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Year 4 Revision > Mix > Flashcards

Mix Flashcards

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1
Q

How do you differentiate between infantile spasms and colic? [1]

A

In infantile spasms the child will become distressed between spasms, whereas in colic the child will become distressed during the ‘spasms’

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2
Q

A patient has acute rheumatic fever.

How do you treat? [2]

A

Stat dose of IV benzylpenicillin
- followed by oral abx

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3
Q

Dermatomyositis is associated with the [] antibody

A

Dermatomyositis is associated with the anti-Jo-1 antibody

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4
Q

What dx test would indicate compartment syndrome? [1]

A

Compartment syndrome produces pain on passive stretch

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5
Q

What is the main finding on the x-ray?

Salter-Harris type 1 fracture
Salter-Harris type 2 fracture
Salter-Harris type 3 fracture
Salter-Harris type 4 fracture
Salter-Harris type 5 fracture

A

Salter-Harris type 3 fracture

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6
Q

What is a poor prognostic factor for CDH? [1]

A

The presence of the liver in the thoracic cavity is a poor prognostic factor for CDH

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7
Q

Tx for Bell’s palsy? [1]

A

Oral prednisolone in 72hrs of onset of sx

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8
Q

Which two cardiac conditions are most common in Turner’s syndrome? [2]
- Which is most common? [1]

A

Bicuspid aortic valve - most common
Coractation of aorta

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9
Q

No 1 cause of gastroenteritis in children? [1]

A

Novovirus

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10
Q

A patient has ?Coeliac’s disease.

What result would you see on a blood film [1]
Why? [1]

A

Howell-Jolly Bodies
- due to hyposplenism

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11
Q

How might you detect a paradoxical embolism? [1]

A

With a bubble-echo
- ultrasound test where tiny bubbles are injected into the bloodstream to help visualize blood flow through the heart. It’s primarily used to detect right-to-left shunts, such as a patent foramen ovale (PFO), which can be a cause of stroke or transient ischemic attack (TIA)

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12
Q

What type of mole is this? [1]

A

Intra-dermal naevi
- elevated and pale
- develops from compound naevi

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13
Q

When is inteferon beta indicated in MS? [1]

A

If RRMS and can walk

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14
Q

[2] are the target antigens in pemphigus vulgaris

A

Desmoglein-1 and desmoglein-3 are the target antigens in pemphigus vulgaris

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15
Q

How do you differentiate between the presenting features of polymyalgia rheumatica and polymyositis? [1]

A

Polymyalgia rheumatica causes bilateral proximal muscle pain, but weakness is not a prominent feature

Polymyositis occurs in the elderly and causes bilateral, proximal muscle weakness, usually without pain. Muscle bulk is preserved until late in the disease

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16
Q

GBS causes upper / lower motor changes? [1]

A

Lower

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17
Q

Describe the vomiting type in pyloric stenosis [1]

A

White / not bilous
- Bilous would indicate intestinal malrotation

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18
Q

Scaphoid fracture w [] = urgent surgical fixture? [1]

A

Scaphoid fracture w proximal pole fracture

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19
Q

How do you differentiate between subacromial bursitis and adhesive capsulitis? [1]

A

Pain with active abduction of the shoulder at 60-120 degrees with reduced range of motion is typical for subacromial bursitis.
- acute presentation

Adhesive capsulitis is also know as frozen shoulder syndrome as there is inflammation of the glenohumeral joint causing restricted passive and active shoulder movements in all directions.
- chronic presentation
- associated with DM / thyroid disease / RA

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20
Q

Describe what is meant by Mittelschmerz and how it presents [2]

A

Mittelschmerz is mid-cycle ovulatory pain
- due to rupture of the Graafian (dominant) follicle, each month, which results in the release of an ovum into the fallopian tube.
- pain can vary from side to side
- Duration of pain can vary from minutes up to a few days

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21
Q

In most patients with endometriosis, the transvaginal ultrasound scan shows what findings [1]

A

In most patients with endometriosis, the transvaginal ultrasound scan is normal.

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22
Q

The triad in The triad in Juvenile Myoclonic Epilepsy (JME) consists of [3]

A

The triad in Juvenile Myoclonic Epilepsy (JME) consists of myoclonic jerks, absence seizures, and generalized tonic-clonic seizures (GTCS)

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23
Q

A patient has a SAH.

What is treatment can be used to stop vasopasm? [1]

