Qs Flashcards
(21 cards)
Symptoms: Chest pain when eating, sweaty, pain is severe. Smoker. Clean history. No ECG available.
Best next step?
Refer to emergency department
Symptoms: anal pain + itch. 9/10 severity. Blood on stools.
Next step?
Physical examination
Symptoms: dark urine, abdominal pain, non-specific joint pain sore throat, headache.
Urine dip stick= microscopic haematuria + proteinuria
What investigation do we want?
Renal biopsy
Contradiction to having a contraceptive coil fitted?
Smoking
Knee locked, unable to fully straighten, difficulty with stairs
Diagnosis?
McMurray’s
Symptoms: Itch, maculopapular rash on trunk, no discharge, bloating, loose stools, constipation
Diagnostic test?
LFTs
Symptoms: fever, malaise, sore throat, scant yellow exudates, pharyngeal erythema, enlarged posterior cervical lymph nodes, no airway obstruction, no diffuse skin rashes.
Mono spot test positive
What physical finding can we expect in patients with this condition?
Splenomegaly
72 y/o shortness of breath, palpitations, fainted pushing lawnmower. Slow raising pulse apex with mid-systolic murmur. BP= 101/50 mmHg.
Likely diagnosis?
Aortic stenosis
45 y/o, cough, sore throat, headache, nasal congestion, sneezing. Cough= productive and purulent. Lung exam= rhonchi- no signs of consolidation. Afebrile, eats at desk, smokes, drinks alcohol.
Causative risk factor?
Smoking
38 y/o, elective cholecystectomy due to gallstones, right sided thyroid module, 2 year history of hypertension, recurrent urinary tract stones.
Biomarker measured?
calcitonin
30 y/o, painful right eye, watery red, redness around sclera and cornea, pupil=irregular, fluorescein staining= no abnormalities Diagnosis? Corneal abrasion dendritic ulcer anterior uveitis acute conjunctivitis
anterior uveitis
55 y/o, dyspnoea, chest pain, productive cough, smoking= high, 20 units of alcohol per day. No haemoptysis, sore throat, weight loss, night sweats. Temp= 38c pulse= 98bpm BP= 110/85mmHg resp rate= 16 breaths per min oxygen sat= 95% in air What is the organism responsible? Haemophilus Influenzae Pneumocystis jirovecii Klebsiella pneumonia
Klebsiella pneumonia
56 y/o, 4 week history of higher urinary frequency and urgency throughout the day. Wait longer and strain before peeing. Frequency at night = problem. He is apyrexial, pulse= normal, bp=normal, no meds.
Appropriate management? metronidazadole TURP Tamsulosin Catheterization Desmopressin
Tamsulosin
23 y/o, emergency department, abdomen pain felt on walking, collapsed while eating, no med history. Pulse= 120bpm, weak, thready BP= 80/50mmHg sweating heavily, tender to palpitation of lower abdominal Appropriate management? Emergency laparotomy Prescribe inotropes serum bHGG Transvaginal ultrasound abdo ultrasound
Emergency laparotomy
52 y/o pituitary tumour involving cavernous sinus. Suspect abducens nerve of patient= damaged by tumour. Which direction would you have patient turn right eye to confirm defect? Downward Upward Outward Inward
Outward
26 y/o, detained in police, abdominal cramps, aching muscles, nausea, vomitting, agitated shivering, shaking hands. Cause of symptoms? Alcohol withdrawal Opiate withdrawal Benzodiazepine withdrawal delirium tremens LSD withdrawal
Opiate withdrawal
6 months old, excoriations + lichenified plaques on extensor aspect of arms and legs, family history of asthma, itchy dry skin. Likely diagnosis? Contact dermatitis Psoriasis Scabies Atopic eczema seborrheic dermatitis
Atopic eczema
40 y/o, non-productive cough, 6 months no dyspnoea/ chest pain, stable weight, good appetite, non-smoker, has hypertension and diabetes mellitus Chest exam= SO2= 98% on air respiratory rate= 19 chest auscultation and cardiac exam= normal X-ray= normal medication responsible for cough? Amlodipine Doxazocin gliclazide ramipril valsartan
ramipril
CHA2DS2-VASc score high or low risk? Score- calculate and should there be recommended to commence on oral anticoagulation for store prevention?
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30 month old boy, echoes words, no speech, no interaction, likes spinnings objects, flaps hands when excited/ agitated Diagnosis? Isolated speech delay language disorder Autism spectrum disorder
Autism spectrum disorder
50 y/o, chronic alcohol excess admitted with alcohol withdrawal and seizures. Clubbed fingernails, palmer erythema, gynaeomastria. Clinically jaundices, abdominal exam = no ascites / hepatomegaly with mild splenomegaly
What clinical signs most likely to predict poor outcome?
finger clubbing
gynaecomastia
non-palpable liver splenomegaly
Palmer erythma
splenomegaly
