Revision Learning Flashcards
(114 cards)
1
Q
What type of environment do dressings promote for ulcer healing?
A
Moist environment
Dressings are normally occlusive as ulcers heal better in a moist environment.
2
Q
What is the primary objective for GPs in managing patients with atrial fibrillation?
A
Rate control
Cardiac output can fall dramatically with tachycardia in surgery.
3
Q
What is the biggest risk factor for SIDS
A
Preterm birth Four times higher risk
Also co sleeping and smoking
4
Q
What condition is characterized by widespread necrotising vasculitis in children?
A
Henoch–Schönlein purpura
Classically affects children aged three to eight years.
5
Q
What is the definition of constipation?
A
Less than three complete stools per week
Constipation is defined as a passing less than three complete stools per week.
6
Q
What are the five clinical features required for a diagnosis of Kawasaki disease?
A
- Fever of at least five days’ duration
- Inflammation of lips, mouth, or tongue
- Erythema, edema, or desquamation of extremities
- Bilateral dry conjunctivitis
- Cervical lymphadenopathy > 1.5 cm
These features are essential for diagnosis.
7
Q
What is the first-line treatment for bites?
A
Co-amoxiclav for three days
For adults allergic to penicillin, alternatives include metronidazole plus doxycycline.
8
Q
What is Erythema Migrans associated with?
A
Lyme disease
The rash usually appears one to four weeks after the tick bite.
9
Q
What is the management approach for pompholyx eczema?
A
- Keep areas clean and dry
- Avoid triggers
- Use topical corticosteroids and/or emollients
Management involves keeping the affected areas clean and dry and using treatments to reduce symptoms.
10
Q
What type of cancer is Mucoepidermoid carcinoma?
A
Most common type of salivary gland cancer
Mucoepidermoid carcinoma is the most common type of salivary gland cancer.
11
Q
What is a common earcondition that affects 10% of the population?
A
Acute otitis externa
A UK consensus document defines acute otitis externa as lasting for up to six weeks.
12
Q
What should men with a BMI over 29 kg/m2 be informed about in terms of sexual health
A
Likely reduced fertility
Men who have a body mass index of more than 29 kg/m2 should be informed about reduced fertility.
13
Q
What is the recommended treatment for troublesome hot flushes from androgen deprivation therapy?
A
Medroxyprogesterone
Initially for a period of 10 weeks.
14
Q
What are the risk factors for gestational diabetes?
A
- BMI above 30 kg/m2
- Previous macrosomic baby
- Previous gestational diabetes
- Family history of diabetes
- Minority ethnic family origin with high prevalence
These factors increase the risk of gestational diabetes.
15
Q
What percentage of women in the general population will conceive within one year?
A
Over 80%
This statistic applies to the general population.
16
Q
What is the recommended treatment for uncomplicated genital chlamydia infection?
A
Doxycycline 100mg bd for 7 days or azithromycin
Doxycycline is contraindicated in pregnancy.
17
Q
What is the typical survival duration for patients with hepatorenal syndrome?
A
Median survival is 12 days
Hepatorenal syndrome frequently complicates portal hypertension.
18
Q
What should be done if a cervical smear is postponed due to pregnancy?
A
Performed 12 weeks after delivery
This timing is recommended for follow-up.
19
Q
What is the diagnostic feature of scleritis compared to episcleritis?
A
Severe, boring ocular pain
True scleritis presents with significant pain and requires urgent assessment.
20
Q
What is the role of intrinsic factor testing?
A
Specific to B12 deficiency
It is a highly specific test for B12 deficiency.
21
Q
What should be the follow-up for patients with an increased risk of suicide starting antidepressants?
A
Reviewed after one week
This is especially for those aged 18-25 years.
22
Q
What is the recommended investigation for suspected renal stones?
A
Non-contrast computed tomography scan
This is the best form of imaging to confirm the diagnosis.
23
Q
What is the treatment for severe oesophagitis?
A
8 weeks full dose PPI
Proton pump inhibitors are the preferred treatment.
24
Q
What is the key complication of untreated coeliac disease?
A
Increased risk of non-Hodgkin’s and Hodgkin’s lymphoma
This includes small bowel adenocarcinoma.
25
What is the treatment for acute infective exacerbations of bronchiectasis?
Antibiotics for 14 days
## Footnote
Standard treatment involves a 14-day course of antibiotics.
26
What is the suggested treatment for a woman with symptoms of salpingitis/PID who can be managed as an outpatient?
