Phase 4 Flashcards
1
Q
5 risk factors for T2DM
A
obesity, PCOS, inactivity, family history, high sugar diet
2
Q
Pathology of Acanthosis Nigrans
A
increase in circulation insulin, activates keratinocyte ILGF receptors. increased IGF leads to keratinocyte and dermal proliferation
3
Q
Pathophysiology of vaso-occlusive crisises
A
Deoxygenated HbS molecules are insoluble and polymerise, become rigid and take up characteristic sickle cell shape. This leads to decreased survival and occlusion of microvasculature, causing ischaemia
4
Q
Other areas of body occlusive crisis will affect
A
Abdomen - mesenteric
Lungs - acute chest syndrome
penis - priapism
5
Q
Treatment of vaso-occlusive crisis
A
IV opiates, O2, rehrydate, warmth, antibiotics - hyposplenism, transfuse if Hb drops, long term hydroxycarbamide
6
Q
FBC and blood film findings in sickle cell
A
sickle shaped RBCs, Howell-Jolly bodies, moderate anaemia, increased MCV
7
Q
4 locations of transitional cell carcinoma
A
Bladder, ureter, renal pelvis, urethra
8
Q
4 risk factors for bladder cancer
A
aromatic amines, Schistosomiasis, smoking, napthylamine
9
Q
Blood supply to the bladder
A
Superior and inferior vesicle arteries which arise from the internal iliac arteries
10
Q
4 eye symptoms found in MS
A
pain at rest, painful ocular movements, decreased visual acuity, colour desaturation
11
Q
4 signs in the legs in MS
A
loss of fine touch sensation, decreased power, spasticity, hyperreflexia
12
Q
3 investigations in MS
A
visual evoked potentials, MRI brain/spine, LP fro CSF analysis - oligoclonal bands
13
Q
Management of MS
A
beta interferon
14
Q
investigations in coeliac disease
A
antiTTG and antiendomysial antibodies.
Duodenal biopsy - villous atrophy, crypt hyperplasia, increased intraepithelial lymphocytes
15
Q
explain changes in JVP in tricuspid regurgitation
A
V wave represents atrial diastole, in tricuspid regurgitation there is increased atrial pressure and therefore V wave is prominent
16
Q
4 As of dementia
A
Aphasia, apraxia, agnosia, amnesia
17
Q
Why do you give long term antibiotics in infective endocarditis
A
neither the valves or vegetations attached to them are supplied by blood vessels
18
Q
4 triggers for a sickle cell crisis
A
cold, hypoxia, stress exercise, infection
19
Q
3 things to palpate in scrotum
A
epididymis, testes vas deferens
20
Q
where does hydrocele arise from
A
tunica vaginalis
21
Q
5 components of the bishops score
A
Length, consistency, position, dilatation, station of head
22
Q
2 ways to induce labour
A
amniotomy, prostaglandin followed by oxytocin
23
Q
4 ways of recognising dehydration in a child
A
decreased skin turgor, sunken fontanelle, dry mucous membranes, decreased urine output
24
Q
What is compartment syndrome
A
swelling of a muscle, leading to increased pressure in compartment, impaired blood flow leads to infarction
25
Signs of compartment syndrome
pain out of proportion with presentation, pain increased on passive flexion/extension of fingers/toes
26
4 complications of compartment syndrome
rhabdomyolysis, renal failure, gangrene, loss of limb
27
6 complications of fractures
DVT/PE, malunion/nonunion, compartment syndrome, avascular necrosis, nerve injury
28
Define dementia
Irreversible progressive global decline in cognitive function without any disturbance of consciousness
29
4 organisms causing pneumonia
Streptococcus Pneumoniae, Haemophilus Influenza, Staphylococcus Aureus, Klebsiella
30
Treatment for pneumonia
Amoxicillin (erythromycin if intolerant)
31
5 complications of pneumonia
Sepsis, respiratory failure, lobar collapse, AF, pleural effusion, pneumothorax
32
4 risk factors for OA
previous trauma, obesity, manual labour, athletes
33
4 findings on XR in OA
Loss of joint space, Osteophytes, Subchondral cysts, Subchondral sclerosis
34
2 drugs to give in IECOPD - name, class and mechanism
Salbutamol, Beta2agonist, direct stimulation of beta2 receptors in bronchial smooth muscle resulting in bronchodilatation.
