1
Q
How do hyper/ hypocalcaemia present on ECG (2)?
A
- Hypercalcemia = short QT
- Hypocalcaemia = long QT
2
Q
What are the treatment HbA1C targets for those with T2DM (2)?
A
- < 48 if on metformin + lifestyle (or other drugs that dont cause hypos)
- < 53 if on a med that may cause hypoglycaemia
3
Q
What is the triad associated with congenital toxoplasmosis (3)?
A
- Hydrocephalus
- Intracranial calcifications
- Chorioretinitis
4
Q
Which out of hep A and E is usually more severe?
A
Hep E - can get it from undercooked BBQ
especially in a pregnant woman
5
Q
How should occupational asthma be investigated?
A
Serial peak flow measurements in and out of work
6
Q
What are the features of a moderate asthma attack (4)?
A
- PEF 50-75%
- Speech normal
- RR < 25
- Pulse < 110
7
Q
What are the features of a severe asthma attack (4)?
A
- PEF 33-50%
- Unable to complete sentences
- RR > 25
- Pulse > 110
8
Q
What are the features of a life threatening asthma attack (6)?
A
- PEF < 33%
- Sats < 92%
- Normal pCO2
- Silent chest, cyanosis or feeble resp effort
- Bradycardia, dysrhythmia, hypotension
- Exhaustion, confusion, coma
high pCO2 = near fatal attack
9
Q
When should amiodarone be given during cardiac arrest (2)?
A
Only patients who are in VF or pulseless VT:
* After 3 shocks = 300mg
* After 5 shocks = 150mg
10
Q
When is an ABG recommended in an acute asthma attack?
A
Sats < 92%
11
Q
How is AF cardioverted (3)?
A
- < 48 hours duration = electrical or pharmacological immediate cardioversion
- > 48 hours duration = anticoagulate for 3 weeks –> electrical cardioversion
- Unstable = immediate cardioversion
12
Q
When are nitrates contraindicated (2)?
A
- BP < 90
- HR < 50
13
Q
Who is considered for ablation to control AF?
A
Failed antiarrhythmic medications + cardioversion and have no structural heart disease/ heart failure
14
Q
How should sensation be assessed in those with possible diabetic neuropathy (2)?
A
- 10g monofilament
OR - Vibration with a tuning fork
15
Q
How much should a breakthrough dose of opioid be?
A
1/6th the dose of daily opioid
16
Q
What are the common adverse effects of gliclazide (2)?
A
- Weight gain
- Hypoglycaemic episodes
17
Q
How is a perianal fistula in crohns managed?
A
Oral metronidazole
18
Q
What causes an isolated rise in protein in the CSF?
A
GBS
19
Q
What are the two scores used in those with GI bleeds (2)?
A
- Glasgow-blatchford score = need for medical intervention before endoscopy
- Rockall score = risk of rebleeding/ mortality post endoscopy
20
Q
How is CVST diagnosed?
A
MR venogram
21
Q
What antibody is found in primary biliary cholangitis?
A
Anti-mitochondrial antibodies
22
Q
What antibody is found in autoimmune hepatitis?
A
Autoimmune hepatitis
23
Q
If a RBC transfusion is needed what type of RBCs are used?
A
Irradiated packed RBCs
CMV negative used for pregnancy and neonates
24
Q
How is acromegally investigated (2)?
A
- IGF-1 levels
- OGTT (if IGF-1 raised)
+ can do MRI brain
25
What is hashimotos vs de quervains thyroiditis?
* Hashimotos = painless goitre + hypothyroid (most common cause of hypothyroid)
* De Quervains = painful goitre + hypothyroid
26
What are the phases of De Quervains (subacute thyroiditis) (4)?
1. Initial hyperthyroid phase
2. Euthyroid
3. Hypothyroid phase
4. Resolution
27
What is seen on thyroid scintigraphy in de quervains thyroiditis?
Globally reduced uptake of iodine-131
28
What is the initial management of COPD without asthmatic/ steroid responsive features managed?
1. SABA or SAMA
2. + LABA and LAMA
3. + ICS
29
What is the initial management of COPD with asthmatic/ steroid responsive features managed?
1. SABA or SAMA
2. + LABA and ICS
3. + LAMA
30
How is phaeochromocytoma investigated?
