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passmed corrections june Flashcards

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1
Q

Sudden popping sound during athletic activity → knee pain. swelling and instability what

A

?ACL injury

anterior draw test
lachmann test

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2
Q

Catching or locking of the knee with an inability to extend fully or bend the joint is seen in

A

a ruptured medial meniscus.

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3
Q

x-ray findings pseudogout

A

chondrocalcinosis
in the knee this can be seen as linear calcifications of the meniscus and articular cartilage

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4
Q

A_____ is used for the prophylaxis of oesophageal bleeding

A

non-cardioselective B-blocker (NSBB)
propranolol

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5
Q

diseases assoc with HLA-DR4

A

type 1 diabetes mellitus*
rheumatoid arthritis

*type 1 diabetes mellitus is associated with HLA-DR

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6
Q

diseases assoc with HLA-DQ2/DQ8

A

coeliac disease

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7
Q

diseases assoc with HLA-B27

A

ankylosing spondylitis
reactive arthritis
acute anterior uveitis
psoriatic arthritis
enteropathic arthritis

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8
Q

diseases assoc with HLA-A3

A

haemochromatosis

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9
Q

diseases assoc with HLA-B51

A

Behcet’s disease

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10
Q

diseases assoc with HLA-DR2

A

narcolepsy
Goodpasture’s

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11
Q

diseases assoc with HLA-DR3

A

dermatitis herpetiformis
Sjogren’s syndrome
primary biliary cirrhosis

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12
Q

pseudocysts result from

A

the organisation of a peripancreatic fluid collection.
The collection is walled by fibrous or granulation tissue and typically occur 2-4 weeks or more after an attack of acute pancreatitis

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13
Q

complication of acute pancreatitis systemically that causes SOB

A

Acute respiratory distress syndrome

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14
Q

best imaging modality for anastomotic leak and when it occurs

A

CT abdo
steroids and other disease modifying anti-rheumatic drugs, are a risk factor for the development of an anastomotic leak
Generalised sepsis causing mediastinitis or peritonitis depending on site of leak
can have faeces in wound and guarding
Fever, pain, peritonitis 5-7 days post colorectal surgery

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15
Q

genetics of marfans what gene affected

A

autosomal dominant
FBN1 gene on chromosome 15 that codes for the protein fibrillin-1

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16
Q

eye complications of marfans

A

upwards lens dislocation (superotemporal ectopia lentis)
blue sclera
myopia

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17
Q

Cubital tunnel syndrome is caused by compression of the_____ and can present with tingling/numbness of the_______

A

ulnar nerve , 4th and 5th finger

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18
Q

________ is the investigation of choice for a suspected pharyngeal pouch

A

Barium swallow combined with dynamic video fluoroscopy

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19
Q

An ______ is the treatment of choice for biliary colic

A

elective laparoscopic cholecystectomy

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20
Q

IBS treatment

A

pain, cramping and bloating: antispasmodic agents (e.g. mebeverine)
constipation: laxatives but avoid lactulose
diarrhoea: loperamide is first-line

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21
Q

staging for colon cancer

Study These Flashcards
A

Dukes’ A - Tumour confined to the mucosa
Dukes’ B- Tumour invading bowel wall
Dukes’ C - Lymph node metastases
Dukes’ D- Distant metastases

TNM classification is slowly replacing Dukes staging of colorectal tumours although it is still widely used

22
Q

TNM staging

Study These Flashcards
A

T1 and T2 is when the tumour is still within the mucosal wall
T3 and T4 the tumour has spread outside the mucosal wall
N0 no lymph node involvement
N1 involves up to 3 regional lymph nodes
N2 involves 4 or more regional lymph nodes
M determines metastasis and is either M0 or M1.

