
A
co amoxicillin
ciproflaxacin
15
Q
what abx is given to treat c.diff
A
metronidazole
16
Q
which sided pain does constipation usually cause
A
left sided pain
17
Q
what is the diagnosis:
generalised abdominal pain then moves to RIF
A
appendicitis
18
Q
what is the 1st line treatment for GORD and how long
A
PPI e.g. omeprazole for 4 weeks if not better then h.pylori stool sample
19
Q
what is site should be used in acute poisoning
A
TOXBASE
20
Q
what is the most diagnostic test for inflammatory bowel disease
A
facecal calprotectin
21
Q
what is used to monitor colon cancer
A
CA
22
Q
what’s the diagnosis
40 yr old female, RUQ pain, murphy positive
A
cholcystitis
23
Q
what is the most common cause of varies
A
alcohol
24
Q
which hernia is most palpable in the scrotum
A
indirect hernia
25
which hernia is more common in women
femoral hernia
26
which hernia has increased risk of strangulation
femoral hernia
27
what is the name of the hernia that can occur anywhere in the abdominal wall
ventral hernia
28
what is 1st line treatment for anal fissures
topical steroids and analgesia
29
what is 2nd line treatment for anal fissures
topical GTN
30
what side effect must you warn the pt about when using topical GTN for anal fissures
headaches
31
what's the diagnosis
2 yr old boy, distended abdo, red jelly stools
intussusception
32
what's the diagnosis
child, projectile vominting, olive mass
pyloric stenosis
33
what is a serious complication of UC
toxic megacolon
34
which type of bowel obstruction is most common
small bowel obstruction
35
in what condition should you measure intrinsic factor
pernicious anaemia
36
when can acylovir be used to treat shingles
with 72 hrs of onset
up to 5 days of onset
37
what is the function of acyclovir is the management of shingles
reduced risk of post neuropathic neuralgia
38
what is 1st line and 2nd line treatment for cluster headache
1st line: nasal/IM triptan
| 2nd line: short burst o2 therapy
39
list 2 conditions that can cause glove and stocking syndrome
diabetes
gillian barre syndrome
40
how does glove and socking syndrome differ in gillian barre syndrome to diabetic
in GBS it develops acutely over a few days
41
what scoring system is used for TIA
ABCD2:
```
age
blood pressure
clinical features
diabetes
duration
```
42
what medication i used in the community to manage a tonic status epileptics
buccal midozalam
43
what test is used to carpal tunnel syndrome
tinnels test
44
what are 2 initial management for carpal tunnel syndrome
wrist splints
| physiotherapy
45
in GP when should you give benzylpenicillin to manage suspected meningitis
meningitis with a rash
46
what is the most common underlying cause in this presentation
loss of power + personality changes
space occupying lesion
47
what is the most common cause of cerebral palsy
birth trauma
48
what is the cause/carrier of lyme disease
ticks
49
what causes a foot drop
damage to common perinea nerve
50
what nerve would be damaged in a fracture of the surgical neck of humerus and what sign would you get
axillary nerve
patch sign
51
what nerve would be damaged in a spiral fracture of the humerus
Radial nerve
52
what nerve would be damaged in a fracture of the medial epicondyle of the humerus
ulnar nerve
53
what type of dementia is associated with Parkinson's
lewy body dementia
54
what type of dementia presents with language disorder and personalty changes
front temporal lobe dementia
55
what signs might suggest vascular dementia (RFx)
HTN
diabetes
signs of arteriopathy
56
what type of sarcoma is present in those with HIV
karposki sarcoma
57
what does pappiloedema suggest
inflammation of optic nerve
| raised ICP
58
what is the diagnosis
drooping eye lid, double vision and chest muscle weakness
MG
59
what is the inheritance pattern for Huntington's
autosomal dominant
60
what type of neuropathy can be present in B12 deficiency but can be easily reversed
glove and stocking syndrome
61
when would you prescribe prednisolone in bells palsy
if presenting within 72 hrs of onset of symptoms
62
what are the 4 types of dementia
alzihmers
lewy body
vascular
front temporal lobe
63
what is the cause of korskoff psychosis
acute alcohol withdrawal due to thiamine deficiency
64
what is the cause of wernikes encephalopathy
chronic thiamine deficiency
65
list 3 conditions that might initially present with 'clumsiness'
```
MND
MS
parkinson's
muscular dystrophy
MG
```
66
what is the 1st line treatment for Parkinsons
levadopa
67
what is important to ask in a pt your suspecting id med overuse headache
over the counter meds
e.g. codeine
68
how long does a typical cluster head last
15mins to 3 hrs
69
what's 1st line treatment in a migraine
'NSAIDs e.g. naproxen
70
give an example of a med that can be used to manage Trigeminal nerve neuralgia
amytriptylline
71
what vessels are the cause of a extradualr bleed
middle meningeal artery
72
what vessels are the cause of a subdural bleed
bridging veins
73
what is the most common cause of SAH
congenital aneurysms
74
what type of intcracrainla haemorrhage presents with a lucid interval
extradural bleed
75
what antipsychotic is tetrogenic
sodium valproate
76
what can be a differential for stroke
prodrome migraine
77
what is QRISK used to assess
assessing risk of having a cardiovascular event in the next 10 yrs
78
what is the treatment for an acute MI <120mins
PCI
79
what is the treatment for acute MI >120 mins
thrombolysis
80
