2024 Flashcards
(159 cards)
1
Q
Rank from narrow to broad spectrum
a. Meropenem
b. Amoxicillin
c. Cefalexin
d. Ceftriaxone
e. Pip taz
A
- Amoxicillin – Narrow spectrum (primarily effective against Gram-positive bacteria, some Gram-negative coverage)
- Cefalexin – First-generation cephalosporin (slightly broader than amoxicillin, better Gram-positive coverage with some Gram-negative activity)
- Ceftriaxone – Third-generation cephalosporin (broader spectrum, good Gram-negative coverage, moderate Gram-positive coverage)
- Meropenem – Carbapenem (very broad spectrum, covers Gram-positive, Gram-negative, and anaerobes, including ESBL-producing bacteria)
- Piperacillin/Tazobactam – Extended-spectrum penicillin with beta-lactamase inhibitor (broadest spectrum among these, excellent Gram-positive, Gram-negative, and anaerobic coverage, including Pseudomonas)
2
Q
Rank from highest to lowest specificity for rheumatoid arthritis
a. HLA B27
b. HLA-DR4
c. Anti-CCP
d. Rheumatoid factor
e. CRP
A
- Anti-CCP
- HLA-DR4
- Rheumatoid factor
- CRP
- HLA B27
3
Q
Rank lowest to highest PTH
a. Pagets (Ca 2.5?)
b. Secondary hyperparathyroidism (Ca 2.2)
c. Primary hyperparathyroidism (Ca 2.9)
d. Breast cancer with bony mets (Ca 2.9? it was high)
e. Osteoporosis (Ca 2.4?)
A
- Breast cancer with bony mets
- Pagets
- Osteoporosis
- Primary hyperparathyroidism
- Secondary hyperparathyroidism
4
Q
Rank platelets from high to low
a. essential thrombocythemia
b. rheumatoid arthritis
c. Normal pregnancy
d. beta thalassaemia trait
e. Autoimmune thrombocytopenic purpura
A
- essential thrombocythemia
- rheumatoid arthritis
- beta thalassaemia trait
- Normal pregnancy
- Autoimmune thrombocytopenic purpura
5
Q
Rank potassium from high to low
a. hypothyroidism
b. addisons
c. ACTH dependent Cushing’s syndrome
d. Cushing’s disease
e. pheochromocytoma
A
- Addison’s disease (Primary Adrenal Insufficiency) – Highest potassium (hyperkalemia) due to aldosterone deficiency, leading to decreased potassium excretion.
- Hypothyroidism – Mildly high or normal potassium due to reduced renal clearance and decreased sodium-potassium ATPase activity.
- Pheochromocytoma – Variable potassium levels (normal, high, or low) depending on catecholamine effects, but hyperkalemia can occur in some cases.
- ACTH-dependent Cushing’s syndrome – Mildly low potassium (hypokalemia) due to excess cortisol and mineralocorticoid effects, leading to potassium wasting.
- Cushing’s disease (Pituitary-dependent Cushing’s) – Lowest potassium because chronically elevated ACTH stimulates excess cortisol, increasing renal potassium excretion more than ACTH-dependent Cushing’s syndrome.
6
Q
Patient with hospital acquired pneumonia, rank from most to least likely organism
a. E.coli
b. Pseudomonas
c. Acinetobacter baumannii (?)
d. Candida Albicans
e. Coxiella burnetii
A
- Pseudomonas aeruginosa
- E. coli
- Acinetobacter baumannii
- Candida albicans
- Coxiella burnetii
7
Q
Rank from largest to smallest vessel affected
a. Cerebral Giant cell arteritis
b. Polyarteritis nodosum
c. Capillaritis
d. Granulomatosis with polyangiitis
e. Takayasu arteritis
A
- Takayasu arteritis – Largest vessels (Affects the aorta and its major branches, including the subclavian, carotid, and renal arteries).
- Cerebral Giant Cell Arteritis (Temporal Arteritis) – Large to medium vessels (Primarily involves the external carotid branches, such as the temporal and ophthalmic arteries).
