8th PM revision

Question 1

A 33 year old woman has had pruritus for 1 year. Her weight and appetite are normal. She is a previous intravenous drug user.
Investigations:
Albumin 39 g/L (35-50)
ALT 105 IU/L (10-50)
AST 29 IU/L (10-40)
ALP 95 IU/L (25-115)
Bilirubin 34 µmol/L (<17)
Which virus is the most likely cause of her abnormal liver chemistry?

Answer 1

Hep C

Question 2

contra-indication to spinal anaesthesia?

Answer 2

ITP

Question 3

A 19 year old man has 3 weeks of diarrhoea. He is a student and has just returned from a gap year in Thailand.
Investigations:
Haemoglobin 96 g/L (130-175)
MCV 76 fL (80-96)
White cell count 10.2 x 109/L (3.0-10.0)
Platelets 240 x 109/L (150-400)
Eosinophils 3.1 x 109/L (0-0.4)
Which is the most likely diagnosis?

Answer 3

Hookworm

Question 4

Tumour lysis syndrome: Which are elevated?

Answer 4

Phosphate and urate

Question 5

Multiple myeloma is cancer of which cell?

Answer 5

Plasma cells

Question 6

Pain in calves on walking?

Answer 6

Right superficial femoral artery

Question 7

Smear cells?

Answer 7

CLL

Question 8

Philadelphia chromosome?

Answer 8

CML

Question 9

Aortic dissection investigation of choice?

Answer 9

Contrast enhanced CT scan of thorax

Question 10

Hernia locations

Answer 10

A femoral hernia is typically inferior and lateral to the pubic tubercle.
Inguinal hernia = superior and medial

Question 11

Strangulation vs incarceration?

Answer 11

Strangulation is painful

Question 12

Abx for copd exacerbation

Answer 12

Amoxicillin, doxycycline, erythromcin, clarithromyicn

Question 13

Man with 3 episodes of blackouts, 12 lead ECG was normal, next investigation?

Answer 13

EEG

Question 14

Women with headaches, pushing on the frontal lobe. Which brain tumour?

Answer 14

Plioglioma

Question 15

Most common side effect of radiotherapy for SCC lung cancer?

Answer 15

Oesophagitis

Question 16

What cell is primarily affected in MS?

Answer 16

Oligodendrocytes

Question 17

gold standard investigation for a suspected spinal cord compression?

Answer 17

Spinal MRI

Question 18

Gram negative bacteria causing pneumonia in CF patient?

Answer 18

Pseudomonas aeruginosa

Question 19

Blood supply to 2nd part of duodenum.

Answer 19

Cephalic artery

Question 20

Lacunar infarct, what drug to give in addition to aspirin?

Answer 20

Aspirin

Question 21

Broca’s aphasia?

Answer 21

Expressive

Question 22

Wernicke’s aphasia?

Answer 22

Receptive

Question 23

Breastfeeding women with hyperthyroidism. Tx?

Answer 23

PTU

Question 24

Which lung cancer produces PTHrp?

Answer 24

Squamous cell carcinoma

Question 25

Non smoker lung cancer?

Answer 25

Adenocarcinoma

Question 26

MI which caused bradycardia and heart block. Which artery is involved?

Answer 26

Right coronary artery

Question 27

Diuretic of choice in ascites?

Answer 27

Spironolactone

Question 28

Nail pitting, back pain, DIP involvement

Answer 28

Psoriatic arthritis

Question 29

Autoimmune hepatitis?

Answer 29

Anti-smooth muscle antibody

Question 30

LP in MS?

Answer 30

Oligoclonal bands

Question 31

19yo girl inverted her ankle during football practice. WHat ligament is most likely to be damaged?

Answer 31

Anterior tabofibular ligament

Question 32

stromal and epithelial elements breast?

Answer 32

Fibroadenoma

Question 33

Gram positive bacilli causing meningitis.

Answer 33

Listeria monocytogenes

Question 34

Interstitial nephritis?

Answer 34

Kidney injury after drugs (NSAIDs)

Question 35

Woman on recreational drugs has hypokalaemia and hyponatraemia?

Answer 35

MDMA/ecstasy

Question 36

Pt with pyelonephritis and raised APTT, PT and thrombocytopenia. What tests to do?

Answer 36

d-dimer and fibrinogen

Question 37

Sickle cell pt with severe pain leg

Answer 37

IV morphine

Question 38

Pain at 80-120 degree

Answer 38

Subacromial bursitis

Question 39

Hodgkin lymphoma diagnosis?

Answer 39

Excision biopsy

Question 40

Swimmer's ear?

Answer 40

otitis externa

Question 41

Saturday night palsy?

Answer 41

Radial nerve (same as wrist drop)

Question 42

Woman with SOB, fever, ?anaemia, blood and protein 2+ on urine dip. What’s the cause?

Answer 42

SLE

Question 43

Unilateral testicular swelling. Disappears when deep inguinal ring canal blocked with finger.

Answer 43

Indirect inguinal hernia

Question 44

Patient asks what is likelihood of having a condition even if test is negative. Which value to look at?

Answer 44

Negative productive value

Question 45

Weight gain T2DM drugs?

Answer 45

sulfonylureas typically cause weight gain I agree