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random quiz q's Flashcards

1
Q

What are the clinical features of uncomplicated malaria?

A

History
Fever, headache, arthralgia and myalgia, cough, anorexia, D&V.

Exam
Obs: fever, tachycardia, tachypnoea.
Inspection: conjunctival pallor, may be jaundice.
Palpation: splenomegaly.

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2
Q

Describe the procedure for the tuberculin skin test (TST)

A

Intradermal injection of tuberculin material, then measurement of area of induration after 48-72h.

NOTES
Positive TST suggests tuberculosis infection.
Mantoux technique = intradermal injection to inner surface of the forearm.
Tuberculin material is usually ‘purified protein derivative’ (PDD).

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3
Q

What is meant by ‘multidrug-resistant tuberculosis’ (MDR-TB)?

A

Resistance to isoniazid and rifampicin and possibly additional agents.

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4
Q

Which are the most common sites of extrapulmonary tuberculosis infection?

A

Sort by incidence

Most common

  1. Lymphatic system.
  2. Bones and joints.
  3. GIT e.g. hepatic disease, enteritis, peritonitis.
  4. CNS e.g. meningitis, tuberculoma.

All the rest e.g. urinary tract, genital tract, adrenal, cardiovascular, skin, breast.

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5
Q

What is meant by HIV seroconversion?

A

Development of detectable antibodies against HIV antigens.

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6
Q

List 4 AIDS-defining conditions

A

Sort by incidence

  1. Pneumocystis jirovecii pneumonia (PCP).
  2. Oesophageal candidiasis.
  3. Kaposi sarcoma.
  4. Toxoplasmic encephalitis.
  5. Disseminated Mycobacterium avium infection.
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7
Q

Which micro-organism causes PCP?

A

Pneumocystis jirovecii (a fungus).

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8
Q

Which investigations may be useful is suspected AIDS-related Kaposi sarcoma?

A

Skin biopsy (confirm diagnosis and rule out bacillary angiomatosis)

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9
Q

What is the lower limit of normal for the CSF-to-serum glucose ratio?

CSF = cerebrospinal fluid.

A

0.6

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10
Q

Which CSF findings are typical of viral meningitis?

CSF = cerebrospinal fluid.

A
  1. WBC usually <250/µL (majority lymphocytes).
  2. Glucose normal.
  3. Protein usually <150mg/dL.
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11
Q

What is the mechanism of action of the carbapenems?

A

Inhibition of a family of bacterial enzymes involved in cell wall synthesis.

NOTES
Carbapenems are beta lactam antibiotics.

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12
Q

What is the mechanism of action of metronidazole?

A

Acts as a substrate for particular enzymes in anaerobic bacteria, the product creates toxic free radicals.

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13
Q

What are the adverse effects of beta lactam antibiotics?

A
  1. IgE-mediated e.g. anaphylaxis, angiodema, urticaria.
  2. Serum sickness.
  3. Skin e.g. morbilliform rash, erythema multiforme.
  4. CNS e.g. penicillin neurotoxicity (only with very high doses).
  5. Kidneys e.g. interstitial nephritis.
  6. GIT e.g. diarrhoea.
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14
Q

β-lactam antibiotics?

A 
Antibiotics that contain a beta-lactam ring in their molecular structure. 
This includes:
penicillin derivatives
cephalosporins
monobactams 
carbapenems 
carbacephems.

Used for bacterial infection

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15
Q

What are the adverse effects of macrolides?

macrolides = antibiotic

A
  1. Heart e.g. QT prolongation.
  2. Liver e.g. hepatitis, cholestasis.
  3. GIT e.g. nausea, diarrhoea (prokinetic)
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16
Q

Name a macrolide and use

A

erythromycin
roxithromycin
azithromycin
clarithromycin

treating respiratory, skin, soft tissue, sexually transmitted, H. pylori and atypical mycobacterial infections.

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17
Q

What are the adverse effects of the tetracyclines?

A
  1. GIT e.g. nausea, diarrhoea.
  2. Skin e.g. photosensitivity.
  3. Teeth and bone (yellow discolouration of teeth in children).
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18
Q

What are the adverse effects of aminoglycosides?

