Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final Year Flashcards > Passmedicine > Flashcards

Passmedicine Flashcards

(245 cards)

Start Studying
1
Q

Procedures that require special preparation:

A

Thyroid surgery; vocal cord check.
Parathyroid surgery; consider methylene blue to identify gland.
Sentinel node biopsy; radioactive marker/ patent blue dye.
Surgery involving the thoracic duct; consider administration of cream.
Pheochromocytoma surgery; will need alpha and beta blockade.
Surgery for carcinoid tumours; will need covering with octreotide.
Colorectal cases; bowel preparation (especially left sided surgery)
Thyrotoxicosis; lugols iodine/ medical therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Preoperative steps for diabetic Pts

Poor Glycaemic control inc rsk of Infx

A 
1st on list
Stop long acting Insulin the night before
Check glucose regularly
Insulin sliding scale until 1st meal
5% Dex c¯ 20mmol
KCl 125ml/hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Testing for PSA

A

6 weeks of a prostate biopsy
4 weeks following a proven urinary infection
1 week of digital rectal examination
48 hours of vigorous exercise or ejaculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Differentials for breast lump

A

Fibroadenoma - highly mobile smooth
Breast cyst - Small discrete, fluctuant
Sclerosing adenosis - may mimic Ca on mammography
Fat necrosis - trauma
Duct papilloma - discharge
Breast Ca - Hard, irregular, tethering (Paget’s disease of the breast = eczematous changes around the areola)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Feeding in head injury w/o BOS #

A

NG tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Feeding after oesophagectomy

A

Jejunostomy

RIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Coffee bean on AXR

A

Sigmoid volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Volvulus MX

A

Sigmoid: Rigid sigmoidoscopy
Caecal: operative, often hemicolectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Caecal volvulus RF’s

Sigmoid volvulus RF’s

A

Pregnant, adhesions

Older pts, chronic constipation, Chagas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hartmann’s procedure

A

Anterior resection, anorectal stump and end colostomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Specific pre-operative complications: Anticoagulation

A 
Based on thromboembolic risk
Low risk e.g. AF
Stop Warfarin 5d's pre-op
Restart next day
High risk e.g. 
Stop Warfarin 5d's pre-op
Start LMWH 
Stop LMWH 12-18hrs pre-op 
Restart LMWH 6hrs post op
Start Warfarin next day
Stop LMWH when INR>2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anal/rectal cancer procedure

A

Abdominoperineal resection

+/- Total mesorectal excision (fatty tissue and LN’s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

TUR syndrome

A 
Complication of TURP
Absorption of electrolyte-free irrigation fluid
1. Hyponatraemia: dilutional
2. Fluid overload
3. Glycine toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Universal donor

A

O rhesus negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Colle’s #

A

FOOSH
Dorsal displacement and angulation of distal bone segments
1 inch proximal to radio carpal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Smith’s #

A

Opposite of Colle’s

Palmar angulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bennett’s#

A

Intra-articular fracture of the first carpometacarpal joint
Impact on flexed metacarpal, caused by fist fights
X-ray: triangular fragment at ulnar base of metacarpal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Monteggia’s #

A

Dislocation of the proximal radioulnar joint in association with an ulna fracture
Fall on outstretched hand with forced pronation
Needs prompt diagnosis to avoid disability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Galeazzi’s #

A

Radial shaft fracture with associated dislocation of the distal radioulnar joint
Direct blow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pott’s #

A

Bimalleolar ankle fracture

Forced foot eversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Barton’s #

A

Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation
Fall onto extended and pronated wrist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lisfranc #

A

Tarso-metatarso joint injury. Subtle widening in between 1st and 2nd Metatarsals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Billous vomiting Differentials

A

Duodenal atresia - assoc w/ Down’s
Malrotation w/ volvulus - 3-7 days of life
Meconium ileus - 24-48hrs of life, assoc w/ CF
Necrotising enterocolitis - 2nd wk of life, assoc w/ prematurity and intercurrent illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

