fourth year > things i didnae know > Flashcards

things i didnae know Flashcards

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1
Q

on warfarin, intracranial bleed

A

IV vitamin K + prothrombin complex

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1
Q

when do women get anti-D prophylaxis

A

28 weeks
34 weeks

only to rhesus negative women

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2
Q

what is the sleepiness scale for obstructive sleep apnoea

A

epworth

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3
Q

determining cause of post-op fever by timeline

A

Day 1-2: ‘Wind’ - Pneumonia, aspiration, pulmonary embolism
Day 3-5: ‘Water’ - Urinary tract infection (especially if the patient was catheterised)
Day 5-7: ‘Wound’ - Infection at the surgical site or abscess formation
Day 5+: ‘Walking’ - Deep vein thrombosis or pulmonary embolism
Any time: Drugs, transfusion reactions, sepsis, line contamination.

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4
Q

which strep causes meningitis

A

strep pneumoniae

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5
Q

what ABG does a panic attack cause

A

respiratory alkalosis
- low CO2
- everything else normal

blowing off loads of CO2

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6
Q

what is fitz-hugh curtis

A

PID that progresses to perihepatitis

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7
Q

what are other symptoms of bell’s palsy, not the facial droop

A

post-auricular pain (may precede paralysis)
altered taste
dry eyes
hyperacusis

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8
Q

first line Mx for PID

A

IM ceftriaxone + oral doxy + oral metronidazole

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9
Q

organisms that cause post-splenectomy sepsis

A

Streptococcus pneumoniae
Haemophilus influenzae
Meningococci

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10
Q

tetralogy of fallot

A

ventricular septal defect
pulmonary stenosis
right ventricular hypertrophy
overriding aorta

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11
Q

MRSA treatment

A

vancomycin

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12
Q

cardiac tamponade Ix

A

echocardiogram

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13
Q

how do you calculate the anion gap

A

(sodium + potassium) - (chloride + bicarb)

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14
Q

DKA: metabolic acidosis with ____ anion gap

A

high

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15
Q

VTE prophylaxis in nephrotic syndrome

A

LMWH

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16
Q

pyloric stenosis presentation

A

non-bilious projectile vomiting
constipation and dehydration
visible peristalsis - stomach trying to push contents past the obstruction

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17
Q

if you are taking epilepsy drugs, what contraception can you be on

A

depo, IUD or IUS

for lamotrigine:
- POP, implant, depo, IUD, IUD

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18
Q

when can CVS be performed

A

between 11-13 weeks

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19
Q

when can amniocentesis be performed

A

after week 15

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20
Q

when is down’s syndrome screening done

A

between weeks 11-14

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21
Q

treatment of genital herpes

A

oral aciclovir

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22
Q

brown pigmentation, champagne bottle legs and ezcema ?

