Capsule Flashcards
(701 cards)
1
Q
Causes of cavitating lung mass
A
Bacterial lung abscess Metastatic SCC GPA Pulmonary infarct Pneumonia
2
Q
Bacteria which cause cavitation are common in homeless people
A
S Aureus
Klebsiella
Mycobacterium Tuberculosis
3
Q
Ear pain and then facial muscle weakness
A
Bells palsy
4
Q
Ear rash and then facial muscle weakness
A
Ramsay hunt syndrome
5
Q
Which nerve supplies the anterior tongue taste
A
Facial
6
Q
Which nerve causes bells palsy
A
Facial
7
Q
Investigation for bells palsy
A
Nerve conduction studies if palsy persists (to look for axonal degeneration)
8
Q
Whats the prognosis like for bells palsy
A
Most people recover
9
Q
Causes of macrocytosis
A
Pregnancy, Alcohol, Folate deficiency, B12 deficiency
10
Q
Treatment of alcohol withdrawal
A
Bezodiazepines based off symptom score
11
Q
Wernickes treatment
A
Thiamine as rapid bolus
12
Q
Thomas’ test
A
Fixed flexion deformity of opposite hip, osteoarthritis is the most common cause
13
Q
Normal resp rate for under 5s
A
30
14
Q
Upper limit of normal heart rate in under 5s
A
150
15
Q
Risks for UTI
A
Diabetes, renal stones, sex
16
Q
Which kids should get a renal ultrasound for UTI
A
1 UTI + Under 6 months= within 6 weeks
Recurrent UTI + Under 6 months= during admission
Recurrent UTI + over 6 months= 6 weeks
17
Q
Which asthma drugs can cause hypokalaemia
A
Salbutamol, prednisolone and theophylline
18
Q
Theophylline monitoring
A
Cardiac monitoring when giving IV
19
Q
Salbutamol side effects
A
Tremor, tachycardia, sleep disturbance
20
Q
What visual change would a lesion in the optic radiation cause
A
Superior quadrantopia
21
Q
Symptoms of acromegaly not in the face
A
Cardiomegaly
Colonic polyps
Hepatosplenomegaly
Diabetic retinopathy
22
Q
Investigations for acromegaly
A
Oral glucose tolerance test
MRI pituitary
23
Q
40 year old hearing loss, bilateral
A
Otosclerosis
24
Q
Most likely cause of hearing loss in a child
A
Glue ear
25
glue ear mechanism
Eustachian tube dysfunction results in negative pressure in the middle ear cleft and subsequent middle ear effusion
26
1st line treatment of glue ear
surveillance
27
Causes of secondary hypertension
Renal Artery stenosis
Polycystic kidney disease
Coarctation
```
Cushings
Conns
Phaeochromocytoma
Acromegaly
Hypothyroid
```
28
Treatment of phaochromocytoma
Alpha blockade then beta blockade
29
Pharmacological options for stopping smoking
NRT, varenicline, bupropion
30
Treatment of a SAH
Coiling and clipping of any aneursym
31
Inpatient fluids for dialysis patient
Dont need
32
Causes of surgical emphysema
Oesophageal tear
Fractured rib
Pleural biopsy
33
Child has jumped off a wall
Calcaneal fracture. Most commonly fractured talus bone, 10% bilateral and also associated with spinal injuries.
34
Salter harris classification
Describes how fractures involve the growth plate in children. 1-2 good prognosis, 5 involves the growth plate
35
Who gets PBC and autoimmune hepatitis
Women
36
3 tests for hereditary haemochromotasosi
Serum iron, total iron binding capacity and ferritin
37
Complications of haemochromatosis
```
skin pigmentation
diabetes (pancreatic deposition)
cardiomyopathy
hepatic cirrhosis
chondrocalcinosis and arthropathy
hypogonadism and pituitary dysfunction
```
38
Why do people get AKI after shock
Acute tubular injury
39
Chance of recovery from AKI
80%
40
Hyperkalaemia ECG
Prolonged PR interval, small tall or “tented” T waves and wide QRS complex
41
J waves on ECG
Hypothermia
42
Phenylketonuria
AR, Low phenylamine diet and amino acid supplements
43
Smooth disc like swelling in one breast in a male
Gynaecomastia
44
Which drugs cause gynaecomastia
Finasteride, PPI, Spironolactone
45
Muscles responsible for shoulder abduction
Deltoid and supraspinatus
46
Nerve supplying deltoid
Axillary
47
S1
Sole of foot
48
L2
Upper anterior thigh
49
L1
Groin
50
S3
Buttock
51
L4
Calf
52
What does Coombs positive suggest
Autoimmune mediated so remove insult and give corticosteroids
53
Does CLL have a good prognosis
Incurable unless bone marrow transplant in young person
54
Splenectomy guidance
Vaccinations (Flu, pneumococcal, Men C, Hib) before surgery and prophylactic antibiotics for two years after
55
Laparoscopy or lapartomy if pelvic mass
Laparotomy as will need to remove mass
56
Amiodarone side effects
Blue-gray skin
57
Gram negative bacillus
E Coli, H influenza
58
Gram positive bacillus
Listeria monocytogenes, Bacillus cereus
59
Fitz hugh curtis syndrome
Hepatitis after PID
60
Common side effect of bacterial meningitis
Sensorineural deafness
61
Drug for chemoprophylaxis of meningitis
Rifampicin (ciprofloxacin ok but off license)
62
Do MR and Ultrasound use radiation
no
63
Raised mole surrounded by flat mole
Compound naevus
64
Flat and coloured mole
Junctional naevia
65
Raised mole
Dermal naevus
66
Benign mole in area prone to mechanical irritation such as razoring and irritation by clothes
Excision reasonable
67
malaise, a widespread maculopapular rash (involving palms and soles) and orogenital ulcers
secondary syphilis
68
Symptom of secondary syphilis
Macropapular rash
69
Testing for secondary syphilis
VDRL testing
70
Syphilis pupil
Argyll Robertson pupil
71
Which is the most common lung cancer
Adenocarcinoma
72
Tests for HCC
Also do AFP and CXR
73
Can hydroceles be felt seperate to the testes
No
74
What word is used to describe increased bone density
Sclerosis
75
Causes of osteosclerosis
Metastatic cancer
| Sickle cell disease
76
Treatment of metastatic prostate cancer
Antiandrogens
77
Two common types of HPV
16 and 18
78
What type of ovarian cyst is most likely to tort
Dermoid
79
Whats the difference between BV and trichomonas
BV fishy, clue cells, no itch
| Trichomonas, itchy, smelly, strawberry cervix
80
Treatment of Bartholins cyst
Marsupialisation
81
Treatment of imperforate hymen
Incision of hymen (not excision)
82
First line treatment of stress incontinence
Pelvic floor training
83
Surgeries for stress incontinence
Urethral bulking agent
Mid urethral sling
Burch colposuppression
84
Investigation for urgency incontinence
Frequency volume chart
85
Treatment of urgency incontinence
Bladder drill
Fluid advice
Local oestrogen
Smoking cessation
86
How do you treat non ruptured ectopics
Methotrexate
