PT 1.0 Flashcards by Navya Arora

Hypercalcaemia causes

Primary hyperparathyroidism
Malignancy:
-bony mets
-myeloma
-PTHrP from squamous cell lung cancer
Sarcoidosis

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Viral meningitis LP vs Bacterial

Viral (commonly Coxsackie B): lymphocyte predominant, mildly elevated protein and normal glucose
Bacterial: low glucose, high protein, polymorphs

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Acoustic neuroma (vestibular schwannoma) Sx

vertigo
hearing loss
tinnitus
absent corneal reflex
-CNVIII: unilateral sensorineural hearing loss, unilateral tinnitus
-CN V: absent corneal reflex
-CNVII: facial palsy

Ix: MRI cerebellopontine angle

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Genital herpes Sx and Ix

Sx: painful ulcers, systemic upset, painful lymphadenopathy

Ix: nucleic acid amplification test

Tx: oral aciclovir

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Bacterial vaginosis Sx + Mx

Gardnerella vaginalis
-Fishy offensive vaginal smell
-thin, white discharge
-ph >4.5
None if asymptomatic
Symptomatic- oral metronidazole 5-7 days

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Bacterial vaginosis vs Trichomonas

BV: thin, white dischagre
Trich: frothy, yellow/green discharge, strawberry cervix and vuvlvovaginitis

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Vaginal candidiasis (thrush) Sx, Ix, Mx

‘cottage cheese’ discharge
vuvitis- superficial dyspareunia, dysuria
itch
No Ix needed
Mx: oral fluconazole 150mg single dose

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Bechet’s syndrome Sx

Oral and genital ulcers
Anterior uveitis
Thrombophlebitis/DVT

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Syphillis Sx

-painless ulcer
-local non-tender lymphadenopathy

later can get:
-fevers, lymphadenopathy, painless warty lesions

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Pain on drinking alcohol+ lymph node swelling

Hodgkin’s lymphoma

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Testicular torsion vs epididymitis

TT: severe, unilateral pain and swelling, raising it does NOT alleviate pain
Epididymitis: elevation eases pain

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Pneumonia + hyponatraemia

Legionella pneuomonia

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Histo: Reed-sternberg/ large multinucleate cells with eosinophillic features/ mirror image nucleoi

Hodgkin’s lymphoma

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Scabies treatment

Permethrin 5%, all household and close contacts should be treated

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Psoriatic arthritis xray

erosions in joint- ‘pencil in cup’ appearance

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Post op complications

5 Ws
Day 1-2: ‘Wind’ - Pneumonia, aspiration, Pulmonary Embolism
Day 3-5: ‘Water’ - Urinary tract infection (esp. if catheterised)
Day 5-7: ‘Wound’ - Infection at the surgical site or abscess formation
Day 5+: ‘Walking’ - Deep vein thrombosis or Pulmonary embolism
Any time: ‘Wonder Drugs’, transfusion reactions, sepsis, line contamination.

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AAA surgery threshold

> 5.5cm / symptomatic
US every 3 months

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Acute bronchitis Mx

with co-morbidities: oral doxycycline
without: supportive management

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Heart failure CXR findings

Alveolar oedema (bat’s wings)
Kerley B lines (interstitial oedema)
Cardiomegaly
Dilated prominent upper lobe vessels
Effusion (pleural)

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COPD target 02 sats

Non-CO2 retainer: 94-98%
CO2 retainer: 88-92%

Check ABG to see if they are a CO2 retainer

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Acoustic neuroma (vestibular schwannoma) Sx

-unilateral deafness/tinnitus
-vertigo
-absent corneal reflex

MRI of cerebellopontine angle

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Otosclerosis Sx

-bilateral conductive hearing loss/ tinnitus
-+ve family history
-age of onset 20-40

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Meniere’s disease sx

Hearing loss, vertigo, tinnitus and sensation of fullness or pressure in one or both ears
Episodic

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Types of hypersensitivity

Type I: IgE e.g. hayfever, rhinitis, drug/food anaphylaxis

Type II: IgG/M e.g. transfusion reactions

Type III: IgG/IgM e.g. SLE, RA, post strep glomerulo

Type IV: T cell e.g. T1DM, MS

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Perthes' disease

Sx: Hip pain over a few weeks, limp, stiffnes and reduced movement can have muscle wasting over hip and +ve trendelenburg Dx: X-ray

Viral labryinthitis sx

Vertigo exacerbated by movement N&V, hearing loss, tinnitus usually self limiting, prochlorperazine may help with vertigo

