1
Q
parkinson’s affects the ……..
A
substantia nigra
2
Q
huntington’’s affects the ……..
A
caudate nucleus
3
Q
what do you give in PEA?
A
IV adrenaline 1mg
4
Q
definitive management for biliary colic
A
lap cholecystectomy
5
Q
definitive management for acute cholecystitis
A
lap cholecystectomy
after 1 week
6
Q
definitive management for ascending cholangitis
A
ERCP
7
Q
nerve involved in foot drop
A
common peroneal nerve
8
Q
nerve root involved in reduced dorsiflexion (foot drop)
A
L5
9
Q
nerve root involved in reduced plantar flexion
A
S1
10
Q
what is measured to monitor resp function in gullian-barre?
A
FVC
11
Q
HRT: LMP < 12 months
A
cyclical
12
Q
HRT: Has uterus
A
combined
13
Q
side effect of bleomycin
A
lung
14
Q
side effect of doxorubicin + herceptin
A
heart (cardiomyopathy)
i love (heart) rubicon (doxorubicin)
15
Q
heart issues in children
downs syndrome
A
atrial septal defect
16
Q
heart issues in children
turners syndrome
A
coarctation of aorta
17
Q
anaphylaxis mx in adults + children
A
adults = 0.5mg adrenaline
children = 0.3mg adrenaline
18
Q
core sx for cervical cancer
A
bleeding after sex
19
Q
traumatic tension pneumothorax - where to put chest drain?
A
5th ICS mid axillary
20
Q
recurrent sinusitis + rash + post-c-ANCA + nodules on chest xr + haemoptysis
A
granulomyotosis w/polyangitis
21
Q
most common artery affected in peripheral arterial disease
A
femoral
22
Q
where do you see target + howell-jolly cells?
A
post splenectomy
hyposplenism (coeliac disease)
23
Q
where in the brain is affected in wernickes
A
sup temp gyrus
24
Q
where in the brain is affected in brocas
A
inf front gyrus
25
where in the brain is affected in conduction aphasia
arcuate fasciculitis
26
when to start POP after birth?
immediatly
27
when to start COCP after birth?
after 21 days
28
when to start IUD/IUS after birth?
within 48 hours post birth
OR
after 28 days (4 weeks)
29
what do you give post-stroke?
clopidogrel + statin
30
what does
yawning in newborns
mean?
opiate withdrawal
31
how often to give pneumococcal vaccine in COPD + HF?
one off
32
how often to give pneumococcal vaccine in hyposplenism + CKD?
5 yearly
33
describe tremor in parkinsons
resting
improves with movement
34
croup organism
parainfluenza virus
35
bronchiolitis organism
respiratory syncytial virus (RSV)
36
mx for tachycardia + haemodynamically unstable
cardioversion
37
IgM and IgG meaning in hep b status
MaGiC
IgM = acute
IgG = chronic
38
confusion screen
b12, folate and bone
39
mx for pregnant + prev DVT
LMWH until 6 weeks post birth
40
anti-emetic for post surgery
ondansetron
41
anti-emetic for decreased gastric mobility
metoclopramide
42
signs of polycystic ovarian syndrome
irregular and infrequent periods
hairy
43
csf for bacterial meningitis
more protein + WCC, less glucose
with polymorphs (Streptococcus pneumoniae)
44
ix for TIA
MRI and US carotids
45
when to stop warfarin before surgery
5 days before
46
weakness and skin changes
dermatomyositis
ix: CK, anti-jo, muscle biopsy
47
when to do surgery for ectopic pregnancy?
if fetal HR present
OR
b-HCG > 5,000
48
where are trophozoites present?
malaria
49
eczema herpeticum organism
HSV 1
50
when to refer if fetus not moving
24 weeks
51
ix for ulcerative colitis
colonoscopy but if severe = sigmoidoscopy
52
murmur in tetralogy of fallot
pulmonary stenosis
ejection systolic louder on inspiration
(child picks up knees)
53
mydriatic pupils
dilated
54
miotic pupils
constricted
55
osteomyelitis organism
staph aureus
56
impertigo organism
staph aureus
57
loss of sensation on pos. forearm
radial nerve
saturday night palsy
58
blood + protein in urine
focal segmental glomerulonephritis
59
deficiency in haemophilia a
factor VIII (factor 8)
60
deficiency in haemophilia b
factor IX (factor 9)
61
commonest type of nephrotic sx in adults
membranous glomerulonephritis
62
gene in coeliac disease
HLA-DQ2
63
night time vision loss and tunnel vision
retinitis pigmentosa
64
horizontal nystagmus
vestibular neuronitis
65
rotatory nystagmus
bppv
66
otitis media organism
h.influenzae
67
mx for pseudomonas aeurginosa
ciprofloxacin
68
antifreeze can cause
acute tubular necrosis (AKI)
69
dex dose in spinal cord compression
16mg
70
chronic liver + COPD in young smoker
alpha-1 antitrypsin deficiency
71
angiofibromas on cheeks + sacral plaque
tuberous sclerosis
72
drug that can cause steven-johnson syndrome
lamotrigine
73
mx for itchiness in liver disease
cholestyramine
74
non-needle mx for gonorrhoea
PO cefixime + PO azithromycin
75
complication of treating syphilis
jarisch-hex reaction
76
syphilis stages
1. chancre
2. fever/rash
3. gummas
77
diabetes mx in palliative
stop oral hypogylcaemics + consider stopping insulin
78
scalp swelling in newborns
caput succedaneum -> reassure
79
complication of long bone fracture
fat embolism (rash, hypoxia, confusio)
80
when to give intrapartum mx for HIV?
