CAP TEST

Question 1

why does serum phosphate tend to rise in CKD

Answer 1

it isn’t efficiently removed by dialysis

Question 2

which vitamin is often prescribed in CKD

Answer 2

activated vitamin D

Question 3

how are phosphate levels managed in advanced CKD

Answer 3

phosphate binders to remove free phosphate from serum

Question 4

which vessels make up the left venous angle

Answer 4

subclavian and internal jugular veins

Question 5

which vessels drain in to the chamber of the heart with the SA node

Answer 5

IVC and SVC

Question 6

where do the intercostal veins from the anterior aspect of the chest drain into

Answer 6

internal thoracic

Question 7

what effect do BDZs have on delirium

Answer 7

worsen and lengthen delirium

Question 8

what is the best treatment for delirium

Answer 8

haloperidol

Question 9

what are the diagnostic criteria of delirium

Answer 9

acute onset
inattention
disorganised thinking/altered level of consciousness

Question 10

at what stage does the embryo implant onto the uterus

Answer 10

blastocyst (day 6-10)

Question 11

where does fertilisation normally occur

Answer 11

ampulla of Fallopian tube

Question 12

what are features of duct ectasia

Answer 12

green/cream nipple discharge
more common in smokers
lump felt under nipple

Question 13

what type of breast pathology is common after trauma

Answer 13

fat necrosis

Question 14

elderly lady with a hot, tender breast and overlying cellulitis that has not responded to 2 courses of antibiotics

Answer 14

suspect inflammatory breast cancer

Question 15

what effect does phenytoin have on OCP efficacy

Answer 15

reduces OCP efficacy as it induces liver enzymes

Question 16

which antibiotic is contraindicated in pregnancy and why

Answer 16

tetracycline

discolours the infant’s teeth

Question 17

can a patient <16 year consent to an abortion

Answer 17

yes, if they have capacity

need written permission from someone over 18 for surgical procedure

Question 18

what consent is needed for non-emergency treatment in a severely brain damaged patient

Answer 18

apply to courts for consent

Question 19

patient in labour and has reassuring CTG but meconium discharge, management?

Answer 19

reassure and re-examine in 2 hours

Question 20

what is the recommended contraception post-partum

Answer 20

BMI <39 COCP

BMI >39 POP

Question 21

which STI causing organism is a flagellated protozoa

Answer 21

trichomonas vaginalis

Question 22

what is radial-femoral delay a sign of

Answer 22

coarctation of aorta

Question 23

what are signs of placental abruption

Answer 23

severe bleeding + uterus tender and tense +/- severe fetal distress /intrauterine death

Question 24

when is mid-forceps delivery appropriate

Answer 24

when foetal head is below the ischial spines

Question 25

what supplements are recommended for all women to take during pregnancy

Answer 25

folic acid 400 mcg | vitamin D 10 mcg

Question 26

how much folic acid should be given to high risk groups

Answer 26

5 mg

Question 27

which hormone should be measured to detect if a woman has ovulated

Answer 27

progesterone

Question 28

which hormone should be measured to assess ovarian reserve prior to IVF

Answer 28

anti-mullerian hormone

Question 29

which artery can be damaged during insertion of lateral abdominal port during female laparoscopic sterilisation

Answer 29

inferior epigastric

Question 30

which artery can be damaged during incision of bartholin's abscess

Answer 30

internal pudendal

Question 31

which artery can be damaged during dissection of the lower end of the ureter

Answer 31

uterine artery

Question 32

which hormone causes enlargement of the mammary glands in breasts to prepare for production of milk

Answer 32

prolactin

Question 33

why is anaemia common in patients with CKD

Answer 33

reduced renal EPO

Question 34

what treatment can help patients with CKD maintain adequate Hb

Answer 34

EPO

Question 35

what monitoring is necessary for LMWH

Answer 35

only monitor if patient is pregnancy or has renal impairment use anti-Xa assay

Question 36

what monitoring is required for dabigatrarin

Answer 36

no routine monitoring

Question 37

what is the mechanism of action of dabigatran

Answer 37

direct thrombin inhibitor

Question 38

what monitoring is necessary for unfractionated heparin

Answer 38

APTT

Question 39

why does roleaux occur

Answer 39

when the charge on the surface of cells is altered as a consequence of cell being labelled with proteins

Question 40

what does low ferritin suggest

Answer 40

iron deficiency

Question 41

what to suspect in anaemia + jaundice

Answer 41

haemolysis

Question 42

what do spherocytes suggest

Answer 42

autoimmune haemolysis or hereditary spherocytosis

Question 43

when is HRT contraindicated

Answer 43

active or recent arterial thromboembolic disease eg angina or MI

Question 44

when would you recommend a blood transfusion for anaemia

Answer 44

Hb <8

Question 45

dactylitis is a common presentation of which anaemia

Answer 45

sickle cell

Question 46

what is the test for sickle cell anaemia

Answer 46

HPLC (Hb high performance liquid chromatography)

