cards

Question 1

compare the following anasthetic agents:
Propofol
Fentanyl
Suxamethonium
Ketamine
Rocuronium
Midazolam

Answer 1

Suxamethonium - increase potassium
- rapid onset of action

Rocuronium - rapid onset

Ketamine -not cause hypotension

Midazolam - minor sedation

Question 2

Compare the following causes of hypoglycemia:
Dumping syndrome
Factiitous hypoglycemia
Intermittent fasting
Impaired insulin sensitivity
Insulinoma

Question 3

wolff- parkinson0white syndrome

Answer 3

accessory pathway from atrium to ventricle bypassing the normal AV node
Short PR interval and pre-excitation/delta wave (more prominent in v1-v6)

1. catheter ablation

Question 4

BPH

Question 5

CI for phosphodiesterase inhibitors

Answer 5

Patients taking nitrates- due to risk of hypotension

Question 6

Orf

Answer 6

contagious ecythyma / contagious pustular dermatitis
Presentation: solitary lesion on the hands or fingers that progresses through 6 stages: maculopapular, target, acute weeping, nodular, papillomatous, finally regressive as it crusts and resolves
Self limiting and resolves within 3-6 weeks

Question 7

how is schistosomiasis transmitted

Answer 7

fresh water containing infected snails

Question 8

mode of transmission for leishmaniasis

Answer 8

sanfly bites

Dogs and rodents are reservoir hosts

Question 9

anticoags for stroke

Answer 9

If a TIA, start anticoag urgently. If moderate stroke: 5-7 days after. If severe stroke: 10-14 days after.

In a stroke without identifiable cause: DAPT with aspirin and clopidogrel . Then only one for lifelong
If stroke due to AF: Aspirin for 7 days then DOAC lifelong

Question 10

CRC guidelines and risk stratification and screening

Answer 10

Category 1 - similar risk as the general population

Asymptomatic people with no family history of colorectal cancer OR
One 1st-degree relative with CRC ≥60 years
Screening: FOBT should be completed every 2 years from 45 years old as per usual screening protocol. Colonoscopy is generally not recommended.

Category 2 - moderately increased risk

Asymptomatic people with one 1st-degree relative CRC diagnosed <60 years OR
Two 1st-degree relatives with CRC at any age or one 1st-degree and one or more 2nd-degree relatives diagnosed at any age
Screening: Colonoscopy should be offered 5 yearly starting at 10 years younger than the earliest diagnosis of CRC in a 1st-degree relative, or age 50 (whichever is earliest).

Category 3 - high risk, without known hereditary cancer syndrome

Asymptomatic with two 1st-degree and one 2nd-degree relative with colorectal cancer, with at least one diagnosed before 50 years old OR
Two 1st-degree relatives and two or more 2nd-degree relatives diagnosed with CRC at any age OR
Three or more 1st-degree relatives with CRC at any age.
Screening: refer to the familial cancer clinic for genetic assessment before a screening decision is made if Lynch syndrome has not been excluded. If Lynch syndrome is excluded, colonoscopy should be offered every 5 years starting at 10 years younger than the earliest age of diagnosis of colorectal cancer in a first-degree relative or age 40 years (whichever is earliest)

Question 11

tx pertussis

Answer 11

5d azithromycin

Question 12

chagas disease

Answer 12

Trypanosoma cruzi- live in cracks and crevices of poorly constructed homes particularly those with mud walls, thatched roofs or adobe structures
Endemic to south america, now seen in australia

Question 13

acute tubulointerstitial nephritis

Answer 13

type 4 HSN triggered by penicillins, NSAIDS, cephalosporins, sulfonamides within days to weeks of starting them
Can be asx. Sympt: fever, maculopapular rash, flank pain, arthralgia
Increased serum creatinnine
U/A- microscopic hematuria, pyuria, eosinophiluria, WBC casts

Question 14

Associations - pyelonephritis

Answer 14

positive leukocyte esterase and bacteria on u/a. +/- nitrates

Question 15

when to specialist referal for lumbar disc herniation

Answer 15

1. no improvement of symptoms after conservative management
2. immediately if the patient shows high steppage gait
3. image findings of disc prolapse

Question 16

diagnostic features of pre-eclampsia

Answer 16

hypereflexia
elevated BP
hyperreflexia
clonus
abnormal liver function tests
significant proteinuria

Question 17

mng of pre-eclampsi

Answer 17

IV magnesium sulphate
4g loading dose followed by 1g per hour maintenance

Fluid balance monitoring and restriction to 80-100ml/hr as these pts are at risk of pulmonary edema

Question 18

treatment for uncomplicated gonhorrea

Answer 18

stat IM ceftriaxone + PO azithromycin

Question 19

tx for gonhorrea and chlamydia

Answer 19

gonhorrea- stat IM ceftriaxone + PO azithromyocin

Chalmydia - PO doxycycline

Question 20

salmonella exclusion criteria for food workers

Answer 20

exlcuded from work until 48 hours after symptoms resolve

Question 21

how is hepatitis A transmitted

Answer 21

fecal oral - sexual, consumption of contaminated food/water in travellers

Question 22

CEA ca?