AXR finding chronic pancreatitis

A

Calcific foci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Chronic pancreatitis
``` pain following a meal, radiates to back steatorrhoea 5 and 25 years after the onset of pain diabetes mellitus Ix AXR - calcified foci ACT - more sensitive Function test - faecal elastase Mx Pancreatic enzyme supplements Analgesia ```
26
Imatinib
Gastrointestinal stromal tumours
27
Infliximab Adalimumab Etanercept
TNF alpha inhibitor Chron's Rheumatoid disease
28
Basiliximab
IL2 binding site | Renal transplants
29
Bevacizumab
Anti-VEGF Colorectal Glioblastoma Renal
30
Trastuzumab
HER receptor | Breast Ca
31
Cetuximab
EGF inhibitor | Colorectal Ca
32
Vessel causing upper GI bleed in duodenal ulcer
Gastroduodenal
33
Pseudomxyoma peritonei
rare mucinous tumour most commonly arising from the appendix. The disease is characterised by the accumulation of large amounts of mucinous material in the abdominal cavity. It is rare, with an incidence of 1-2/1,000,000 per year
34
Drug used in SAH to minimise complications
Nimodipine - to prevent vasospasm
35
Irregular nodule in Testes AFP and HCG not raised
Seminoma
36
TPN complications
Derranged LFT's
37
Unexplained IDA Ix
Faecal occult blood testing
38
Urgent referral guidelines Bowel Ca
patients >= 40 years with unexplained weight loss AND abdominal pain patients >= 50 years with unexplained rectal bleeding patients >= 60 years with iron deficiency anaemia OR change in bowel habit tests show occult blood in their faeces (see below)
39
Hormone therapy for Breast Ca (ER+ve)
Anastrozole
40
UC and Crohn's differences
``` UC Bloody Rectal extending proximally Submucosal inflammation Crypt abscesses Primary sclerosing cholangitis Crohn's Non bloody Skip lesions All thickness inflammation Caseating granulomas ```
41
Extra intestinal manifestations of IBD
Skin - Pyoderma gangrenosum, Clubbing Eyes - Iritis, Conjunctivitis Joints - Arthritis, Ank spond, sacroilitis HPB - PSC (UC), Cholangiocarcinoma (Crohn's)
42
Inducing remission UC
1st line: 5-ASA | 2nd line: Prednisolone
43
Maintaining remission UC
1st line: 5-ASAs PO – sulfasalazine or mesalazine  Topical Rx may be used in proctitis 2nd line: Azathioprine or 6-mercaptopurine  Relapsed on ASA or are steroid-dependent  Use 6-mercaptopurine if azathioprine intolerant 3rd line: Infliximab / adalimumab
44
Indication for surgery in IBD
Perforation Haemorrhage Failure to respond to Rx Ca
45
Inducing remission in Crohn's
1st line: glucocorticoids. Budesonide is an alternative 2nd: 5-ASA drugs (e.g. mesalazine) not as effective 3rd: azathioprine or mercaptopurine not used as monotherapy. Methotrexate is an alternative to azathioprine 4th: infliximab is useful in refractory disease and fistulating Crohn's. Patients typically continue on azathioprine or methotrexate N.B. metronidazole is often used for isolated peri-anal disease
46
Rx for Diabetic neuropathic pain
1st line: amitriptyline, duloxetine, gabapentin or pregabalin if the first-line drug treatment does not work try one of the other 3 drugs tramadol may be used as 'rescue therapy' for exacerbations of neuropathic pain topical capsaicin may be used for localised neuropathic pain (e.g. post-herpetic neuralgia) pain management clinics may be useful in patients with resistant problems
47
Rx for diabetic gastroparesis
Metoclopramide, domperidone or erythromycin
48
Diabetic gastroparesis Px
Erratic blood glucose control, bloating vomiting
49
Increased INR 5-8 No bleeding Rx
Withhold 1-2 doses, reduce maintenance dose
50
Increased INR 5-8, minor bleeding Rx
Stop warfarin IV vit K 1-3mg Resume when INR <5
51
Increased INR >8 no bleeding Rx
Stop warfarin Give vitamin K 1-5mg by mouth, using the intravenous preparation orally Repeat dose of vitamin K if INR still too high after 24 hours Restart when INR < 5.0
52
Increased INR >8 minor bleeding Rx
