HIGH YIELD RECALLS Flashcards by Sheila Sarmiento

Impaired ability to walk along a straight line touching the heel of one foot to the toe of the other

Cerebellar Dysfunction

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Acute onset, severetesticular pain and swelling.
The testicle is tender and elevated

Testicular tosion

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Milk coming out from nipple

Switch to Quetiapine
Dx; Risperidone - induce galactorrhea

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Alcoholic patient, chronic, presented with abdominal pain tenderness,
distention, hepatomegaly, LFT abnormal, Abdominal Paracentesis done. What is the next appropriate test?

Neutrophils count

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0.9 cm pituitary adenoma on treatment with Bromocriptine
Now she wants to conceive
Prolactin was 1315 and now 1135
nxt?

Cabergoline

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bright red bleeding per rectum for 2 days
Daily - Furisemide and Spirolactone as well as water and sodium restriction
Abdominal distention@+ peripheral edema
Had variceal banding
urine sodium 5mmol
Cause of Acute kidney Injury?

Renal Hypoperfusion

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Which of the ff is the most appropritate treatment for the dendritic ulcer shown in the above picture

Oral Valacyclovir

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No passed motion and flatus for 3 days
Has abdominal pain with nausea
Vital signs stable
Diagnosis?

Sigmoid Volvulus

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Menstruation associated itchyness and redness without any discharge

Do nothing

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Given youg girl Bell’s palsy pic
come to ED within 6 hrs
mentioned Left ear examination (no rashes)

Oral Prednisolong and Oral Acyclovir

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Middle age
Jaundice
RUQ pain
High ALP
Gamma GT
Bilirubin

ERCP

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Joint pain
Morning stifness
symmetric join swelling
elevated anti-cyclic citrullinated peptide (anti-CCP) antbodies

Rheumatoid Arthritis

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detected with PLSIL
Next step?

HPV DNA test in 12 months

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Negative smear - No endocervical cells
Negative smear - Inflammatory cells

Repeat in 2 years

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Unsatisfactory smear

Repeat smear in 6-12 weeks
(allow regeneration of cells)

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Possible LSIL and definite LSIL

Repeat pap test at 12 months
If the woman is 30+ years and has no negative cytology in previous 2-3 years, refer for colposcopy or repeat the test in 6 months

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Possible HSIL and definite HSIL

Refer for colposcopy

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Glandular abnormalities including adenocarcinoma in situ

Refer to a gynaecologist

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Invasive squamous cell carcinoma or adenocarcinoma

Refer to appropriate specialist gynaecologist or unit

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nconclusive - raising possibility of high grade diease

Refer for colposcopy and possible biopsy

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Advice most appropriate to the mother in regard to breast feeding

Frequent feeding from both side

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The baby wakig up at nifht crying and consoled by breastfeeding
What to do next?

Add rice and other foods

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Harsh Inspiratort stridor
Barking brassy
TX: Adrenaline
6 montha to 3 -6 years sometimes older
Org: parainfluenza, influenza

Croup
(Laryngotracheobranchitis)

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Haemophilus type B
6 months - 6 years
Soft expiratory Stridor
Soft, cleat to muffled
Sitting forward,
Cherry red epiglottis
Tx: Cephalosporine, Ceftriaxone

Epiglottitis

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RSV 2 wks - 9 months < 1 yr Bilateral, Expiratory, wheeze Barrel-shped, subcostal recession Fine inspiratory crackles Nasal flaring Tx: 02

Bronchiolitis

Hemothorax, 1800 ml drained with 2 L crystalloid What will you do?

Thoracotomy

Hyperresonant

Pneumothorax

Dull

Haemothorax

If intubation tried already and didn't respond.'

Thoracotomy

Young female Fever dysuria with lower abdominal pain LaB pus cells What is the diagnosis?

UTI

A case of RIsperiodone What drug to counteract

Aripiprazole

Unilateral Undescended testis

Indirect inguinal Hernia

Post op Patient Oliguric with indwelling catheter, fever 38.5 What is your most approp management?

