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Things you just need to know Flashcards

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1
Q

AKI definition

A

Creatinine > 26 umol/L within 48hrs
Creatinine > 1.5 x baseline
Decreased urine volume < 0.5 mL/kg/hr for 6 hrs

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2
Q

AAA screening recommendations

A

Invitation to screening at 65 y/o
Normal - no rescan
3-5cm - rescan every 6 months
>5cm - rescan every 3 months

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3
Q

CHA2DS2-Vasc score

A 
Congestive HF 1
HTN 1
Age >75 2
DM 1
Stroke/TIA 2
Vascular disease 1
Age 65-74 1
Female sex 1
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4
Q

Asthma attack

A

ABCDE resus
High flow O2
Salbutamol nebs (5mg, initially continuous then 2-4 hourly)
Ipratropium bromide (0.5 mg QDS
Steroid therapy (100-200 mg hydrocortisone followed by 40 mg oral prednisolone for 5-7 days)
If no improvement, IV magnesium sulphate, IV aminophylline, IV salbutamol)
Discharge when PEFR >75% predicted and stable for 24 hrs

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5
Q

Chronic asthma management

A
  1. Inhaled SABA prn (e.g. salbutamol)
  2. 1 + regular ICS (e.g. beclomethasone)
  3. 2 + LABA, then increase steroid dose
  4. Increase inhaled steroid dose, add leukotriene antagonist/theophylline/oral BA
  5. Add regular oral steroids, maintain high-doses and seek specialist care
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6
Q

Calculating plasma osmolality

A

2Na + 2K + glucose + urea

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7
Q

Diagnosing diabetes

A

HbA1c 48mmol/mol (6.5%) or more

FBG >6.9 mol/L (>125 mg/dL)
RBG >11.1 mmol/L (>200 mg/dL)
OGTT >11.1 mmol/L (>200 mg/dL)

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8
Q

LP results: cloudy CSF, high neutrophils, low lymphocytes, high protein, low glucose

A

Bacterial meningitis

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9
Q

LP results: clear CSF, low neutrophils, high lymphocytes, high protein, normal glucose

A

Viral meningitis

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10
Q

LP results: fibrinous CSF, low neutrophils, high lymphocytes, high protein, low glucose

A

TB meningitis

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11
Q

Cerebellar signs

A 
Dysdiadocokinesia
Ataxia
Nystagmus
Intention tremor
Speech changes
Hyperreflexia
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12
Q

Bacterial meningitis

Gm +ve cocci, elderly

A

Streptococcus pneumoniae

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13
Q

Bacterial meningitis

Gm -ve diplococci

A

Neisseria meningitides

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14
Q

Bacterial meningitis
Cheese consumption
Alcoholic

A

Listeria monocytogenes

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15
Q

Bacterial meningitis
Child
Unvaccinated

A

Haemophilus influenzae

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16
Q

Bacterial meningitis
Neonate
Extended labour, infection in previous pregnancy

A

Group B streptococcus

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17
Q

Bacterial meningitis

Late neonatal infection

A

E coli

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18
Q

Bacterial meningitis

Chronic infection

A

Mycobacterium TB

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19
Q

Infective endocarditis buzzwords

A 
Prosthetic valve
Dental procedure
New onset murmur
Right heart
Indwelling catheter
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20
Q

Bone marrow failure with Auer rods

A

Acute myeloid leukaemia

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21
Q

Bone marrow failure in children

A

Acute lymphoblastic leukaemia

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22
Q

Bone marrow failure with Philadelphia chromosome

A

Chronic myeloid leukaemia

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23
Q

Bone marrow failure with smear cells and warm agglutinins

A

Chronic lymphocytic leukaemia

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24
Q 
Painless lymphadenopathy
Reed-Sternberg cells
Binucleate lymphocytes
Pain after alcohol
Single group of nodes
A

