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Mixed practice review Flashcards

1
Q

Visual field defects:

Define congruous vs incongruous:

Homonymous hemianopia - sites of:

Incongruous defect:

Congruous defect:

Macular sparing:

A

A congruous defect: complete or symmetrical visual field loss
Incongruous defect: incomplete or asymmetric.

Incongruous defect: Lesion of optic tracts

congruous defect: lesion of optic radiation or occipital cortex

macula sparing: lesion of occipital cortex

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2
Q

Visual field defects:

Homonymous quadrantopias:

Superior vs inferior

A

superior: lesion of the inferior optic radiations in the temporal lobe (Meyer’s loop)

inferior: lesion of the superior optic radiations in the parietal lobe

mnemonic = PITS (Parietal-Inferior, Temporal-Superior)

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3
Q

Bitemporal hemianopia: sites of compression
Lesion site?

Upper quadrant defect
Lower quadrant defect

A

lesion of optic chiasm

upper quadrant defect > lower quadrant defect = inferior chiasmal compression, commonly a pituitary tumour

lower quadrant defect > upper quadrant defect = superior chiasmal compression, commonly a craniopharyngioma

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4
Q

Bell’s Palsy

Forehead:

Treatment:

A

Not spared - lower MN lesion thus forehead affected by paralysis

Oral prednisolone and artificial tears

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5
Q

Urge incontinence management:

A

1) Bladder re-training for 6 weeks
2) Anti-muscarinics: Oxybutinin (immediate release) or tolterodine (immediate release)

Oxybutinin should be avoided in frail elderly people
Mirabegron may be used if concerned about anti-cholinergic side-effects

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6
Q

Stress incontinence management

A

Pelvic floor excercises

surgical procedures: e.g. retropubic mid-urethral tape procedures

Duloxetine may be offered to women if they decline surgical procedures

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7
Q

Features of essential tremor

Management

A

Postural tremor:
Worst when arms outstretched
Improved by alcohol and rest
Most common cause of titubation (head tremor)

Management: Propranolol

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8
Q

Hypertrophic obstructive cardiomyopathy (HOCM)

Management:

Drugs to avoid:

A

ABCDE
Amiodarone
Beta-blockers or verapamil for symptoms
Cardioverter defib
Dual chamber pacemaker
Endocarditis prophylaxis

Nitrates
ACEis
Inotropes

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9
Q

T2DM Diagnosis

1) If symptomatic:

2) If asymptomatic

A

1) Fasting glucose greater than or equal to 7.0 mmol/l
random glucose greater than or equal to 11.1 mmol/l (or after 75g oral glucose tolerance test

2) On two occasions: HbA1c of greater than or equal to 48 mmol/mol (6.5%) is diagnostic of diabetes mellitus

HbA1c value of less than 48 mmol/mol (6.5%) does not exclude diabetes (i.e. it is not as sensitive as fasting samples for detecting diabetes)

In patients without symptoms, the test must be repeated to confirm the diagnosis

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10
Q

Impaired glucose tolerance criteria:

A

A fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l implies impaired fasting glucose (IFG)

Impaired glucose tolerance (IGT) is defined as fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l

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11
Q

Factors affecting HbA1c
1) Falsely elevated

2) Falsely reduce

A

1) Due to increased RBC lifespan: IDA, Splenectomy, Vit B12 and folic acid def.

2) Due to reduced RBC lifespan: Sickle-cell anaemia
GP6D deficiency
Hereditary spherocytosis
Haemodialysis

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12
Q

AF pharmacologic cardioversion methods:

Which cannot be used in structural heart disease

A

Amiodarone

Flecainide (if no structural heart disease)

others (less commonly used in UK): quinidine, dofetilide, ibutilide, propafenone

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13
Q

Genital ulcers:

single painless:
single painful:
Multiple painless:
Multiple painful:

A

single painless: syphilis
single painful: Haemophillus ducreyi (chancroid)
Multiple painless: HPV warts
Multiple painful: Herpes Simplex

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14
Q

Potential class of side effects of Donepezil

May be exacerbated by:

A

Bradycardia -> SA/AV block

Rate limiting CCBs -> Verapamil

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15
Q

Acute ischaemic stroke management:

A

If within 4.5 hours of symptoms on-set = thrombolysis AND thrombectomy
If within 6 hours = thrombectomy

if well within 6-24 hours = thrombectomy

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16
Q

SVT with haemodynamic compromise Tx.