Stop warfarin Give intravenous vitamin K 1-3mg Repeat dose of vitamin K if INR still too high after 24 hours Restart warfarin when INR < 5.0
53
Major bleeding increased INR Rx
Stop warfarin Give intravenous vitamin K 5mg Prothrombin complex concentrate - if not available then FFP*
54
ECG features of Hypokalaemia
``` U waves small or absent T waves (occasionally inversion) prolong PR interval ST depression long QT ```
55
ECG features of hyperkalaemia
``` Peaked T waves Flattened P waves ↑ PR interval Widened QRS Sine-wave pattern → VF ```
56
Monitoring of T1DM
HbA1c every 3-6 mnths Aim for 6.5% or lower Bld Glucose 4x a day, before every meal and before bed Aim for 5-7 on waking and 4-7 before meals Inc frequency with illness and sport
57
PEA Rx
DR ABCDE CPR for 2 mins assess rhythm 1mg adrenaline, then adrenaline every other cycle
58
Drug causes of galactorrhoea
Metoclopramide Chlorpromazine Haloperidone Domperidone
59
Ix of choice for suspected Bladder Ca
Cystoscopy
60
Chemo that causes cardiomyopathy
Doxorubicin
61
Side effects of methotrexate
Lung fibrosis | Liver fibrosis
62
Acute causes of confusion
Constipation Pneumonia UTI COPD exacerbation
63
Mx of Bell's palsy
``` Conservative Eye drops Educate Med Pred if w/in 72hrs onset ```
64
Inheritance of HOCM
Autosomal dominant
65
Lung function results for idiopathic pulmonary fibrosis
Increased FEV1/FVC ratio | Reduced transfer ratio
66
Restrictive lung diseases
Pulmonary fibrosis Sarcoidosis Acute respiratory distress syndrome Neuromuscular disorders
67
Obstructive lung disorders
Asthma COPD Bronchiectasis
68
Ix for Legionella pneumonia
Urinary antigen test
69
K/Na/Cl requirement /kg/day
1mmol/kg/day 80kg pt = 80mmol
70
Water requirement /kg/day
25-30ml/kg/day 80kg pt = 2 liters
71
Glucose requirement /kg/day
50-100g/kg/day
72
Diagnosis of DM
If the patient is symptomatic: fasting glucose greater than or equal to 7.0 mmol/l random glucose greater than or equal to 11.1 mmol/l (or after 75g oral glucose tolerance test) Asymptomatic must have two recorded values
73
Rx of Epilepsy
1st line generalised: Sodium valproate 1st line partial: Carbamazepine 2nd line: Lamotrigine
74
Skull XR in exam
Paget's disease - Marked thickening of the calvarium
75
pANCA most strongly associated w/
Churg-Strauss
76
cANCA most strongly assoc w/
Granulomatosis with polyangitis
77
Sickle cell anaemia | Sudden low Hb and low reticulocyte count
Parvovirus
78
Blood transfusion threshold
70g/L
79
Diagnostic Ix for asthma
Fractional exhaled nitric oxide FeNO | Spirometery and bronchodilator reversibility test
80
DM diagnosis based on HbA1c
>6.5% with symptoms
81
Diarrhoea in HIV pts
Cryptosporidium
82
Resp infx in HIV pts
Histoplasmosis
83
Carcinoid syndrome
Liver mets that release serotonin into the circulation Hypotension watery diarrhoea
84
Ototoxic drugs
Loop diuretics
85
QRISK2
Risk of cardiovascular disease
86
Monitoring of statins
Check LFT's | Discontinue if 3x the upper limit
87
Infx assoc w/ Guillian-Barre syndrome
Campylobacter jejuni
88
Which joint condition is assoc w/ lung fibrosis
Rheumatoid arthritis
89
Triad of symptoms for Ascending cholangitis
Fevers RUQ pain Jaundice
90
Ca assoc w/ Crohn's
Mucosal associated lymphoid tissue lymphoma
91
Marker raised to diagnose anaphylaxis
Tryptase
92
Opioids in CKD
Buprenorphine, fentanyl, alfentanil
93
Wilson's disease Px diagnostic Ix
Dementia, tremor, dyskinesias Cu & caeruplasmin, urinary Cu excretion
94
Wilson's Rx
Chelating agent, Penicillamine
95
Peutz-Jeghers syndrome Def Px
Autosomal dominant condition causing harmatomatous polyps in the GI tract. characteristically having freckles on the lips face palms and soles Px: intestinal obstruction (intussusception), GI bleeding
96
Glucose in DKA and HHS | Hyperglycaemic hyperosmolar state
>30mmol/L
97
Scoring system for PE
Wells >4 PE likely <4 PE unlikely
98
Child-Pugh scoring system
Liver cirrhosis
99
APGAR