87
How do you treat ruptured ectopics
urgent laparoscopy
88
What should you complete after an someone falls on the ward
DATIX
89
What would you use to sedate an elderly patient
0.5mg lorazepam
90
What would you use to treat faecal impaction
8 sachets of laxedo
91
What counts as a postural drop
20+/10+
92
cANCA
Wegeners GPA
93
Is DDimer useful in pregnancy
No
94
CTPA or VQ in pregnancy
Discuss with mum, CTPA better, CTPA=Breast Ca, VQ=childhood cancer
95
Gestation sac but no evidence of foetal pole
Missed miscarriage
96
Drugs which cause uterine contractions so could be used in PPH
```
Syntocin
Syntometrine
Ergometrine
Misoprostol
Carboprost
```
97
Management of PPH
ABCDE
Call for help
Rub up uterine contraction
Syntocin
98
What diabetes symptoms do you get in gestational diabetes
Polyuria
Thirst
Dysuria
99
What non glucose test should you do in a patient with gestational diabetes
Obstetric ultrasound
100
Monitoring for gestational diabetes
Monitor diet carefully and have daily plasma glucose levels
101
Treatment of preterm labour
Tocolysis and steroids
102
Name a tocolytic
Nifedipine
103
Liver signs in pregnancy
Pruritis
Spider naevi
Palmar erythema
Cholasma
104
Placenta praevia management
Depends on US and clinical findings
Cross match blood
Vaginal examination is contraindicated
105
Which syndrome is associated with preeclampsia
HELLP
Haemolysis
Elevated liver enzymes
Low platelets
106
3 methods used for fetal monitoring during labour
Intermittent auscultation
CTG
Fetal blood scampling
107
Treatment of suspicious CTG
IVI
Left lateral position
Turn down oxytocin infusion
108
Hormone levels in premature ovarian failure
High FSH and LH
| Low oestrogen
109
Hormone levels in PCOS
LH raised
| FSH normal
110
Hormone levels in pregnancy
LH and FSH are low
| Oestradiol is high
111
Three common routes for HRT
Transdermal
Transvaginal
Oral
112
Unnoposed oestrogen HRT risks
Breast and endometrial cancer risk
113
Progestogen HRT risks
Bloating, constipation, irritability
114
Bromocriptine SE
Postural hypotension
115
Chance of successful vagina birth after caesarean first time
75%
116
VBAC (vaginal birth after caesarean) plan
Continous CTG
| IV access
117
Grading of vaginal tears
First-degree tear: Injury to perineal skin and/or vaginal mucosa.
Second-degree tear: Injury to perineum involving perineal muscles but not involving the anal sphincter.
Third-degree tear: Injury to perineum involving the anal sphincter complex:
Grade 3a tear: Less than 50% of external anal sphincter (EAS) thickness torn.
Grade 3b tear: More than 50% of EAS thickness torn.
Grade 3c tear: Both EAS and internal anal sphincter (IAS) torn.
Fourth-degree tear: Injury to perineum involving the anal sphincter complex (EAS and IAS) and anorectal mucosa.
118
Follow up after vaginal tear inc anal sphincter
Analgesia
Laxatives
Physio appointment for pelvic floor exercises
119
Two options for morning after pill
Copper IUD
| Levonorgestrel
120
Steps in prolonged labour
1. artificial rupture of membranes
2. start oxytocin infusion
3. caesarean
121
What is defined as slow labour
Less than 2cm dilatation in 4 hours
122
1st line investigation of ectopic
TVUS
123
When do you use methotrexate for ectopic
If a mass isnt seen
124
What is the treatment of ectopci
Diagnostic laparoscopy with view towards laparoscopic salpingectomy
125
Which contraceptive is a risk factor for ectopic pregnancy
Copper IUD
126
Gram positive coccus
S pneumoniae
127
Gram positive bacillus
Ballis cerues, listeria monocytogenes
128
Are never events serious incidents
Yes
129
Does duty of candour apply to organisations or individuals
Organisations
130
Causes of ptosis
3rd nerve palsy
| Horner syndrome
131
Mandibular fracture
orthopantomogram
| maxillofacial surgeons
132
When can you give details to police about a crime
Only when threat to life or limb, not theft etc.
133
Questions for prognosis in dementia
Deteriorating function
| Would you be surprised if they died in next few days, weeks, months
134
Does DOLS apply to all settings
No. All care settings but not patients own home
135
Signs of dying
Sleeping more
Eating less
Cheyne Stokes breathing
Cool peripheries
136
Preemptives
Midazolam, morphine sulfate, cyclizine and glycopyrronium.
137
Reversible causes of agitation at end of life
```
infection
hypoxia
urinary retention
constipation
raised intracranial pressure
alcohol withdrawal
opioid toxicity
```
138
Death certification, 1a, 1b, 1c
Part 1 shows the immediate cause of death (part a), plus what may have caused this (part b,c). Part 1c should lead to 1b, which in turn should lead to part a
139
Risk factors for bowel cancer
```
Male
Diabetic
Smoker
Obese
UC
Familial Adenomatous Polyposis
HNPCC
```
140
Swallowing difficulties of solids and liquids from the start
Achalasia
141
Achalasia diagnostic investigation
Oesophageal manometry
142
Scans for babies with UTI
MCUG- ?reflux
| DMSA- ?scarring
143
atypical UTI and under 1
Prophylactic abx
144
Treatment of vesicoureteric reflux
Improves with time
145
Pen allergic alternative to amoxicillin
Clarithromycin
146
Which antiemetic works directly on gut
Metoclopramide
147
How does ondansetron work
Ondansetron blocks 5HT3 receptors in the CNS and the GI tract
148
DABS
```
Clopi 75
Aspirin 75
Ramipril 5
Bisoprolol 2.5
Atorvastatin 80
```
149
Risk of liver biopsy
Bleeding
150
Pompholyx
Eczema with tiny blisters on hands
151
Bleeding in one nostril not solved by silver nitrate cautery
Rapid rhino in each nostril
152
Consequences of C difficile
Peritonitis
Toxic megacolon
Pseudomembranous colitis
153
Severe C difficile treatment route
You give Metronidazole or Vancomycin orally as better absorption
154
Treatment of severe malaria
Urgent IV Artesunate
155
Whats the difference about vivax or ovale
More severe, benign, so you give primaquine afterwards
156
Seosis from something bowel treatment
Cefuroxime and metronidazole
157
Treatment of traumatic bowel perforation
Digital retrieval of rectal body
| Lapartomy
158
Most common lung cancer
Adenocarcinoma
159
NICE lung cancer, What counts as chronic cough
3 weeks
160
Should you give antibiotic prophylaxis for kids with UTI
Not after just 1
161
Treatment of most uk food borne gastroenteritis
