These are the High Yield Points for for PLAB by Clinchers
Rheumatology:
- Hot, painful, swollen joint +/- fever= septic arthritis= Ix: aspirtion = Rx: FLUCLOXACILIN
- Young man, lower back pain = ankylosing apondylitis = Ix: x-ray sacroiliac joint
- Polyarteritis nodusa – necrotising vasculitis – cause aneurysm / thrombitis of medium sized arteries – leads to infarct, Rx: Systemic Steroids, M>f, ass. With Hep-B
- Arterial occlusion + HTN, Female = Takayasu arteritis (big vessel vasculitis),
- Child = Kawasaki
- A joint pain with ear pinna plaque = gout (raised uric acid level)
- Pt. with progressive relapsing remitting arthritis = RA
- Intermittent severe arthritis with symptoms free interval = Gout
- Arthritis with pitted finger nail = psoriatic arthritis
- Young man with lower back pain = ankylosing spondylitis
- Lower back pain with paravertebral shadow = TB of vertebra
- Elderly mand with lumbar back pain + enlarged vertebra = pagets
- Septic arthritis Ix : joint aspiration ???
- RA Ix : Rh factor
- Reiter’s syndrome Ix : chlamydial IgA
- Thiazide diuretics raises uric acid level = Gout
- Arthritis following travelling history(india, spain, Thailand) usually Reiters synd
- Schirmer test +ve in sjogren synd
- Best Ix to Dx nerve compression = MRI
- AS does not need any Ix as its Dx is clinical
- Talengedtasia / Raynauds = Crest = Ix: Anti-centromial Ab
- Female / pruiritis / raised Gamma GT = PBC = Ix: Anti-mitochondrail Ab
- Rash on cheeks, photophobia = SLE = Ix: Anti-double Strand DNA Ab.
- Pt. with thyroid with hashimoto = Anti-paroxy/thyroglobulin Ab
- GCA Mx = Steroids
- Diabetic retino pathy Mx = laser
Haematology:
- ITP initial Mx = Steroids
- Very low ph with purura = ITP, Mx with predinsone, Ix: anti PLT antibody
- Anemia with blood film showing target cells = thalassemia
- Celiac disease will cause decreased folate anemia due to malabsorption
- Rx with cyclophosphamide will cause aplastic anemia
- Blood film showing immature cells = leukemia = confirm Dx by Bone Marrow Biopsy
- Inherited anemia = pernicious (decreased vit-B12) + Haemophilia (coagulation defects)
- HSP (Henoch Schonlein purpura) : abd pain, purpura on buttocks/thigh is allergic inflammation of blood vessel wall.
- DIC due to sepsis
- Phenytoin / Methotrexate reduces Serum folate level
- Thalassemia/sickle cell Ix = electrophoresis
- Anemai with sore tongue = decreased Vit-B12
- Anemia + bruising + infection = aplastic anemia (leukemias well)
- Easy bleeds, all tests are normal with family history = osler weber rendu synd
- Easy bleeds, prolonged clotting time with family history = von willi brands
- Male, pale, anemic with paresthesia = pernicious anemia = Ix: Ab against intrinsic factor
- Post. Cricoids web with decreased Fe anemia = plummer Vinson synd
Infectious:
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- Children usually have viral meningitis, Ix: CSF MCS => PCR
- TB = wt. loss, african, night sweat
- Brucellosis = Hx of Farm work, visit to MECCA
- Lyme = Hx of forest walk, insect/tic bite
- Malaria by plasmodium falciparum – severe intermittent fever, can cause cerebral malaria, Dx: LP-CSF
- I/V Acyclovir for varicella zoster = elderly, decreased immune, opthalmic
- Orla acyclovir for varicella zoster = mild surgery + in pregnancy
- For typical chicken pox = no management
- Varicella Ig for high risk exosure on moderate compromise e.g pregnancy
- Cellulitis caused by strep.pyogenes
- Mucoid urethral discharge = chlamydia
- Purulent urethral discharge = GC
- Thick blood film confirms malaria
- Hep-B Ag confirms active disease
- Dye industry workers have increased risk of renal cell Ca.
- MRSA found in ward = test all medical staff
- MRSA +ve staff should be Rx with Mupurocin nasal spray
- Staphylococcus is coagulase +ve cocci
- Pneumococcus is gram +ve diplococcic
- TB meningitis Ix = ????????
- Meningitis after URTI = Strep
- Syncope with sweating = hypoglycemia
- Meningitis with rash Tx = Blood culture
- Meningitis with raised ICP no LP
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