Child's health straight after birth
100
HAD | GAD
Hospital anxiety and depression | general anxiety scoring system
101
Cha2ds2vasc
Anticoagulation with AF
102
Aspirin MOA
Antiplatelet inhibits production of thomboxane A2
103
Clopidogrel MOA
Antiplatelet Inhibits ADP binding to platelet receptor
104
Enoxaparin
Anticoag Activated antithrombin III = potentiates inhibition of anticoagulation factor Xa
105
Fodaparinux MOA
Anticoag activaates antithrombin III = potentiates inhibition of anticoagulation factor Xa
106
Abciximab MOA
GpIIb/IIIa receptor antagonist
107
PDA pulse character
Bounding, collapsing
108
Qrisk scoring system
risk of stroke w/in next 10 yrs | >20= statin
109
ETOH RF for which cardiomyopathy
Dilated
110
PCI indication on ECG
ST elevation >1mm in II, III or aVF >2mm in 2 or more consecutive anterior leads v1-v6
111
Glycaemic control following MI
Dose adjusted insulin infusion
112
HF investigation w/ prev MI w/o prev MI
``` w/ = Echo w/o = BNP ```
113
Features of Small cell lung cancer
``` Usually central Associated w/ secretions: ADH - hyponatraemia ACTH - Cushing's syndrome (Lambert-Eaton syndrome Ab's to Ca channels mimicking MG) ```
114
Mx of Small cell lung cancer
Very early disease: T1-2aN0M0 considered for surgery | Most Pts recieve cehmo w/ radio adjuvant
115
Indication for long term O2 therapy
Two arterial bld tests w/ O2<7.3kPa
116
Transpyloric plane
``` Level L1 2nd part of the duodenum Pylorus - stomach left kidney hilum Fundus of gallbladder Neck of pancreas Duodenojejunal flexure SMA Portal vein Lt and Rt colic flexurespleen ```
117
Histological findings of TB tissue biopsy
Epitheliod histiocytes found in granuloma
118
Histological findings ``` Owl-Eyes nucleus Reed sternberg Psammoma bodies Keratin pearl Poikilocytes ```
``` CMV infx Hodgkins lymphoma Papillary thyroid carcinoma SCC in lung Ca Myelofibrosis ```
119
COPD Rx using salbutamol inhaler PRN
FEV1>50% - LABA or LAMA | FEV1<50% - LABA + ICS or LAMA
120
Pneumonia assoc w/ birds
Chlamydia psittaci | treated with tetracyclines
121
Pneumonia assoc w/ alcoholics and red currant jelly like sputum
Klebsiella | Can cause pleural empyema formation
122
Buproprion MOA
Norepinepherine and dobutamine reuptake inhibitor and nicotinic antagonist
123
Femoral nerve injury Px
Weak hip flexion Weak knee extension Impaired quadriceps tendon Sensory deficit in anteromedial aspect of the leg
124
Common nerves affected during surgery: 1) Varicose veins 2) Posterior approach to the hip 3) Posterior triangle lymph node biopsy 4) Lloyd davies stirrups 5) Thyroidectomy 6) Anterior resection of rectum 7) Axillary node clearance 8) Inguinal hernia 9) Carotid endarterectomy
1) Sural and saphenous nerves 2) Sciatic 3) Acessory nerve 4) Common peroneal 5) Recurrent laryngeal nerve 6) Hypogastric autonomous nerves 7) Long thoracic nerve, thoracodorsal, intercostobrachial nerves 8) Ilioinguinal nerve 9) Hypoglossal
125
Sensation to the anterolateral aspect of the thigh
Lateral cutaneous nerve of the thigh
126
Charcot's triad Whats it for Whats it made up of Mx of condition
Ascending cholangitis RUQ pain Jaundice Fever Mx IV Abx ERCP
127
Anaesthetic agent with anti emetic properties
Propofol
128
``` Neuro conditions Put simply G M M M ```
Guillian-Barre syndrome: immune mediated post (camp J) infx, causing ascending weakness (proximal legs 1st) Motor neuron disease: UMN + LMN Sx's of unknown Ax after 40, clinical diagnosis = no sensory signs, Multiple sclerosis: relapsing remitting, affecting eyes, motor nerves (weakness), or sensory nerves (parasthesia) Myasthenia gravis: Autoimmune affecting nAChr, causing progressive weakness w/ inc used, eyes, swallowing
129
Guillian barre Ax Px Ix Mx
