1
Q
What is the 2nd Line Treatment for Moderate/Severe OCD?
A
Clomipramine - TCA that can be used.
2
Q
When should a referral to Urology be made for undescended testes?
A
3 Months
3
Q
When is the POP working?
A
48 Hours
4
Q
Which contraceptive methods are valid after 7 days?
A
IUS, COCP, Implant, Injection
5
Q
What is the rate for paediatric compressions?
A
100-120 BPM
6
Q
When should low dose aspirin be taken for pre-eclampsia prophylaxis?
A
From 12 Weeks to Term
7
Q
What do Cafe Au Lait spots suggest?
A
Neurofibromatosis Type 1
8
Q
Where in the prostate does BPH & Prostate cancer start?
A
BPH - Transformational Zone
Prostate Ca - Peripheral Zone
9
Q
What Trisomies are Edwards and Patau’s?
A
Edwards - Trisomy 18
Patau’s - Trisomy 13
10
Q
What is the most common side effect of ECT?
A
Retrograde Amnesia
11
Q
By what age should Febrile Seizures Cease?
A
Age 6
12
Q
What vessel is associated with Locked-in Syndrome?
A
Basilar Artery
13
Q
What diet is good for mild premenstrual syndrome?
A
Regular frequent meals that are rich in complex carbohydrates.
14
Q
What is the difference between Circumstantiality and Tangtientiality?
A
Circumstantiality - The patient eventually returns to the topic/question that was asked.
15
Q
What test is used for School Entry Hearing Testing?
A
Pure Tone Audiometry
16
Q
What is recommended for all patients who have been seen by Sexual Health Services with a diagnosis of Neisseria Gonorrhoea?
A
Recall for a test of cure to prevent further spread.
17
Q
Are Staph and Strep Gram Positive or Negative?
A
Gram Positive
18
Q
What is the difference in presentation between Post-Streptococcal Glomerulonephritis and IgA nephropathy?
A
PSGN - Tends to present 2+ weeks after a throat infection (Test: Anti streptolysin O titre) whereas IgA presents a few days after (Test: Renal Biopsy).
19
Q
What is the Haemoglobin Level Cutoff for Treatment in Pregnancy?
A
1st Trimester <110g/L
2nd Trimester <105g/L
3rd Trimester <105g/L
<100 Post Partum
20
Q
How is Pre-existing diabetes mellitus managed in pregnancy?
A
Metformin + Insulin
21
Q
What is Meig’s Syndrome?
A
Triad of an Ovarian Fibroma, Ascites and Pleural Effusion.
22
Q
What did the Black Report (1980) find?
A
The main cause of health inequalities is economic inequality.
23
Q
When should Triptans be taken in the context of a migraine?
A
They should be taken when the pain begins rather than at the onset of the aura.
24
Q
How much fluid is given as a Paediatric Bolus Dose?
A
10ml/Kg STAT (Over less than 15 mins)
25
What are the TORCH infections?
Infections which can be transmitted antenatally or Intrapartum
T - Toxoplasma gondii
O - Other (HIV, Treponema, VZV, Parvovirus B19)
R - Rubella
C - Cytomegalovirus
H - Herpes Simplex.
26
What enzyme is deficient in CAH?
21-Hydroxylase
27
What marker is raised in CAH?
17-Hydroxyprogesterone
28
What is classified as a failure to thrive?
Falling across two or more centile lines on a customised growth chart.
29
What medication is given for focal seizures?
Levetiracetam or Lamotrigine
30
What are the two dimensions of Health Equity?
Spatial Factors (Geographical), Social Factors (Age, Sex, Race)
31
Why do people continue to partake in health-damaging behaviours?
Unrealistic Optimism - People have a poor perception of their own risk and susceptibility due to:
- Lack of personal experience with a problem
- Belief that it occurs infrequently
- Belief it isn't preventable by personal action.
- Belief that if it hasn't happened by now it isn't likely to.
32
What does estrogen do in pregnancy?
Increases CV output and Myometrial Hypertrophy
33
What does Progesterone do in pregnancy?