A

SYNCHRONISED DC Cardioverson

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17
Q

Apple core sign seen in:

A

Oesophageal cancer

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18
Q

Most common endogenous cause of Cushing’s

A

PITUITARY adenoma

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19
Q

Endometrial cancer risk factors:

Protective factors:

A

Excess oestrogen (nulliparity,early menarche,late menopause,unopposed oestrogen

Metabolic syndrome (obesity, diabetes, PCOS)

Smoking, multi-parity, COCP

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20
Q

Acute epiglottitis
Causative organism:

Diagnosis

Treatment:

A

Haemophilus I. type B

Clinically or may use X-ray (thumb-sign)

Oxygen + IV antibiotics

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21
Q

Red eye:
Answer:
pain or no pain?
visual acuity affected?
Pupil size/dilated?
other features

Acute angle closure glaucoma
Anterior uveitis
Scleritis
Endophthalmitis

A

Acute angle closure glaucoma:
Severe pain
Reduced VA, patient sees haloes
Semi-dilated pupil
Hazy cornea

Anterior uveitis
Acute onset, pain, blurred vision and photophobia
Small fixed oval pupil, ciliary flush

Scleritis
Severe pain, worse with movement

Endophthalmitis
Painful red eye, visual loss following intraocular surgery

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22
Q

Rinne’s and Weber’s

Normal
CHL
SNHL

A

Normal: Rinne = AC>BC // Weber= midline

CHL: Rinne = BC>AC (affected ear) Weber: Lateralised to affected ear (contrary to instinct)

SNHL = AC>BC Weber: Lateralises to unaffected ear

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23
Q

Blurring of vision again years after cataract surgery may be due to:

A

Posterior capsule opacification

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24
Q

Cauda Equina:
Causes - most common:
Discs affected:

A

Most common cause is central disc prolapse L4/L5 or L5/S1
Other causes: tumours, infection, trauma, haematoma

