PassMed 7 Flashcards
(170 cards)
1
Q
RF for retinal detachment
A
T2DM
2
Q
How to correct hypernatremia espec in kids
A
SLOWLY
3
Q
If patients treated with PCI for MI are experiencing pain or haemodynamic instability post PCI,
A
Arrange CABG
4
Q
Felty syndrome =
A
RA, splenomegaly and low white cell count
5
Q
During a lower segment Caesarian section, the following lies in between the skin and the fetus:
A
Superficial fascia
Deep fascia
Anterior rectus sheath
Rectus abdominis muscle (not cut, rather pushed laterally following incision of the linea alba)
Transversalis fascia
Extraperitoneal connective tissue
Peritoneum
Uterus
6
Q
? can worsen glucose tolerance
A
thiazides
7
Q
gonadotrophin independent precocious puberty
A
- FSH and LH both low
- commonly caused by adrenal hyperplasia
8
Q
Ix of choice for a psoas abscess
A
ct abdo
9
Q
Initial management for epistaxis is
A
adequate first aid- pinch the nasal ala (nostrils) firmly and lean forward for 20 minutes
10
Q
characteristically presents with posterior circulation symptoms, such as dizziness and vertigo, during exertion of an arm.
A
subclavia steal syndrome
11
Q
Aortic stenosis management:
A
: AVR if symptomatic, otherwise cut-off is gradient of 40 mmHg
12
Q
most common cause of septic arthritis in young pp
A
gonorrhoea (chlamydia for epididmocorhcitis)
13
Q
big RF for retinal detachment
A
myopia
14
Q
Blue sclera + multiple #
A
Osteogenesis imperfecta
15
Q
Surgery / sulfonylureas on day of surgery:
A
- omit on the day of surgery
exception is morning surgery in - patients who take BD - they can have the afternoon dose
16
Q
Rhinitis medicamentosa
A
Rhinitis medicamentosa is a condition of rebound nasal congestion brought on by extended use of topical decongestants - only use for 7 days
17
Q
Following panretinal laser photocoagulation up to 50% of patients have
A
a reduction in visual field
18
Q
Ethylene glycol toxicity management
A
Ethylene glycol toxicity management - fomepizole. Also ethanol / haemodialysis
19
Q
most common cause of mitral stenosis
A
rheum fever
20
Q
ASD vs VSD
A
- ASD: split double
- VSD: very systolic
21
Q
mx of AMI
A
LAPAROTAMY - especially if signs of peritonitis or sepsis
22
Q
erythema marginatum is seen in
A
RF - recent sore throat, chorea (jerk, irregular movements) and polyarthralgia
23
Q
DI visual defect
A
This patient has diabetes insipidus due to a craniopharyngioma. This causes a lower bitemporal hemianopia.
24
Q
what is an absolute contraindication to laparoscopic surgery?
A
acute intestinal obst w dilated bowel loops
25
? passes anterior to the medial malleolus and is commonly used for venous cutdown
long saphenous
26
Co-presentation of iron deficiency anaemia and B12 deficiency anaemia may lead to a normocytic anaemia - differentiated from anaemia of chronic disease due to
low/ normal ferritin and wide distribution of red blood cell volume
27
DCM diagnosis
cannot be diagnosed by XR
28
Renal mass + exposure to chemicals in the textile, plastic and rubber industry.
TCC
29
A 35-year-old male presents with haematuria. He is found to have bilateral masses in the flanks. He has a history of epilepsy and learning disability.
Angiomyolipoma
30
? is associated with a decreased incidence of hyperemesis gravidarum
smoking
31
? is not recommended in the diagnosis of type 1 diabetes
hba1c
32
Blood pressure target (< 80 years, clinic reading) -
140/90
33
The following ECG changes are associated with hypocalcaemia:
corrected long QT
34
Hypokalaemia wave
u
35
proteinuric CKD mx
1) ACE/ ARB
2) SGTL2 inhibitor
36
Preterm infants with haemodynamically significant patent ductus arteriosus 1 week after birth
- give ibuprofen/indomethacin to promote duct closure
37
ASA - current smoking
2
38
Amiodarone test before initiation
- TFT, LFT, U&E, CXR prior to treatment
TFT, LFT every 6 months
39
Paeds BLS
5 Rescue breaths -> then check pulses -> compressions
40
Patients with end stage renal disease undergoing regular scheduled dialysis are classified as ASA
III
41
Cause of fungal nail infection
trichophyton rubrum
42
antismooth muscle antibodies seen in
autoimmune hep
43
Enteropathic arthritis is a seronegative spondyloarthropathy associated with
HLAB27
44
What is the first sign of puberty in boys?