- Polyarteritis nodosa (PAN) – Medium vessels (Affects muscular arteries, such as renal, mesenteric, and coronary arteries; spares capillaries and venules).
- Granulomatosis with polyangiitis (Wegener’s) – Small vessels (Affects arterioles, venules, and capillaries, especially in the lungs, kidneys, and upper respiratory tract).
- Capillaritis – Smallest vessels (Primarily affects capillaries, leading to microscopic inflammation and bleeding).
8
Q
Development of cancer in chronological order
a. Carcinoma
b. High grade dysplasia
c. HPV
d. Low grade dysplasia
e. Lymph node mets
A
- HPV
- Low grade dysplasia
- High grade dysplasia
- Carcinoma 5. Lymph node mets
9
Q
Thrombosis risk (lowest to highest)
a. Brisk 1 hour walk
b. 75mg Aspirin
c. Inherited antithrombin III deficiency
d. 4 hour flight
e. COCP to someone heterozygous for Factor V Liden
A
- 75mg aspirin
- brisk 1 hour walk
- 4 hour flight
- COCP to someone heterozygous for Factor V Liden
- Inherited antithrombin III deficiency
10
Q
- Rank the development of liver cancer
a. Fatty changes
b. Steatohepatitis
c. Cirrhosis
d. Fibrosis
e. hepatocarcinoma
A
- Fatty changes
- Steatohepatitis
- Fibrosis
- Cirrhosis
- hepatocarcinoma
11
Q
- Blood results for a woman previously treated for breast cancer with chemotherapy and radiotherapy. Hb Low, WBC normal, Neutrophil low, lymphocyte normal, film shows pelger-huet cells. dx?
A
Myelodysplastic syndrome
12
Q
Most common haematological malignancy in young adults.
A
Hodgkin lymphoma
13
Q
Which amyloidosis is associated with multiple myeloma.
A
amyloid light-chain
14
Q
Lady with fever, schistocytes, confusion, low platelets, low GFR (renal failure).
A
TTP
15
Q
What process should be performed prior to transplant to prevent GvHD.
A
Irradiation
16
Q
Woman with microcytic anaemia and feeling tired, most likely diagnosis?
A
Iron deficiency anaemia
17
Q
Patient had a DVT after a surgery, was treated with apixaban and tolerated it well. How long should you continue the treatment?
A
3 months
18
Q
A woman came in for her antenatal appointment. Blood results with only slightly low platelets
A
Gestational thrombocytopenia
19
Q
Man with acute onset back pain, GP sent straight to A&E. The ambulance crew tested and he can’t walk properly and have paresthesia. What is the next most urgent investigation?
A
MRI spine
20
Q
Plasma type given as universal donor.
A
AB
21
Q
How to monitor LMWH if needed?
A
Anti-Xa assay
22
Q
Major obstetric haemorrhage, blood results showing anaemia and DIC. What blood product to give someone with low fibrinogen?
A
Cryoprecipitate
23
Q
JAK2 mutation with high Hct, leukocytosis and thrombocytosis —> what blood disorder?
A
polycythaemia rubra vera
24
Q
- Normal IgM, low IgA and low IgG. Hx of ITP. Repeated infections but in adulthood - said happened over the last few years. Bloods were all normal. What is the cause?
A
Common variable immunodeficiency (CVID) - no B cell differentiation
25
Child with limp. High wcc, low platelets. Most likely diagnosis?
ALL
26
Name a breast cancer that varies from benign to malignant?
phyllodes tumour
27
Which bone disease is there a jig-saw/mosaic pattern of bone with bone pain?
Paget's disease
28
Amyloidosis is associated with which cardiomyopathy?
Restrictive
29
Most common cause of aortic stenosis?
age-related calcification
30
Commonest cause of chronic pancreatitis
Alcoholism
31
Name of lung disease in someone with A1 antitrypsin deficiency?
Emphysema
32
Which bullous disease is intraepidermal acantholysis?
