MCCQE1 Flashcards
(208 cards)
1
Q
Bariatric surgery thresholds
A
Any patient with a BMI > 40 kg/m
Patients with BMI > 35 kg/m and serious coexisting medical problems (e.g. OSA , severe DM, cardiomyopathy, Pickwickian syndrome)
2
Q
Most likely cause of hypercalcaemia and hyperphosphatemia
A
Vitamin D excess
3
Q
Dysphasia
A
Broca’s - Expressive. Word finding difficulties.
Wernicke’s - Receptive. Fluent but meaningless speech.
4
Q
Acute intermittent porphyria
A
Abdominal pain, psychiatric episodes, neurological deficits, abnormal LFTs and elevated porphobilinogen.
Avoid barbiturates (sodium thiopental) and any medication that induces P450 cytochrome
5
Q
TTP pentad
A
MAHA, thrombocytopenic purpura, neurological abnormalities, fever and renal disease.
Avoid platelet transfusion
6
Q
Genu varus
A
Bow legs
Usually spontaneously corrects by age 2
7
Q
Myeloma symptoms
A
CRAB Calcium Renal Anaemia Bone
8
Q
Conservative management of splenic injuries
A
Grade 1-2 splenic injury, haemodynamically stable, < 55 years old, no additional injuries on CT, recovery of bowel function, no loss of consciousness, no rebound tenderness or guarding.
9
Q
Cervical cancer screening
A
Recommended for all women > 25 who have been sexually active every 3 years
Women > 70 with 3 normal tests in a row and no abnormal tests for the last 10 years can stop screening
Requires Thin Prep of endocervical, transformation zone and exocervical cells.
Smears shouldn’t be taken during menstruation, mid-cycle (just before ovulation) is ideal. Date of LMP required at screening.
10
Q
Evaluation of pulmonary artery hypertension
A
1st) Doppler echocardiography
2nd) Right heart catheterisation
11
Q
Roseola infantum
A
Sixth disease, exanthem subitum, humar herpes virus type 6
9-12 month old infant with abruptly high fever (> 40 degree) which lasts 3 days then disappears with the appearance of a maculopapular rash
12
Q
Fragile X syndrome
A
X linked disorder (males have more severe symptoms than females)
Intellectual disability
Prominent jaw, forehead and nasal bridge with large protuberant ears
Macroorchidism
Hyperextensibility
High arched palate
Complications: MVP, seizures, scoliosis
13
Q
S4
A
Extra sound prior to SI (Tennessee)
Atria forcefully contracting against a stiff or hypertrophic ventricle
Associated with aortic stenosis, pulmonary hypertension and systemic hypertension
14
Q
Varicella zoster immunoglobulins
A
IgG - Previous exposure and natural immunity
IgM - Active infection
15
Q
Phase 2 of drug trials
A
Proof of concept - Trialled on disease
Highest rate of failure
16
Q
Hypothermia
A
Mild 32-35
Moderate 28-32
Severe 20-28
Profound < 20
Bretylium used for arrhythmias
Rewarming at a rate of > 2 degrees/hr improves mortality
Rewarming can lead to hypotension, metabolic acidosis, hyperkalaemia, hypocalcaemia and hypomagnesemia
17
Q
Peptic ulcer disease
A
Treat with PPI for 4-8 weeks. Extend duration if persistent.
18
Q
Classification of bipolar disease
A
1) Manic episodes and depressive episodes
2) No manic episodes. Hypomanic episodes and depressive episodes.