24 hour urinary collection of metanephrines
*this has replaced catecholamines*
31
What medication is important to stop before an OGD investigating a possible malignancy?
PPIs - 2 weeks before surgery
32
What condition should metoclopramide be avoided in (2)?
* Bowel obstruction
* Parkinsons (cyclizine preferred)
33
What has been shown to improve long term survival in those with COPD (3)?
* Long term oxygen therapy
* Smoking cessation
* Lung volume reduction surgery (in some patients)
34
Who with COPD should be offered long term oxygen therapy (2)?
* pO2 < 7.3
* pO2 7.3 - 8 + (secondary polycythaemia or peripheral oedema or pulmonary hypertension)
35
How does fragile X present (5)?
* Learning difficulties
* Large low ears
* Thin face
* High palate
* Mitral valve prolapse
*features in females usually less severe*
36
What genetic abnormality is present in fragile X?
Trinuleotide repeat disorder affecting FMR1 gene
37
What bacteria are coagulase negative vs positive staph?
* Positive = staph aureus
* Negative = epidermidis/ saprophyticus
38
What is the first line imaging of the breasts (2)?
* < 35 = USS
* > 35 = mammogram
*if 35-40 and have a lump then USS is usually used first in this case as well*
39
How can you differentiate NMS and serotonin syndrome (4 each)?
* Serotonin syndrome = faster onset, hyperreflexia, clonus, dilated pupils
* NMS = slower onset, hyporeflexia, lead pipe rigidity, normal pupils
40
How can primary hyperaldosteronism be managed medically?
Potassium sparing diuretics (e.g. amiloride, or spironolactone - an aldosterone antagonist)
41
How can pityriasis rosea itching be treated (2)?
* Topical emollients/ steroids
* Oral antihistamines
42
How is anterior uveitis managed (3)?
* Urgent ophthalmology review
* Steroid eye drops
* Cycloplegics (dilates pupil) - e.g. atropine, cyclopentolate
43
What is one contraindication and one important interaction statins have?
* Contraindication = pregnancy
* Interaction = macrolides
44
What are the typical electrolyte disturbances seen on refeeding bloods (3)?
* Hypophosphataemia
* Hypokalaemia
* Hypomagnesaemia
45
How should hypophosphataemia be managed?
* Mild/ moderate = oral replacement
* Sever (< 0.32) or symptomatic = IV infusion
46
How is viral induced wheeze managed (2)?
1. SABA
2. LTRA (montelukast) or ICS or both
47
What is De Quervain's tenosynovitis?
Sheaf containing extensor pollicis brevis/ abductor pollicis longus tendons is inflamed
48
What nerve is damaged in a humeral shaft vs neck injury?
* Neck = axillary nerve
* Shaft = radial nerve
49
How is DKA managed (3)?
1. Fluids
2. Check electrolyte levels (especially potassium)
3. Begin fixed rate insulin infusion at 0.1 units/kg/hour
*these can all be started immediately, insulin should only be started if K > 3.5*
50
What can lithium toxicity be precipitated by (5)?
* Dehydration
* Renal failure
* NSAIDs
* Thiazides
* ACE-i
51
When should APGAR be measured?
1, 5 minutes
52
What is trousseaus sign?
BP cuff --> wrist flexes - due to HYPOcalcaemia
53
What is seen on x-ray in osteosarcoma?
Sunburst pattern + codman triangle
54
What would be seen on an ewing sarcoma on X-ray?
Onion skin appearance
55
How would vitamin B2 (riboflavin) deficiency present?
Angular cheilitis - inflammation + crusting/ cracking at corners of mouth
56
Which non-hodgkin lymphoma carries the best and which the worst prognosis and which is the most common subtype (3)?
* Best = lymphocyte predominant
* Worst = lymphocyte depleted
* Most common = nodular sclerosing
57
What medication must be stopped 36 hours before starting sacubitril-valsartan (angiotensin receptor-neprilysin inhibitor)?
ACE-i
58
When should a CXR be repeated in a patient with pneumonia?
6 weeks after resolution
59
How is hyperemesis gravidarum managed (4)?
