Part 2 Flashcards
(588 cards)
1
Q
Brucellosis tx
A
Doxy and rifampicin 6 weeks
2
Q
Wellens syndrome ECG
A
T wave inversion or biphasic T waves V2-V3
3
Q
Wellens syndrome significance
A
Critical LAD stenosis
4
Q
Wellens syndrome treatment
A
Tx as STEMI
5
Q
Scleroderma renal crisis tx
A
ACEi Dialysis/transplant
6
Q
Bleeding with prolonged APPT
A
VWD
7
Q
Drug to bring out Brugada ECG changes
A
Flecanide
8
Q
Whipples disease features
A
*Diarrhoea* *Arthralgia* Neuro sx Skin pigmentation/photosensitivity Middle aged men
9
Q
Chest pain <48hr after MI
A
Pericarditis
10
Q
Diarrhoea + low B12 + high folate
A
SBBO
11
Q
Temp post Blood transfusion (TRALI or TACO)
A
TRALI
12
Q
Blood products more commonly causing TRALI
A
FFP/platelets
13
Q
What is Plummer Vinson syndrome
A
Esophageal webs Dysphagia IDA
14
Q
Liver cirrhosis + previously lived abroad
A
Schistosomiasis
15
Q
Tx for HUS
A
Supportive Plasma exchange Ecuzilumab
16
Q
What is Nijmegen questionnaire for?
A
hyperventilation syndrome
17
Q
How to adjust NIV to get rid of more CO2?
A
Increase IPAP
18
Q
How to adjust NIV to improve oxygenaton?
A
Increase EPAP or 02
19
Q
What is carcinoid syndrome
A
Tumour secreting serotonin
20
Q
Features of carcinoid syndrome
A
Valve disease (P or T) Right sided heart failure Chronic diarrhoea Flushing Hypotension
21
Q
Ix for carcinoid syndrome
A
urinary 5-HIAA plasma chromogranin A y
22
Q
Tx for HTN in pregnancy
A
labetalol
23
Q
Fasting BM of >7 in pregnancy management
A
Insulin Aspirin
24
Q
Esinophilia - Churg Strauss or Wegners?
A
Churg Strauss - esinophilia with polyangitis
25
TB drug causing arthalgia
Pyrazinamide
26
MI + CCF - what drugs do you need to be on?
ACEi beta blocker statin mineralocorticoid receptor antagonist (e.g. eplenerone)
27
Kleinfelters + can’t smell
Kallmans
28
Anaemia and gallstones =?condition
Hereditary spherocytosis
29
Tx Q fever
Doxycycline
30
Farmer, fever, transamenitis
Q fever
31
Tx botulism
Trivalent antitoxin
32
Muscle weakness “Endomysial lymphocytic infiltrates that invade nonnecrotic muscle fibres”
Polymyositis
33
Muscle weakness “Perimysial inflammation of lymphocytes and parafascicular atrophy “
Dermatomyositis
34
Lupus + loin pain + haematuria
Renal vein thrombosis
35
Drugs causing DRESS syndrome
Anti epileptics Allopurinol Chemo
36
Features of DRESS syndrome
(Drug Reaction With Esinophilia and Systemic Symptoms)
Widespread rash
Fever
High lymphocytes
Esinophils
37
Malignant MCA syndrome
Young people have MCA infarct then bleed out, get raised ICP, drop GCS, need craniotomy
38
How do you calculate anion gap?
Sodium - (bicarb + chloride)
39
Normal anion gap
8-12
40
Poisoning causing acidosis and raised anion gap
glycols methanol oxoproline lactate ketones aspirin,
41
Ix to diagnose MG?
Single fibre EMG
42
Dementia with fluctuating cognition
Lewy Body
43
1st line tx RA
Methotrexate and pred
44
Cluster headache frequency, duration
1 every other day - 8x day last 15-180 minutes
45
Paroxysmal hemicrania
\>5x/day respond absolutely to indomethacin
46
Hemicrania continua
continuous headache like cluster but never lets but responds to indomethacin
47
How to reduce eye complications in methanol poisoning
Folinic acid
48
HIV neuro symptoms headache CSF India ink positive
Cryptococcal meningitis
49
Tx for cryptococcal meningitis
amphotericin B & flucytosine
50
Non caseating granulomas (on bronch)
Sarcoid
51
Africa + itchy skin + asthma
strongyloides
52
Strongyloides tx
Ivermeticin
53
Ank spond features (As)
Apical fibrosis Anterior uveitis Aortic regurgitation Achilles tendonitis AV node block Amyloidosis
54
POEMS syndrome
paraneoplastic polyneuropathy, organomegaly, endocrinopathy, M-protein band from a plasmocytoma, and skin pigmentation
55
Young people presenting with PVD symptoms but no vascular risk factors, possibly affecting upper limbs
Thrombophlebitis obliterans
56
"yellow-green colour under Woods lamp"
Pityriasis versicolour
57
Valproate + high ammonia + impaired GCS
valproate-associated hyperammonaemic encephalopathy (VHE)
58
Homozygous FH presentation age
\<30
59
Heterozygous FH presentation age
\>30
60
Jarisch-Herxheimer reaction
syphilis - get fever, rash and tachycardia after B abX started
61
How to diagnose DeQuervains thyroidits
thyroid scintigraphy globally reduced uptake of iodine-131
62
1st line treatment for T2DM w new HTN (regardless of age or race)
ACEi
63
Monitoring for primary hyperparathyroidism
DEXA 1-2 years U+Es Ca2+
64
Angiod retinal streaks
Ehler Danos
65
Aquaporin-4 +ve
Neuromyelitis optica
66
Polymorphic eruption of pregnancy vs Pemphigoid gestationis
PEP - last trimester PG blisters, often starts around umbilicus
67
Limbic Encephalitis antibody
NMDA
68
Test for SBBO
jejeunal aspirate
69
Councilman antibodies
Yellow fever
70
Features of severe malaria
hypoglycaemia acidosis coma convulsions severe anaemia pulmonary oedema
71
When to Ix anaemia in dialysis
Hb \<110 or sx of anaemia
72
Blood test for auto immune pancreatitis
IgG4
73
Tx for high output stoma not responding to loperamide
Ocreotide
74
Antibodies for MG
Anti ACh Anti MUSK
75