19
Q
Zinc deficiency
A
Poor wound healing
Hypogonadism secondary to low testosterone
Seen in Crohn’s disease
20
Q
High-grade squamous intraepithelial lesions (HSIL)
A
Pap smear result that should always lead to colposcopy
21
Q
Streptococcus gallolyticus
A
Previously known as streptococcus bovis-associated endocarditis
Causes villous adenomas and colonic cancer
22
Q
Proctalgia fugax
A
Recurrent rectal pain unrelated to defecation
Sharp pain last from seconds to minutes
Absence of pain between episodes
23
Q
Sick euthryroid syndrome
A
Low T3, normal T4, normal TSH
Following disease/trauma
24
Q
Common variable immune deficiency (CVID)
A
B cell dysfunction
Upper and lower respiratory tract infections, otitis media and sinusitis
Increased risk of autoimmune conditions (RA, vitiligo, ahaemolytic anaemias, thrombocytopenia, GI disease)
Increased risk of lymphoma
25
Endometriosis
Mulberry spots
Infertility
Dyspareunia, pre and post menstrual spotting, sacral backache with menses, bowel and bladder symptoms
26
Wallenberg syndrome
Lateral medullary syndrome
Posterior inferior cerebellar artery
Ipsilateral Horner's syndrome with contralateral temperature and pain sensation loss, ipsilateral ataxia and dysphagia, dysarthria and dysphonia
27
MEN 1
Pituitary
Parathyroid
Pancreas
28
Lead poisoning
Levels > 45 micrograms/dL require chelation treatment
Oral chelation - Succimer
Emergency hospitalisation and IV chelation if levels > 70 micrograms/dL
29
Bacterial meningitis
Hearing impairment in children
| Hyponatraemia from SIADH
30
Erythema marginatum
Rheumatic fever
| Serpiginous central blanching
31
Amenorrhoea
Primary - Ultrasound abdomen. Is there a uterus?
Secondary - Pregnancy test, TSH + prolactin, progesterone challenge test, eostrogen-progesterone challenge test, hysteroscopy (is there an outflow obstruction - Asherman's syndrome secondary to surgical procedures, endometriosis, terminations)
32
Hereditary spherocytosis
```
Gallstones
Jaundice
Splenomegaly
Haemolytic anaemia
Treat with splenectomy
More common in Northern Europeans
Due to mutation in the gene for ankyrin and spectrin proteins of red blood cells
```
33
ALL good prognosis
Age 1-10
Leucocyte count < 50
B cell immunophenotype
Rapid response to initial chemotherapy
34
Botulism
Clostridium botulinim (gram positive rod)
Honey often the source
Avoid aminoglycosides
Flaccid paralysis
35
Turner syndrome
45X
Short stature and infertility
Webbed neck and sausage shaped digits
Cardiac defects and coarctation of the aorta
Oestrogen given to commence puberty at age 12 (if given earlier causes short stature)
36
Medications causing galactorrhea
```
Antipsychotics
Cimetidine
Metoclopramide
Methyldopa
Tricyclic antidepressants
AND MORE...
```
37
Giardia lambilia
```
1-2 week incubation period
Watery diarrhea
Abdominal pain
Loss of appetite
Flatulence
```
38
Chlamydia conjunctivitis
Bilateral conjunctivitis at 5-14 days age
Acquired from birth canal
Systemic treatment (Erythromycin)
39
SIADH
Urine osmolality > 100 mOsm/kg
40
Croup
```
Laryngotracheobronchitis
Ages 4 months to 5 years
Stridor and seal like barking coughing
Caused by parainfluenza
Treated with steroids (dexamethasone)
```
41
Bacterial vaginosis
Diffuse milky discharge with a fishy odor
Wet mount test - clue cells
Positive Whiff test (addition of KOH leads to odor)
Vaginal pH > 4.5
Gardnerella
Only treat pregnant patients: Metronidazole 500mg BID for 7 days or topical clindamycin cream (which can lead to vaginal candidiasis)
42
Best SSRI in children
Fluoxetine
43
Positive predictive value
The proportion of positives that correspond to the presence of a condition
(TP/(TP+FP))x100
44
Latent TB treatment
9 months of isoniazid
45
G6PD deficiency
Mediterranean and African-American greatest at risk
Jaundice and haemolytic anaemia
X-linked recessive
Fava beans
46
Hypertrophic cardiomyopathy
```
Double apical pulse
Bifid carotid impulse
Exertional syncope and dyspnea
Increased murmur with valsalva
1st line Ix: ECG THEN echo (systolic anterior motion defect of mitral valve) THEN cardiac MRI
```
47
Mesenteric angiography
Can only spot bleeds > 0.5ml/min
48
What type of reaction is anaphylaxis?