Pemphigus vulgaris
33
8. Haemorrhage type associated with berry aneurysms?
Subarachnoid haemorrhage
34
Skin lesions and transmural inflammation, which IBD?
Crohn's
35
Lobe of prostate most likely to be origin of malignancy?
posterior
36
What type of tissue calcification is hypercalcaemia associated with?
dystrophic
37
Type of cancer of parafollicular parathyroid cells?
medullary
38
Greatest risk factor for Hepatocellular Carcinoma?
Chronic hepatitis B
39
Protein deposited in the kidneys in Familial mediterranean fever that causes nephrotic syndrome
Amyloid AA
40
What is present in the urine of normal people but not in those with obstructive jaundice?
Urobilinogen
41
The common source molecule of all steroids?
Cholesterol
42
First line treatment for severe hypercalcaemia?
IV 0.9% saline
43
3. Man with IVDU, tried to inject then misses his vein. Has blood in urine but no red cells - name of protein responsible.
Myoglobin
44
5. Which hormone acts on the adrenal gland to stimulate cortisol production.
Adrenocorticotropic hormone (ACTH)
45
What acts on adrenal to stimulate aldosterone production.
Angiotensin 2
46
Hormone that stimulates osteoblasts?
Parathyroid hormone (PTH), growth hormone, calcitonin
47
Slightly high prolactin and suppressed other pituitary hormones ?
Non-functioning pituitary adenoma
48
Vitamin C deficiency disease.
Scurvy
49
Vitamin D deficiency disease.
Osteomalacia
50
Positive birefringence on aspirate of knee.
Pseudogout
51
Enzyme expressed in sarcoidosis that causes hypercalcaemia
1 alpha hydroxylase
52
Enzyme targeted by evolocumab
PCSK9
53
Which small interfering RNA is given as a twice annual injection for people with high lipids?
Inclisiran
54
Asymptomatic patient registered at GP. Normal LFTs with isolated raised unconjugated bilirubin. Diagnosis?
Gilbert's syndrome
55
Mpox causes serious disease, what vaccine is given to high risk e.g. healthcare workers caring for infected patients?
Smallpox vaccine
56
What drug do you give in anaphylaxis?
IM adrenaline
57
12y girl with urticaria & wheeze when she ate walnuts. How do you confirm walnut allergy?
skin prick test
58
Post strep glomerulonephritis - what hypersensitivity reaction?
Type III
59
Goodpasture's Syndrome, what type of hypersensitivity reaction?
Type II
60
Which arthritis can rituximab be used against?
Rheumatoid arthritis
61
Gene thats affected in IPEX?
Foxp3
62
Cells targets in effector phase of acute antibody-mediated organ rejection.
Endothelial cells
63
Child with recurrent immune infections and abnormal dihydrorhodamine (DHR) test. Dx?
Chronic granulomatous disease
64
Antibodies found in droopy eyelids and weakness, worst at the end of the day.
Anti-acetylcholine receptor
65
11. Need to check thiopurine methyl transferase (TPMT) before starting what drug ?
azathioprine
66
Antibodies found in graves?
TSH receptor antibodies
67
Mutation in the common gamma chain of interleukin-2?
X-linked SCID
68
Man with recent weight loss, sinusitis, nose bleeds, renal failure and ANCA positive. Biopsy showed cytoplasmic granular deposits. What is the most likely diagnosis ->
granulomatosis with polyangitis (Wegner's)
69
Woman with dry eyes, specifically denies CREST symptoms. Anti ro and la +ve.
Sjogren's disease
70
How is mycoplasma pneumonia resistant against beta lactam antibiotics?
no cell wall
71
A 2 day old newborn has blood culture with gram-negative rods, and mother had fever in labour. What is the likely organism?
E. Coli
72
Patient present with knee swelling, cultures show MRSA. What antibiotic should be started?
Vancomycin
73
What is the single most important intervention in someone who has catheter-associated UTI?
Remove the catheter
74
Which vaccine-preventable illness can cause subacute sclerosing panencephalitis 7-15 years later?
