key concepts

• Preceding influenza predisposes to Staphylococcus aureus pneumonia
• HIV is a risk factor for non-Hodgkin's lymphoma
• First line treatment in diabetic neuropathy is with amitriptyline, duloxetine, gabapentin or pregabalin
• If a first episode of C. difficile doesn't respond to either vancomycin or fidaxomicin then oral vancomycin +/- IV metronidazole should be tried
• Activated charcoal can be used within 1 hour of a paracetamol overdose, then N-acetylcysteine if indicated by paracetamol levels
• Ethylene glycol toxicity management - fomepizole. Also ethanol / haemodialysis
• Bone pain, tenderness and proximal myopathy (→ waddling gait) → osteomalacia
• Diabetes mellitus - HbA1c of 48 mmol/mol (6.5%) or greater is diagnostic
• When assessing blood transfusion reaction, hypotension is an ominous sign that suggests a serious reaction necessitating the stopping of the transfusion - it can indicate anaphylaxis, acute haemolytic reaction or transfusion-related acute lung injury (TRALI).
• Macrolides e.g. clarithromycin may cause prolongation of the QT interval
• In the step-down treatment of asthma, aim for a reduction of 25-50% in the dose of inhaled corticosteroids 
• Negative predictive value = TN / (TN + FN)
• Adult polycystic kidney disease increases the risk of brain haemorrhage due to ruptured berry aneurysms
• Cholera can present with diarrhoea and hypoglycaemia
• IgA deficiency increases the risk of anaphylactic blood transfusion reactions
• Positive predictive value = TP / (TP + FP)
• Phenytoin, an antiepileptic drug, is known to cause megaloblastic anaemia
• Pontine haemorrhage commonly presents with reduced GCS, paralysis and bilateral pin point pupils
• Juvenile myoclonic epilepsy is classically associated with seizures in the morning/following sleep deprivation
• Sickle cell anaemia and other haemoglobinopathies can give falsely low HbA1c readings due the decreased lifespan of RBCs
• Ascites - use spironolactone
• MRI brain with diffusion-weighted imaging is the preferred modality in patients with suspected TIA who require brain imaging
• Ultrasound is the initial imaging modality of choice for suspected Achilles tendon rupture
• Campylobacter infection is characterised by a prodrome, abdominal pain and bloody diarrhoea
• Patients who take a staggered paracetamol overdose should receive treatment with acetylcysteine
• Anti-dsDNA is a highly specific test for SLE
• In life-threatening C. difficile infection treatment is with ORAL vancomycin and IV metronidazole
• If a patient cannot complete sentences, they have severe asthma
• Adductor pollicis is innervated by ulnar nerve and therefore, damage to ulnar nerve results in loss of thumb adduction
• Cubital tunnel syndrome is caused by compression of the ulnar nerve and can present with tingling/numbness of the 4th and 5th finger
• Neuroleptic malignant syndrome is typically seen with pyrexia, tachycardia, renal failure, and elevated creatine kinase, in patients who have just commenced treatment. Renal failure may occur secondary to rhabdomyolysis.
• In patients with non-alcoholic fatty liver disease, enhanced liver fibrosis (ELF) testing is recommended to aid diagnosis of liver fibrosis
• Patients using methotrexate require effective contraception during and for at least 6 months after treatment in men or women
• Asymptomatic patients with an abnormal HbA1c or fasting glucose must be confirmed with a second abnormal reading before a diagnosis of type 2 diabetes is confirmed
• Supportive therapy is the mainstay of treatment in Cryptosporidium diarrhoea. In a patient with HIV presenting with diarrhoea, Cryptosporidium parvumis the most likely causative organism.
• Iron defiency anaemia vs. anaemia of chronic disease: TIBC is high in IDA, and low/normal in anaemia of chronic disease
• Surgery / diabetes: patients on insulin who have good glycaemic control and are undergoing minor procedures, can be managed during by adjustment of their usual insulin regimen.
• Lip smacking + post-ictal dysphasia are localising features of a temporal lobe seizure
• Bromocriptine is a treatment for galactorrhoea, which is caused by e.g. Metoclopramide, Chlorpromazine, Haloperidol, Domperidone
• Lateral epicondylitis: worse on resisted wrist extension/suppination whilst elbow extended