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oelomar's version from 2018-05-04 01:47

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Question Answer
What are the side-effects of vancomycin?Nephrotoxicity, Ototoxicity, Thrombophlebitis, red man syndrome. Vancomycin is well tolerated in general - it does NOT have many problems.
Vancomycin can cause "red man syndrome". What is red man syndrome?Vancomycin is recommended to be administered in a dilute solution slowly, over at least 60 min (maximum rate of 10 mg/min for doses >500 mg) due to the high incidence of pain and thrombophlebitis and to avoid an infusion reaction known as the "red man syndrome". This syndrome, usually appearing within 4 to 10 min after the commencement or soon after the completion of an infusion, is characterised by flushing and/or an erythematous rash that affects the face, neck, and upper torso.
How can red man syndrome be (largely) avoided?Slow infusion rate and pre-treatment with antihistamines.
What 5 things allow for one to distinguish between the carotid pulse and the JVP?JVP has a double waveform (carotid is single); JVP varies with breathing - decrease on inspiration, increase on expiration; JVP varies with position - the more flat the patient, the higher the JVP; JVP is impalpable; JVP can be increased via hepatojugular reflux.
What is Volkmann's contracture?Volkmann's contracture is a permanent flexion contracture of the hand at the wrist, resulting in a claw-like deformity of the hand and fingers. Passive extension of fingers is restricted and painful.
What causes Volkmann's contracture? Is there a specific type of fracture with which it is associated?Volkmann's contracture is especially associated with supracondylar fractures of the humerus, although any any fracture in the upper arm or elbow region may lead to it. Volkmann's contracture results from acute ischaemia and necrosis of the muscle fibres of the flexor group of muscles of the forearm, especially the flexor digitorum profundus and flexor pollicis longus. The condition is caused by obstruction on the brachial artery near the elbow, possibly from improper use of a tourniquet, improper use of a plaster cast, or compartment syndrome.
Atrophy of the thenar eminence is associated with a lesion of which nerve?Median nerve.
Atrophy of the hypothenar eminence is associated with a lesion of which nerve?Ulnar nerve.
Meralgia paraesthetica causes a burning sensation in the antero-lateral thigh due to compression on a nerve. Which nerve?Lateral cutaneous nerve.
What relevance do dipyridamole and aminophylline have with adenosine?Dipyridamole enahnces the effect of adenosine, whereas aminophylline reduces it.
What medication class should be prescribed to anyone with left ventricular dysfunction?ACE inhibitors.
Damage to which nerve causes foot drop?Common peroneal nerve (common fibular nerve). It winds round the head of the fibula - damage to the head of the fibula may therefore damage the common peroneal nerve.
A loose hanging arm which is medially rotated and pronated, classically referred to as the "waiter's tip", is associated with which palsy?Erb's palsy (severing of the upper trunk C5–C6 nerves).
Blockage of which coronary artery is normally associated with bradyarrhythmias such as third degree heart block?Normally the right coronary artery, as it supplies the SA node and the AV node in the majority of people. Bradyarrhythmias due to RCA blockage are likely to recover, whereas the rarer bradyarrhythmias induced by LAD blockage are less likely to recover.
What is Felty's syndrome?A rare autoimmune disease characterised by rheumatoid arthritis, splenomegaly, and neutropenia. It is a complication of long-standing rheumatoid arthritis.
Which drugs can cause drug-induced lupus?38 of them, but the three that report the highest number of cases are hydralazine, procainamide, and isoniazid.
Which nerve allows one to plantarflex?Tibial nerve.
Which nerve allows one to abduct the hip? When damaged, what sign is evident on examination?Superior gluteal nerve - may be damaged by posterior hip dislocation, resulting in a positive Trendelenburg sign.
What is Leriche syndrome?Also known as aortoiliac occlusive disease, this is a form of central artery disease involving the blockage of the abdominal aorta as it transitions into the common iliac arteries. Classically, it is described in male patients as a triad of the following signs and symptoms: claudication of the buttocks and thighs, absent or decreased femoral pulses, and erectile dysfunction.
Prolonged usage of steroid medication can cause Addison's disease. True or false?True.
Most common side-effect of verapamil?Constipation.
Most common side-effect of colchicine?Diarrhoea.
Most common side-effects of triptans?Tingling, heat, tightness (e.g. throat and chest), heaviness, pressure
Which SSRI is particularly associated with antidepressant discontinuation syndrome?Paroxetine.
Which psychiatric medication may increase the risk of stroke and venous thromboembolism in elderly patients?Atypical antipsychotics.
What is the SSRI of choice in children and adolescents?Fluoxetine.
