NExT Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) Flashcards

24 sample cards from the Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What is the immediate management of a tension pneumothorax?

   Emergency needle decompression (large-bore cannula, 2nd intercostal space midclavicular line or 5th ICS anterior axillary line), followed by chest tube insertion.

2. What is the most common ECG finding in pulmonary embolism, and the classic (but rare) specific pattern?

   Sinus tachycardia is most common. The classic specific pattern is S1Q3T3 (S wave in lead I, Q wave and inverted T in lead III).

3. What scoring system estimates the clinical pretest probability of PE, and what test is used to rule it out in low-probability patients?

   Wells score (or revised Geneva). A negative D-dimer rules out PE in low/intermediate pretest probability.

4. List the components of the Child-Pugh score used to grade cirrhosis severity.

   Bilirubin, Albumin, INR (prothrombin time), Ascites, and Encephalopathy.

5. What is the serum-ascites albumin gradient (SAAG) cutoff for portal hypertension, and what value indicates it?

   SAAG ≥1.1 g/dL indicates portal hypertension (e.g., cirrhosis); SAAG <1.1 g/dL suggests non-portal causes (e.g., TB, malignancy).

6. Contrast the typical location and histology of Crohn's disease versus ulcerative colitis.

   Crohn's: any part of GI tract (mouth to anus), skip lesions, transmural inflammation, non-caseating granulomas. UC: continuous from rectum proximally, limited to colon, mucosal/submucosal inflammation, crypt abscesses.

7. What are the Rome IV criteria-based features distinguishing irritable bowel syndrome (a functional disorder)?

   Recurrent abdominal pain ≥1 day/week (last 3 months) associated with ≥2 of: related to defecation, change in stool frequency, change in stool form. No alarm features/organic disease.

8. What is the most common cause of peptic ulcer disease, and the standard triple therapy for its eradication?

   Helicobacter pylori. Triple therapy: PPI + clarithromycin + amoxicillin (or metronidazole) for 14 days.

9. Define acute kidney injury by the KDIGO creatinine and urine output criteria.

   Rise in serum creatinine ≥0.3 mg/dL within 48 h, OR ≥1.5x baseline within 7 days, OR urine output <0.5 mL/kg/h for ≥6 hours.

10. Differentiate prerenal AKI from intrinsic (ATN) AKI using FENa and urine osmolality.

    Prerenal: FENa <1%, high urine osmolality (>500), high urine specific gravity (concentrated). ATN: FENa >2%, urine osmolality ~300 (isosthenuria), muddy brown casts.

11. What GFR threshold defines CKD, and what are the stages by eGFR (mL/min/1.73m²)?

    CKD = GFR <60 for ≥3 months or kidney damage markers. Stages: G1 ≥90, G2 60-89, G3a 45-59, G3b 30-44, G4 15-29, G5 <15 (kidney failure).

12. Distinguish nephrotic from nephritic syndrome by their defining features.

    Nephrotic: proteinuria >3.5 g/day, hypoalbuminemia, edema, hyperlipidemia. Nephritic: hematuria (RBC casts), hypertension, oliguria, mild proteinuria, azotemia.

13. What is the most common cause of nephrotic syndrome in children, and its treatment?

    Minimal change disease; treated with corticosteroids (usually highly responsive).

14. State the diagnostic criteria for diabetes mellitus (any one).

    Fasting plasma glucose ≥126 mg/dL, OR 2-hour OGTT ≥200 mg/dL, OR HbA1c ≥6.5%, OR random glucose ≥200 mg/dL with symptoms.

15. What is the biochemical triad of diabetic ketoacidosis (DKA)?

    Hyperglycemia (>250 mg/dL), high anion gap metabolic acidosis (pH <7.3, HCO3 <15-18), and ketonemia/ketonuria.

16. Contrast the thyroid function test pattern in primary hypothyroidism versus primary hyperthyroidism.

    Primary hypothyroidism: high TSH, low free T4. Primary hyperthyroidism: low TSH, high free T4/T3.

17. What is the most common cause of hyperthyroidism, and its characteristic antibody and signs?

    Graves disease; TSH receptor antibodies (TRAb/TSI). Signs: diffuse goiter, ophthalmopathy (exophthalmos), and pretibial myxedema.

18. Contrast the electrolyte and cortisol findings in Addison disease (primary adrenal insufficiency) versus Cushing syndrome.

    Addison: low cortisol, hyponatremia, hyperkalemia, high ACTH, hyperpigmentation. Cushing: high cortisol, hypernatremia, hypokalemia, hypertension, hyperglycemia.

19. What dynamic test confirms acromegaly, and what is the underlying hormone abnormality?

    Failure of growth hormone (GH) suppression after an oral glucose tolerance test, with elevated IGF-1. Caused by a GH-secreting pituitary adenoma.

20. What is the relationship between calcium, phosphate, and PTH in primary hyperparathyroidism?

    High calcium, low phosphate, and high (or inappropriately normal) PTH. Most common cause is a parathyroid adenoma.

21. What is the classic peripheral blood smear finding and treatment of falciparum malaria, the most severe vector-borne infection in India?

    Ring forms and banana-shaped gametocytes of Plasmodium falciparum. Severe malaria treated with IV artesunate (artemisinin-based).

22. At what CD4 count is Pneumocystis jirovecii pneumonia (PCP) prophylaxis started in HIV, and which drug is used?

    CD4 <200 cells/mm³; prophylaxis with co-trimoxazole (trimethoprim-sulfamethoxazole).

23. Classify anemias by MCV and give one cause of each: microcytic, normocytic, macrocytic.

    Microcytic (MCV<80): iron deficiency, thalassemia. Normocytic (80-100): anemia of chronic disease, acute blood loss. Macrocytic (>100): B12/folate deficiency, hypothyroidism.

24. What malignant cell/feature distinguishes Hodgkin lymphoma, and what does the Philadelphia chromosome indicate?

    Hodgkin lymphoma: Reed-Sternberg cells. Philadelphia chromosome t(9;22) BCR-ABL is diagnostic of chronic myeloid leukemia (CML), treated with imatinib.

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Medicine and Allied Specialties (General Medicine, Dermatology, Psychiatry, Radiology) flashcards FAQ