Cause of low TSH and low T4 (secondary hypothyroidism)
Pituitary failure
76
How to diagnose acromegaly
Oral glucose tolerance test, IGF, growth hormone
77
Anti epileptic to avoid in absence seizures and juvenile epilepsy
Carbemazepine
78
Medication for cystine renal stones
D pencillamine
79
HIV med causing psychosis in toxicity
Efavirenz
80
Spirometry measurement for GBS
FVC
81
Medication prophylaxis for altitude sickness
Acetozolamide
82
What type of RTA is nephrocalcinosis
1
83
Migraine prophylaxis for child bearing
Propanolol
84
Definition of bisphosphonate failure
two or more fractures on treatment, or one fracture with a reduction in bone density
85
Treatment of hyperthyroidism in pregnancy
Propilthyrourcil in early pregnancy
Carbimazole in late pregnancy
86
Hypokalaemia + low urine calcium
Gittlemans
87
Missipissi
Histoplasmosis
88
Prolonged high aldosterone on standing
Adrenal hyperplasia
89
PD meds causing loss of control/impulse disorders
Pamiprexole
90
Tx for peritonitis from dialysis
intraperitoneal vanc and gent
91
Goodpastures treatment
Pred, cyclophosphamide, plasmapheresis
92
Dextrocardia ECG findings
inverted P wave in lead I, right axis deviation, and loss of R wave progression
93
R waves in V1-2 MI location
posterior
94
Tx prosethtic valve replacement IE
IV vancomycin + rifampicin + low-dose gentamicin
95
Most common cause of canon ball mets
Renal cell carcinoma
96
Acute 3rd nerve palsy
Posterior communicating artery aneurysm
97
ABx you cant give with methotrexate
Trimethoprim/ Co-trimoxazole
98
Ferritin target in CKD
\>200
99
Malodorous sweat infection
Brucellosis
100
Tx for VTE if 7 days pre op
IVC filter and LMWH
101
Hypokalaemia + renal stones
RTA 1
102
Baseline test before starting natalizumab
JCV antibody (otherwise can cause progressive multifocal leukoencephalopathy)
103
Anaemia, weight loss, lymphadenopathy post transplant
EBV
104
Antibody test for drug induced lupus
Anti histone antibodies
105
Heinz bodies
GP6D
106
Underlying condition/deficiency leading to warfarin induced necrosis
Protein C deficiency
107
Vitamin D \<30
loading dose
108
Vitamin 30-50
maintenance dose
109
Osteomalacia + Hypokalaemia = RTA?
RTA 2
110
Tx for prognosis pulmonary fibrosis
carbon monoxide transfer factor
111
Auer Rods
Acute Promyelitic Leukaemia
112
Leopard print rash
Oncheriasis
113
Tx crusted scabies
Ivermectin
114
Monitoring for acromegaly tx
Insulin like growth factor
115
Meds to avoid with cocaine
beta blockers
116
No vaccinations + fever + rash + pancytopaenia
Parvovirus B19
117
Hepatitis + ANA +ve + Anti smooth muscle +ve + raised IgG
Type 1 auto immune hepatitis
118
Hepatitis + LKM1 + only kids
Type 2 auto immune hepatits
119
young + episodes of tachycardia + short PR
Lown–Ganong–Levine syndrome
120
Most common inherited thrombophilia
Factor V Leiden
121
Tx for anti GBM/Goodpastures
Methylpred Cyclophosphamide Plasma exchange
122
Amiodarone induced thyrotoxicosis with goitre
ie increased blood flow on thyroid doppler
Type 1
123
Amiodarone induced thyrotoxicosis without goitre
ie reduced blood flow on thyroid doppler
Type 2
Tx with steroids
124
Tx for AIT Type 1 (goitre/ increased blood flow on doppler)
carbimazole/potassium perchlorate
125
Tx for AIT Type 2 (no goitre/ decreased blood flow on doppler)
Steroids
126
Tx for salmonella gastroenteritis
If immunosuopressed/over \>50/ valve disease - cipro
127
Most common electrolyte abnormality in alcohol withdrawal
Hypophosphataemia
128
ECG features of HCOM
ST depression Deep T wave inversion LVH
129
ECG features of LVH
Deep S waves V1, V2 and tall R waves V5, V6
130
Fitz Hugh Curtis syndrome
PID causing perihepatic adhesions, RUQ pain worse on breathing
131
Cut off for carotid stenosis
\>70%, or 50-69% if symptomatic
132
Tx for myexedemic coma
Levothyroxine, liothyronine
133
Tx of sodium valproate overdose
L-cartinine
134
Bleeding cut off for LP pre thrombolysis
7 days
135
Bleeding cut off for stroke/head injury pre thrombolysis
3 months
136
Bleeding cut off for GI bleed pre thrombolysis
3 weeks
137
NAFLD vs ALFD LFTS
NAFLD ALT \> AST
138
Cirrhosis HCC screening
USS and AFP every 6 months
139
Hyper IgM syndrome
PCP, hepatitis, diarrhoea
140
Cancer TTF 1 positive
Lung cancer - NSCLC, adenocarcinomas Thyroid cancer
141
Lacunar infarct presentation
Unilateral weakness or pure sensory stroke or ataxic hemiparesis
142
Posterior circulation infarct
cerebellar/brainstem syndrome or LOC or isolated homonymous hemianopia
143
Tx of NADH methaemoglobinaemia reductase deficiency
Ascorbic acid
144
Isolation for active millary TB
negative pressure isolation
145
Anti epileptic causing pancreatitis
Sodium valproate
146
Tx of ethylene glycol toxicity
Fomepizole Alcohol Sodium bicarb
147
Histoplasmosis tx
Itraconazole
148
Tx for Kallmans infertility/ low FSH +LH
Pulsed GNRh
149
Oculocutaneous albinism Type 1
Light everything
150
Oculocutaneous albinism Type 3
Reddish hair, blue eyes
151
Ascites with raised SAAG
related to portal hypertension eg portal vein thrombosis
152
Cause of hyperglycaemia in malignancy
PTH-RP
153
HIV med causing fat redistribution/diabetes