what blood test is used if suspecting HF
BNP
81
what blood marker is used if you are suspecting MI
troponins
serial troponin
82
what medication used in AF helps to improve mortality
beta blocker
83
what test should be carried out before staring an AF on medication
baseline kidney function
84
what is small vessel disease
when small vessels of the heart become damaged
85
what is the cause of prinzmetal angina
occlusion or coronary artery spams
coronary artery spasm
86
what medication should a pas with raynauds be started on
calcium channel blocker
87
what range of ABPI would indicate peripheral vascular disease
<0.7
88
list 3 RFx for developing PE/DVT
```
recent travel
COCP
HT
cancer
immobilisation
trauma
obesity ]
preganancy
```
89
when is it preferred to use apixaban over rivaroxaban
in venous thromboembolism t reduce risk of reoccurrence
90
which is a VERY common feature of PE
1. chest pain
2. haemoptyisis
3, cough
4. tachycarida
tachycardia
91
what's the diagnostic investigation for PE
CT pulmonary angiogram
92
which type of heart block is common in athletes
morbitz type 1
93
which types of heart block require pacemaker
morbitz type 2
| type 3
94
what is important to warn pt about with adenosine
feel like they are dying
95
what medication is used to treat SVT
adenosine
96
what non pharm treatments are there for SVT
vasovagal manoeuvres
| carotid sinus massage
97
what is the dosage for adenosine in SVT
6
12
12
98
what is present in ECG in pericarditis
saddle shaped ST elevation
99
where is a pacemaker typically placed
left hand side
| under the clavicle
100
what is a common side effect associated with ACEi use
dry cough
101
list 2 common side effects associated with CCB use
peripheral oedema
| flushing
102
what is a common side effect associated with statin
myopathy
103
what difference in BP would suggest aortic dissection
radio radio delay
104
when would sugary be indicated as treatment for AAA
>5.5cm
105
what criteria i used for endocarditis
dukes criteria
106
how should blood culture be collected for a patient with suspected infective endocarditis
3 separate occasions from 3 different areas
107
what are the 3 types of pneumathoracies
tensions
spontaneous
traumatic
108
what is the most common cause of croup
parainfluenza
109
3 features present in croup
barking cough
fever
stridor
110
how can you tell resp distress in someone/child
```
use of accessory muscles
intercostal recession
tracheal tug
cyanosis
reduced feeding and wet nappies
```
111
what is the treatment for croup
single dose dexamethasone
112
what is the cause of bronchiectasis
widening of the alveoli
113
what scaring system is used for pneumonia
```
CURB65
confusion
urea
RR
BP
>65yrs
```
114
what is a prolonged complication of viral pneumonia
pleurisy
115
does pneumonia usually present
unilateral or bilateral
unilateral
116
what vaccine are important in old pts with underlying lung disease
pneumococcal
| influenza
117
what should you think about investigating if a pt has fungal pneumonia
HIV/immunocomprimised
118
when should you do a repeats chest X-ray for pt who has pneumonia
after 6 weeks
119
what is the typical presentation of a pneumothorax
young
tall
male
smoker
120
what are the 2 findings of pneumothorax
hyperessonance on percussion
| reduced/no breath sounds
121
what is the most common cause for bronchitis
RSV
122
what is a common complication for lung cancer
pleural effusion
123
which type of lung cancer is less common
small cell lung cancer
124
which type of lung cancer is after spreading and not associated with smoking
small cell lung cancer
125
list 2 types of lung cancer
squamous cell lung cancer
adenocarcinoma
small cell lung cancer
126
what condition would cause a bilateral pleural effusion
heart failure
127
what do you test for when looking at the pleural effusion
PH
| protein
128
what type of pleural effusion is more commonly associated with bacterial pneumonia
exudative pleural effusion
129
what is used to manage COPD with non-asthmatic features
LABA/LAMA
130
what is the diagnostic test for COPD
spirometry
131
what are the 3 vaccinations we want COPD its to of had
pneumococcal
influenza
covid
132
what medications are used to treat exacerbations of COPD
abx
nebulisers
steroids
133
what scoring system is used for PE/DVT
wells score
134
what blood test can be carried out if suspecting PE/DVT
d-dimer
135
what is the treatment for COPD with asthmatic features
LABA/ICS
136
what is cor pulmonale
right sided HF due to increased pressure in lungs
137
list 3 features of cor pulmomale
peripheral oedema
raised JVP
hepatomegaly
ascites
138
what is the treatment for PE
anticoagulation/DOAC
| apixaban
139
list 3 occupations that can cause pulmonary fibrosis
miners
builders
roofers
asbestos exposure
140
name one drug that can cause pulmonary fibrosis
amiradone
methotrexate
nitrofurantoin
141
name one condition that can cause pulmonary fibrosis
autoimmune conditions e.g. RA
SLE
systemic sclerosis
alpha 1 antitrypsin deficiency
142
what type of tumours secrets hormones
carcinoid tumours
143
list 3 features that a carcinoid tumour might present with
facial flushing
diarrhoea
tachycardia
144
list 3 causes for the formation of a pulmonary nodule
cancer
calcification
underlying lung disease
145
what type of lung disease is sarcoidosis
restrictive lung disease
146
what med can be used to treat pulmonary HTN
sildenafil
147
what are 2 RFx for developing emphysema
pneumonia