Ciprofloxacin
162
When shouldnt you give loperamide
IBD, high temperature
163
Most common cause of bowel obstruction
Colon cancer
| Sigmoid volvolus
164
Are left or right sided bowel cancers more likely to obstruct
Left as poo more solid and smaller diameter
165
What do bony mets look like
Sclerotic
166
If someone has a breast abscess what should you screen for
Diabetes
167
ER positive medication
Tamoxifen
168
HER2 positive medication
Trastuzumab
169
Post menopausal medication for breast cancer
Anastrozole
170
Mammory duct ectasia treatment
2ww
171
Trauma then long standing breast lump history
Fat necrosis
172
Tests for CF
Guthrie heel prick
Reduced faecal elastase
Sweat test
Gene testing
173
Investigation for pyloric stenosis
Ultrasound
174
Investigation of tonsilitis
Throat culture
| Rapid streptococcal antigen test
175
Treatment of GABHS tonsilitis
Phenoxymethylpenicillin and paracetamol
176
Which way is the shunt if it is cyanotic
Right to left
177
Steps in tetralogy of fallot
```
Pulmonary stenosis
VSD
Overriding aorta
RVH
(they get more cyanotic on straining)
```
178
Transposition of the great arteries
Presents on day 2
| Give prostaglandin to maintain PDA
179
Patent Ductus arteriosus
Machinery murmur
| NSAIDs
180
Coarctation
Increasing symptoms with age
Commonly at ductus arteriosus
Stent and surgical repair
181
Rheumatic fever causative organisum
S pyogenes, 2 weeks post tonsilitis
182
Skin sign of rheumatic fever
Erythema marginatum
183
Investigation of rheumatic fever
ASO swab
184
Treatment of Rheumatic fever
NSAIDs and prophylactic abx
185
Whats the difference between Exomphalos and Gastrochisis
Gastrochisis is uncovered
186
Treatmtent of developmental dysplasia of hip
Harness and surgery
187
Investigation of biliary atresia
Laparatomy
188
Treatment of biliary atresia
Surgical bypass
189
Types of cerebral palsy
Hemiplegic
Diplegic
Ataxic
Dyskinetic
190
What can babies do at 8 month
Sit unsupported
Pincer grip
Straigh back
191
at what age can they walk
1 year
192
Shapes and ages
Circle 3
Square 4
Triangle 5
193
Treatment of HSP and Nephrotic syndrome in children
Oral prednisolone
194
Tests to do in baby with jaundice
Coombs test and TORCH screening
195
Treatment of jaundice in baby
Phototherapy
196
Cause of jaundice in baby less than 24 hours old
Haemolytic anaemia
| Infecgion
197
Cause of jaundice in baby up to 2 weeks old
Physiological
| Breast milk
198
Define Hirshprungs
Failure to pass meconium in first 48 hours of life
199
investigation of hirschprungs
Suction rectal biopsy
200
Treatment of hirschprungs
Surgery
201
Gene defect in Turners
45XO
202
Abnormalities in Turners
Webbed neck
Short
Wide spaced nipples
Delayed puberty
203
Edwards syndrome
Trisomy 18
Kidneys and occiput
Die in 15 days
204
Patau syndrome
Trisomy 13
Polydactyly
Heat defects
Developmental delay
205
Tests for Downs
Triple at 12 weeks- hCG, PAPPA-A, nuchal US
| Quad at 16 weeks- hCG, AFP, oestiol, inhibin A
206
What does guthrie test for
```
CF
Sickle cell
Congenital hypothyroid
Phenylketonuria
MCAD
MSUD
```
207
What is 12 weeks test for
Chromosome tests
208
What is 20 weeks scan for
Neural tube
Heart
Renal
Brain
209
Chorionic villous sampling
12 weeks
2% miscarriage risk
Chromomes and inherited disorders
210
Amniocentesis
16 weeks
1% miscarriage risk
Chromosomes and gender
211
Meningitis cause in neonates
E Coli
212
Treatment of meningitis in community
IM BenPen
213
Treatment of meningitis in hospital
IV ceftriaxone
214
Prophylaxis of meningitis
PO rifampicin or ceftriaxone
215
Treatment of febrile seizures
Paracetamol
216
Who gets malar flush
Mitral stenosis
217
Hypertensive emergency
IV sodium nitroprusside
Reduce BP to 110 over 24 hours
CT scan head
Admit to monitored bed
218
When to treat hypertension in elderly
If still present after 3 months and lifestyle factors
219
How many samples for TB microbiology
3
220
Signs of opioid withdrawal
Yawning
Rasied BP
Cool/clammy skin
221
What drug is used for opioid abstinence in an inpatient setting
Naltrexone
222
Which disc prolapses in sciatica
L5/S1
223
Treatment of sciatica
Reassurance
| NSAIDs, physio, mobilisation
224
Investigation of colonic abscess
1. US
| 2. CT
225
Name causes of fistulae
Diverticular disease
| Crohns
226
Pharmacodynamic interaction
Drugs competing at receptor site
227
Pharmacokinetic interaction
Drugs changing absorption of another drug
228
Phenytoin OD
Headaches, insomnia, tremor, nausea
229
Causes of SIADH
Cancer
Stroke
Lung abscess
230
Risk factors for smoking
FHx
Smoking
Head injury
231
NMDA receptor antagonist
Memantine
232
Acetylcholinestarase inhibitors
Rivastigmine
Donepezil
Galantamine
233
Cause of intraperitoneal air
Perforated oesophageal ulcer
Laparotomy 24hours ago
Perforated diverticulum
234
Which parts of the GI tract are retroperitoneal
3rd part of duodenum
Ascending colon
Descending colon
235
Which antibiotics should be avoided in first trimester of pregnancy and why
Trimethoprim (antifolate)
Ciprofloxacin
Cotrimoxazole
236
What is the most common ASD
PDD-NOS (pervasive developmental disorder-not otherwise specified)
237
Types of ASD
PDD-NOS (pervasive developmental disorder-not otherwise specified)
Rett syndrome
Aspergers
238
What can be a presenting feature of Polycythaemia
TIA
239
Causes of polycythaemia
CKD
HCC
COPD
Primary polycythaemia
240
Which heart medication can cause low mood
Beta blocker
241
Moclobemide
Tricyclic
242
Dosulepin
RIMA
243
How long should a first episode of depression be treated for
At least 6 months
244
How would you assess facial nerve
Ask the patient to raise their eyebrows, bare their teeth and close their eyes, respectively, and look for asymmetry of movement
245
Where do testicular lymphatics drain to
Paraaortic
246
High bHCG testicular cancer
Choriocarcinoma- think placenta
247
High AFP testicular cancer
terAtoma
248
High PLAP testicular cancer
Seminoma
249
Drugs for reducing regime for alcohol detox
Chlordiazepoxide
| Diazepam (more than lorazepam)
250
A 41-year-old gentleman is brought to the ED with a history of heavy alcohol use now presenting with clouding of consciousness, agitation, paranoid delusions and tactile and visual hallucinations. His mental state is very fluctuant and he’s sweating profusely.