Ax: Immune mediated demyelination of PN's often triggered by an infx (campylobacter j) Px: Growing weakness i.e. Symmetrical: ascending (legs 1st) flacid weakness/paralysis LMN signs: areflexia, fasciculations Proximal > distal trunk, respiratory, CN's esp VII Progressive phase lasts < 4wks Ix: clinical diagnosis, anti-ganglioside Abs, Spirometry for lung function monitoring, NCS dec or normal Mx: Supportive: Airway, Analgesia, Autonomic - inotropes, Antithrombotic - TEDS, LMWH Med: IVIG or plasmapheresis 85% complete recovery
130
Motor neuron disease Px Ix Mx
Cluster of degenrative disease characterised by axonal degeneration Px: UMN+LMN signs, absence of sensory Sx's, doesn't affect eye movements Ix: clinical diagnosis, MRI to exclude structural lesions, LP to exclude inflam, NCS exclude neuropathy ``` Mx: Cons: MDT, palliate Med: Riluzole (prolongs life by 3mnths), Sx treatment i.e. Resp failure - NIV Dyspagia - RIG Drooling - propantheline ```
131
Multiple sclerosis Def Px Ix Mx
Chronic progressive inflammatory condition of the CNS characterised by multiple plaques of demyelination disseminated in time and space Classified into relapsing-remitting, progressive, secondary progressive and progressive relapsing Px: TEAM Tingling: parasthesia Eye: optic neuritis (dec central acuity + movement pain) Ataxia +cerebellar signs Motor: usually spastic paraparesis, swallowing Ix: diagnosis clinical MacDonalds criteria Fundoscopy - swollen optic nerve head Gd-enhancing MRI - Plaques LP - oligoclonal Abs Mx Acute relapse - high dose steroids dec dur of attacks Disease modifying - beta interferon reduces relapse rates Other medical - Glatiramer, natalizumab, fingolimod
132
Myasthenia Gravis Def Px Ix Mx
Autoimmune disease mediated by Abs vs nAChr in the neruomuscular junction Px: inc muscular fatigue Extra-ocular - bilateral ptosis, diplopia Bulbar - voice deteriation on speaking for 2mins Face - myasthenic snarl on smile attempt Limb - asymmetrical limb weakness Ix Tensilon test - edrophonium IV, +ve if improvement Anti-AChr Abs EMG - dec t train of impulse Mx Sx control - long acting anticholinesterase (pyridostigmine) Immunosuppression - Pred Myasthenic crisis - Plasmapheresis or IVIg
133
Rx epilepsy guidelines
1st seizure = referral to epilepsy clinic only unless - neuro deficit, sturctural abnormality, EEG changes 2nd = Sodium valproate (carbamazepine for focal)
134
Migraine Rx
``` Acute episode 1st - paracetamol + metoclopramide/domperidone 2nd - NSAID (ketoprofen) + M/D Prophylaxis Avoid triggers 1st - Popanolol, topiramate Riboflavin, acupuncture ```
135
Triceps reflex
C7-C8
136
Biceps reflex
C5-C6
137
Ankle reflex
S1-S2
138
Knee reflex
L3-L4
139
Absence seizure EEG sign
3Hz symmetrical oscillations
140
Cluster headache Px Rx
``` Px Rapid onset severe pain behind one eye Red, watery eye, nasal congestions Miosis, ptosis 15-3hrs, 1-2x/day, mostly nocturnal Cluster last 4-12wks, remission lasts 3mo-3yrs ``` Rx High flow O2 Sumitriptan Prevention - verapamil
141
Triptan MOA Inidication SE
5HT1 agonist Migraine Triptan sensations - tightness around the chest, tingling, heat, heaviness
142
Verapmil or digoxin in WPW syndrome
Contraindicated as may predispose to VT or VF
143
Child-Pugh
``` Scoring system for liver cirrhosis Bilirubin Albumin Ascites Prothrombin time Encephalopathy ```
144
Warterloo on PT
Warfarin Prothrombin time
145
MELD
Calculate pts survival w/ liver cirrhosis
146
Drug contraindicated in Parkinson's
Metoclopramide - D2 antagonist, Ind: nausea, GORD Chlorpromazine Haloperidol
147
Polyposis syndromes
FAP - APC gene, screen and resect, HNPCC - colonic Ca, endometrial Ca Peutz-Jeghers - pigmentation, harmatomas
148
COPD signs with basal ephysema and derranged LFT's
alpha1-antitrypsin deficiency
149
Statin adverse effects
Myopathy: myalgia Liver impairment: Rx discontinued if LFT>3xULN Intracerebral haemorrhage
150
Atorvastatin dose Primary prevention Secondary prevention
1ry - 20mg | 2rd - 80mg
151
Thiazide diuretics SE
``` HypoNa, HypoK, HyperCa Postural hypotension D\ehydration Gout Impaired glucose tolerance ```