| immunocompromised
148
what does inhalation of asbestosis cause
mesothelioma
149
what is the APGAR score used for
newborn babies
150
according to NICE what is the diagnostic test for asthma
FENO
151
when can serial peak flows be used in asthma
monitor progression
152
what vaccine is given to prevent epiglottis
haem influenza
153
diagnosis:
obese, male, day time somnolence, poor concentration, snoring, fatigue
sleep apnoea
154
what is pertussis
whooping cough
155
what is the most common feature of pertussis
prolonged coughing making it difficult to breath
156
what is the treatment for pertussis
clarithromycin/erythromycin
157
what is the 1st line abx for pneumonia
amoxicillin
158
what is the abx of choice for COPD exacerbation
doxycycline
159
what is present on ABG of a pt with an exacerbation of COPD
rest acidosis
160
what is the treatment for c.diff infection
metronidazole
161
what is the appropriate immediate intervention for tension pneumothorax
needle aspiration
162
what blood maker is always raised in cancer
platelets
163
most common cause of transudative pleural effusion
heart failure
164
most common cause for exudative pleural effusion
pneumonia/bacterial infection
165
diagnosis:
male, homeless, 6m cough, night sweats, weight loss, pyrxia
TB
166
what is the most common cause pulmonary fibrosis
idiopathic
167
what is the most appropriate investigation for bronchiestasis
CT scan
168
what non invasive test can be used to test for pulmonary HTN
echocardiogram
169
what type of imaging can be used to diagnose interstitial lung disease
high resolution CT
170
how will the CT scan appear in interstitial lung disease
ground glass appearance
171
what other investigation can be used when the diagnosis of interstitial lung disease is unclear following CT scan
lung biopsy
172
is interstitial lung disease:
1. reversible
2. irreversible
2. irreversible
173
how does idiopathic pulmonary fibrosis present
insidious onset
SOB and dry cough
bibasal fine inspiratory crackles
finger clubbing
174
what are the 2 consequences of working with asbestosis
causes fibrosis of the lung
can cause cancer
175
what 4 problems can asbestosis inhalation cause
lung fibrosis
pleural thickening and plaques
adenocarcinoma
mesothelioma
176
what is the most common interstitial lung disease
idiopathic pulmonary fibrosis
177
what zone of the lung is most affected in cystic fibrosis
1. upper zone
2. lower zone
upper zone of the lung
178
what zone of the lung is most commonly affected on idiopathic lung fibrosis
1. upper zone
2. lower zone
lower zone
179
what is pneumoconiosis
inertial fibrosis secondary to occupational exposure
180
give 2 types of pneumoconiosis
coal miners lung
asbestosis
181
list 2 complications associated with pneumoconiosis
lung cancer
cor pulmonale
182
what type of pattern is seen in spirometry on a pt with interstitial lung disease
restrictive pattern
183
give an example of a medication that can be used to treat idiopathic pulmonary fibrosis
pirfenidone
nintedanib
184
what is the primary cause of mesothelioma
asbestosis exposure
185
name the condition
presence of non caseating granulomas
sarcoidosis
186
what organs are predominant affected in sarcoidosis
the lungs
187
what 3 ways can the lungs react in an exacerbation of asthma
bronchoconstriction
inflammation
excess mucus secretion
188
what immune cells are responsible for the immune reaction seen in asthma
TH2 cells
189
what are the 3 main treatments given in an exacerbation of asthma
oxygen
nebulised bronchodilators
corticosteroids
190
what is the inhertance pattern for cystic fibrosis
autosomal recessive
191
what test can be used to diagnose cystic fibrosis
sweat test
192
how many g/L in transudative effusion
<30g/L
193
how many g/L in exudative effusion
>30g/L
194
2 causes of transudative effusion
heart failure
| cirrhosis
195
2 causes of exudative effusions
pneumonia
| malignancy
196
what criteria is used to distinguish between transudative and exudative effusions
lights criteria
197
what is the most common cause of bronchiolitis
respiratory syntactical virus
198
what are the 3 management methods for bronchiolitis
nasal suctioning
oxygen if required
fluids
199
what age does bronchiolitis usually present
<1 yrs old
| 3-6 months
200
how can children with respiratory distress present
```
subcostal/intercostal recession
tracheal tug
nasal flaring
reduced feeding
reduced wet nappies
cyanosis
```
201
what does bronchiolitis usually affect:
1. upper airways
2. lower airways
2.lower airways
202
where dies croup usually affect:
1. upper airways
2. lower airways
1. upper airways
203
what is the most common cause of croup
parainfluenza virus
204
which has typical onset of 6months - 3yrs
1. bronchiolitis
2. croup
croup
205
which condition is treated with a single dose of dexamethasone
1. bronchiolitis
2. croup
3. epiglotitis
4. whooping cough
croup
206
what position will a children with is having epiglotitis and why
tripod position
optimises airflow through narrowed airway
207
what finding will be seen on lateral neck radiography in a pt with epiglotitis
thumb print sign --> enlarged epiglottis
208
what is another name for pertussis
whooping cough
209
what finding in the Hx might suggest whooping cough
no/incomplete vaccinations
210
what does NICE reccomend and 1st line treatment for a child with whooping cough
clarithromycin
211
what is the most important thing to correct in a child presenting with respiratory distress