Delerium tremens
251
Can ARB and ACEI be used together
Yes in renal
252
Causes of third nerve palsy
Rapidly expanding aneurysm
Internal carotid dissection
Thrombotic occlusion of blood supply
253
What should you give if its within 2 hours of ingestion of overdose
Activated charcoal by mouth
254
SE of NAC
Rash, but dont stop treatment because of it
255
Aspirin overdose Sx
Vomiting, hyperventilation, sweating, tinnitus
256
Most common cause of cushings syndrome
Exogenous steroids
257
Local anaesthetics
Lidocaine for short things
| Bupivacaine for regional blocks
258
Which med could bring on gout
Aspirin
259
What does colchicine cause
Diarrhoea
260
SE of oxytocin
Water intoxication cos its similar structure to ADH (both released by posterior pituitary)
261
How long should you give an SSRI for if its a recurrence of depression
2 years
262
Name an Noradrenaline and specific serotonin antidepressant (NaSSA)
Mirtazepine
263
Name an Selective Noradrenaline reuptake inhibitor
Reboxetine
264
What type of drug is trazadone
TCA
265
What type of drugs are Duloxetine and venlafaxine
Serotonin and Noradrenaline reuptake inhibitor (SNRI)
266
Renal colic 1st line investigation
Non contrast CT KUB
267
When shouldnt you give PR diclofenac for renal colic
obstructed kidneys or sepsis, give IV paracetamol instead
268
When do you remove renal stone
After the infection has been treated
269
Carpal tunnel
Median nerve, Loss of sensation in the thumb, index, mid finger.
OCP, pregnancy, heart failure, wrist trauma, RA, hypothyroid
270
Gram positive cocci
Streptococcus pyogenes and MRSA (methicillin resistant Staphylococcus aureus)
271
Gram negative rods
Escherichia coli, Pseudomonas aeruginosa and Haemophilus influenza
272
Gram negative cocci
Neisseria meningitidis
273
Treatment of impetigo
A 7 day course of oral aciclovir
274
Investigations for myeloma
Blood film and bone marrow aspirate
MRI spine and thoracic and lumbar spine XR
Serum electrophoresis and free light chains
Skeletal survey
275
Investigation of urge incontinence
Bladder diary/ frequency volume chart
276
Leading cause or urge incontinence in both men and women
Overactive bladder (detrusor overactivity)
277
What is the most common cause of lung mets
Breast
278
Do drugs help BPPV
No
279
Treatment of oesophageal candidiasis
Oral Nystatin
280
What nerve is in the parotid gland
Facial nerve
281
Which type of nerves does multiple sclerosis affect
Upper only
282
Hepatotoxic drugs
Paracetamol
Erythromycin
Simvastatin
283
Which illicit drug can cause parkinsons
Heroin
284
Tongue ulcer and cervical lymphadenopathy, lung signs
Metastatic scc
285
Cannon waves in jvp
Ventricular tachycardia and complete heart block
286
Oliguria definition
<0.5ml/kg/hr or <400ml in 24hrs
287
Who gets a carotid doppler
Outpatient after TIA
288
Bony swelling and tenderness
Suspect bone tumour
289
HPV in genital warts
6 and 11
290
HPV in CIN
16 and 18
291
Steps in speeding up labour
1) Artifical rupture of membranes
| 2) oxytocin infusion
292
What is established labour
4cm and regular contractions
293
Treatment of orthostatic hypertension
Fludricortisone
294
Which eye signs can be in any type of thyroid eye disease
Lid retraction and lid lag
295
When to DC shock AF
HR over 150
| Chest pain
296
Who cant have combined COCP
- smoker (15 a day) and over 35
| - within 6 weeks of giving birth
297
Causes of ptosis
3rd nerve palsy
Horners
Age
Myasthenia gravis
298
Does RAPD suggest problem with that eye or opposite
That eye
299
Which branch of the trigeminal is the opthalmic
1st
300
Virus for shingles
Herpes Zoster
301
Mydriasis
Fixed dilated pupil in acute angle glaucoma
302
Treatment of acute angle closed glaucoma
IV acetazolamide
Topical steroids
Pilocarpine
303
Treatment of pyelonephritis
IV coamoxiclav
304
OA examination findings
Crepitus
Limited range of motion
Abnormal gait
305
Describe sclerodactyly
Thickening and tightening of skin
306
What are ENA antibodies
ANA antibody subtypes screen
307
First line treatment of gout if theyve had a gastric ulcer
Oral colchicine
308
Treatment of PMR
Oral pred
309
Causes of death in Ank Spond
Amyloidosis and Aortic valve disease
310
Investigation of erythema nodosum
CXR
311
First line treatment of OA
Oral Paracetamol
312
Main treatment of Ank Spond
Exercise therapy
313
Treatment of achilles tendon rupture
Equinus cast
314
Test for achilles test
Simmonds or squeeze test
315
Which nerve roots comprise the radial and ulnar nerves
C5-T1
316
Which nerve roots comprise the median nerve
C8-T1
317
Most common cause of wrist drop
Trauma
318
Causes of bone mets
Breast
Prostate
Lung
Kidney
319
Where do bone mets commonly occur
Spine
Pelvis
Ribs
320
Mosaic wart
Cluster of warts
Sole of foot
Contagious so use veruca sock if swimming, avoid sharing showers
321
Paronychia
infection around the nail
322
Isotretinoin vs tretinoin
Tretinoin for mild acne
| Isotretinoin for treatment resistant
323
Most common areas for melanoma in men and women
Men torso
| Women legs
324
What is the biopsy called if it is a big lesion
Incisional biopsy
325
Bullous pemphigold
Bullous on top of erythema, big rash.