Ipratropium, antimuscarinic, antagonises action of acetylcholine on muscarinic receptors on bronchial smooth muscles and results in muscle relaxation and bronchodilatation
35
IECOPD treated but blood gases still deteriorating - what next?
non invasive positive pressure ventilation
36
Haemophilia A - bleeding time/PT/APTT normal reduced or prolonged
Bleeding time - normal
PT - normal
APTT - prolonged
37
One mechanical and one pharmacological management of haemoarthrosis
Mechanical - rest and elevation
| Pharmacological - treatment with factor VIII
38
How is haemophilia inherited
x linked recessive
39
Kid with haemophilia A needs dental extraction, what to prescribe pre op
Tranexamic acid or Desmopressin
40
4 features on XR suggestive of small bowel obstruction
Multiple dilated bowel loops, dilated bowel loops are central, no gas in large bowel, valvulae conniventes are seen across whole width of dilated bowel
41
3 causes of SBO
adhesions, incisional hernia, malignancy
42
4 immediate management of someone presenting with SBO
NG tube and suction, IV fluids, catheterise, analgesia, antiemetics, antibiotics
43
Features of UC
continuous lesions, superficial, crypt abscesses, decreased goblet cells, pseudo polyps, leadpipe appearance on xray
44
Features of Crohns
skip lesions, granulomas, strictures and fistulas, increased goblet cells
45
Complications of TURP
haematuria, urethral trauma/stricture, TUR syndrome, infection, ED, incontinence, retrograde ejaculation
46
5 side effects of atypical antipsychotics
weight gain, reduced libido, gynaecomastia, insulin resistance, agranulocytosis
47
Pt with CLL, where would you take a BM biopsy from
posterior iliac crest
48
4 features of a lump that would make you think of malignancy
hard consistency, painless, irregular margins, fixation to skin/chest wall, skin changes, discharge
49
commonest histological type of breast cancer
ductal adenocarcinoma
50
Management of acute pancreatitis
NBM, NG tube, IV fluids, analgesia, ERCP if gallstones cause
51
2 physical signs seen in pt with bulimia
Russells sign - callouses on knuckles
| Dental erosions
52
4 symptoms of frontal lobe damage
Loss of attention, loss of abstract thought, perseverations, change of affect, loss of inhibitions, violence
53
3rd nerve palsy - 3 findings
eye down and out, dilated pupil, lid ptosis
54
signs of papilloedema on opthalmoscopy
venous engorgement, loss of venous pulsation, optic disc haemorrhages, blurring of optic margins, elevation of optic disc, Patons lines
55
signs of liver failure
ascites, gynaecomastia, jaundice, spider naevia, asterixisis, clubbing, leuconychia, hepatomegaly
56
Synthetic liver function tests
PT, INR, albumin
57
5 physical signs in acromegaly
brow enlargement, jaw enlargement, spade like hands, feet enlargement, increased interdental spaces, wide nose
58
6 signs of SLE
raynauds, malar rash, discoid rash, pallor, joint swelling, pericardial rub
59
6 symptoms of SLE
fatigue, malaise, dyspnoea, rash, photosensitivity, myalgia, joint pain
60
Mechanism of recurrent miscarriages in antiphospholipid syndrome
thrombosis of placental blood vessels
61
2 x management of SLE - drugs and class
Prednisolone - corticosteroid
| Azathioprine - DMARDs
62
2 fat soluble vitamins and consequences of deficiency
K - reduced clotting factor production - bruising and bleeding
A - night blindness
63
4 treatments for HER2 +ve and oestrogen +ve breast cancer
Tamoxifen, herceptin, chemo, radiotherapy, node clearance
64
CSF analysis in bacterial vs viral meningitis
viral - clear, normal/low glucose, normal/high protein, lymphocytes
bacterial - turbid, low glucose, high protein, neutrophils
65
Where is klebsiella colonised in healthy populations vs alcoholics
Gut, lung in alcoholics - aspiration
| treat with cefotaxime
66
5 differentials for acute headache
SAH, meningitis, trauma, stroke, pituitary apoplexy, central venous thrombosis
67
Pathophysiology of Addisons