correct the temperature
212
what is the typical age onset for bronchiolitis
3-6 months
213
what are the 2 classical finding of auscultation of the chest in a child with bronchiolitis
wheeze and crackles
214
what is the most common cause of a viral induced wheeze
RSV
215
what is 1st line treatment in child with a wheeze who is hypoxic
nebuliser salbutamol
216
what is the 1st thing to do in a child who is a RR of 0
5 rescue breaths
217
how many rescue breaths do you give in a child
5
218
what is pads basil life support
5 rescue breaths
| 15:2 compressions
219
give 3 viral examples of respiratory distress in a child
croup
asthma exacerbation
VIW
bronchiolitis
pneumonia
220
what is 1st line treatment for T2DM
metformin
221
what is the MOA of metformin
increases insulin sensitivity
222
what is a pro of metformin
does not cause hypoglycaemia
| does not cause weight gain
223
what are 2 side effects of metformin
causes GI upset
can increase risk of lactic acidosis
224
give an example of a drug that is used 2nd line to treat T2DM
gliclazide (sulfonylurease)
225
what medication (group) is used 3rd line to treat T2DM
```
DPP4 inhibitor (gliptens)
stitagliptin
```
226
what medication is used 4th line to treat T2DM
SGLT2
| dapagliflozin
227
what is the tareget HbA1C
<48mmol
228
what annual monitoring is offered to patients with T2DM
annual eye check
| annual foot checks
229
how can diabetic foot disease progress in patients with recurrent ulcers
move into bone --> osteomyelitis
230
what is the range of HbA1C for pre diabetes
42-47mmol
231
what is the most common cause of hyperthyroidism
Graves disease
232
what is the most prominent autoantibody present in graves `
TSH auto antibodies
233
what is the diagnosis
tender goitre + symptoms of hyperthyroidism
sucbacute hyperthyroidism
234
what can trigger subacute hyperthyroidism
starts following a viral infection that causes inflammation of the thyroid gland
235
what is the diagnostic test for diagnosing thyroid cancer
biopsy
236
what is usually 1st line investigation in a patient presenting with a thyroid lump/mass
ultrasound scan of thyroid
237
what will the TFT blood show in hyperthyroidism
Low TSH high T4
238
what will the TFT blood show in hypothyroidism
high TSH low/normal T4
239
how long should you wait when thinking of adjusting the dose of meds in hypothyroidism
give at least 1 month to adjust the dose
240
what are 2 blood findings suggestive of cancer
raised platelet
| hypercalcaemia
241
what is the cause of addisons disease
low cortisol and aldosterone
242
what are the Na and K+ findings in additions disease
hyponatreamia and hyperkalaemia
243
list 3 features of addisons disease
hyperpigmentation
postural hypotension
dizziness
vomitign
244
what is the cause of cushing disease
excess cortisol
245
what is the mots common cause of Cushing disease
iatrogenic --> corticosteroid use
246
apart from insulin and autoantibodies what other marker in the blood can be used to detect T1DM
cleaved C peptide
247
what are the 3 types of insulins
long acting
short acting
intermediate acting
248
what type of acid base disorder is present in DKA
metabolic acidosis
249
along with insulin and fluids what else might a patient receive when trying to treat DKA
K+
250
what are 3 symptoms of phaeachromocytoma
```
severe HTN
sweating
palpitations
headaches
hot flushes
```
251
what is the most appropriate imaging for diagnosing phaeachromocytoma
CT abdomen and pelvis
252
what is the cause of gynacomastia and erectile dysfunction
low testosterone
253
what hormones are secreted by the pituitary gland
FSH, LH, ADH, prolactin, GH, TSH
254
what is given in hyperkalaemia to stabilise the heart
calcium gluconate
255
what will the ECG in hyperkalaemia show
tall t waves
| broad QRS
256
what meds can be given to treat hyperkalaemia
calcium gluconate
insulin
nebulise salbutamol
calcium resonium
257
What hormones are responsible for regulating calcium
PTH and calcitonin
258
what is the pneumonic for hypercalaemia
moans
groans
stones
psychiatric tones
259
what electrolyte should always be checked when there is abnormalities in Ph
Mg
260
where is Mg absorbed in the gut
small bowel
261
what is one adverse feature of hyponatraemia you should be worried about
seizures
262
what are the 2 most common causes of metabolic acidosis
DKA
| sepsis
263
when does NICE recommend starting treatment for hypothyroidism
TSH >10
264
list 3 causes of hypercalaemia
dehydration (elderly)
drugs
cancer
hypophosphataemia
265
what is the cause of conn syndrome
high aldosterone
266
which bone condition is associated with hyperparathyroidism
osteoperosis
267
what is 1st line treatment in T1DM pt who collapses and is unconscious
IV 10% dextrose
268
what is the diagnosis
acute onset thyroid pain, fever, post viral infection, T4 raised
subacute thyroiditis
269
how does a thyroid storm present
arrythmias, HTN, very unwell, very high thyroid levels
medical emergency
270
what is the most common cause of hypoparathyrodisim
surgical resection of the parathyroid glands
271
what is the diagnosis:
BP: 210/110, HR: 120, sweating, pallor, dyspnoea
phaeochromocytoma
272
what hormone is responsible for acromegaly/gigantism
GH
273
what is the most appropriate way of calculating the need for statin
QRISK2
274
lack of what hormone causes diabetes insupidus
ADH
275
what is the diagnosis
previous bowel resection, muscle weakness, tremor, palpitations