COPD LOT threshold

If resting sats 92% test ABG, if PO2 <7.3kPa, O2 therapy referral

Lupus flare vs infection

Flare: isolated rise in ESR Infection: CRP, WBC, ESR raise

Pregnant women UTI

Symptomatic: nitrofurantoin Asymptomatic: amoxicillin 7 days

Myeloma histology

Rouleaux formation

Sickle cell crisis sx + ix + mx

Vaso-occlusive events: obstruction of blood flow by sickled erthrocytes Ix: haemoglobin electrophoresis -analgesia, rehydrate, O2

chronic myeloid leukaemia blood film

increase in granulocytes at different stages of maturation +/- thrombocytosis Sx: splenomegaly

multiple myeloma histo

increased number of plasma cells

Most common type of prostate cancer

Adenocarcinoma

Bilateral nerve block given in the vagina for instrument assisted delivery blocks which nerve?

Pudendal (supplies the vagina, external genitalia and perianal area)

Cerebral venous sinus thrombosis

Sx: headache, seziure, decreased GCS, raised ICP symptoms, papiloedema RF: pregnancy, COCP Dx: MRI with venography

Ovarian cancer on a bx of endometriosis histology

-endometrioid carcinomas with clear cell in NON ENDOMETRIOSIS serous carcinomas with epithelial cells

clozapine side effects

-agranulocytosis, neutropenia -reduced seizure threshold -constipation -myocarditis

MOA + SE retinoblastoma

Loss of copies on both genes (C13) SE: absence of red-reflex, strabismus and visual problems

COPD MOA

Proteolytic destruction of alveoli

Stages of labour

Active stage 1: 4cm dilated to fully Stage 2: delivery Stage 3: delivery of fetus and membranes

Phaeochromocytoma sx

hypertension headaches palpitations sweating anxiety IX: 24 hour metanephrines Mx: initially alpha blocker e.g. phenoxybenzamine then surgical

primary hyperaldosteronism Sx

hypertension, hypokalemia (muscle weakness)

Mastitis Mx

1st line: continue breastfeeding with analgesia + warm compress If sign of infection or not improving, give 10 days oral flucloxacillin 10-14 days which can be breastfed with

Pre-eclampsia vs eclampsia Mx

Pre-eclampsia management: Oral labetalol Eclampsia management: Magnesium sulfate (to prevent seizures in severe pre-eclampsia and if seizures begin)

Calcium channel blocker SEs

HF, constipation, hypotension, heart failure, ankle swelling

IgA nephropathy vs Post-Streptococcal glomerulonephritis

IgA: HPP rash, 1-2 days posst URTI, haemturia, arthralgia PSG: oedema, hypertension, headache, proteinuria

DVT prophylaxis in pregnancy

apixaban is NOT safe in pregnancy Dalteparin is

Ibuprofen pregnancy RF

Premature closure of ductus arteriosus

Epidural drug used

Bupivacaine

what receptors do atypical antipsychotics work on?

dopamine D2 receptors

what are the main inhibitory and excitatory neurotransmitters in the CNS?

Exitatory: glutamate Inhibitory: GABA

Scleritis vs episcleritis vs anterior uveitis

Scleritis (RA/SLE): painful red eye Episcleritis: red eye not painful AU: acute painful may have small irregular pupil worse at night any painful eye gets same day opthal assessment

Neutropenic sepsis

usually 7-14 days after chemo -high temp (>38) cause: coagulase-negative, Gram-positive bacteria are the most common cause, particularly Staphylococcus epidermidis ANTIBIOTICS IMMEDIATELY!

ARB side effects

hypotension, hyperkalemia

UMN vs LMN signs

UMN: INCREASED tone, rigidity and spasticity Increased reflexes Babinski +ve LMN: DECREASED tone, muscle wasting and fasciculation, Decreased or absent reflexes Normal/no movement

AAA screening

-Less than 3cm: no action -3-4.4cm: rescan every 12 months -4.5-5.4cm: rescan every 3 months ->5.5cm: 2ww for surgery

Benign rolandic epilepsy

-childhood epilepsy syndrome can occur in sleep/ clusters sx: unilateral facial sensorimotor signs e.g. tongue paraesthesias, cheeck numbness, dysphagia can also have tonic clonic movements

Most common nerve damage with humerus fracture

radial (C5,6,7,8, T1)

PT 1.0 Flashcards

(60 cards)