Measles
75
Person with meningitis symptoms but is allergic to penicillins & cephalosporins (anaphylaxis). What antibiotic should she be given?
Chloramphenicol
76
Why has avian influenza H5N1 etc not caused a pandemic in humans?
No human-human transmission
77
Mother has active herpes lesions (at 37 weeks?)How should the baby be delivered?
C-section
78
Question describing life cycle of a helminth and asking which type autoinfects.
Strongyloides
79
Influenza vaccines given to children as a nasal spray?
Fluenz Tetra? Live attenuated
80
Kid visits a petting zoo, then get bloody diarrhoea, pathogen that causes HUS ->
E. coli O157:H7
81
Which hepatitis is coinfection with hepatitis D?
Hep B
82
Name preventative measure to give to a patient with Howell jolly bodies on blood film.
Vaccination/prophylactic pen V
83
What common anti-viral for which there is resistance via mutated thymidine kinase?
acyclovir
84
Which 2 drugs are multidrug resistant TB resistant against?
rifampacin
isoniazid
85
Which of the following is associated with HMB synthase deficiency
a. acute intermittent porphyria
b. hereditary coporphyria
c. erythrocytic coporphyria
d. basically listed all the other porphyrias
a
86
Woman is a smoker who has been on furosemide for a long time. Has high Hb, high Hct, normal red cell mass, low plasma volume, Jak2 negative. What is the likely cause?
a. Primary polycythaemia
b. Secondary polycythaemia
c. Psuedo(relative) polycythaemia
c
87
middle-aged man has a DVT what is the most important thing to rule out
a. Occult malignancy
b. Haemoglobinopathy
c. Hereditary thrombophilia
a
88
Patients with liver failure and heart failure, on biopsy there are iron deposits in the heart and liver. Iron studies reveal the following: Low transferrin (0.5) . Iron was like 4000 and saturation 100% (normal value around 50%)
a. Ferroportin transporter deficiency
b. Hereditary haemachromatosis
c. Alcoholic disease
d. Hepatitis B
e. Other options might be correct
b
89
Question about auer rods, granules and DIC, blood film shows immature myelocytes
APML
90
Woman who is a B thalassemia carrier and has no clinical features. Her partner has been tested and he does not carry any of the gene. What is the likelihood that their child will have symptomatic B thalassemia?
a. 0
b. 1 in 4
c. 2 in 4
d. 3 in 4
e. 4 in 4
a
91
A 38 week pregnant woman is at moderate risk of VTE - what should she be on? - similar to specialties question
a. Aspirin and heparin
b. LMWH
c. Aspirin
b
92
Lady spends 10 days in hospital and develops a VTE in her femoral vein. Greatest risk factor for VTE in vignette?
a. Pregnancy
b. Immobilisation
c. Chronic alcoholic
d. Protein C deficiency
b
93
What condition does HTLV1 cause?
acute T cell leukaemia/lymphoma
94
Low platelets on FBC, first investigation to request?
a. Blood film
b. Bone marrow biopsy
c. Inherited thrombogenic condition?
a
95
Man comes back from Ghana. Feels tired or unwell. No palpable splenomegaly. Thrombocytopaenia. Reticulocytes low, neutrophils high. 37.5C. Sickle cell trait. Unwell 10 days ago, then fully recovered. Now unwell again with non blanching rashes.
a. Parvovirus B19
b. Splenic sequestration
c. Sickle trait
d. CML
e. Bone marrow infarct
a
96
CLL drug ibrutinib targets what enzyme
a. Bruton tyrosine kinase
b. ACL gene
a
97
Person that came in with leukaemia symptoms. Blood tests showed high lymphocytes and blast cells. What investigation would reveal the most information?
a. Peripheral blood immunophenotyping
b. Cytological and genetic analysis
c. Bone marrow test
d. CT scan
c(?)
