mix

• Streptococcus pneumonia is the most common cause of community-acquired pneumonia but is less prevalent than staphylococcus aureus following influenza infections. 
• Klebsiella pneumonia is more commonly associated with pneumonia in alcoholic patients. The sputum produced is also normally fairly blood-stained, classically described as red-currant jelly in appearance. 
• Mycoplasma pneumonia does not normally present with speed and severity. The disease process is typically more indolent and prolonged with a dry cough. 
• Chlamydia psittaci is normally associated with patients who have avian pets as they are natural vectors for the bacterium.
• Atropine is used in organophosphate poisoning (as well as in bradycardia). Organophosphates are often found in insecticides, and poisoning can present with anxiety, restlessness, headache, and muscle weakness. If severe, it can cause widespread paralysis with respiratory failure and bronchospasm with bronchial secretions. 
• Flumazenil is used in benzodiazepine overdose. This presents with drowsiness, dizziness, and ataxia, and if severe, coma and respiratory depression.
• Glucagon is used in beta blocker overdose. This would usually present with sinus bradycardia, hypotension, and coma
• Naloxone is used for opioid overdose. Characteristic signs of opioid poisoning are respiratory depression, pinpoint pupils, and coma.
• The commonest features of Pagets disease include skull frontal bossing, headaches, and hearing loss (secondary to auditory foramen narrowing).
• An HbA1c between 42 and 47 mmol/mol (6.0 - 6.4%) is diagnostic of pre-diabetes.
• Cholera can cause many metabolic abnormalities including hypokalaemia, hypoglycaemia, and metabolic acidosis.
• Blood in the stool and recently eating raw chicken can be associated with Campylobacter jejuni and Salmonella
• Recently eating some reheated rice is associated with the bacterial infection Bacillus cereus
• Exposure to a newly installed air-conditioning system is part of the classic history for Legionella infection
• Repeat injury from GORD and smoking cause damage to the squamous epithelium lining the distal third of the oesophagus and over time metaplasia occurs with the cell lining changing to simple columnar epithelium, in a condition known as Barrett's oesophagus. Barrett's oesophagus is a premalignant condition and over time, the continued injury will lead to the development of adenocarcinoma of the oesophagus. 
• Absence (petit mal) seizures typically present with short periods of non-responsiveness or staring into space, often picked up by teachers or parents, typically with a short post-ictal period of lethargy. 
• Benign Rolandic epilepsy is seen in children aged 3-13yrs and is characterised by short seizures that involve twitching and paraesthesia of one side of the face and tongue.
• Polymyalgia rheumatica (PMR) typically presents in older adults with bilateral aching and stiffness in the shoulder and hip girdle muscles, often with morning stiffness lasting more than an hour.
• Polymyositis is an inflammatory myopathy that causes proximal muscle weakness rather than muscle aches. It would be unusual for polymyositis to present solely with muscle aches without any accompanying weakness or other systemic symptoms such as fever or weight loss.
• Bendroflumethiazide can be used as a diuretic in hypertension and oedema but is not licensed for ascites.
• Codeine could cause harm as it can lead to constipation, which would increase the risk of encephalopathy.
• Furosemide is used as a diuretic in heart failure and can be used for resistant hypertension.
• Ramipril is most often used for hypertension but is also used in heart failure, chronic kidney disease, and for secondary prevention post-myocardial infarction.
• A heroin overdose typically causes respiratory depression leading to hypoventilation and subsequent respiratory acidosis
• Anti-dsDNA is a highly specific test for SLE (>99%) so, if positive, would provide good evidence for this patient to have SLE.ANA has high sensitivity which makes it a useful rule out test for SLE, but it has low specificity.Anti-histone antibodies are generally used as a marker for drug-induced SLE.
• Despite a normal chest x-ray an ex-smoker with shortness of breath, weight loss and hyponatraemia should be investigated on an urgent basis for lung cancer.
• Damage to ulnar nerve usually results in wasting of hypothenar muscles, loss of thumb adduction, wasting of 1st web space and ulnar claw hand (hyperextension at metacarpophalangeal joint, flexion at interphalangeal joint).
• Radial nerve palsy would typically present with wrist drop and loss of sensation from 1st dorsal web-space.
• Musculocutaneous nerve palsy would result in reduced flexion at elbow and loss of supination.
• Median nerve innervates thenar muscles and provides sensory innervation to lateral three and a half digits. Median nerve compression results in carpal tunnel syndrome.
• Axial nerve palsy would result in the wastage of deltoid muscles and loss of sensation from the badge area.
• Carpal tunnel syndrome is due to compression of the median nerve at the wrist, where it runs through the carpal tunnel. This would present with generalised pain and tingling of the hand and wrist
• De Quervain's tenosynovitis would present with pain on movement of the thumb/wrist. The radial styloid may be hardened and thickened.
• Medial epicondylitis, or golfer's elbow, would present with pain along the medial elbow, close to the cubital tunnel - but localised to the area as it is a tendinopathy, and not compression of the nerve. 
• Radial tunnel syndrome is due to compression of the radial nerve and may lead to tingling/numbness/pain along the back of the hand and forearm.
• The presence of valvulae conniventes (lines all the way across) in an abdominal x-ray, is a classic sign of small bowel obstruction.
• On an upright abdominal x-ray, pneumoperitoneum would typically present as a radiolucent area underlining the diaphragm (especially on the right side due to the buoyancy of gas).
• Whilst Barrett's oesophagus increases the risk of oesophageal adenocarcinoma, achalasia increases the risk of squamous cell carcinoma of the oesophagus.
• Lateral epicondylitis is commonly exacerbated by wrist extension and supination of the forearm. Sometimes referred to as 'tennis' elbow, but remember other activities can also trigger it.
• Medial epicondylitis is commonly referred to as 'golfer's' elbow. The pain is aggravated by wrist flexion and pronation. Sometimes it is associated with ulnar nerve compression