Increase in tetsicular volume
45
which ab increase risk of IIH
TETRACYCLINES
46
Anisocoria worse in bright light implies a problem wit
the dilated pupil - right ciliary ganglion if the right pupil is dilated
47
twisting knee injury ->
meniscal tear
48
multiloculated and heterogenous cyst above the hyoid bone
Dermoid cyst`
49
A 16-year-old boy presents with renal colic. His parents both have a similar history of the condition. His urine tests positive for blood. A KUB style x-ray shows a relatively radiodense stone in the region of the mid ureter.
CYSTEIENE
50
Paracetamol OD: ongoing raised ALT despite NAC
Continue NAC and consult hepatologist
51
Hypocalcaemia: prolonged QT interval is an indication for
urgent IV calcium gluconate
52
what is not seen in panc
jaundice
53
Hypsarrhythmia on EEG suggests
wests syndrome - infantile spasms
54
Benign rolandic epilepsy
- focal symptoims
- including paraesthesia on one side of a child's face or mouth
- twitching
55
first line in occult hip fracture
MRI
56
Ptosis ->
CN3
57
HZO occular comp
anterior uveitis
58
dactylitis is seen with
reactive arthritis
59
Epigastric pain + steatorrhoea → ?
CP
60
MX of asymptomatic bilateral hilar lymphadenopathy.
no Tx
only treat sarcoid with pred if symptomatic
61
which antihypertensives interact with lithium
Diuretics, ACE-inhibitors and angiotensin II receptor antagonists
62
what to monitor with HUS
blood pressure and urinanalysis should be monitored to detect progressive renal involvement
63
Acute cholesystitis tx
intravenous antibiotics + early laparoscopic cholecystectomy within 1 week of diagnosis
64
The most common causes of viral meningitis in adults are
enterovirus
65
HIV seroconversion occurs from ? weeks
3-12
66
Complete heart block following an inferior MI is NOT an indication
for pacing
BUT CHB following anterior MI IS!!!!
67
URETHRAL INJURY
Urinary retention, blood at the urethral meatus and a high riding prostate on digital rectal examination are the typical features.
68
Inferior homonymous quadrantanopias are caused by lesions of the
Superior optic radiation of parietal lobe
69
? is often the most effective treatment for prominent telangiectasia in rosacea
laser therapy
70
HIV, neuro symptoms, headache, CSF India ink positive
cryptococal meningitis
71
What is the most appropriate way to confirm a diagnosis of pertussis?
per nasal awab
72
school exclusions
Scarlett fever: 24hr after Abx
Infleunza: After recovered
Chicken pox: When crusted over (usually 5 days after)
Rubella: 5 days from onset of rash
Mumps: 5 days from swollen glands
Measles: 4 days from onset of rash
Whooping cough (21 days from onset Sx or 48hrs after Abx)
Diarrhoea & Vomiting: 48 hours from settling
Impetigo: 48 hours from Abx or lesions crusted over
Scabies: Until treated
73
Low levels of which one of the following types of complement are associated with the development of systemic lupus erythemato
c3 an 4
74
can be used to guide whether patients with acute bronchitis require antibiotics
CRP
75
Syringe drivers: respiratory secretions & bowel colic may be treated
hyoscine hydrobromide, hyoscine butylbromide, or glycopyrronium bromide
76
tx of pseudogout
same as gout - NSAID and colchicine
77
statin monitoring
lfts at baseline, 3m, 12m
78
which bb causes long qt
sotalol
79
what should be done before starting trastuzumab
echo - cardiotoxic
80
If after 28/40 weeks, if a woman reports reduced fetal movements and no heart is detected with handheld Doppler then
do immediate US
81
compressions and ventilations at a rate of ? newborns
3:1
82
adenoma sebaceum
benign tumour growth seen with tuberous sclerosis
83
1st stage labour
latent phase = 0-3 cm dilation
active phase = 3-10 cm dilation
84
1st line of treatment for blepharitis is
hot compresses
85
Adrenaline induced ischaemia mx
phentolamine
86
mx of dry AMRD
There is no curative medical treatment for dry AMD. High dose of beta-carotene, vitamins C and E, and zinc can be given to slow deterioration of visual loss
87
What can be diagnosed prenatally
A1AT deficiency
88
best site of access for PCI
radial artery
89
If eosinophil count/FeNO do not confirm suspected asthma, and spirometry is not available then
measure peak expiratory flow (PEF) twice daily for 2 weeks
90
When prescribing fluids, the glucose requirement is
50-100g/day regardless of weight
91
severe CP and neuro signs
aortic dissection e.g. horners syndrome
92
? is required in the investigation of all patients presenting with an AKI of unknown aetiology
renal US within 24 hrs
93
pt found to be MRSA + in pre-opp
Nasal mupirocin + chlorhexidine for the skin.