Increases Ventilation and promotes myometrial quiescence.
34
What does HPL do in pregnancy?
Mobilises fats from adipose tissue stimulates glucose production, acts as an insulin antagonist and stimulates the breast tissue to differentiate and become milk-secreting.
35
Name some physiological changes that occur during pregnancy.
Increased Blood Vol and CO
Increased Erythropoesis
Hyperventilation
Increased Bone turnover
Increased basal metabolic rate
Increased body weight
Breast development
36
What sign is suggestive of Eczema Herpeticum?
Punched out lesions on the skin
37
What investigation findings are typical of asthma in children?
FeNO >35 parts per billion, Bronchodilator reversibility of spirometry (>12%, >10%)
38
Combined Test Down's Syndrome
Thickened Nuchal Translucency, Increased B-HCG, Reduced PAPP-A
39
What medications are used to treat Acute Dystonias and Tardive Dyskinesia?
Acute Dystonias - Procyclidine
Tardive Dyskinesia - Tetrabenzine
40
What is Weber's Syndrome?
Midbrain stroke due to occlusion of a posterior cerebral artery presents with ipsilateral oculomotor nerve palsy and a contralateral hemiparesis or hemiplegia
41
What is Wallenberg's Syndrome?
Also known as lateral medullary syndrome, this occurs due to a posterior inferior cerebellar (PICA) infarct. Presents with ataxia, dysphagia, horners syndrome, dysphonia and contralateral sensory deficits.
42
What are the three main Parkinson's Plus conditions and what defines them?
Progressive Supranuclear Palsy - Early postural instability and frequent falls.
Multisystem Atrophy - Early autonomic dysfunction
Corticobasal Degeneration - Unilateral parkinsonism with "alien limb" phenomenon.
43
What is the Classical Presentation for a Subdural Hematoma?
Fluctuating GCS on a background of head injury in the context of Alcohol Excess, with a CT head that demonstrates a crescent-shaped Hemorrhage.
44
What is the ROSIER Scale Used for?
Recognising Stroke in the Emergency Department.
45
Which Antipsychotic medication has the least risk of hyperprolactinemia?
Aripiprazole - It may even lower Prolactin levels!
46
How do you estimate the due date for a pregnancy?
Naegele's Rule
First day of LMP + 1 Year + 7 Days - 3 Months
47
What is Logoclonia?
When people with Parkinson's disease get stuck on a word and repeat it.
48
Difference between Peri-orbital and Orbital Cellulitis?
Orbital Cellutis affects ocular structures so presents with eye signs and requires IV AbX.
49
What is a Strawberry Cervix?
Where the Cervix is red, dotted and papilliform.
It is pathognomonic of Trichomonas Vaginalis infection.
50
Mifepristone and Misoprostol
Mifepristone - Synthetic steroid that is antiprogesterone which prevents a normal development of pregnancy.
Misoprostol - Synthetic Prostaglandin E1 analogue that causes stronger uterine contractions and leads to expulsion of POC.
51
Mefenamic Acid
An NSAID that is used for pelvic pain and dyspareunia in endometriosis.
52
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53
What genetic mutation is ALL associated with?
t(12:21)
54
How long must symtoms be present for to make a diagnosis of PTSD?
>4 Weeks
55
Surgical Treatment for SAH
Endovascular Coiling
56
What Monoclonal Antibody can be given for HER2 receptor postive breast cancer?
Herceptin (Trastuzamab)
57
What does the Bishop Score assess?
The Cervix to assess whether it is favourable for Spontaneous Vaginal Delivery.
<6 - Unfavourable for Spontaneous
6 - 7 - Use clinical judgement.
>7 - NVD more likely
58
Impetigo Management
- Localised non-bullous impetigo: topical treatment with hydrogen peroxide 1% cream (apply two or three times daily for 5 days) is first-line
If unsuitable, second-line options include fusidic acid or mupirocin (if fusidic acid resistance).