Blood Culture

A case of hyperkalemia, labs show 6. Everything was normal except urea ans. creatinine was high. What to do?

Resonium

Nephrotic Syndrome treated with Steroid Developed Hypertension Diffuse abdominal pain, vomiting for 1 week What is the probable diagnosis?

Acute Pyelonephritis

Bipolar Hypomania

Lithuyn

External Hemorrhoids

Band Ligation

Complain pain in combing your hair

Steroid - Prednisolone

Studying efficacy

RCT

39 wks pregnancy with RUQ pain Gallbladder removed What to do next?

USG

Traveller, Hep A vaccine done What is the possible infection?

Hepatitis E

71 yo lady presented first time in 5 years What will you do

Cervical Screening

Positive bilateral Rinne Test Weber lateralize to the Right ear

SNHL in the Left

Multiple rib fractures Chest CT right side haemothorax What's next

Chest Drain

Vulval lump picture, discomfort while sitting and standing, no redness, no discharge , no fever what is next?

Sits Bath

RTA, xray fracture in the anterior pubic ramus blood in urethral meatus acute urinary retention

Supra Pubic Catheterization

39 wks in labor sudden abdominal pain, vaginal bleeding 1000 ml blood loss BP 90/50 no fetal heart sound After fluid resuscitation What's next?

Amniotomy

Boy with aggressive behavior, involve in fights

ODD

Mother felt lump in the lateral neck while bathing lower 1/3 of lateral neck, neck tilted to the side of the lump no pain

Sterdomatoid tumour

Socially withdrawn for 12 months No hallucinations or delusions

Shizophreniform psychosis? or Shizophrenia?

If there is pain and redness in the finger and has penicillin allergy

Clindamycin

Can't see after closing her right eye

Central Retinal Vein Occlusion

Boy with enuresis and has wetting issue mgt?

bell and pad

testicular lump no tenderness USS Cystic

Testicular tumor markers

What is the cause of Gynecomastia in 15yo

Physiological

What is the cause of gynecomastia in 17 yo

Idiopathic

What is the cause of gynecomastia in 21yo

Drug Related Anabolic Steroid

Bipolar hypomania tx?

Olanzapine

1 yo chld's mother with domestic violence what will you do?

Report to Child's protection services

Schizophrenic patient with knife in his hand and was stable on Clozapine hat will you do

Also I checked his Clozapine levels

Blood in urethra Bladded distended on palpation next step?

Suprapubic catheter

Agraphia, alcalulia, inability to tell left from Right side

Left Parietal Stroke

Dyslexia Apraxia Agnosia Dysphasia Dyscalulia

Parietal

Foot ulcer 1 cm with pus discharge cellulitis present till mid shin After irrigation and debridement what will you do

Inj Ticarcilling Calcinate IV

Nonhealing DM foot ulcer more than 6 weeks Inv?

MRI

Less than 6 wks

Xray

1 wk URTI with amoxicillin , enlarged tonsils and adenopathy

Stop Antibiotics

Red velvety Patch

Erythroplakia

Precancerous yellow white lesion

Leukoplakia

Chronic Pancreatitis in heavy alcoholic liver Inv?

Lipase

Female pt 60yo with pain in the First Metacarpophalangeal joint and DIP joints

Idiopathic OA Early stage of OA

EF 35% Aortic stenosis with systolic gradient 45mmHg Symptoatic

Aortic Valve replacement

ECG Afib With rate 130 and CHADsVAs > 2

Atenolol

Picture of Granuloma in the finger nail dx? mgt?

Pyogenic Granuloma Mgt: Excision

child knee pain and tenderness and blood picture of lymphoma

Bone marrow biopsy

COPD patient 28% supplemental Oxygen

Increase Oxygen

In type 2, Resp failure increasing oxygen would worsen the condition

First decrease the O2 then give assisted ventilation NIV, Bpap

Trauma patient with hemorrhagic pleural effuison what will you do

Pass Chest tube

COVID patient wife, husband also develop features what will you do?