| Emolient and Pred
326
Scalp ringworm
Requires oral not topical antifungals
327
Discoid eczema
Well demarcated round patches
| Topical Steroids
328
Diagnosis of secondary syphilis
VDRL
329
Signs of neuro syphilis
Tabes Dorsalis
| Argyll Robertson Pupil
330
Causes of rash on soles of feet and palms of feet
Syphilis
331
How long after exposure for HIV seroconversion
2 weeks to 12 weeks
332
How long after exposure for Secondary Syphilis
6 weeks to 6 months
333
Diagnosis of PCP
Bronchoscopy and bronchoalveolar lavage
334
Giardia Lamblia treatment
Metronidazole
335
Why do you CT head before LP
To exclude raised ICP
336
Herpes in pregnancy
Oral aciclovir in first 2 trimesters
Suppressive therapy
Dont need c section
337
Vaginal candidiasis diagnosis
Vulvovaginal swab taken for direct gram-stain microscopy from the anterior fornix
338
How is trichomonas vaginalis diagnosed
Posterior fornix swab taken for wet mount, to look for Trichomonas vaginalis
339
Candida treatment
Any topical Azole- clotrimazole vaginal pessary
340
What must you suspect in any bone swelling and tendernesss
Bone cancer
341
Where does osteosarcoma affect
End of the bone
342
Where does ewings sarcome affect
Mid shaft
343
Do falls have to be referred to coroner
Yes
344
Can you put cardiac arrest as main cause of death
No, shouldnt, its a symptom
345
Rash affecting hands and soles
HIV, Syphilis, Measles, Erythema Multiforme
346
What causes sudden death in hypertrophic cardiomyopathy
Arrythmia
347
Treatment of dental pain
NSAID analgesia
348
Which CURB65 score= severe
3 or more
349
Whats an alternative to calcium gluconate
Calcium chloride
350
Carcinoid syndrome
flushing, diarrhoea, bronchospasm, weight loss and hyper and hypotension. Heat Disease
351
Testing for infectious mononucleosis
Monospot
| Paul Bunnell
352
Which part of the colon is intraperitoneal
Transverse
353
What should you do if doesnt respond to SSRI in anxiety
Swap to another
354
Maximum duration of benzos for anxiety
2-4 weeks
355
How does post op uti present
Asymptomatic
356
Atypicals used for psychosis
Quetiapine, Olanzapine, Aripiprazole
357
Which antihypertensive drug can cause low mood
Beta blockers
358
% manic patients which get depression
Over 90
359
Acute mania treatment
Antipsychotics and benzos
360
Diagnosing post natal depression
Ask about anhedonia and low mood
| Then give Edinburgh Post Natal Depression Score
361
Bulimia symptoms
hypokalemia, hypocalcaemia, hypotension and a decreased red blood cell count
362
Tool for assessing risk of violence
HCR 20
363
Tool for assessing psychopaths
PCL-R
364
Treatment of EUPD in GP
Refer to community mental health team for formal diagnosis
365
Most common cause of a learning disability
Low socioeconomic class
366
What is overshadowing
When presenting symptoms are assumed to be caused by background diagnosis but are actually not
367
Atypicals
Aripiprazole
Olanzapine
Risperidone
368
First line for severe Alzheimers
Memantine
369
When do paracetamol levels peak after overdose
4 hours
370
Wehn should you give activated charcoal
If present within an hour
371
Which drugs go IV
Heroin
Cocaine
Amphetamines
372
Most common cause of suicide in both men and women
Hanging
373
% people who attempt suicide who have mental illness
Over 90%
374
% suicide who have self harmed before
50%
375
Islet autoantibodies to rule out T1DM
Islet cell autoantibody, GAD65, ZnT8
376
Non diabetic causes of hyperglycaemia
Endocrine: Cushing’s, acromegaly, phaeochromocytoma
Medications: steroids, SGA
Exocrine pancreas: CF, pancreatitis, amyloidosis, haemochromatosis
377
DKA triad
Diabetic = glucose>11
Keto = ketones in blood/ urine
Acidosis HCO3<15, pH<7.3
378
Common differential for depression
Hypothyroidism
379
Treatment of moderate- severe depression
Refer for CBT and offer to start sertraline
380
Which hallucination is a schneiderian 1st rank symptom
3rd person- commentary or discussing them
381
Examinations for lower mn facial palsy
Otoscopy
Palpation of the parotid gland and neck
Movement of the facial muscles
382
Causes of facial nerve palsys
Bells
Heerfort's syndrome- sarcoidosis
Mucoepidermoid carcinoma of the parotid- most common parotid cancer
383
What causes hyperacusis (sensisitivity to loud noise)
Facial nerve palsy as supplies the motor supply to the stapedis
384
Swallowed foreign body possible complications
Oesophageal perforation
| Retropharyngeal abscess
385
Lung mets are what cancer until proven otherwise
Colon
386
When would you use central venous access
If elderly and risk of heart failure so need accurate idea of fluid statsu
387
Treatment of a non shockable rhythm
Adrenaline every 3-5 minutes and cpr
388
Scarlet fever
Strawberry tongue and pharyngitis.
389
Complications of tonsilitis
Quinsy- urgent ENT referral ?tonsillectomy
390
Depression causing medication
```
Corticosteroids
Oral Contraceptives
Statins
Ranitidine
Beta blockers
```
391
Bloods for IBS
FBC
ESR and CRP
TFT
392
Which serum level do you need in order to interpret CSF results
Plasma glucose
393
Treatment of ringworm
Oral terbinafine
394
Which ethnic group gets obstetric cholestasis
Asian
395
Is ESR reliable in pregnancy
No will be raised anyway
396
How many UTIs needed for child to have renal ultrasound
Under 6 months=1
| Over 6 months= recurrent
397
Contraindications to HRT
Undiagnosed vaginal bleeding
Pregnancy
History of venous thrombosis
398
Which drug can bring on gout
Aspirin§
399
Investigations for acute epilepsy
Blood glucose
MRI
(EEG used in opd setting)
400
Why does asthma get worse in pregnancy
People often get GORD in pregnancy
401
Which antibody in breastmilk
IgA
402
Does breast milk or formula cause more diarrhoea and vomitting in infants
Breast milk causes less diarrhoea and vomitting
403
Indurated ulcer on side of tongue, smoker
Squamous cell carcinoma
404
Heavy dragging feeling of the testes
Suggestive of tumour
405
Testicular cancer surgery
radical inguinal orchidectomy
406
Which testicular tumour produced AFP
Teratoma
407
What cause gout
Meat, seafood, alcohol (not cheese)
408
In children does high fever suggest bacterial
Not necessarily
409
How do you change steroid doses in hypoadrenalism when ill
Double
410
Sail sign
Left lower lobe collapse
411
Why does asthma get worse in pregnancy
People often get GORD in pregnancy
412
Which antibody in breastmilk
IgA
413
Does breast milk or formula cause more diarrhoea and vomitting in infants
Breast milk causes less diarrhoea and vomitting
414
Indurated ulcer on side of tongue, smoker
Squamous cell carcinoma
415
Heavy dragging feeling of the testes
Suggestive of tumour
416
Testicular cancer surgery
radical inguinal orchidectomy
417
Which testicular tumour produced AFP
Teratoma
418
What cause gout
Meat, seafood, alcohol (not cheese)
419
In children does high fever suggest bacterial
Not necessarily
420
How do you change steroid doses in hypoadrenalism when ill
Double
421
Sail sign
Left lower lobe collapse
422
Can you take paracetamol when you give vaccine
No dont cos wanna be able to see if fever
423
Investigation when upper GI bleed but not seen on OGD
Mesenteric Angiography
424
What electrolyte changes happen after vomiting
hypochloraemic, hypokalaemic metabolic alkalosis
425
Diagnostic test for pyloric stenosis
Ultrasound abdomen
426
pyloric stenosis treatment
Ramstedt’s pyloromyotomy
427
What causes rheumatic fever
Group A beta haemolytic strep
428
Treatment of rheumatic fever
Admit and bed rest
Im benpen
10 day oral amox
429
Symptoms of rheumatic fever
Sore throat then new murmur.
| Pericardial rub, sydenhams chorea, conduction defects
430
Do you need to wait for troponin for acute mi diagnosis
No
431
Cardiogenic shock and low blood pressure treatment
CPAP. CPAP pushes fluid back into vessels
432
Type A aortic dissection
Ascending aorta
433
Type B aortic dissection
Descending aorta
434
LV Strain pattern on ECG
Big R waves in V6
435
RV Strain pattern on ECG
Big R waves in V1
| Big S waves in V5/6
436
LV strain pattern on ECG
Big S waves in V1
| Big R waves in V5/6
437
Bleeding and warfarin
Prothrombin complex
438
Why do you ultrasound in infective endocarditis
Splenic infarcts
439
Criteria for IE
Major diagnostic criteria include more than one positive blood culture (typical organism in 2 separate cultures or presistently positive blood cultures), or positive echocardiogram findings of vegetation, abscess or abscess prosthetic valve.