- Widespread non-bullous impetigo:
Topical (fusidic acid/mupirocin) or oral antibiotics for 5 days, such as flucloxacillin
- Bullous impetigo, or impetigo in those systemically unwell or at high risk of complications:
Oral antibiotics as above for up to 7 days
59
Which Sections of the MHA should be used in A&E?
As A&E counts as the community, Section 5(2) cannot be used as an emergency order. Section 2 or 4 should be used.
60
What is the only ABSOLUTE contraindication for ECT?
**Raised ICP**
Other Contraindications include - MI < 3 months ago, Unstable fracture, Anuerysm, Stroke, History of status and Severe Anaesthetic risk.
61
Pressure Sore Grading
I - Non-blanching erythema or intact skin.
II - Partial-thickness skin loss involving epidermis dermis or both.
III - Full-thickness skin loss involving damage to or necrosis or SC tissue that may extend down to, but not through underlying fascia.
IV - Full-thickness skin loss with extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures.
62
What are Maxwell's 6 Dimensions of Healthcare Quality?
1. Safety
2. Effectiveness
3. Patient Centred
4. Timeliness
5. Efficiency
6. Equity
63
Folic Acid and Vitamin D Doses (Pregnancy)
Folic Acid - 400ug per day up to 12 Weeks.
* 5mg for those at risk of NTD (FH, Obesity, Medications, DM, Sickle cell)
Vitamin D - 10mg (400 Units) per day thorughout pregnancy and breastfeeding.
64
Treatment for Vaginal Candidiasis
PO Fluconazole 150mg STAT.
Intravaginal Clotrimazole (Pregnancy)
65
Treatment for Bacterial Vaginosis
Metronidazole
66
Treatment for Trichomoniasis
Metronidazole PO (STAT or BD 7 Days)
67
Treatment for Chlamydia
Doxycycline (PO BD 7 Days) OR Azithromycin (1g STAT PO)
68
Treatment for Gonorrhoea
Ceftriaxone + Azithromycin (Covers CO-infection w/ Chlamydia)
69
What are the Risks of Neonatal Artificial Ventilation ?
* Bronchopulmonary Dysplasia
* Pneumothoraces
* Retinopathy or Prematurity
* Pumonary or Intraventricular Haemorrhage
* NEC
70
Which TOF defect has the most impact on severity?
Pulmonary Stenosis - It determines the degree of cyanosis due to correlation w/ larger volumes of deoxygenated blood not reaching the lungs.
71
What is the main difference between Hypochondriasis and Somatisation disorder?
Hyperchondriasis tends to cause a focus on conditions and Somatisation leads to a focus on symptoms.
72
Anorexia Nervosa Biochemical Abnormalities
* Low FSH, LH Test and Oestrogen
* Normal T4, Low T3
* Low K, Ca, Mg
* Metabolic Alkalosis
* High Cortisol
73
How long should Sertraline be continued for after symptoms of OCD have subsided?
12 months
74
What is the most characteristic sign of Lithium toxicity?
Seizures.
75
What is the common age range for Perthe's disease to present?
4-8 Years
76
What is Enterobius Vemicularis?
Threadworm
77
What are the two main signs of Neonatal hypoglycemia?
Jittery/Tachypnoeic
78
What are the 3 main risk factors for SIDS?
Smoking, Baby sleeping on its front, Sleeping in the same bed as a baby.
79
What do "Stools containing carrots and peas" suggest in children?
Toddler's Diarrhoea - Chronic non-specific diarrhoea.
80
What electrolyte abnormality are SSRIs associated with?
Hyponatremia
81
How long after a dose should Lithium levels be measured?
12 Hours
82
What are the criteria which indicate surgical management of an ectopic pregnancy?
>35 mm, Foetal Heartbeat, B-HCG > 5000 IU/L.
83
Which screening tool can be used for the detection of postnatal depression?
Edinburgh Scale
84
Why is Tamoxifen a risk factor for endometrial cancer?
Although it usually acts as an oestrogen antagonist, in endometrial tissues, it may act as an agonist.
85
Why is Trimethoprim preferred to Nitrofuranotin in breastfeeding?