T1 hypersensitivity reaction
| IgE mediated
49
Fastest progressing cause of aortic stenosis?
Degenerative calcification
| More so than bicuspid valves and rheumatic fever
50
Froment's sign
Assessment of ulnar nerve damage
Ask a patient to hold a sheet of paper in between thumb and index finger (pinch grip), if paper can be pulled out it's positive
51
Placenta praevia
Painless bright red vaginal bleeding in third trimester
Risk factors - Advanced maternal age, previous uterine surgery, gestational hypertension, multiparity, multifetal gestation and smoking
52
Neural tube defects
Screening with serum alpha fetoprotein (abnormal if high)
USS to confirm gestational age for dating errors
Amniocentesis alpha fetoprotein acetylcholinesterase (elevation is highly specific)
53
Antiphospholipid syndrome
Multiple miscarriages
Lupus anticoagulant and anticardiolipin antibodies
False negative syphilis (VDRL) testing
Thrombocytopenia
54
Valproic acid side effects
Can lead to elevated ammonia levels
| Treated with carnitine
55
Encephalitis vs meningitis
Altered mental status in encephalitis
| Treat early with acyclovir
56
Renal vein thrombosis
Secondary to nephrotic syndrome (especially membranous)
| Nausea, vomiting, flank pain, haematuria, worsening proteinuria and high LDH
57
Courvoisier's sign
Enlarged gallbladder, non-tender and associated with jaundice
Pancreatic carcinoma, ampulla carcinoma, cholangiocarcinoma
58
Lead time bias
Overestimation of survival duration among screen detected cases where survival is measured from diagnosis
59
Pap smear results most likely to signify carcinoma
Atypical glandular cells not otherwise specified (AGC-NOS)
60
Miliary TB
Seen in alcoholics due to immunosuppression
Diffuse small pulmonary nodules on x-ray
Weight loss, fatigue and cough
61
Hantavirus
Exposure to mouse droppings
Indistinguishable from influenza
Lifethreatening respiratory syndrome in western hemisphere
Eastern hemisphere presents as haemorrhagic fever with renal failure
62
Trichomonal vaginitis
```
Yellow frothy discharge
Abnormal vaginal odor
Vulvovaginal itching and soreness
Dyspareunia and dysuria
Strawberry cervix
Positive Whiff test on wet mount with flagellated protozoa
```
63
Freidreich's ataxia
```
Autosomal recessive
Progressive ataxia with loss of deep tendon reflexes
Extensor plantars
Kyphoscoliosis
Pes cavus
Family history
```
64
Intranuclear ophthalmoplegia
Lesion in the medial longitudinal fasciculis
Slow adduction of contralateral gaze
Suggestive of MS but also seen in vascular disease and other rarer conditions
65
Maintaining remission of MS
Interferon beta
Glatiramer acetate
Natalizumab
Fingolimod
66
Patau syndrome
```
Trisomy 13
Severe congenital anomalies
Micro/anophthalmia
Clef lip and/or palate
Postaxial polydactyly
```
67
Confirmatory test for CLL
Flow cytometry of peripheral blood cells
68
Chronic stable angina investigation
Exercise ECG
69
Steady state of drugs
Achieved by 5 half lives (i.e. if OD dosing check levels at 5 days after changing dose or initiating)
70
Apnea
Prolonged absence of airflow for > 20 seconds or associated with bradycardia or cyanosis
Idiopathic - 2nd to 7th day of life. Persists until 37 weeks gestational age
71
ARDS
Acute onset
Bilateral infiltrates on chest radiograph
PCWP < 18 or no evidence of increased left atrial pressure
PaO2/FiO2 < 200
72
Gestational hypertension treatment
Nifedipine
73
Rotavirus schedule
Oral vaccine given from 6 weeks of age at ages 2, 4 and 6 months OR 2 doses at 2 and 4 months
74
SAAG
> 1.1 Portal HTN related
| < 1.1 Non-portal HTN related
75
