Passmed Qs we get wrong Flashcards
1
Q
Eczema Herpticum vs Chickenpox
A
Eczema herpeticum typically spreads and crusts within days whilst Chickenpox has a slower onset
2
Q
Vitreous Haemorrhage vs Retinal detachment symptom wise
A
Vitreous Haemorrhages cause your central vision field to get worse on LYING DOWN
Retinal Detachment is peripheral vision first and then central vision loss
3
Q
Management of toxoplasmosis gondii
A
Pyrimethamine + Sulphadiazine
4
Q
First line management of Rosacea
A
Topical ivermectin
5
Q
What dose of rectal diazepam is given in the vent of a seizure
A
10mg
6
Q
Management of pityriasis rosacea
A
Supportive only
7
Q
What condition predisposes oligohydramnios
A
Pre-eclampsia
8
Q
Management of scarlet fever
A
10 days of oral penicillin or azithromycin
9
Q
What is chushing;s triad (raised ICP signs)
A
Widened pulse pressure
Respiratory changes
Bradycardia
10
Q
First line management of syphillis
A
IM Benazthine Penicillin
11
Q
Management of an inguinal hernia in a newborn
A
IMMEDIATE surgery
12
Q
Onset of alcohol withdrawal
A
72 hours
13
Q
What is retinopathy of prematurity
A
<32 weeks
Giving them oxygen can cause neovascularisation and bilateral LOSS of red reflex
14
Q
Complication of diverticulitis in women
A
Colonvesical fistuals (posing through the vagina)
15
Q
Characteristic sign of meniscal tears
A
Locking of the knee
16
Q
What paCO2 level indicates the need for non invasive ventilation in cold exacerbation
A
If over 6 and medical management is not working
17
Q
How long does CRP stay elevated in the body after an infection
A
48 Horus
18
Q
Is a CT head in a head injury done with contrast or without
A
Without contrast
19
Q
What two types of cancers can acanthosis nigricans
A
gastric
pancreatic
20
Q
What medication causes ventricular tachycardia
A
Verapamil
21
Q
What is a characteristic effect of MAO B inhibitors
A
Tyramine cheese reaction - causes hypertensive crisis
22
Q
Management of complete heart block and Mobitz type II block
A
Causes bradycardia/asystole
Transvenous pacing
23
Q
Symptoms of an acetabular labral tear
A
Hip/groin pain and snapping sensation
Can weight bear
24
Q
What part of the lungs does extrinsic allergic alevolitis
A
Uppper zone fibrosis
25
Management of extrinsic allergic alveolitis
Stop triggers
26
Spirometry results in extrinsic allergic alveolitis
FVC reduced
FEV1 normal
FEV1/FVC > 80%
27
What medication must be stopped when clarithromycin is started
Statins
28
Indications for sttarting orlistat
BMI > 30
29
How long is orlistat given for
1 year
30
4 features of HSP
1. Palpable rash
2. Asymmetrical oligoarthritis
3. Abdo pain
4. Renal dailure
31
How is adrenaline given in asystole
IV
32
Symptoms specific to cubital tunnel syndrome
Symptoms worsen when elbow is resting on a firm surface or flexed for a long time
33
Management of lidocaine toxicity
IV 20% Lipid imulsion
34
Management of GI syjmptoms in metformin
Switch to modified release metformin
35
What happens to the size of the kidneys in Diabetic nephropathy
They enlarge rather than shrink
36
What medication can slow the rate of CKD progressin in ADPKD
Tolvaptan
37
How do we manage allergic reactions in blood transfusions
Temporary transfusion termination + antihistamine
38
When should someone be given a 2 week wait referral to resp team
>40 with unexplained haemoptysis
39
Name two metabolic disturbances caused by thiazide diuretics
Hyponatraemia
Hypercalcaemia
40
Pulomnary stenosis vs aortic stenosis on examination
Pulmonary stenosis = louder on inspiration
Aortic = louder on expiration
41
What is sick euthyroid syndrome
Normal TSH but low T3/T4
42
What is the AST/ALT ratio for alcohoilic hepatitis
2:1
43
When is a total hip replacement preferred to a hemiarthroplasty
THR is given to someone with a relatively high life expectancy who is active
Hemiarthroplasty would be given to less mobile individuals
44
Why would a biopsy need to be repeated in giant cell arthritis
Due to skip lesions making biopsies normal
45
Firts line treatment for hereditary haemochromatosis
Venesection
46
When is spironolactone given for hypertension vs alpha and beta blockers
If K+ < 4.5 = spironolactone
If K+ > 4.5 = alpha blocker
47
Triad for MEN Type 1
Peptic ulceration
Galactorrhoea
Hypercalcaemia
48
Inguinal hernia vs femoral hernia
Femoral hernia is lateral and inferor to the pubic tubercle
Inguinal hernia is medial and superior to the pubic tubercle
49
How can we treat maiodarone-caused hypothyroidism
COntinue amiodarone. + start levothyroxine concurrently
50
Management of scaphoid fractures with proximal scaphoid pole fractures
Surgical fixation
51
At what age threshold should people on SSRIs be followed up 1 week after starting
<25
52
Management of facial flushing in rosacea
Brimonidine gel
Metronidazole is for papules and pustules
53
Is a tender goitre seen in graves disease?