if viral load is >1000
81
definitive test for downs syndrome
chronionic villous sampling
82
complication of chronic lymphoid leukaemia
non-hodgkins (reichters transformation)
83
mx for STI but not chlamydia or gonorrhoea
doxycycline
84
RF for N+V with chemo
female, younger age
85
how long to wait post birth for cervical smear
3 months
86
mx for placental abruption if fetus is alive + < 36 weeks
IV corticosteroids for lung maturation
87
med mx for premature prelabour rupture of membranes
IM corticosteroids to reduce resp distress
88
rules for planned vaginal birth after c section (VBAC)
>37 weeks after a single c section
89
mx for local anaesthetic toxicity
lipid emulsion
90
malignant hyperthermia mx
dantrolene
91
when to excise fibroadenoma
if > 3 cm
92
mx for acute stress disorder
trauma CBT
93
mx for bishops < 6
vag prostaglandin E2
94
max time for ulipristal
120 hours post UPSI
95
max time for levon
72 hours post UPSI
96
mx for hiccups in palliative care
chlorpromazine
97
painful arc =
supraspinatus tendonitis
98
mx for RA + pregnancy
sulfalazine (DMARD)
99
complication of chicken pox
strep a -> nec fasc
100
med mx for abortion
mif + miso
101
mex mx for ectopic
im methotrexate
102
ix for acl rupture
lachmans
103
ix for meniscal tear
mcmurrays
104
reversal agent for apixaban
andexanet alfa
105
reversal agent for dabigatran
idrarucizumab
106
reversal agent for heparin
protamine sulfate
107
what hpv are genital warts
6 + 11
108
what hpv for cervical ca
16 + 18
109
schizo + dlva rules
dont drive for 3 months + inform dvla
110
flail chest can cause
tension pneumothorax
111
complication of measles
otitis media
112
tetanus sx
muscle spasms
113
what type of organism is e.coli
gram -ve rod
114
mx for scarlet fever
phenoxymethylpenicillin
115
mx for lyme disease
doxycycline
116
mx for hospital aquired pneumonia
co-amox then pip-taz
117
what does india ink stain look for
cryptococcus - fungal infection of CNS
118
name the live vaccines
BCG
MMR
polio
yellow fever
typhoid
119
common type of hep in pregnancy
hep e
120
bacterial meningitis organisms
strep pneum (pneum)
neisseria (meningiococcus)
121
non-needle hypoglycaemic agent
DDP-4 inhibitor
122
blood diarrhoea: crohns or UC
UC
123
complication of chest drain
pneumothorax
124
how many nodes to find on sent. biopsy to do an axillary node clearance?
3
125
small cell cancer complications
cushings
siadh
126
type of IgA vasculitis
henoch-s..purpura
127
gi complication of downs syndrome
duodenal atresia - vomiting bile
128
non-sedating antihistamine
loratadine
129
complication of carotid endarctectomy
haemorrhage
130
?ovarian ca ix
US
131
where is lesion in amourosis fag
same side internal carotid artery
132
mx for n+v in parkinsons
domperidone
133
line infection organism
staph aureus
134
electrolyte abnormality from thiazides
↑ calcium
↓ sodium + potassium
135
criteria for surgical aortic valve replacement
gradient > 40 OR LVEF <55 or symptomatic
136
big toe dermatome
L5
137
cranial nerve responsible for tongue
hypoglossal
138
↓ B12 can cause
subacute degeneration of spinal cord
rombergs +ve
139
?renal ca ix
CT
140
serum osmolality equation
(2xna) + glucose + urea
141
ix for heart failure
echocardiogram
142
when not to give duloxetine for diabetic neuropathy
if egfr< 30
143
ix for biliary colic
US abdo
144
chest pain in lung ca?
mesothelioma
145
palpable masses in both flanks point to
PCKD
146
radiofemoral delay is characteristic of
coarctation of aorta
turners
147
tonsilitis like sx with jaundice
ebv
148
young person with stroke/dvt - ix?
anticardiolipin antibody
SLE?
