2019 Flashcards
1
Q
Palliative Care. Breathlessness?
A
Morphine
2
Q
Lung cancer on CXR. Flushing?
A
5HT from Carcinoid
3
Q
2.5 Cm breast lump encapsulated with a septum excised?
A
Breast Cyst
4
Q
Non haemolytic febrile reaction. Increase in temperature when giving blood products?
A
Give Paracetamol
5
Q
headache, unilateral poor vision over a few days?
A
GCA
6
Q
Left red eye and fixed semi-dilated pupil, pain?
A
Acute Glaucoma
7
Q
What artery supplies the left colon
A
IMA
8
Q
Woman with palm laceration. Weak flexion of MCP and PIP middle finger?
A
FDS - Trigger Finger (middle finger or ring finger)
9
Q
ntrinsic muscles of the hand that flex the metacarpophalangeal joints and extend the interphalangeal joints
A
lumbricals
10
Q
Haemathrosis and pain on lateral aspect of knee?
A
ACL
11
Q
Ascites management?
A
- fluid and salt restrict, spiro, fruse, tap, daily wt
12
Q
Parietal Lobe
A
visuospatial problems (somatosensory)
13
Q
Temporary Lobe
A
Hearing and Wernicke
14
Q
Frontal Lobe
A
Broca
15
Q
gram negative diplococci
A
gonorrhea
16
Q
Otitis Media organisms?
A
- Strep Pneumonia
- Haemophilus
(Amoxicillin)
17
Q
Sore Throat antibiotic?
A
Phenoxybenpen
18
Q
Otitis Externa antibiotic?
A
Flucloxicillin
19
Q
28 year old girl with cyclical lower abdominal pain for the last 7 months whos been having difficulties trying to conceive. She has associated deep dyspareunia. All her observations were normal and she was otherwise well. No PMH, no DH, no SH.
What is the most diagnostic test available to identify her condition?
A
laparoscopy is the gold-standard investigation
20
Q
9 Month old baby presenting to A&E, with a temperature of 38.9 degrees, bulging anterior fontanelle, Cap refill of 4 seconds, baby is very faint, and has severe difficulties feeding/SOB.
What is the most likely cause of the babies presentation?
A
Meningococcal disease
21
Q
Klebsiella pneumonia → Abx to give?
A
Cefotaxime
22
Q
Lady with falciparum. Other than doxy, what other abx would you give her?
A
Quinine
(N.B. first line = Artemisinin combination therapy (ACT) w artesunate)
23
Q
Which of the DMARDs cause retinopathy?
A
Hydroxychloroquine
24
Q
Which of the DMARDs cause azoospermia and bone marrow suppression?
A
Sulfasalazine
25
Lady with hx of AF presents to A&E with fast AF, pulmonary oedema and peripheral oedema. What do you give initially?
DC Cardioversion
(syncope, shock, MI, heart failure)
26
Lady presents with acute MI, no details. What do you give?
**Aspirin and Beta Blocker**
27
Guy on prednisolone presents with darkened red reflex and problems with night vision. What does he have?
Cataracts
28
Lady from some Pakistan or somewhere with HTN controlled on amlodipine and BP of 150/90 has retinal findings: blot haemorrhages and yellow deposits (hard exudates I think) on macula. What is this?
**Diabetic Retinopathy**
29
Footballer inverts his ankle and presents with foot pain, surprised he has no ankle pain. What does he have?
**Fractured base of 5th metatarsal**
30
Guy jumps and lands on his knee
**patella fracture**
31
Pulmonary adenocarcinoma Ca met to liver via what route?
Haem
32
Middle aged lady presenting with atypical chest pain – what would be used to decide pre test probability she has ischaemic heart disease?
epidemiological evidence of something
33
Person with 4cm head of pancreas ca that has invaded mesenteric vessels. How do you manage?
**ERCP and biliary stent**
34
Son of 75-year-old lady requests home visit for mother who has recent behavioral changes. Sometimes gets confused and sees people in the room who aren’t there. Recent loss of appetite. Cause?
Acute confusional state
35
75 year old lady with 2.5cm firm breast lump not tethered to skin and no skin changes. Daughter 40 year old just had benign breast cyst diagnosed. What does the old lady have?
**Ductal carcinoma**
36
Young guy vomiting after a night out presents with chest and epigastric pain, left sided pleural effusion, subcutaneous emphysema. What happened?
**Oesophageal rupture**
37
Guy on ibuprofen started recently for some pain. Comes in with two episodes of vomiting bright red blood. No further episodes. Stable obs, low Hb. What do you do?
OGD within 2 hours (within 24 hours)
38
Histology showing classic **PBC** dense lymphoid infiltrate in a portal tract with minimal periportal lymphoid extension in a pre-cirrhotic stage of PBC.
39
Guy with metastatic renal cancer has severe pain. Is/has vomited 4 times or something. Currently on oral morphine solution prn and helps for about 2 hours. What pain therapy should he be on?
**Morphine sub cut infusion**
40
Guy who smokes and keeps pigeons, progressive shortness of breath on climbing hills. CXR shows reticulonodular shadowing?
**EAA**
41
Caucasian lady with Raynaud’s colour order?
white → blue → red
42
Post-transplant patient has dry cough and SOB. Desaturates from 90+ to
83% on exercising. What does he have?
PCP
43
Bilateral conductive hearing loss in old lady (Had to interpret Rinne Webers to work it out). Cause?
Otosclerosis
44
Someone with URTI symptoms has purple nodules on shins. What does she have?
**Erythema Nodosum**
45
Commonest cause of corneal ulceration (branching)?
