Infection

Question 1

What is the most common cause of encephalitis

Answer 1

Herpes simplex virus

Question 2

Melanoma ABCDE

Answer 2

• Asymmetry
• irregular Borders
• Colour variegation
• Diameter >6mm
• Elevation/evolution of a skin lesion.

Question 3

Fitzpatrick skin scale

Answer 3

• 7 scales of skin

Question 4

What is the most common type of melanoma that has a long radial phase?

Answer 4

Superficial spreading melanoma (Pagetoid)

Question 5

Which melanoma type has a very long radial phase and exists as lentigo maligna before it starts invading the basement membrane?

Answer 5

Lentigo maligna melanoma (Hutchinson’s melanotic freckle)

Question 6

What is the most aggressive type of melanoma that has no radial phase?

Answer 6

Nodular melanoma (ab initio)

Question 7

Which melanoma type has a short radial phase, occurs more frequently in patients with darker skin tones, and involves the palms or soles?

Answer 7

Acral lentiginous melanoma

Question 8

What type of melanoma grows under the nail?

Answer 8

Subungual melanoma

Question 9

What type of melanoma lacks pigmentation?

Answer 9

Amelanotic melanoma

Question 10

Max amount of units of alcohol per week

Answer 10

14 units

Question 11

How to calculate units of alcohol

Answer 11

Units = strength (ABV) x volume (ml) ÷ 1000

Question 12

Medical managment of smoking cessation- NRT

Answer 12

• NRT (patches and oral for 8 weeks)
• Start on quit day
• Should not be used with varenicline or bupropion
• contra-indicated in severe cardiovascular disease
• SIDE EFFECTS: nausea, dizziness, vivid dreams and palpitations.

Question 13

Bupropion

Answer 13

• originally an anti-depressant
  *inhibits reuptake of dopamine, noradrenaline and serotonin in the brain. Helps with cessation
• start 7-14 days before quit date

Question 14

Contradiction of Bupropion

Answer 14

• Epilepsy (decreases seizure threshold)
• Eating disorders and bipolar disorder
• CNS tumours
• Those experiencing current benzodiazepine or alcohol withdrawal
• Pregnancy and breast-feeding

Question 15

Varenicline (Champix)

Answer 15

• partial nicotinic acetylcholine receptor agonist.
• 7-14 days before the quit date; needs to be titred
• contradicted in pregnancy

Question 16

Who can use POP

Answer 16

• women who smoke >15 cigarettes a day
• over 35 years old
• migraines with auras
• breast-feeding women

Question 17

Asthma exaccebation signs and symptoms

Answer 17

• Tachypnoea
• Increased work of breathing
• Hyperinflated chest
• Expiratory polyphonic wheeze throughout the lung fields
• Decreased air entry (if severe)

Question 18

Death verification procedure

Answer 18

• Confirming the patients identity
• Checking for any obvious signs of life
• Checking response to verbal and painful stimuli
• Assessing pupils - they should be fixed and dilated
• Feeling a central pulse
• Listening for heart sounds and respiratory sounds for a total of 5 minutes.

Question 19

LUTI managment

Answer 19

• 3 days oral nitrofurantoin or trimethoprim
• conservative measures (e.g fluids)

Question 20

UTI in Men managment

Answer 20

• trimethoprim or nitrofurantoin for 7 days
• Refer to urology if repeating symptoms

Question 21

UTI during Pregnancy (with no haematuria) managment

Answer 21

• nitrofurantoin (but avoid at term), for 7 days.
• 2nd line: amoxicillin/cefelexin for 7 days.

Question 22

Managment of pylonephritis

Answer 22

• hospital admission
• IV broad-spectrum cephalosporin, a quinolone, or gentamicin