Random facts from the MCQs - just facts not questions

Question 1

Don’t treat gastrointestinal symptoms in children with antibiotics in the absence of positive stool cultures

Answer 1

For children with depression go for psychological therapies as first option

Question 2

All breastfed babies need supplemental vitamin D

Answer 2

Rotator cuff tears need surgery

Question 3

Treat hypercalcaemia with intravenous fluid resuscitation

Answer 3

Familial contacts of n. meningitidis meningitis need rifampicin (or ciprofloxacin)

Question 4

Never biospy a testicular mass

Answer 4

Someone who has had a mastectomy might have a long thoracic nerve injury

Question 5

Fecal occult bloods are only a screening tool for bowel cancer not an investigation

Answer 5

Provide PEP to all household contacts of a pertussis case

(erythromycin, clarithromycin, and azithromycin)

Question 6

Magnetic resonance cholangiopancreatography or MRCP is noninvasive and for imaging only

Answer 6

Zika can be sexully transmitted and couples need to use barrier methods of contraception for three months

Question 7

Up to 20% of patients with inferior STEMI develop either second- or third degree heart block. This may be because of ischaemia of the AV node

Answer 7

Fever, chills, rigor, hypotension, headache, tachycardia, hyperventilation, vasodilation

1–3 hours after a first dose of antibiotics

Think Jarisch–Herxheimer reaction.

Usually seen in syphilis treatment.

Question 8

Elderly people presenting with microcytic anaemia have bowel malignancy until proven otherwise

Answer 8

Antenatal corticosteroid therapy reduces infant mortality and reduces necrotising enterocolitis risk by 60%

Question 9

Intrahepatic chloestasis of pregnancy increases risk of neonatal prematurity and death

Answer 9

Antenatal steroids can be administered between 23 and 34 weeks

Question 10

Endoscopy every 3 years in cirrhosis patients without known varices

Question 11

Diabetics with albuminuria need ACE inhibitors

Answer 11

Give osteoporotic hip fractures calcium, Vitamin D and bisphosphonates

Question 12

Correct chronic hyponatremia slowly to avoid osmotic demyelination syndrome

Answer 12

Abdominal x rays first investigation in suspected bowel obstruction

Question 13

Don’t use barium enhancement for X-Rays of a ?perforated viscus or toxic megacolon

Answer 13

CT is more sensitive than MRI for acute subarachnoid haemorrhage

Question 14

Left sided varicoceles are associated with infertility and right sided with renal pathology

Answer 14

If you think the patient has a sarcoma do an MRI before you biopsy it

Question 15

Bleeding after thyroidectomy is life threatening-remove both the skin clips and deep layer sutures and evacuate the hematoma beneath. Do this at the bedside not in theatres.

Question 16

IGF-1 levels, not growth hormone, to diagnose acromegaly

Question 17

Tension pneumothorax

Needle thoracostomy 2nd ICS mid clavicular line

Chest tube 5th ICS anterior axillary line

Question 18

Simple febrile seizures do not require investigation

Question 19

Failure to report children who may be in need of protection, including instances of suspected child abuse, to the appropriate child welfare authorities constitutes an offence.

Answer 19

In an emergency, when the patient (or substitute decision maker) is unable to consent, a physician has the duty to do what is immediately necessary without consent. Treatments should be limited to those necessary to prevent prolonged suffering or to deal with the imminent threats to life, limb, or health.