Stavudine
154
Anti malarial worsening psoriasis
Chloroquinine
155
Vitamin tx in Acute Promyletic Leukaemia DIC
Vitamin A/ ATRA
156
Coeliac ---\> weight loss, night sweats, raised viscocity
Enteropathy associated T cell lymphoma
157
Abx causing obstructive jaundice
Co-amoxiclav
158
Abx interacting with theophyline
Erythromycin
159
Features of cyanide poisoning
HTN and bradycardia Then hypotension, coma, SOB, abdo pain
160
Receptor involved with familial hypercholesterolaemia
LDL receptor
161
Clicking sound synchronous with heart sounds
Left apical pneumothorax
162
Organism causing endocarditis in farmers
Coxiella (can be culture negative)
163
T score for osteoporosis
less than -2.5 at hip or spine or less -1.5 if on steroids
164
Tick bite in: Massechuteses Long Island Marthas Vineyard Nantucket NY
Babeosis
165
Diabetes med worsening heart failure
Glitazone
166
Sepsis with black skin lesions
Echythma gangrenosum from pseudomonas auerginosa infection
167
Which part of the kidney does gent damage
Proximal tubule
168
Tx for lewy body dementia
Acetyl cholinesterase inhibitors eg Rivastigamine
169
Flagellate protazoa in stool
Giardia
170
Pneumonia w +ve Coombs test
Mycoplasma
171
Tx for mycoplasma pneumonia
Clarithromycin
172
Tx for calcium channel blocker overdose
IV Calcium chloride then insulin dex
173
Tx for low fibrinogen
Cryopreciptate or FFP
174
STI with multiple painful ulcers and flu like sx
Herpes simplex
175
Tx for long QT
Beta blocker
176
Tx for meningococcal mengiitis
IV cef
177
Tx for Dressler syndrome
Aspirin 650mg QDS
178
Restrictive lung disease with reduced KCO (transfer factor)
Sarcoidosis
179
Worms causing GI bleeding
N americanus Ancylostoma duodenale
180
HIV Itchy rash CD4 \<300
Eosinophilic folliculitis
181
Tx for crytosporidium (ooyst cysts)
Nitazoxinide
182
Tx for well Mobitz I
Nothing
183
Tx for Mobitz II
Pacemaker
184
Vasculitis PR3 +ve
Granulomatosis with polyangitis
185
Foreign travel reduced ET walking barefoot abdo and chest sx IDA
Hookworm
186
Hyperviscocity syndrome features
Ax with waldenstroms or multiple myeloma Triad : bleeding gums + visual changes + neurological sx
187
Type 1 HIIT
48hr-72hr platelets stay \>100 no tx needed
188
Type 2 HIIT
5-10 days platelets drop to \<100 Needs tx with danapuroid, lepirudin, argobatran
189
How does amlodipine OD cause hypotension and tachycardia (mechanism)?
L type calcium channel blockade
190
Post MI 5-10 days New murmur pansystolic LSE SOB/pulmonary edema/hypotension
VSD
191
Sx of aspirin OD
tinnitus, vomiting, hyperventilation
192
Poor school perfomance then seizures and visual deterioration then unresponsiveness/rigidity
Subacute sclerosing panecephalitis (from measles)
193
Diagnostic test for groin ringworn (tinea cruris)
KOH-treated skin scrapings
194
Low Hb Low platelets High PPT Low fibrinogen Shistocytes
DIC
195
ST elevation in I and AVL - MI location
High lateral wall MI
196
Greyish skin pigmentation
Haemochromatosis
197
Tx for strongyloides
Ivermectin
198
Fractures Precocious puberty Cafe au lait
McCune Albright Syndrome
199
Tx for raised INR warafin if really unwell/risk of major bleed
Prothrombin complex (beriplex)
200
Deteriorating vision Pins and needles Muscle weakness Hx of autoimmune
hypoparathyroidism (with secondary cataracts)
201
Legionella rather than mycoplasma
Flu like sx Haemoptysis GI sx Middle aged Office/air con Hyponatraemia
202
Mycoplasma rather than Legionella
Rash Younger 2w prodrome Can have normal white cells Neuro Haemolytic anaemia
203
Surveillance for HNPCC
Colonoscopy every 2 years until 40
204
Primary hyperparathyroidism
High PTH causes high Calcium and low phosphate
205
Secondary Hyperparathyroidism
Chronic renal failure causes low calcium and high phosphate
206
Tertiary hyperparathyroidism
Have secondary for ages , so high PTH, high calcium
207
"wood grain" rash
Erythema gyratum repens EGR paraneoplastic, usually from lung ca SCC Bronchus
208
Lymphocytic meningitis differentials
TB or crytpococcal
209
Ix for cryptococcal meningitis
India Ink stain CSF
210
Tx for latent TB in HIV on HAART
Isoniazid for 6-9 months
211
Drusens spots in young person
Malattia levantinese Auto dom No tx
212
Raised congugated billirubin Normal haptoglobins Dark granule hepatocytes
Dubin Johnson sydrome
213
"Onion skin" periductal fibrosis liver biopsy
PSC
214
Lung cancer causing hypercalcaemia
SCC
215
Lutembacher syndrome
mitral stenosis ASD presents as AF and fatigue in 40s
216
Olaparib MOA
poly ADP ribsome inhibitor PARP
217
Tx of lithium toxicity
Haemodialysis
218
HIV LRTI + visual change/GCS change/deranged LFTS
CMV pneumonitis
219
Haematuria after cyclophosphamide
Bladder ca
220
Foreign travel + lymphedema + eosinophilia + rash
Lioasis
221
Mildly elevated urinary cortisol/early morning post low dose dex cortisol
Pseudo cushings
222
Haemochromatosis + joint pain
Pseudogout/ pyrophosphate arthropathy
223
Tx for listeria meningitis
Ampicillin and gent
224
Tx for pen allergic meningitis
Chloramphenicol
225
Tx for protein C deficiency
Lifelong NOAC
226
ST depression V1-4 which artery?