Raised urea and creatinine - pre renal failure due to reduced circulating volume. Lack of aldosterone = lack of sodium reabsorption and lack of potassium secretion
68
2 drugs to treat addisons
hydrocortisone - glucocorticoid
| fludrocortisone - mineralocorticoid
69
signs and symptoms of addisonian crisis
hypotension, severe abdominal pain, pyrexia, circulatory collapse
70
complications of PBC
cirrhosis, osteoporosis, malabsorption of fat soluble vitamins, hepatocellular carcinoma, renal tubular acidosis
71
Management of PBC
Colostyramine, fat soluble vitamins, Ursodeoxycholic acid, liver transplantation
72
Management of portal venous hypertension - acute bleed
resuscitation with cross matched blood and fluids, IV terlipressin, endoscopic band ligation
73
2 signs of MI on ECG
ST elevation >2mm in 2 or more chest leads, >1mm in 2 or more limb leads. Pathological Qwaves
74
2 drug treatments for angina and mechanism
Atenolol - bblocker - decreased sympathetic drive to the heart, decreased myocardial O2 demand. CCB - dilate peripheral vessels - decreased preload
75
4 symptoms of mania
delusions of grandiosity, pressure of speech, overactivity, inappropriate sexual behaviour, loss of inhibitions, reduced need for sleep, spending money recklessly
76
side effects of lithium
fine tremor, weight gain, polyuria, polydipsia, metallic taste
77
signs/symptoms of toxic dose of lithium
coarse tremor, confusion, diarrhoea and vomiting, ataxia, drowsiness
78
medications that increase lithiums effects in the body
ACEI, NSAIDs, SSRIs, diuretics
79
Organism causing HUS
Escherichia Coli O157
80
Pathology of HUS
Microangiopathic haemolytic anaemia. Endothelial layer of small vessels is damaged, as RBCs travel then get fragmented - intravascular haemolysis. Resulting schistocytes (fragments of red cell) are targeted for destruction by reticuloendothelial system in spleen
81
4 endocrine causes of hypertension
phaeochromocytoma - adrenaline
cushings - glucocorticoid
thyrotoxicosis - t4
SIADH - adh
82
5 contraindications of thrombolysis
Active bleeding, suspected aortic dissection, recent head trauma, intracranial neoplasm, previous haemorrhage stroke, previous allergic reaction to fibrinolytic agent
83
treatment of scabies
permethrin for pt and household members, wash clothing/bedding/towels
84
features of aspirin overdose
mixed respiratory alkalosis and metabolic acidosis. hyperventilation, tinnitus, lethargy, sweating, nausea, seizures, coma
85
what is primary biliary cholangitis
autoimmune chronic liver disorder, inflammation of interlobular bile ducts leads to progressive cholestasis and cirrhosis
86
which antibodies in PBC?
anti mitochondrial
87
management of primary biliary cholangitis
pruritus - cholestyramine
fat soluble vitamin supplementation
ursodeoxycholic acid, liver transplantation
88
complications of PBC
cirrhosis, osteomalacia, osteoporosis, increased risk of hepatocellular carcinoma
89
what organism causes gonorrhoea
neisseria gonorrhoeae - gram negative diplococcus
90
treatment of gonorrhoea
ceftriaxone IM 500mg, azithromycin 1g PO
91
what organism causes chlamydia
chlamydia trachomatis - obligate intracellular pathogen
92
TB treatments and side effects
Rifampicin - orange secretions
Isoniazid - peripheral neuropathy
Pyrazinamide - hepatotoxic
Ethambutol - optic neuritis
93
Examples of typical antipsychotics vs atypical antipsychotics
chlorpromazine, haloperidol
| atypical - clozapine, aripiprazole, olanzapine, quetiapine
94
4 dopamine pathways that antipsychotics work on
mesolimbic, mesocortical, nigrostriatal, tuberoinfundibular
95
Symptoms of depression
Core - low energy, low mood, anhedonia
cognitive - memory, concentration, thoughts of suicide, feelings of guilt, worthlessness, hopelessness
functional - sleep, weight loss/gain, loss of libido
96
Feature of insecticide poisoning
Accumulation of acetylcholine - SLUD
Salivation, lacrimation, urination, defecation
hypotension, bradycardia, small pupils. treat with atropine
97
How does tamoxifen work?