152
Ix of choice for liver fibrosis
Transient elastography
153
Churg-Strauss
``` Small-medium vessel vasculitis Px Asthma Paranasal sinusitis Mononeuritis multiplex pANCA ```
154
Test for H. Pylori
Urea breath test
155
Weber's syndrome
III nerve palsy | Contrlateral weakness
156
MEN type I MEN type IIa MEN type IIa
``` MEN type I: 3 P's - parathyroid, pituitary, pancreas (ulceration) MEN type IIb: 2 P's - Phaeo, parathyroid MEN type IIb: 1 P - Phaeo ```
157
Pneumonia w/: Derranged LFT's Hyponatreamia and lympopaenia Sig O2 desat on exercise Upper lobe consolidation
Mycoplasma Legionella PCP TB/Kleb
158
MRSA treatment 1st line 2nd line
Vancomycin Linezolid
159
Amyloidosis Def Px Ix Mx
Extracellular deposition of insoluble fibrillar protein Deposition leads to organ dysfunction e.g. nephrotic syndrome Congo-Red stain Serum amyloid precursor scan Rectal biopsy
160
Blood products in haemorrhage w/ anticoagulants
FFP - clinically sig. but not major haemorrhage INR>1.5 Cryoprecipitate - haemophilliacs, liver disease Prothromin complex concentrate - severe bleeding, intracranial bleeding
161
Cytotoxic side effects Methotrexate Cisplatin Doxorubicin
Myelosuppression, liver fibrosis, mucositis Hypomagneseamia Cardiomyopathy
162
Delerium Rx
Haloperidol or olanzopine 1st line
163
Peri-arrest bradycardia Rx
500micrograms Atropine
164
ECG leads location and blood supply
``` I - lateral, Lft circumflex artery II+II+aVF - inferior, rt coronary artery v1-v2 - anterior, LAD v3-v4 - septal, LAD V5-v6 - Lateral, left circumflex ```
165
Takayasu arteritis
Large vessel vasculitis Absent pulse females and asians
166
Statin and erythromycin/clarithromycin
Myopathy | inc CK
167
Addison's Mx
Hydrocortisone 20-30mg a day Fludrocortisone Hydro dose double w/ concurrent illness
168
ABG in Conn's syndrome
Hypokalaemic metabolic alkalosis
169
Graves
Anti-TSH receptor stimulating antibodies
170
H. Pylori Rx
PPI + Amoxicillin + Clarithromycin or Metronidazole + Clarithromycin
171
Rx for ruptured varices
``` ABC FFP Vasoactive agents - terlipressin Abx Endoscopy - ligation (1st) or sclerotherapy ```
172
Octreotide
Somatostatin analogue | used in carcinoid syndrome
173
Fluid maintenance rate
25-30ml/kg/day | 80kg = 2L/day
174
Adrenaline | Indications and dose
Anaphylaxis = 0.5mg 1:1000 IM Cardiac arrest = 1ml 1:1000 IM or 10ml 1:10,000 IV
175
Nicorandil Indication MOA
K channel activator
176
Kusmaul's sign
JVP ↑ w/ inspiration
177
Distended bowel w/ absent bowel sounds after rt hemicolectomy
Paralytic ileus
178
Which anaesthetic agent stongest analgesic effect
Ketamine
179
VTE prophylaxis in hip replacement
TED stockings and dalteparin <6hrs after op
180
Breast Ca Hormonal receptors and responding therapy
ER - Tamoxifen | HER - Herceptin
181
Surgery for Ca: 10cm from anal verge Caecal Sigmoid
Lower anteroir resection w/ loop ileostomy Rt Hemicolectomy Lft Hemicolectomy
182
Rx for anal fissure
``` Diet modification Laxatives Lubricants prn Analgesia Topical GTN ```
183
Duke's classification
``` Staging of colorectal Ca Dukes A = confined to bowel wall Dukes B = invasion of muscularis propria Dukes C = LN metastases Dukes D = Distant mets ```
184
Indications for immediate head CT after injury
``` GCS<13 GCS<15 at 2hrs post injury ?skull fracture Post traumatic seizure Focal neurological deficit More than 1 episode of vomiting ```
185
Ca markers Carcinoembryonic Ag Alphafeto protein CA19-9
Colonic Hepatocellular Cholangiocarcinoma
186
High rupture risk AAA
Symptomatic Diameter>5.5 Velocity of growth >1cm/yr
187
AAA Rx
low rupture risk <5.5cm US and monitor High rupture risk Endovascular aortic repair (EVAR)
188
``` Surgical jaundice put simply Pancreatic Ca Cholangiocarcinoma Gallstones Cholangitis ```
Pancreatic Ca Painless jaundice w/ palpable mass Courvoisier's law Cholangiocarcinoma Gradual obstructive picture, assoc w/ UC+PSC Gall stones Intermittent biliary colic, eating a meal, radiates to back Cholangitis RUQ pain, fever, jaundice Charcot's triad