Right circumflex
227
MOA Entacevir
Nucleoside analogue
228
Tx for bronchopulmonary aspergillosis
Steroids and itraconzole
229
Abx to avoid to ciclosporin
Erythromycin/ clarithromycin
230
Monitoring/management for asymptomatic aortic regurgitation
Yearly echo
231
CD4 cut off for likely PCP
200
232
Drug causing red man syndrome
Vanc
233
Tx red man syndrome
Topical steroid
234
Kallmans MRI findings
absent olfactory bulbs
235
fever myalgia v unwell new york
West Nile disease
236
"brown coloured rash on shins" =
pretibial myexedema
237
Nocardia asteroides
Sulphadiazine
238
Lofgrens syndrome
Acute sarcoidosis
239
Lofflers syndrome
Esinophil collection in lungs from parasite
240
Iron test for haemochromatosis
Transferrin saturation
241
Tx for hepatorenal syndrome
Terlipressin
242
Tx for diarrhoea in bile acid malabsorption
Cholestyramine
243
How does rifaximin reduce hepatic encephalopathy
Decreases ammonia production
244
Colon IE bugs
strep bovis bacteroides fragiles
245
Gardners syndrome
Tumours: bone, soft tissue, colon
246
Focal consolidation in HIV organism
Strep pneumoniae
247
Diffuse consoldation in HIV organism
PCP
248
Tx for bleeding/hyperviscocity in Waldenstroms
Plasmapheresis
249
TRAL antibody mediation
Anti HLA or Anti granulocyte
250
Mucupurulent cervical discharge
Chlamydia
251
Cardioversion for AF if young well and no IHD
IV Flecanide
252
Tx for syphilis in pen allergy
Doxy
253
Migraine with aura stroke like sx Family hx migraine and early dementia No Vascular risk factors
CADASIL
254
HLA for chinese patient taking phenytoin
HLA B5102
255
Bright enlarged liver on USS Raised transaminases No ETOH
NASH
256
Tx for PCP if pen allergic
Pentamidine nebs Clindamycin + pramaquine + pred
257
mass in epigastrium + hard palpable liver
gastric carcinoma
258
What type of renal stones do patients with small bowel syndrome get?
Oxalate
259
Abdo pain seizures worsening w epileptics neuropathy (mimicking GBS) Low sodium
Acute intermittent porphyria
260
Tx for acute intermittent porphyria
IV 5% dex saline High carb meal
261
Polyglandular syndrome Type 1
2 or more of: Hypoparathyroidism Adrenal insufficiency Mucutocutaeous candidia Hypothyroidism Hypogonadism
262
Polyglandular syndrome Type 2
Type 1 diabetes Hypothyroidism Primary adrenal failure
263
Tx for adrenal cortical carcinoma
Mitotane
264
Tx for legionella
Azithromycin
265
ABx causing blue black pigmentation
Minocycline
266
Tx for flare of minimal change disease
Steroids
267
Primary versus secondary pulmonary hypertension
Secondary is due to pulmonary fibrosis
268
Nuclear pleomorphism and absent mitoses
Bronchial carcinoid
269
Tx for absence seizures
Sodium valproate
270
Diabetes with proximal pain and weakness femoral nerve
Diabetic amyotrophy
271
272
Tx for TTP
Plasmapharesis
273
Features of chagas
VTE
Mega esophagus
Conduction defects eg BBB
274
Mechanism of AIHA with CLL
Autoreactive T cell induction
275
Mullerans cells
Ovarian ca
276
Drug for diabetic retinopathy
Ranibizumab
277
Cause of negative Mantoux in TB
HIV
278
Causes of torsades
Prolongd QT, AF
Low Mg, Low K, Low Ca2+
Female
Alkalosis
Macrolides, digoxin, sotalol
279
Tx for VTE in Factor V Leiden
Anticoagulants at least 3 months
280
Anticoagulation for x2 provoked VTE
6 months
281
282
Necrobiosis lipidecta
Tx with topical steroids
283
?
Retinal vein occlusion
| (disc swelling, haemorrhages)
284
?
Retinal artery occlusion
285
?
Optic nerve atrophy
286
Papilloedema
287
Malignant Hypertension
haemorrhages
cotton wool spoots
optic disc swelling
288
Diabetic retinopathy
289
Proliferative retinopathy
290
AVRNT
Pseudo R waves V1
291
Chest complication of severe pancreatitis, v unwell
ARDS
292
When is cardiac resynchronisation therapy indicated?
Max dose of meds including Ivabradine
Ventricular dys-synchrony eg LBBB/broad QRS
293
Features and management of Bells Palsy
NO FOREHEAD SPARING
Tx - steroids and eye taping
294
Tx for malignant hypertension/hypertensive encephalopathy
Sodium nitroprusside
295
296
Test to differentiate ?pleural plaques vs ?mesothelioma
Pleural biopsy (thorascopy)
297
Thoracoplasty
rib resection + loss of lung volume
298
Risk factors for mesothelioma
Abestos
Radiation exposure
(smoking increases risk of abestosis causing mesothelioma but doesn't cause mesothelioma in itself)
299
Ventilator settings indicated in ARDS
| (PEEP, TV and RR)
High PEEP
Low tidal volume
RR up to 35
300
Travel to Turkey
Deranged LFTs
Hepatitis A
301
Hair loss
White patches on mouth and vulva
Lichen planopilaris
302
Features of WPW (short PR, delta wave)
Surigcal heart repair in childhood
+- collapse
+- palpitations
Ebsteins anomaly
303
Rash over cheeks, chest, back of hands
SOB, chest crackles
Muscle weakness
Dermatomyositis
| (Crackles are ILD)
304
Abx for CSF leak meningitis (ie Staph aureus meningitis)
IV linezolid
305
Tx for methotrexate overdose
Calcium folinate
(By passes step folate metabollism step blocked by methotrexate)
306
Response to desmopression test in cranial DI
urine osmolality should improve to \>660
307
Farmer
Liver cysts/heptomegaly
+- pleural effusion
Deranged LFTs
Eosinophilia
(Dx, Ix, Tx)
Hydatid disease
Dx with ELISA testing for echinococcus