94
positive head inpulse ->
peripheral cause of vertigo - posterior stroke rules out
95
mx of opiate detox
methadone or buprenorphine
96
ectopic and PID
do salpingotomy > salpingectomy due to tube damage
97
Spirometry in obese
- FEV1 and FVC reduced
- Normal FEV1/FVC ratio
- reduced exp reserve volume!!!
98
break bone fever
fever and severe muscle ache - dengue
99
thiazides and calcium
hypercalcaemia and hypocalciuria
100
Long QT syndrome - usually due to loss-of-function/blockage o
K+ channels
101
mx of empyema
prompt chest tube drainage and ab
102
COPD does not causef
CLUBBING
103
Decreasing vision over months with metamorphopsia and central scotoma should cause high suspicion of
wet age related macular degen
104
Palivizumab
monoclonal antibody which is used to prevent respiratory syncytial virus (RSV) in children who are at increased risk of severe disease.
105
mx of TLS
IV fluids and IV rubricase
106
One of the cardiac complications of Ehler-Danlos is
Aortic regurg
107
is a risk factor for the development of osteoporosis and used in the FRAX assessment tool
RA
108
Most common cause of endocarditis:
Staphylococcus aureus
Staphylococcus epidermidis if < 2 months post valve surgery
109
is a cause of recurrent watery or sticky eye in neonates and usually, self-resolves by 1 year of age
Nasolactrimal duct obs
110
labetolol
used in phaechromocytima - blocks A and B receptors
111
post splenectomy sepsis
SMH - strep pneumonia, haemophilus, menigocci
112
Globus, hoarseness and no red flags → ?
reflux
113
target sign on US
intusseception - Pneumatic reduction under fluoroscopic guidance
114
COPD and Ph
the use of NIV in COPD shows that patients with a pH in the range of 7.25-7.35 achieve the most benefit. If the pH is < 7.25 then invasive ventilation should be considered
115
Disseminated gonococcal infection triad =
tenosynovitis, migratory polyarthritis, dermatitis
116
impaired fasting glycaemia
fasting plasma glucose level between 6.1 mmol/l and 6.9 mmol/l
117
Impaired glucose tolerance
IGT is diagnosed when 2-hour plasma glucose levels during an OGTT are between 7.8 and 11.mmol/l.
118
mx of AS
NSAIDs and physio -> entanercept (TNFa blocker)
119
how long does POP take to become effective
48 hrs
120
Slow growing, painless, mobile lump in the parotid gland of older female → ?
pleomorphic adenoma
121
is by far the most common form of lymphoma in the UK
diffuse large B cell
122
Wernicke's aphasia is due to a lesion of the
superior temp gyrus
123
Genital warts - 90% are caused by
6 and 11
124
mx of acute sinusitis
- Consv, analgesia
- intranasal steroids if symptoms more than 10 days
125
public lice mx
malathion or permethrin
126
small cell cancer, sudden confusion
ADH -> SIADH -> cerebral oedema
127
Which is the best assessment tool for differentiating between stroke and stroke mimics?