Minor criteria include:
predisposition (cardiac lesion, IV drug abuse);
fever over 38 °C;
vascular signs, e.g. mycotic emboli, Janeway lesions (painless palmar/plantar macules);
immunological signs e.g. Oslers nodes (painful swelling fingers/toes), positive RhF, glomerulonephritis
microbiological evidence not fitting major criteria.
Diagnosis is made on 2 major, 1 major/3minor or >5 minor criteria.
440
Digoxin ECG
Sloping ST depression in V5 and V6
441
If the TB is drug resistant what do you add
streptomycin and ciprofloxacin
442
What type of hypersensitivity is asthma
1
443
Angle of safety position
6th intercostal space, mid-axillary line
444
Causes of pneumothorax
```
Marfans
Asthma
COPD
Mechanical ventilation
rib fracture
```
445
where are the ascending and descending aorta in the body
Ascending near the front, descending near the back
446
What posture is helpful for svc
head up
447
What type of drug is theophylline
Phosphodiesterase inhibitor
448
What causes consolidation on chest x ray
alveoli filled with something- air, fluid, mass
449
Treatment of pen allergic pneumonia
Clarithromycin
450
Features of sarcoid
Hypercalcaemia
Lung fibrosis
Hepatosplenomegaly
Uveitis
451
What should the CO2 be like in severe asthma and what is a worrying sign
Should be low, so if it is normal then that is concerning that it is going up
452
Steroid side effects
Osteoporosis
Diabetes
Weight gain
Increased rates of infection
453
How do you notify the authorities of a disease
Notify the Health Protection Consultant in office hours/through a notification form
454
Which asthma medications should you change during pregnancy
None, keep them the same
455
Treatment of oesophageal stricture
Balloon dilatation
456
Which extra GI manifestations are due to the activity of the colitis
Episcleritis
| Erythema nodosum
457
IV PPI in varices
Dont give ppi before endoscopy
458
Treatment of varices if banding hasnt worked
Insertion of Sengstaken-Blakemore tube
459
How long to give LMWH for when giving warfarin too
5 days or until therapeutic INR, whichever is longer
460
What is the cause of ascites in alcoholic hepatitis
Cirrhosis
461
Treatment of autoimmune hepatitis
Pred and azathioprine
462
Pancreatic cancer options
```
Mild= Whipples Procedure
Severe= stent
```
463
Chronic pancreatitis on AXR
Calcification in the pancreatic area
464
Imaging fo chronic pancreatitis
CT
465
Anti smooth muscle antibodies
Autoimmune hepatitis
466
Biologic options for crohns
Anti-integrin therapy (Vedolizumab)
Anti-interleukin therapy (Ustekinumab)
Anti-TNF antibody treatment (Infliximab or Adalimumab)
467
Cause of duodenal ulcer when not on nsaid
H pylori (if confirmed on colonoscopy you dont have to test for)
468
tests for IDA
Colonoscopy and gastroscopy
469
Which organisms can mimic crohns
TB
| Yersinia
470
Pancreatitis management
IV fluids
IV analgesia
ABG
471
Complications of acute pancreatitis
Pancreatic pseudocyst
472
Faecal elastase
Exocrine pancreatic function
473
Which solid organ is most commonly injured in trauma
Spleen. May need laparotomy and splenectomy
474
Symptomatic gallstone without CBD stone or dilation
Lap Chole this admission
475
Glasgow score for pancreatitis
```
PaO2
WCC
Serum calcium
urea
LDH
Albumin
Glucose
```
476
Imaging of fibroadenoma or cysts etc
First mammogram then US then core biopsy/needle aspiration then either discharge or excise if big
477
How long should you continue insulin infusion for
Until ketones are under 0.3
478
Sedation in parkinsons
Lorazepam as haloperidol contraindicated
479
Rhabdomyolysis CK
Over 10000
480
How to detect C spine fracture
CT neck
481
How long after surgery do you get PE
10 days
482
Investigation for IE
Transoesophageal echo
483
Do you always treat AF
Not if asymptomatic and rate controlled and chadsvasc is 0
484
Bleeding duodenal ulcer
Gastroduodenal artery
485
Gout and CKD
Give pred not nsaid
486
All the fluid in the lungs, low BP, no urine output.
| I.e. overloaded but in the wrong places
Noradrenaline is used for vasoconstriction
487
Which part of the brain is affected first in alzheimers
Temporal
488
Fibrosis but without clubbing
From amiodarone
489
Treatment of acute mania
antipsychotic- quetiapine, risperidone, olanzapine
490
Mitral stenosis
Apex beat tapping, low rumbling murmur, caused by rhuematic fever
491
What are blast cells suggestive of
Acute leukaemia
492
CLL
Smudge
493
Translocation 9:22
Philadelphia chromonsome
494
Myeloma causes what in bones, what do mets cause
```
Myeloma= lytic
Mets= sclerotic
```
495
Initial steps for nose bleed
Sit the patient up with the neck flexed, and tell the patient to press the soft part of the nose below the nasal bones
Ice pack
496
First investigation for ITP
Blood film
497
Treatment of frequent sickle cell crisis
Hydroxycarbamide
498
When does subacute degeneration of the cord occur
When you replace folate without B12
499
Tumour lysis syndrome
Hyperkalaemia
Hyperphosphataemia
Hyperuricaemia
Hypocalcaemia
500
Cause of purpuric rash
Meningococall sepsis
Pneumococcal sepsis
Staphylococcal
501
When would you not give ceftriaxone for meningitis
Only if previus life threatening reaction
502
What perspective is imaging
You are always looking up from feet
503
Most common cause of TIA
Carotid artherosclerosis
504
In young adults whats the most common cause of meningitis
Viral
505
Should you LP and blood culture before antibiotics in meningitis
Only if it wont delay treatment
506
Hypokalaemia causes
Reduced ingestion
Increased excretion
Loop or thiazide diuretics
507
Hypokalaemia features
```
Absent reflexes
Constipation
Cramps
Weakness
Tiredness
```
508
Reintroduction of potassium
Not at a rate of more than 10mmol/hr
509
Chornic management of hyperkalaemia
Low potassiumd diet
510
Nephrotic in adults
Membranous glomerulonephritis
511
Enlarged gall bladder is always suspicious for what
Head of pancreas tumour
512
Incubation period for HCV
4-20 weeks
513
Complications of legionnaires
Endocarditis, pericarditis, pancreatitis, pulmonary fibrosis, respiratory failure
514
Which cancers are associated with EBV
Nasopharyngeal cancer and Burkitt lymphoma
515
Types of noicieptive pain
Somatic and visceral pain
516
Types of neuropathic pain
Allodynia
| Dysesthesia
517
Opioids for renal failure
Alfentanil
518
What imaging if confused after seizure and hasnt returned to baseline
CT head
519
features of aura (smell and fear) and posturing with automatisms without complete loss of consciousness
Temporal epilepsy
520
Treatment of Guillain Barre