**HSV** (dendritic ulcer)
46
Painful vesicular derm lesion on one side of face around forehead, eye and cheek. Cause?
**VZV** *(shingles)*
47
30+ year old lady with fever and fits. Scan shows temporal lobe necrosis. Cause?
HSV
48
Old lady, takes nitrofurantoin - gets watery diarrhea, 2 others in care home have diarrhoea too?
**Norovirus** (common in carehomes)
49
Blood transfusion, starts second unit, immediately has chest pain, SOB, dark urine. What happened?
**ABO incompatibility** *(immediate haemolytic transfusion reaction*)
50
T1DM girl on subcut insulin pump comes in with frequent episodes of SOB, palpitation and tingling of fingers. Cause
**Hyperventilation syndrome**
51
Most appropriate pre-operative investigation for well-controlled asthmatic about to undergo a diagnostic laparoscopy?
**PEFR**
52
Guy comes in with swollen legs and bilateral scrotal swelling with recent 10kg weight gain?
**peripheral oedema**
53
Lady with metastatic breast ca and hypercalcaemia (like over 3). What do you do first?
**IV fluids**
54
Guy with hypercalcaemia, renal failure, anaemia, bone pain. What does he have?
**MM**
55
Lady who recently came from Afghanistan with low calcium, raised PTH. What test to confirm Dx?
**Serum vitamin D**
56
Guy with epilepsy and now housebound. Pain in spine and on compressing rib cage? What does he have?
**Osteomalacia** (= housebound à low vitamin)
57
Guy has episodes of syncope and goes blue during. No other problems. How to investigate?
**24 hour ECG**
58
Guy with haemorrhoids that do not prolapse. First line?
Fibre
59
High ESR, pain on abducting shoulder?
PMR
60
Lady with fever with catheter in situ 14 days after some bowel surgery. Eating and drinking normally, no resp or GI symptoms. Cause of fever?
UTI
61
ENT question on purulent otorrhoea, hearing loss, some reference to keratin. Cause?
Cholesteatoma
62
Lady comes back from India 3 days ago with abdo pain, diarrhoea and vomiting. What do you do?
Stool culture and microscopy
63
Hypertensive young guy with mildly raised creatinine and proteinuria on multiple occasions. Physical exam otherwise unremarkable. What does he have?
**hypertensive nephropathy**
64
. Lady about to undergo ovarian tumour resection and needs thromboprophylaxis but had a PE in the past. What do you give?
LMWH
65
Post mastectectomy + LN clearance lady gets winging of scapula. What nerve damaged?
**Long thoracic**
66
Patient with lung ca findings + cushingoid features. Heavy smoker. What’s wrong?
**_Small Cell (ectopic ACTH - SIADH, LEMS)_**
N.B. SCC = PTH
67
Someone with Hodgkins lymphoma, mediastinal mass and night sweats. What is most appropriate treatment?
**Curative chemo**
68
Old lady gets dysphagia to solids every now and again. 20 year hx of GORD?
Stricture
69
Some standard change in bowel habit + weight loss + fresh blood mixed in with stool. Dilation of colon proximal to sigmoid. Diagnosis?
CRC
70
Someone has bloody stool. Proctosigmoidoscopy is normal. What do you do next?
Colonoscopy
71
Patient with hx of biliary colic, now presenting with jaundice and obstructive -picture. What is diagnosis?
**Gallstone in CBD** (gallstone ileus)
72
Lady with collapse High K, Low Na, plus some other bloods suggesting addisons. What would get you the Dx?
**ACTH and cortisol levels**
73
Patient gets pain to right of epigastrium a few hours after food. Relieved by milk and wakes up at night with pain?
Duodenal ulcer
74
Post op lady with sx consistent with DVT. What test confirms diagnosis?
Venous duplex
75
Which cardiac drug contraindicated in asthma?
Atenolol
76
One about someone with CXR pleural plaques, presenting with picture of pleural effusion, breathlessness. What ix helps with diagnosis?
USS guided tap
77
Guy with pulseless electrical activity, given one dose of adrenaline (1ml 1 in 10,000). Still no carotid pulse. What now?
**Continue CPR**
*During a VF/VT cardiac arrest, adrenaline 1 mg is given once chest compressions have restarted after the third shock and then every 3-5 minutes (during alternate cycles of CPR)*
78
One with a patient with RTA then complete white out of one side of lung?
**_Haemothorax_**
(effusion, collapse, consolidation, pneumonectomy, massive tumour)
79
Young guy with poor stream, takes ages to pee, previous episode of non-specific urethritis. Cause?
**urethral stricture**
80
DKA treatment?
**IV fluids with IV insulin**
81
Marathon runner has a large heart found on post mortem?
Hypertrophy
82
Patient with asthma has a short hx of yellow sputum and wheeze, was given oral amox which improved sputum but wheeze still there but afebrile, what now?
**give oral prednisolone**
83
Patient has carotid endarterectomy and develops stridor post-op
Haemorrhage
84
Why is MR spine the best imaging choice in someone with disc prolapse?
**Better soft tissue detail**
85
Patient on warfarin having nasal polypectomy - what do you do to the warfarin?
**Admit patient two days pre-op and start heparin** (N.B. 5 days)
86
56 year old with weight loss, heartburn responding to antacids, smoker, drinker. What do you do?
Gastroscopy and treat H pylori if positive
87
Guy with dull ache in groin, lump appears on standing, no cough impulse, does not transilluminate. Cause?
Varicocele
88
Lady with splenectomy, needs to be on penicillin. Why?
Pneumococcus
89
Patient ventilated on ITU, develops respiratory alkalosis, what do you do?
**Decrease frequency of ventilations**