23
Q

Duke criteria are used to diagnose

Study These Flashcards
A

infective endocarditis

24
Q

most common organism in iliopsoas abscess

Study These Flashcards
A

Staphylococcus aureus: most common

25
secondary causes of iliopsoas abscess
Crohn's (commonest cause in this category) Diverticulitis, colorectal cancer UTI, GU cancers Vertebral osteomyelitis Femoral catheter, lithotripsy Endocarditis intravenous drug use
26
Infective endocarditis - what is an indication for emergency valve replacement surgery
severe valvular incompetence aortic abscess (often indicated by a lengthening PR interval) infections resistant to antibiotics/fungal infections cardiac failure refractory to standard medical treatment recurrent emboli after antibiotic therapy
27
Inflammatory arthritis involving DIP swelling and dactylitis points to a diagnosis of
psoriatic arthritis also nail pitting, bilateral
28
3 main causes of crackles are
infection, pulmonary oedema and lung fibrosis (expiratory)
29
pulmonary oedema signs on XR
A is for alveolar oedema B is for Kerley B lines C is for cardiomegaly D is for dilated upper lobe vessels E is for pleural effusion- notching of the costophrenic angles, indicative of fluid pooling there
30
what organism accounts for the majority of cases of croup
parainfluenza virus
31
Do not examine the throat if ______is suspected
acute epiglottis
32
_____ causes an 'allergic' type picture consisting usually of raised urinary WCC and eosinophils, alongside impaired renal function
Acute interstitial nephritis 'hypersensitivity triad' of fever, rash, and raised eosinophils. Arthralgia may also occur.
33
anti-D prophylaxis should be given to women who are rhesus D negative and are having an abortion after ________
10+0 weeks' gestation
34
large volume, bounding, collapsing pulse in a neonate suggests
PDA left subclavicular thrill also
35
Offer women with any of the other risk factors for gestational diabetes a 75-g 2-hour OGTT at)_______
24-28 weeks women who've previously had gestational diabetes: OGTT should be performed as soon as possible after booking and at 24-28 weeks if the first test is normal
36
risk factors of gestational diabetes
6 -BMI of > 30 kg/m² -previous macrosomic baby weighing 4.5 kg or above -previous gestational diabetes -first-degree relative with diabetes -family origin with a high prevalence of diabetes (South Asian, black Caribbean and Middle Eastern) -unexplained stillbirth in a previous pregnancy
37
risk factors for group B strep
prematurity prolonged rupture of the membranes previous sibling GBS infection maternal pyrexia e.g. secondary to chorioamnionitis
38
Breast cancer screening is offered to all women aged ______ (mammogram every__ years)
50-70 years, 3, After 70, women still may have mammograms, but are encouraged to make their own appointments and are not automatically notified.
39
bowel cancer screening is for everyone aged ____ , every ____ years
50-74, 2
40
_____criteria is used to assess the probability of septic arthritis in children
Kocher's used to differentiate septic arthritis from the often-considered alternative diagnosis of transient synovitis fever >38.5 degrees C non-weight bearing raised ESR raised WCC
41
_______ is the first-line investigation for preterm prelabour rupture of the membranes
Careful speculum examination to look for pooling of amniotic fluid in the posterior vaginal vault Digital examination should be avoided due to the risk of introducing infection if pooling of fluid is not observed, NICE recommend testing the fluid for placental alpha microglobulin-1 protein (PAMG-1) (e.g. AmniSure) or insulin-like growth factor binding protein-1 (IGFBP-1)
42
management of PROM
oral erythromycin should be given for 10 days (or until labour is established, whichever is sooner) antenatal corticosteroids (typically dexamethasone) consider IV magnesium sulphate for fetal neuroprotection if < 30 weeks and birth is imminent delivery is generally recommended at 37 weeks of gestation
43
coarctation of aorta murmur
murmur during systole
44
mitral stenosis management
patients with associated atrial fibrillation require anticoagulation -warfarin is still recommended asymptomatic patients- monitored with regular echocardiograms symptomatic patients- percutaneous mitral balloon valvotomy or mitral valve surgery (commissurotomy( more in RF related), or valve replacement)
45
Aortic stenosis management:
AVR if symptomatic, otherwise cut-off is gradient of 40 mmHg surgical AVR- for young, low/medium operative risk patients. Cardiovascular disease may coexist. For this reason, an angiogram is often done prior to surgery so that the procedures can be combined transcatheter AVR (TAVR)- for patients with a high operative risk balloon valvuloplasty- may be used in children with no aortic valve calcification or in adults limited to patients with critical aortic stenosis who are not fit for valve replacement
46
first investigation in stroke/ tia if patient is diabetic
hypoglycaemia causes symptoms like TIA so blood glucose
47
actinic keratoses is
rough, scaly patches on the skin that are caused by excessive exposure to the sun. They can potentially develop into squamous cell carcinoma, a type of skin cancer. fluorouracil cream: typically a 2 to 3 week course. The skin will become red and inflamed - sometimes topical hydrocortisone is given following fluorouracil to help settle the inflammation topical diclofenac- mild AK, fewer side effects topical imiquimod cryotherapy curettage and cautery
48
Solitary firm papule/nodule that dimples on pinching →
dermatofibroma, occur following injury
49
There are 6 tests to confirm brain death;
pupillary reflex corneal reflex oculo-vestibular reflex cough reflex, absent response to supraorbital pressure and no spontaneous respiratory effort
50
Carbidopa is
a peripheral dopa-decarboxylase inhibitor that prevents the conversion of levodopa to dopamine outside the central nervous system levodopa alone is taken up and made into doapmine which cant cross BBB so acts peripherally and causes side effects- nausea, vomiting, cardiac arrhythmias, and orthostatic hypotension allows less levodpa dose cus it can just do its thing without being interfered with by silly dopamine
51

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