Pass med questions Flashcards by Sam Skerritt

Common side effects of amlodipine?

Headache and oedema

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Who should you not use HRT in?

Established heart disease

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First line med management for angina?

Usually beta blocker

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Angina not controlled on beta blocker what can you add?

Calcium channel blocker

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When to consider nitrate in angina?

If mono therapy does not control and other option contraindicated or if cab and bb used and has symptoms but is waiting for revacularisation.

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p450 inducers?

Phenytoin, carbamazepine , rifamp, st johns alcohol phenobarbitone griseofulvin

CRAP GPS

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Holmes adie pupil?

Unilateral sluggish often absent ankle reflexes

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Causes of hypoglycaemia? (EXPLAIN)

E- exogenous drugs
P- pituitary insufficiency
L- liver failure
A- Addison’s
I-islet cell tumours
N- non pancreatic neoplasms

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Rapid correction of hyponatraemia?

Osmotic demyelination

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What is osmium second?

ASD most common 70% ECG RBBB and RAD

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Diabetic nephropathy investigation?

Albumin:creatinine ratio early morning sample. high ratio bad

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SGLT2 inhibitor may cause what infection?

Thrush

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Persistent ST elevation after MI suggestive of?

Left ventricle aneurysm

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Acute management of renal colic meds?

IM Diclofenac

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Brown sequared syndrome symptoms?

Paralysis and proprio loss one side pain and temp loss another. Hemisection on side of paralysis

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Recent ERCP presents with pain?

Pancreatitis

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Abdo pain and distension, vomiting recent cholecystitis?

Gallstone Ileus

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Churg Strauss (eosinophilic polyangitis) related to which autoantibody?

pANCA

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Pioglitazone contraindicated in patients with what?

HF and also bladder cancer

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morning stiffens in proximal limb muscles, polyarthralgia, lethargy, low grad
fever, night sweats and? Blood results?

CK normal ESR >40 PMR diagnosis

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cloudy low glucose, high protein polymorphs in CSF?

Bacterial

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Viral CSF?

Clear or cloudy, 60-80% glucose plasma

normal or raised protein, lymphocytes

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TB CSF?

Cloudy fibrin, Low glucose, high protein, lymphocytes

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Lambert eaton syndrome? Which cancer?

Weakness in proximal arms and legs-worse often neoplastic problems precipitated
Small cell

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Muscle weakness increased strength after use?

Lambert eaton

Muscle fatigue in myasthenia gravis?

Muscle tires after use becomes weaker.

Fatty stool and unwell?

Giardia

Metformin may treat which female condition?

PCOS

Aortic stenosis SAD?

Syncope, angina, exertion

Narrow pulse pressure, absent s2 ?

Aortic stenosis

Parkinson's may cause which skin condition?

Seborrhoeic dermatitis

Female <30 non tender fully mobile breast lump?

Fibroadenoma

Elevated JVP but persistent hypotension despite fluids?

Cardiac tamponade

Post menopausal women oestrogen positive cancer use what?

Anastrozole

Haemochromatosis bloods?

Raised transferrin, and ferritin with low iron binding capacity

Male bronze, impotent?

Haemochromatosis

Aplastic crisis may happen following what in what disease?

Parvo infection in sickle cell

Eosinophillic cast sign of what ?

Tubulointerstitial nephritis

Muscle tone sustained may affect vocal chords FHx?

Essential tremor

Hashimotos thyroiditis symptoms and bloods?

Painless goitre and anti thyroid peroxidase

First line treatment of HTN in diabetes?

Ace inhibitors

Hypokalaemia ecg features?

U waves, small t waves

Bloods in upper GI bleed?

low HB and rise in urea due to breakdown of blood

Phaeocromocytoma HTN treatment?

Phenoxybenzamine

Kidney transplant increased risk which cancer?

SCC

Extradural haematoma features?

Lucid interval often hit to side of head Extra-lentis (lentiform)

Treatment of idiopathic intracranial HTN?