Question 47

what type of inheritance does hereditary shperocytosis show

Answer 47

autosomal dominant

Question 48

man presents with back pain, proteinuria and microscopic haematuria

Answer 48

multiple myeloma

Question 49

presents with high lymphocyte count and lymphadenopathy

Answer 49

CLL

Question 50

atypical mononuclear cells

Answer 50

EBV

Question 51

29 yo acute mania that may be pregnant, drug management?

Answer 51

prescribe olanzapine

Question 52

30 yo with schizophrenia, non-response to quetiapine and haloperidol, drug management?

Answer 52

clozapine

Question 53

how long does a compulsory treatment order last

Answer 53

6 months in hospital

Question 54

what test should be done before starting lithium

Answer 54

U&Es

Question 55

what is the first line treatment in depression

Answer 55

SSRI eg citalopram

Question 56

reduced GABA is a sign of

Answer 56

withdrawal from sedative-hyponotic slugs

Question 57

excessive activation of dopamine receptors is present in

Answer 57

schizophrenia

Question 58

serotonin is low in

Answer 58

depression

Question 59

what is malingering

Answer 59

faking illness for secondary gain

Question 60

which neurotransmitter is most involved in appetitive and approach systems

Answer 60

dopamine

Question 61

what are features of migraine

Answer 61

``` unilateral pulsating moderate-severe aggravated by routine activities last between 4-72 hours ```

Question 62

what can make benign intracranial HTN worse

Answer 62

coughing/sneezing (raise ICP) | COCP

Question 63

what is dystonia

Answer 63

sustained abnormal posture caused by persistent contraction

Question 64

how is dystonia managed

Answer 64

anticholinergics phenothiazines botulinim toxin

Question 65

what is a spasm

Answer 65

uncontrolled contraction of a muscle

Question 66

what is blepharospasm

Answer 66

spasm of eyelid

Question 67

what is hemiballismus

Answer 67

uncontrolled flailing of limbs

Question 68

nerve roots for biceps reflex

Answer 68

C5/6

Question 69

nerve roots for ankle reflex

Answer 69

S1

Question 70

nerve roots for knee reflex

Answer 70

L3/4

Question 71

acute dystonic reaction is a side effect of what type of drugs

Answer 71

EPS side effect | typical antipsychotics

Question 72

what is metabolic syndrome

Answer 72

central obesity HTN hypercholesterolaemia insulin resistance

Question 73

metabolic syndrome is associated with which class of psych drugs

Answer 73

atypical antipsychotics

Question 74

receptive aphasia is due to a lesion in

Answer 74

wernicke's area

Question 75

how does receptive aphasia present

Answer 75

speech is fluent but words spoken are incorrect

Question 76

expressive aphasia is due to a lesion in

Answer 76

frontal lobe of dominant hemisphere | broca's area

Question 77

how does expressive aphasia present

Answer 77

able to understand but lose fluency | unable to get words out despite knowing what to say

Question 78

what is the first area affected by Alzheimer's

Answer 78

nucleus basalts of meynert

Question 79

lesion to which cranial nerve can cause pain in the posterior triangle of the neck

Answer 79

CN VII

Question 80

what pattern go inheritance does Huntington's show

Answer 80

autosomal dominant

Question 81

how does lamotrigine work

Answer 81

block voltage sensitive sodium channels | reduces release of glutamate

Question 82

what is the first line treatment of simple partial seizures

Answer 82

lamotrigine or carbamazepine

Question 83

oligoclonal bands in CSF is associated with

Answer 83

MS

Question 84

what does xanthochromic CSF indicate

Answer 84

presence of blood | ?subarachnoid haemorrhage

Question 85

which drugs improve survival in heart failure

Answer 85

ACEI

Question 86

desire to void occurs with bladder is how full

Answer 86

250 ml

Question 87

what is the definition of polyuria

Answer 87

>2.8 L of urine a day

Question 88

parasympathetic nerve stimulation has what effect on the detrusor muscle

Answer 88

contracts

Question 89

how long is the female urethra

Answer 89

3-4 cm

Question 90

what causes a right shift in the O2-Hb dissociation curve

Answer 90

acidosis (lower pH) increased CO2 increased 2,3-DPG increased temp

Question 91

what causes myasthenia graves

Answer 91

antibodies directed against postsynaptic ACh receptors

Question 92

is treponema pallidum a true anaerobe

Answer 92

nope | its a bacterium