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25
Degenerative cervical myelopathy Risk factors: Symptoms Hoffman's sign Test of choice
smoking, genetics, occupation (high axial loads) Pain (affecting the neck, upper or lower limbs) Loss of motor function Loss of sensory function causing numbness Loss of autonomic function (urinary/faecal incontinence) Gently flicking one finger on patients hand MRI -> to then be referred to orthopaedic spinal team
26
Accumulation of acetylcholine features (SLUD)
Salivation Lacrimation Urination Defecation/diarrhoea Also small pupils, muscle fasciculation
27
Malignant otitis externa Most common organism: Key features: Investigation: Antibiotics
Pseudomonas aeruginosa Diabetes (90%) or immunosuppression Severe, unrelenting deep-seated otalgia, purulent otorrhoea, dysphagia, hoarseness, and/or facial nerve dysfunction CT scan Ciprofloxacin
28
BMI classes: <18.5 18.5 - 24.9 25 -29.9 30 -34.9 35 - 39.9 >40
<18.5 underweight 18.5 - 24.9 Normal 25 -29.9 Overweight 30 -34.9 Obese ( I ) 35 - 39.9 Clinically obese ( II ) >40 Morbidly obese ( III )
29
Phaeochromocytoma: Secretes: Where: Features: Tests: Treatment:
Catecholamines Adrenals Hypertension, headaches, palpitations, sweating, anxiety 24 hour urinary collection of metanephrines Phenoxybenzamine (alpha blocker) given BEFORE Beta blocker e.g propranolol
30
Preferred SSRI in MI
Sertraline
31
Suspected colorectal cancer pathway: Change
Now use FIT tests more widely rather than colonoscopy first line: NICE recommend a FIT is used to guide referral in the following scenarios: with an abdominal mass, or with a change in bowel habit, or with iron-deficiency anaemia, or aged 40 and over with unexplained weight loss and abdominal pain, or aged under 50 with rectal bleeding and either of the following unexplained symptoms: abdominal pain weight loss, or aged 50 and over with any of the following unexplained symptoms: rectal bleeding abdominal pain weight loss, or aged 60 and over with anaemia even in the absence of iron deficiency
32
Which cognitive impairment may present with intermittent confusion/fluctuating cognition:
Lewy Body dementia
33
Asthma initial tests
FeNO and bronchodilator reversibility test
34
Most common cause of traveller's diarrhoea Profuse watery diarrhoea, NOT common amongst travellers Flu-like prodrome followed by crampy abdominal pains - may mimic appendicitis. Complications include GBS 2 types: vomiting within 6 hours (rice) or diarrhoeal illness occurring after 6 hours Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last several weeks Prolonged non-bloody diarrhoea
E.coli Cholera Campylobacter Bacillus Cereus Amoebiasis Giardiasis
35
STEMI -> PCI: drugs to give Fibrinoysis for MI: what should be given at same time: Following procedure:
Prasugrel with unfractionated heparin and bailout glycoprotein IIb/IIIa inhibitor Antithrombin (Fondaparinux) Ticagrelor
36
Vaccinations: Live attenuated viruses: Inactivated form
BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid rabies hepatitis A influenza (intramuscular)
37
Pneumonia causing skin rash (erythematous lesions on trunk) Treatment:
Mycoplasma Pneumoniae Doxycycline or macrolide (clindamycin (C.diff risk) or erythromycin)
38
Pneumonia organism secondary to influenza infection:
Staph aureus
39
Capgras syndrome:
Delusion that people have been replaced by an identical imposter
40
Cluster headaches: Acute management: Prophylaxis
100% oxygen + Sc triptan Prophylaxis: Verapamil
41
Asthma steps of therapy:
1) SABA 2) SABA ICS 3) SABA ICS LTRA 4) SABA ICS LABA 5) SABA LTRA MART 6) SABA LTRA med dose MART 7) SABA LTRA high dose MART MART is ICS plus LABA in single inhaler
42
Pneumonia with cavitation on XR organism:
Klebsiella Pneumoniae
43
Asthma assessment of severity features: Moderate: Severe: Life threatening:
Moderate: PEFR 50-75% best or predicted RR < 25 / min Pulse < 110 bpm Severe: PEFR 33 - 50% best or predicted Can't complete sentences RR > 25/min Pulse > 110 bpm Life threatening: PEFR < 33% best or predicted Oxygen sats < 92% 'Normal' pC02 (4.6-6.0 kPa) Silent chest, cyanosis or feeble respiratory effort Bradycardia, dysrhythmia or hypotension Exhaustion, confusion or coma
44
Time restrictions for delivering PPCI in STEMI
Within 12 hours of symptoms on-set and within 2 hours of presentation
45
Gout management Acute: ULT: When offered What it involves: first line agent Second line agent
monosodium urate NSAIDs or colchicine are first line Oral steroids may be considered if NSAIDs or colchicine contraindicated If patient taking allopurinol already it should be CONTINUED After first attack of gout 2 weeks after exacerbation - ALLOPURINOL first line Colchicine cover should be considered when starting allopurinol. Febuxostat (also a xanthine oxidase inibitor)
