General AF

Question 1

Hypocalcaemia ECG findings

Answer 1

Prolonged QTc

Question 2

Sedating antihistamine

Answer 2

Chlorphenamine

Question 3

Recent sore throat, rash, arthritis, murmur

Answer 3

Rheumatic fever

Question 4

Which contraceptive might wheelchair users avoid?

Answer 4

COCP due to clotting risk

(wheelchair users are UKMEC 3)

Question 5

Recent travel + hyponatraemia =

Answer 5

Legionella

• best diagnosed by urinary antigen test

Question 6

HRT for woman without uterus?

Answer 6

Oestrogen without progesterone (“unopposed oestrogen”)

Question 7

Does HRT increase the risk of endometrial cancer?

Answer 7

Oestrogen does.

Progesterone doesn’t.

Question 8

Advantage of transdermal HRT vs tablets ?

Answer 8

Reduced risk of VTE, e.g. DVT

Question 9

When can you give HRT in current/past breast cancer?

Answer 9

NEVER

Question 10

Peri vs post-menopausal?

Answer 10

Post = 1 year since last period

Question 11

When to give oestrogen-only HRT?

Answer 11

Total abdominal hysterectomy AND Mirena IUS

Question 12

What causes a raised anion gap?

Answer 12

Increased organic acid production, e.g. diabetic ketoacidosis

(Normal anion gap = loss of bicarbonates which raises acid:base ratio, e.g. diarrhoea

Question 13

Latent TB - do you give the BCG vaccine?

Answer 13

NO, BCG is a live vaccine which can reactivate latent TB

Do a tuberculin skin test to exclude latent TB before giving BCG vaccine

Question 14

Drugs to avoid in pregnancy

Answer 14

LAMBAST CCC:
* Lithium
* Amiodarone
* Methotrexate
* Benzodiazepines
* Aspirin
* Sulphonamides
* Tetracyclines
* Carbimazole/ Citalopram- both debatable
* Chloramphenicol
* Ciprofloxacin

Question 15

Local anesthetic toxicity can be treated with ?

Answer 15

IV 20% lipid emulsion

Question 16

What actually is xanthochromia ?

Answer 16

Bilirubin in the CSF

due to breakdown of red blood cells in a bleed (subarachnoid haemorrhage)

Question 17

Bence-Jones proteins in urine?

Answer 17

Multiple myeloma

Question 18

Whooping cough started <21 days ago

Answer 18

Give azithromycin / clarithromycin

(if more than 21 days, supportive management only)

Question 19

Whooping cough - which antibiotics?

Answer 19

Macrolides, typically azithromycin or clarithromycin

Question 20

ABG results for salicylate overdose?

Answer 20

Respiratory alkalosis before metabolic acidosis

Question 21

What is used to replace prednisolone in the perioperative period?

Answer 21

IV hydrocortisone

Question 22

Cancer causing 1. hepatomegaly 2. haematuria

Is it renal cell carcinoma or hepatocellular carcinoma

Answer 22

Renal cell carcinoma

causes hepatosplenomegaly