MSRA Revision Flashcards
(107 cards)
1
Q
What is the triad for an Acute Haemolytic Reaction?
A
Fever
Abdominal Pain
Hypotension
2
Q
How do you calculate Anion Gap?
A
Sodium + Potassium - Chloride - Bicarbonate
3
Q
What is the triad for Wernicke’s?
A
Ataxia
Ophthalmoplegia
Confusion
4
Q
What is the Parkland Formula for fluid calculation in burns patients?
A
4ml x kg weight x % burns
5
Q
Posterior hip dislocations present how?
A
Shortened, adducted, and internally rotated
6
Q
Anterior hip dislocations present how?
A
Abducted, externally rotated. No leg shortening
7
Q
Which blood product has the highest risk of to immunocompromised patients and why?
A
Platelets, are more likely to be contaminated with bacteria. Short shelf life of five days
8
Q
How often should sickle-cell patients receive a pneumococcal vaccine?
A
Every 5 years
9
Q
Which electrolyte abnormality can pre-dispose you to Digoxin toxicity?
A
Hypokalaemia
10
Q
Which conditions can falsely give a lower HbA1c than expected, due to shortened RBC lifespan?
A
- Sickle-cell anaemia
- GP6D deficiency
- Hereditary spherocytosis
- Haemodialysis
11
Q
Which conditions can falsely give a increase HbA1c than expected, due to increased RBC lifespan?
A
Vitamin B12 deficiency
Folic acid deficiency
Iron-deficiency anaemia
Splenectomy
12
Q
U waves on an ECG correspond to what electrolyte abnormality?
A
Hypokalaemia
13
Q
What is the SSRI of choice post-MI?
A
Sertraline
14
Q
What electrolyte abnormalities will occur following aggressive NaCl 0.9% fluid resuscitation in a patient?
A
Hyperchloraemic Metabolic Acidosis
15
Q
What medications are first-line for spasms caused by Multiple sclerosis?
A
Baclofen
Gabapentin
16
Q
What is the side-effect of Amoxicillin?
A
Rash with infectious mononucleosis
17
Q
What is a side-effect of Co-amoxiclav
A
Cholestasis
18
Q
What is a side-effect of Flucloxacillin
A
Cholestasis
19
Q
What is a side-effect of Erythromycin
A
Long QT syndrome
20
Q
What is two side-effects of Ciprofloxacin
A
Tendonitis
Reduces seizure threshold
21
Q
What is a side-effect of Metronidazole
A
Reaction following alcohol
22
Q
What is a side-effect of Doxycyline
A
Photosensitivity
23
Q
What is three side-effects of Trimethoprim
A
Rashes
Pruritus
Suppression of haematopoesis
24
Q
What should be given to patients as prophylaxis for a variceal bleed before endoscopy?
A
Terlipressin
Antibiotics
25
Koplik spots is associated with..?
Measles
26
What is the first-line treatment for Syphilis? What is second-line?
IM Benzathine Penicillin
Doxycyline is second line
27
What is the treatment for Otitis Externa? What is the preferred antibiotic? What if there is a tympanic membrane perforation?
Topical antibiotic, or topical antibiotic & steroid. Aminoglycoside. If perforation however, avoid this
28
How long should we wait before prescribing a Phosphodiesterase inhibitor such as Sildenafil post MI?
6 months
29
Phenytoin
1. What is used to treat?
2. What is the mechanism of action?
3. P450 inducer or inhibitor?
4. Chronic side-effects?
5. Monitoring requirements? If so, how?
6. Teratogenicity?
1. Seizures
2. Sodium Channel Blocker
3. P450 Inducer
4. Peripheral neuropathy, Gingival hyperplasia, Megaloblastic anaemia, Hitsuitism
5. None, unless dose change, suspected toxicity. Trough levels before dose
6. Yes, Associated with cleft palate and congenital heart disease
30
Symptoms of radial nerve palsy?
What is it also known as?
1. Wrist drop. Sensory loss to small area between the dorsal aspect of the 1st and 2nd metacarpals
2. Saturday night palsy
31
What is the dose and mode of administration for termination of seizures in adults?
10mg Rectal Diazepam
32
What is the first-line management for patients with heart failure with reduced ejection fraction? What is second line?
1. ACEI / ARB and Beta Blocker
2. Aldosterone antagonist / Mineralcorticoid receptor antagonist i.e. Spironolactone / Eplenerone
33
Which plasma autoantibody has the highest specificity for Rheumatoid Arthritis?
Anti-CCP
34
What is the most common organism causing a UTI in adults and children?