hypo magnesia
small bowel reabsorbs Mg
276
what is the diagnosis:
Baby bottle fed, eczema, colic, loose frequent stool, GORD, poor growth:
lactose intolerance
277
what is the diagnosis:
Painful bones, renal stones, abdo groans, moans:
hypercalaemia
278
when should a statin not be used to treat hyperlipidaemia
in patients with hep B
279
what medication use can be associated with galactorrhea
antipsychotics
280
what is the diagnosis:
fatigue, weight loss, hypeorpigmentation
addisons
281
what would indicate prostitis on examination using DRE
painful during DRE
282
what is 1st line medication for BPH
tamsulosin
283
what type of medication is tamsulosin
alpha blocker
284
what is 2nd line management in BPH after tamsulosin
finasteride
285
what pathogen is the most common cause for balantitis `
candida albicans
286
what spinal roots are involved in a spinal cord injury presenting with incontinance
sacral 2,3,4,
287
what would you inspect in a patient presenting with bowel incontinance
antler tone and sphincter tone
288
what is the diagnosis
testicular mass that transluminates on examination
hydrocele
289
what is the next best step:
85yr old female, +nitrites
obtain a hx
290
would you urine dip test on a 80 yr old female presenting with UTI symptoms
nope
bacterial would be present anyway
291
what organism is the most likely cause for prostitis
e.coli
292
what investigations would you do 1st line in
unprotected sex, new partner + penile discharge
1st line void urine sample
293
what should you look for in
unprotected sex, new partner + penile discharge
gonorrhoea
294
what is the most appropriate 1st line investigation in:
present female, loin to groin pain and microscopic haematruria
USS because she is pregnant
295
what imaging would you perform in a female suspecting kidney stones
CT KUB
296
what is the most common cause for urethral injury
surgical trauma
297
what is phimosis
swelling of the of the foreskin and is not retractable
298
what is the most appropriate treatment for phimosis
hydrocortisone
299
list 3 features of nephrotic syndrome
facial oedema
lipiduria
low serum albumin
300
what is the most common genetic inheritance pattern for polycystic kidney disease
autosomal dominant
301
what can affect the result of a PSA test
rectal exam, UTI and sexual intercourse
302
what is the diagnosis
left loin pain + microscopic haemoturia
pylonephritis
303
what is 1st line treatment in pyelonephritis
ciprofloxacin
304
what is the diagnosis
14 yr old sudden onset severe scrotal pain, no traum
testicular torsion
305
what is epididomocytis
infection of the epidiyomsos and testicle
306
what is the diagnosis
7 yr old, painless palpable mass in the loin
wilms tumour
307
list 3 Rfx for renal cell carcinoma
age, obesity and HTN
308
how does a posts abscess present
deep abdo pain
309
what is the most common cause of anaemia in CKD
reduced erythropoietin synthesis
310
how would an abscess present on USS
it would look dense and think on USS
311
list 3 occupational RFx for bladder cancer
working with paint/dyes
312
what imaging would you use if you see a soft tissue mass/hydrocele and why
USS to determine the density
313
what is a common symptoms of bladder cancer
unexplained painless haematuria
314
what imaging technique should you use to look for bladder cancer
cystoscopy
315
give 2 hygiene advises you would give to prevent UTI
seeing after sex
| wipe from front to back
316
when should you consider referrals in UTI
recurrent UTI >3 in year
317
what should you do if patient has not responded to abx given for UTI
urine sample and culture
if need to change abx or for resistance
318
how would you diagnose a hydronephrosis
USS
319
what is hydronephrosis
build up of fluid in the kidney commonly due to obstruction
320
list 3 causes of pre-renal AKI
hypovolaemia
blood loss
dehydration
HF
321
what are the common causes of renal AKI
glomerularnephritis
nephrotic syndrome
nephritis syndrome
322
list 3 causes of post renal AKI
stones
cancer
tumour
323
what is present ninth urine in nephritic syndrome
blood
324
what is present in the urine on nephrotic syndrome
protein
325
what symptoms will be present with a loss of protein in the urine
oedema
326
what will be high in the blood in pts with nephrotic syndrome and why
high cholesterol because the liver is trying to compensate
327
how would you diagnose nephrotic/npehritic syndrome
biopsy
328
what number of GFR would make you consider dialysis
GFR <10
329
what are the 2 most common causes of renal problems
HTN and diabetes
330
list 2 causes that increase the risk of developing stones
dialysis
| dehydration
331
what is a stag horn calculi
large renal stones
332
what size of renal stone would make you refer to renal
>5mm
333
what is management options for balantitis
hydrocortisone and hygiene
clean properly
retract the foreskin
334
what medication is used to treat prostitis
2 weeks of ciprofloxacin
335
what is the diagnosis
difficulty starting stream of urine, dribbling and nocturnal urination
BPH
336
list 2 alpha blockers that can be used to treat BPH
tamsulosin
| doxazosin
337
list 2 SE that are common with the use of alpha blockers
postural hypotension
| dizziness
338
what type of medication is finasteride
alpha educate inhibitor
339
what levels will be high in rhabdomyolysis
CK
340
what is the cause of rhabdomyolysis
breakdown of skeletal muscle
341