46
Overstimulation of parasympathetic system (as seen in organophosphate poisoning) symptoms : DUMBELS mnemonic
Defecation and diaphoresis Urinary incontinence Miosis (pupil constriction) Bradycardia Emesis Lacrimation Salivation More in depth than SLUD
47
Examples of dopamine receptor antagonists Commonly used in side effects
Bromocriptine, ropinirole, cabergoline Parkinson's Impulse control disorder, hallucinations, daytime somnolence Cabergoline and bromocriptine may cause pulmonary, retroperitoneal and cardiac fibrosis
48
Features of Tetralogy of Fallot (4)
VSD RV hypertrophy Overriding aorta RV outflow tract obstruction
49
Difference between DKA and alcoholic ketoacidosis
Normal or low glucose in AKA
50
5 red rashes of childhood: Cold with fever which is followed 1-2 weeks later by erythematous rash across the trunk and limbs: Starts with erythematous rash behind the ears and spreads to rest of body. Associated with fever, conjunctivitis, coryzal symptoms and white Koplik spots inside the mouth: Rash first appears on the cheeks, spreading to trunk and arms, preceded by 2-5 days of mild fever and non-specific viral symptoms Caused by group A strep usually begins as tonsillitis, red-pink rash that begins on the trunk. Associated with fever, strawberry tongue and cervical lymphadenopathy
Roseola infantum Measles Parvovirus B19 Scarlet fever
51
Hypersensitivity reaction, commonly caused by infections. Commonly caused by herpes simplex virus. Appears as target lesions, initially seen on the back of hands before spreading to the torso. Also seen as a drug reaction to penicillin, NSAIDs, COCP, SLE, sarcoidosis and malignancy
Erythema multiforme
52
Marker of acute infection in Hep B How long does this typically last Antibody implying immunity Antibody implying current or previous infection. Which immunoglobulin is seen in acute infection, which one persists
HBsAg 1-6 months Anti-HBs - negative in chronic disease Anti-HBc IgM -> IgG
53
Monomorphic punched out lesions Caused by
Eczema herpeticum HSV 1or 2
54
Management of varicella zoster (shingles) Main benefit of antivirals
Antivirals within 72 hours unless <50 with mild truncal rash Reduced incidence of post-herpetic neuralgia
55
Most common testicular swelling with posterior swelling, separate to testicle Soft non-tender swelling of the hemi-scrotum, usually anterior to and below the testicle, transilluminates with pen torch Most common on the left side, bag of worms associated with subfertility
Epidiymal cyst Hydrocele Varicocele
56
Definitions of conditions: Rubbery, painless lymphadenopathy, night sweats, organomegaly, pain while drinking alcohol (uncommon) More common in patients <20, usually in the mid-line, moves upwards with protrusion of tongue More common in older men, usually not seen, may gurgle on palpation, symptoms of dysphagia, regurgitation, aspiration, chronic cough. Congenital lymphatic lesion typically found in the neck on the left side, most evident at birth, 90% before aged 2 years. Oval mobile, cystic mass, develops between SCM. Due to failure of the obliteration of second branchial cleft in embryonic development. Presents in early adulthood. More common in females, may cause thoracic outlet syndrome
Lymphoma Thyroglossal cyst Pharyngeal pouch Cystic hygroma Branchial cyst Branchial cyst Cervical rib
57
Side effects of which drug: Angioedema, hyperkalaemia, first dose hypotension, cough
ACEi
58
Paediatric squint management:
Refer to secondary care for further management
59
Pneumonia causing: Dry cough, confusion, hyponatraemia, bradycardia and deranged LFTs Treat with
Legionella pneumophilia Erythromycin or clarithromycin
60
1) DVT management if Wells greater than 2 -> 2) If investigation can not occur for 4 hours: 3) If US is negative but D-dimer positive
1) Proximal leg vein ultrasound should be carried out within 4 hours -> if negative, a D-dimer should be sent. 2) D-dimer should be sent and interim anti-coagulants started 3) Stop interim DOAC offer repeat leg vein US 6-8 days later
61
Most common organsim for COPD exacerbation
Haemophilus influenzae
62
Migraine management: Acute vs prophylaxis
Acute: NSAID or triptan Prophylaxis: Propranolol (not if asthmatic) or topiramate (not in women of child bearing age)
63
1) Dysphagia to both solids AND liquids from the beginning with heartburn 2) Process:
Achalasia Failure of oesophageal peristalsis and of relaxation of the lower oesophageal sphincter due to degenerative loss of ganglia from Auerbach's plexus
64