149
teratoma vs seminoma ages
teratoma ↓
150
↓ FSH + LH =
pituitary adenoma (hypogonadotrophic hypogonadism)
151
crackles + murmur post MI =
papillary m rupture
152
what eye stuff is affected in pituitary adenoma
optic chiasm
153
bariatric surgery criteria
BMI > 40 OR BMI >35 w/co-morbidities
154
bypass or endarctectomy
do bypass in people with severe limiting disease
155
mx for neuropathic bladder from MS
self-catheterise
156
acute cholecystitis ix
US
157
valve issue in PCKD
mitral valve prolapse
158
bradycardia + haemodynamically unstable
IV atropine
159
what not to give in asthma in arrhythmias
adenosine
160
mx for infective endocarditis at native valve
amoxicillin
161
AF and stroke rules
aspirin lifelong
start anticoagulant (DOAC/LWMH/warfarin) after 2 weeks
162
ALS - after 5 shocks, give
150mg amiodarone
163
fibrinolytic drug =
alteplase
164
ix for stable chest pain on exertion
CT coronary angiogram
165
post-MI + constant VF?
implantable cardiac defib
166
marfan's syndrome heart issue
aortic regurg
167
issue that causes pansystolic murmur louder at left sternal edge
ventricular septal defect
168
mx for beta-blocker od
glucagon
169
V1-V4 = ..... STEMI
anterior
170
mx for wolff parkinson white
flec
171
most common fracture from FOOSH
colles
172
galezzi fracture
distal radius fracture w/dislocation of radioulnar joint
common in children
173
pain better on leaning forward
spinal stenosis
ix: MRI
174
systemic sclerosis
raynauds
tight skin
anti centromere antibodies
175
bence jones proteins
multiple myeloma
176
factor Xa inhibitor
DOAC
177
key characteristic of chronic myeloid leukaemia
splenomegaly
178
schistocytes
DIC
179
↓ b12 deficiency blood film shows
hypersegmented neutrophils
180
mx for painful sickle cell disease
hydroxyurea
181
mx for von willebrands disease
desmopressin
182
usual limit for termination of pregnancy
24 weeks
183
abdo pain post fever + sore throat?
mesenteric adenitis
184
ix for neuroleptic malignant syndrome
creatinine kinase
185
spondylolisthesis
where one vertebrae slips out of line with the one above it
186
initial mx for pelvic organ prolapse
pelvic floor exercises
187
key features of systemic lupus erythmatosus
joint pain, mouth ulcers, pleuritic chest pain
188
most common method of metastases from lung ca
haematogenous spread
189
differentiating between non-hodgkins lymphoma and CLL
CLL = ↑ lymphocytes
190
where in the shoulder is a common site for metastatic cancer to spread to
proximal humerus
191
most common sinus involved in chronic sinusitis
maxillary sinus
192
genetic mutation in turners
45X0
193
painful arc from 80-120 =
subacromial bursitis
194
HPV is associated with what of oesophagus
SCC
195
pain in young female is associated with surge in what hormone
LH
196
first line mx for hodgkins lymphoma
chemotherapy
197
how to reverse neuromuscular blockade from general anaethestic
neostigmine (ach inhibitor)
198
mx for oesophageal cancer in palliative patients
stent
199
ix for multiple myeloma
serum free light chains
bence
200
AFP is elevated in what cancer
hepatocellularcarcinoma
201
key ix in tumour lysis
urate
202
mx for septic shock
iv noradrenaline/norepinephrine infusion
203
mx for breast lump in pregnancy
triple assessment
204
ix for haemolytic anaemia
direct antiglobulin test
205
blood film has spherocytes =
haemolytic anaemia
206
spasms in neck + facial muscles =
dystonia
207
ix for newborn deafness
brainstem evoked response test
208
most common cause of early pre-eclampsia features
molar pregnancy
209
mx for post partum haemorrhage + hypertension
oxytocin
210
when to do a partial vs radical nephrectomy
< 7 = partial
211
symptomatic renal cell carcinoma is usually stage
4
212
hand, foot + mouth organism
coksackie
213
macrocephaly and learning difficulties
fragile x syndrome
214
scarlet fever organism
group a strep
215
cause of nec fasc in chicken pox in kids
strep pyogenes
216
mx of whooping cough if within 21 days
azithromycin or clarithromycin
217
rocker bottom feets
edwards syndrome
218
when to do ECV in breech
nulli = 36 weeks
multi = 37 weeks
219
mx for preterm prerupture of membranes (3)
oral erythromycin, IV corticosteroids (lung maturation), IV MgSO4 (neuroprotection)
220
mx for intrahepatic cholestasis of pregnancy
induction of labour at 37 weeks
221
which pregnant women need anti-d at 28 weeks and 34 weeks?
rh-ve who are not sensitised
222
mx for bishops > 6
amniotomy and IV oxytocin
223
mx for bishops < 6
vaginal prostaglandins
224
SAH is associated with (electrolyte abnormality)
hypo natraemia
225
diff in sx between small and large bowel obstruction
small bowel = ↑ nausea + vomiting
226
in emergency surgical setting - what colostomy/ileostomy is made?
end colostomy
227
heavy periods first line mx
ius (mirena)
228
COCP increases risk of which cancers
breast + cervical
229
how long does IUD (copper) take to become effective?
immediatly
230
how long does POP take to become effective?
2 days
231
how long does COCP, IUS, injection, implant take to become effective?