Tx with albendazole +- surgical excision
308
Management of obstetric cholestasis
Ursodeocyholic acid for sx, rifampicin
If term - deliver baby
309
Dx and Rx
common in IBD
Pyoderma gangrenosum
1st line - topical steroids
2nd line - topical DMARD eg tacrolimus
3rd line - systemic biological eg Infliximab
310
Nodular face lesion, sun exposure, most common
BCC
311
When to stop NAC
INR \<1.3
ALT \<60/twice upper limit normal
312
Prognostic markers for myeloma
B2 microglobulin
Albumin
CA FISH
LDH
313
Diagnosis and management
Severe atopic eczema
1st line - topical steroids
2nd line - topical calcineurin inhibitors eg tacrolimus
314
Tx for severe psoriasis
Methotrexate
315
Tx for MODY
Sulphonylureas initially (eg gliclazide)
Probably needs insulin later
316
CKD or recent contrast scan
Skin tightening
"Woody plaques"
Pulmonary fibrosis/ cardiomyopathy/ pulmonary HTN
317
Intermittent wheeze, flushing and diarrhoea
Carcinoid syndrome
Ix urinary HIAA
318
Knuckles, trunk
Diseemenated granuloma annulaire
Lymphoma/HIV
Should resolve over years, otherwise systemic immunosuppression/HAART
319
Tx for aspirin OD
Activated charcoal
Correction of K+
Urinary alkylisation
320
Leukaemia
High lymphocytes
abberhent expression of T-cell marker CD5
CLL
321
Problems releasing grip/ opening closely eyes quickly
Distal weakness
Inherited
Worse in cold weather
Myotonic dystrophy Type 1
322
Meningitis
Lymphocytic pleocytosis
Ependymal enhacement MRI
CSF: raised protein, low glucose, clear
CMV meningoencephalitis
323
Bartter Vs Gitelman
Both cause hypokalaemia
**Bartters** presents **profound hypotension childhood**,
Gitelman young adults
Gitelman has reduced urinary calcium excretion
324
Skin abcesses/other infection
Descending paralysis
Bilateral ptsosis
Hypoventilating
Botulism
325
Indications for specialist liver referral in paracetamol OD
pH \<7.3
PT \>100
Cr \>300
Hepatic encephalopathy III or IV
326
Sudan black +ve
Myeloperoxidase +ve
Auer rods
Non specific esterase ++
Acute monocytotic leukaemia
327
Jamaican
Skin nodules
Ulcers
VRDL +ve
Yaws
328
Chest infection and hepatomegaly from Sri Lanka
(diagnosis and tx)
Amboeiasis - entamoeba histoltyca
Tx with co-amoxiclav, clarithromycin, metronidazole
329
Vocalisation episodes
Worse at night
Mild post ictal phase
Frontal lobe seizures
330
Melanosis coli on colonoscopy
Laxative abuse
Senna abuse
331
Congenital adrenal hyperplasia
enzyme/test
21 hydroxylase deficiency
(also 17 alpha hydroxylase but much less common)
332
IgA nephropathy (ie mesangioproliferative glomeluronephritis) vs post strep glomeurlonephritis
IgA is within 2-3 days of sore throat
Post strep is weeks after
333
Goodpastures treatment
High dose pred and cyclophosphamide
334
Edema
Asthma
Eosinophils
Deteriorating renal function
Esinophilic granulomatosis with polyangitis
pANCA +ve
Tx IV steroids
+- biologics
335
Best indicator of severity of liver failure in paracetamol OD
PT
336
Chronic inflammatory condition
+hepatosplenomegaly
+malabsorption
+cardiac disease
+proteinuria
+waxy skin plaques
Amyloidosis
337
Pink skin papules
+travel Asia
+ abdo pain
+headache
+GI upset
Typhoid
Tx with cef
338
Breast Ca drug causing heart failure
Trastuzumab
339
Hypokalaemia
U waves
340
"Hot and dry skin"
OD
widened QRS
dilated pupils
TCA
341
Features of amiodaraone toxicity lungs
B/L infiltrates
Pneumonitis
Pleural effusion
Pleuritic chest pain
Cough
Pulmonary fibrosis
342
Pericardial calcification
eg constrictive pericarditis
343
"High intensity echo signal around the heart"
on echo
Constrictive pericarditis
344
Meningitis:
young well person
elevated CSF pressure
high lympocytes
slightly high protein
Viral meningitis
345
Where is the lesion:
- reduced sensation all 3 branches of trigeminal
- Lateral rectuc is paretic
Left petrous temporal
e.g schwannoma, meningioma, mets, nasophryngeal carcinoma
346
Anterolateral MI vessel
LAD + circumflex
347
Diagnostic test for CJD
RT1uIC and 14.3.3 protein analysis in CSF
348
Drugs worsening psoriasis
Lithium, anti malarials, NSAIDs, beta blockers
349
Tx for neuroleptic malignant syndrome
Aggressive IV fluids (for rhabdo)
Bromocriptine/dantrolene can be used but not much evidence
350
renal failure w chest sx
"cresenteric glomerulonephritis with IgG staining on immunofluorescence"
anti GBM
351
Young person
seizures after waking/myoclonic jerks in the morning
+- generalised seizures
+- absence seizures
Juvenile myoclonic epilepsy
352
Erectile dysfunction
Tremor
Rigidity
Incomplete voiding
Ataxia
Multi systems atrophy
(if mentions erectile dysfunction, postrual hypotension, urinary frequency or urgency etc - MSA)
Plus parkinsonian symptoms that don't respond well to tx
353
LBBB
(M shaped QRS in aVL, notched R lead I, monophasic R wave V6)
354
Tx for Lambert Eaton Syndrome
3, 4-diaminopyridine
355
356
How to diagnosis for IgA nephropathy
Renal biopsy
(blood levels IgA will be raised but are non specific)
357
What type of creature spread Dengue?
Aedes mosquito
358
Fever
Macular rash
"bone breaking" muscle and joint pain
Worst headache ever
Vomiting
Travel
Dengue
359
Post pancreatitis:
Abdo pain
Mass
Fever
Persistently raised amylase
Pancreatitic pseudocyst
360
How do you diagnosis Whipples disease?
