Phase 4 Past Papers

Question 1

For acute exarcebation of asthma name the drugs and their drug class

Answer 1

OH SHIT mE

Question 2

Advice for taking GTN spray?

Answer 2

• Sit down for 5 mintues before and after taking it
• Might give you a headache / postural hypotension/flushing
• Don’t take alongside Viagra
• Can become tolerant- so make sure have a nitrate free period each day usually at night
• Take it as a preventor- i.e take in anticipation of doing more sctive stuff rather than when you are struggling.

Question 3

Treatment of angina? Drugs and MOA?

Answer 3

• GTN spray-2 sprays- vasodialation of venus system
• Beta blocker-atenolol- 50-100mg OD- reducing sympathetic drive on heart
• Ca channel blocker-verapamil-80mg TDS- relaxation of cardiac muscle, and cardiac arteries.

Question 4

Signs of cushing’s?

Answer 4

BECLAMETHASONE

Buffalo Hump
Easy bruising
Cataracts

Larger appetite
Obesity
Moonface
Euphoria
Thin arms and legs and proximal weakness
Hyperglycemia and hypertension
Avascular necrosis of femoral head
Skin thinning, striae
Osteoporosis
Negative nitrogen balance (don’t know what this means)
Emotional Lability

Question 5

Dexamethasone suppresion tests interpret

Answer 5

ot suppressed by low-dose dexamethasone Cushing’s syndrome not due to primary causes, i.e. likely secondary to corticosteroid therapy
Not suppressed by low-dose, but suppressed by high-dose dexamethasone Cushing’s disease
Not suppressed by low- or high-dose dexamethasone Ectopic ACTH syndrome likely

Question 6

What is pathophysiology behind HELLP syndrome?>

Answer 6

microangiopathic haemolytic anaemia (MAHA) - RBC injury passing through small
vessels with endothelial damage (
liver enzymes high - because of poor blood supply to the liver due to vasoconstriction
= liver damage
MAHA w/in liver = liver damage??
Haemolytic anaemia and thrombocytopaenia through endothelial activation and RBC
haemolysing as a result of entrapment and injury.

Question 7

Acute management of Pre-eclampsia?

Answer 7

A-E. Admit, Labetolol + MgSO4. Emergency C-S
increased fetal surveillance, us + CTG
labetalol
birth in hospital
mgs04

Question 8

What are B-symptoms? Examples?

Answer 8

fever, night sweats, weight loss

Question 9

How do you stage HL? What is the staging?

Answer 9

he Ann Arbor staging system is commonly used
Stage Features
I Single lymph node region
II Two or more regions on the same side of the diaphragm
III Involvement of lymph node regions on both sides of the diaphragm
IV Involvement of extra nodal sites

Question 10

Pathophys behind ascites? 4 examples

Answer 10

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Question 11

Pathophys behind oesophageal varices?

Answer 11

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