98
Most important thing to be matched when doing a stem cell transplant?
a. HLA
b. Blood group
c. CMV status
d. Gender
e. Ethnicity
a
99
What type of lymphoma has an indolent course?
a. follicular
b. Hodgkin’s
c. Burkitt’s
d. Diffuse large B cell
e. Mantel cell
a
100
Man has inflammation from anus to splenic flexure and crypt abscesses. What is he at risk of?
a. Perianal fistula
b. Primary sclerosing cholangitis
c. diverticulitis
b
101
Keratin pearls and intraepithelial bridges, what histological type of malignancy?
a. squamous cell carcinoma
b. adenocarcinoma
c. Basal cell carcinoma
a
102
Alcoholic with hematemesis after a bout of vomiting, a history of liver cirrhosis, what is the cause? (repeat)
a. oesophageal varices
b. strictures
a
103
Dilated heart chambers and normal valves
a. restrictive cardiomyopathy
b. Dilated cardiomyopathy
c. Hypertrophic cardiomyopathy
b
104
Virus in japan associated with H.pylori. It causes cancer of what organ?
a. Lung
b. Colon
c. Stomach
d. Breast
e. Uterus
c
105
30 cm tumour that is in the left retroperitoneum, obscuring left psoas muscle. Colon is normal. No blood in stool. What is the tumour?
a. Liposarcoma
b. Adenocarcinoma
c. Hamartoma
d. Lymphoma
e. melanoma
a
106
Mother describes 3mm red lump on child's chest ? What is it?
a. Haemangioma
b. Melanoma
a
107
Which testicular tumour is sensitive to radiation?
a. Seminoma
b. yolk sac tumour
c. sertoli cell tumour
d. Leydig cell tumour
a
108
What feature characterises a malignant cell?
a. Atypia
b. Invasion
c. Pleomorphism
d. Increased nuclear/cytoplasm ratio
b
109
Likely cancer that someone with uncontrolled coeliac disease would get
a. Lymphoma
b. Adenocarcinoma
a
110
Child with nephrotic syndrome. Likely biopsy of kidney shows:
a. Minimal change
b. Crescent something
c. Glomerulonephritis
a
111
Middle aged woman is itching. Anti ama what condition?
primary biliary cholangitis
111
Chemotherapy given for leukaemia. Renal failure develops later. Most likely cause?
a. Nephrocalcinosis,
b. urate nephropathy
c. membranous glomerulonephritis
b
112
Women presenting with facial rash, oral ulcerations, raynauds, small joint pain in her hands, what antibody would you look for?
anti dsDNA
113
Which part of adrenal is responsible for production of aldosterone
a. zona glomerulosa
b. zona fasciculata
c. zona reticularis
d. cortex
e. medulla
a
114
Mother of a child with T1DM reports being hypoglycaemic whenever she checks. Her has low C-peptides, high Insulin and low glucose (2 mmol). Cause ?
a. Taking exogenous insulin
b. Insulinoma
c. T1DM
d. i think sulphonylurea was also an option
a
115
Breathless women with widespread wheeze. Low pH. Normal bicarbonate. (I think low O2 and high PCO2)
a. Resp acidosis uncompensated
b. Resp alkalosis
c. Mixed resp and metabolic
d. Metabolic acidosis compensated
e. Metabolic alkalosis
a
116
Patient with complete 21 hydroxylase deficiency, what is the likely electrolyte balance
a. Low sodium, low potassium
b. Low sodium, high potassium,
c. High sodium, low potassium
d. High sodium, high potassium
b
117
Man who had COVID and treated with dexamethasone for 10 days. He has noticed central weight gain and striae, which has continued despite finishing treatment and regular exercise. 1 mg dexamethasone test. Cortisol 700 (normal: smth - 700) midnight cortisol was low (as expected). Administration of 1mg dexamethasone suppresses cortisol (even more) by the morning. CT showed small bilateral adrenal mass. MRI pituitary showed a 2mm pituitary mass. lung X ray showed infiltrates and areas of consolidation.
a. Ectopic ACTH
b. Pituitary dependent ACTH
c. Simple obesity
d. COVID induced renal failure
e. adrenal carcinoma
c
118
Which complication does SGLT 2 help prevent in diabetic patients
a. MI
b. renal failure,
c. Stroke
d. Neuropathy
e. Retinopathy
a and/or b ?