Heparin induced thrombocytopenia
Platelet drop of 50% or more within 5-15 days of starting heparin therapy
Treat with danaparoid
76
Normal pressure hydrocephalus
Triad: Ataxia, urinary incontinence, dementia
| Gold standard diagnostic test: Lumbar puncture and drainage of CSF
77
Barrett's oesophagus
Normally squamous epithelium of distal oesophagus becomes columnar epithelium (precursor to adenocarcinoma)
No dysplasia - 3-5 yearly EGDs
Low grade dysplasia - 6-12 monthly EGDs
High grade dysplasia - 3 monthly EGDs
78
Transient tic disorder
Same diagnostic criteria as Tourette syndrome
| Treat with fluphenazine or pimozide
79
Levodopa dosing
Start at 100mg TID
| Sinemet (levodopa/carbidpoa) 100/25mg
80
Meningococcal prophylaxis
PO 4 x doses of rifampicin Q12H
IM 1 x dose of ceftriaxone if pregnant
Respiratory isolation can be discontinued 24 hours after antibiotic therapy has started
81
Specificity
The proportion of patients without the condition that test negative
TN/(TN+FP)
82
Sensitivity
The proportion of patients with the condition that test positive
TP/(TP+FN)
83
Number needed to treat
1/Absolute Risk Reduction
84
Exudative effusion (Light's criteria)
Ratio of pleural fluid protein to serum protein is > 0.5
| Ratio of pleural fluid LDH to serum LDH is >0.6 or 2/3 the upper limit for serum LDH
85
Cruciate ligaments
Rupture anterior - anterior movement of tibia
| Ruptured posterior - posterior movement of tibia
86
Shoulder dystocia
Associated with clavicular fractures which are treated conservatively and will recover over several months
Rarely brachial plexus injuries or pneumothoraces can occur
87
Down's syndrome and triple screening
Majority of births (70%) are by women < 35
Likelihood if positive triple test = 2%
Alpha fetoprotein and unconjugated estriol are low and hCG levels high in a positive test
88
Plan B contraception
Emergency contraception - 2 x 0.75mg levonorgestrol 12 hours apart
Delays/inhibits ovulation
Effective up to 72 hours post intercourse
89
Tourette's syndrome
Both multiple motor and vocal tics have been present for < 1 year
Before the age of 18
Treat with clonidine (alpha agonist)
90
Cystic fibrosis
Autosomal recessive
1 in 3000 Caucasians (much less common in Asians and blacks)
Psuedomonas most common organism in CF patients, however in new patients S. Aureus and H. influenzae most common
91
Good prognostic factors in schizophrenia
```
Late onset disease
Obvious precipitating factors/stressors
Acute onset
Presence of mood disorders
Good support system
Positive symptoms of schizophrenia
```
92
Charcot's triad
RUQ pain
Fever
Jaundice
Indicative of cholangitis
93
Beta HCG
Peaks at 8-12 weeks gestational age then falls
94
Neutropenic enterocolitis
Clostridium septicum
95
Pyloric stenosis
```
3-6 week old infants
Projectile vomiting post feeds
Olive shaped mass
Peristaltic waves
Hypochloraemia, hypokalaemic, metabolic alkalosis
```
96
Hyperthyroidism in pregnancy
Propylthiouracil - For 1st trimester
Methimazole - For 2nd and 3rd trimesters
Titrate NOT block and replace
97
Chronic vs acute immunoglobulins
IgG - Chronic
| IgM - Acute
98
Selective dorsal rhizotomy
Treatment of spasticity in CP
| Targets Ia sensory fibres
99
Cervical radiculopathy
X-ray
| Treat with NSAIDs
100
Tanner staging
1) Prepubertal breasts
2) Breast bud
3) Breast become conical
4) Areolar elevates off breast mound
5) Normal breast development
101
Cushing’s triad
Bradypnoea
Bradycardia
Hypertension
102
Samter’s triad
Aspirin induced asthma
Nasal polyps
Asthma
103
Beck’s triad
Muffled heart sounds
Distended neck veins
Hypotension
104
Bartholins abscess
