MSRA EXAM Flashcards
(63 cards)
NICE recognise any of the following criteria to diagnose AKI in adults?
↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours
MOTOR NEURONE EYE SYMPTOMS?
This condition = demyelinating disease of CNS
often presents with optic neuritis = eye pain and a relative afferent pupillary defect (RAPD).
RAPD
relative afferent pupillary defect (RAPD).
RAPD is an abnormal finding on the swinging flashlight test where the pupils dilate when light swings from the unaffected to the affected eye. It’s indicative of an optic nerve lesion, such as in optic neuritis - a common early symptom of multiple sclerosis.
Patient >= 60 years old with new iron-deficiency anaemia →
FIT TEST THEN urgent colorectal cancer pathway referral
Primary hyperparathyroidism is caused by
BLOODS =
excess secretion of PTH resulting in hypercalcaemia
raised calcium, low phosphate
symptomatic features of primary hyperparathyroidism ….
‘bones, stones, abdominal groans and psychic moans’
painful bones, kidney stones,
lung abscess features
Characterised by swinging fevers, night sweats, pleuritic chest pain, dyspnoea, and cough.
breast cancer medication OR+
pre menopause
post menopause
pre-menopause = tamoxifen
post menopause = Anastrozole (aromatase inhibitor)
Osteoarthritis 1st line treatment?
paracetamol + topical NSAIDs (if knee/hand) first-line
management post MI?
+ HF or LV dysfunction add..
- dual antiplatelet therapy (aspirin plus ticagrelor)
- ACE inhibitor
- beta-blocker
- statin
.. add aldosterone antagonist eg epelerone (K sparing like spiro)
primary dysmenorrhoea treatment
secondary dysmenorrhoea
Offer a trial of mefenamic
2 - refer to gynae as likely underlying cause
COPD management general
> smoking cessation advice: including offering nicotine replacement therapy, varenicline or bupropion
annual influenza vaccination
one-off pneumococcal vaccination
pulmonary rehabilitation to all people who view themselves as functionally disabled by COPD (usually Medical Research Council [MRC] grade 3 and above)
COPD INHALER therapy
1st line - SABA OR SAMA
2nd line
- if steroid response –> LABA + ICS
- if no steroid response –> LABA + LAMA
positively birefringent crystals on aspirate?
pseudogout = calcium pyrophosphate deposition disease
presents as a monoarticular effusion in a patient RF = disease that disrupt iron and calcium homeostasis.
EG include haemochromatosis, parathyroid disorders, renal impairment, and thyroid dysfunction.
Central retinal artery occlusion
sudden, painless vision loss in one eye
poor direct pupillary light response, normal consensual light reaction
Fundoscopic findings - pale and opaque retina with a cherry-red spot
Treatment for onychomycosis.
oral terbinafine
Thiazides / Bendroflumethiazide affect which mineral?
cause hypercalcaemia (loss of appetite, nausea, fatigue)
Acute presentation of atrial fibrillatio + HISS ->
(HF, ISCHAEMIA, shock, syncope)
electrical cardioversion, as per the peri-arrest tachycardia guidelines
Pneumonia follow up ?
All cases of pneumonia should have a repeat chest X-ray at 6 weeks after clinical resolution
Pericarditis ECG changes
widespread ST elevation
PE ECG
Large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III describes the S1Q3T3 pattern,
URTI symptoms + amoxicillin → rash ?
glandular fever
Bishop score
should be assessed prior to induction of labour
Cervical position (posterior/intermediate/anterior)
Cervical consistency (firm/intermediate/soft)
Cervical effacement (0-30%/40-50%/60-70%/80%)
Cervical dilation (<1 cm/1-2 cm/3-4 cm/>5 cm)
Foetal station (-3/-2/-1, 0/+1,+2)
De Quervain’s tenosynovitis
Pain on the radial side of the wrist/tenderness over the radial styloid process
Finkelsteins test = thumb under fingers, ulnar deviation