119
7. Tingling in extremities following a surgery for toxic multinodular goitre removal. Which of these would we want to measure in bloods?
a. calcium,
b. thyroxine,
c. potassium
d. cant remember the other options
a
120
Drug causing hypoglycaemia
a. quinine,
b. thiazide,
c. prednisolone
d. glucagon
a
121
What increases following intravascular haemolysis?
a. Calcium
b. Sodium
c. Potassium
c
122
Which term is defined as true negatives divided by the people who don’t have the disease?
a. Specificity
b. Sensitivity
c. Positive predictive value
d. Negative predictive value
e. Z score
a
123
Palpitations, hyperthyroid woman. Most important medication to give
a. doxazosin
b. propanolol
b
124
Low GFR. Patient with uremia, most likely complication?
a. metabolic acidosis
b. mixed alkalosis
c. metabolic alkalosis
d. respiratory alkalosis
e. respiratory acidosis
a
125
13. What hormone triggers the release of prolactin from the pituitary gland?
a. CRH
b. GH
c. TRH
d. ACTH
e. GNRH
c
126
type of vaccine is diphtheria
a. subunit
b. toxoid
c. inactivated
d. live
b
127
What vaccine should not be given to immunosuppressive people due to risk of reactivation
a. Polio
b. tetanus
a
128
Which condition would plasmapheresis most likely benefit?
a. Myasthenia gravis
b. Rheumatoid arthritis
c. X linked Hyper IGM Syndrome
d. IgA vasculitisis
a
129
Patient is on immunosuppression (prednisolone and something else). Which vaccine should they not receive?
a. Zostavax
b. Cant remember rest
a
130
Which auto-antibody is able to cross the placenta and cause congenital cardiac problems?
a. Anti Jo
b. Anti Ro
c. Anti-Sm (smith)
d. Anti-smooth muscle
e. Anti-cardiolipin
b
131
Hep B acute active infection.
surface antigen positive or negative?
+ve
132
Condition treated with anti IL1
a. asthma
b. gout
b
133
Condition treated with anti IL-4
asthma
134
CART cell therapy is used for?
large B cell lymphoma
135
Which disease is polygenic auto inflammatory?
a. crohn’s
b. ALPS
c. graves
a
136
How to confirm anaphylaxis
Serial mast cell tryptase at 3 hours and 24 hours
137
Infection with Neisseria, normal C3 and C4. Abnormal classical and alternative pathway tests CH50, AP50. Which complement is deficient?
C7
138
Patient with transplant had tacrolimus and mycophenolate, what additional drug should you give to manage acute T cell mediated rejection?
a. ciclosporin
b. corticosteroids
c. azathioprine
d. rituximab
b
139
Drug used to treat metastatic melanoma
pembrolizumab
140
Man with hypertension and diabetes. No immunosuppression. Had a brain abscess - most likely organism?
a. Acinetobacter baumannii
b. Cryptococcus neoformans
c. Staphylococcus smth?
d. Mycobacterium dt
e. streptococcus anginosus
e
141
Inpatient who has been on co-amoxiclav for 5 days. She now has green mucous in stool and abdominal pain, what is most likely cause?
a. Clostridium difficile
b. Yersinia pestis
a
142
20 y/o IVDU has infective endocarditis. What is the most likely pathogen that you can’t culture using normal lab tests?
a. Strep smth
b. Another coccus
c. Coxiella burnetii
d. Cardiobacterium hominis
e. Acinetobacter?
d
143
What is the most specific indicator of an e.coli UTI?
nitrites in urine dip
144
Someone with falciparum malaria, parasitaemia of 0.5%, fever but generally well. What medication(s) would you give?
a. IV artesunate
b. IV quinine
c. Artemether and lumefantrine
d. Chloroquine
c
145
What is the recommended procedure to prevent surgical site infection before cutting into the skin, but not near mucousal surfaces?