Intramuscular ceftriaxone 1000mg single dose plus oral doxycycline 100mg BD for 14 days plus oral metronidazole 400mg BD for 14 days
## Footnote
Alternative regimens include oral ofloxacin 400mg BD for 14 days with metronidazole or oral moxifloxacin 400mg OD for 14 days.
27
What should be done if doxycycline is contraindicated or not tolerated for treating chlamydia
Azithromycin is used if doxycycline is contraindicated or not tolerated.
28
What is the recommended timing for starting treatment with varenicline?
Treatment with varenicline is recommended to start while the person is still smoking. (Start 1-2 weeks before stopping smoking)
29
After starting varenicline, when should a person be advised to stop smoking?
7–14 days after starting varenicline.
30
True or False: Cocaine can lead to vasoconstriction and increase the risk of stroke.
True.
31
What serious cardiovascular events can cocaine cause?
Stroke and/or coronary artery spasm and myocardial infarction.
32
What is the most sensitive marker for autoimmune thyroiditis?
Anti TPO
33
If someone has has shingles before should they have a shingles vaccine?
Yes- prior infection does no provide lifelong immunity and the vaccine can reduce the risk of recurrence and postherpstic neuralgia
34
In the contact of poor LV function what would raised ALP and GGT be most consistent with?
Biliary Obstruction
(Due to Congestive hepatopathy.)
35
CENTOR criteria what are the age modifiers
<14 ADD ONE POINT
>45 MINUS ONE POINT
36
What amount of menstural blood loss will lead to iron deficiency anaemia?
60mls per cycle
37
What site is routinely used for MenB at 2 months?
Left thigh (6 in 1 is given in right)
38
What site is routinely used for 6 in 1 vaccine at 2 months?
Right thigh (Men B given in left)
39
The MenB booster at 12 months, where is it given?
Left Deltoid
40
The MMR at 12 months, where is it given?
Right deltoid
41
When is the highest VTE risk
Post partum first 4 weeks ( 15-25x)
42
Watering eyes in <1 year. What is the most likely cause and will it resolve?
Congenital nasolacrimal duct obstruction
Will resolve spontaneously in 90% of cases
43
What is the average delay to diagnosis of endometriosis
8 years
44
What pulse in sepsis makes someone high risk
>130
45
What systolic BP in sepsis makes someone high risk
<90
46
When are odds ratio and relative risk very similar
When events is rare
47
What is the use of CA 19-9 in pancreatic cancer?
Treatment monitoring NOT SCREENING
48
Name some commonly used quinolones
Ciprofloxscin
Levofloxacin
(Ofloxacin, Moxifloxacin)
49
Name common common macrolides?
Erythromycin
Clarithromycin
Azithromycin
50
Name some tetracyclines
Tertracyline
Doxycycline
51
What is melasma?
An acquired hypermelanosis presenting as hyperpigmented macules bilaterally on sun-exposed sites, especially the face.
## Footnote
Melasma often occurs in women and can be triggered by sun exposure, hormonal changes, and certain medications.
52
61-year-old woman with Intense vulval itching, ivory-white macules and plaques on the labia, bruising, crinkled and thin skin.
These symptoms may indicate lichen sclerosus (LS).
53
What treatment does the British Association of Dermatologists recommend for lichen sclerosus?
A three-month trial of clobetasol propionate 0.05% topically, combined with a soap substitute and a barrier preparation.
## Footnote
This treatment is suggested if there is confidence in the diagnosis of LS.
54
When should a referral to a specialist vulval clinic be considered with LS
In cases of LS not responding to topical steroid, if not confident of the diagnosis, or if surgical management is being considered.
## Footnote
This ensures specialized care for complex cases.
55
What is the initial treatment for hirsutism in women with polycystic ovarian syndrome?
Topical eflornithine cream.
## Footnote
This treatment should be tried before considering other oral preparations.
56
What should be advised if a woman is taking rifampicin and COCOP?
Change the COCOP or ensure a minimum of 50ug during treatment and for a further 28 days.
## Footnote
Rifampicin is a strong enzyme inducer affecting contraceptive efficacy.
57
What is a serious risk associated with selective serotonin reuptake inhibitors (SSRIs)?
Toxicity and interactions between different SSRIs.
## Footnote
Particular caution is needed when switching from fluoxetine to other antidepressants.
58
What does NICE guidance recommend when switching from fluoxetine to another SSRI?