IVIG and plasma exchange
521
Investigation of Guillain Barre
Lumbar puncture
| Nerve conduction studies
522
Prognosis of GBS
90% fully recover
523
Which nerve causes foot drop
Common peroneal nerve
524
Visual symptoms of papilloedema
Enlarged blind spots and constricted fields
525
What should you also prescribe in diseases with gait disturbance
Physiotherapy
526
Investigations for essential tremor
Clinical, just do bloods to exlude hyperthyroid and anaemia
527
First lines for essential tremor
Primidone
| Propranolol
528
Things present in true parkinsons but not drug induced
Dyskinesia
Levodopa improved symptoms
Unilateral rest tremor
529
Scan for parkinsons
DaTscan
530
How is CIN different from cervical cancer
Cells have not invaded the basement membrane
531
Which lobe causes Somatosensory neglect
Parietal
532
Further investigtions after EEG in epilepsy
ECG
| Refer to neurology
533
Which drugs do you give when giving chemo
Aciclovir
Allopurinol
Cotrimoxazole
534
Lifetime risk of breast cancer in women
1 in 8
535
Chemo after surgery
Adjuvant chemo
536
Chemo before surgery
Neo adjuvant chemo
537
Side effects of anastrozole
Joint aches
538
Metastatic cord compression treatment
Radiotherapy and surgical decompression
539
5Ds of charcot arthropathy on CXR
```
Density changes
Destruction
Debris (loose bodies and bone fragments)
Distension (joint effusion)
Dislocation
```
540
Causes of pneumothorax
Asthma
COPD
Liver biopsy
Chest drain insertion
541
Sigmoid vs Caecal volvolus
```
Sigmoid= LBO
cAECAL= sbo
```
542
Differences between LBO and SBO
Peripheral distribution
Presence of haustration
Presence of faeces
543
Lines across the bowel in LB vs SB
```
LB= haustration
SB= valvular conniventes
```
544
When do you use an IVC filter
When recurrent PEs despite coagulation
545
High fever and bone pain
Osteomyelitis
546
Diseases associated with pseudogout
hyperparathyroidism, hypothyroidism or haemochromatosis
547
Which drug is contraindicated in heart block
Beta blockers
548
How long after ingestion do you take a paracetamol level
4hours
549
What do you need to do with all patients who have had an OD
Psych referral
550
Most sensitive marker of liver dysfunction after paracetamol overdose
PT or INR
551
Advice to people with HTN
Salt restrict and lose weight
552
Should you up dose of existing or start new drug for HTN
Up dose of existing
553
Bendroflumethiazide action
It inhibits sodium reabsorption in the early distal tubule via the Na-Cl co-transporter
554
What to call fibrosis when suspected but not confirmed cause
Fibrosing alveolitis
555
Drugs which cause fibrosis
Nitrofurantoin
Amiodarone
Sulfasalazine
556
Can you use amiodarone for bradycardias
No
557
Risk of stroke doubles and risk of MI x1.5 for each ...mmHg rise in HTN
15
558
What is the cause of renal artery disease in young women
Angiodysplasia
559
Amlodipine and atorvastatin can cause
GORD
560
How does H pylori eradication improve GORD symptoms
It doesnt
561
Risk factors for H Pylori
Low socioeconomic status
| Crowded living conditions
562
FAP
Thousands of polyps
563
HNPCC
One big polyp
564
Peutz Jheuger
Polyps and pigemented mouth lesions
565
Treatment of single lung met
Surgical removal
566
Which fibres are acted on by local anaesthetic as they transmit pain and temprature sense
Small C fibres
567
Physical threat from a patient response
Leave situation and call security
568
Which electrolyte abnormality can heparins cause
Hyperkalaemia
569
patient perception of pain 7-8
Strong opioid is appropriate
570
which antiemetics can be used in parkinsons
Ondansetron
| Cyclizine
571
OTC for OA pain
Paracetamol
572
Which drugs shouldnt be taken with antiretrovirals
Statins
| Fluticasone
573
Contraindications to atropine
MG
| Paralytic ilues
574
Faecal softener
Docusate
575
Osmotic laxatives
Lactulose
| Macrogol
576
How long does lactulose take to act
2-3days
577
What type of drug is digoxin
Cardiac glycoside
578
When do you commence detox regime with chlordiazepoxide
Only when sobered up
579
Define pain
unpleasant sensory and emotional experience associated with actual or potential tissue damage
580
Something to tell people taking methotrexate and folic acid
Avoid multivitamins as these will include folate which they are already taking
581
Drug good against MRSA
Vancomycin
582
How many standard errors is the confidence interval
2 either side
583
What type of drug is adrenaline
Non selective adrenergic agonist
584
25 micrograms fentanyl patch is equivalent to what dose of morphine
90
585
Which laxative to go with morphine
senna
586
Which structures go through the parotid gland
Facial nerve
External carotid artery
Retromandibular vein
587
Most common thyroid cancer
Papillary carcinoma
588
Midline neck lumps
thyroid nodule, a thyroglossal duct cyst and a dermoid cyst
589
Treatment of primary haemorrhage after thyroid surgery
High flow oxygen and remove surgical clips
590
If someone comes in with teeth out what should you do
Anaesthetise and reimplant teeth asap
591
Upper aerodigestive tract tumours
Squamous cell
592
Common non accidental injury sites
Retinal Haemorrhages
| Rib Fractures
593
Treatment of osteomyelitis
IV antibiotics then surgical debridement
594
Which foot condition is associated with developmental dysplasia of the hip
Talipes
595
Slapped cheek disease
Parvovirus B19
596
Two XRay views for SUFE
AP and frog lateral
597
Haemophilia inheritance
X linked recessive
598
Consequence of neonatal jaundice
Kernicterus
599
What should you give haemolytic anaemia jaundiced babies to prevent further anaemia
Folic acid
600
Investigations for diagnosis of HSP
FBC, clotting screen, renal function, and urine dipstick
601
Causes of bloody diarrhoea
Salmonella
| E Coli
602
Describe the mass in intussuseption
Right upper quadrant, sausage shaped mass
603
What is the most common type of intussuseption
Ileocolic
604
Two investigations to confirm air enema
Ultrasound and air contrast enemas
605
Twice as potent as oral morphine
Subcut morphine
606
options for respiratory distress when normal oxygen saturations
Hand held fan
| Teaching him/ his wife acupressure points
607
Good medications for opioid constipation
Glyceride suppositories
| Senna
608
Requirements for advanced decision to refuse treatment
Must be written down
Must be hand signed by patient
Must be created when patient has capacity
Must be witnessed
609
Bad signs for end stage COPD prognosis
Low BMI
LV failure
Frequent exacerbations
610
Investigations for hydronephrosis
KUB
then
IV urogram
611
Haematuria first line imaging
Ultrasound renal tract
612
RF for RCC
Smoking
FH
Obesity
Von HIppel Laudua
613
Torsion first line investigation cos its really quick
Dipstick urine
614
Most common group for testicular torsion
11-30
615
Causes of raised PSA
BPH, UTIs, Acute and chronic prostatitis, retention, on catheterisation, taking biopsies of the prostate, TURP, ejaculation
616
Common presenting complaint of RCC
Haematuria
617
Tachypnoea, hypoxia, hypotension and pulmonary oedema within 6 hours of transfusion
TRALI- transfusion related acute lung injury
618
Mild temperature rise shortly after transfusion
A febrile, non haemolytic reaction
619
Allergic reaction to transfusion symptoms
Urticaria, angioedema, wheeze and pruritis
620
Increase in temperature and pulse rate, abnormal bleeding and Low BP after transfusion
ABO incompatbility
621
Which artery causes posterior nose bleeds
Sphenopalatine
622
What do you want to do if you think someone might have broken their nose
Anterior rhinoscopy to exclude septal haematoma
| ENT clinic in 7-10days
623
Mesenteric adenitis
Appendicitis and URTI
624
How to treat appendicitis
Appendectomy
625
Post op reduced bowel sounds
Small bowel ileus
626
Pseudoobstruction
Post surgery, can be caused by electrolyte disturbance
| Colonic decompression
627
Pseudomembranous colitis
From C dificile, before toxic megacolon
628
Threshold for transfusing patients without cardiovascular disease
80g/L
629
Does intraop hypothermia increase or decrease blood loss
Increases as impairs clotting
630
Colorectal cancer diagnosis
Colonoscopy with biopsy
631
Most common inguinal hernia
Indirect
632
How can you differentiate a femoral and inguinal hernia
Inguinal is superior and medial to the pubic tubercle
633
Inguinal canal contents
Spermatic cord
634
What should you do if routine operation and anaemic
Correct and delay operation
635
How to reduce risk of aspiration during surgery
Rapid sequence induction
| Administer antacid before anaesthesia
636
Liver biopsy risks
Pneumothorax
Biliary peritonitis
Shoulder pain
637
Upper age limit of baby for abortion
24 weeks
638
Who can make an advanced directive
Anyone over 18
639
Which pathway does warfarin affect and INR measure
Extrinsic
640
Which pathway does APTT measure
Intrinsic
641
Which routes can warfarin be given
Only oral
642
Dose for immediate NAC
150mg/kg
643
Major bleed and needs warfarin reversal
Prothrombin complex
644
Does the patient have a pulse with ventricular fibrillation
No
645
Electrolyte abnormality caused by hypothyroid
Hyponatraemia
646
What causes pseudo dementia
Depression
647
Where is the blockage for a TACS
Middle cerebral artery
648
Ischaemic stroke: should you treat high blood pressure
No, monitor for now
649
Two most common types of dementia
Alzheimers and Vascular
650
Dementia brain scan
CT (excludes space occupying lesion)
651
Who can fill out cremation form 5
Someone from a different team or practise who has been qualified for atleast 5 years
652
Which diabetes drug causes fluid retention/ heart failure
Glitazones
653
Which diabetes drug causes lactic acidosis and diarrhoea
Metformin
654
On metformin and normal weight
Sulfonylurea- gliclazide
655
On metofrmin and no risk factors for osteoporosis
Pioglitazone
656
Confusion Bloods
U&E, FBC, LFT, glucose, CRP, calcium, B12 & folate, ferritin, iron and transferrin, TFT, vitamin D.
657
COMT inhibitor
Entacapone
658
Dopamine agonist
Bromocryptine
659
MAOB inhibitor
Selegiline
660
Essential tremor
Symmetrical
Improves with alcohol
Propanolol and primdione
661
Experiencing pain from stimuli that are not normally painful
Allodynia
662
Causes of peripheral neuropathy ABCDE
```
Alcohol
B12 deficiency
Cancer
CKD
Diabetes
Drugs (isoniazid)
Every vasculitis
```
663
Triggering pathogens for guillain barre
Campylobacter jejuni
Cytomegalovirus
EBV
664
First line treatment of chronic open angle glaucoma
Prostaglandin eye drops (causes eyelash growth and eyelid pigmentation) (latanoprost)
665
Name three medications for open angle glaucoma
Latanoprost (prostaglandin)
Timolol (beta blocker)
Brinzolamide (carbonic anhydrase inhibitor)
Brimonidine (alpha 2 antagonist)
666
Which medications can cause acute angle closure glaucoma
Tricyclic antidepressants
| Anticholinergic medications
667
Halos around lights
Acute angle closure glaucoma
668
Treamtent of acute angle closure glaucoma
Supine without pillow
Pilocarpine
Acetazolamide
Laser iridotomy
669
5 signs of hypertensive retinopathy
AV nipping
| then just same signs as diabetic
670
Cataracts reflex
Red reflex missing
671
Starbusts around lights
Cataracts
672
How to treat episcleritis
Lubricating eye drops (baso just injured episclera)
673
Stain used in opthalmology
Fluroescin
674
Management of painful red eye in GP
Same day opthalmology referrale
675
Eye drops to test for horners
Cocaine
676
Painless flashes and floaters
Posterior vitreous detachment
677
Treatment of posterior vitreous detachment
None.
| Exclude retinal tear and retinal detachment
678
Treatment of retinal tear
Laser therapy
679
Treatment of retinal detachment
Vitrectomy and replacement
680
Causes of CRVO
Leukaemia
Myeloma
HTN
Diabetes
681
Cause of CRAO
GCA
682
Night blindness
Retinitis pigmentosa
683
Give two causes. of dementia
HIV
| Parkinsons
684
Doses for anaphylaxis
200mg IV hydrocortisone
| 10mg IV chlorphenamine
685
Which rule is used for estimating burns coverage
Rule of 9s
686
How to calculate fluid requirement in burns
4ml x weight in kg x % burnt
687
What should you do with blisters in burns
De-roof blistered areas, dress with non-adherent dressing and review in dressing clinic in 48 hours.
688
Monitoring for oral terbinafine
LFTs
689
Thickened and scaly skin with fissures
Contact dermatitis
690
Psoariasis treatmetn
Calcipotriol
691
What are seborrheic warts also known as
Basal cell papilloma
692
Amoxicillin and EBV
Avoid
693
Bupropion
Start 7 days before stop smoking
| CI seizures, liver, anorexia
694
Options for steroid delivery for RA
IM
Intraarticular
Oral
695
Septicaemia definition
multiplication of bacteria in the bloodstream
696
Migraine prophylaxis
propranolol, amitriptyline and topiramate
697
Alternative to statins
Ezetimibe
698
Rash which starts behind ears
Measles
699
Complications of measles
Encephalitis
Subacute sclerosing panencephalitis
Bronchopneumonia
700
Keratoacanthoma differential diagnosis
SCC
701
ALARMS symptoms
```
Anaemia
Loss of weight
Anorexia
Recent
Mass
Swallowing difficulties
```