No - just de quervain's thyroiditis
54
Triad of fat embolism
Petechial rash
Hypoxemia
Neurological deficits
55
Management of ABO incomptaibility in renal transplants
TAKE THE GRAFT OUT
56
In what time frame is a post splenectomy infection most common
within 2 years of the operation
57
Management of mania
Rispiridone
58
Tricuspid vs mitral regurgitation
Tricuspid - inspiration makes it louder
Mitral - expiration makes it louder
59
Common cause of late decelerations in a neonate
Acidosis/hypoxia
60
What autoimmune condition is associated with a MALT lymphoma
Hashimoto's thyroiditis
61
What anitbiotic typically caues cholestasis
Co amoxiclav
62
Most common cause of Cushing's syndrome
Pituitary adenoma
63
Where are parentreral nutrition lines installed
Subclavian vein
64
What is th emost common complication of intraventricular haemorrhages (intracerebral bleed on CT)
Hydrocephalus
65
Complications seen in RA
IHD
66
What should be corrected first in osteoporosis
Calcium/Vit D THEN give bisphosphonates
67
What anaesthetic has the strongest analgesic effect
Ketamine (used hevaily in emergencies)
68
What is the most sensitive and specific lab result that indictaes cirrhosis of the liver
Low platelet counts
69
What is the criteria for adding on a GLP-1 mimic (-tides) to diabetic control
BMI still over 35
Has T2DM
Weight loss >3% at 6 months
OR
BMI <35 and insulin is not wanted
70
Management of pseudomonas infections
Ciprofloxacin
71
What is a HiNTs exam
used to differentiate vestibular neuronitis from posterior circulation strokes
72
What anti emetic may cause galactorrhoea
Metoclopramide
73
What is Wellen's syndrome
Critical stenosis of the left anterior descending artery (EMERGENCY)
74
Management of wellen's syndrome
Urgent PCI
75
ECG findings in Wellen's syndrome
DEEP inverted T waves in V2-3 + no ST elevation
76
What fracture can cause raidal nerve palsies
Fracture of the humeral shaft
77
What fracture is associated with axillary nerve injruy
Fracture of the humeral neck
78
What nerve is injured in fractures to the olecronon
Ulnar nerve
79
What formula is used to calculate the amount of fluid IV required for burns resusciation
Parkland formula: burn % * weight * 4
80
WHen is fluid IV required in burns (criteria)
>10 % burns in children
>15% burns in adults
81
How to calculate percentage burns
Wallace rule of 9: 9% for head and neck
9% for each arm
9% for each anterior part of the leg
9% for each posterior part of the leg
9% anterior chest
9% posterior chest
9% anterior abdomen
9% posterior abdomen
82
Management of circumferential burns around the torso
Escharotomy to divide burnt tissue
83
What structure is compromised by scaphoid fractures if left untreated
dorsal carpal branch of the radial artery
84
Under what age is an S3 sound considered 'normal' variant
Dilated cardiomyopathy
85
What is the daily required glucose intake
50-100 g/day irrespective of weight
86
What is the potassium, sodium and chloride intake needed a day
1mmol/kg/day
87
Why is chicken pox a risk factor for necrotising fasciitis
Because it allows group A strep to invade soft tissue
88
Surgical management of SUFE
Internal fixation
89
What usually cuases Hep E infections
Undercooked pork
90
Laeukamia vs lymphoma on data interpretation
Non hodgkin's lymphom adoes not have raised neutrophil counts (unlike CML)
91
What is the first line surgical intervention for uterine atony if syntocinon fails
Intrauterine balloon tamponade
92
Management of whooping cough
Clarithromycin
93
If Anti-HBs stays the same after 3 months of recieving the injection, what shouhld be done
Give anotehr vaccine
94
Under 20 weeks, gestation, how is VZV exposure treated