7 days
232
first ix for endometrial ca
transvaginal us
233
acid-base abnormality in cushings
hypokalaemia metabolic alkalosis
234
loss of vibration sense points to
subacute degeneration of the spinal cord
235
third nerve palsy features
dilated pupil
down and out
drooping of eye
236
type of tremor in idiopathic parkinsons
assymetrical
237
inferior vision affected in bitemporal hemianopia
craniopharyngioma
238
superior vision affected in bitemporal hemianopia
pituitary adenoma
239
loss of corneal reflex =
acoustic neuroma
240
what tongue issue with bells palsy?
loss of taste to anterior 2/3rd of tongue
241
mx for alcohol withdrawal with + without liver impairment
no liver cirrhosis = chlordiazepoxide
with liver cirrhosis = lorazepam
242
mx of agitation in parkinsons disease
lorazepam
243
mx of agitation in patients NOT WITH parkinsons disease
haloperidol
244
mx of organophosphate od
atropine
245
why do a loop ileostomy?
to defunction the colon to protect an anastomosis
246
what is cushings triad
hypertension
bradycardia
irregular breathing
247
how does smoking affect hyperemesis gravidarum?
↓ it
248
breast screening rules
ages 50-70 every 3 years
249
mx of genital herpes in pregnancy
oral aciclovir + c section
250
epiglottitis organism
h.influenze
251
1st line mx of rhabdomyolysis
iv sodium chloride
252
most common endogenous cause of cushings syndrome
pituitary adenoma
253
254
normal pressure hydrocephalus triad
urinary incontinence
abnormal gait
cognitive impairment
255
how to differentiate between mesothelioma and adenocarcinoma
adenocarcinoma = more cough
mesothelioma = more shortness of breath
256
most common type of viral hepatitis
hep e
257
what is choledocholithiasis
gallstones in common bile duct
258
what to do if hip fracture like hx but nothing comes up on xray
MRI
259
describe caecal volvulus
dilated colon with twisting of mesentery involving ileocolic vessels
260
key signs of multiple myeloma
bone pain
hypercalcaemia signs (back pain)
anaemia
tiredness
261
loud S2 sound =
pulmonary hypertension
262
what to do for UC if steroids + ciclosporin hasn't worked
subtotal colectomy and ileostomy
263
1st line for prolactinomas
cabergoline
264
what can lead to renal artery stenosis in adults (unexplained hypertension)
atherosclerotic disease
265
no need to do FRAX, just do DEXA in what patients
>50 with fragility fracture
266
MS pathophysiology
t-cell mediated oligodendrocyte damage
267
what are damaged in GBS?
schwann cells
268
HIV patients with CD4 < 200, most common organism causing pneumonia is
pneum. jiv
269
HIV patients with CD4 > 200, most common organism causing pneumonia is
strep. pneumoniae
270
what problems should be referred to nephrologist?
ACR >30 with haematuria
271
what is associated with cataracts?
double vision
272
what is used for latent TB testing for in young children/young adults?
mantoux test
273
what is used for latent TB testing for > 60 yo?
chest x ray
274
if there is obvious metabolic acidosis (with ↓ HCO3) and also ↑ CO2 - what does this mean?
mixed respiratory and metabolic acidosis
275
mx for proliferative retinopathy
panretinal photocoagulation
↓ in visual fields + night vision
276
what are the first line abx for COPD exacerbation?
amoxicillin or clarithromycin or doxycycline
do not give clarithromycin in long QT syndrome
277
what is a tumour flare and when does it occur
bone pain, constipation
prostate cancer from GnRH agonists (goserelin)
278
med mx for BPH
1. alpha 1 antagonist (tamsulosin)
2. 5 alpha reductase antagonist (finasteride)
279
immediate mx of VF/pulseless VT
1 shock
280
if you are on warfarin or anti-coagulant and you have a head injury, when do you do CT scan?
within 8 hours
281
definitive ix for myasthenia gravis
antibody screen
282
if you press on deep inguinal ring + still see the hernia, what type is it ?
direct inguinal hernia
283
what does a positive TPHA mean?
antibody vs syphilis
present or current infection
284
explain a nontreponemal (RPR/VDRL) test
tests for cardiolipin
↑ cardiolipin means more infection so treated syphilis = -ve
285
why do people with ckd present with iron deficiency anaemia?
EPO deficiency
286
what is the triad of acute liver failure?
confusion (encephalopathy)
jaundice
+ deranged coagulation screen (INR >1.5)
287
what to do if med mx of bradycardia fails?
pacing (cutaneous and external are the same thing)
288
what's the first line ix for acromegaly ?
Serum IGF-1 levels
289
if +ve IgA TTG, what ix is next?
gluten-containing diet w/intestinal biopsy
290
what arrthythmia occurs in unconscious patients ?
VF
291
where does the high-dose dexamethasone test act on ?
anterior pituitary gland
291
what can cause an unusually increased HbA1c level?
splenomegaly
292
med mx for hyperthyroidism in pregnant women in first trimester
propylthiouracil
then go to carbimazole
293
mx for severe urticaria after antihistamine
cont.antihistamine and add 5 day PO prednisolone
294
wrist drop is a sign of what nerve damage
radial nerve damage from humeral shaft (body) fracture
295
what ECG can be caused by a large pulmonary embolism
right bundle branch block
296
bacterial vaginosis organism
gardenerlla vag
297
what drugs are responsible for SIADH?