Incision and insertion of Word catheter
105
Haemophilus influenzae
Nontypeable isn’t vaccinated and causes otitis media
| H. Influenzae B causes epiglottitis, septic arthritis and meningitis
106
Diabetic nephropathy protein excretion
> 300mg/day albuminuria confirmed on 2 occasions 3-6 months apart
107
Acute psychosis treatment
Haloperidol 5mg IM+/- lorazepam 2gm IM
Olanzapine 2.5-10mg PO/IM
Risperidone 2mg PO
108
Neuroleptic malignant syndrome
```
FARM
Fever
Autonomic changes
Rigidity of muscles
Mental status change
```
109
Cholangitis vs cholecystitis treatment
Cholangitis - Sphincterotomy
| Cholecystitis - Chilecystectomy
110
Nasopharyngeal carcinoma
More common in Asian males
EBV risk factor
Nasal or ear symptoms
Treat with chemoradiotherapy
111
Scleroderma renal crises
Stop steroids
| Start ACE inhibitor
112
BNP
Released from ventricles
Increased in CKD
Inhibits the RAAS
113
CIDP
Chronic inflammatory demyelinating polyneuropathy
Associated with HIV, Hodgkin’s lymphoma, monoclonal gammopathy, MS and IBD
Paraneoplastic syndrome
114
Hodgkin’s lymphoma treatment
ABVD regime
115
Rubella
Live vaccine - delay until delivery in pregnancy
| Avoid contact with people with rubella
116
Uterine fibroids
```
Benign tumours of uterus
Most likely subserous
Change with oestrogen (grow and become painful)
Menorrhagia
Irregular bleeding
Chronic pain
Urinary frequency and urgency
Can cause spontaneous abortions
USS gold standard
Myomectomy - removes thyroids
Uterine artery embolisation
Leuprolide (analogue)
```
117
Ebstein’s anomaly
Displacement of septal leaflet of tricuspid valve towards the apex
Increase in right heart volume and atrialization of RV
RA enlargement
TR +/- TS
CYANOTIC heart disease
118
Bronchiolitis
Ignore steph and give oxygen
| Cause by RSV
119
Birth weight
Initially drops up to 10% in first few days
By 14 days should be back at birthweight
Should gain 20-30g a day
120
Vulval cancer
HPV 16 and 18 leading risk factor
| Lichen sclerosis in older women
121
Prognosis of pancreatitis at admission (non gallstone)
```
Ranson’s criteria
BG > 11
Age > 55
Serum LDH > 350
AST > 250
WCC > 16
```
122
Scleroderma prognosis
No new organ involvement once skin involvement has peaked
123
Transcervical amniotransfusion
Variable decelerations and thick meconium fluid
124
Ischaemic stroke
1st line aspirin
| If already on aspirin then switch to clopidogrel
125
CIN
I - Mild. Pap at 6 months or colposcopy
II - Moderate. Colposcopy at 6 and 12 months
III - Severe. Conization of cervix (LEEP)
126
ASA poisoning
Nausea, vomiting, sweating and tinnitus
127
Infantile strider
Laryngomalacia - worse supine improves postionally
| Choanal atresia - improves with crying
128
Pancreatitis haemorrhage signs
Grey turner sign - flanks
| Cullen’s - periumbilical
129
Sleep apnoea associated with CHF, CVA, DM, hypothyroidism or other conditions
CENTRAL
130
Polycythaemia rubra vera
Haemoglobin > 165 in men > 160 in women OR HCT > 49% in men or > 48 % in women
Bone marrow biopsy showing hypercellularity
Presence of JAK2 mutation
Low serum EPO
131
Vitamin B9
Folate - reduces rates of ALL if supplemented in pregnancy
132
Removal of IUDs in pregnancy
Reduces rates of septic abortion
| Small increased risk of spontaneous abortion
133
Androgenic alopecia
Finasteride and minoxidil
134
Endometriosis
Dysmenorrhoea, dyspareunia, dyschezia, dysuria
Cyclical symptoms
Laparoscopy gold standard
135
Bone metastases from prostate cancer
Osteoblastic lesions
136
HPV
16 & 18 malignant
| 6 & 11 genital condylomata
137
Skin malignancy on face
Mohs procedure
138
Spinal stenosis