Acetazolomide

Apical fibrosis typical in?

Anklylosing spondylitits

Schobers

<5cm

TNF alpha may activate?

Venous ulceration where?

Above medial malleolus

Mydriatic drops can precipitate?

angle closure glaucoma

Diverticula found where?

Sigmoid usually

Angioedema drug induced cause?

ACEi

Mcmurrays test for what?

meniscal tear

Xray finding on RA?

Loss of joint space, soft tissue, articular osteoporosis, sparing of DIPS

Grossly elevated APTT?

Haemophillia B

Transient elastography uses?

Cirrhosis screening

Night blindness and tunnel vision progressive?

retinitis pigmentosa

True love and witts ?

Diagnose and to treat BPPV?

Dix-hallpike diag | epley to treat

Exerting arm and dizziness and vertigo?

Subclavian steal

Dermatomyositis can cause what lungs which antibody?

Anti jo fibrosis

Compression of optic chasm by what can cause what?

Bitemporal upper hemianopia

AF and which endocrine problem?

Hyperthyroid

ABX for meningitis prophylaxis?

Cipro

Peripheral arterial disease which antiplatelet?

Clopidogrel

Rest pain in foot for >2 weeks or ulceration or gangrene?

Critical ischaemia

Facial rash, raised calcium and lymphadenopathy?

Sarcoid

Antidepressant that may cause retention?

Amitriptyline

Acute flare of crohns treatment?

IV Hydrocortisone for 5 days if not working consider infliximab

02 target in CO poisoning?

100%

Seizure drug causing aplastic anaemia?

Phenytoin

IVDU with back pain?

Consider psoas abscess

Most common type of hodgkins?

Nodular sclerosing

Nail fungal severe?

Terbinafine

When to give LTOT ion COPD?

pa02 <7.3 twice 3 weeks apart or <8 with functional problems polycythaemia or heart failure

urinary antigen for ?

Legionella

Pneumonia with weird signs and rashes?

Mycoplasma

Leptospirosis in who what symptoms?

farmers, vets, sewage workers. Fever flu like symptoms, renal failure, jaundice, - doxy and ben pen

Treat torsades de pointes?

Magnesium for wide polymorphic complex

First line migraine prophylaxis for asthmatic?

Topirimate

Hypothermia can cause...

pancreatitis

Lung cancer most associated with smoking?

SCC

Anti cardioliptin?

Antiphospholipid syndrome

Schistosomiasis associated with?

SCC bladder

Restless legs treatment?

Ropinirole

Tricep reflex?

C7-8

L3 L4 reflex?

Knee 3 4 kick door

Ankle reflex?

S1 S2 buckle shoe?

Gliclazide side effects?

Hypoglycaemia and weight gain

Long term steroid use myopathy?

Proximal

Beta blockers, adenosine and said contra in this disease?

Asthma

Psoriasis exacerbated by?

trauma, alcohol, beta blockers, lithium and ACEi

Pain relief for kidney diseased individuals?

Fentanyl good

Empyema values?

Turbid, pH<7.2 low glucose and raised LDH

Guttate psoriasis may be precipitated by?

Strep throat

Metabolic acidosis, high bicarb and abdo pain?

Mesenteric ischaemia

Malignant otitis externa organism?

Pseudomonas

Organism most likely in bronchiectasis?

Pseudomonas

VSD will cause murmur and where?

Pansystolic loudest left sternal edge

Low platelets, Prolonged bleeding, and APTT plus PT and degradation products?

DIC

When to offer carotid edarterectomy?

>70% occlusion

Chronic alcoholism can cause which electrolyte disturbance?

Hypomagnesaemia

Stable chest pain angina first line investigation?

CT angiogram

When would you consider NIV in COPD patient?

pH 7.25-7.35 also medical management has failed for 60mins but if severe offer anyway

What should FRAX score be greater than to offer a DEXA?

10%

What improvement in post bronchodilator indicates asthma?

>12%

Diurnal peak flow variations % difference asthma?

20%

Signs and symptoms of optic neuritis?

Unilateral decrease in visual acuity over hours or days, red desaturated, pain worse on eye movement, central scotoma

Dilated cardiomyopathy common which group of patients?

Alcoholic

Low sodium and rasied urea points to what cause of AKI?

Pre-renal

Blood tests in primary biliary cholangitis? Treatment?

↑ALP and ↑GGT use cholestyramine

SSRI use and pregnancy?

Avoid

Galactocele?

women who have recently stopped breastfeeding, build up of milk creates a cyst— no systemic signs and painless

What leaking causes subdural haemorrhage?

Bridging veins

Extradural haematoma what has ruptured?

Middle meningeal

Severe hyperglycaemia, dehydration and renal failure and mild/absent ketonuria?

HHS

Otitis media organism?

Haemophillus

Causes of spider naeviua (3)

Liver, Preg, COCP

Most common side for varicocele and problem if on other side?

usually left right can indicate renal tumour

What to check before starting amiodarone?

TFT and LFT

Bloods before methotrexate?

FBC U+E and LFT

Supracondylar fractures of humerus which nerve damaged? Signs?

Ulnar ring and little finger altered sensation

Mid shaft humerus damage which nerve and which sign?

Radial wrist drop

Investigation of haematuria?

Usually cystoscopy

Azathioprine bloods?

thiopurine methyltransferase deficiency

DAS 28?

RA severity

What is the anterior draw test also known as and what does it test?

Lachman tests anterior cruciate

Question mentions indian ink staining ?

Cryptococcus neoformans

Post thyroid stridor?

Remove clips

Pulmonary fibrosis signs?

Clubbing and fine end expiratory crackles

Three resp causes of clubbing?

Fibrosis, CF/Bronchiectasis, malignancy

Solitary hot nodule on thyroid?

Toxic adenoma

ABX when for otitis media?

symptoms >4 days, immunocompromised, younger than 2 with bilateral or with perforation

Endocrine and vitiligo?

Addisons

Causes of lambert eaton mysathenic?

Small cell lung cancer

Strongest indication for thrombolysis in PE?

Hypotension

Knee arthroplasty can cause damage to what and what symptoms?

Common peroneal - dorsiflexion affected

URTI and haematuria?

Usually IgA nepohropathy

Heart failure antiemetic caution?

Cyclizine

Cypropterone acetate prescribed with goserelin why?

Prevent tumour flare as testosterone can ↑ at first

Raindrop skull xray?

Multiple myeloma

When to stop PPI before endoscopy?

2 weeks

What may CLL transform to?

Non Hodgkins

Intracapsular mobile treatment?

Total

Intracapsular not mobile?

Hemiarthro

Trochanteric fracture?

Hip screw

Subtreochanteric fracture?

Intramedullary

Acute glaucoma treatment?

carbonic anhydrsse and betablockers or pilocarpine

Weakness improving after exercise?

Lambert eaton

What can be seen on dry macular degeneration?

Drusen

Sarcoid may cause which skin change?

Erythema nodosum

Reactive arthritis symptoms?

Conjunctivitis Nongonococcal urethritis Asymmetric oligoarthritis Keratoderma blennorrhagicum (less common)

Reactive arthritis usually follows what? Common in who?

HLA-B27 genotype and preceding chlamydial or GI infection. more males

Vitiligo common in what types of disease?

Autoimmune

Fever in well patient post op (24hrs)?

Physiological usually

How to feed post oesophagectomy?

Jejunostomy

Signs of gastic volvulus?

vomiting, pain and failed attempts to pass an NG

Shortened internally rotated leg?

Posterior dislocation of hip

What do you see in acute tubular necrosis, microscope?

Muddy casts

Alternating days fever?

Malaria

Adult maintenance fluids ml/kg?

30ml

Test for addisons?

Short synacthen

Prolactinoma drug treatment?

Bromocriptine

Malignancy associated with acanthosis nigrans?

GI/ gastric

Struvite/staghorn associated with which bacteria?

Proteus

Duct ectasia discharge?

Green

Periductal mastitis in who?

Smokers indurated area

Stage IV retinopathy?

Pappiloedema

Stage III retinopathy?

Cotton woll and flame and blot

Just had influenza and get pneumonia organism?

Staph Aureus

What blood results may suggest myeloma?

Renal failure, anaemia and hypercalcaemia

pH <7.25 COPD?

Invasive vent

Rifampicin side effects?

orange fluids, hepatotoxic

TB drugs causing peripheral neuropathy?

Isoniazid

Pyrazinamide may cause ?

Gout and arthralgia

Optic neuritis TB drug?

Ethambutol

Which drugs stopped after 2 months in TB?

Ethambutol and pyrizinamide

Which drugs continued throughout TB treatment?

Rifampicin and isoniazid

HyPOnatraemic, HyPErkalaemic metabolic acidosis?

Addisons

First line investigation in addisonian crisis?

Look at blood and if K high need ECG

Grey skin drug?

Amiodarone

Open angle glaucoma treatment?

prostaglandin analogue (latanoprost) then beta blocker (timolol)

Optic fisc cupping and loss of vision?

Open angle glaucoma

Tumor lysis syndrome prophylaxis?

Allopurinol

Lymphoma and these bloods high potassium and phosphate with a low calcium ?

Tumour lysis

Haemolytic anaemia provoked by malaria prophylaxis in?

g6pd

Renal transplant and infection?

CMV

Multi system atrophy?

Parkinsonism with autonomic dysfunction often told parkinsons first

CCF drugs imnproving mortality?

Spiro, ACEi and BB

Horners syndrome eye signs

Ptosis and MIosis (Mini constricted)

Ptosis and Mydriasis?

CNIII palsy

Role of loop diuretic in heart failure?

Symptomatic only

BP target in diabetes?

End organ damage 130/80 otherwise 140/80

Burkitt lympoma on histology?

Starry night

Most common cause of hirsutism?

PCOS

Muscarinic agonist example?

Pilocarpine

Which diuretic in ascites?

Spiro

Most common lymphoma?

Diffuse large B cell

PSC which cancer?

Cholangiocarcinoma

Pityriasis rosacea follows/

Viral disease

Renal AKI cause?

Acute tubular necrosis

Genital warts which viruses/

6 and 11

Painkiller causing serotonin syndrome?

Tramadol

Amouris fugax with headache?

GCA

Mitral regurg murmur type?

Pansystolic

Long term steroid use issue?

Avascular necrosis

Complication of femoral hernia?

↑risk strangulation

ECG cor pulmonale?

R axis deviation

Aortic stenosis pulse finding?

Narrow pressure slow rising

PSA delayed how long after prostatitis?

4 weeks

INR 5-8 no bleeding?

Withhold 2 doses

ECG hypothermia?

J waves

SIADH and lung?

Paraneoplastic feature of small cell

Primary hyperparathyroidism bloods?

PTH ↑ Ca2+↑ PO4↓

Secondary hyperparathyroidism bloods?

PTH↑ Ca2+↓ PO4↑

Causes of secondary hyperparathyroidism?

CKD usually

Primary hyperparathyroidism causes?

Adenoma usually

CRAB for myeloma?

Hypercalc, renal insufficiency, anaemia, bone pain, buttock pain

IHD and migraines?

No triptans

Gout and IHD ?

Colchicine

Acoustic neuroma symptoms?

Unilateral progressive hearing loss

Hypercalcaemia ecg problem?

Short QT

What replacement can cause lack of levothyroxine absorption?

Iron

Prolonged APTT, low platelets and miscarriages?

Antiphospholipid

Worst melanoma?

Nodular

LAck of dorsiflexion and foot eversion?

Common peroneal

Strongest risk for bells palsy?

Pregnancy

Old man bone pain and raised ALP normal calcium?

Pagets

Anti centromere elevated?