SSRI
298
med mx for myxoedemic coma
thyroxine and hydrocortisone
299
what drug causes cholestasis?
co-amoxiclav
300
if a patient can't take oral levodopa, what do you give instead?
dopamine agonist patch
301
what is the preferred ix for cushings disease
overnight dexamthasone suppression test
302
1st line mx for whous sinus thrombosis
LMWH
303
ix for cause of central artery occlusion
carotid doppler
304
diabetes mx for NG tube
insulin
305
what indicates sbp?
neutrophils < 250 mm3
306
clubbing + joint pain points towards what type of lung cancer
adenocarcinoma
307
mx for new onset afib is presented within 48 hours
direct current cardioversion
308
features of wernickes encephalopathy
confusion, gait ataxia, nystagmus + ophthalmoplegia
309
for infertility, when should progesterone be taken for ix?
cycle - 7 = this day
310
what should HIV patients with CD4<200 be given?
antiretroviral
+ co-trimox prophylaxis
311
initial mx for shoulder dystocia
mcroberts manourvere (suprapubic pressure)
312
most common ligament sprain from inversion of ankle
anterior talofibular ligament
313
after med abortion, when to have pregnancy test?
2 weeks after
314
when to give corticosteroids in sarcoidosis
parenchymal lung disease, uveitis, hypercalcaemia and neurological or cardiac involvement
315
best non-tablet contraception for younger girls
progesterone only implant
316
what electrolyte abnormality is there in compartment syndrome
hyperkalaemia
317
PO morphine to SC morphine
divide by 2
318
mx for trichomonas vaginalis
PO metronidazole
319
mx for vaginal candidia
PO fluconazole
320
abx for UTIs in pregnancy
do not give....... in third trimester
nitrofurantoin
321
uterine w mx
<3 = COCP
>3 = myomectomy
322
difference between tetralogy of fallot + transposition of great arteries
TGA - immediately after birth
ToF - ejection systolic murmur + more common
323
rules for starting COCP after giving birth
3 weeks
6 weeks if breastfeeding
324
first line mx for idiopathic thrombocytopenic purpura
PO prednislone
325
what is given to those with polycythaemia vera to reduce VTE?
aspirin
326
mx for mothers who are pregnant with baby 2 previous group b strep in baby 1
intrapartum IV benzylpencillin
327
what does SPAM stand for in perianal tears?
S - Superficial
P - Perineal
A - Anal sphincter
M - Mucosa
328
damage to what causes dyskinetic cerebral palsy?
basal ganglia and the substantia nigra
329
HUS and inevitable miscarriage mx
dilatation and curretage
330
med mx of miscarriage + abortion
oral mif then mis
331
med mx of ectopic pregnancy
methotrexate
332
mx of transient tachypnoea of the newborn (fluid in lung fissure)
supportive treatment
333
criteria for iron supplementation in women
115 for non-pregnant women
110 in early pregnancy
105 in later pregnancy
100 after childbirth
334
what anti-diabetc drugs can be continued on day of surgery?
DDP-4 (-gliptins)
and
GLP-1 (-tides)
335
what abx for UTI is safe in breastfeeding?
trimethoprim
336
what 2 things are hyoscine hydrobromide used for in palliative care?
respiratory secretions + bowel colic
337
mx for low lying placenta
rescan at 32 weeks
338
mx for intussception
reduction via air insuffliation
339
difference between duct ectasia and duct papilloma
ectasia = green/yellow discharge
papilloma = blood
340
plans for mother who has had previous c section before
if horizontal scar = can have vaginal birth at 37 weeks
if vertical scar = c section at 37 weeks
341
mechanism of aromatase inhibitors (anastrozole)
↓ synthesis of oestrogen
342
mechanism of tamoxifen
partial antagonism of oestrogen receptor
343
what RR is a red flag in paeds?
>60
344
surgical mx for healthy person with undisplaced intracapsular fracture
internal fixation
345
how is chlordiazepoxide given in alcohol withdrawl
tapering doses
346
best type of airway mx to prevent aspiration
endotracheal tube
347
how does LH:FSH ratio change in PCOS?
↑
so ↑ LH but ↓ FSH
348
what are the side effects of clomipramine
is a TCA so dry mouth and weight gain
349
whats the best way to give total parenteral nutrition
central line
350
how does lidocaine work
blocks sodium channels
351
what does chemotherapy ↑ the risk of
gout
↑ urate
352
where to check for paeds pulse
brachial and femoral
353
describe salter harris fracture classification
S - straight through
A - above
L - beLow
T - two or through
ER - erasure of growth plate
354
where is an ectopic pregnancy most likely to end up
isthmus
355
difference between specificity and sensitivity
sensitivity - prop of people WITH disease with +ve result
specificity - prop of people WITHOUT disease with -ve result
356
what is likelihood ratio for a positive test result + how to calculate it
sensitivity / (1 - specificity)
how much the odds of the disease increase when a test is positive
357
what is likelihood ratio for a negative test result + how to calculate it
(1-sensitivity)/specificity
how much the odds of the disease decrease when a test is negative
358
what statistical test is used to compare before + after
wilcoxon signed-rank test
359
what statistical test is used to compare percentages or proportions
chi-squared test
360
describe a case control study
what is used to report results
observational and asking them about past exposure
odds ratio
361
describe the clinical trial phases
0. exploratory studies
1. safety
2. efficiacy
3. effectiveness
4. looking at longterm
362
difference between prevalence and incidence
incidence is the number of new cases per population in a given time period
prevalence is the total number of cases per population at a particular point in time
363
how does incidence and prevalence differ bewteen acute and chronic disease
chronic disease prevalence>incidence
acute disease the incidence > prevalence
364
describe cohort study
followed up to see how many people develop outcome
365
what is a late sign of compartment syndrome?