189
Ulcers put simply
Venous Haemosideran deposits, varicose veins, painless Artery Painful, punched-out, pulseless, low ABPI Neuropathic Pressure points, T2DM, Painless
190
Glasgow criteria
``` Severity of pancreatitis. Severe pancreatitis if 3 or more are detected w/in 48hrs PaO2 <8KPa Age >55y/o Neutrophillia >15*10^9 Ca <2.0mMol/L Renal, urea <16mMol/L Enzymes LDH>600/AST>200 Albumin < 32g/L Sugar bld glucose <10mMol/L ``` N.B. Amylase tested in ?paancreatitis but not related to severity
191
Age of presentation of testicular Ca
20-30
192
Renal cell Ca
Nephroblastoma = Wilm's tumour Adenocarcinoma = Gratwitz Transitional cell tumours = 80% lower UT Renal cell Ca = most common renal Ca
193
BPH Rx
alpha 1 antagonist Surg TURP
194
Staghorn calculus Infx organism
Proteus mirabilis
195
Diagnostic criteria of Heritary haemorrhagic telangectasia
Or Osler-Weber-Rendu Epistaxis Telangectases - lips, oral cavity, fingers, nose Visceral lesions - i.e. GI or arterio-venous malformations Family Hx
196
Murmurs
Ejection systolic - aortic stenosis Pan systolic - Mitral regurg Early diastolic - Aortic regurg
197
INR target for indications
VTE = 2.5 or 3.5 if recurrent AF = 2.5 Mechanical heart valve dependent on valve and location
198
``` MOA of Tirofiban Abciximab Enoxaparin Clopidogrel ```
Tirofiban - GPIIb/IIIa receptor antagonist Abciximab - GPIIb/IIIa receptor antagonist Enoxaparin - antithrombin III agonist Xa inhibitor Clopidogrel ADP2Y platelet inhibitor
199
HbA1c normal range and diabetic diagnosis
Different from glucose! <41mMol/L (5.9%) normal >48mMol/L (6.5%) diabetes between = prediabetes
200
Phaeo diagnostic test
24hr collection of metanephrines
201
Idiopathic thombocytopaenic purpura Path Px
Immune mediated | Epistaxis , isolated thobocytopaenia in a well pt
202
G6PD def Def Crisis protagonists
Most common RBC enzyme defect, commonest in Mediterranean and African, X-linked recessive Drugs Ciprofloxacin Anti-malarials Sulph-
203
HIV | Multpile ring enhancing lesions on CT head
Cerebral toxoplasmosis
204
Sepsis 6
1. Blood cultures - out 2. Fluids (0.9% Normal Saline) - in 3. Urinary Catheter - in 4. Oxygen - in 5. Lactate (Venous blood gas or Arterial Blood gas) - out 6. Antibiotics - in
205
``` Abx for the following Chalmydia Pyelonephritis Cellulitis Exacerbation of COPD Atypical pneumonia Syphillis Gonnorhoea BV ```
``` Chalmydia - Doxy/azithromycin Pyelonephritis - Broad spectrum cephalosporin or quinolone Cellulitis - Fluclox Exacerbation of COPD - Amoxicillin or clari or tetracycline Atypical pneumonia - Clarithromycin Syphillis - Benpen Gonnorhoea - Ceftriaxone or azithromycin BV - metronidazole PID - ofloxacin + met ```
206
Acute vs chronic graft rejection
Acute = <6mnths
207
``` Parkinson's drugs Levodopa Cabergoline Procyclidine Selegiline ```
Levodopa - Dopamine precursor, reduced effectiveness over time Cabergoline - Dopamine receptor agonist, lung and heart fibrosis Procyclidine - Anti-muscarinics, help with tremor and rigidity MAOi - Inhibits breakdown of doapmine
208
Drug used in MND
Riluzole
209
Nerves at risk of injury Falling from tree/arm traction during delivery Pronated and medially rotated # of neck of humerus
Brachial trunks C8-T1 - Klumpke's palsy Brachial trunks C5-C6 - Erb's palsy Axillary nerve
210
Features of Wernicke's encephalopathy
Thiamine deficiency ``` CANOPEN Confusion Ataxia Nystagmus Opthalmoplegia PEripheral Neuropathy ```
211
Wernicke's encephalopathy relationship with korsakoff syndrome
Korsakoff syndrome can develop if Wernicke's is not treated with thiamine Features include confabulation and retrograde amnesia
212
Trigeminal neuralgia Rx
Carbamazepine
213
Thiazide diuretics MOA
Na Cl symporter
214
Hernia definition
The protusion of a vicus or part of a viscus through an abnormal defect in the wall that usually contains it