E. Coli
35
Which pupillary syndrome is associated with Syphillis? Describe it
Argyll-Robertson Pupil. Small, irregular pupils. Accommodation Reflex Present (ARP) but Pupillary Reflex Absent (PRA)
36
Glandular fever
1. What is it caused by?
2. What is the triad?
3. How is it diagnosed?
4. How is it managed?
1. EBV / HHV-4
2. Sore throat, fever, lymphadenopathy
3. Monospot test and FBC
4. Supportive, avoid contact sports for 4 weeks due to splenic rupture risk
37
What is the investigation of choice for Varicose veins?
Venous Duplex Ultrasound
38
When should a referral be made to foetal medicine if a baby's movements haven't been felt yet in a pregnant mother?
24 weeks
39
If pharmacological cardioversion has been agreed on clinical and resource grounds for new-onset atrial fibrillation, what drug is offered?
Flecainide or Amiodarone if there is no evidence of structural or ischaemic heart disease or
Amiodarone if there is evidence of structural heart disease.'
40
What investigation is required before commencing Herceptin (Trastuzumab)
Echo - Cardiac toxicity is common
41
Scarlet fever
1. What is it caused by?
2. In what age group is it seen in?
3. Presenting features?
4. Diagnosis?
5. Management?
6. School exclusion rule?
1. Group A Streptococcus
2. Aged 2-6 years old
3. Fever, malaise, sore throat, strawberry tongue, sandpaper rash
4. Throat swab
5. Penicillin V for 10 days
6. Can return to school 24 hours after initiating antibiotics
42
What is the management of ITP?
Oral Prednisolone
43
Metformin
1. What is the mechanism of action?
2. What are the side effects?
3. What are contraindications to Metformin?
4. How should Metformin be titrated?
1. Increases insulin sensitivity decreases and hepatic gluconeogenesis
2. Gastrointestinal upset, lactic acidosis
3. CKD, recent MIs
4. Slowly, if GI upset switch to MR
44
What is the best test of Pancreatic exocrine function?
Faecal elastase
45
What are the symptoms of Weber's syndrome?
Ipsilateral lower motor neuron type oculomotor nerve palsy and contralateral hemiparesis or hemiplegia
46
Aortic Stenosis
1. Describe the murmur
2. Clinical features of it
3. Features of SEVERE aortic stenosis?
4. Causes of aortic stenosis?
5. Management of aortic stenosis
1. Ejection systolic murmur, with radiation to the carotids
2. Chest pain, SOB, syncope
3. Narrow pulse pressure, slow rising pulse, soft S2
4. Degenerative calcification, Bicuspid aortic valve, William's syndrome, HOCM
5. If asymptomatic = observe, if symptomatic, valve replacement
47
What should all patients be offered following ACS?
1. Dual antiplatelet therapy (aspirin plus a second antiplatelet agent)
2. ACE inhibitor
3. Beta-blocker
4. Statin
48
What is Holmes Adie Syndrome? Describe the findings. What is it also associated with?
A type of dilated pupil.
Slowly constricts, once the pupil has constricted it remains small for an abnormally long time. Slowly reactive to accommodation but very poorly (if at all) to light.
Associated with absent knee / ankle reflexes
49
What is AKI Stage 1 referred to as?
Increase in creatinine to 1.5-1.9 times baseline, or reduction in urine output to <0.5 mL/kg/hour for ≥ 6 hours
50
What is AKI Stage 2 referred to as?
Increase in creatinine to 2.0 to 2.9 times baseline, or reduction in urine output to <0.5 mL/kg/hour for ≥12 hours
51
What is the treatment for MSRA?
Nasal mupirocin + chlorhexidine for the skin
52
How do you convert the dose of Oral to subcutaneous Morphine?
Half it
53
Which antibiotics should be avoided in patients with Methotrexate?
Trimethoprim
Co-trimoxazole
54
What medications can be administered to prevent Tumour Lysis Syndrome?
Allopurinol
Rasburicase
55
Treatment for a corneal abrasion
Topical antibiotic
56
Treatment for dendritic ulcer on cornea
Topical anti-virals
57
What is early menopause defined as?
The onset of menopausal symptoms and elevated gonadotrophin levels before the age of 40 years
58
If an expectant mother has had a previous baby with Group B Strep, what can be given to prevent this from happening again?
Maternal IV antibiotics during labour
59
Iron deficiency anaemia, what are the following levels:
Ferritin
TIBC
Serum Iron
Transferrin
↓ Ferritin, ↑ total iron-binding capacity, ↓ serum iron, ↓ transferrin saturation
60
Which antibodies are associated with Sjrogen's syndrome?
Anti-Ro
Anti-La
ANA
RF
61
Dose of adrenaline for anaphylaxis in children under 6 months?
100 - 150 micrograms (0.1 - 0.15 ml 1 in 1,000)
62
Dose of adrenaline for anaphylaxis in children 6 months - 6 years?