Selective oestrogen receptor modulator (SERM) - acts as an oestrogen receptor antagonist. Used in oestrogen +ve breast cancer. s/e - menstrual disturbance, hot flushed, VTE, endometrial cancer risk increased.
98
causes of delirium
```
Pain
Infection
Nutrition
Constipation
Hydration
Medication
Environment
```
99
driving rules in epilepsy
no driving for 6 months following first seizure. seizure free for 12 months before driving. no driving while mediation being withdrawn.
100
organisms causing bronchiolitis
RSV, human metapneumovirus, adenovirus, parainfluenza
101
2 signs on exmainatino for bronchiolitis
expiratory wheeze, widespread fine inspiratory crackles
102
who can have PSA checked
over 50 with lower urinary symptoms, monitoring of prostate cancer resection, suspicious PR findings
103
4 medications that cause constipation
opiates, iron tablets, anticholinergics, calcium
104
pre op tests for somebody with RA
neck extension, malampati, cervical XR, CXR
105
post op complications in a patient with RA
VTE - hypercoagulable
Poor healing - steroids
Infection - immunosupressed
Resp difficulty - lung fibrosis
106
Investigations in intermittent claudication
ABPI
| Doppler test brachial and medial malleolar pulse, extinguish wtih cuff. <0.9 some disease, <0.5 critical ichaemia
107
Treatment of quinsy
IV fluids, analgesia, drainage, abx - clindamycin
108
Which lymphnode affected by quinsy
Jugulodigastric node
109
differentiating torsion and epidydimo-orchitis
epididymo-orchitis - Prehns sign, retrotesticular pain
| torsion - red, swollen, transerse lie, n+v, absent cremasteric reflex
110
How do nephrotoxic meds cause AKI
ACEI - reduce angiotensin2, less tone of efferent arteriole, more blood leaves
NSAIDs - inhibit prostaglandin, constriction of afferent arteriole, hypoperfusion
111
Which lung cancer most common in non smokers
adenocarcinoma
112
which lung cancer associated with hypercalcaemia
squamous cell - secretion of parathyroid related peptide
113
What is a Howell Jolly body and when is it seen
Basophilic nuclear remnants in circulation erythrocytes - normally removed by spleen but seen in hyposplenism
114
Haem results in Polycythaemia Rubra Vera
Rise in haemoglobin, rise in WCC, rise in PLT. Also Jakll mutation
115
Pathology of DIC
Coagulation factors and platelets are consumed faster than they can be produced resulting in haemorrhage. Activation of coagulation cascade forms thrmbin which convert fibrinogen to fibrin, which in turn is broken down into degradation products - DDimer. Fibrin strands damage red blood vessels -> fragmented cells on blood film.