215
``` Ortho tests Knee - 3C's Hip - TT Shoulder - ISITS Simmonds ```
``` Knee Collaterals, cruciates, cartilages Hip Thomas', Trendelenburg Shoulder Impingement, Supraspinatus, infrspinatus, teres minor, Subscapularis Simmonds Achilles tendon rupture, feet off of bed and one more dorsiflexed, squeeze w/ no movement ```
216
Malari Rx
Falciparum severe = Artesunate IV Falciparum moderate = PO artesunate combination therapy Non - falciparum = PO ACT or chloroquinine if not resistant
217
Red flags for sepsis
systolic blood pressure < 90mmHg or > 40mmHg fall from baseline mean arterial pressure < 65mmHg heart rate > 131 per minute respiratory rate > 25 per minute unresponsive or responsive only to voice or pain
218
Abx drug classes and examples
Penicillins - cillin, amoxicillin Cephalosporins - cef, ceftriaxone, Macrolide - mycin, clarithromycin, azithromycin, vanc Tetracycline - Doxycycline
219
Waterlow
Risk of pressure sores
220
Prophlaxis for SBP
Ciprofloxacin
221
Red flag Sx's for gastric Ca
``` New-onset dyspepsia in a patient aged >55 years Unexplained persistent vomiting Unexplained weight-loss Progressively worsening dysphagia/ Odynophagia Epigastric pain ```
222
Plummer-Vinson syndrome
Dysphagia Glossitis IDA
223
Strong emotion and collapse or reduced muscular tone
Cataplexy
224
Neurofibromatosis vs Tuberous sclerosis
``` Both neurocutaneous syndromes Tuberous sclerosis Hypopigmented patches sub-ungal fibromata Epilepsy Developmental delay Neurofibromatosis Axillary/groin freckles Acoustic neuromas Phaeo's ```
225
Drugs that ↑ prognosis in HF
ACEi BB Spironolactone Hydralazine w/ nitrates
226
Rx for cerebral metastases
High dose dexamethasone to reduce cerebral oedem
227
Loss of corneal reflex, dizziness, hearling loss
Acoustic neuroma
228
SE of phenytoin
Acute Dizziness, diplopia, confusion, nystagmus, ataxia Chronic Gingival hyperplasia, megaloblastic anaemia, peripheral neuropathy, lymphadenopathy
229
Ix for carcinoid sydrome
urinary 5-Hydroxyindoleacetic acid 5-HIAA
230
Most common Haemophillia Thrombophillia Hbopathy
VWD FV Leiden G6PD def
231
Small bowel obstruction and air in biliary tree
Gallstone ileus
232
Hepatic encephalopathy
Confusion, altered GCS (see below) Asterix: 'liver flap', arrhythmic negative myoclonus with a frequency of 3-5 Hz Constructional apraxia: inability to draw a 5-pointed star Triphasic slow waves on EEG Raised ammonia level (not commonly measured anymore)
233
Syringomyelia features
Loss of pain and temperature in a shawl like distribution LMN Sx's - wasting and weakness in arms Loss of reflexes
234
Status epilepticus steps
Buccal midazolam/IV Lorazepam IV lorazepam Pheytoin Rapid sequence induction of anaesthesia w/ sodium thiopental
235
Most common transplant viral infection
CMV
236
Renal cloic analgesia
IM Diclofenac
237
UTI & pregC
Nitrofurantoin used in pregC Trimethoprim used in Breastfeeding
238
RA Mx
Combination of DMARD Methotrexate Sulfasalazine Pred short course
239
Rx of tetanus
High risk wound | Tetanus IG
240
Casts in urine meaning
Red cell casts - Glomerulonephritis White cell casts - Acute pyelonephritis Granular (muddy-brown) casts - Acute tubular necrosis Fatty casts - nephrotic syndrome
241
Scrotal problems
Epididymal cyst - most common form of scrotal swelling Hydrocele - fluid collection in tunica vaginalis, transilluminates Varicocele - Enlargement of testicular veins, bag of worms
242
High output stoma ABG
Metabolic acidosis, ↓K, ↓Na | due to loss of bicarbonate and cations from bowel
243
Complication of acute urinary retention
Acute kidney injury
244
Scoring system for Prostate Ca
Gleason >5=malignant | ↑ score = ↓ prog
245
Thyroid blood testing Assess completeness of surgical resection Hashimoto's
Calcitonin | Thyroid peroxidase Ab's

Final Year Flashcards (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions