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15 Cards in this Set
- Front
- Back
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What are the types of sleep disorders? |
- Dyssomnia's (hypersomnia or insomnia) - Circadian Rhythm disorders (delayed sleep phase) - Parasomnias (involve abnormal movements, emotions, activities whilst asleep. Bed wetting, sleep terror, sleep walking come here) - Medical or psychiatric condition induced (such as depression) |
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You see a patient who is complaining about their sleep. They say they feel frozen and paralysed just as they are about to fall to sleep, or when they are just waking up. They also report hallucinations during sleep. What could this be and what is the Mx? |
Sleep paralysis (occurs shortly after waking up or shortly before falling asleep) Mx = Clonazepam |
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Pt presents with a fungal nail infection. What is the likely cause? |
Dermatophyte or yest infection. If Dermatophyte Tricophyton Rubrum causes it If yeast infection Candida causes it |
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How do you manage a dermatophyte fungal nail infection? How about a yeast fungal nail infection? |
Dermatophyte - Mx = Oral Terbinafine Candida - Mx = Topical antifungals (Amorolfine)...serious ones with oral itraconazole |
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If a patient has facial nerve palsy (bell's palsy)...apart from treating the cause of that what other type of management is hugely important and why? |
Eye care. Prescribe artificial tears and eye lubricants. If not done corneal ulcers and blindness could happen as complications. |
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What advice do you give to a patient regarding food and drink who is due in to go for surgery which will be under general anaesthetic? |
Food - No food for 6 hours before induction Drink - No clear fluid for up to 2 hours before the induction |
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Mother who is due to have her first child by vaginal delivery is concerned about developmental dysplasia of the hip as she herself had it when she was born. She asks you what the risk of it happening are? What are the risk factors? |
- Female sex - Breech presentation - Positive family history - Oligohydraminos - First born children - Macrosomia |
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You are doing a newborn examination on a baby. Which two tests do you do to check for developmental dysplasia of the hip? How would you confirm this diagnosis? |
Barlow's test - Attempts to dislocate an articulated femoral head Ortolani's test - Attempts to relocate a dislocated femoral head Ultrasound confirms the diagnosis |
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Whilst doing a newborn examination on a baby you perform the Ortolani test and Barlow's test. Both are positive. What is the diagnosis? What is the key investigation and management? |
Developmental dysplasia of the hip Ultrasound confirms this diagnosis Management = Most resolve spontaneously by 3-6 weeks - Pavlik harnsess (flexion abduction orthosis) is used in children < 5 months if not resolving - Surgery in older children |
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Why should patients on cabergoline/bromocriptine (ergot derived dopamine receptor agonists) for mx of parkinsons be closely monitored? |
Due to risk of pulmonary, cardiac and retroperitoneal fibrosis. |
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You see a patient in your clinic who has an enlarged and painful left testis. On exam you see that it is enlarged, palpation of the mass feels like a bag of worms and the testis on this side is slightly smaller. What is the dx? What is a crucial cause to rule out and why? |
Varicocele (enlarged pampiniform venous plexus in the testis) Could be caused by Renal cell carcinoma and would present on the left as the left testicular vein drains into the left renal vein...thus if the renal vein is occluded it can lead to a varicocele forming. This anatomy is not present on the right hand side) |
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55 yr old Pt comes in with frank haematuria whilst undergoing a 24 hour urine collection for hypertension. What could be a cause? |
Renal Cell Carcinoma (as you also have the associated paraneoplastic effect...hypertension) |
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What are the signs in someone who is having a life threatening asthma attack...rather than a severe one. |
- Silent chest - Poor respiratory effort - PEF<33% - Agitation - Cyanosis - Altered consciousness |
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30 yr old pregnant lady comes in complaining of itchy rash near her umbilicus and on her arms. Blisters are also present. What is the diagnosis? |
Pemphigoid Gestationis (the blisters differentiate this from other pregnancy rashes such as polymorphic eruption) |
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What are the 3 main indications for putting in a chest drain into someone with a pleural infection? You have done a ultrasound guided needle aspiration already and have the results. |
- If fluid from needle aspiration is purulent or turbid/cloudy - Identification of organisms present in the fluid confirming the infection - If pH of fluid is < 7.2 |