Hodgkin’s lymphoma

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25
Painless lymphadenopathy | Multiple groups of nodes
Non-Hodgkin's lymphoma
26
Bone marrow failure without splenomegaly | Ringed sideroblasts
Myelodysplasia
27
Bone marrow failure with massive splenomegaly | Dry bone tap
Myelofibrosis
28
Increased calcium, renal failure, anaemia, bone lesions | Bence-Jones proteins (dense band)
Multiple myeloma
29
Plethoric face, headache, aquagenic pruritis
Polycythaemia vera
30
Normal Sodium levels
135-145
31
Normal Potassium levels
3.5-4.5
32
Normal urea levels
2-7
33
Normal CRP
0.5-10
34
Normal Ca levels
2.2-2.6
35
Lung cancer Male, smoker Found central at proximal bronchi Spreads locally with late mets
Squamous cell carcinoma
36
Lung cancer Female, non-smoker Peripheral Early mets
Adenocarcinoma
37
``` Lung cancer Smoking Aggressive, early mets Found centrally in proximal bronchi Paraneoplastic syndromes (e.g. SiADH) ```
Small cell carcinoma
38
``` Lung cancer Male Gynaecomastia (beta HCG) Peripherally Late mets ```
Large cell carcinoma
39
``` Lung cancer Found in apex Horner's syndrome Hoarse voice Pancoast syndrome - wasting of arm muscles, pain, paraesthesia, paresis ```
Pancoast tumour
40
Paraneoplastic syndromes
``` SiADH Cushing syndrome Hypoglycaemia Hypercalcaemia Carcinoid syndrome Lambert-Eaton Myasthenia syndrome Acanthosis nigricans Dermatomyositis ```
41
Complications of AKI
``` Metabolic acidosis Hyperkalaemia Uraemia Fluid overload Hyperphosphataemia Hypocalcaemia HTN ```
42
Pre-renal causes of AKI
``` IMPAIRED PERFUSION Cardiac failure Sepsis Blood loss Dehydration Vascular occlusion ```
43
Renal causes of AKI
Glomerulonephritis Small vessel vasculitis Acute tubular necrosis - drugs, toxins, prolonged hypotension Interstitial nephritis - drugs, toxins, inflammatory disease, infection
44
Post-renal causes of AKI
``` Urinary calculi Retroperitoneal fibrosis Benign prostatic enlargement Prostate cancer Cervical cancer Urethral stricture/valves ```
45
AKI with brown cell casts in urine
Acute tubular necrosis
46
AKI with white cell casts in urine, infective
Acute interstitial nephritis | Pyelonephritis
47
AKI with eosinophilia, immune/non-infective
Acute hypersensitivity
48
Hypoalbuminaemia Oedema Lipid abs Proteinuria
Nephrotic syndorme - HOLP | Structural (nephrosis)
49
``` Proteinuria Haematuria Azotemia Red cell casts Oliguria HTN ```
Nephritic syndrome - PHAROH | Inflammation (nephritis)
50
Previous UTI Fever Proteinuria, +leucocytes +nitrates Normal also US
Acute interstitial nephritis
51
Ejection systolic murmur
Aortic stenosis
52
Early diastolic murmur
Aortic regurg
53
Mid diastolic murmur
Mitral stenosis
54
Pansystolic murmur
Mitral regurg
55
Aortic equivalent
Pulmonary
56
Mitral equivalent
Tricuspid
57
Machinery murmur
Patent ductus arteriosus
58
HTN treatment ladder | 1st line <55 yrs
ACEis (e.g. ramipril)/ARBs (e.g. losartan)
59
HTN treatment ladder | 1st line >55 yrs/black
CCBs (e.g. amlodipine)
60
HTN treatment ladder | 2nd line
ACEi + CCB
61
HTN treatment ladder | 3rd line
ACEi + CCB + thiazide like diuretic (e.g. indapemide)
62
HTN treatment ladder | Final step
B blocker/alpha blocker
63
WHO pain ladder | Step 1
Non-opioid +/- adjuvant (e.g. paracetamol, NSAIDs)
64
WHO pain ladder | Step 2
Weak opioid +/- adjuvant (e.g. tramadol/codeine)
65
WHO pain ladder | Step 3
Strong opioid +/- adjuvant (e.g. morphine)
66
Staph abx
Flucloxacillin, vancomycin, gentamicin
67
Enterococcus abx
Ampicillin, gentamicin
68
Strep abx
Benzylpenicillin, gentamicin
69
Defining a lump
``` Size, shape, skin, situation Colour, contour, consistency Tethering, transillumination, temperature, tenderness Fluctuant Pulsatile Expansile Reducible ```
70
Treatment of MI | MONARCH BARS