116
Treatment of severe c diff
oral vancomycin and IV metronidazole
117
What kind of organism is listeria monocytogenes
gram +ve bacillus
118
What kind of organism is neisseria
gram -ve diplococci
119
What kind of organism is haemophilus influenza
gram -ve cocci
120
What kind of organism is E Coli
gram -ve bacillus
121
CSF findings in bacterial meningitis
WCC raised - predominantly polymorphs, protein rasied, glucose low (<60% of serum)
122
What kind of organism is streptococcus
gram +ve cocci usually in chains
123
What kind of organism is staphylococci
gram +ve cocci in clusters
124
What is charcots triad
Swinging fevers, RUQ pain, jaundice
| Ascending Cholangitis
125
Which antibiotics are most likely to cause C Diff
clindamycin, fluoroquinolones, cephalosporins and carbapenems
126
Investigations for C Diff
Stool culture and PCR
127
4 ways of preventing spread of c diff
Hand washing, bare below elbow, barrier nursing, disposable gloves, not using rectal thermometers
128
Reversible causes of cardiac arrest
Hypoxia, Hypovolaemia, Hypothermia, Hyper/hypokalaemia, Tension pneumothorax, Toxin, Thombus, Tamponade
129
Causes for a raised troponin
MI, sepsis, myocarditis, PE, heart failure, renal failure
130
When do biochem cardiac markers peak and fall following MI
CK rises 4-8 hours post STEMI, peak at 24, fall 3-4 days
| Troponin rise 3 hours, and stay high for 7-14 days
131
3 signs of right heart failure
raised JVP, pulses paradoxes, kussmauls sign
132
Complications following MI
Recurrent infarction, angina, pericarditis, pericardial effusion, PE, fever, VSD, mitral regurgitation, free wall rupture
133
4 signs of severe haemodynamic compromise in arrhythmias
impending cardiac arrest, sever pulmonary oedema, SBP <90, decreased consciousness (treat immediately with unsynchronised external defibrillation for tachy and external pacing for brady)
134
2 examples of regular and irregular broad complex tachycardias
regular - VT, SVT with BBB
| irregular - AF with BBB, torsades de pointes
135
2 findings of WPW on ECG
delta wave, short PR
136
Pathology of respiratory failure
Type 1 - hypoxia - ventilation perfusion mismatch
| Type 2 - hypoxia with hypercapnia - alveolar hypoventilation
137
5 causes of haemoptysis
Bronchiectasis, PE, Cancer, Infection (TB, pneumonia, aspergilloma), trauma, goodpastures, wegeners
138
3 causes each of transudative/exudative pleural effusions
Trans - fluid overload, cardiac failure, nephrotic syndrome
| Exu - pneumonia, malignancy, RA, pancreatitis, haemothorax
139
Which nerve at risk in humeral fracture and how to test
Radial, wrist extensions
140
Which nerve at risk in suprachondylar fracture?
Ulnar nerve
141
Which scoring system for assessing severity of GI bleeding
Rockall score
142
Which scoring system to assess severity of liver disease in patients with cirrhosis
Child-Pugh score
143
Define AKI
abrupt (<48h) reduction in kidney function associated with an increase in creatinine >26umol or >50% increase from baseline, or a reduction in UO (<0.5ml/kg/hour for >6hours)
144
3 causes of pre renal, renal and post renal AKI
pre renal - hypovolaemia, renal artery stenosis, hypotenison
renal - vasculitis, sepsis, NSAIDs, gomerulonephritis
post renal - stones, BPH, HIV meds, increased abdo pressure
145
indications for dialysis in AKI
```
Acidosis
Electrolytes
Intoxication
Overload
Ureamia
```
146
5 causes of decreased consciousness
hypoglycaemia, hypoxia, meningitis/encephalitis, tumour, epilepsy, opiates
147
adrenaline dose in anaphylaxis
0.5ml of 1:1000 IM, repeat in 5 min
148
ALARM symptoms in GI
```
Anaemia
Loss of weight
Anorexia
Recent onset
Malaena/haematemesis
Swallowing difficulty
```
149
Components of the Glasgow score for pancreatitis
```
PaO2 - <8
Age - >55
Neutrophils - >15
Calcium - <2
Renal - urea >16
Enzymes - LDH >600, AST >200
Albumin - <32
Sugar - >10
```
150
What do you measure to monitor carcinoid syndrome
Urinary 5-hydroxyindoleacitic acid (urinary 5-hiaa)
151
Vesicular rash on face with tip of nose involved - what sign?
