Passmed Flashcards
(163 cards)
1
Q
Insulin when ill
A
Continue it, don’t change it but check blood glucose more frequently
2
Q
Cancer patient VTE
A
6 months DOAC
3
Q
pityriasis versicolor orgnaism
A
Malassezia furfur
4
Q
prevention of vaso-occlusive crisis in sickle cell
A
Hydroxyurea
5
Q
How long is shingles infective for?
A
5-7 days, until the lesions have crusted over
6
Q
What is used for prophylaxis of oesophageal bleeding?
A
Propranolol
7
Q
What drugs are contraindicated in people with hypertrophic obstructive cardiomyopathy?
A
ACEi
8
Q
Codeine to morphone
A
Divide by 10
9
Q
Primary hyperparathyroidism
A
- Tumour
- PTH high
- Calcium high
10
Q
Secondary hyperparathyroidism
A
- low vitamin D/CKD
- high PTH
- low/normal calcium
11
Q
Tertiary hyperparathyroidism
A
- hyperplasia
- high PTH
- High calcium
12
Q
Chronic kidney disease staging
A
1: eGFR>90
2: 60-90 +some signs
3a: 45-59
3b: 30-44
4: 15-29
5 <15
13
Q
Type of anaemia CKD
A
Normochromic normocytic
14
Q
Management of bone disease secondary to CKD
A
- low phosphate diet
- phosphate binders
- vitamin D
- calcium
15
Q
MEN 1
A
- primary hyperparathyroidism,
- pancreatic tumours,
- pituitary tumours
16
Q
MEN 2a
A
- medullary thyroid carcinoma
- phaeochromocytoma
- hyperparathyroidism
17
Q
MEN 2b
A
- medullary thyroid cancer
- phaeochromocytoma
- marfanoid body habitus
- neuroma
18
Q
Diagnosis of phaeochromocytoma
A
24 hour urinary collection of metanephrines
19
Q
Water deprivation test cranial diabetes insipidus
A
- starting plasma osmolality high
- final plasma osmolality <300
- desmopressin >600
20
Q
Water deprivation test nephrogenic diabetes insipidus
A
- starting plasma osmolality high
- final plasma osmolality <300
- desmopressin <300
21
Q
What is the reversal agent of dabigitran?
A
Idarucizumab
22
Q
What is used for prevention of cluster headaches?
A
Verapamil
23
Q
What causes lower zone lung fibrosis?
A
A: Asbestos
C: connective tissue disease
I: idiopathic pulmonary fibrosis
D; Drugs: e.g. methotrexate or nitrofuratoin
24
Q
Atypical lymphocytes
A
Mono
25
First trimester when give iron
110
26
Second and third trimester when give iron
105
27
Sickle cell most common cause of osteomyelitis
Salmonella
28
What neurovascular structure is most likely to be compromised in a scaphoid fracture?
Dorsal carpal arch of the radial artery
29
When to repeat pregnancy test after termination
3 weeks
30
Which diabetes medications are contra-indicated in pregnancy?
- gliclazide
- liraglutide
Switch to metformin
31
What are the causes of tunnel vision?
- papilloedema
- glaucoma
- retinitis pigmentosa
- choroidoretinitis
- optic atrophy secondary to tabes dorsalis
- hysteria
32
Patau syndrome chromosome
13
33
NICE red flag for paeds traffic light
- Moderate or severe chest wall recession
- Does not wake if roused
- Reduced skin turgor
- Mottled or blue appearance
- Grunting
34
What is the most common complication of meningitis?
Sensorineural hearing loss
35
What does a preceding influenza predispose to
Staph aureus pneumonia
36
post splenectomy sepsis
Streptococcus pneumoniae
Haemophilus influenzae
Meningococci
37
What causes syphillis
Treponema pallidum
38
Conservative management of pneumothorax
Follow up every 2-4 days as an outpatient
39
normal pressure hydrocephalus
Urinary incontinence + gait abnormality + dementia
40
Visible haematuria following a URTI in a child
- IgA if 1-3 days
- post streptoccocal if 7-14 dyas
41
What do you give to treat an episode of severe alcoholic hepatitis
prednisolone
42
Treatment of vault prolapse
Sacrocolpopexy
43
What visual defect can a prolactinoma cause?
bi temporal superior quadrantanopia
44
What type of STEMI can affect the AV node?
Inferior STEMI
45
Features of achondroplasia
- short limbs and stature
- trident hands
- frontal bossing
- lumbar lordosis
- flattened nasal bridge
46
What cancer is linked to coeliac?