Jejunal biopsy
shows macrophages +ve PAS (periodic acid schiff staining)
361
Pale conjunctivae
Blue lines on gums
(Dx and Tx)
Lead poisoning
Dimercaptosuccinic acid
362
Erythema nodosum
Painful, red tender nodules
Ax with throat infections, sarcoid, IBD TB, leprosy
363
Tx for bifasicular block with pauses
PPM
364
STI with rash on soles of feet
Keratoderma Blennorrhagcia
Ax with chlamydia
(often ax with reiters syndrome)
365
Increase in total T3/ T4
Normal free hormones
Pregnancy
366
Gastric ulcer
367
Tx for carbon monixde poisoning
100% O2
can consider hyperbaric O2
ventilation only if comatose
368
Ataxia
Deafness
Epilepsy
DM
Eye movement problems
Maternal inheritance
Mitochondrial disorder
369
Live vaccines
Mumps/MMR
BCG
Typhoid
Yellow Fever
Chicken pox
370
Recommended vaccines for HIV
Pneumococcal
Flu
Hep A, Hep B
371
Management of Barrets
Low grade dysplasia - repeat OGD 6 months
High grade dysplasia - consider endoscopic ablation therapy
372
Management of Melanoma
Exicison with at least 1cm margin
373
Abdo pain
Ascites
Hepatomegaly
Prolonged PTT
Budd Chiari
| (from clot from lupus)
374
Veil sign
Loss of left heart border
Left sign white than right
Shows LUL collapse
375
Tx and prophylaxis of cluster headaches
Tx - high flow O2 and triptans
Prophylaxis - verapamil
376
Drug tx for prolactinoma
Bromocriptine
| (can also use ropinerole)
377
Tx for depression with psychotic features in PD
Clozapine
378
Treatment for premature ventricular ectopics
Beta blockers
379
Precordial heave
Wide split second heart sound
Pulmonary flow murmur
RBBB
Prominent pulmonary arteries
ASD
Needs echo and right heart catherisation ?suitable for closure
380
MEN I
3 P's
Parathyroid
Pituitary
Pancreatic
381
MEN IIA
2 P's, 1 M
Phaechromocytoma
Parathyroid
Medullary thyroid cancer
382
MEN IIB
Medullary Thyroid Cancer
Phaeochromocytoma
Marfans/neuromas
383
Management when unable to wean steroids after 12 months PMR
Add tocluzimab
384
Cancers ax dermatomyositis
Bronchial carcinoma
Esophageal carcinoma
385
Tx for Crohns flare in pregnancy
Steroids
386
How to differentiate between Progressive multi focal leukoencephalopathy and HIV encephalopathy
PML will be JC virus +ve
387
How do you differentiate between cervical myelopathy and MND
Cervical will have primarily sensory sx, MND sensation is intact
388
Buccal pigmentation - suggests adrenal insufficiency/Addisons
389
"absent erythropoesis" on bone marrow
Pure red call aplasia
390
Intrahepatic cholestasis of pregnancy Vs Acute fatty liver of pregnancy
Cholestasis: v high ALP (obstructive LFTS), **prolonged PT**, malaise, pruritis
AFLP: all transaminases raised, more **unwell** - abdo pain, encephalopathy, DIC, **raised WCC**
391
What counts as a positive Schirmers test?
\<5mm wetting per 5 mins
392
Diabetic
Worsening glycaemic control
weight loss
Loose stools
Pruritis skin rash
Glucagonoma syndrome
393
Features of glucagonoma syndrome
| (4 Ds)
Dermatitis (necrolytic migratory erythema)
Depression
DVT
Diabetes
394
Which is Epley and Dix Hallpike
Dix Hallpike - diagnostic
Epley - manouevre
395
Young person (usually woman)
Flash pulmonary edema
HTN
Fibromuscular dysplasia
396
Immunoglobulin raised in ABPA
IgE
397
What is fenofibrate for?
Hypertriglyceridaemia
NOT HIGH CHOLESTEROL
398
Name and ax condition
Granuloma annulare
Diabetes
399
Dermatomyositis
Gottrons papules
400
Bug indentified at revision of prosthetic joint but not causing any issues or symptoms
Propionibacterium acnes
401
Initial LOC then recovers, then drops GCS again
Head injury
Extradural haematoma
402
Ventilation settings for COPD
PEEP no more than 12
403
Causes of lymphocytosis meningitis
EBV
TB
404
Weight loss
Night sweats
Haematuria
Variocele
Renal cell carcinoma
405
Features of androgen insensitivity syndrome
Normal external genitalia
No internal female organs
B/L undescended testes which present as BL inguinal hernias few weeks after birth
Absent or reduced pubic hair
XY karyotype
406
RTA 1 features
(all are hyperchloraemic metabollic acidosis)
**Hypokalaemia**
**Nephrocalcinosis**
Hypercalciuria, ax with auto immune
unable to generate acid in distal tubule
407
RTA 2 Features
Ax with Fanconi syndrome, myeloma or acetozolamide/sulfonamides, Wilsons
Increased urinary excretion of: glucose, uric acid, phosphate, amino acids, citrate, calcium, K+, protein
**can't reabsorb bicarb**
causes **osteomalacia**
Tx with citrate and K+ supplementation
408
RTA 4 features
Deficienct aldosterone action on distal tubule
caused by diabetic nephropathy or chronic interstitial nephritis
**_Hyperkalaemia_**
Can be precipitated by ACEi or mineralocorticoid receptor antagonists
409
Failure of ventricular capture
410
Most likely organism for endocarditis in native valve and dental procedure
Strep viridans
411
Deranged LFTs with no/only slight raise in ALP
AMA +ve
(Dx and Tx)
Auto immune hepatitis
Prednisolone
412
Tx for familial transthyretin amyloidosis
Tafamidis
413
Mechanism of promthrombotic state in nephrotic syndrome
Decreased anti thrombin III
| (is lost in urine with the albumin)
414
Left sided abdo pain
bloody diarrhoea
Travel/day care/hostel
(Dx and Tx)
Shigella
Tx with azithro
415
Normal pressure hydrocephalus
416
Failed ventricular capture
(ie pacing spike doesn't transmit to ventricles, pacing spikes without QRS or then with weird broad QRS)
417
"Owl eye" on MRI spine
Spinal infarct
418
Antibody for systemic sclerosis
Anti-scl70
419
Hypoxia + pulmonary edema + pulmonary haemorrhage
Recently ventilated and extubated
Obese/airway obstruction
Blood stained fluid from chest suction
Haemorrhage pulmonary edema
420
Cameroon