what are elderly people who have had a fall and found on the floor over a long period of time at risk of developing
rhabdomyolysis
342
what causes AKI in rhabdomyolysis
myoglobin released and deposits in the kidney
343
what is the most common cause of urinary retention
urethral strictures
344
list 3 obstructive causes of urinary retention
stones
masses
post surgery
medication
345
what investigation would you consider in patients with urinary retention
bladder scan
346
does caudal equine present with urinary incontinance or urinary retention
urinary retention
347
what investigation should you consider in pt with testicualr cancer and why
MRI spine to look for mets
348
what is a major complication of testicular torsion if left untreated
infertility
349
what meds are used to treat vasculitis
steroids
350
what are the 2 common STI that present with penile discharge
gonorrhoea
| chlymidia
351
what is 1st line medication for chlymidia
doxycycline
352
what other blood would you consider in its with STI
HIV screen
353
where do you refer pts too if diagnosed with an STI
sexual health screen
354
what is the diagnosis and what is the other name of the presentation
single painless genital ulcer
syphillis
shanks
355
what is crytochidism
undescended testes can be unilateral
356
does cryptorchidism present
unilateral or bilateral
can be both
357
what can increase the risk of cryptorchidism
alcohol use during pregnancy
358
how would you manage cryptochidism
refer to urology
359
what is 1st line treatment for depression
SSRI
citalopram
centreline
fluoxetine
360
what does NICE recommended as 1st line treatment for depression
SSRIs
361
when is fluoxetine given to a pt with depression
<18 yrs old
362
what SSRI will be prescribed to an 18yr old with depression
fluoxetine
363
given an example of a sedation antidepressant
lofepramine
| mirtazepine
364
when would grief reaction be considered abnormal
>6 months
365
what is 1st line management for grief reaction
CBT
366
give an exmaple of a mood stabiliser
lithium
367
what medication can be used bipolar to stabilise mood
lithium
368
how often do pts on lithium get their blood monitored
every 6 months
369
what must pts on lithium be informed about when on it
lithium toxicity
370
what anti-psychotics has a risk of agranulocytosis
clozapine
371
what med is used 1st line treatment in alzhimes
donepezil
372
what is the moa of donepezil in treating alzheimer's
slowing down cognitive decline
373
list 2 antipsychotics
Rispiradone
| olazapine
374
what is 1st line treatment for anxiety
CBT
375
what med can be used to manage SOB and palpitations in anxiety
propranolol
376
what medication would be used in someone who presents with anxiety and low mood
sertraline
377
what BMI does NICE suggest considering bariatric surgery
>35 BMI
378
give an example of a medication that can be used to help with weight loss
orlistat
379
what is given in acute alcohol withdrawal to prevent psychiatric complications
thiamine
380
what does NICE reccomened as 1st line treatment for smoking cessation
NRT
381
who should you contract when there is a suspicion of child abuse
child safeguarding lead and safeguarding officer
382
what is 1st line treatment for OCD
CBT
| fluoxetine
383
what is 1st line treatment in for a child with ADHD
methylpenidate
384
what is the best way to treat panic disorder
CBT
385
what is the diagnosis:
17 yr old girl, thinks shes fat, BMI 16.5, poor eating, uses weight loss pills
anorexia nervosa
386
what is the most appropriate adjunct for generalised anxiety
sertraline
387
what is 1st line treatment for new schizophrenia
quetapine
388
what is dysthymic disorder
chronic long term mild depressive mood
389
what is 1st line treatment for dysthymic disorder
CBT
390
what is the diagnosis:
Mixed low mood, disinhibition, poor concentration, flight of idea
bipolar disorder
391
how bipolar disorder characterised
episodes of depressive mood and mania
392
what is the best treatment for PTSD
CBT
393
what test should be done initially in a female present with menorrhagia
STI screen
394
what is the 1st line treatment for menorrhagia
COCP
| tranexamic acid
395
what is the diagnosis:
discharge from cervix, infection and inflammation
cervicitis
396
what is the most common cause of cervicitis
STI
397
what symptoms does fibroids present with
pain
menorrhagia
dysmenorrhoea
398
what is the most common complication of gestational diabetes
oversized baby
399
what is hypothyroidism associated with in pregnancy
mental retardation
400
what happens to thyroid medication in hypothyroidism during pregnancy
increased due to an increase in demand
401
what is the diagnosis:
43 yr old, breast pain, redness, tenderness and nipple discharge
mastitis
402
what does the management of a cystocele involve
ring pessary
403
what is the diagnosis
white cream discharge + vaginal soreness and irritation
thrush
404
what is the management for vaginla thrush
clotrimazole cream
405
what is an alternative that can be used to manage vaginal thrush if clotrimazole cream does not work
single dose fluconazole
406
would you refer this pt for the 2ww
33 yrs old + unexplained axially lump
yes
407
would you refer this pt for the 2ww
50 yrs + nipple retraction
yes
408
how would you be able to differentiate between mastitis and milk mastitis
milk mastitis improves after feeding the baby
409
what is a cystocele
when the bladder drops into the vagina due to weakness in the walls
410
what is placenta preveria