A

venous ulcers
- chronic venous insufficiency

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23
Q

what electrolyte ambnormality can happen from transfusion with packed red cells

A

hyperkalaemia

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24
which autoimmune haemolytic anaemia is CLL associated with
warm
25
definitive diagnosis of sickle cell
haemoglobin electrophoresis
26
management of minimal change nephropathy
oral corticosteroids first always! then IV cyclophosphamide if steroids don't work
27
if elevated urea to creatinine what type of AKI
pre renal
28
when prescribing fluids, what is recommended water requirement per day
25-30ml/kg/day
29
what's seen on blood film in DIC
schistocytes
30
what is richter's transformation
CLL can transform to high gradde lymphoma making patients rly unwell
31
32
what drug slows CKD progression in ADPKD
tolvaptan
33
raised ESR and osteoporosis
multiple myeloma until proven otherwise
34
management of autoimmune haemolytic anaemia
steroids +/- rituximab
35
what is rasburicase
reduces uric acid levels, used in addition to chemo to prevent/treat tumour lysis syndrome in non-hodgkin's lymphoma
36
blood film myeloma
rouleaux formation
37
when should HbA1c be measured in type 1 diabetics
every 3 - 6 months
38
diagnosis of asymptomatic T2DM
abnormal HbA1c or fasting glucose must be confirmed with a second abnormal reading
39
interactions of levothyroxine
iron, calcium - absorption of levothyroxine reduced, give at least 4 hours apart
40
what is orlistat
pancreatic lipas inhibitor used in the management of obesity
41
whats the most common reason a hip replacement needs to be revised
aseptic loosening
42
following a fragility fracture, who can be prescribed bisphosphonates with no DEXA scan
women >= 75 yrs
43
what does dix hallpike elicit in BPPV
recreation of symptoms when rapidly lowered and a ROTATORY NYSTAGMUS
44
most common cause of discitis | the bacteria
staph aureus
45
management of acute dystonia
procyclidine
46
what is a -gliptin
DPP4 inhibitor
47
MoA of DPP4 inhibitor
reduces peripheral breakdown of incretins
48
which drugs cause hypoglycaemia
sulfonylureas or insulin | -ides
49
central vision loss
ARMD
50
whats MODY | mature onset diabetes of the young
autosomal dominant condition that causes T2DM in <25 yrs
51
risk factors for retinal detachment
diabetes myopia age trauma previous cataract surgery
52
chondrocalcinosis
pseudogout
53
first rank symptoms of schizophrenia
thought broadcasting throught withdrawal delusional perceptions auditory hallucintations
54
when should an additional drug be added to T2DM management
when HbA1c rises to 58
55
thyroid scan: reveals patchy uptake
toxic multinodular goitre
56
example of SGLT2
-gliflozin
57
side effects of bisphosphonates
- oesophageal reactions - osteonecrosis of the jaw - atypical stress fractures - hypocalcaemia - acute phase response following administration
58
down's syndrome/cleft palate with glue ear
refer to ENT - are less likely to recover spontaneously
59
when should patients weight bear after hip fracture surgery
immediately
60
pre diabetes and BMI over 35 Mx for weight loss
liraglutide
61
how much weight loss does a person need to have to continue using orlistat
5% in 12 week trial
62
which surgery for a distal transverse or descending colon cancer
left hemocolectomy
63
pseudopolyps IBD
ulcerative colitis
64
skip lesions
crohns
65
definitive management of acute angle closure glaucoma
laser peripheral iridotomy
66
which eye drops for angle closure glaucoma
- direct parasympathomimetic (pilocarpine) - beta blocker - alpha-2 agonist
67
what is managed with topical prostaglandin analogues
open angle glaucoma
68
cervical screening in pregnancy
delayed until 3 months post partum - unless missed screening or previous abnormal smears
69
PEFR severe asthma attack
33-50
70
PEFR moderate asthma attack
50-75
71
when should younger people (<65 for women <75 for men) get a FRAX score
- prev fragility fracture - use of corticosteroids - history of falls - family history of hip fracture - smoking - escess alcohol (>14 units/weeks) - low BMI (less than 18.5) - other conditions that could cause osteoporosis
72
monitoring of SLE
- anti-dsDNA is high in active disease - compliment levels are low during active disease - CRP indicates underlying infection
73
suspicious of ovarian cancer, and theres a mass what next?
measure CA-125 and refer urgently to gynae - can bypass the USS
74
when should a DEXA be done without fragility risk score
- >50 with a hisotry of fragility fracture - < 40 with a mjory risk factor - before starting treatment that have a rapid adverse effect on bone density
75
where should children with a squint be referred to
opthalmology
76
miosis, ptosis, enphalmos and anhidrosis
HORNER'S SYNDROME
77
horner's syndrome no anhidrosis
Carotid artery dissection Carotid aneurysm Cavernous sinus thrombosis Cluster headache | C's
78
horner's syndrome anhidrosis of the face
pancoast's Tumour Thyroidectomy Trauma Cervical rib | T's
79
horner's syndrome anhidrosis of the face, arm and trunk
Stroke Syringomyelia multiple Sclerosis Tumour Encephalitis | S's
80
patient has a TIA/stroke and is then identified to have AF, when should they be started on anticoagulation
TIA: immediately stroke: commenced after 2 weeks
81
which electrolyte abnormality can present similarly to hypocalcaemia | tingling and shit