T cell lymphoma
47
Bloods tumour lysis syndrome
- hyperkalaemia
- hypocalcaemia
- incrased phosphate
- urate/uric acid high
48
Presentation of tumour lysis
- oligouria/renal failure
- confusion
- seizures
- nausa and vomiting
- muscle cramps and tetany
49
Renal colic pain mangement
IM diclofenac
50
Bacteria in periotoneal dialysis peritonitis
staph epidermis
51
What are the cerebellar signs?
- Dysdiadochokinesia
- Ataxia
- Nystagmus
- Intention tremor
- Slurred or staccato speech
- Hypotonia
52
Management of pyoderma gangrenosum
steroids
53
medical management of urge vs stress incontinence
urge: oxybutinin
duloxetine: stress
54
Management of angia
- GTN spray to stop attacks
- aspirin and statin
- CCB or BB first line
- Add in either CCB or BB if not controlled by one alone
- If cant tolerate a CCB then add in a long acting nitrate
55
When should you give a platelet infusion?
Platelet transfusion is appropriate for patients with a platelet count < 30 x 109 and clinically significant bleeding
56
What drug should be stopped before coronary angiogrpahy?
Metformin due to lactic acidosis
57
Breech baby normal baby check
All breech babies at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery
58
Morphine for palliative patients with mild/moderate renal impairment
Oxycodone
59
Local anaesthetic toxicity
IV 20% lipid emulsion
60
Chronic myeloid leukaemia drug
Imatinib
61
How do you calculate positive predictive value?
Positive predictive value = TP / (TP + FP)
62
What are the signs of osmotic demyelination syndrome (also known as central pontine myelinolysis)?
symptoms of brainstem damage, such as spastic quadriparesis, pseudobulbar palsy, and emotional lability (i.e. pseudobulbar affect). Therefore, spastic quadriparesis is the correct answer.
63
How do you reduce the risk of peripheral retinopathy of isoniazid
pyridoxine
64
What increases the risk of azathioprine toxicity?
Allopurinol
65
What valve abnormality is turners associated with?
Bicuspid aortic valve
66
What is vitiligo associated with?
- addisons
- T1DM
- autoimmune diseases
67
For how long does lactational amenorrhoea work as contraceptive?
For 6 months
68
What is given for preterm prerupture of the membranes?
Dexamethasone
69
mania referral
urgent community
70
raised ICP imaging
CT head to rule out haemorrhage
71
what is a contraindication to digoxin?
Thiazide like diurtetics
72
Statins in pregnancy
stop them
73
what drugs to avoid in G6PD
sulf drugs
74
When is metaformin contraindicated?
If eGFR is less than 30
75
otitis externa if diabetes
ciprofloxacin to cover for pseudomonas
76
how long no food/non clear liquids before surgery?
6 hours
77
renal colic imaging
non contrast CTKUB
78
codeine to morphine
divide by 10
79
breakthrough dose
1/6th
80
ECG hypercalcaemia
Shortened QT
81
ECG hypocalcaemia
prolonged QT
82
correction of hypocalcaemia
calcium gluconate 10ml of 10%
83
ECG hyperkalaemia
- tall tented T waves
- small p waves
- widened QRS
84
What are the causes of an alkalosis and hypokalaemia?
- vomit
- diuretics
- cushings
- conns
85
What are the causes of acidosis and hypokalaemia?
- diarrhoea
- renal tubular acidosis
- acetazolamide
86
ca125
ovarian
87
ca 19 9
pancreatic
88
ca 15-3
breast
89
AFP
hepatocellular, teratoma
90
CEA
colorectal
91
investigation neoplastic spinal cord compression
whole spine MRI within 24 hours
92
which cancer is most common in non smokers?
Adenocarcinoma
93
Which cancers are central in lung
Squamous
94
Which cancers are peripheral in the lung?
Large cell
adenocarcinoma
95
What is the presentation of myxoedema coma?
Hypothermia and confusion
96
What is the management of myxoedema coma?
- IV thyroid replacement
- IV fluid
- IV corticosteroids (until the possibility of coexisting adrenal insufficiency has been excluded)
- electrolyte imbalance correction
97
Presentation of thyroid storm
- fever >38.5
- tachycardia
- confusion and agitation
- nausea and vomiting
- hypertension
- heart failure
- abnormal liver function test
98
Management of thyroid storm
- beta blockers
- symptom management e.g. paracetamol
- anti-thyroid drugs
- dexamethasone
99
What are the side effects of Biguanides
e.g. metformin - GI upset, lactic acidosis
100
What are the side effects of GLP-1 mimetics?
nausea, vomiting, pancreatitis
101
What are the side effects of thiazolidinediones?
e.g. pioglitazone
bladder cancer
102
What is given for premature rupture of the membranes?