150 micrograms (0.15 ml 1 in 1,000)
63
Dose of adrenaline for anaphylaxis in children 6 years - 12 years?
300 micrograms (0.3ml 1 in 1,000)
64
Dose of adrenaline for anaphylaxis in children / adults >12 years?
500 micrograms (0.5ml 1 in 1,000)
65
What is the antidote for Paracetamol overdose?
If <1 hour = Activated charcoal
Otherwise, NAC or liver transplant
66
What is the antidote for Salicyclate overdose?
IV Bicarbonate
Or Haemodylasis
67
What is the antidote for Benzodiazepine overdose?
Flumazenil
68
What is the antidote for TCA overdose?
IV Bicarbonate
69
What is the antidote for Lithium overdose?
Fluid resuscitation
or Haemodylasis
70
What is the antidote for Warfarin?
Vitamin K
Prothrombin complex
71
What is the antidote for Heparin?
Protamine Sulphate
72
What is the antidote for Beta blockers?
Atropine
If fails, Glucagon
73
What is the antidote for Ethylene glycol?
Ethanol
Fomipazole
If fails, haemodialysis
74
What is the antidote for Methanol?
Ethanol
Fomipazole
If fails, haemodylasis
75
What is the antidote for Organophosphate poisoning?
Atropine
76
What is the antidote for Digoxin?
Digoxin specific antibody fragments
77
What is the antidote for Iron?
Desferroxamine
78
What is the antidote for Lead?
Dimercaprol
79
What is the antidote for Carbon monoxide?
100% Oxygen
Hyperbaric oxygen
80
What is the antidote for Cyanide?
Hydroxocobalamin
81
Most common type of penile cancer?
SCC
82
Define conversation disorder?
Is a psychiatric condition where psychological distress is expressed through physical symptoms.
83
Chvostek and Trosseu's sign indicate what?
Hypocalcaemia
84
Which ulcers are relieved by eating? Gastric or duodenal?
Duodenal
85
Which ulcers are worsened by eating? Gastric or duodenal?
Gastric
86
Primary biliary cirrhosis is associated with which antibodies?
AMA
87
Pneumocystis jiroveci penumonia is treated how?
Co-trimoxazole
88
Diagnostic test for Allergic contact dermatitis?
Patch testing
89
Androgen insensitivity syndrome:
1. Phenotypically, how do patients present?
2. Genotypically, what are they?
3. What is the inheritance pattern?
4. What are the features?
5. Noted on blood results?
1. As female
2. Male genotypically, 46XY
3. X linked inheritance
4. No periods, no axillary or pubic hair. Undescended testes
5. High testosterone
90
How can you differentiate between Bullous Pemphigus and Pemphigoid?
No mucosal involvement: Bullous pemphigoid
Mucosal involvement: Pemphigus vulgaris
91
In the acute management of DKA, how shall insulin be prescribed?
Insulin should be fixed rate whilst continuing regular injected long-acting insulin but stopping short actin injected insulin
92
What is offered to the contacts of a patient with meningococcal meningitis?
Oral ciprofloxacin
93
Dermatomyositis is associated with which antibody?
Anti-Jo
94
What is the treatment for community-acquired pneumonia caused by Legionella
Clarithromycin
95
What is the antibiotic of choice in Whooping cough?
Azithromycin or
Clarithtomycin
96
Which medication gives blue tinged vision?
Sildenafil
97
Which medication gives yellow-green tinged vision?
Digoxin
98
Ulipristal should be used with caution in which patients?
Those with asthma
99
In Idiopathic Pulmonary Fibrosis, what is the FEV1/FVC? What is the TLCO?
FEV/FVC > 0.7
Reduced TLCO
100
What test can help differentiate between T1D and T2D? In which is it raised?
C-peptide levels and diabetes-specific autoantibodies are useful to distinguish between T1D and T2D
In T2D, C-peptide is raised
101
What is first-line treatment for CML?
Imatinib
102
Jacksonian march indicates what epilepsy?
Frontal lobe
103
Describe features of a Temporal lobe epilepsy?
An aura occurs in most patients
typically a rising epigastric sensation
also psychic or experiential phenomena, such as deja vu, jamais vu. Less commonly hallucinations (auditory/gustatory/olfactory)
Seizures typically last around one minute automatisms (e.g. lip smacking/grabbing/plucking) are common
104
What does the blood work look like in Cushing's syndrome?
Hypoakalaemic metabolic alkalosis
105
Which medication is used to treat tremor in drug-induced Parkinsonism?
Procyclidine
106
Which medication is used for Parkinson's Disease but has reduced effectiveness over time?
Levodopa
107