Stop fluoxetine and start the new SSRI at a low dose 4-7 days later.
## Footnote
This minimizes the risk of adverse effects due to fluoxetine's long half-life.
59
What risk do SSRIs/SNRIs pose for patients on warfarin?
Increased risk of bleeding.
## Footnote
This interaction necessitates careful monitoring of INR levels.
60
What is Sever’s disease?
A calcaneal apophysitis at the point of insertion of the achilles tendon.
## Footnote
It commonly affects children and adolescents during growth spurts.
61
What are the core features of Charles Bonnet syndrome?
Well formed, vivid, elaborate, and often stereotyped visual hallucinations in a partially sighted person with insight into their unreality.
## Footnote
There should be no features of psychosis or other cognitive impairments.
62
What should be sought for families with breast cancer and specific criteria?
Further advice from specialist genetics service
## Footnote
Criteria include bilateral breast cancer, male breast cancer, ovarian cancer, Jewish ancestry, sarcoma in a relative younger than 45 years, glioma or childhood adrenal cortical carcinomas, complicated patterns of multiple cancers at a young age, and paternal history of breast cancer.
63
What is the suggested treatment duration for children older than three months with lower urinary tract infection?
Oral antibiotics for three days
64
What is the key finding from Dr. Meredith Belbin's research on teamwork?
Individuals in a team assume different 'team roles'
## Footnote
He produced a questionnaire to identify nine types of personalities important in teams.
65
Which type of antihistamines has a higher anticholinergic burden?
Sedating antihistamines, such as chlorphenamine
66
What should be done for patients with suspected Meniere’s Disease?
Refer to ENT for diagnosis
67
What does the Health and Social Care Act 2001 require regarding gifts?
Registration of gifts from patients or their relatives valued at £100 or more
68
What does an SMR of 100 indicate?
The number of observed deaths is the same as expected for the general population
69
What is the most appropriate treatment for a patient with suspected allergic conjunctivitis?
Sodium cromoglycate
70
What is FAP, and what does it indicate?
Familial Adenomatous Polyposis, autosomal dominant condition associated with a family history of early-onset colon cancer and multiple polyps
71
Where do Fordyce spots typically occur?
On the glans or shaft of the penis, labia, inside of the cheeks, and on the lips
72
What should women with mastitis be advised to do?
Continue breastfeeding if possible
73
At what age can an LNG-IUS be removed if a woman wishes to consider earlier removal?
Age 55
74
What is the risk associated with chickenpox infection during the first two trimesters of pregnancy?
Intrauterine infection in up to 25% of cases
75
What is the role of VZIG in relation to chickenpox exposure?
Post-exposure prophylaxis (PEP) when a non-immune woman has significant exposure
76
What should be done for women who develop chickenpox in pregnancy?
Refer to a fetal medicine specialist for discussion and detailed ultrasound
77
What are the time frames for the trimesters of pregnancy?
First trimester: conception to week 12, Second trimester: week 13 to week 27, Third trimester: week 28 until birth
78
What should be considered for mild to moderate depression in the postnatal period?
Facilitated self-help
79
What should be done for a woman with known stable hypothyroidism who becomes pregnant?
Immediately increase the levothyroxine dose
80
What may relieve an intractable cough in palliative care?
Moist inhalations or regular administration of oral morphine
81
What should a person suspected of having OSA with excessive sleepiness do regarding driving?
Stop driving and notify the DVLA if symptoms are not controlled
82
What should be done to relieve inferior vena cava compression in a pregnant woman at 20 weeks or more?
Manually displace the uterus to the left or tilt the mother to the left
83
Common drug causes of hyponatraemia
Diuretics
SSRIs
Antipsychotics (such as haloperidol and phenothiazines)
84
When should gestational correction for weight measurements continue for premature babies?
Until one year of age
## Footnote
Gestational correction is important for accurate growth assessment in premature infants.
85
What are the conditions under which people with impetigo can attend a setting?
All lesions healed, dry, and crusted over or 48 hours after commencing treatment
## Footnote
Treatment may include hydrogen peroxide cream or antibiotics.
86
How long should patients who have undergone a tonsillectomy take away from school or work?
2 weeks
## Footnote
Adequate analgesia and good oral intake are advised during recovery.
87
What are gouty tophi?
Firm, white nodules under translucent skin
## Footnote
Gouty tophi are characteristic of chronic gout.
88
What are rheumatoid nodules?