1. Simple measures: plain foods/ rest
2. Antihistamines (e.g. **cyclizine**) or phenothiazines (**prochlorperazine**)
3. **Ondansetron** (risk of cleft lip in first trimester) or **metoclopramide** (not for more than 5 days due to risk of EPSEs)
* Thiamine + fluid hydration may be needed
60
When should a suspected scaphoid fracture not visible on x-ray be reviewed?
Repeat imaging in 7-10 days + orthopaedic review
61
What visual defect does a pituitary tumour cause?
Upper quadrant bitemporal hemianopia
62
What visual defect does a craniopharyngioma cause?
Lower quadrant bitemporal hemianopia
63
How should secondary haemorrhage (5-10 days) post tonsillectomy be managed?
Admit to hospital with antibiotics
*often due to underlying wound infection*
64
What PHQ-9 scores suggest less severe and more severe depression?
* Less severe < 16
* More severe > 16
65
What is the most common location of an AAA?
Infrarenal aorta
66
How is acromegaly managed medically (3)?
1. Somatostatin analogues (e.g. octreotide)
2. Pegvisomant
3. Dopamine agonists (e.g. cabergoline/ bromocriptine)
67
What is the mechanism of cyclizine?
H1 receptor antagonist
68
How long should sport be avoided for after EBV?
3 weeks from symptom onset
69
What hormones are abnormal in PCOS?
* Raised LH:FSH ratio
* Testosterone normal/ raised
* Sex hormone binding globulin (SHBG) low/ normal
70
What are the diagnostic criteria for hereditary haemorrhagic telangiectasia?
* Epistaxis (spontaneous)
* Telangiectasis (at multiple sites)
* Visceral lesions (e.g. GI telangiectasis, pulmonary AV malformation)
* First degree relative with hereditary haemorrhagic telangiectasis
71
What is considered impaired fasting glucose?
6.1-6.9
*> 7 = diabetes*
72
What type of allergic reaction does NAC sometimes cause?
Anaphylactoid reaction (non-IgE mediated mast cell release)
73
How does fondaparinux work?
Activates antithrombin III
74
What type of imaging is most useful for supporting a diagnosis of ankylosing spondylitis in early disease?
Pelvic x-ray = sacroilitis
75
What movement aggravates the pain in lateral epicondylitis vs medial epicondylitis?
* Lateral = wrist extension when elbow extended
* Medial = wrist flexion when elbow extended
76
What are some adverse effects of quinolones (3)?
* Lower seizure threshold
* Tendon rupture/ damage
* Lengthens QT
77
When should acne be referred (4)?
* Scarring/ pigment change/ nodulo-cystic
* Moderate/ severe that has not responded to at least 1 oral antibiotic
* Mild that has not responded to 2 courses of treatment
* Causing mental health disorder/ persistent psychological distress
78
What nasal symptom would warrant an urgent ENT referral?
Any unilateral nasal symptoms
79
What is the management of chronic sinusitis (> 12 weeks) (2)?
1. Intranasal corticosteroids + nasal irrigation with saline
2. Referral after 3 months of treatment
80
How is aPl syndrome managed (3)?
* Primary prevention = low dose aspirin
* Secondary (if they have had a VTE) = warfarin
* Pregnancy = low dose aspirin + LMWH
81
How does roseola infantum present (2)?
1. High fever for a few days
2. Maculopapular rash (after fever settles)
82
When is childs hearing tested in the UK (2)?
1. Newborn = otoacoustic emission test
2. Auditory brainstem response test (if abnormal otoacoustic emission)
3. School entry = pure tone audiometry
83
How should patient on steroids be managed if having surgery?
Give IV hydrocortisone at induction of anaesthesia
84
Which NSAID increases the risk of cardiovascular events the most?
Diclofenac
*contraindicated in IHD, PAD, heart failure, cerebrovascular disease*
85
How should be vaccinated against Hep A (4)?
* MSM
* IVDU
* Liver disease
* Travelling to high risk areas
86
What is the transfusion freshhold for platelets in patients with severe bleeding?
< 90
87
When is jaundice considered physiological in newborn?
2 days (over 24 hours) until 2 weeks
88
How should otitis media with effusion be managed?
* Observation for up to 3 months, then refer
* Grommet insertion
*if child has downs or cleft palate, then immediate referral*
89
What pH is candidiasis vs BV?