Send Swab

Nurshing home patient violent with carer and fellows

Shift to emerfency

41 with PCOS features, sugar 6.1, obese Treatment?

Serial USGs

2 large stones in the GB What will you do?

ERCP

Acute RUQ pain with stone in the neck of bladder Cholangitis features present, antibiotics started but condition worsens What will you do?

Percutaneous Cholecystectomy

Frank blood stool Abdominal cramping

Mecke's diverticulum

PSGN 3-4+ proteinuria inv?

ASO titre

2 ks old baby developed jaundiced on the 3rd day

Phototherapy

1 cm solid tumor of the kidney in lower pole

Partial Nephrectomy

Child 2 -3 years with neck swelling and child keeps his head tilted

Sternocleidomastoid tumor

Young male with history of orchidopexy of Right Testis present with Right testis larger than the left one On USG there is cystic lesion

Blood tumor marker

4 yo child with knee pain and tenderness and blood picture of lymphoma

Bone Marrow biopsy

Multiple Spider bites with pain and erythema BP 30/90 what to give?

Antivenom

Cocaine sniffing with bulging under neck muscle and subcutaneous emphysema, crepitations during auscultation

Pneumothorax

Head lice and nits treated with Permethrin lotion still persisting nits what to do next?

Treat their pet dog

BP . 140/90 - 2019 (45 cases) - 2022 (50 cases) - in a populatoon of 200. What is the incidence of Hypertensin in a population of 1000

feeling of food getting stuck in the throat everytime she eats No abnormal findings mild eczema Diagnosis?

Eosinophilic Esophagitis

Ilove you, I love you you are my life

Mania

Risk percentage of radiation in CT scan

10%

Bright red vaginal bleeding after vaginal delivery blood loss of 1500 ml complete removal of placenta No signs of infection Uterus palpable below umbilicus What to do next?

IV fluids

Elderly man with rectal bleeding and anemia Source of bleeding could not be identified after endoscopy What to do next?

Capsule Endoscopy

Elderly man with pain in the R upper quadrant USG reveals inflammation of the Gallbladder with stone obstructinng the bile duct IV fluids and Antibiotics give Symptoms didn't resolve What is next?

Laparoscopic Cholecystectomy

Middle age man requiesting for colon cancer screenig no family no signs of colon ca What do you recommend?

FOBT 2 yearly

Incidental mass foud by mother in 1 yo baby on the Left sided flank

Wilm's tumor

Middle age man with norexia, weight loss and mass on the supraclavicular region What to do next?

FNAC

2 yo child with painless lateral neck mass with nexk extension

Cystic hygroma

17yo recently sexuallya active BMI 31 Screening?

6yo with abdominal pain and low mood skipped school for many days due to this and father recently remarried Most approp tx?

Behavioral therapy

Soiling underwear everyday for the past 3 months Vague abdominal pain Not coping well in school and is one year behind compared to peers What is the cause

Sexual abuse

Total loss of reflexes sensation and movement of the lower limbs starting from 3 cm below the umbilicus What is the cause?

Cauda Equina Syndrome

Severe lower back pain Leg weakness or numbness Loss of bowel or bladder control Sexual dysfunction Saddle Anesthesia (numbness in the inner thigh and groin area)

Cauda Equina Syndrome tx: Surgical decompression

20 yo presents to the ED with a 5 cm laceratin on his thigh and a lot of pain Doctor instructed nurse tob give Codeine Patient complains of pain and the nurse said she didnt codeine so give her PCM instead What should the doctor do next?

Discipline the nurse for her actions

Svere pain, redness and the formation of pus filled blisters

Pyoderma Gangrenosum

Treatment of Pyoderma Grangrenosum

Cautery and Excision Combination of Medications Wound care and Addressing the Underlying cause

Dyspareunia and lower abdominal pain for 2 years Retroverted uterus, tenderness on palpating on bilateral adnexa but no mass felt and a haemorrhagic lesion seen in the posterior fornix of the vagina Dx?