Pain worse on walking and standing
139
Disc herniation
Pain relieved when standing
140
Abruption
Abdominal pain, bleeding, contractions, hypotonicity of uterus
Risk factors PROM, hypertension, cocaine, smoking, multiparty, trauma
Management depends on foetal compromise (can be managed conservatively)
141
Gingko
Used in dementia, tinnitus and intermittent claudication
142
Conversion disorder
Treated with CBT
143
PCP intoxication
Hallucinations, dissociative feelings, confusion, odd behaviour, agitation, tachycardia, pupillary dilation and nystagmus
ONLY ilciit drug to cause vertical nystagmus
144
Tay-Sach's disease
Lysosomal lipid storage disease
Infantile deafness, blindness and hypotonia
Seizures, developmental delay
145
Asbestos pleural effusion
Much more likely benign than malignant
| Benign are commonly haemorrhagic
146
Periodinitis - Tooth abscess
Treat with Clindamycin or Co-Amoxiclav
147
Burkitt lymphoma
```
Non-hodgkins lymphoma
Facial swelling in Africans
Associated with HIV
Starry sky appearance of H&E staining
Translocation of 8;14
Commonly causes tumor lysis syndrome
```
148
Tardive dyskinesia treatment
Clozapine as antipsychotic alternative
149
Colonoscopy screening
HNPCC - Colonoscopy every 1-2 years from age 20
FAP - Annual sigmoidoscopy from age 12
AAPC - Annual colonoscopy from age 18
1st degree relative with cancer < age of 60 or 2 relatives at any age - Colonoscopy every 5 years
1-2 adenomas at colonoscopy - Colonoscopy every 5 years
> 2 adenomas at colonoscopy - Colonoscopy every 3 years
150
Inferior MI with ST depression in leads V1-3
Left circumflex rather than RCA
151
Uterine rupture vs placental abruption
Uterine rupture will give - absent foetal heart tones, tense abdominal wall, hypovolaemia
152
Borderline personality disorder
Unstable relationships with parents or spouse
Efforts to avoid abandonment
Labile affect
Outbursts of anger and impulsivity
Frequent suicide attempts
Treat with dialectical behavioral therapy or psychodynamic psychotherapy
153
Serotonin syndrome treatment
Cyproheptadine
154
Patch testing classification
Type IV delayed hypersensitivity (contact dermatitis)
1 + erythema and oedema
2 + papules
3 + vesicles or bullae
155
PID in pregnancy
Inpatient IV cefoxitin or cefotetan and oral azithromycin 1g orally
156
Budd-Chiari syndrome
Abdominal pain
Ascites
Hepatomegaly
157
Tinea capitis
Treat with oral antifungal agents to penetrate hair follicles
158
Hypercalcaemia symptoms
```
Constipation
Lethargy
Confusion
Increased urinary frequency
Anorexia
```
159
Anion gap calculation
Na - (HCO3 + Cl)
160
Hyperemesis gravidarum gas
Ketosis leads to high anion gap with normal pH due to hypochloraemic alkalosis
161
Pulsatile tinnitus and grooving in skull vault
Dural arteriovenous fistula
| Digital subtraction angiography
162
Physiological jaundice
Maximal at 3 days of life
Bedside phototherapy if bilirubin > 15mg/dl
Direct Coombs test
163
H. Pylori treatment
PPI, amoxicillin, metronidazole and clarithromycin
OR
PPI, bismuth subsalicylate, metronidazole and tetracycline
164
Dravet syndrome
Myoclonic epilepsy of infancy usually preceded by prolonged, frequent febrile seizures. Developmental delay ensues.
165
Hypercalcaemia with low 24 hour urine calcium
Familial hypocalciuric hypercalcaemia
166
Respiratory depression in pre-eclampsia
Magnesium toxicity
167
Symptomatic fibroids but wants to maintain fertility
Myomectomy
168
Staghorn calculus
Struvite stones
Ammonium phosphate and magnesium phosphate
Acetohydroxamic acid inhibits bacterial urease
169
Thalassaemia - frequent transfusions lead to...