Small amounts can be found in breastmilk which can cause haemolysis in children with G6PD deficiency.
86
How should the COCP be taken if it is being used for irregular periods?
Tricycling - Every day for 9 weeks followed by a 4 or 7-day pill-free interval.
87
Which contraceptive method is known to cause depression?
POP
88
What is the causative agent for Roseola Infantum?
Human Herpes Virus 6 ("Sixth Disease")
89
What is the most serious long-term complication for women with Turner's syndrome?
Increased risk of Aortic dilatation and dissection.
90
What should be monitored closely when giving Magnesium Sulphate?
Respiratory rate (RR depression is a recognised complication of MgSO4), Reflexes (Hyporeflexia is a sign of Hypermagnesemia).
91
How long should MgSO4 be continued when given for Eclampsia?
24 hours after delivery or 24 Hours after the last seizure.
92
What type of Memory Loss is seen in Pseudodementia?
Global Memory Loss
93
What should be co-prescribed with an SSRI in patients who are taking NSAIDs?
PPI
94
What is the Waterlow Score used for?
Identifying patients who are at risk of pressure sores.
95
What are the 4 main predisposing risk factors for pressure sores?
Malnutrition, Incontinence, Immobility, Pain
96
What class of drug is indapamide?
Thiazide-like diuretic.
97
Why is PCOS a risk factor for Endometrial Ca?
Oestrogen-secreting follicles have no corpus luteum to provide protective progesterone.
98
What does a normal PCO2 indicate in asthma exacerbation?
Exhaustion! (Life-threatening)
99
What is the first line of anti-emetic in Hyperemesis gravidarum?
Promethazine (Anti-histamine)
100
What mood stabiliser should be used in pregnancy?
Carbamazepine
101
What is the main complication associated with induction of labour?
Uterine Hyperstimulation
102
What is normal Vaginal pH?
4.0-4.5
103
What is the most common cause of infective endocarditis in children?
Streptococcus viridans
104
What is the difference between Caput Succedaneum and Cephalohaematoma?
Caput Succadaneum - crosses the suture lines and occurs due to pressure on the scalp.
Cephalohaematoma - doesn't cross suture lines an occurs due to bleeding under the scalp.
105
When is the APGAR score measured?
1,5 and 10 mins.
106
What are the components of the APGAR score?
Appearance, Pulse, Grimace, Activity, Respiration
107
What diet is most beneficial in CF?
High calorie, high fat with supplemental pancreatic enzymes.
108
What procedure is used for Biliary atresia?
Kasai Procedure - blocked bile duct replaced with a segment of the child's small intestine.
109
What is the pathophysiology of Duchenne muscular dystrophy?
DMD mutation leads to a deficiency of Dystrophin.
110
What is the most common cause of Menorrhagia?
Fibroids (Leiomyoma)
111
What marker can be used to diagnose recent Streptococcus pyogenes (Strep.A) infection retrospectively?
Anti-streptolysin o titre
112
What antibiotic is given in cases of PPROM?
Erythromycin
113
Fine Vs Coarse Tremor in Lithium
A fine tremor is a normal side effect of Lithium treatment, a coarse tremor is a sign of Lithium toxicity.
114
What drugs are given before surgery for fibroids?
GnRH agonists as they shrink the fibroids and reduce the risk of them bleeding during the surgery.
115
Endometriosis Clinical Examination Findings
Pelvic Tenderness, Palpable Masses, Fixed Retroverted Uterus, Reduced Organ Mobility, Visible Lesions in the Vagina
116
What are the criteria for Oligohydramnios and Polyhydramnios (Amniotic Fluid Index AFI)?
Oligohydramnios <5cm
Polyhydramnios >25cm
117
What are Static Risk Factors?
Risk Factors that cannot be altered through intervention.
118
What are the 4 Methods used for Induction of Labour?
Membrane Sweep - Separate Amniotic Membranes from Cervix
Vaginal Prostaglandins (PGE2) - Ripen the cervix and induce contractions.
Amniotomy - Artificial rupture of membranes.
Balloon Catheter - Mechanical Dilatation of Cervix.