Drancunculus (guinea worm)
from unfiltered water
blister with worm track under the skin
421
Esophaegeal malignancy
Similar to achalasia but achalasia would be smooth below narrowing (plus not have red flag sx)
422
Biltaeral hydronephrosis - ureteral dilatation
423
Whats the mechanism of VT in:
a) pacemaker
b) temporary pacing wire
pacemaker - undersensing of atrail and ventricular signals
pacing wire - lead displacement
424
Cirrhosis
425
Tx for Pelvic Inflammatory Disease with chlamydia
IM cef
+
14 days doxy BD
+
14 days metronidazole BD
426
Impaired fasting glucose tolerance definition
6.1-6.9
427
Fasting glucose level diagnostic of diabetes
\>7
428
Impaired glucose tolerance definition
7.8-11.1 after food or 2 hour OGTT
429
Vesitubular schwannoma
430
Tx for diabetic retinopathy
Ranibizumab (anti VEGF)
Focal photocoagulation
431
KUB malignancy causing polymyalgia type syndrome
Renal adenocarcinoma
432
mechanism of ACEi induced angio edema
Increased bradykinin
433
Management for adrenal insufficiency in labour
100mg IV hydrocortisone evey 6 hours
434
Tx for methanol/ethylene glycolFome overdose
Fomepizole
435
Tx for hydatid disease
Albendazole
436
Tx for sx of PBC/hyperbillirubinaemia
1) Ursodeoxycholic acid
2) if end stage disease of pregnant - colestryamine
437
Bullous pemphigoid biopsy findings
Linear IgG deposits at dermal-epidermal junction
438
Pemphigus vulgaris biopIgGsy findings
IgG deposition throughout dermis
439
Hilar mass causing Cushings syndrome
Small cell carcinoma of bronchus
440
Obese
Pitting edema to knee
Erythema
Eczema
Hyperpigmentation medial ankles
Normal pulses
(Dx and Tx)
Stasis dermatitis
Tx with compression bandaging
441
Felty syndrome triad
RA +Splenomegaly +neutropaenia
+anaemia
skin ulcers
leg pigmentation
442
Globally increased uptake, likely Graves
443
Palpitations and preisyncope in myotonic dystrophy
Atrial tachycardia - like pAF
444
Branch retinal vein occlusion - flames are only over one half
445
Bug causing painful cervical lymphadenopathy in HIV
Mycobacterium avium
446
Compression bandaging ABPI cut off
\>0.8 triple layer bandaging
0.5-0.8 lesser bandaging
\<0.5 not suitable
447
HCOM
448
Auer rods
AML
449
Insulinoma
450
Direct antiglobulin test in AIHA
+VE
451
Direct antiglobulin test in G6PD
-ve
452
453
454
Left atrail myxoma
455
Travel (Colombia)
Began as erythematous plaque
Developed into painless ulcer
Cuteanous leishmaniasis
456
Flu like symptoms
Painful thyroid
Hyperthyroidism
Subacute thyroiditis
Don't treat
457
Neuropathic ulcer
Callus edge
Clean base
458
Indications for DigiFab
Haemodynamic instablity
Life threatening arrythmia
K+ \>5
plasma digon \>13
ingestion \>10mg adults or \>4mg kids
recurrent bradycardia
459
Tx for dermatitis herpetiformis
Gluten free diet
Dapsone
Sulfapyridine PO - risks of agranulocytosis
460
Neurofibromatomas features
Cafe au lait spots
axially or inguinal freckles
Neurofibroma
Optic nerve glioma
(2 or more) Iris haemartomas
Sphenoid dysplasia or long bone abnormalities
461
Electrolyte disturbance with cisplatin
Hypomagnesaemia
462
Tx for thyrotoxicosis in pregnancy
Propylthioraci 1st 3 months
Carbimazole after that
463
TB med causing:
confusion
seborrheic dermatitis
stomatisis
peripheral neuropathy
Pyridoxine deficiency from Isoniazid
| (replacement worsens PD symptoms)
464
Cicatrical alopecia
465
Telogen effluvium
Non scarring hair loss due to stress
466
Alopecia areata
Non scarring
pruritis or burning sensation
Broken hairs - exclamation points
467
E HISTOLYTICA TREATMENT
METRONIDAZOLE
468
Delta sign
Saggital sinus thrombosis
469
Multi ring enhancing lesions
Toxoplasmosis
470
Parkinsonism
Postural hypotension
Hallucinations
Low Mood
Lewy Body Dementia
471
Meds then ---\>
worsening renal function
white cells, protein and blood on urine dip
K+ high
eosinophilia
rash
Acute interstitial nephritis
472
Causes of acute interstitial nephritis
Mycoplasma
NSAIDS
Penicillin
Diuretics
Cephalosporins
473
K+ \>5.5 pre renal transplant surgery
Do extra dialsysis
474
Stanford **A** aortic dissection
**A**scending **a**orta
475
Stanford B aortic dissection
Descending aorta
476
What ODs can you use activated charcoal in?
Carbemazipine
Dapsone
Phenobarbital
Digoxin
Theophylline
Quinine
477
Biologics for psoriasis
Etanercept
Infliximab
Adalimumab
Ustekinumab
478
Tumour with:
- raised HCG
- normal AFP
- normal CEA
Testicular choriocarcinoma
479
Painful eye with perilimbal injection
photophobia
pain on eye movement
blurred vision
Anterior uveitis
ax with sarcoid
480
Painful eye with gritty feeling
Episcleritis
481
Painful eye with
severe eye pain which deteriorates with movement, possibly affecting vision
Scleritis
482
Features of theophyline toxicity
Tachycardia
Vomiting
Hypokalaemia
Hyperglycaemia
Mild acidosis
483
Type of hepatitis transferred with unscreened blood transfusions eg Haemophiliiacs from other countries
Hep C
484
Treatment for Lewy Body Dementia
Rivastigmine
485
Bandage for pressure sores
Calcium alginate
Then hydrocolloid
486
Silicosis
487
CKD + pericardial rub
Uraemic pericarditis
Risk of cardiac tamponade
Needs urgent dialysis
488
Mechanism of steroids causing osteoporosis
Alteration of parathyroid hormone
489
Tx of multi focal atrial tachycardia in COPD
Verapamil
490
491
Is MND upper or lower motor neuron?
Both
492
Muscle weakness - **quadriceps** and **finger flexors**
Mild CK rise
Inclusion body myositis
493
Causes of absent ankle reflexes and upgoing plantars
Syringomylia
Fredreichs Ataxia
Conus medullaris
MND
Subacute combined degeneration of the cord
Taboparesis (teriary neurosyphilis)
494
What is sick euthyroid syndrome?