ROSIER
128
Tonic or atonic seizures first line in females
lamotrigine
129
distended abdomen and bilious vomiting
intestinal malrotation
130
A 1-day old child is born by emergency cesarean section for foetal distress. On examination, he has decreased air entry on the left side of his chest and a displaced apex beat. Abdominal examination demonstrates a scaphoid abdomen but is otherwise unremarkable.
CDH
131
hrt and surg
stop 4 weeks before
132
Renal impairment, flank masses, hypertension → ?
AKPD
133
? requires therapeutic monitoring in patients with renal failure
vancomyci
134
Treatment for Wilson's disease is currently
penicillmine
135
Patients with stable CVD who have AF are generally managed on
Patients with stable CVD who have AF are generally managed on an anticoagulant and the antiplatelets stopped
136
DVT + ckd
UFH or dose adjusted LMWH
137
which anaesthetics cause malignant hyperthermia
Volatile liquid anaesthetics
(isoflurane, desflurane, sevoflurane)
138
Lithium toxicity can be precipitated by
nsaida
139
Pituitary gland tumour VFD
Pituitary gland tumour
PITS- (Parietal-Inferior, Temporal-Superior) and (PITuitary Superior)
140
Patient who has had an extensive stroke with right-sided hemiplegia
right homonomyous hemianopia
141
sign differentiates between organic and non-organic lower leg weakness
Hoovers
142
?score is recommended by BTS guidelines to be used to help identify patients with a pulmonary embolism that can be managed as outpatients
pulmonary embolism severity index
143
lupus AB
Most sensitive antibody = ANA - ana is sensitive
Most specific antibody = dsDNA - DNA has a very spec sequence
144
? is the intervention of choice in patients with malignant distal obstructive jaundice due to unresectable pancreatic carcinoma
biliary stenting
145
Kallmans syndrome
LH & FSH low-normal and testosterone is low
146
klinefelter vs kallman
FSH/LH fall in Kallman's
FSH/LH climb in Klinefelter's
147
giving a shock in a periarrest sit ->
unsynchronised
148
stopping AED
can be cons if seizure free >2yrs with AEDs stopped over 2-3m
149
The most common secondary brain tumours ar
lung, breast, kidney, melanoma and colorectal cancers metastases
150
? may normally have carboxyhaemoglobin levels of up to 10%
smokers
151
corneal ulcer. Which of the following is most likely to have resulted in this developing?
steroid eye drops -> fungal infections -> corneal ulcers
152
A 50-year-old man who, on examination, you notice his jaw appears deviated towards the right and he has an absent right-sided corneal reflex.
trigeminal
153
vertical diplopia
trochlear nerve
154
A 72-year-old man who has noticed a change in his voice with some difficulty swallowing. On examination, you notice his uvula deviates towards the right.
vagus (left side)
155
umbilical hernia mx
watch and wait - mos resolve by 12 months
156
should be performed in patients with suspected acute angle-closure glaucoma
tonometry and gonioscopy
157
ADPKD is associated with (cardiac)
MVP
158
Diastolic murmur + AF → ?
mitral stenosis
159
subacute cord degen reflexes
- hypereflezia
- loss of prop & vibration sense
160
? can cause hyperkalaemia
heparin - suppresses aldosterone
161
Asymptomatic renal stones < 5mm are generally managed with
watchful waiting
162
proliferative diabetic retinopathy mx
Intravitreal VEGF inhibitors may be used in addition to panretinal laser photocoagulation
163
mneumonic for paeds red flags
Really Sick Babies Get Antibiotics
1. Recessions (moderate or severe chest wall recessions)
2. Skin turgor reduced
3. Blue or mottled appearance
4. Grunting
5. Asleep (does not wake if aroused)
164
mx of organophosphate poisoning
IV atropine - a for O
165
Cervical cancer screening: if two consecutive inadequate samples then →
colp
166
) are the investigation of choice in genital herpes
NAAT
167
are used to detect occupational asthma
Serial peak flow measurements at work and at home are used to detect occupational asthma
168
Water deprivation test: primary polydipsia
urine osmolality after fluid deprivation: high
urine osmolality after desmopressin: high
169
Nebulised ipratropium bromide should be given to all patients with
severe/ life threatening asthma
170