VZIG
> 20 weeks: Aciclovir or VZIG
95
Management of reactive arthritis
NSAIDs
96
What dermatome is responsibel for knee sensations
L4
97
Is acidosis seen in HHS
No
98
What blood is a universal donor of fresh frozen plasma
AB RhD negative blood
99
WHat time frame is needed to give a diagnosis of chronic fatigue syndrome
3 months
100
Management of bed wetting in children <5
Advice and reassurance
101
Indication for adding SGLT-2 inhibitors to DM treatment
If there are signs of IHD/HF (add it regardless of glucose levels)
102
Management of athlete's foot
TOpical antifungal then oral terbinafine
103
What dementia is associated with MND
frontotemporal dementia
104
Is defirbillation required for asystole
No
105
Management of digoxin toxicty
Cease digoxin - review levels in 8 hours
106
Transudative vs exudative causes of pleural effusions on data findings
Exudative: protein/serum ratio > 0.5
Transudative: protein/serum ratio < 0.5
107
Causes of transudative pleural effusions
HF
Hypoalbuminaemia (nephrotic syndrome)
Liver cirrhosis
108
Causes of exudative pleural effusions
Pneumonia
Cancer
PEs
109
How is malignant hyperthermia inherited
Autosomal dominant
110
What type of person is predisposed to ACL ruptures
Foootballers due to high twisting force applied to a flexed knee
111
What is an indication for a liver transplant in people with paracetamol overdose
If pH < 7.3 after 24 hours of ingestion
112
Monitoring people on IV MG SO4
Monitor reflexes + RR
113
Management of gastroparesis
Metoclopramide
114
Symptoms of gastroparesis
Bloating and vomiting after eating
115
Management of children <0.4th centime for height
Referral to paediatrics
116
Can the MMR vaccine be given during pregnancy
No
117
What part of the brain is affected to cause weber's syndrome
Midbrain
118
What are Osler nodes
Painful purple lesions on the index finger (SLE and IE)
119
What is red man syndrome
Causes facial flushing from rapid IV vancomycin infusion
120
What cannula is given for fluids
20g pink cannula
121
When are intraosseous access indicated
When people are peripherally shut down
122
When are PICC lines/ Hickman lines indicated
Long term treatment and management of a patient
123
What anaesthetic cannot be used in a pneumothorax
NO
124
Side effect of indapamide
Sexual dysfunction
125
What artery is occluded in an MI that can cause a heart block
right coronary artery lesion
126
When is a V/Q perfusion scan indicated over a CTPA for a suspected PE
If renal impairment is present (can't be given contrast for a CTPA)
127
What is seen on an ECG for a posterior MI
Tall R waves in V1 and V2
128
What lifestyle factor can cause dilated cardiomyopathy
Chronic alcohol use
129
What drug is the most common angi-oedema causer
ACEi
130
If someone's albumin: creatinine ratio >30, how should hypertension be managed
ACEi first (can help with nephropathy)
131
Aortic rupture vs tension pneumothorax
Aortic rupture has PERSISTENT hypotension vs Tension pneumothorax where this is terminal syptoms
132
Cause of croup
Parainfluenza virus
133
When does malrotation commonly affect children
First 30 days of life
134
How does ACEi cause renal impairment
Usually if patient suffers from bilateral renal artery stenosis
135
What dose of adrenaline is given during cardiac events
10ml 1:10,000 IV
or
1ml of 1:1000 IV
136
What type of ysndrome is focal segmental glomerulosclerosis
Nephrotic syndrome
137
Management of alcoholic hepatitis
Prednisolone
138
Early signs of lithium toxicity
POlyuria
139
If someone has presented to the GP within 7 days of having a TIA, under what time frame should they be seen at a TIA clinic
24 hours
140