Most effective form of contraception Are additional contraception methods required for this after insertion Main adverse effects:
Nexplanon If not inserted between days 1-5 of woman's menstrual cycle. Irregular/heavy bleeding Progestogen effects (headache, nausea, breast pain)
65
COPD step up therapy
1) SABA or SAMA 2) DEPENDS ON ATOPY -> If atopic, SABA or SAMA plus LABA and ICS -> If not, SABA or SAMA plus LABA plus LAMA 3) SABA LABA LAMA ICS
66
Infertility - How long should couples be having regular intercourse for before referral to specialist First line investigation -
1 year Day 21 progesterone (7 days prior to next expected period)
67
1) Name the condition: Acute onset, ocular pain, pupil may be small and irregular due to sphincter muscle contraction, photophobia, blurred vision, red eye, lacrimation with ciliary flush, hypopyon (pus in anterior chamber) 2) Associated conditions: 3) Management
1) Anterior uveitis 2) HLA B27 -> ankylosing spondylitis, reactive arthritis, UC, Crohn's, Sarcoidosis 3) Urgent review ophthalmology -> Cycoplegics (dilate pupil which relieves pain and photophobia) e.g atropine or cyclopentolate Steroid eye drops
68
Eczema which commonly shows up in the hands due to high humidity and increased temperatures
Pompholyx eczema
69
Name the condition: Painful red eye, watering and photophobia, gradual reduction in vision. Risk factors include Rheumatoid arthritis, SLE, GPA Management:
Scleritis Same day assessment by ophthalmology Oral NSAIDs Oral glucocorticoids
70
Metabolic acidosis causes: Normal anion gap: Raised anion gap:
Norma (hyperchloraemic metabolic acidosis): GRAAD GI bicarbonate loss Renal tubular acidosis Addison's Ammonium chloride injection Drugs Raised: LUKA Lactate: shock, sepsis, hypoxia Urate: Renal failure Ketones : DKA, AKA Acid poisoning: Salicylates, methanol
71
Arteries implicated: 1) POCI (posterior circulation infarcts) 2) Lacunar
Vertebrobasilar arteries Perforating arteries around the internal capsules TACI and PACI: Middle and anterior cerebral arteries (partial anterior = smaller arteries)
72
Name the disease: Thromboangitis obliterans. Small and medium vessel vasculitis which is strongly associated with smoking. Extremity ischaemia, superficial thrombophlebitis, Raynaud's
Buerger's disease
73
Courvoiser's law:
A palpable non tender enlarged gallbladder accompanied with PAINLESS jaundice is unlikely to be gallstones. Instead consider malignancy.
74
RAPD: Define: Seen in:
The affected and normal eye appear to dilate when light is shone on the affected eye Retina detachment and optic neuritis (common first sign of MS)
75
Angina management:
BB or CCB (rate limiting) first line -> dose maximised before switching/adding. If adding CCB to BB, a dihydropyridine CCB should be used. If patient cannot tolerate BB and CCB, add one of: Long-acting nitrate, Ivabradine, Nicorandil, Ranolazine
76
Vitamin name and effects of deficit: A B1 B3 B6 B9 C D
retinoid - night blindness Thiamine - Beriberi, Wernicke, heart failure Niacin - Pellagra (dermatitis, diarrhoea, dementia) Folic acid - Megaloblastic anaemia, NTDs Scurvy - gingivitis, bleeding chole/ergocalciferol - rickets, osteomalacia
77
Testicular cancer: 95% of tumours are: These are divided into: Examples of each: Markers:
Germ cell tumours Seminoma and non-seminoma Non-seminoma: embryonal, yolk sac, teratoma, choriocarcinoma Non-germ cell tumours include: leydig cell tumours and sarcomas Seminoma: hCG Non-seminoma: AFP or b-hCG LDH is raised in around 40% of germ cell tumours
78
1st line anti-platelet in PAD What should be co-prescribed
Clopidogrel Atorvastatin 80mg
79
Heart murmur: Early diastolic murmur: intensity increased by handgrip manoeuvre Wide pulse pressure Quincke sign (nailbed pulsation) De Musset's sign (head bobbing) Common causes:
Aortic regurgitation Disease: Rheumatic fever (developing world) CTDs Infective endocarditis Structural: Bicuspid aortic valve, spondyloarthropathies, hypertension Aortic dissection
80
Presents in the first 24-48 hours of life with abdominal distension and bilious vomiting, more common in cystic fibrosis
Meconium ileus
81
Vertigo , hearing loss, tinnitus, absent corneal reflex: Location Nerves implicated:
Acoustic neuroma (vestibular schwannoma) Cerebellopontine tumour V,VI, VIII
82
Time from myocardial infarction to complication: 0-4 hours 4-24 hours 1-3 days 4-7 days Months:
0-4 hours: Cardiogenic shock, CHF, Arrhythmia 4-24 hours: Arrhythmia 1-3 days: Pericarditis 4-7 days: Rupture of free wall, septum or papillary muscle (causes mitral regurgitation) Months: Dresslers, aneurysm, thrombus
83