``` Morphine Oxygen Nitrates Aspirin Reperfusion (thrombolysis/PCI) Clopidogrel Heparin ``` Beta blocker ACEi Risk factors Statin
71
Complications of MI
``` Death Arrhythmia Rupture Tamponade Heart failure Valve disease Aneurysm Dressler's syndrome Emboli Recurrence ```
72
Crohn's test
Faecal calprotectin
73
H pylori test
Urease breath test
74
Coeliac test
Anti-endomysial abs | Anti-transglutaminase abs
75
Liver cancer marker
Alpha fetoprotein
76
Ovarian cancer marker
CA125
77
Breast cancer marker
BRCA1/2 | CA15-3
78
Liver/pancreas/gallbladder cancer marker
CA19-9
79
Testicular cancer marker
B HCG
80
Prostate cancer marker
PSA
81
B symptoms
Fever, night sweats, weight loss
82
Sepsis 6
``` Blood cultures Urine output Fluids Antibiotics Lactate Oxygen ```
83
Antiphospholipid antibodies
Anticardiolipin
84
EBV + ampicillin
Widespread maculopapular rash
85
Dense/patchy consolidation +/- bronchograms
Pneumonia
86
Ground glass shadowing
Alveolitis
87
Complete absence of lung markings
Pneumothorax
88
Dense pacification with meniscus/fluid level
Pleural effusion
89
Fluffy opacification (bilateral and lower zones)
Pulmonary oedema
90
Patches of defined and varying consolidation
Mets
91
Large mass in perihilar region
Lung cancer
92
Hyperinflation (>6 ant ribs), flattened hemidiaphrams, increased bronchovascular markings
COPD
93
Reticulonodular shadowing
Interstitial lung disease/fibrosis
94
Perihilar lymphadenopathy
Sarcoidosis
95
Heart failure CXR signs
``` Alveolar oedema Kerley B lines Cardiomegaly Dilated upper lobe vessels Effusion ```
96
Batwing sign
Pulmonary oedema
97
CURB-65 score
``` Pneumonia Confusion Urea Resp rate BP Age >65 ```
98
Post abdo exam
``` Full history Basic obs External genitalia exam Examine hernial orifices DRE Urinalysis Stool sample ```
99
Post cardio exam
``` Full history Basic obs Urinalysis 12 lead ECG Fundoscopy ```
100
Post neuro exam
``` Full history Basic obs Full neurological examination GALS screen Nerve conduction studies Head CT ```
101
Post breast exam
Imaging - mammography (>35), US (<35) | Biopsy - FNA, core biopsy
102
Basic obs
Oxygen sats, temperature, RR
103
Post respiratory exam
``` Full history Sputum Peak flow O2 sats Temperature CXR Blood gases ABG ```
104
Post thyroid exam
Full history Basic obs TFTs ECG
105
PR exam
``` Full history Basic obs Stool sample and culture Abdo exam PSA, FBC, haematinics, faecal occult blood CXR Colonoscopy ```
106
After peripheral vascular exam
``` Full history Cardiovascular exam Lower limb near exam ABPI Venous doppler US ```
107
After AMTS
Full history Full collateral history MMSE Head CT
108
ABCD2 score
``` Stroke risk post TIA Age BP Clinical features (weakness, speech disturbance) Duration of TIA DM ```
109
Child-Pugh score
``` Prognosis of cirrhosis Bilirubin Serum albumin PT Ascites Hepatic encephalopathy ```
110
GCS
Eyes - AVPU (alert, voice, pain, un) Speech - ACISU (alert, confused, inappropriate, sounds, un) Movement - ALWFEU (alert, localises, withdraws, flexion, extension, un)
111
Wells score
DVT/PE scoring
112
FUNDHIPS BPH
``` Frequency Urge incontinence Nocturia Dribbling Hesitancy Incomplete voiding Poor Stream ```
113
CKD definition
>3 months GFR <60mL/min/1.73m2
114
SLE serology marker
ANA
115
Wegener's serology marker
C-ANCA
116
Goodpasture's serology marker
Anti-GBM
117
Nephrotic syndrome triad
Proteinuria, hypoalbuminaemia, oedema
118
Gout crystals
Needle shaped | Negative birefringence
119
Pseudogout crystals
Rhomboid shaped | Positive birefringence
120
Gout crystal composition
Urate
121
Pseudogout crystal composition
Calcium pyrophosphate
122
Order of loss of pit hormones
``` Go Look For The Adenoma Please GH LH FSH TSH ACTH P ```
123
Kernig's sign
Pain on knee extension when hips are flexed
124
Bordzinski's sign
Pain on flexion of the neck

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