Hutchinsons - strong predictor of ocular involvement
152
Mechanism of Dorzolamide
Carbonic anhydrase inhibitor - reduces production of aqueous humour
153
How to differentiate horners syndrome and 3rd nerve palsy
3rd nerve palsy - ptosis and dilated pupil
| Horners - ptosis and constricted pupil
154
Triad of Wernickes
Confusion, ataxia, opthalmoplegia
155
5 fs of abdo distension
fat, fluid, foetus, flatus, faeces
156
Parkland formula
4ml x %TBSA x weight in kg = total over 24 hours, 50% over first 8 hours, 50% over next 16 hours
157
Blood results in DIC
platelets low, PT up, APTT up, fibrinogen low, DDimer up, on film - fragmented RBCs - schistocytes
158
Treatment of DIC
Platelets, Cryoprecipitate to replace fibrinogen, FFP to replace clotting factors,
159
What is quinsy
peritonsillary abscess
160
complications of food bolus
perforations, aspiration
161
Mechanism of rivoroxiban
factor xa inhibitor
162
Mechanism of warfarin
Vitamin K antagonist
163
Mechanism of dabigatran
direct thrombin inhibitor
164
4 AIDS defining illnesses
Kaposis sarcoma, PCP, CMV, TB
165
3 cells that express CD4
dendritic cells, macrophages, T helper cells
166
2 screening tests for TB
Mantoux, interferon gamma release assay
167
2 ways of monitoring HIV
CD4 count, viral load
168
Treatment for HCV
pegylated interferon a, ribavirin
169
3 screening test in HCV+ve pt
OGD - varices
AFP + USS - HCC
fibroscan - cirrhosis
170
3 investigations for diagnosing HCV
immunoblot assay, enzyme immunoassay, PCR
171
5 cancers that commonlyl spread to bone
thryoid, breast, lung, kidney, prostate
172
5 signs of decompensated liver failure
asterixis, ascites, hepatorenal syndrome, encephalopathy, varices
173
3 histological findings in coeliac
villous atrophy, crypt hyperplasia, lymphocytic infiltration
174
5 key symptoms in palliative care
```
N+V
Secretions
Pain
Breathlessness
Distress/delirium
```
175
kawasakis signs/symptoms
```
Mucosal involvement
Hands/feet - erythema/desquamation
Eyes - bilateral conjunctivitis
Adenopathy - cervical
Rash - truncal, pleomorphic
Temp - >5 days
```
176
Treatment of kawasakis
Prevent CAAs, ivig, high dose aspirin, echo at follow up
177
4 components of tetralogy of fallot
VSD
Overriding aorta
LVH
RVOO - usually PV stenosis
178
triad of nephrotic syndrome
proteinuria
oedema
hypoalbuminaemia
(most common cause in kids is minimal change - treat with pred)
179
What is Bells palsy
Acute, unilateral facial nerve paralysis. Lower motor neuron - forehead affected. treat with pred/eye care
180
risk factors for ovarian cancer
+++ ovulations - early menarche, late menopause, nulliparity. pill is protective - reduces ovulations
181
risk factors for endometrial cancer
same as ovary - +++ovulations. also diabetes, obesity, tamoxifen, PCOS
182
Investigating post menopausal bleeding
>55 y/o - TVUSS if <4mm endometrial thickness high NPV. if >4 = hysteroscopy and biopsy
183
Pathophysiology of antiphospholipid syndrome
Paradoxical rise in APTT, reaction of lupus anticoagulant antibodies with phospholipids involved in coagulation cascade
184
Where does varicella zoster reside
geniculate ganglion
185
3 actions of PTH
osteoclast activation, retention of Ca in kidneys, increased Ca absorption from GIT
186
Investigations for beta thalassaemia
FBC - microcytic hypochromic anaemia
Hb electrophoresis
DNA testing
187
Investigations in iron deficiency anaemia
Colonoscopy/endoscopy
faecal calprotectin
anti TTG/endomysial antibodies
188
classes of antidepressants with one example of each
Selective serotonin reuptake inhibitors - sertraline
Tricyclics - amitriptylline
Monoamine oxidase inhibitors - selegiline
Serotonin and norepinephrine reuptake inhibitor - venlafaxine
189
Vestibular Schwannoma symptoms
vertigo, hearing loss (sensironeural), tinnitus, absent corneal reflex, ataxia, raised ICP
190
What is an acoustic neuroma
tumour of the vestibulocochlear nerve (CNVIII)
191
3 causes of SNHL
pathology in cochlear or CNVIII - rubella, MMR, acoustic neuroma, menieres, ototoxis drugs (aminoglycosides)
192
3 causes of conductive hearing loss
wax, foreign body, cholesteatoma, perforation
193
Audiogram - axis
x axis - frequency in hertz, y axis - hearing level in decibels
194
Rinnes and Webers findings in SNHL and CHL
normal - R=AC>BC, W=equal
SNHL - R=AC>BC, W=localises to normal ear
CHL - R=BC>AC, W=localises to affected ear
195
Signs and symptoms of salicylate overdose
High anion gap metabolic acidosis, respiratory alkalosis, tinnitus, pyrexia, n+v, seizures, coma
196
Treatment of salicylate overdose
ABCDE, activated charcoal, IV sodium bicarbonate, haemodialysis
197
how to calculate alcohol units
vol in ml x ABV /1000
198
What is the Maddrey score and when/how is it used
Alcoholic hepatitis. score above 32 poor prognosis - steroids may help.