* Candidiasis < 4.5
* BV > 4.5
*trichomonas vaginalis also has pH > 4.5*
90
What is ludwigs angina?
Cellulitis on floor of the mouth
91
How should cellulitis near eye/ nose be managed?
Co-amox
92
How is intrahepatic cholestasis of pregnancy managed (2)?
* Bile acids > 100 = deliver at 35-36 weeks
* Bile acids 40-99 = deliver at 38-39 weeks
93
Why does coeliacs cause reduced immunity?
Splenic reticuloendothelial atrophy
94
When is the shingles vaccine offered to patients?
65th birthday
95
What is a key ECG change in hypothermia?
J waves
96
When should NAC be given for paracetamol overdose?
* Paracetamol > 100mg/l at 4 hours or > 15mg/l at 15 hours
* Staggered overdose
* Presenting 8-24 hours after ingestion + > 150 mg/kg ingested
* Presenting > 24 hours if jaundiced, hepatic tenderness or elevated ALT
97
How is labyrinthitis vs vestibular neuronitis differentiated?
* Vestibular neuronitis = vertigo
* Labyrinthitis = vertigo + hearing loss
98
What are the 9 thought/ speech disorders in psychiatry?
* **Circumstantiality** = give excessive detail, but return eventually to the point
* **Tangentiality** = wander from topic, dont return
* **Neologisms** = new word formations
* **Clang associations** = relation due to sounding similar (e.g. rhyme)
* **Word salad** = complete incoherent speech
* **Knights move** = no link between thoughts
* **Flight of ideas** = leap between topics, with discernible link
* **Perseveration** = repetition of ideas/ words, despite change of topic
* **Echolalia** = repetition of anothers speech
99
What factors are known to worsen psoriasis (7)?
* Trauma
* Alcohol
* Beta blockers
* Lithium
* Antimalarials
* NSAIDs
* ACE-i
100
What are actinic keratoses vs seborrhoeic keratoses?
* Actinic = precursor to Bowens/ SCC (crusty scaly lesions)
* Seborrhoeic = stuck on appearance
101
How should patients with degenerative cervical myelopathy be managed?
Urgent referral for cervical decompression surgery
102
What are the moderate and high risk factors for pre-eclampsia (11)?
* **pHx**
* **CKD**
* **Autoimmune disease e.g. SLE**
* **Diabetes**
* **Chronic hypertension**
* First pregnancy
* > 40 years
* Pregnancy interval > 10 years
* BMI > 35
* FHx
* Multiple pregnancy
103
How should pregnant women with risk factors for pre-eclampsia be managed?
If 1 or more high risk or 2 or more moderate risk then:
**Low dose aspirin from 12 weeks until birth**
104
What are 3 signs of right sided heart failure?
* Peripheral oedema
* Raised JVP
* Hepatomegaly
105
What are the parkinson plus syndromes?
* Multisystem atrophy
* Progressive supranuclear palsy
106
What are the features of multi system atrophy (2)?
* Autonomic disturbance (e.g. postural drop, erectile dysfunction)
* Cerebellar signs
107
What are the features of progressive supranuclear palsy (2)?
* Impaired vertical gaze
* Postural instability - stiff, wide gait
108
When does POP become effective as contraception (2)?
* Immediately if < day 5 of cycle
* 48 hours if another part of cycle
109
What are the different types of miscarriage (5)?
* **Threatened** = painless PV bleeding, os closed, foetal HB seen
* **Missed** = dead foetus (> 7mm, no heartbeat), os closed, often no Sx (can have mild cramping/ bleeding)
* **Inevitable** = os open, painful bleeding + clots, no tissue, products in uterus
* **Incomplete** = os open, pain + bleeding, tissues passed, some products remain
* **Complete** = os closed, painful bleeding + clots/ tissue, uterus empty
110
What are some causes of LBBB (4)?
* MI
* Cardiomyopathy
* Aortic stenosis
* Hypertension
111
When can patients have fluids and food before an operation?
* Food = 6 hours
* Fluids = 2 hours
112
What is the imaging of choice for osteomyelitis?
MRI
113
What is a simple test that can be used to differentiate fluid draining from the nose between CSF and mucous?