Firm, skin-coloured, non-tender swellings within subcutaneous tissue
## Footnote
Often found over extensor surfaces in rheumatoid arthritis.
89
What is the leading cause of heel pain in active individuals?
Plantar fasciitis
## Footnote
It involves inflammation of the plantar fascia at the medial calcaneal tubercle.
90
What initial treatments are recommended for plantar fasciitis?
Analgesia (NSAIDs), eccentric stretching, ice packs
## Footnote
Referral to physiotherapy should be considered if symptoms do not improve.
91
What is prolotherapy's role in the treatment of plantar fasciitis?
It has a role if symptoms are refractory to conservative management
## Footnote
Referral to an orthopaedic surgeon may be needed for surgical management.
92
Which NSAIDs are considered to have favorable thrombotic cardiovascular safety profiles?
Naproxen (1000 mg a day or less) and low-dose ibuprofen (1200 mg a day or less)
## Footnote
These NSAIDs are often preferred for long-term use.
93
What is diabetic amyotrophy?
A subacute, painful, mainly motor mononeuropathy involving the femoral nerve
## Footnote
It leads to wasting and weakness of the quadriceps muscle.
94
What are the characteristic features of motor neurone disease?
Motor symptoms of gradual onset
## Footnote
It affects muscle control and strength progressively.
95
What type of neuropathy does phenytoin cause?
Symmetrical, sensory neuropathy
## Footnote
It can lead to various sensory disturbances.
96
What are the characteristic features of vitamin B12 neuropathy?
Symmetrical paraesthesia and numbness
## Footnote
Pain can occur, but these features are more typical.
97
What risk is associated with children treated with bone marrow transplantation?
Increased risk of diminished bone mineral density i.e osteoporosis
## Footnote
A baseline evaluation is recommended two years after completion of therapy.
98
What does NICE guidance recommend for second-line treatment of moderate to severe atopic eczema?
Topical tacrolimus
## Footnote
Recommended for adults and children aged two years and over when not controlled by topical corticosteroids.
99
What is recommended 2nd line in IBS?
Amitriptyline
100
How should gabapentin be reduced?
In increments e.g. 300 mg every one to two weeks
## Footnote
Opiates can be reduced by 10% per one to two weeks.
101
What is the highest risk factor for prostate cancer?
Age
## Footnote
The risk rises rapidly over 50 years.
102
What percentage of patients with visible haematuria have a malignancy at presentation?
14-34% i.e. Majority of people with haematuria do not have a cancer
## Footnote
Bladder cancer is more common in men and increases with age.
103
What constitutes first-line treatment in psychotic depression?
Dual therapy with an antipsychotic and an antidepressant
## Footnote
Combination therapy is more effective than either treatment alone or placebo.
104
What is the effectiveness of electroconvulsive therapy in treating psychotic depression?
Effective if the patient chooses it or if the depression is life-threatening.
Usually do antipsychotic and antidepressant though
105
What do visual hallucinations most likely indicate?
Organic brain disorder
## Footnote
Auditory hallucinations suggest psychosis; delusions of persecution may occur in various conditions.
106
What is Sudeck's atrophy?
A form of complex regional pain syndrome affecting feet or hands
## Footnote
Affects around 5% of all traumatic injury cases.
107
What is the first-line treatment for low back pain if no contraindications?
NSAIDs with gastroprotection if indicated
## Footnote
Codeine with or without paracetamol is second-line.
108
What is a typical presentation of ankylosing spondylitis?
Morning back pain and stiffness in men aged 18 to 30 years.
109
What are risk factors for osteoporosis?
Low body mass index, excess alcohol consumption, early menopause, female sex, smoking
## Footnote
BMI below 20 kg/m2 is particularly noted.
110
Which medications are too irritant to be used subcutaneously in syringe drivers?
Prochlorperazine, diazepam, chlorpromazine
## Footnote
Cyclizine and levomepromazine can also cause irritation.
111
When should live vaccines be postponed after stopping immunosuppressive drugs?
At least three months after high-dose systemic corticosteroids and six months after other immunosuppressive drugs.
112
What factors increase the risk of ongoing symptoms of COVID-19? I.e long covid
Older age, high BMI, female sex, asthma
113
Most patients with bladder cancer present with what?
Visible haematuria
114
When can live vaccines be given in the post-partum period?
Immediately even if breastfeeding
Exemption to this is yellow fever <6 months is breastfeeding