paralysis
366
why might methotrexate cause macrocytic anaemia?
if not taken with folate
367
what is the most common congenital heart defect in babies whose mother has diabetes?
transposition of the great arteries
368
what are neurofibromatosis 1 and 2 associated with
1 = optic gliomas
2. bilateral vestibular schwannomas
369
most common cause of septic arthritis
staph aureus
clusters gram+ve
370
what is the management for acute chest crisis in sickle cell disease
supportive
o2, morphine etc
371
what type of drugs is first line for alzheimers
acetylcholinesterase inhibitor
372
what is the best contraception for up to 5 days post UPSI
copper coil
373
what does FSH and LH look like in premature ovarian failure?
both ↑
loss of -ve feedback
374
what might a loud 2nd heart sound + systolic murmur represent?
either
ventricular septal defect OR
patient ductus arteriosus
375
why is ibuprofen contra-indicated in pregnancy?
premature closure of ductus arteriosis
376
what can lead to early haemolytic jaundice in the newborn?
maternal blood group O positive
incompatibility -> breakdown of newborns RBC
377
what is a bad left ventricular ejection fraction?
<50
378
difference between de musset and quincke’s sign
de musset = de music = bopping your head to the music
quincke's = quicky with the fingers (nailbed pulsation)
379
what indicates hypertension and headaches?
pheochromocytoma
ix: adrenaline/noradrenaline tests
380
in ACS, what level of Hb indicates a need for red blood cell transfusion
<80
381
what electrolyte disturbance might occur after a total thyroidectomy
↓ calcium
so get seizures, tapping face = twitching
382
what cranial nerves are in the midbrain, pons and medulla?
Midbrain CN 1,2,3,4
Pons CN 5,6,7,8
Medulla CN 9,10,11,12
383
what might strep pneumoniae CAP present with?
cold sores - can exacerbate herpes
ix: urinary antigen test
384
ix for orbital cellulitis
CT orbits
385
what is syringiomyelia?
characteristic 'cape-like' distribution of pain and temperature loss due to compression of the spinothalamic tract in the spinal cord
386
what might cause secondary polycythaemia?
COPD
387
what virus is a renal transplant patient at risk of ?
CMV
388
what deaths should be referred to the coroner?
deaths from trauma e.g. falls
389
what anti-emetic might cause acute dystonia
metoclopramide
390
in paracetamol overdose, what is a good prognostic indicator?
INR/PT
391
features of cavernous sinus thrombosis
double vision, painful eye
392
when should clopidogrel be stopped before surgery?
7 days
393
most common cause of osteomyelitis
staph aureus
394
sustained ST elevation after an MI =
ventricular aneurysm
395
when you cant give furosemide for acute heart failure, what do you give?
inotropes (dombutamine)
396
patients suffering from C. difficile need isolation for how long
at least 48 hours
397
what is the 4AT score used for?
likelihood of getting heparin induced thrombocytopenia
398
what is a positive schoebers test for AS
<5
399
plan for mum getting herpes during pregnancy
elective c section at 37 weeks
400
what murmur is heard in turners
ejection systolic due to bicuspid aortic valve
401
what is hirschprungs disease
delay >48 hours in passing first poo in newborns
402
if a child has impertigo, how long do they have to stay off school
48 hours
403
mx for already hypertensive women who want to get pregnant
switch to labetalol
404
mx for impertigo (2)
1. hydrogen peroxide
but if near eyes
2. fusidic acid
405
what does previous c section ↑ the risk of
uterine rupture
406
what ix is used to confirm diagnosis of suspected small bowel bleeding
capsule endoscopy
407
what is at risk of neck of humerus fracture
axillary nerve
408
what are key features of neonatal sepsis
jaundice, floppy, feed refusal
409
what is indicated by a white area around the cervical os?
cervical intraepithelial neoplasia
410
what is the best ix to confirm multiple myeloma
bone marrow biopsy - plasma cells
411
when should you refer patient for urgent chest xray
>40 with 2+ of :
Cough
Fatigue
Shortness of breath
Chest pain
Weight loss
Appetite loss
Have ever smoked
412
what are white strands in otitis externa caused by
candidia albicans
413
how do you ix risk of getting diabetes after gestational diabetes?
fasting plasma glucose at 6-13 weeks post partum
414
features of bronchiolitis
runny nose, new wet cough
415
what is associated with polymyalgia rheumatica
giant cell arteritis
416
rules of red cell transfusion
must be used within 4 hours of being taken out of fridge
417
ferritin levels in iron deficiency anaemia
in infection, ferritin may rise but this does not mean it IS NOT iron deficiency anaemia
418
ix for epstein-barr virus
hetrophile antibody test
419
what is the cause of reduced movement in wrist after colles fracture
malunion
420
mx for pregnant women with new hypertension but NO proteinuria
placental-like growth factor
rule out pre-eclampsia
421
ix for endometrial ca after transvaginal us
pipelle biopsy
422
what does pancytopenia indicate?
