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what are signs of tetralogy of fallot?
ejection systolic murmur (PS), cyanosis (shunting), concave left heart border
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what is the cause and presentation of roseola infantum?
HHV-6, macular rash without lymphadenopathy
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how does erythema multiforme look?
target lesions with blistering
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pulled elbow injury is due to what?
subluxation of proximal radial head. Also known as nursemaid's elbow. Often associated tear of annular ligament.
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what are the components of gardner's syndrome?
multiple osteomas, cutaneous and soft tissue tumous, polyposis coli. (autosomal dominant)
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what is the WHO definition of blindness?
Mar-60
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in bacterial meningitis, what is added to cefotaxime for children and adults?
Under 3 months and over 50 years, amoxicillin is added to cover for Listeria monocytogenes meningitis, though it is rare.
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what ecg changes are seen in digoxin toxicity?
sees the reverse tick phenomenon, with S-T segment depression and an accentuated U-wave. Digoxin may have numerous other effects on the ECG including AF with slow ventricular rate, non-paroxysmal junctional tachycardia, atrial tachycardia with block
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what are the important contraindications to thrombolysis?
pregnancy, active bleeding, recent stroke or surgery, malignant hypertension, GI malignancy, prolonged CPR. Proliferative diabetic retinopathy.
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when is V/Q scanning used?
in pregnant women to reduce radiation of CTPA in assessing for PE
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what are the main risk factors for bronchial carcinoma?
smoking, age, asbestos, radiation
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what is the commonest cause of macrocytosis in a person with HIV?
zidovudine causes macrocytosis. It can also cause anaemia.
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why aer flucloxacillin and clindamycin synergistic?
flucloxacillin is bactericidal for staph and strep, whilst clindamycin has an anti-toxin effect. Use together for rapid control.
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what abnormality is associated with a 'jerky' pulse?
HOCM
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what marker is associated with pancreatic cancer?
CA19-9
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what is Ca125 associated with?
primarily ovarian cancer, also lung, breast, endometrial.
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what is the curb criteriae?
Confusion, Urea >7, RR>30, BP<90, age>65
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what is anti-M2 antibody used for?
primary biliary cirrhosis
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what are presenting symptoms of retinitis pigmentosa?
night blindness, tunnel vision
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how does osteogenic sarcoma spread and where to?
adolescent cancer of knee spreading to lungs via. Blood
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what are the signs of retinal detachment and what is the commonest area affected?
flashes and floaters. Superior temporal region
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what are the commonest thyroid neoplasms?
papillary neoplasms
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what are the commonest causes of an anterior mediastinal mass?
thymoma, hodgkin's disease, germ cell tumours
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what is the cause of an anterior mediastinal mass in a person with myasthenia gravis?
70% of people with mg have thymic hyperplasia, 10% have a thymoma
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what is erythema marginatum and what are the associations?
pink rings that come and go, it's a major criteria Duckett-Jones for rheumatic fever
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what are the signs of trichomonas infection?
green frothy offensive discharge, strawberry vervix with multiple petechial haemorrhages, wet film protozoa
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what are the aetiological and causative differences between bulbar palsy and pseudobulbar palsy?
bulbar is medullary disease (e.g. polio, MND, CVA, guillain Barre), whilst pseudobulbar affects the corticobulbar tracts e.g. CVA, MS, MND, neurosyphillis
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what are the signs of a bulbar palsy?
tremulous lips, drooling, weak wasted tongue, rasping dysphonia, difficulty pronouncing R, unable to pronounce consonants
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what are the signs of a pseudobulbar palsy?
tongue unable to protrude, donald duck speech, exaggerated jaw jerk, nasal regurgitation, dribbling, dysphnia, dysphagia, emotional lability.
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what are the facial signs of systemic sclerosis?
facial telangiectasia, small mouth, beaking of the nose.
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what kind of visual field defect is most likely to occur in ms
central scotoma
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what are causes of tunnel vision?
glaucoma, retinitis pigmentosa, retinal panphotocoagulation
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which antibiotics potentiate warfarin?
trimethoprim, erythromycin, isoniazid
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what is in co-trimoxazole?
sulphonamide and trimethoprim
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what are the associations of erythema nodosum?
streptococcal infection, sarcoid, TB, JBD, drugs
-
what are the criteriae of metabolic syndrome?
- increased waist circumference, raised triglycerides, raised HDL, raised BP, raised fasting glucose
- what are side effects of phenytoin?
-
haem (megaloblastic anaemia, aplastic anaemia, thrombocytopaenia) neuro (peripheral neuropathy, ataxia, nystagmus, dyskinesia, granulocytosis)
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what are the associations of acute histoplasmosis?
mediastinal lymphadenopathy, arthralgia, erythema nodosum, chest infection. Caused by soil.
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what are the associations of IPF?
RA, SLE, sjogren's, UC, chronic active hepatitis, polymyositis
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what are the x ray findings for silicosis?
reticulonodular shadowing, hilar gland enlargement, eggshell calcification
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what are dermatomes of the middle finger, nipple, umbilicus, big toe, lateral foot
c7,t4,t12,l5,s1
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describe necrobiosis lipoidica diabeticorum
This is an unusual complication of diabetes characterised by erythematous plaques often over the shins, which gradually develop a waxy brown discolouration
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what is the commonest cause of acute tubular necrosis?
hypotension
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where might you see j waves?
hypothermia
-
what is charcot's triad and what does it describe?
ascending cholangitis: ruq pain, jaundice, fever with rigors
-
what is the action of chlorpromazine?
dopamine blockade in the mesolimbic system
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what is the best test of cortisol and growth hormone capacity?
insulin tolerance test
-
what is in hartmann's?
sodium, chlorida, potassium, calcium, lactate
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what is hess's test?
a test of platelet adhesion and aggregation
-
what are the cardiac complications of erythromycin?
long QT syndrome and torsades de pointes
-
which antibodies are present in PBC?
antimitochondrial andibodies
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what are the side effects of cocaine and amphetamines in pregnancy, respectively?
Placental abruption, birth defects, IUGR (cocaine), hypertension, increased postpartum haemorrhage (amphetamine abuse)
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what is beck's triad and to what does it apply? What aer further signs?
increased CVP, decreased BP, muffled heart sounds. Cardiac tamponade
-
what are the associations of cubital tunnel syndrome?
male sex, worse on elbow flexion, weak grip, sensory deficit, clawing of little finger, hypothenar wasting
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what are the hand signs of hypertrophic pulmonary osteoarthropathy and what is the cause?
nicotine staining, clubbing, wrist pain. Due to bronchial carcinoma or idiopathic
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Where is Hesselbach's triangle?
where direct hernias come through
-
what is a richter's hernia?
a hernia where one wall of the bowel only is in the hernial orifice
-
what are signs of homocystinuria?
malar flush, arachnodactyly, ectopia lentis, generalised osteoporosis, mental retardation
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how is aspergillus fumigatus pneumonia treated?
IV amphotericin B
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what are the torch infections?
toxoplasmosis, other (syphillis, varicella), rubella, cytomegalovirus, herpes
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