Due to illness
Low T3, T4
Normal TSH
Don't treat will self resolve
495
Subclinical hypo/hyperthyroidism
TSH is off but T4/T3 fine
496
Cat scratch disease
Bartonella
Self resolves or azithro for severe lymphadenopathy
497
Tx for gonorrhea
IM cef
Or Azithro if pen allergic
498
Anti psychotics causing weight gain/T2DM
Olanzapine
Clozapine
499
VIPoma
vasoactive peptide secreting tumour of pancreas
flushing, diarrhoea, hypokalaemia, acidosis
half are malignant
500
Tx for typhoid
Ceftriaxone
501
Rash worse on hands and nipples
Scabies
502
Pearly nodule with overlying telangectasia
BBC
503
Pulsatile tinnitus
X, XI, XII
+- flushing, sweating, headache
paraganglionoma
504
dysphagia woserning as you eat,
improves after regurgitation
pharyngeal pouch
505
Hunter criteria serotonin syndrome
Spontaenous clonus
Inducible clonus with tremor/sweating
Ocular clonus plus agitation or sweating
tremor with **hyperreflexia**
hypertonia and temp \>38
506
Rash after cipro and sun exposure
Phototoxic reaction
507
Campylobacter
508
Sx of vertebral artery dissection
Dizziness, vertigo, nausea
(can be ax with infarct of posterior inferior cerebellar artery)
509
Basilart artery stroke
Locked in syndrome
510
Reticular rash
Gangrene/ulcers/necrosis
VTE
ax w SLE/ Hep C/RA/ Sjorgens
Cryoglobulinaemia
511
Polyarteritis Nodosa
Hep B
Mononeuritis
Weight loss
Livedo reticularis
Renal impairment
512
Giant a waves
Pulmonary/tricupsid stenosis
513
Smudge/smear cells
CLL
514
Blast cells
ALL
515
516
Most common renal disease in adults
Focal segmental glomerulonephritis
517
Overweight
Raised AST, ALT
Normal ALP
Steato hepatitis - NASH or alcoholic
518
Grey/white membranes on tonsils
Diptheria
1st tes is PCR for dipetheria toxin
Then culture and Elek testing
519
520
Freidrichs ataxia
Progressive ataxia
cerebellar ataxia
progressive LL weakness
can have pes cavus/scolisos
eye/hearing problems
521
Tx for RA in pregnancy
Sulphasalazine
2nd line azothioprine
Can give TNF alpha in early pregnancy but not ideal
522
Main ABx to avoid in myasthenia
Gent, clarithromycin. erythromycin
523
Effect of diabetes on cholesterol
Low HDL
High tryglycerides
524
Mediterrean or African
Recent meds (Abx)/food ---\>
Jaundice, abdo pain
**Low Hb**
High LDH
Urobilligen +
**Heinz bodies, Bite cells**
G6PD Deficiency
525
Oculogyric crisis
Dopamine blockade at basal ganglia from eg Metoclopermide
Tx with procyclidine or trihyxphenidyl (benzhexol)
526
Signification of calcified diaphragm
Abestosis
527
Questionnaire for social anxiety
Mini Spin
GAD
528
Tx for restless legs
Pramiprexole
529
Tx for Shigella
Azithro
530
First cardiac marker to be elevated
Myoglobin
531
Rx of keloid scars
1st line - intralesion triamcinolone
2nd line - intra lesional 5 fluorouracil
3rd - radiotherapy and surgery
532
brain met
533
Liddles syndrome
Hypokalaemia metabollic alkalosis
## Footnote
**Hypertension in adolesence**
534
Mononeuritis
Vasuculitis
SOB
**Esinophilia**
**pANCA +ve**
Esinophilic granulomatosis with polyangitis
535
Inclusion bodies on colon biopsy
CMV infection
tx with ganciclovir
536
Trifsacicular block
Needs PPM
537
Meningitis with SIADH
B/L VI nerve palsies
TB
538
INR 5-8 no bleeding
stop warfarin
539
INR \>5 with minor bleeding
IV Vit K
540
INR \> 8 no bleeding
IV vit K PO (IV prep PO)
541
Diarrhoea
immunocomprised
cysts
**Acid fast +ve**
Cryptosporidium
542
Deranged LFTs after high risk sex
Hep B
543
Hormone secreted by MEN parathyroid cancer
Calcitonin
544
Thickened gallbladder and pericholecystic fluid
No gallstones
ITU/burns
Acalculous cholecystitis
545
How to differentiate between hyperaldosteronism due to Conns vs due to fibromusclar dysplasia
Conns has supressed plasma renin
fibromusclar dysplasia has elevated plasma renin
546
Anti MPO +ve
microscopic polyangitis
(or other small vessel vasculitis eg rheuamtoid vasculitis)
547
Lichen planus
548
LIF pain and temp
Diverticulitis
549
Vasculitis with nasal sx
Granulomatosis with polyangitis
550
Succession splash
Gastroparesis
551
Nephropathy improving quickly with steroids
Minimal change
552
Rapidly growing keratotic lesion
Immunosuppressed
Sun exposed area
SCC
Needs excision
553
Pityriasis versicolour
554
Management of CLL
Usually nothing
if; fever, weight loss, night sweat, bone marrow suppresion - can give biologics
555
Bug if meningitis from ear infection
Strep pneumoniae
556
Subarachnoid haemorrhage
557
Extra dural haemorrhage
558
Subdural haemorrhage
559
Meningoma
560
Glioblastoma
561
HSV Encephalitis
562
What does bicalutamide do?
Reduces tumour flare w goserelin
563
How to diagnose sarcoid with BHL
Transbronchial needle aspiration
564
Test for post strep glomerulonephritis
Anti streptolysin O titre
565
Spike and dome renal biopsy
Membranous glomerulonephritis
566
Alternative to eGFR if you're dead muscley
C Cystatin
567
Haematuria in sickle cell
Papillary necrosis
568
Meningitis bacteria if neurosurgery
Staph epidermis
569
Tx for nacrolepsy
Modafinil
570
Tx for nacrolepsy/cataplexy
Oxybate
571
Tx of aortic root dilatation in Marfans
Bets blockers
572
Toxoplasmosis Retinits
573
Retinal detachment
574
AKI + eosinophilia
Acute interstitial nephritis
575
HPOA
NSCLC
Periosteitis
576
Tx for cyanide poissning (polyuerthane)
Dicobalt edetate
577
PR3 +ve
Granulomatosis with polyangitis
578
Erythema multiforme
579
Drusen spots
580
Tx for Wilsons
Trietine
581
Antibody for auto immune hepatitis
Anti smooth muscle
Anti nuclear antibody
582
Tx of hyperparathyroidism in renal disease
Alfacalcidol
Cinacalcet if on dialysis and not fit for surgery
583
Aortic dissection management
Type A (involving ascending aorta) - surgery
Type B - IV labetolol
584
Medicines worsening.causing gallstones
Fenofibrate
585
Tx for organophosphate poisoning
Atropine
Pralidoxime
586
Tx for myasthenia if sx not resolving with pyridostigmine
IV immunoglobulin
587
Treatement threshold of kappa IgG paraprotein in myasthenia
\>30
588
Pressure sore dressing (exudate vs no exudate)
No exduate - hydrocolloid
Exduate - alignate