A
  1. Nephrotoxicity.
  2. Ototoxicity (vestibular and cochlear damage).
  3. Neuromuscular blockade.
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19
Q

What type of antibiotic is erythromycin?

A

macrolide

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20
Q

What is the treatment for epistaxis?

A
  1. Resus
    A+B - consider airway support and oxygen.
    C - consider IV access.
  2. Conservative e.g. lean forward, pinch lower nose for 15-20 minutes, mouth breath; ice pack; suction of visibile clots.
  3. Nasal packing e.g. ribbon gauze, nasal tampon.
  4. Topical e.g. nasal cautery (silver nitrate-impregnated stick); naseptin cream.
  5. Surgical e.g. post nasal pack; ligation of arteries such as sphenopalatine artery.
21
Q

Define: nasal cautery

A

A procedure where a chemical or electrical device is applied to the mucous membranes in the nose to stop bleeding.

22
Q

What is chronic otitis media?

A

A middle ear condition characterised by recurrent otorrhoea through a perforated tympanic membrane.

23
Q

define: otorrhoea

A

discharge from the ear and may originate from the ear canal or the middle ear.

24
Q

What are the clinical features of acute otitis media (AOM)?

A

History
Recent upper respiratory tract infection.
Unilateral otalgia (pain may suddenly resolve followed by mucopurulent discharge).
Deafness.

Exam
Obs: fever.
Otoscopy: red, bulging, immobile tympanic membrane with loss of light reflex. If perforated, mucopurulent discharge may be visible in canal.
Palpation: tender postauricular lymph node.

25
Q

What are the clinical features of otitis externa?

A

History
Local symptoms e.g. pain, pruritis, scanty discharge, hearing loss.
Systemic symptoms e.g. fever, lymphadenopathy.

Exam
Obs: fever.
Inspection: auricular/ tragal erythema, discharge.
Otoscopy: moist debris, erythema, oedema, intact tympanic membrane.
Palpation: tragal/ meatal tenderness, post auricular lymphadenopathy.

26
Q

What are the causes of acquired conductive hearing loss?

A
  1. Obstruction e.g. wax, bony growth, malignancies.
  2. Infection e.g. otitis externa, AOM, OME.
  3. Trauma e.g. penetrating injury, barotrauma secondary to eustacian tube congestion.
  4. Other e.g. otosclerosis.

NOTES
AOM = acute otitis media.
OME = otitis media with effusion.

27
Q

Which micro-organisms most commonly cause acute otitis media (AOM)?

A
  1. Viral e.g. RSV, rhinovirus, influenza.
  2. Bacterial e.g. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis.

NOTES
Mixed infection is typical.
RSV = respiratory syncytial virus.

28
Q

What are the complications of acute otitis media (AOM)?

A
  1. Intra-temporal
    Infection: OME, chronic otitis media, labyrinthitis, mastoiditis, petrositis.
    Neurological: CN VII, VIII palsy.
  2. Intra-cranial
    Infection: meningitis, abscess (extradural, subdural, parenchymal).
    Vascular: lateral sinus thrombosis.

NOTES
OME = otitis media with effusion.

29
Q

What is otitis media with effusion (glue ear)?

A

A common complication of acute otitis media, characterised by a collection of fluid within the middle ear.

NOTES
Also called serous otitis media, secretory otitis media.

30
Q

What are the clinical features of otitis media with effusion (glue ear)?

A

History
Recent acute otitis media.
Local symptoms: hearing loss, otalgia, popping/ fullness.
Behavioural symptoms: speech, language and cognitive delay, poor attention, irritability.

Exam
Otoscopy: healthy external canal, dull, immobile, retracted tympanic membrane, fluid level.

NOTES
Audiogram shows conductive hearing loss.
Impedance audiometry shows flat curve typical of fluid in the middle ear.

31
Q

define: otalgia

A

earache

32
Q

What is BPPV (benign paroxysmal positional vertigo)?

A

A vestibular condition characterised by repeated episodic positional vertigo.

NOTES
Pathophysiology: calcium debris within the posterior semicircular canal (known as canalithiasis).

33
Q

What is Meniere disease?

A

An inner ear condition characterised by a triad of episodic vertigo, tinnitus and hearing loss.