Glucose test
*present in CSF*
114
How is aPl managed in pregnancy?
Aspirin + LMWH
115
Which DMARDs are preferred in pregnancy (3)?
* **Hydroxychloroquine**
* Azathioprine
* Sulfasalazine
116
What are the features of holmes-adie pupil (4)?
* Pupil dilated
* Light response = sluggish or absent
* Accommodation = slow but present
* Deep tendon reflexes supressed = holmes-adie syndrome
117
What antibody is in diffuse cutaneous systemic sclerosis?
Anti-Scl-70
118
How is congenital adrenal hyperplasia investigated?
* Elevated 17-hydroxyprogesterone
* Diagnosis = ACTH stimulation testing
119
What is the most serious long term health complication of turners?
Aortic dilatation + dissection
120
How is neonatal hypoglycaemia managed (3)?
* 2-2.6 = encourage feeding
* 1-2 = glucose gel
* < 1 or < 2+ symptomatic = IV 10% dextrose + critical care
121
How is a massive PE managed?
Thrombolysis + unfractionated heparin IV
122
Can digoxin toxicity occur whilst in therapeutic range?
Yes - usually due to concurrent hypokalaemia
123
When should a patient with a perforated eardrum be referred?
Watch + wait for 6 weeks, then refer
124
What is the preferred benzo for alcohol withdrawal in patients with liver cirrhosis?
Lorazepam
125
What is autonomic dysreflexia?
Extreme hypertension following transection of the spinal cord above T6
126
What are some causes/ triggers of autonomic hypertension (2)?
* Urinary retention
* Faecal impaction
127
What are the criteria in pleural fluid analysis for transudative vs exudative effusions (4)?
* Protein > 30 = exudative; protein < 30 = transudative
Lights criteria (if protein 25-30) suggest exudative if:
* Pleural protein/ serum protein > 0.5
* Pleural LDH/ serum LDH > 0.6
* Pleural LDH > 2/3rd the maximum expected serum LDH
128
What is the most common cause of perianal itching (especially in children)?
Threadworms (enterobius vermicularis)
129
What are the features of organophosphate poisoning (6)?
* Salivation
* Lacrimation
* Urination
* Defecation/ diarrhoea
* Hypotension + bradycardia
* Miosis (small pupils)
130
How should primary haemorrhage (6-8 hours) post tonsillectomy be managed?
Immediate return to theatre
131
What are the diagnostic criteria for rheumatic fever (10)?
Evidence of recent step infection +
Jones criteria (2 major/ 1 major, 2 minor)
* **Erythema marginatum** (red ringed rash)
* **Sydenham's chorea**
* **Polyarthritis**
* **Carditis/ valvulitis**
* **Subcutaneous nodules**
* Raised ESR/CRP
* Pyrexia
* Arthralgia
* Prolonged PR
132
What antibiotics are first line of infective COPD exacerbation (3)?
* Amoxicillin
* Doxy
* Clarithromycin
133
What is a complication of long term mechanical ventilation?
Tracheo-oesophageal fistula
134
What is meralgia paraesthetica?
Burning pain in outer thigh - due to entrapment of lateral femoral cutaneous nerve
135
What is the preferred test to diagnose chronic pancreatitis?
CT pancreas
136
How is standard error calculated?
Standard deviation/ square root (number of participants)
137
How should diabetic meds be taken the day before surgery?
Take as normal
138
What is important to know about topical corticosteroid prescribing?
Breaks in treatment are often needed
*e.g. 4 weeks in psoriasis*
139
What are some of the drugs that should be avoided during breastfeeding (8)?
* Antibiotics (cipro, tetracyclines, sulphonamides)
* Lithium
* Benzos
* Aspirin
* Carbimazole
* Methotrexate
* Sulfonylureas
* Amiodarone
140
Why are living donors superior to deceased donors?
Longer graft survival time
141
What are the different severities of placenta acreta/ abnormally invasive placentas (3)?
* Placenta accreta = to surface of myometrium
* Placenta increta = into myometrium
* Placenta percreta = into perimetrium
142
What is the initial imaging for achilles tendon ruptures?
USS
143
How should SJS be managed?
Cease all medications, begin fluid rescussiation
144
What are the features of edwards (4)?