Haemosiderosis (grey skin and pulmonary crackles)
| Treat with hydroxyurea to increase production of foetal haemoglobin
170
Most common cause of jaundice in pregnancy
Viral hepatitis
171
High risk of gestational diabetes
```
Severely obese (BMI > 35)
Previous GDM
Previous birth weight of > 4000g
Heavy glycosuria
PCOS
Strong history of T2DM
If initial screening (OGTT on discovery of pregnancy) is negative then it should be repeated at the end of the 2nd trimester
```
172
Somatization disorder
Symptoms
| Regular appointments every 2-4 weeks
173
Migratory thrombophlebitis
Trousseau's sign
| Pancreatic carcinoma
174
Mothers with anti Ro/SSA (Sjogren syndrome antibodies)
Neonatal lupus and heart block
175
Worsening of central sleep apnoea
Anything that lowers PCO2 (High altitude) or lowers cardiac output (Heart failure)
176
Acute pancreatitis with ALT threefold elevation
Gallstones
177
Cervical length < 25mm
Cervical insufficiency
| Treat with cervical cerclage
178
Lithium with hypothyroidism
Start levothyroxine, continue lithium
179
Warfarin induced skin necrosis
Localized parasthesia with erythema progresses to petechiae and haemorrhagic bullae
Discontinue warfarin, give FFP, vitamin K and LMWH
180
PCP lab results
Raised LDH
181
Cocaine associated chest pain
Treat with ASA and benzodiazepines
IV NTG and nitroprusside for resistant hypertension
AVOID beta blockers
182
Endometrial cancer risk factors
Risk factors: PCOS, excess oestrogen exposure, tamoxifen, early menarch, late menopause, nulliparity.
Protective factors: Multiparity, late menarche, COCP, breastfeeding, smoking!
183
Clavicular fractures when to perform surgery
Open fractures
Neurovascular compromise
Presence of a 'floating shoulder'
Complete displacement
184
Biggest risk factor for post partum fever
C section
185
Oral hypoglycaemic that acts on alpha and beta cells
DPP4 inhibitors e.g. Sitagliptin
| Prevent breakdown of GLP-1
186
Predictive values
```
PPV = TP / (TP+FP)
NPV = TN / (TN + FN)
```
187
Breath holding spells
Associated with iron deficiency anaemia
188
Solitary brain metastasis
Surgical resection followed by whole brain radiotherapy
189
Colonic volvulus
Insertion of rectal tube
| Elective sigmoidectomy
190
PMR treatment
Prednisone 15mg/day
191
BPPV
Otoliths in the posterior semicircular canal
192
Gold standard test for carcinoid
24 hour urine hydroxyindoleacetic acid (5-HIAA)
193
Oppositional defiant disorder treatment
Parental management training (PMT)
194
Osteogenesis imperfecta
Blue sclera, easily fractured bones, joint laxity and hearing loss
195
Ruxolitnib
Post polycythaemia myelofibrosis. Reduces splenomegaly
196
Congenital adrenal hyperplasia
21-hydroxylase deficiency
197
Pregnancy with hypothyroidism
Immediately increase dose
198
JIA extra-articular effects
Uveitis
199
Lead poisoning
Burton's lines (blue lines on gums)
Wrist drop
Foot drop
Basophilic stippling
200
G6PD triggers
TMP-SMX
| Fava beans
201
Typhoid fever
Abdominal pain, fever, altered mental status
| Positive Widal test
202
Inferior MI with ST depression in V1-3
Left circumflex rather than RCA
203
Interstitial cystitis
Urinary frequency up to 60 times a day
Diagnose with cystoscopy - reveals benign bladder ulcers
Pentosan polysulfate sodium or oxybutynin
204
Starting isotretinoin
Check CBC, LFTs and lipid profile
205
Urge incontinence
Oxybutynin
| Common in demyelinating disease
206
Dystonic reactions
Metoclopramide (not domperidone)
| Treat with benztropine or diphenhydramine
207
Measles complication
Subacute sclerosing panencephalitis 7-10years post infection beginning with behavioural changes
208
Amniotic fluid embolism
Sudden hypotension, hypoxia or cardiac arrest within 30 minutes of C section or labor
Associated with oxytocin stimulated labor