a. Iodine
b. Iodine + alcohol
c. Chlorhexidine
d. Alcohol only
e. Chlorhexidine + alcohol
e
146
Test for diagnosing latent TB
a. IGRA
b. Sputum culture
c. Sputum something again
a
147
Candida esophagitis and Candida GLABRATA infection on swab of rectum (NON ALBICANS). What drug to treat?
a. Fluconazole
b. Clomitrazole
c. Miconazole
d. Flucytosine
e. Anidulafungin
e
148
What can you give for prophylaxis of RSV?
palivizumab
149
Mechanism of resistance towards penicillin of streptococcus pneumoniae
a. Changing target
b. Effluxing it out
c. Inactivating it by making enzyme
a
150
Patient with HIV, CD4 count is like 350 something. What complication is he most susceptible at this CD4 count?
a. Mycobacterium Tuberculosis
b. Kaposi’s and/or herpes zoster infections/candida
c. Herpes zoster/candida only
d. PCP
e. Cryptococcus neoformans
b
151
What’s the likely mechanism that HIV has not been cured by antiretroviral drugs?
a. It quickly integrates in CD4 T cells in 48-72 hours <- ?
b. many changing strains
c. failure to produce broad antibodies
d. Toxicity of HAART
a
152
Invasive candidemia test
beta d glucan
153
Man comes back from holiday and now has a fever, rash, low platelets
dengue
154
Man with HIV and not on treatment reveals to sexual health consultant that he has been having unprotected sex with many partners. Consultant asks to contact trace but they did not exchange contacts.
a. contact police and tell patient you will
b. contact nightclubs where he went and had sex with people so they can warn them
c. Dont tell anyone because he has a right to confidentiality
d. Tell patient that intentional transmission is a crime but do not take further action as there no identifiable people at risk
a
155
A 38 year old man is admitted with decompensated liver failure and gross ascites. Initial investigations show that he has Hepatitis B that has not been previously diagnosed. The following day he deteriorates and becomes encephalopathic. Two days later he dies of overwhelming sepsis. His wife, asks to speak to the FY2 who looked after her husband. She cannot understand how her husband could have developed liver failure as he never drank alcohol. How should you advice the FY2 in terms of disclosure of the man’s Hep B status? (repeat 2021)
a. Intentional transmission of hep B is a crime and therefore the information can be disclosed to the wife on the grounds of prevention of serious crime.
b. The legal duty of confidentiality can be legally breached in order to prevent serious harm to others
c. The legal duty of confidentiality no longer applies after death so his hep b status can be disclosed to his wife
d. The man was probably becoming encephalopathic when he refused disclosure to his wife and therefore the legal duty of confidentiality can be lawfully breached on the grounds that he lacked capacity.
e. The man cannot be harmed by the disclosure and therefore his wife should be informed of his hepatitis B status
b
156
26yo man is brainstem dead and removed himself from ODR 6 years ago. Parents say he would have wanted his organs donated and didn’t know he removed himself previously. Family had recent discussion and he expressed that he would have donated his organs. What should the consultant do?
a. He was 20 years old at the time and therefore it doesn’t count anymore
b. ODR must be renewed every 5 years so it doesn’t count anymore
c. Have specialist staff nurse gather more information from parents in order to best understand his recent wishes <- ?
d. Explain his organs cannot be donated in this circumstance
e. Explain that he is brainstem dead so they can’t take his organs anyways (i dont think this was an option)
?
157
76 year old dies. Has advance written note stating she wants her brain to be used in research. After her death the son says they are orthodox and hence that you cannot give her brain to research (seems easy but options were very similar and weird)
a. As she has written an advanced note, there is a legal obligation to use her brain her research
b. As she has written an advanced note, the human tissue act does not apply and her brain can be used for research
c. Brain can be used for research despite refusal from family
d. Family wishes must be respected
e. Anything can be used for research without consent
?
158
17 year old dies. His mother has given permission for his body to be donated for research autopsy, however his brother disagrees - REPEAT
a. the option where it can still go ahead with mother’s decision overriding sibling’s
b. where there is family disagreement this cannot go ahead
?