hypomagnesaemia
82
metabolic alkalosis + hypokalaemia
prolonged vomiting
83
methanol poisoning ABG
severe metabolic acidosis with raised anion gap - lactic acidosis
84
who gets intrapartum antibiotic prophylaxis for GBS
- previous GBS in a pregnancy (offered) - women with a previous baby with GBS disease - preterm labour - women with pyrexia
85
which antibiotic for GBS in pregnancy
benzylpenicillin
86
hypokalaemia symptoms
- arrythmias - weakness of muscles - leg cramps - ascending paralysis
87
at what level of hypokalaemia do symptoms begin
below 3
88
presenting features of haemochromatosis
- fatigue - erectile dysfunction - arthralgia
89
haemoglobin in haemochromatosis
normal !
90
what are reversible complications of haemochromatosis | has been asked in exams!!
- cardiomyopathy - skin pigmentation
91
what are the irreversible complications of haemochromatosis
- liver cirrhosis - diabetes mellitus - hypogonadotrophic hypogonadism - athropathy
92
should pregnant women get the flu vaccine
yes - they are considered at risk
93
management of a tricyclic overdose
IV bicarbonate
94
if a fissure is found somewhere that isnt the posterior midline, what should be done
refer to colorectal surgery to look for another cause
95
post MI: left ventricular aneurysm
like an outpouching - then thrombus can form in it - widespread ST elevation and left ventricular failure
96
post MI: left ventricular free wall rupture
causes acute feat failure secondary to cardiac tamponade - raised JVP - pulses paradoxus - diminished heart sounds
97
post MI: acute mitral regurgitation
due to papillary muscle rupture/ischaemia - causes pulmonary oedema - hypotension - early-mid systolic murmur
98
when can pericarditis happen post MI
first 48 hours
99
when can dressler's syndrome occur post MI
2-6 weeks
100
most common cause of death post MI
ventricular fibrillation
101
oral morphine to sub cut morphine
divide by 2
102
AAA 4.5 - 5.4cm, scanned how often?
every 3 months
103
an AAA 3 - 4.4cm, scanned how often
every 12 months
104
AAA < 3cm, scanned how often?
no further action
105
women >=75 years with a fragility fracture (hip fracture), what do you do
immediate bisphosphonates - no need to do a DEXA scan
106
most common site in a bone for osteomyelitis
children: metaphysis adults: epiphysis
107
If asthma is not confirmed by eosinophil count, FeNO, BDR or PEF variability but still suspected on clinical grounds?
refer for bronchial challenge test
108
antiemetic for reduced gastric motility and stasis
metoclopramide and domperidone - these are pro-kinetic agents | NOT IN BOWEL OBSTRUCTION
109
oral allergy syndrome
pollen-food syndrome - hypersensitivity reaction to raw plant based food - rapid onset of mild symptoms like itching
110
what drugs can cause tinnitus
Aspirin/NSAIDs Aminoglycosides - like gentamicin Loop diuretics Quinine
111
most common cause of traveller's diarrhoea
e. coli
112
who gets bisphosphonates when taking steroids
patients over 65 years !!!!!! patients who have previously had a fragility fracture
113
irregularly irregular pulse with a qrs > 120ms in a stable patient
AF with bundle branch block - BBB always broad QRS
114
QRS complex in AF
narrow - <120 ms
115
ptosis + dilated pupil
CN 3 palsy | oculomotor nerve
116
ptosis + miosis (constricted pupil)
horner's
117
tension pneumothorax management
needle thoracostomy
118
scarlet fever presentation and management
fever sore throat strawberry tongue - got white bits on it rough sandpaper like rash Mx penicillin V for 10 days
119
when can kids with scarlet fever go back to school
24 hours after starting antibiotics
120
where do you check for a pulse in an infant
brachial or femoral
121
how do you differentiate kawasaki from scarlet fever
kawasaki: fever is longer (> 5 days) they have conjuntival injection + bright red cracked lips scarlet: rough sandpaper rash
122
which antidepressants suitable for breastfeeding
sertraline or paroxetine
123
complication of measles
otitis media: the most common complication pneumonia: the most common cause of death encephalitis: typically occurs 1-2 weeks following the onset of the illness) subacute sclerosing panencephalitis: very rare, may present 5-10 years following the illness
124
most common place for stress metatarsal fracture
2nd
125
cut off for receiving oral iron in pregnancy and post partum
first trimester - < 110 2nd/3rd trimester - < 105 post partum - < 100
126
no cremasteric reflex
TESTICULAR TORSION
127
Ix for duchenne muscular dystrophy
definitive diagnosis) genetic testing high CK
128
Ix for myeloma
whole body MRI!!!!
129
most common cause of cardiac arrest in children
respiratory problems
130
Mx metastatic bone pain
bisphosphonate infusion radiotherapy strong opioids
131
what bug causes scarlet fever
group A haemolytic strep
132
133
4-8-year-old boy with an irritable hip, limp, and reduced range of motion, despite no history of trauma or systemic symptoms. X-ray imaging may demonstrate epiphyseal sclerosis
perthe's disease
134
what drugs cause erectile dysfunction
SSRI beta blockers
135
when should magnesium sulphate be stopped in eclampsia
24 hours after last seizure
136
inadequate sample cervical screnning
do again in three months
137
how often do women who are HIV positive get cervical screening
annually
138
management of severe hypocalcaemia (<1.9)
calcium gluconate infusion
139
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