199
2 bugs that commonly cause cellulitis
strep pyogenes
| staph aureus
200
Causes of hyperparathyroidism
80% solitary adenoma, 15% hyperplasia
201
Signs and symptoms of hyperparathyroidism
polydipsia, polyuria, bone pain, renal stones, depression, hypertension
202
What imaging to use in hyperparathyroidism
Technetium MIBI subtraction scan
203
Which vessels affected in subdural haematoma
Rupture of bridging veins, elderly and alcoholics at risk
204
Mechanism of hydroxycarbamide in SCA
increased production of HbF, decreased Hb polymerisation, NO raised
205
Fundoscopy findings in CRVO
tortuous veins, optic disc edema, retinal haemorrhages, cotton wool spots
206
3 causes of proteinuria in children
nephrotic syndrome, alport syndrome, glomerulonephritis
207
quadruple test for downs syndrome
oestradiol, hCG, AFP, inhibin A
208
booking tests in pregnancy
syphilis, rubella, HIV, hepB
209
hypothermia ECG findings
J waves, arrhythmias
210
define hernia
Protrusion of a viscus/part of a viscus through the walls of its containing cavity into an abnormal position
211
4 Rs of fracture management
Resuscitation, Reduction, Restriction, Rehabilitation
212
What organism causes gas gangrene
clostridium perfringens
213
4 injuries of shoulder
dislocation, impingement syndrome, adhesive capsulitis, rotator cuff tear
214
What is disc prolapse
herniation of nucleus pulposus through annulus fibrosis
215
5 causes of carpal tunnel syndrome
```
Water - pregnancy
Radial #
Inflammation -RA
Soft tissue swelling
Toxic - EtoH
```
216
3 types of hearing test
Pure tone audiometry, tympanometry, evoked response audiometry
217
2 types of neonatal hearing screening
otoacoustic emissions, audiological brainstem responses
218
why do you get hyperacusis in bells palsy?
stapedius palsy
219
3 ways of protecting eye in bells palsy
lubricating eye drops, tape closed at night, dark glasses
220
What is ramsay hunt syndrome
reactivation of VSV in geniculate ganglion on CNVII
221
presentation of retinal detachment
4 fs
flashers, floaters, fall in acuity, field loss
painless
Rx - urgent surgery
222
What drug for intermittent claudication
Naftidrofurly oxalate
223
diagnosis of bullous pemphigoid
skin biopsy of blister - split under epidermis
| direct immunoflourescence staining of adjacent skin shows antibodies
224
why do we have blind spot in eyes
optic disc - no photoreceptors
225
pattern of loss in macular degeneration
central visual loss
226
causes of macrocytic anaemia
B12/folate deficiency, alcohol excess, reticulocytosis, hypothyroidism, myedlodysplastic syndromes
227
findings in central retinal vein occlusion
severe retinal haemorrhages, stormy sunset appearance, poor acuity, RAPD, cottonwool spots, retinal vein dilatation
228
triad of HUS
microangiopathic haemolytic anaemia, thrombocytopaeniam renal insufficiency
229
2 complications following bells palsy
synkinesis - eye blinking makes corners of mouth turn up
| crocodile tears - eating causes unilateral lacrimation instead of salivation
230
2 physical signs in appendcitis
rovsings sign - pain in rif when lif pressed, rebound tenderness
231
Transudate and exudate in pleural effusion
```
Effusion protein < 25g/L = transudate
Effusion protein >35g/L = exudate
If between 25-35g/L: apply Light’s Criteria
Light’s Criteria
serum protein ratio >0.5
serum LDH ratio
LDH is 0.6 x ULN
```
232
signs and symptoms of hypercapnia
confusion, asterixis, decreased consciousness, bounding pulse
