Things I've Learned from EMQs Flashcards Preview

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Flashcards in Things I've Learned from EMQs Deck (22):

When can it be normal for boys to have gynaecomastica?

During puberty if transient


What are the features of congenital adrenal hyperplasia and how should you investigate?

  • 21 hydroxylase deficiency
  • Ambiguous genitalia or bilateral undescended testicles
  • Risk of salt losing adrenal crisis (vomiting, weight loss, floppy unwell infant) typically around 1-3 weeks of age
  • Measure urea and electrolytes in addition to chromosomal analysis and pelvic ultrasound


What are the features of Klinefelter's?

  • 47XXY
  • Tall stature
  • Delayed puberty
  • Possibly mild learning difficulties


What are the features of Turner's syndrome?

  • 45 chromosomes no Y
  • Lymphoedema
  • Short stature
  • Delayed puberty
  • Thyroid disorders
  • Coarctation of the aorta
  • Aortic stenosis
  • horseshoe kidney and coeliac disease


What are the features of galactosaemia?

  • Deficiency in galactose-1-phosphate uridyl transferase
  • Illness with lactose containing milks
  • Cataracts
  • Recurrent E coli sepsis



Is group B strep gram positive or negative?



What is the initial management for NEC?

NBM and IV Fluids


How do you diagnose microdeletion syndromes?



What is CHARGE syndrome?

  • Coloboma
  • Heart defects
  • Atresia choanae
  • Retardation of growth and devleopment
  • Genitourinary abnormalities
  • Ear anomalies


What's the difference in presentation between Tetralogy of Fallot and transposition of the great arteries?

Transposition presents at birth as the ductus starts to close.  Tetralogy presents at about 6 months with cyanotic spells.


What is choanal atresia?

Congenital blockage of the nasal airway which presents with newborn cyanosis and respiratory distress (as infants are obligate nasal breathers)


What is the most likely site for an inhaled foreign body to cause lung collapse?

Right middle lobe


What pattern of lung disease is seen in muscular dystrophy?



What are the common congenital heart defects in order of most common to least?

  1. VSD
  2. PDA
  3. Atrial septal defect, coarctation of the aorta, transposition of the great arteries


Which heart diseases are associated with Down's?

AVSD, VSD, tetralogy of fallot


What is seen on an ECG in SVT?

Narrow complex tachycardia


How is SVT treated?

  • Vagal manoeuvres
  • Adenosine if that doesn't work
  • Sedated synchronised cardioversion if that doesn't work (but do this urgently without waiting for sedation if the patient becomes cardiovascularly compromised e.g. loss of consciousness)


What are the diagnostic criteria for Kawasaki disease?

5 out of 6 of:

  1. Fever for >5 days
  2. Bialteral non purulent conjunctivitis
  3. Rash
  4. Oral changes e.g. dry, cracked red lips, strawberry tongue
  5. Erythema and oedema of the hands or feet
  6. Cervical lymphadenopathy


Inflammation at the BCG scar site is common but not a diagnostic criterion


What are the major criteria for rheumatic fever?

  • Pancarditis e.g. endocarditis - Murmur or valvular dysfunction
  • Myocarditis - heart failure
  • Pericarditis - rub, effusion or tamponade
  • Polyarthritis common in the knees, wrists, and ankles and may flit from joint to joint lasting more than 1 week in total (cf reactive arthritis)
  • Sydenham's chorea starting 2-6 months after the infection
  • Erythema marginatum
  • Subcutaneous nodules


What are the minor criteria for rheumatic fever?

  • Arthralgia
  • Family or personal history of rheumatic fever
  • RAised inflammatory markers
  • ECG changes e.g. prolonged PR interval