* Micrognathia (small lower jaw)
* Low set ears
* Rocker bottom feet
* Overlapping fingers
145
What are the features of pataus (3)?
* Microcephaly + small eyes
* Cleft lip/ pallate
* Polydactyly
146
What factor is best at determining the severity of C. diff infection?
WCC
147
How should genital herpes be diagnosed?
NAAT on swab
148
What meds can be given for painful peripheral neuropathy (4)?
* Amitriptyline
* Duloxetine
* Gabapentin
* Pregabalin
149
How is carbon monoxide poisoning managed?
15l non rebreathe O2 mask
*sats can be paradoxically high due to similarities between carboxyhaemoglobin and oxyhaemoglobin*
150
How does lichen planus appear?
Well-demarcated purple papules with white lines running across them
151
What is a normal amount of weight for a newborn to lose in first week of life?
Up to 10% of body weight
152
How should a newborn that loses > 10% body weight be managed?
Referral to midwife lead breastfeeding clinic
153
How should patients with superficial thrombophlebitis be managed?
Offer compression stockings
*USS if long saphenous vein affected*
154
What are the general steps in treating obesity (3)?
1. Diet, exercise advise
2. Medications
3. Bariatric surgery
155
What medications can be used to treat obesity (2)?
* Orlistat (pancreatic lipase inhibitor)
* GLP-1 mimetics
156
What are some examples of GLP-1 mimetics (3)?
* Liraglutide
* Semaglutide
* Tirzepatide
157
Which CN is responsible for corneal reflex?
CN V1 (trigeminal - ophthalmic branch)
158
What are the features of webers syndrome (left posterior cerebral artery ischemia) (2)?
* Ipsilateral CN III palsy
* Contralateral upper + lower extremity weakness
159
What is spondylolysis?
Small crack/ fracture/ defect in the vertebrae of the spine (pars interarticularis of the vertebrae)
160
What is spondylolisthesis?
Vertebra is displaced relative to the inferior/ superior vertebral body
*sponylolysis is most common cause of this in children*
*more likely to have neuro Sx when compared to spondylolysis*
161
How is chlamydia managed (2)?
* Doxycycline - 7 days
* If pregnant = azithromycin (erythromycin/ amox alternatives)
162
What is the earliest and most common symptom of spinal cord compression?
Back pain
163
What is the most common cause of stridor in infants (around 4 weeks of age)?
Laryngomalacia
*congenital abnormality of larynx/ floppy epiglottis*
164
What are some causes of dubuytrens (3)?
* Manual labour/ trauma
* Liver disease
* Diabetes
165
What are the CURB-65 criteria?
* Confusion (AMT 7
* RR > 30
* BP < 90/60
* Age > 65
166
What are the important things to be aware of when prescribing contraceptives postpartum (5)?
* POP can be started at any point (even if breastfeeding)
* COCP contraindicated if < 3 weeks
* COCP contraindicated if < 6 weeks + breastfeeding
* COCP MEC2 if breastfeeding from 6 weeks to 6 months
* IUD/ IUS must be inserted within 48 hours or more than 4 weeks after birth
167
What are the key features of HSP (4)?
* Palpable purpuric rash over buttocks/ legs
* Abdominal pain
* Polyarthritis
* Haematuria/ renal failure
168
What are some side effects of ciclosporin (6)?
* Hypertension
* Hyperkalaemia
* Tremor
* Gingival hyperplasia
* Immunocompromise
* Impaired glucose tolerance
169
How is standard deviation calculated from variance?
Square root of variance
170
What are red flag features for lower back pain (7)?
* Age < 20/ > 50
* PHx malignancy
* Night pain
* Trauma
* Thoracic pain
* Systemic Sx
* Cauda equina Sx
171
How is urticaria managed (2)?
1. Anti-histamines (sedating if night time symptoms)
2. Oral steroids (if severe/ widespread)
172
Which recreational drug is known to cause hyponatraemia?
Ecstasy
173
How can people prescribed LMWHs be monitored and who should be monitored (3 things)?
Anti-Xa activity
* Overweight/ underweight
* Poor renal function
174
What vaccines are MSM offered (4)?
* Hep A
* Hep B
* HPV
* Men B (gives some protection against gonorrhoea)
175
How should all children with croup be managed?