low lying placenta that partially/completely covers the cervix
411
how would you manage dysmenorrhoea in a female who is not sexually active and has no PMH
1. COCP
2. IUD
3. mefenamic acid
Mefenamic acid
412
how would you manage dysmenorrhoea in a female who is sexually active and has no PMH
COCP/IUD
413
what is the treatment for chlamydia
doxycycline for 7 days
414
what is the treatment for chlamydia if doxycycline is contraindicated
azithromycin
415
where do you refer someone to if they have tested + for UTI
GUM clinic
416
how would you manage this pt
severe premenstural symptoms, taking time off work, PMH migraine with aura
SSRI during the leutal phase
417
what scan is used in pregnancy to look at the thickness of a the neck in helping to diagnose downs syndrome
nuchal translucency scan
418
what are you at risk of developing if you forget to take your tampon out
toxic shock syndrome
419
at what age are women sent for cervical screening and how often
25-64
every 3 years till 50
420
what is the diagnosis
infertility, cyclic pelvic pain, deep dysparenuina, heavy bleeding, not responding to NSAID
Endometriosis
421
what is the 1st investigation to carry out in a female presenting with RIF pain
pregnancy test
422
what is the possible diagnosis
pregnant female + proteinuria
pre-eclampsia
423
what medication would you give to a pregnant female with HTN and proteinuria
labetalol
424
how would you manage a lady on antidepressants who is trying to conceive
adjust the medication according to the risks/benefits
425
what is the diagnosis
28 yr old, irregular periods, hirtirism, acne
PCOS
426
after how long should you consider referral in those unable to conceive
>12 months
427
what should you check in females who are unable to conceive
day 21 progesterone (28 day cycle)
428
what should you check in males who are unable to conceive
check sperm count
429
what is the priamry risk of rhesus incompatibility in pregnancy
newborn haemolytic anaemia
430
what are the 2 emergency contraceptions that can be given
ella one
IUD
431
what is the diagnosis
snowstorm appearance on USS
molar pregnancy
432
what signs might indicate a molar pregnancy
dark vaginal bleeding
| pain
433
how would you manage this patient
52 yr old, sweats, irritable vaginla dryness
combined HRT
434
what is the medical management for ectopic pregnancy
methotrexate
435
what could be the possible diagnosis:
52 yr old abdo pain, distention and pelvic pain
ovarian cancer
436
what is the cancer marker for ovarian cancer
ca125
437
what is the diagnosis
27 yr old struggling to have sex due to vaginal muscle spasms
vaginismus
438
what is the 1st line treatment for vaginismus
psychosexual counselling
439
what is second line treatment for vaginismus
vaginal dilators
440
what joint does gout present on
usually 1st metatarsal
441
what is 1st line medication for gout
NSAIDs
442
what is 2nd line medication for gout
colchicine
443
what is 3rd line medication for gout
prednisolone
444
what is prophylaxisis treatment for gout
allopurinol
445
what is important to mention to the patient when initially starting them on allopurinol for gout
initially causes a flare in gout
446
what is 1st line treatment for sprain/strains
RICE
rest
ice
compression
elevation
447
what is the diagnosis:
70 yr old, proximal muscle weakness no meds
poly myalgia rheumatica
448
what blood marker would you look for in poly myalgia rheumatica
ESR
449
what is medical treatment for poly myalgia rheumatic
trial prednisolone
450
what are the 4 features present on X-ray in osteoporosis
loss of joint space
osteophytes
subchondral cysts
sclerosis
451
what is the characteristic presentation of pagets disease
bow legs
452
whihc is the most common direction of dislocation of the shoulder joint
anterior
453
what nerve is at greatest risk of damage in shoulder dislocation
axially nerve
454
what sign will be present in axially nerve damages
payers patch
455
what assessment tool is used in the diagnosis of osteoporosis without RFx
qfax
456
name a bisphosphanate used in the treatment for oesteoperosi
alendrenic acid
457
what is the initial treatment for a score of -2.5
calcium
vit d
alendronic acid
458
what is osgood scatters disease
inflammation and swelling on the the tibial tuberosity
459
what is the most common group to develop osgood shatters disease
common in teens who are very active
460
what is the most appropriate 1st line medication for tennis elbow
topical NSAIDS
461
apart from NSAID what are the other management options for tennis elbow
physio
| steroid injection
462
how is carpal tunnel treated initially
splint
463
what is the clinical test used for the diagnosis of carpal tunnel
tinnels test
464
what is the most common cause of caudal equine
disc herniation
465
what are 3 features of caudal equine
sandal paraesthesia
faecal incontinance
urinary retention
466
what is the diagnosis:
tenderness on the 5th metacarpal
boxers fracture
467
what is the name of the fracture that is a result of a fall on a outstretched hand
collies fracture
468
what is the name of the deformity seen in a collies fracture
dinner fork deformity
469
what is the displacement send in a collies fracture
posterior displacement of the radius and ulna
470
what is the diagnosis:
24 yr old, 3 month recurrent back pain, fatgiue, stiffness that disturbs sleep
ankylosing spondylosis
471
does ankylosing spondylosis improve with expertise or worsen with exercise
improves with exercise