Limited scleroderma

What back pain is red flag?

Thoracic

Autosomal dominant cause of deafness affecting young adults?

Otosclerosis

Falsely high Hba1c?

Splenectomy

Trigger of liver decompensation?

Constipation

Prophylaxis of SBP?

Cipro

Diabetic patient and operating list?

Put first

Classify rapidly enlarging AAA and when to repair at any time?

>1.2cm repair at >5.5 unless symptoms

↓Na after TURP?

TURP syndrome

SAH can cause which fluid disturbance?

SIADH

When to shower after operation?

Usually 48hrs

Post h.pylori test?

Urea breath test

Which diabetic drugs stopped in MI?

Metformin due to lactic acidosis (start sliding scale)

Sings of acute angle closure glaucoma?

Red sclera, dilated pupil hazy cornea

Antiemetic in parkinsons?

Domperidone

Upper lobe cavitating which organism?

Klebsiella

Wernickes triad?

Confusion, ataxia and nystagmus

Modifiable factor for thyroid eye disease?

Smoking

Idiopathic pulmonary fibrosis which investigation?

High res CT

Posterior dislocation of hipo which nerve?

Sciatic

Acromegaly associated with?

Cardiomyopathy

Coughing up what in klebsiella?

Red currant jelly

Metformin guidelines egfr?

<30 stop 30-45 caution and do not start only keep if already on

Schobers test

<5cm

Bone protection in long term steroids?

immediately bisphos and vitD and calc

Steroids safe in breast feeding?

Yes

Classification for NOF?

Garden

Describe lichen planus?

itchy papular rash most commonly on palms, soles and flexor surfaces (polygonal flat topped papular lesions

1st line anti HTN diabetic?

ACEi

Which ABX idiopathic intracranial HTN?

Tetracyclines

True vs pseudo seizure test?

Prolactin

Most common lung cancer non smoker?

Adeno

Pigmented gallstones?

Sickle cell

Being a smoker classifies as what ASA?

Anal fistula imaging?

MRI

BP target clinic <80 years?

140/90

Lead or drainpipe colon?

Synthetic function of liver deranged?

PT time and albumin

How long after EBV to resume contact sports?

8 weeks

Antiplatelets in stroke?

300mg first 14 days then clopidogrel 75mg therafter

Cervical myelopathy gold standard?

MRI

Weakly positive bifringent rhomboid crystals?

Pseudogout

Negatively bifringent needles?

Gout

Symptoms implying negative prognosis in lymphoma?

B symptoms

Increased goblet cells?

Crohns

MS brain MRI?

Areas of demyelination

Anti CCP?

Ra can cause which nerve problem?

Carpal tunnel

>90% of ↑Ca2+ is?

HPT or malignancy

Causative organism lyme disease?

Borrelia burgdorferi

Central retinal artery occlusion symptoms?

Red spot pale opaque retina

Gastroenteritis >3 weeks?

Giardia?

Hypokalaemia can lead to ?

Long QT and U waves

ABX for animla and human bites/

Co-amox

Suspect phaeochromocytoma?

24hr metanephrines

Roughened patches over lumbar spine?

Tuberous sclerosis

High risk wound eg: soil in what to do?

Give tetanus immunoglobulin regardless of immunisation status

Parallel line shadows Xray?

Bronchiectasis

Subclinical hypothyroidism bloods?

High TSH normal T4

Scleroderma antibody?

Anti centromere

Hep A treatment?

Supportive no ↑risk of liver cancer

Hairy black tongue?

Tetracyclines

PSC associated with?

Immunocompromised patients pneumonia other than PCP?

Aspergillosis CXR shows small round mass soft tissue like but with air level

When to start allopurinol?

2-3 weeks after acute attack

Occult hip fracture imaging gold standard ?

MRI

Where is lesion for autonomic dysreflexia?

Above T6

Superficial thrombophlebitis treatment?

Naproxen

Anticoagulation with mechanical heart valve?

Warfarin

Pass med questions Flashcards

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