NOTES
Pathophysiology: distentiion of endolymph-containing structures of the labyrinthine system.

34
Q

What is the long term treatment for Meniere disease?

A
  1. Conservative e.g. diet low in salt, caffeine, and chocolate; smoking cessation; vestibular rehabilitation programme.
  2. Medical e.g. betahistine (antihistamine).
  3. Surgical
    Destructive e.g. intratympanic gentamicin injection, labyrinthectomy, vestibular nerve section.
    Nondestructive e.g. endolymphatic sac decompression/ shunting, micropressure therapy.

NOTES
Patients with Meniere disease must inform DVLA.
Diuretics are occasionally used to manage symptoms in secondary care.

35
Q

Which micro-organisms most commonly cause otitis externa?

A

Most common: Pseudomonas aeruginosa.

All the rest

  1. Staphylococcus epidermidis.
  2. Staphylococcus aureus.
  3. Candida.
36
Q

What is stridor?

A

A high pitched, monophonic, inspiratory sound heard with upper airway obstruction.

37
Q

What are the clinical features of squamous cell carcinoma of the pharynx?

A

History
Symptoms due to primary e.g. dysphagia, may be odynophagia, otalgia.
Symptoms due to mets e.g. neck lumps, weight loss.

Exam
Inspection: visible lesion in the pharynx.
Palpation: cervical lymphadenopathy.

38
Q

Define: odynophagia

A

Painful swallowing

Pain in mouth or throat
Can be with or without difficulty swallowing

39
Q

Define: dysphagia

A

Swallowing difficulties

Problems swallowing certain foods and liquids or cannot swallow at all

40
Q

Signs of dysphagia?

A

Coughing or choking when eating or drinking

Bringing food back up, sometimes through nose

41
Q

What are the clinical features of nasal polyps?

A

History
Chronic sinusitis e.g rhinorrhoea, nasal/ facial congestion, hypo-/ anosmia, snoring, headache.

Exam
Inspection: pedunculated, yellow- grey nasal outgrowth.
Palpation: smooth, moist, non-tender.

NOTES
Unilateral nasal polyp/ blood-stained discharge may suggest underlying malignancy.

42
Q

Define: anosmia

A

Loss of sense of smell
Can be total or partial

Can be caused by head injury, infection blockage of nose

43
Q

Define: nasal polyps

A

Soft painless noncancerous growths on the living of the nasal passage or sinuses
a result of chronic inflammation

Associated with asthma, recurring infection allergies, drug sensitivity or immune disorders

44
Q

How is the Weber test performed?

A

Strike the tuning fork against your knee or elbow.
Then place the base of the fork in the midline, high on the patient’s forehead.
Ask the patient ‘Do you hear the sound louder in one ear than the other? If so, in which ear is it louder?’

NOTES
Normal Weber test = sound is heard equally in both ears.
Abnormal Weber test = sound is heard louder in one ear (indicating either conductive hearing loss in that ear, or sensorineural hearing loss in the opposite ear).

45
Q

What is vestibular neuritis?

A

Viral infection of the vestibular portion of the eighth nerve.
Characterised by acute, severe vertigo, nausea, vomiting and ataxia.

If combined with unilateral hearing loss, termed labyrinthitis.

46
Q

What are the clinical features of BPPV (benign paroxysmal positional vertigo)?

A

History
Episodic vertigo, triggered by a change in head position.
Nausea and vomiting.

Exam
Unremarkable.

NOTES
Episodes of vertigo typically last 1 minute.
Diagnosis is confirmed with Dix-Hallpike manoeuvre.
Most common positions that trigger vertigo are getting out of bed/ rolling over in bed.

47
Q

Which type of hearing loss is suggested if the Weber test lateralises to a side that is Rinne negative?

A

Conductive hearing loss on that side.

NOTES
Rinne positive = air conduction louder than bone conduction (normal).
Rinne negative = bone conduction louder than air conduction (abnormal).

48
Q

What is the epididymis?

& role?

A

Long coiled tube that stores sperm and transports to the testes

49
Q

What is the seminal vesicles?

& role?

A

2 small glands that store and produce the majority of fluid that makes up semen

Gen med random Q's (1 decks)

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