Answer 22

CRC

Question 23

management of hepatitis A

Answer 23

supportive
contact tracing and post exposure prophylaxis to contacts- may be vaccination or Ig within 2 weeks
Abstain from sexual contact , not prepare food or drinks for others

Question 24

AFP ca ?

Answer 24

HCC

Question 25

CA15-3 ca?

Answer 25

breast ca

Question 26

CA 19-9 ca?

Answer 26

gastrointestinal ca- pancreatic, gallbladder, biliary tract, esophagus, gastric ca

Question 27

CA 125 ca?

Answer 27

ovarian ca

Question 28

Parkinson's management

Question 29

dyskinesia

Answer 29

involuntary , erratic, writhing movements of the face/arms/legs/trunk

Question 30

compare: diabetic peripheral neuropathy, alcoholic neuropathy, peripheral arterial disease, charcot-marie-tooth diease,

Answer 30

diabetic Peripheral neuropathy - distal symmetrical pattern affecting the feet first with reduced sensation to multiple modalities and diminished reflexes alcoholic neuropathy - sensory and motor symptoms in a non length dependent pattern - affects upper and lower limb. may have autonomic features. Concurrent nutritional deficiency PAD- intermittent claudication, critical limb ischemia. reduced pulses, cool extremities, pallor Charcot-marie-tooth disease- motor and sensory neuropathy. distal muscle weakness and wasting- esp peroneal muscles leading to foot drop. Pes cavus, hammer toes

Question 31

indications for reciving Hep A and Hep B vaccines

Answer 31

developmental disability chronic liver disease

Question 32

Lyssavirus

Answer 32

closely related to rabies trasmitted through bats- bites and scrathces

Question 33

next step: STEMI who has recieved fibrinolysis and 20% recovery in ST segment elevation after 90 min

Answer 33

transferring to tertiary PCI capable hospital for urgent coronary angiography and PCI

Question 34

What dx is important to consider in persisting transient synovitis

Answer 34

legg calve perthes disease

Question 35

what is cinacalcet

Answer 35

calcimimetic agent for parathyroid induced hypercalcemia

Question 36

when are monoclonal ab used in hypercaclemia

Answer 36

unresponsive to bisphosphonates or if CI due to renal impairment

Question 37

leg calve perthes

Answer 37

unknown cause - osteonecrosis of femoral head presents: hip pain and/or limp, MC in male children between 3-10yo with acute onset In early disease, XR often normal- MRI next (gold s)

Question 38

XR finsings in early leg calve perthes

Answer 38

normal

Question 39

risk factors for endometrial hyperplasia

Answer 39

obesity dm tamoxifen use

Question 40

next steps in a patient with post menopausal bleeding

Answer 40

cervical co test gyn assessment TVUS Refer for gyn assessment incl endometrial sampling

Question 41

dx of cushing's

Answer 41

2 confirmatory test: low dose dexamethasone suppresion, 24 hour urinary free cortisol, midnight salivary cortisol

Question 42

Huntington

Answer 42

AD Progressive chorea - irregular, flowing, non repetitive involuntary movements Cognitive decline esp executive function Psych symptoms - irritability, depression, impulsivity onset: 30-50

Question 43

Sydenham chorea

Answer 43

following group a streptococcal infection affects children and adolescents

Question 44

tourette syndrome

Answer 44

stereotyped, repetitive movements

Question 45

wilson disease

Answer 45

<30 yo neuropsychiatric symptoms liver disease kayser-fleischer rings

Question 46

creutzfeldt jakob disease

Answer 46

rapidly progressive dementia with myclonus rapid course - usually death within one year of symtpom onset

Question 47

xray features of heart failure

Answer 47

a-> E

Question 48

Confirmation of hepatitis A?

Answer 48

testing for IgM antibodies

Question 49

what factors increase risk for agranulocytosis

Answer 49

Women Older patients ashkenazi jewish descent more common in the first 6mo of treatm

Question 50

first line treatment of frost bite

Answer 50

rapid rewarming 37-42*

Question 51

what is given in clinically significant bleeding associated with warfarin

Answer 51

IV vitamin K and prothrombinex FFP added if lifethreatening

Question 52

Addisonian crisis/ acute adrenal insufficiency

Answer 52

hypotension resistant to fluid resus, hyponatremia, hyperkalemia, hyperpigmentation

Question 53

screening age for iFOBT

Answer 53

50-74

Question 54

most effective measure in preventing transmission of gastroenteritis and foodborne pathogens

Answer 54

hand hygiene secondary to this is proper food storage temperatures and timing

Question 55

fish consumption during pregnancy

Answer 55

avoid high mercury fish but consume low mercury fish 2-3 per week High in mercury: shark, swordfish, king mackerel and tilefish

Question 56

first line managemetn of patient with closed head injury and raised ICP

Answer 56

IV mannitol and hyperventilation

Question 57

fungal nail inf treatment

Answer 57

terbinafine