25
HIV x raised ALP and LDH x abdominal pain x diarrhoea = which pathogen? [1]
**MAI** - abdominal pain caused by abdominal lymph nodes enlarging and compression liver etc
26
Status epi. 2 x BDZ used but still seizure is ongoing. - Apart from IV phenytoin, which drugs can be used? [2]
**Levetiracetam or Valproate**
27
Renal agenesis = oligo/polyhydromanios? [1]
**oligo**
28
What is the no. 1 side effect of isotretinoin? [1]
**Skin fragility**
29
Post-stroke (ishaemic), what drug regimen should be used? [2]
**2 weeks**: aspirin (300mg) and clopi (75mg) **After 2 weeks:** just clopi
30
SAH surgical mx? [2]
1. Endovascular coiling 2. Clipping
31
When would you perform Monospot vs EBV serology for ?infectious mononucleosis [2]
**Epstein-Barr virus (EBV)**: - the **monospot test** is the most appropriate next test given its speed of results and cost; if this yields a negative result in the context of high clinical suspicion, **serology testing may then be indicated.** **Epstein-Barr virus (EBV) serology** * It is used in the context of high clinical suspicion with a **negative monospot** or with **immunocompromised patients.**
32
What imaging results would indicate vascular dementia? [1]
White matter hyperintensities on MRI are commonly associated with vascular dementia as they represent chronic small vessel ischemic changes in the brain.
33
Adhesive capsulitis, or frozen shoulder, is best managed with early **[]** following pain control to improve range of motion.
Adhesive capsulitis, or frozen shoulder, is best managed with early **physiotherapy** following pain control to improve range of motion.
34
How do you differentiate between threatened and inevitable miscarriage? [1]
Threatened: cervical os closed Inevitable: open
35
What are the main side effects of valproate? [+]
The main side effects of valproate can be remembered with the mnemonic **"VALPROATE".** **V**omiting **A**lopecia **L**iver toxicity **P**ancreatitis/Pancytopenia **R**etention of fats (ie. weight gain) **O**edema **A**norexia **T**remor **E**nzyme inhibition
36
Confusion, ataxia and bone marrow suppression would be caused as a side effect from which psych drug? [1]
**Carbamazapine**
37
Hirsutism, gingival hyperplasia and lymphadenopathy would be caused as a side effect from which psych drug? [1]
Phenytoin
38
Regular unprotected intercourse for **[time period]**, without a successful pregnancy, should lead to a referral for further investigations at a fertility service
Regular unprotected intercourse for **1 year,** without a successful pregnancy, should lead to a referral for further investigations at a fertility service
39
What does this indicate? [1] CT head is performed on arrival to the emergency department and **reveals a high-attenuating amorphous substance filling the sulci within the brain.**
CT head findings consistent with **haemorrhagic stroke**
40
A 55-year-old male patient presents with several rough, scaly patches on his scalp, forehead, and ears, which are non-tender and non-itchy. He has a history of significant sun exposure over his lifetime. Dx and Tx? [2]
**Imiquimod** is a topical immunomodulator used to treat **actinic keratosis**
41
The patient likely has intrahepatic cholestasis of pregnancy (ICP), characterised by pruritus (especially on the palms and soles) and elevated bilirubin. Current guidelines recommend which treatment? [2]
The patient likely has intrahepatic cholestasis of pregnancy (ICP), characterised by pruritus (especially on the palms and soles) and elevated bilirubin. **Current guidelines recommend using emollients for skin relief and chlorphenamine as an antihistamine for itching.**
42
This is the correct answer. In patients with at least 50% carotid stenosis, resulting in symptoms, **[]** is recommended
This is the correct answer. In patients with at least 50% carotid stenosis, resulting in symptoms, **carotid endarterectomy** is recommended
43
How do you manage a pregnant (nearly at term) patient with ?chorioamnionitis [2]
**Labour should be induced within 24 hours** in cases where patients have premature rupture of membranes and chorioamnionitis. **Bacterial culture and broad spectrum antibiotics should be completed first**
44
A wood's lamp is used to confirm which dermatological condition? [1]
**Vitiligo** is confirmed by the characteristic accentuation under a Wood's lamp, **indicating a complete loss of melanocytes**
45
Apart from a drug history, how would you differentiate between drug induced and idiopathic schizophrenia? [1]
Symmetrical tremor = Drug induced Idiopathic is not
46
SSRI discontinuation syndrome vs Neurolpetic malignant sydrome Sx? [+]
Dizziness, electrical shocks and anxiety = **SSRI discontinuation syndrome** Fever, muscle rigidity and confusion = **NMS**
47
Polymorphic eruption of pregnancy has which defining feature? [1]
Periumbilical sparing
48
What does a CNIV palsy look like if the patient is looking straight on? [1]
**Affected eye is up and out**
49
What is the most common cause of osteomyelitis? [1]
Staph aureus
50
What is lateral medullary syndrome presentation? [3] - Caused by ischaemia in which artery? [1]
**Facial** and **contralateral body loss of pain sensation** along with **nystagmus** and **ataxia** - **PICA ischaemia**
51
A ptx is dx with discitis and is found to be from Staph aureus. What is the next appropriate investigation? [1]
**Echo** - ?endocarditis
52
Minimally displaced transverse fracture at level below of talar dome. What is the mx? [1]
Weber A: allow weight bearing as tolerated in controlled ankle motion boot
53
Which is OA and RA: - Boutonierre - Bouchards
**Boutonierre**: Flexion in PIP in RA **Bouchards**: Bony enlargements at PIP in OA
54
If NSAIDS/COCP are not controlling endometriosis symptoms, what is next step up? [1]
**GnRH analogues**
55
At what age does Eisenmenger syndrome usually occur? [1] Describe how it usually occurs [2]
his occurs when congenital heart defects are untreated. The left-to-right shunt is reversed due to pulmonary hypertension. The reversal generally **occurs in teenagers** and **causes cyanosis, clubbing and right-ventricular failure** *On examination, the child appears pale and evidently breathless. Inspection demonstrates finger clubbing. There is a systolic murmur heard in the left parasternal region. ECG shows evidence of right-ventricular failure.*
56
How do you work out break through morphine dose if they also are on codeine? [1]
Convert codeine dose to morphine: 10mg codeine = 1 mg of morphine

Year 4 Revision (77 decks)

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