119
What investigation can confirm the prelabour rupture of membranes after the sterile speculum?
Actim-PROM vaginal swab
Detects insulin-like growth factor binding protein-1 (IGFBP-1) in vaginal fluid. The concentration of IGFBP-1 is much higher in the amniotic fluid than in the maternal blood.
120
How should an SSRI be stopped?
It should be gradually reduced over the period of four weeks.
121
What is the actual name of the IUS?
Levonorgestrel Intrauterine System
122
What is Mcrobert's Maneouvere?
Hyperflexion of the Maternal Hips - Knees to Chest position.
123
What elements make up Kocher's Criteria?
Fever - >38.5, Non-Weight bearing, ESR >40 mm/hr, WCC > 12000/mm3.
124
What is the most common genetic risk factor for developing Alzheimer's disease?
Apolipoprotein E (APOE) Gene
125
Placental Abruption Risk Factors
Maternal Trauma, Advanced Maternal Age, Multiparity
126
What is the classic presentation of Placenta praevia?
Painless vaginal bleeding
127
Other than Campylobacter, name an infective cause of GBS?
HIV, Cytomegalovirus, Epstein-Barr.
128
What changes should be made to Mood Stabilisation Therapy in Bipolar Women who are pregnant?
Lithium should be stopped and they should be switched to an atypical antipsychotic.
129
What is the treatment for Generalised Tonic Clonic Seizures?
Lamotrigine/Levetiracetam
130
What is the treatment for Focal Seizures?
Lamotrigine or Levetiracetam (Carbamazepine can be used Second Line)
131
What is the treatment for Absence seizures?
First Line - Ethosuximide
Second Line - Male (Sodium Valproate), Female (Lamotrigine or Levetiracetam)
Note - Carbamazepine may exacerbate absence seizures.
132
What is the treatment for Myoclonic Seizures?
Levetiracetam
133
What is the treatment for Tonic/Atonic Seizures?
Lamotrigine
134
What happens to blood pressure in pregnancy?
Blood Pressure tends to fall in the first trimester, it continues to fall up to 20-24 weeks then it rises to pre-pregnancy levels or even higher in the third trimester
135
What is Carbidopa?
A decarboxylase inhibitor that increases the peripheral bioavailability of levodopa.
136
What is defined as a low-lying placenta?
<2cm from internal Cervical Os
137
What BMI is COCP UKMEC4?
>40
138
When should the Guthrie test be done?
5 Days of Life
139
What are the Negative Symptoms of Schizophrenia?
Flattened affect, Alogia, Anhedonia, Asociality, Avolition
140
Breast Cancer Screening Program
Ages 50 - 70 - Mammogram every 3 Years.
141
When is the External Cephalic Version (ECV) performed?
It is usually performed around 37 weeks but can be done from 36 for nulliparous women.
142
Which Contraceptive method impacts Bone Mineral Density BMD?
Depo Provera
143
In what situation is the APGAR score measured at 10 mins?
If there have been low scores at 1 and 5.
MBChB Finals
flashcards
Decks in class (24)
# Cards
-
Internal Medicine: Cardiology95
-
Internal Medicine: Endocrinology66
-
Internal Medicine: Gastroenterology85
-
Dermatology88
-
TheKnowledgeBuster143
-
GP, Public Health, Ethics & Law320
-
ObsGyn560
-
Child Health510
-
Psychiatry170
-
Internal Medicine: Metabolic Medicine29
-
Internal Medicine: Neurology126
-
Internal Medicine: Geriatrics32
-
Ophthalmology51
-
Ear Nose & Throat64
-
Internal Medicine: Haematology103
-
Internal Medicine: Respiratory67
-
Internal Medicine: Urology & Nephrology161
-
Musculoskeletal (Ortho & Rheum)168
-
Internal Medicine: Infectious Diseases138
-
Internal Medicine: Oncology/Palliative Care37
-
Statistics37
-
Knowledge Buster 242
-
Night Before (SAQ)45
-
Night Before/Knowledge Buster (SAQ)32