myelodysplastic syndrome
“hypolobated”, “macro”, “large” and “atypia” seem to suggest a significant presence of abnormal (dysplastic) cells
423
features of a ganglion cyst
base of finger
catching sensation
pea under skin
424
molar pregnancy features + mx
snowstorm appearance
suction cutterage
425
mx for pregnant people with secondary PPH
syntometrine and controlled cord traction
426
mx for GORD vs mx for cows milk intolerence
GORD = thickened formula
cow's milk intol = hydrolysed formula
427
mx of stable undisplaced ankle fracture
walking boot
428
mx for patient ductus arteriosus
prostaglandin e2 e.g. indomethacin
429
what is the mx used to prolong survival in motor neurone disease
riluzole
glutamate inhibitor
430
describe the rash associated with coeliac disease
dermatitis herpetiformis
vesicles on extensor surfaces of knees and elbows
431
mx for neuroleptic malignant syndrome
iv dantrolene
432
key ix for confirming diagonosis of infective endocarditis
trans OESOPHAGEAL echocardiogram
433
best anti-psychotic for less side effects
aripiprazole
434
what is bupropion contraindicated in
epilepsy
435
what is the pathophysiology of endometeriosis?
ectopic implantation of endometrial-like tissue outside the uterus
436
what is most at risk of damage in total thyroidectomies?
reurrent laryngeal nerve
437
features of a hiatus hernia
mass felt
heartburn
regurg
438
mx for prevention of HIV
daily PO tenofovir–emtricitabine
anti-retrovirals (PreP)
439
what surgery occurs for an isolated sigmoid adenocarcinoma?
high anterior resection
440
first line mx for rheumatoid arthritis
DMARDs
441
why is a paired t test used?
to compare before + after
442
what is first line mx for magnesium sulphate respiratory depression?
calcium gluconate
443
what might increase risk of endometrial cancer?
↑ oestrogen
obesity
444
what cancer is barrets oesphagus associated with
oesophageal adenocarcinoma
445
what cancer is achalsia associated with
squamous cell carcinoma
446
what is a cause of a pulsatile liver
right heart failure
447
mx for heparin induced thrombocytopenia
switch to direct thrombin inhibitors
448
what is seen on an ECG in an NSTEMI
t wave inversion
449
ring enhancing lesions on CT in an HIV patient shows what?
+ whats the mx?
toxoplasmosis
mx: sulfadiazine and pyramethamine
450
what eye condition is associated with T2DM + what is its mx?
vitreous haemorrhage
mx: vitrectomy
451
biologic agents in UC can cause reactivation of what
TB
452
what is an eye complication in giant cell arteritis (sx of jaw pain weight loss)?
arteritic anterior ischemic optic neuropathy (AION)
sudden painless vision loss
453
what is a complication of legionella pneumonia?
↓ Na+ due to SIADH
454
what is a complication of mycoplasma pneumonia?
anaemia
455
what might digoxin toxicity be precipitated by?
gastroenteritis
↓ K+
456
why might a venous thromboembolism cause a stroke in arterial circulation?
cardiac defect e.g. patent foramen ovale
ix: bubble echocardiogram
457
how to tell the difference between squamous and transitional cell bladder cancer?
squamous (squeamish) = schistosomiasis infection, long-term catheterisation
transitional = tobacco
458
how to tell the difference between bladder cancer and renal cell cancer with painless haematuria?
bladder cancer is more common
renal cancer = renal mass or flank pain
459
complication of abdominal pain that leads to pain on deep breathing and coughing
alectasis
chest physio
460
most common cause of aortic stenosis in young person
congenital bicuspid valve
461
ix for erectile dysfunction if other bits of puberty are ok
HbA1c
462
how does toxic shock syndrome present
fever
hypotension
organ dysfunction
463
with suspected patient >65 with uti, what ix ?
urine CULTURE
not dipstick (dipshit)
464
mx for normal pressure hydrocephalus
shunt
465
what indicates jaundice but no other signs of liver disease?
gilberts
466
what is a carcinoid tumour + how does it present?
GI tumour
diarrhoea, flushing, hypotension, and predominantly right sided heart murmurs
467
ix for suspected rheumatic fever from recent strep throat infection
anti-streptolysin O (ASOT) titre
468
complication of patients with liver disease + cirrhosis
spontaneous bacterial peritonitis
469
mx for sbp
cefotaxime
470
what type of hypersensitivity reaction is anaphylaxis?
type 1
471
what ix is most suggestive of a repeat MI?
CK
472
how to calculate units of alcohol
alcohol units = (Volume of drink in ml) × (ABV in %)/ 1000
473
difference between surgical vs medical CNIII palsy
surgical = painful
474
antifreeze od mx
fomepizole
475
what are red cell casts on urinalysis indicative of
glomerular condition -> renal biopsy
476
monkeypox vs herpes vs lymphoma verenum
monkeypox lesions are bigger + painful
lymphogranuloma = painLESS
477
overflow diarrhoea mx
phosphate enema
478
what might cause molluscum contagiosum in adults
HIV
479
mx for PE in end stage renal failure or eGDR <15
unfractioned heparin
480
what FeNO level is indicative of asthma
50+ ppb
481
painless rectal bleeding in children
meckels diverticulum
482
mx for opioid detoxification
methadone
483
mx for giardiasis
metronidazole
484
what type of sickle cell crisis is associated with a sudden drop in hb?
aplastic
parvovirus
485
what stoma is formed in a UC prophylactic pan-proctocolectomy
end ileostomy
486
how does transferrin, ferritin and TIBC change in haemochromatosis?