10 days of erythromycin
103
MS prolapse
high dose methylprednisolone
104
Type 1 error
null hypothesis is rejected when true
105
Type 2 error
null hypothesis is accepted when flase
106
Late sign of cauda equina
Urinary incontinence
107
Hypotensive bradycardia
DONT SHOCK
108
What is power
the probability of detecting a statistically significant difference
109
How long should you wait before titrating up metformin?
a week
110
What is the method of the newborn hearing test?
Otoacoustic emission then if abnormal auditory brainstem response
111
Auscultation of idiopathic pulmonary fibrosis
fine end inspiratory crackles
112
Side effect of amiodarone
thrombophelbitis
113
If a semen sample test is abnormal, when should you retest
3 months
114
Melanosis coli
pigmentation of the colon due to laxative abuse
115
Impaired fasting glucose
A fasting glucose greater than or equal to 6.1 but less than 7.0 mmol/l
116
What is sildenafil contraindicated by?
Nitrates and nicorandil
117
Chondrocalcinosis joint
pseudogout
118
Impaired glucose tolerance
fasting plasma glucose less than 7.0 mmol/l and OGTT 2-hour value greater than or equal to 7.8 mmol/l but less than 11.1 mmol/l
119
Which drugs worsen glycaemic control
Thiazide diuretics
120
How should you test for HIV?
HIV p24 antigen and HIV antibody
121
What type of haemorrhage causes pinpoint pupils?
Pontine haemorrhage
122
In ACS what is contraindicated in patients with hypotension?
Nitrates
123
What are a risk factor for C diff?
PPIs
124
How do you calculate standard error?
standard deviation / square root of number of patients
125
What is the management of sudden onset sensori-neural hearing loss
Refer to ENT and give high dose oral prednisolone
126
antibiotic causing jaundice
co amoxiclav
127
Opioids for renal failure
- buprenorphine
- alfentanil
- fentanyl
128
What is a normal ABPI?
0.9-1.2
129
PAD ABPI
Less than 0.9
130
osteomalacia
- low calcium
- low phosphate
- high ALP
- Hight PTH
131
Bradycardia failure to atropine
- subcutaneous pacing
- transvenous pacing
132
Sarcoidosis
- skin rash (erythema nodosum) and cough
- test ACE
133
What electrolyte abnormality can lead to VT?
Hypokalaemia
134
MRSA pre surgery
- nasal mupirocin
- clorhexidine for skin
135
side effect of trimethoprim
Tubular damage leading to hyperkalaemia and raised serum creatinine
136
painless ulceration on genitals
syphilis
137
what is the treatment for sypilis
benzylpenicillin
138
what causes bacterial vaginosis?
gardnerella vaginalis
139
what is the main cause of rheumaitc fever
group A beta haemolytic streptococci
140
Restrictive cardiomyopathy echo
increased ejection fraction, reduced left ventricular volume
141
When would you do CABG over PCI for angina?
- over 65
- diabetes
- complex 3 vessel disease
142
Long term management of WPW
catheter ablation of the accessory pathway
143
What drugs are contraindicatied in WPW
- NDP CCB e.g. verapamil
- Digoxin
144
What heart condition haemochromotosis?
Dilated cardiomyopathy
145
Diastolic murmur + face erythema + opening snap
mitral stenosis
146
What murmurs are louder on expiration
- mitral
- aortic
147
what murmurs are louder on inspiration
- pulmonary
- tricuspid
148
ejection systolic mumurs
- aortic stenosis
- pulmonary stenosis
149
pansystolic murmurs
- mitral regurg
- tricuspid regurg
150
mid/late diastolic murmur
- mitral stenosis
- tricuspid stenosis
151
What reduces clopidogrel action
Omeprazole
152
mid humeral shaft fracture nerve
Radial nerve - wrist drop
153
Which drugs exacerbate psoriasis
beta blockers
154
Test for C diff
Stool toxin
155
What drugs cause gynaecomastia?e
- spironolactone (most common drug cause)
- cimetidine
- digoxin
- cannabis
- finasteride
- GnRH agonists e.g. goserelin, buserelin
- oestrogens, anabolic steroids
156
What is the formula for osmolarity
2Na + 2K + urea + blood glucose
157
Acute mesenteric ischaemia investigations
blood gas to show raised lactate
158
What is the max dose of metformin?
1g BD
159
How often should people with sickle cell get the pneumococcal vaccine?
Once every 5 years
160
Pancytopenia post chemo
myelodisplastic syndrome
161
lead pipe
ulcerative colitiis
162
trigeminal neuralgia
carbamazepine
163
