End of block assessment

Question 1

Drug causes of hyponatraemia

Answer 1

SSRIs
PPIs
Loop and thiazide diuretics 
ACEI 
NSAIDs

Question 2

what drugs can be associated with complete heart block

Answer 2

B blockers
digoxin
CCB
(antiarrhythmics)

Question 3

What proportion of people with parkinsons have a slow shuffling gait with forward stoop

Answer 3

about a third

Question 4

when is a high steppage gait seen

Answer 4

in patients with foot drop

Question 5

What gait is seen in patients with stroke

Answer 5

hemiplegic gait where the steps are slower and the leg is dragged in an arc

Question 6

what is the cause of an antalgic gait

Answer 6

pain

Question 7

Cerebellar disease has increased muscle tone and exaggerated reflexes, true or false

Answer 7

False

Question 8

In cerebellar disease, Rhombergs test is positive, true or false

Answer 8

false, it is positive in sensory ataxia

Question 9

What is acute brain injury

Answer 9

non-degenerative injury to the brain resulting from trauma, stroke, hypoxia, metabolic conditions, tumour

Question 10

the gold standard method for diagnosing dementia is the MMSE, true or false

Answer 10

false

It requires a good history as well as examination

Question 11

a score of <10/30 is severe impairment in the MMSE, true or false

Answer 11

true

Question 12

Delirium is associated with increased mortality, true or false

Answer 12

true

Question 13

what can precipitate acute urinary retention

Answer 13

constipation - from impaction of stool on the bladder outflow tract
infection - inflammation and narrowing if urinary tract
medications - anticholinergics

Question 14

symptoms of urinary retention

Answer 14

anuria
urinary frequency 
urge incontinence
delirium 
palpable bladder

Question 15

what investigation can you do for urinary retention

Answer 15

post void bladder scan USS can confirm larger residual volumes

Question 16

management of acute urinary retention

Answer 16

catheterisation

Question 17

leucocytes, protein and blood from a catheter sample is indicative of infection, true or false

Answer 17

false

could be from irritation by the catheter, patient must have symptoms corresponding to a UTI

Question 18

risk factors for fractures in the elderly

Answer 18

smoking 
osteoporosis 
steroids
calcium and vit D deficiency 
previous fall 
older age 
sex hormone deficiency

Question 19

palliative care is only for patients with a diagnosis of cancer, true or false

Answer 19

false

patients can be referred for cancer, organ failure, chronic pain

Question 20

In AF, what do B blockers and digoxin control

Answer 20

ventricular rate

Question 21

how can amlodipine, perindopril and tamsulosin cause hypotension

Answer 21

through vasodilatation

Question 22

Topical B blockers can have systemic side effects, true or false

Answer 22

true

Question 23

How does digoxin cause hypotension

Answer 23

AV node blockade causes bradycardia and hypotension

Question 24

List drugs that can cause a tremor

Answer 24

salbutamol 
lithium 
sodium valproate
cyclosporin 
caffeine

Question 25

what is refeeding syndrome

Answer 25

fatal condition with hypophosphataemia/kalaemia/magnesaemia and arrhythmias occurs after feeding a malnourished patient with a high protein calorie intake

Question 26

A MUST score of ??? requires referral to a dietician

Answer 26

MUST >2

Question 27

criteria for diagnosing postural hypotension

Answer 27

``` SBP drop >20 DBP drop >10 taken after: 5 min flat 1 min standing 3 min standing ```

Question 28

How do PPIs work

Answer 28

inhibit gastric acid secretion through the H/K ATPase in gastric parietal cells

Question 29

side effects of PPIs

Answer 29

``` hyponatraemia decreased gastric acidity increased C.diff risk alopecia osteoporosis ```

Question 30

side effects of corticosteroids

Answer 30

``` weight gain thin skin osteoporosis myopathy thrush delirium / psychosis hypokalaemia insulin resistance / DM dyspepsia fluid retention adrenal suppression ```

Question 31

NSAID side effects

Answer 31

renal impairment PUD and GI bleeding fluid retention

Question 32

risk factors for osteoporosis

Answer 32

``` low BMI vit D and calcium deficiency female prolonged corticosteroid use FH ```

Question 33

what treatments can reduce fracture risk

Answer 33

bisphosphonates | Vit D + Calcium (but not alone)

Question 34

which patients have a waddling gait

Answer 34

those with proximal myopathy in the pelvic girdle