↑ transferrin, ↑ ferritin and ↓ TIBC
487
gas gangrene is caused by what organism
clostrium perf
488
characterstics of a loop ileostomy
RIF
spouted
liquid
489
campylobacter vs e.coli after holiday
campylobactor = bloody diarrhoea
490
what is indicated by a young patient with hypertension + systolic murmur?
coarctation of the aorta
491
most sensitive test for pancreatitis
lipase
492
what acid base imbalance does vomiting cause
hypernatraemia and metabolic acidosis
493
acute mx of hypocalcaemia
calcium gluconate
494
difference between horners + third nerve palsy
both the same but
horners = pupils constrict
third nerve palsy = pupils dilate
495
side effect of TURP vs radiotherapy for prostate cancer
radiotherapy = proctitis
TURP = retrograde ejacu
496
mx for flare of myasthenia gravis
pyridostigmine
497
when should a 2nd drug be added to t2dm mx?
> 58 mmol/mol
498
most common organism causing neutropenic sepsis
staph epidermis
499
when should you start oral aciclovir for chicken pox?
7 days post exposure
500
when to stop COCP before surgry?
4 weeks
501
what type of pneumonia is typical in a younger smoker?
mycoplasma
502
ascending cholangitis organism
e.coli
503
how to test for lyme disease
serology
504
features of anterior cerebral artery stroke
affects lower limb over upper limb
NO FACE ISSUES
505
most common type of hodgkins lymphoma
nodular
506
where are iron, folate and B12 absorbed?
Dude I Just Feel Ill Bro
Duodenum (Iron), Jejunum (Folate), Ileum (B12)
507
what 2 indications are there that pleural effusion is an exuadate
protein > 30 OR effusion:serum protein ratio > 0.5
508
how does congenital syphilis present
ear issue and rash
509
how does congenital rubella present
cataracts
510
recurrent STIs, RUQ pain points towards what
pelvic inflammatory disease
mx: IM ceftriaxone for gonorrhea, PO doxycycline for chlamydia and other pathogens, and PO metronidazole for anaerobic coverage, usually over 14 days.
511
baby with vomiting but electrolyte changes (↓ Na+ and ↑ K+ - what is this
congenital adrenal hyperplasia
512
+ve anti-histone antibodies are found in what
drug induced lupus
e.g. isoniazid (used for TB), procainamide, hydralazine, minocycline and phenytoin
513
name the 2 shockable rhythms
ventricular fibrillation/pulseless ventricular tachycardia (VF/pulseless VT)
514
when are antibiotics given in tonsilitis
when centor > 3
515
what drugs can cause ↑ neutrophils
steroids
516
what is indicated by a 'sunburst appearance?' on xray
oesteosarcoma
517
key features of avascular necrosis
insidious onset and pain in the groin/buttock region
from steroids?
518
whats given to children who are immunocompromised and need protecting from bronchiolitis
Palivizumab
519
what drug can cause eye issues
Hydroxychloroquine for RA
520
what does lead poisoning cause
wrist drop
weakness
basophilic stippling on blood film
521
diagnosis of baby with 'scaphoid abdomen and barrel chest'
congenital diagphragmatic hernia
522
is mif or mis used for induction of labour
misoprostol
523
what organism causes roseola infantum
herpes 6
524
features of lateral epicondylitis
worst wrist extension when elbow is extended
worse supination
525
mx for otitis media in diabetes
ciprofloxacin
526
mx for benzodiazepine od
flumenazil
527
mx for methanol od
fomepozile or ethanol
528
mx for digoxin od
antibodies
529
diabetes + gi issues think of
gastroperesis
530
what is cannonball mets usually caused by
renal cell carcinoma
do CT abdo
531
what anti-emetic is used in small bowel obstruction
cyclizine
532
codeine to morphine
divide by 10
533
HIV with homogenous on CT
lymphoma
534
whats radial tunnel syndrome
basically same as lateral epicondylitis but worse on PRONATION not supination
535
background of what might trigger torsades des pointes?
long QT syndrome
536
what are first line for muscle stiffness in MS?
baclofen + gabapentin
537
difference between wernickes and conduction aphasia
understanding is impaired in wernickes
538
how does a stroke in PICA present?
cant chew (PICA-chew)
temperature + pain sensation loss
539
mx for myasthenic crisis
iv immunoglobulins + plasmaphoresis
540
in subacute degeneration of spinal cord from b12 deficiency, what tracts are affected
dorsal columns and lateral corticospinal tracts
541
when is carotid endarterectomy indicated in patients who have had a TIA?
stenosis > 70%
542
when do you get a shingles vaccination?
65yo
543
AST:ALT or ALT:AST
AST:ALT
ass first
544
what is biopsied in coeliac disease
jejenum
545
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