What drug can be given to reduce the incidence of calcium stones forming
Thiazide diuretics (make it make sense)
141
Signs of a retinoblastoma on fundoscopy
Absent red reflex
Bilateral white pupil
142
Strongest risk factor for bladder cancr
Smoking
143
First line investigation for posts abscess
CT Abdomen
144
Most common complication post renal transplant
Squamous cell carcinoma of the skin
145
Pituitary adenoma vs pituitary apoplexy
Pituitary apoplexy = ACUTE
Pituitary adenoma = gradual
146
What is the threeshold for offering a 6 month trial of levothyroxine
<65 AND TSH between 5.5 and 10 mU/L with symptoms
Otherwise if TSH > 10mU/L on two separate occasions if asymptomatic
147
What ECG finding is characteristic of hypothermia
J waves
148
Management of Spontaneous Bacterial Peritonitis in hospital
IV Cefotaxime
149
Prophylaxis for spontaneous bacterial peritonitis
Ciprofloxacin
150
What is an escharostomy needed for
To stop ventilation issues (especially if burns are on the torso)
151
Malaria vs Dengue
Splenomegaly vs no splenomegaly
152
What routine prescription drug can cause c.diff infections
PPIs
153
Prophylaxis of hepatic encephalopathy
Lactulose and Rifaximin
154
Wilson's vs Haemochromatosis
Wilson's presents with neurological deficits (can happen in haemochromatosis but is very rare)
155
What Lithium levels are indicated for hameodialysis
SEVERE: >2 mmol/L
156
First line management of euvolaemic and hypervolaemic hyponatraemia
Fluid restirction
157
Indication for hypertonic saline in hyponatraemia
Severe: <120 mmol/L
158
Management of hypovolaemic hyponatraemia
IV 0.9% NaCl
159
Symptoms of ischaemic colitis
Generalised abdominal pain after eating
160
What cerebral artery would cause leg weakness but not affect the face
Middle cerebral artery
161
Most common cause of an infection in bronchiectasis
H. influenzae
162
What surgery is indicated for an ascending aortic dissection
Aortic root repair
163
First line management of endometriosis
Ibuprofen (manage dyspareunia first)
164
Management of placental abruption if no distress signs vs distress signs
No distress signs = steroids and admit
distress signs = c-section
165
Ferritin levels in anaemia of chronic disease
Raised
166
Management of legionella pneumonia
Clarithromycin
167
Name an SGLT-2 inhibitor
Canagliflozin
168
Symptoms of hypocalcaemia
Perioral paraesthesia
Cramps and numbness in hands
Tetany
169
When is amiodarone indicated in ALS
Ventricular fibrillation: Give 5 shocks and then amiodarone
170
Signs of hypokalaemia on an ECG
prolonged QT
171
How does Sodium Valproate affect INR
Increases it as it's an enzyme inhibitor
172
Management of a PE during CPR
Alteplase
173
What defines a postpartum haemorrhage
Over 500ml blood loss
174
ECG findings for hypertrophic obstructive cardiomyopathy
LVH
T wave inversions
deep Q waves
175
How long should a woman wait after taking ullipristal, before starting the COCP again
5 days
176
Side effect of trastuzumab
Cardiac toxicity
177
What substance causes hepatic encephalopathy
Ammonia crossing the BBB
178
What drug commonly interacts with SSRIs
Triptans
179
In VT, when should amiodarone and adrenaline be given
After three unsuccessful shocks
180
What bone tumour typically has sunburst sclerosis
Osteosarcoma
181
Anaemia of chronic disease vs iron deficiency anaemia
TIBC is raised in iron deficiency anaemia, but normal in anaemia of chronic disease
182
How is Marfan's inherited
Autosomal dominant
183
What should be done to PPIs prior to endoscopy
Be stopped two weeks before
184
What should be seen in a fundoscope for GCA
Swollen pale disc and blurred margins
185
Gold standard for diagnosing hydronephrosis
USS
186
