Passmedicine Finals/UKMLA

Central retinal vein occlusion: fundoscopy.

Widespread hyperaemia (increase of blood flow to different tissues in the body) + severe retinal haemorrhages (stormy sunset) → sudden vision loss.

Exostosis (repeated exposure to cold water causes bone to grow abnormally in ear): type of hearing loss.

Conductive.

Rx of broad complex VT vs. SVT.

Broad complex - IV amiodarone (more letters = wider QRS).

SVT - IV adenosine.

Rx of mild-moderate distal UC.

Rectal aminosalicylate (mesalazine) → oral ± topical steroid → oral + oral steroid.

Preparing diabetic patients for surgery.

Well-controlled (HbA1c < 69 mmol/mol) + minor procedure = withhold diabetic drug in surgery day.

Poorly controlled = variable rate IV insulin infusion.

Surgery requiring long fasting period = variable rate IV insulin infusion.

Rx of descending aortic dissection (uncomplicated).

IV labetalol (prevent progression), bed rest.

Eczema herpeticum: causative organism.

HSV-1 / HSV-2.

Aortic regurgitation: auscultation features.

3rd left ICS (Erb’s point), louder on expiration, high-pitched and blowing.

Hoover’s sign.

Tool to differentiate organic from non-organic leg paresis. In non-organic paresis, pressure is felt under the paretic leg when lifting the non-paretic leg against pressure, this is due to involuntary contralateral hip extension. Supports diagnosis of conversion disorder.

HTN + chest/back pain + pulse deficit (weak/absent pulses or variation in SBP between arms).

Aortic dissection → CT angiography of chest, abdomen, pelvis.

Surgery: indications for prophylactic Abx.

1. Prosthesis / valve placement.

2. Clean-contaminated procedure (e.g. appendicectomy).

3. Contaminated procedure.

Rx + prophylaxis of spontaneous bacterial peritonitis.

Treat = IV cefotaxime.

Prevent = OD ciprofloxacin (ascites + previous SBP or fluid protein <15 g/l).

Postmenopausal bleeding + dyspareunia / post-coital bleeding.

Vaginal atrophy.

RF for endometrial hyperplasia.

Obesity, PCOS, tamoxifen, unopposed oestrogen use, DM.

Causes of postmenopausal bleeding.

Vaginal atrophy, HRT, endometrial hyperplasia, cancers.

Pain / leg swelling (worse on exercise) + itchy dry skin: DDx and Rx.

Chronic venous insufficiency - emollients + graduated compression stockings → endothermal ablation, surgery.

(The image shows lipodermatosclerosis, which describes hard and tight skin, and hyperpigmentation due to haemosiderin deposition.)

Ankylosing spondylitis: CXR.

Apical fibrosis.

Pneumococcal vaccine in sickle cell patients: intervals.

5 years.

Ciprofloxacin: side effects.

1. Lowers seizure threshold.

2. Tendonitis.

Proximal muscle weakness + heliotrope rash in periorbital region + Gottron’s papules: DDx and associations.

Dermatomyositis - associated with CTDs, underlying malignancy.

Dermatomyositis: antibodies.

ANA +ve, anti-Jo-1, SRP antibodies, anti-Mi-2 antibodies.