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Mechanism of action of dipyradimole?
What should be monitored once a pregnant lady is started on Mg2+ for eclampsia?
How long should treatment be continued for and why?
- Resp rate
- O2 sats
- Urine output
Continue treatment for 24hrs after last seizure or delivery as 40 % of patients have post-labour seizures.
Features of Shigella and its treatment?
Treat with ciprofloxacin
C1q. C1rs, C2 and C4 deficiency imply...?
A deficeincy in the 'classical pathway'
Predispose to immune-complex diseases, SLE Henoch-choenlien,
C3 defieciency predisposes to?
Recurrent bacterial infections.
C5 deficiency causes?
Leiner's disease - reccurrent sebbhoreic dermatitis, wasting and diarrhoea
Treatment of sortic dissections?
- Type A = ascending aorta = IV labetalol + surgery
- Type B = descending aorta = Iv Labetalol ONLY
Keep BP between 100 and 120 systolic.
How often do you perform DOTS for TB?
3 times a week.
What paraneoplastic process does Anti-Ri cause? What tumors is it asocc with?
- Cause by small cell and breast
What paraneoplastic process does Anti-Yo cause? Which tumors is it Assoc with?
- Cerebellar syndrome
- Assoc with ovarian and breast
What paraneoplastic syndrome does Anti-GAD cause? What tumors cause it?
- Stiff person syndrome.
- Breast, colorectal and SCLC.
How long does finasteride take to work?
Up to 6 months!!
Treatment options for Oesophageal varices?
- Endoscopic variceal band ligation.
Assoc with the C-myc translocation of MYC oncogene to an immunoglobulin (8:14)
What causes aplastic crisis in pts with hereditary spherocytosis?
Anything to do with cysteine...??
TEST WITH cyanide-nitroprusside test.
What is familial mediterranean fever? How do you treat it?
- Disease which affects Arabic, armenian and turkish people.
- Also called recurrent polyserositis!
- Abnormality in a protein called pyrin (coded for on MEFV gene) which normally inhibits interlukin 1B, therefore interlukin 1 B goes around causing all the inflam it wants.
- Causes flares of inlam commonly, abdo, joints, pleura, tunica vaginalis, pericarditis, myalgia, erysipelas and fever on its own.
- Long term comp = AA amyloidosis
- Treat with daily colchisine +- anakinra(IL1 antag).
- These therapies aim to decrease flare frequency.
Causes of LAD?
- Left ventricular hypertrophy
- Left ant hemiblock
- WPW with right accessory pathway
- Ostium primum ASD
- Tricuspid atresia
Treament for Trigeminal neuralgia?
Contraindications to surgery in Lung cancer?
- Malignant pleural effusion
- Tumor near hilum
- Evidence of Mets
- Vocal cord paralysis
- SVC obx
How is it best to differentiate between neuro toxo and neuro lymphoma in a person with HIV?
- Toxo: Ring-enhancing, multiple lesions, Thallium SPECT negative
- Lymphoma: Single lesion, Solid enhancment, Thallium SPECT positive.
Indication for Botox?
- Hemifacial spasm
- Hyperhidrosis of axillae
- Focal Spasticity including CP and Stroke
- Spasmodic torticollis
Indications for steroids in sarcoid?
- Eye, heart or neuro involvment
- Worsening lung function
IgA Nephropathy is assoc with what conditions?
- Alcoholic cirrhosis
Characteristic features of Dengue on bloods?
Which meds for depression after MI?
What do people on dialysis die of?
Ischaemic heart disease
What investigations do you do in PE during pregnancy?
- Everyone gets a CXR
- Duplex legs could give you indirect evidence and save radiation.
- CTPA increases risk of breast cancer in mum
- VQ increase risk of abnorms in baby
Imaging modality of choice in osteomyelitis?
Whats the difference between a MUGA and a MIBI?
- MUGA is for accurate ejection fraction calculation before starting cardiotoxic drugs.
- MIBI is to assess myocardial perfusion + viability.
Drugs that cause impaired glucose tolerance?
- Thiazides, furosemide
- nicotinic acid
- Interferon alpha
Clinically sig albumin:cr ratio in a non-diabetic?
Clinically sig albumin:cr ratio in a diabetic?
A flat, pinkbrown, asypmtomatic rash generally in the groinaxillae caused by the diptherioid Coryne bacterium minutissimum.
Treat with topical miconazole or an antibacterial.
Examination under UV-A light shows coral red fluoresence.
Most specific ECG marker for pericarditis?
Weight cut-offs for bariatric surgery?
- With risk factors (T2DM, HTN etc) = 35
- Without risk factors = 40
After DC cardio version what is the minimum time you shud cont anticoag for?
Best way to get yer HDLs up?
X-linked dominant diseases??
- Vit d resistant rickets
- rett's disease
Test for Gilbert's disease?
Causes of a respiratory alkalosis?
- cns disorders
- early salicylate poisoning
SSRI + NSAID = ?
Gi bleeding risk. Start lansoprazole.
What is Capecitabine?
Orally administered prodrug that is enzymatic ally converted to 5Fu in the tumour.
What's a non drowsy anti histamine?
Incongruous hemianopias = ?
Congruous hemianopias = ?
Radiation or occipital lesion.
Order the steroids in order from most mineral to most glucocorticoid in action
Management of schizophrenia
- Oral atypicals
- manage CV risk early.
UKMeC 4 conditions =?
- Migraine with aura
- uncontrolled hypertension
- previous thrombosisthrombogenic mutation
- over the age of 35 and smoking >15/day
- Breast cancer
- breast feeding <6 weeks postpartum
- Major surgery with prolonged immobilisation
What's the guiding principle in UC management?
- Induce remission with ASAs or Steroids.
- maintain it with Asa's or azathioprine.
What drugs cause tinnitus?
- loop diuretics
Causes of tinnitus apart from drugs?
- Acoustic neuroma
- hearing loss
- Impacted cerumen
Treatment of Solar keratosis?
- Topical 5FU (followed by topical hydrocortisone to treat redness)
- Topical diclofenac
- curretage +cautery
Annual incidence of HCC developing in patients with cirrhosis secondary to hep C?
Antibodies for dermatomyositis?
- ANA most common
- Anti-mi-2 most specific.
cANCA are antibodies targeted against?
What are they +ve in?
+ve in Wegner's and microscopic polyangitis.
pAnca are targetted against?
what are they +ve in?
- +ve in Microscopic polyangitis, Churg-strauss, PSC
Whats the most common ocular sigin in Wernicke's?
What could you find on investigation?
- Can find decreased red cell transketolase
- Can also find haemhorrages into thalamus + mammillary bodies on MRI.
Causes of co-arctation of the aorta?
- Bicuspid aorta
- Beryy aneurysms
Whats interfeon alpha released from?
Whats it a useful therapy for?
What are its adverse effects?
- Released from leucocytes
- Therapy in Hep B+C, Metastatic renal cell cancer, hairy cell leukemia and kaposi's sarcoma.
Adverse effects include flu-like symptoms and depression.
IFN beta is released from?
Is used to treat?
IFN gamma is released from?
Is used to treat?
- T-cells and NK cells
- Granulomatous disease and osteopetrosis.
What is Noonan's syndrome?
The 'male version of turner's'
Poor prognostic factors following MI?
- Onset of HF
- cardiac arrest
- st segment deviation
- low systolic bp
- increase in creatinine
- killip score