When does rhythm control become first line for AF management
If there is coexistent HF
First onset AF
Or an obvious reversible cause
187
When should adrenaline be given in systole
ASAP (no shocks are needed)
188
Management of an uncontrolled vatical bleed after IV terlipressin
Sengstaken-Blakemore tube
189
Diagnosis of toxic megacolon
Abdominal X-Ray
190
How to calculate a pre renal cause of disease
divide creatinine by 10
If urea is greater than creatinine = pre renal disease
191
When can calcium gluconate be given without an ECG tracing
If K+ > 6,5 mmol/L
192
Spinal stenosis vs disc prolapse
Spinal stenosis: pain improves on bending forward
Disc prolapse: Pain gets worse on bending forward
193
A patient presents with reducedoxygen count and reduce breath sounds in BOTh lung bases, what is the diagnosis (post operatively)
Bilateral atelactasis: assocaied with pain
194
When is an ascitic tap, the first line investigation in suspected liver disease
If there is diffuse abdomen tenderness and a fever
195
ICP in meningitis
Raised
196
What causes upper lobe fibrosis
CHARTS
Coalworker's pneumoconiosis
Hypersensitivity pneumonitis
AS
Radiation
TB
Sarcoidosis/SIlicosis
197
Management of pituitary apoplexy
IV Hydrocortisone (prevents adrenal crisis)
198
Management of thrombosis in APL
Low dose aspirin
199
Management of toxic megacolon
Subtotal colectomy
200
Management of UC Crohn's with recurrent fistulas and rectal bleeding
Proctectomy (need to avoid sepsis)
201
Management of testicular torsions
Within 6 hours = bilateral orchidopexy (attach to the back of the scrotal wall
After 6 hours = orchidectomy
202
What can cause septic arthritis from joint prosthesis
Staph Epidermis
203
How does the supraspinatus attach to the humerous
greater tubercle
204
What two muscles of the shoulder is innervated by the accessory nerve
Teres minor
Deltoid
205
Name the four rotator cuff muscles
Supraspinatus
Infraspinatus
Subscapularis
teres Minor
206
Role of the spuraspinatus
Abduction
207
Role of the trees minor and infraspinatus
External rotation
208
Role of the subscapularis
Internal rotation
209
What does a painful arch between 60 and 120 degrees show
subacromial Impingement syndrome
210
Where in the painful arch is acromio-clavicular joint dysfunction seen
180 to 170 degrees
211
What blood finding is an indication for Androgen Insensitivity Sydnrome
Raised Testosterone > Oestrogen
212
What gene abnormality is Androgen insensitivty syndrome
XY46 (men but look female)
213
Early symptoms of AIS
Cryptorchidism
214
Define primary infertility vs secondary
Primary - couple was never able to concieve
Secondary - couple can no longer concieve after previously being able to do so
215
Consequence of having an IUD fitted in
Cervical shock: vasovagal reaction + bradycardia
216
Management of later stage endometrial cancer
External beam radiotherapy + Chemotherapy §§
217
What lymph nodes do endometrial cancers typically spread through
Inguinal lymph nodes
218
First line management of hospital acquired pneumonia
Co-Amoxiclav (if been in hospital for 5 days)
219
What murmur is heard in Turner's Syndrome
Ejection Systolic Murmur
220
When is dexamethasone contraindicated for meningitis
If a purpural rash is present (meningococcal septicaemia) - just used in bacterial and viral meningitis without rash
221
Risk Factors for neonatal sepsis
Pre-Term and Low Birth Weight
222
What medication can be given to stop breastfeeding (lactation)
Cabergoline
223
How should a low lying placenta at 20 weeks be managed
Rescan at 32 weeks
224
At what week can the baby be felt
12 weeks
225
What prophylaxis is given for GBS during pregnancy
Benzylpenecillin