Surgical management of cancer: 1) Colorectal cancer with perforation treated with which procedure? 2) Caecal, ascending or proximal transverse colon? 3) Distal transverse, descending colon 4) Sigmoid 5) Upper rectum 6) Low rectum 7) Anal verge
1) Hartmann's 2) Right hemi-colectomy 3) Left hemi-colectomy 4) High anterior resection 5) Anterior resection (TME) 6) Anterior resection (low TME) 7) Abdomino-perineal excision of rectum
84
Primary amenorrhoea, little or no pubic hair, undescended testes showing as groin swellings Breast development as a result of testosterone breakdown to oestradiol Genotype: How does this differ from congenital adrenal hyperplasia
Androgen insensitivity syndrome 46XY - but raised as female Development of male characteristics in females (hirsutism, deep voice) Body is still responsive to testosterone. No bilateral lower pelvic swellings (no undescended testes)
85
Arthritis occurring in someones <16 years old that lasts for more than 3 months Associated skin sign Pauciarticular JIA refers to cases where X or less joints are affected
Juvenile idiopathic arthritis Salmon pink rash 4
86
Serotonin syndrome vs NMS main difference: NMS occurs hours to days after starting: Reflexes in NMS vs SS Pupils in NMS vs SS Which one do you get rigidity in?
serotonin syndrome presents over hours rather than days like in NMS. Anti-psychotic Reflexes are reduced in NMS and increased in SS Normal in NMS, dilated in in SS NMS
87
Breast disorders: 1) Common in women under the age of 30 years 'breast mice' discrete, non-tender, highly mobile lumps 2) Most common in middle-aged women 'Lumpy' breasts may be painful. Symptoms worsen prior to menstruation 3) Tender lump around the areola +/- a green nipple discharge. Most common around menopause 4) May present with blood stained discharge 5) obese women with large breasts May follow trivial or unnoticed trauma, Mimic breast cancer so further investigations required
1) Fibroadenoma 2) Fibroadenosis 3) Mammary duct ectasia 4) Duct papilloma 5) Breast cancer
88
Heparin monitoring: Does it require it
LMWH does not Unfractionated heparin required monitoring with aPTT
89
Contraceptives: Time till effective IUD: POP: COC, injection, implant, IUS
IUD: instant POP: 2 days COCP, injection, implant IUS: 7 days
90
Pregnant women with BP over XX/YY should be admitted and observed
160/110
91
Lung cancer: Most common Ca: Cavitating lesions ADH/ACTH secreting PTrH secreting Gynaecomastia Lambert Eaton Syndrome
Adenocarcinoma Squamous carcinoma Small cell Squamous cell Adenocarcinoma Small cell
92
Sectioning under the mental health act: Which number 1) Admission for assessment for up to 28 days, not renewable. treatment CAN be given against a patient's wishes 2) Admission for treatment for up to 6 months, can be renewed. Treatment CAN be given against patient's wishes 3) 72 hour assessment order, used as an emergency, when section 2 would cause delay 4) Person can be taken from a public place to a place of safety if they appear to have a mental disorder only used for up to 24 hours 5) Allows patients to break into property to remove a person to a place of safety: 6) CTO - may be used to recall a patient to hospital if they do not comply with conditions of the order in community
Section 2 Section 3 Section 4 Section 136 Section 135 Section 17a
93
Iron studies: Raised in IDA, normal in anaemia of chronic disease Raised in inflammatory disorders but low in IDA
TIBC Ferritin
94
Primary hyperaldosteronism Features: signs and electrolytes Investigations: Treatment:
Hypertension, Hypokalaemia Plasma aldosterone/renin ration (high aldosterone with low renin levels) Then high resolution CT abdmoen and adrenal venous sampling is used to differentiate between unilateral adenoma or bilateral hyperplasia Adrenal adenoma: surgery Bilateral adrenocortical hyperplasia: Aldosterone antagonist
95
Hormonal therapy for breast cancer: which is used when
Tamoxifen if PRE-menopausal Anastrozole for post-menopausal As aromitisation accounts for the majority of oestrogen production in post-menopausal women.
96
COCP: Increases risk of which cancers: Decreases risk of which cancers:
Breast and cervical Colorectal, Ovarian and endometrial
97
Breast cancer risk factors: (early/late) menarche (early/late) menopause
Early menarche Late menopause Think of oestrogen exposure
98
Dermatomyositis: Typically associated with which cancers -> Characteristic antibodies
Breast, Ovarian, lung cancer Most are ANA positive Anti-jo 1
99
Folic acid in pregnancy should be started when and stopped when?
pre-conception till 12th week of pregnancy
100
Chlamydia: First line investigations:
Male: Urine test Female: Vulvovaginal swab

MSRA (15 decks)

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