SSRI + NSAID = risk of what?GI bleeding (therefore give PPI as well).
Which vitamin, if taken in high doses, may be teratogenic?Vitamin A.
Postmenopausal bleeding is what until proven otherwise?Endometrial cancer.
What is cottage-cheese/thick white discharge indicative of?Candida/vagina thrush.
An overweight female with hirsutism, acne, and/or amenorrhoea, likely has what?Polycystic ovarian syndrome.
How is polycystic ovarian syndrome treated?Metformin and clomefine (first-line to stimulate ovulation).
Progesterone, which is a good marker for ovulation, is best checked when?7 days before the end of the cycle (so with a 28 day cycle, day 21 is the best day to measure progesterone levels).
Should a pregnant woman who is at moderate risk of pre-eclampsia take aspirin?Yes. 75mg daily from 12 weeks gestation until birth.
A pregnant woman has a high-vaginal swab showing group B streptococcus. How should she be managed?Give intrapartum intravenous benzylpenicillin.
What is the relationship between the COCP and cancer?COCP use increases the risk of breast and cervical cancer, but is protective against ovarian and endometrial cancer.
What is Weber's syndrome?A form of stroke characterised by the presence of an ipsilateral oculomotor nerve palsy and contralateral hemiparesis or hemiplegia.
How would a pontine haemorrhage present?Often occurring as a complication secondary to chronic hypertension, patients often present with reduced Glasgow coma score, quadriplegia, miosis, and absent horizontal eye movements.
Mydriatic drops are known to precipitate what ophthalmologic emergency?Acute angle closure glaucoma.
What should one avoid prescribing concurrently with methotrexate?Trimethoprim or cotrimoxazole - can increase the risk of bone marrow aplasia.
What can be given to prevent attacks of Meniere's disease?Betahistine and vestibular rehabilitation exercises may be of benefit.
What can be given to treat acute attacks of Meniere's disease?Buccal or intramuscular prochlorperazine. Admission is sometimes required.
What are the features of normal pressure hydrocephalus?"Wet, wobbly, and wacky" - urinary incontinence, ataxic gait, and dementia.
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Question Answer
A lesion in the right optic nerve will give rise to what visual defect?Complete loss of vision in right eye.
A lesion in the left optic nerve will give rise to what visual defect?Complete loss of vision in left eye.
A lesion in the perichiasmal area will give rise to what visual defect?Nasal hemianopia on that side.
A lesion in the optic chiasm (e.g. due to a pituitary adenoma) will give rise to what visual defect?Bitemporal hemianopia.
Inferior chiasmal compression is likely to be caused by what, and gives rise to what visual defect?Bitemporal hemianopia with predominately the upper quadrants being affected. Likely to be caused by a pituitary adenoma.
Superior chiasmal compression is likely to be caused by what, and gives rise to what visual defect?Bitemporal hemianopia with predominately the lower quadrants being affected. Likely to be caused by a craniopharyngioma.
A lesion in the right optic tract will give rise to what visual defect?Left homonymous hemianopia.
A lesion in the left optic tract will give rise to what visual defect?Right homonymous hemianopia.
A lesion in the right occipital lobe will give rise to what visual defect?Left homonymous hemianopia.
A lesion of the left parietal lobe will give rise to what visual defect?Right inferior homonymous quadrantanopia.
A lesion of the right parietal lobe will give rise to what visual defect?Left inferior homonymous quadrantanopia.
A lesion of the left temporal lobe will give rise to what visual defect?Right superior homonymous quadrantanopia.
A lesion of the right temporal lobe will give rise to what visual defect?Left superior homonymous quadrantanopia.
Homonymous hemianopia with macula sparing is as a result of which lesion?Lesion of the occipital cortex.
What are the features of oculomotor nerve palsy?Eye is deviated "down and out", ptosis, diplopia, dilated pupil, and pain (when due to a posterior communicating artery aneurysm).
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Question Answer
What is the acute treatment for cluster headache?Oxygen and/or a subcutaneous or nasal triptan.
What is the prophylactic treatment for cluster headache?Verapamil.
What is the acute treatment for migraine?Triptan + NSAID or triptan + paracetamol.
What is the prophylactic treatment for migraine?Topiramate or propranolol.
Topiramate is especially recommended for migraine prophylaxis in pregnant women. True or false?False. Topiramate is teratogenic.
Opioids are useful in the management of tension headache. True or false?False. Opioid usage can lead to medication overuse headache.
What medications can cause medication overuse headache?Triptans, opioids, ergots or combination analgesic medications on 10 days per month or more, or paracetamol, aspirin or an NSAID, on 15 days per month or more.
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