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1
Q

empiric AB choice for febrile neutropaenia

A

piperacillin/tazobactam

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2
Q

how do you diagnose dengue

A

4 fold rise in Ab titre over 2 weeks

Flavivirus PCR

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3
Q

common prodrome to Guillan-Barre

A

viral illness or vaccination

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4
Q

what are the 3 mechanisms that can cause hypercalcaemia in malignancy

A
  • osteolytic metastasis with local release of cytokines
  • tumour secretion of PTHrP
  • tumour production of 1,24 Vit D
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5
Q

presentation of eaton-Lambert syndrome

A

opposite to MG

  • stronger muscle response with repetition
  • recovery of lost deep tendon reflexes
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6
Q

when are the ONLY two reasons to treat asymptomatic bacteruria

A

pregnant

having a urological procedure

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7
Q

treatment of Bell’s palsy

A

prednisolone +/- valciclovir +/- tape eye shut

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8
Q

treatment of dengue fever

A

symptomatic and supportive therapy

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9
Q

clinical presentation suggestive of epidural abscess

A

fever and localised back pain

and focal neurological deficits

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10
Q

definition of febrile neutropaenia

A
  • neutrophils less than 0.5

- once off fever of more than 38.3 or a sustained temp of more than 38 for more than 1 hour

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11
Q

top 2 complications of diabetes

A

CVD

infection

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12
Q

3 cardinal features of claudication

A

pain with exertion
relieved by rest
reproducible

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13
Q

when do you do an ERCP with pancreatitis

A

when you suspect gallstones and cholangitis (high bilirubin)

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14
Q

clinical presentation of malaria

A 
fever
flu like illness
N&V, diarrhoea
anaemia, jaundice
cough
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15
Q

What cancers, other than SCC, are patients post-transplant particularly susceptible to

A
  • HPV - cervical/vulval
  • EBV - lymphoma, lymphoproliferative
  • HHV8 - Kaposi’s sarcoma
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16
Q

explain how HIV enters CD4 cells

A

gp120 protein on HIV virus binds to CD4 –> structural rearrangement of gp120 –> binding site for CCR5/CXCR4 protein of T cells –> binding –> structural rearrangement of gp41 protein on HIV virus –> fusion with CD4 T cell

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17
Q

4 major side effects or interactions of azathioprine

A

macrocytosis
myelosuppression –> cancer
dangerous with allopurinol = causes severe BM toxicity
can cause pancreatitis

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18
Q

specific indications for dialysis

A

uraemia –> pericardial rub, pleuritis, bleeding diathesis
fluid overload refractory to surgery
electrolyte imbalance

19
Q

Clinical presentation of dengue

A

fever, headache, myalgias, RASH

20
Q

standard treatment for meningitis

A

dexamethasone –> ceftriaxone, vancomycin and penicillin –> CT –> LP

21
Q

Homonymous hemianopia is always due to a problem with which artery

A

posterior cerebral artery

22
Q

Common areas for Dengue

A

South East Asia

Caribbean

23
Q

treatment of typhoid

A

antibiotics

24
Q

why don’t you give anti-coagulants with a stroke presentation

A

it increases the chance of ischaemic transformation

25
treatment of acute ischaemic limb
immediate heparinization | urgent revascularisation
26
what infections should you consider in a patient with HIV at different CD4 counts
CD4 less than 200 = PJP CD4 less than 100 = toxoplasmosis CD4 less than 50 = MAC
27
what clinical presentation do you get with conduction aphasia
poor ability to repetition
28
when do you give alteplase with stroke
ischaemic stroke less than 3 hours (up to 4.5)
29
explain the presentation of steroid myopathy
symmetrical proximal weakness
30
treatment of falciparum malaria
artesunate combinations or malarone | ADMISSION
31
which movements of the hip are limited in OA of the hip
extension abduction internal rotation
32
clinical presentation of tyhpoid
fever | bloody diarrhoea or constipation
33
treatment and prevention of cluster headache
Rx - oxygen or triptans | prevention - CCB
34
treatment and prevention of tumour lysis syndrome
prevention - hydration and allopurinol started 24 hours prior to chemo treatment - haemodialysis if in renal failure
35
Strep bovis is associated with
colorectal cancer
36
where is Wernicke's area
posterior temporal and parietal lobes
37
clinical presentation of motor neuron disease
mixture of UMN and LMN signs with NO SENSORY changes
38
why don't you give radiotherapy for colon cancer
bowel moves too much
39
indications for home oxygen
PaO2 less than 50mmHg or less than 60mmHg if signs of RHF or high Hct
40
acute and longer term management of hyercalcaemia due to malignancy
acute - saline + calcitonin | longer - bisphosphonates
41
treatment of immune thrombocytopaenia
prednisolone and IVIg | 2nd line = splenectomy
42
what causes the severe complications of Plasmodium falciparum
endothelial adherence of infected RBCs
43
highest risk areas for malaria
Sub-Saharn Africa Papua New Guinea Soloman Islands
44
what are 3 specific physical signs for Grave's disease
thyroid acropatchy proptosis pre-tibial myxoedema

Z MD 2 (15 decks)

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