Ebdometriosis

Painful perios, painful sex, painful bowel movement and infertility for 2 years

Endometriosis

Second most common site of endometriosis

cul de sac

Full thickness burn on a 5yo child Resgistrar suggests to transfer the patient to a tertiary hospital for tx Head surgeon said the patient can be managed at that hospital What should the registrar do?

Ask surgeon to justify his decision

8 wks primigravida pt lesion on her vula past hx HSV infection mgt?

Give antiviral now and continue for 5 days

Painful swelling anterior to the Tragus of Left ear Pain increases when cheweing food Dx?

Sialolithiasis

Pain and swelling if teh affected gland on eating and drinking Best initial test

USG accurate CT scan

Early, debilitated, dehydrated patients with poor oral hygiene History of recurrent, intermittent swelling of the gland Patient may be toxic with fever and raised WCC What is the dx?

Acute Parotitis

Patient present with a slow-gorig salivary lump or painless solid lump Inv of choice

CT or MRI

Man who is alcoholic (stopped drinking 2 yrs ago) Presents with umbilical veins, mild ascitis, confusion and fatigue Investigation?

Serum Ammonia Levels

MOther saying he doesn't concentrate on his tasks, can't sit and watch Tv for too long He's always running around and doesn't concentrate during lessons Mgt?

Methyphenidate - ADHD

What are the treatments for ADHD

Methyphenidate - Ritalin , Concerta - increases the availability of Dopamine and Norepinephrine in the brain, improving attention focus and impulse control. Amphetamines - Adderall and Vyvanse - improving attention and reducing hyperactivity

SFH is measuring 36m Blood group ) positive Previous visit at 18 wks gestation and everything was normal

Polyhydramnios

Displaced scaphoid frscture management

ORIF

Picture of a man's cheek and a brown black lesion about 4 cm. The lesion has been there for the past 10 years and it didn;t bother him until 3 wks ago when it started becoming itchy. What's the next best step?

Excisional Biopsy

Multiple Atypical naevi

Melanoma

sebaceous nevus

BCC

Bowen's disease

SCC

What is the most common melanoma

Superficial spreading

What is the initial mgt of Superficial Spreading

Excisional Biopsy theb 2mm margin removal always minimum

73M complains ear pai past 1 wk Tympanic membrane appeared normal, and no discharge No rash seen on the face Dx?

Tongue Carcinoma

Man underwent surgery for fracture of femur Developed Pulmonary embolism and subsequently dies of cardiac arrest Primary cause of death?

Cardiac Arrest

Bradykinesia, ttremors on fine motor movements of fingers, blunted facial espressions and slow speech bext dx inv?

MRI brain

ECG with no P waves and heart rate of about 60 bpm

Afib

22yo no palpitations, chest pain or dyspnea no complaints ECG shows bradycardia with delta aves in Lead 2

Wolff-Parkinson White syndrome

gma

Serum osmolality

Hypotonic Hyponatremia

Urine osmolality low Serum Osmolality low

Primary Polydipsia

Serum osmolality is low Urine osmolality is increased

SIADH

Inappropriate water retention

Dilutuial hyponatreamia

Most common cause of hemorrhagic stroke

Uncontrolled high blood pressure

2 types of weakened blood vessels

Brain aneursysms Arteriovenous malformations

Has breast cancer, 58F She is on Procholorperazine only Cause of her vomiting

Hypercalcemia

Hyperkalemia Hyperphosphatemia Hyperuricemia HYpocalcemia

Tumor Lysis Syndrome

Boy with autism showed violent behaviour towards younger sister tX?

Risperidone

First line for children with Tourette Syndrome

Clonidine

Irritability and Aggression tx?

Risperidone

Hematuria Proteinuria Polyuria Hypertension

Adult Polycystic Kidney Disease