EOY Mock SAQ paper

Question 1

Apart from paediatricians and psychiatrists, state 4 professionals who can contribute to a diagnosis of ASD

Answer 1

CAMHS nurse
Speech and language therapist
Occupational Therapist
Educational psychologist
Teacher

Question 2

DDx for ASD in teenagers?

Answer 2

OCD

Question 3

Give some medical conditions that are comorbid with ASD

Answer 3

ADHD
Epilepsy
Fragile X
Visual and hearing impairement

Question 4

Give 2 features assocaited with poor prognosis in ASD

Answer 4

lack of speech before 5 years
IQ below 50

Question 5

What behavioural strategies can you suggest to manage constipation?

Answer 5

scheduled toileting
reward charts
use of a bowel diary
addressing psychological issues

Question 6

What is the most appropriate drug class for simple constipation in kids? Give a named example

Answer 6

Macrogol e.g. Movicol

Question 7

What is the role of a health visitor?

Answer 7

Offer support and encouragment to families through early years from pregnancy and birth to primary school

Question 8

Give some physical signs and behaviours to suggets physical abuse in an older person

Answer 8

Signs:
weight loss
pressure sores
hypothermia
dehydration
injuries

behaviours:
withdrawn
not wanting to be left alone/ with certain people

Question 9

Risk factors for elder abuse?

Answer 9

social isolation
memory problems
communication problems
carer has addictions e.g. alcohol or drugs

Question 10

How can you reduce risk of refeeding syndrome?

Answer 10

replace B vitamins
reintroduce food slowly

Question 11

Give some immediate management steps for a patient with a subdural bleed

Answer 11

stop anticoagulants
monitor GCS with regular neuro obs
contact neurosurgeons

Question 12

MOA of apixaban?

Answer 12

factor Xa inhibitor

Question 13

Give a scoring system that assesses risk of stroke in non-anticoagulated patients

Answer 13

CHADS2 VASc

Question 14

Give a scoring system that assesses risk of major bleeding on anti-coagulation

Answer 14

ORBIT

Question 15

Which antihypertensive carries a higher risk of postural hypotension?

Answer 15

amlodipine

Question 16

State some physical complications of AN

Answer 16

Heart failure
Arrythmias
Osteoporosis
Anaemia
Amenorrhea

Question 17

2 recommended psychological therapies for AN?

Answer 17

CBT - ED
MANTRA

Question 18

What blood tests are important to support a diagnosis of NMS?

Answer 18

FBC, U&Es, LFTs
Creatine kinase

Question 19

Other than headache and sxs of PMR, give some features that would suggest a diagnosis of temporal arteritis

Answer 19

jaw claudication
tender temporal artery on palpation
fever
vision loss
WL and night sweats

Question 20

Give some adverse effects of tx with a systemic steroid

Answer 20

osteoporosis
diabetes mellitus
weight gain
myopathy
risk of infection

Question 21

What can be prescribed for osteoporosis?

Answer 21

bisphosphonate
Adcal D3 (calcium and vitamin D supplement - must say both for mark)

Question 22

Explain how GCA can cause vision loss

Answer 22

vasculitis affects the central retinal artery leading to reduction in blood flow to the retina

Question 23

Describe the pathophysiology of bradykinesia in PD

Answer 23

Neuronal degeneration in the nigrostriatal pathway leads to dopamine deficiency in the basal ganglia

Question 24

Name two dopamine receptor agonists that can be prescribed in PD

Answer 24

ropinirole
rotigotine

practice SAQ answers say avoid bromocriptine and cabergoline due to risk of valve disease

Question 25

Give some non-motor manifestations of PD

Answer 25

Mood changes Hallucinations Sleep disorder Hypotension

Question 26

What class of drug is rasagiline? Name 4 side effects

Answer 26

Monoamine -oxidase B inhibitor abdominal pain arthralgia postural hypotension sleep disorder

Question 27

What ddx should you consider for otitis media with effusion?

Answer 27

adenoidal enlargement

Question 28

Give 4 sxs of otitis media with effusion besides pain and difficulty hearing

Answer 28

nasal obstruction associated asthma / eczema snoring

Question 29

What specific features need to be seen on Dix-Hallpike to diagnose BPPV?

Answer 29

latency torsional geotropic nystagmus fatigue

Question 30

Outline the investigations you would do for new vaginal discharge and what each one is looking for

Answer 30

High vaginal swab - BV and candidiasis Endocervical swab - Chlamydia Trachomatis and Neisseria Gonorrhoea Urinary PCR

Question 31

What 3 components of triple assessment are performed at breast clinic?

Answer 31

clinical examination imaging - USS / mammography FNA cytology / core biopsy

Question 32

Give 4 features that suggest poor prognosis of breast cancer

Answer 32

large primary tumour poor differentiation axillary lymph node spread BRCA positive

Question 33

What should prompt a referral for BRCA mutation screening?

Answer 33

relative with breast cancer < 50 male relative with breast cancer

Question 34

What red flags would prompt a 2ww for upper GI endoscopy?

Answer 34

dysphagia haematemesis melaena abdominal mass upper epigastric pain

Question 35

What type of anaemia is most likely to be seen in someone with gastric cancer

Answer 35

IDA due to chronic blood loss depleting iron stores test ferritin

Question 36

Give dietary advice for someone who has undergone a gastrectomy

Answer 36

small meals - reduces dumping syndrome B12 injections - loss of IF Calcium supplements

Question 37

What associated conditions should you screen for in an eczema hx?

Answer 37

asthma hayfever urticaria food allergy

Question 38

What is lichenification? What does it suggest if a child with eczema has lichenification?

Answer 38

skin thickening/ hyperpigmentation exaggerated skin lines suggests eczema is chronic

Question 39

Give some side effects of topical steroids

Answer 39

skin thinning telangiectasia excessive hair growth folliculitis

Question 40

give some alternatives to topical steroids that can control inflammation in eczema

Answer 40

topical immunomodulators topcial calcineurin inhibitors