472
what is the name of the maker specific to ankylosing spondylosis
HLA B27
473
what does the management for ankylosing spondylosis involve
physio
| analgesia
474
what is the diagnosis:
reactive arthritis, conjunctivitis, urethritis
Reiters syndrome
475
what is the most common cause of reiters syndrome
STIs
476
what is the diagnosis:
joint pain, butterfly rash, mouth ulcers, fatigue, lymphadenopathy
SLE
477
how is SLE treated
DMARDs
478
what age group is osteosarcoma commonly seen in
young
479
what is the most specific antibody see in RA
ACCP
480
what is polyarertitis nodosum
chronic vasculitis presenting with skin manifestations
481
what is the diagnosis
dry eyes
dry mouth
joint pain
sjogren syndrome
482
what is the diagnosis
fibrous thickening of the skin due to excess collagen formation
scleorderma
483
what is a consequence of bit d deficiency
osteomalacia
484
deficiency in what vitamin with cause night blindness
vit a
485
deficiency in what vitamin causes survey
vit c
486
deficiency in vitamin b1 causes what condition
beriberi
487
what is the diagnosis
progressive pain, restricted movement in shoulder over few months
adhesive capsulitis
488
what is the treatment for adhesive capsulitis
physio
| analgesia
489
what is the classic sign seen in suprasinatus tendonitis
painful arch
490
what is the classic sign seen in biceps rupture
popeye sign
491
what is the diagnosis:
unilateral swollen joints, red, inflamed, pain on movement, pyrexia
septic arthritis
492
what happens in a pulled elbow
partial dislocation of elbow
493
what is the main risk of an open fracture
osteomyelitis
494
what is the most common sign present in meniscus injury
locking of the joint
495
what is the most common sign on examination with a cruciate ligament injury
giving way
496
what spinal vertebrae is injured in a hangman's fracture
c2
497
what is the diagnosis:
12 yr old boy, overweight, pain in left hip and limp
slipped upper femoral epiphysis
498
what is perthes disease
stopped blood flow to the head of the thigh bone which causes avascular necrosis
499
what age group does perthes disease commonly affect
young
children aged 3-11
500
what is the pathophys of irritable hip
inflammation of the synovial membrane usually following viral infection
501
what imaging technique is used to diagnose irritable hip
USS
502
what medications group show poor management in MSK pain
opioids
503
what is the diagnosis
2 yr old, seal like barking cough, coryza symptoms, mild intercostal recession
croup
504
what is the management of croup
single dose dex
505
what finding in the hx would indicate epiglottitis
unvaccinated child
506
where would a forge in body commonly get stuck in hinhalation
right lobe
507
what is the diagnosis:
child, lethargy, unconscious, sweet smelling breath
DKA
508
what is the diagnostic test in DKA
capillary blood glucose
509
what is the cause of cerebral palsy development
hypoxia during birth
510
what is the treatment for worms
mebendazole
511
list 3 childhood vaccines
MMR
HPV
pertussis
512
what is the diagnosis
Adult exertional dyspnoea, congestive HF congenital cardiac abnormality
atrial septal defect
513
what heart defect present with a machinery murmur
patent dutose arteriosus
514
which heart defects present early as a child
VSD
| PDA
515
what are the 4 heart defects in tetralogy of fallot
VSD
right ventricular hypetropy
pulmonary stenosis
correction of the aorta
516
what congenital conditon is associated with tetralogy of fallot
downs syndrome
517
what is the diagnosis
7 yr old, repetitive speech, abnormal emotional response, low social interest:
autism spectrum disorder
518
how should asthma be diagnosed in a child
clinical judgement
519
what is the management of ?asthma in a child <5 yrs old
trial steroid inhaler
520
what is the recommended asthma management in teens and why
MART
combined maintenance and deliver due to less compliance
521
what is the diagnosis:
Episodic abdo pin, vomiting, drawing knees to chest, blood/mucus in stool:
intersusception
522
what is the diagnosis:
Previous bacterial throat infection, 4 wk later swollen joints, chest pain, dyspnoea, rash
rheumatic fever
523
what is the most common cause of rheumatic fever
streptococcus
524
what age should you refer a child 2ww a child to beads with undescended testes
>8 weeks
525
what is the diagnosis
African refugee, initial bone pain, acute abdo pain, anaemia on FBC
sickle cell anaemia
526
what is the diagnosis:
5m child, 2 day coryza, tachypnoea, crackles on chest
bronchiolitis
527
list 2 reps conditions that cane arise from an unvaccinated child
epiglottis
| whooping cough
528
what vessel is at risk of injury in a distal fracture of humerus with anterior displacement
brachial artery
529
what is the diagnosis
Adolescent boy, anterior knee pain during exercise,, settles with rest
osgood scalpers disease
530
what is the diagnosis
6yr old child, 4 day limp, viral URTI, otherwise well
transient syvonitis
531
what medication can help with bed wetting
desmopressin
532
what conservative management can help with bed wetting
enuresis alarm
533
what what age would you be worried about a child bedwetting
>5 yrs
534
what xlinked condition can cause haemolytic crisis in children
G6PD deficiency
535
what is the diagnosis
Unvaccinated child, headache, joint pain, fever, parotid swelling:
mumps
notifiable disease
536
what is the diagnosis
sudden severe abdo pain
strangulated hernia