Single dose dexamethasone (0.15mg/kg)
176
What is diabetic nephropathy?
All patients screened with ACR, if > 3 = clinically significant
177
How should patients with diabetic nephropathy be managed (2)?
* BP < 130/80 (if ACR > 3)
* ACE-i/ ARB started
178
What are some causes of upper lobe pulmonary fibrosis (7)?
* **F**armers lung
* **A**nkylosing spondylitis
* **S**arcoidosis
* **S**ilicosis
* **T**B
* **E**osinophilic granuloma
* **N**eurofibromatosis
179
What are some causes of lower lobe pulmonary fibrosis (4)?
* Asbestosis
* Drugs (e.g. amiodarone, methotrexate, nitro, bleomycin)
* Rheumatoid arthritis
* Scleroderma
180
What are some DVLA restrictions for different medical conditions (4)?
* Unprovoked/ isolated seizure + no structural/ EEG changes = 6 months (increased to 12 months if these conditions are not met)
* Epilepsy/ multiple seizures = 6 months
* Stroke/ TIA = 1 month
* Multiple stroke/ TIA = 3 months
181
How should a patient with an inadequate cervical smear be managed (2)?
1. Repeat sample < 3 months
2. (Still inadequate) --> colposcopy
182
When would pregnant women with hypertension require admission for observation?
BP > 160/110
183
What are the school exclusion criteria for different infections (8)?
* Scarlet fever = 24 hours after Abx
* Whooping cough = 2 days after Abx/ 21 from onset of Sx if no Abx
* Measles = 4 days from rash onset
* Rubella = 5 days from rash onset
* Chickenpox = until crusted
* D+V = 48 hours after Sx settle
* Impetigo = lesions crusted/ 48 hours after Abx
* Scabies = until treated
184
How is breast cancer managed (5)?
* Mastectomy/ wide local excision + axillary node clearance
* Radiotherapy (if wide local excision performed)
* ER +ve = tamoxifen (pre menopausal), anastrozole (post menopausal)
* HER2 +ve = trastuzumab (herceptin)
* Chemo (FEC-D) especially if triple negative
185
What is the nerve supply of sensation to the hand and which parts does it supply (3)?
* Ulnar = medial 1.5 fingers back and front
* Median = lateral 3.5 fingers front + back nailbeds
* Radial nerve = back of hand lateral 3.5 fingers (except nail beds)
186
What is usually considered the first line med for MS?
Natalizumab
187
Which antibodies are the most specific markers for SLE (2)?
* Anti DS-DNA
* Anti Sm (smith)
188
What are the features of TURP syndrome (3)?
* Hyponatraemia
* Fluid overload
* Glycine toxicity
189
How should oxygen be delivered at different pH values in an exacerbation of COPD (2)?
* pH < 7.25 = invasive ventilation
* pH 7.25 - 7.35 = NIV
190
How should an infective exacerbation of COPD initially be managed (3)?
* Nebulised salbutamol + ipratropium bromide
* Oral pred
* Antibiotics
191
What is another name for frozen shoulder?
Adhesive capsulitis
192
What is the most common cause of aortic stenosis in a young patient?
Congenital bicuspid valve
193
What valve is usually affected in rheumatic fever?
Mitral stenosis
194
What is first line for treatment of CML?
Imatinib = tyrosine kinase inhibitor
195
How can a methotrexate overdose be managed?
Folinic acid
196
How should those requiring contrast radiography with a low eGFR be managed?
IV 0.9% NaCl 12 hours before and 12 hours after contrast
*reduces chance of AKI*
197
What is a common complication of psoriatic arthritis/ psoriasis?
Cardiovascular disease
198
What are some causes of erythema nodosum (7)?
* Streptococci
* TB
* IBD
* Sarcoidosis
* Malignancy/ lymphoma
* Pregnancy
* Drugs: penicillins, sulfonamides, COCP
199
What type of visual field defect do temporal vs parietal infarcts cause (2)?
* **P**arietal = **I**nferior
* **T**emporal = **S**uperior
*PITS*
200
When should a mastectomy vs wide local excision be done?
* > 4cm = mastectomy
* < 4cm = wide local excision
Quesmed stuff wrong
flashcards
Decks in class (6)
# Cards
