Who is the breast cancer screening programme most often offered to in the UK?
Women aged 50 years of age and above who have reached menopause. (every three years)
Why would the BCG vaccine be given?
Travel to a country with a high TB rate
Parent / Grandparent born in a country with a high TB rate
TB in a relative or a close contact
Born or lived in a country with a high TB rate
When assessing a patients pain, what should you ask about?
SOCRATES Site Onset Character Radiation Associating Symptoms Time/Duration Exacerbators and Relieving Factors Severity
Which immunisations are given to a baby at 8 weeks (7)?
DTaP/IPV/Hib/HepB (6 in one) and PCV and MenB and Rota Diphtheria, Tetanus, Acellular Pertussis [whooping cough], Inactivated polio vaccine, Haemophilus Influenzae b [Hib] vaccine, Hepatitis B vaccine Pneumococcal vaccine Meningococcal B vaccine Rotavirus vaccine
Which vaccine is given to girls in year 8?
HPV (human papillomavirus vaccine) (two doses at least 6 months apart)
Which cells initiate the acute bronchoconstriction response to allergens ?
Mast Cels
Which vaccination is most commonly associated with fever?
Meningococcal B
When should you consider referring individuals using a suspected cancer pathway referral (two week wait) with regard to breast cancer?
Consider a suspected cancer pathway referral(for an appointment within 2 weeks)
people:
- With skin changes that suggest breast cancer or
- Aged 30 and over with an unexplained lump in the axilla (new NICE recommendation
for 2015).
When you suspect leukaemia, how quickly should a full blood count be assessed?
Within 48 hours
What are the grades of breast cancer?
low grade (G1) – the cells, although abnormal, appear to be growing slowly medium grade (G2) – the cells look more abnormal than low-grade cells high grade (G3) – the cells look even more abnormal and are more likely to grow quickly
What is the atopic march?
When somebody is prone to getting allergic conditions such as atopic dermatitis, atopic rhinitis and asthma (genetic and environmental factors)
When should you definitely perform an urgent X-Ray on somebody that you suspect may have lung cancer?
Offer an urgent chest Xray (to be performed within 2 weeks) to assess for lung
cancer in people aged 40 and over if they have 2 or more of the following
unexplained symptoms,orif they have ever smoked and have 1 or more of the
following unexplained symptoms:
- cough
- fatigue
- shortness of breath
- chest pain
- weight loss
- appetite loss
What are the six basic Activities of Daily Living?
Bathing and showering
Personal hygiene and grooming (including brushing/combing/styling hair)
Dressing
Toilet hygiene (getting to the toilet, cleaning oneself, and getting back up)
Functional mobility, often referred to as “transferring”, as measured by the ability to walk, get in and out of bed, and get into and out of a chair; the broader definition (moving from one place to another while performing activities) is useful for people with different physical abilities who are still able to get around independently.
Self-feeding (not including cooking or chewing and swallowing)
Which class of T Cells are predominant in asthma?
Th2
Which Immunoglobulin responds to allergic reactions? What type of immune reaction is this?
IgE - Type 1
What are the teenage booster vaccines?
dT/IPV (low dose diphtheria, tetanus, inactivated polio vaccine)
MenACWY (meningococcal ACWY vaccine)
What does a long acting inhaler contain?
Used once or twice a day to stop
symptoms occurring.
Contain corticosteroids, which reduce inflammation and swelling of airways.
Don’t work straightaway, so must keep using a reliever to begin with.
What do the Barlow and Ortolani Tests check for?
In babies, these tests check for Congenital Dislocation of the hip or Developmental Dysplasia of the Hip (DDH) - Part of the 8 Week Baby Check
Which immunisations are given to a baby at 16 weeks (5)?
DTaP/IPV/Hib/HepB (6 in one)and PCV and MenB
Diphtheria, tetanus, acellular pertussis [whooping
cough] - Part 3,
Inactivated polio vaccine - Part 3,
Haemophilus influenzae b [Hib] vaccine - part 3,
Hepatitis B vaccine and pneumococcal conjugate vaccine
Meningococcal B vaccine - part 2
Which immunisations are given to a baby at 12 weeks (5)?
DTaP/IPV/Hib/HepB (6 in one) and Rota
Diphtheria, tetanus, acellular pertussis [whooping cough] - part 2,
Inactivated polio vaccine - part 2,
Haemophilus influenzae b [Hib] vaccine - part 2,
Hepatitis B vaccine - part 2
Rotavirus vaccine - part 2
How would the differential diagnosis of asthma be confirmed?
If FEV1 improves by 12% or more with a beta-2-agonist
Diurnal variation in peak flow readings also indicates asthma
What pathology could an absent red reflex indicate?
Congenital cataract, Retinoblastoma, Refractive Error
What are the various grades of T in the TNM scoring system?
Primary tumor (T)
TX: Main tumor cannot be measured.
T0: Main tumor cannot be found.
T1, T2, T3, T4: Refers to the size and/or extent of the main tumor. The higher the number after the T, the larger the tumor or the more it has grown into nearby tissues. T’s may be further divided to provide more detail, such as T3a and T3b.
What are the various grades of N in the TNM scoring system?
Regional lymph nodes (N)
NX: Cancer in nearby lymph nodes cannot be measured.
N0: There is no cancer in nearby lymph nodes.
N1, N2, N3: Refers to the number and location of lymph nodes that contain cancer. The higher the number after the N, the more lymph nodes that contain cancer.
What is the atopic triangle?
Atopic Dermatitis (Eczema)
Atopic Rhinitis (Hayfever)
Asthma
These are the three most common allergic conditions
What are the risk factors for Breast Cancer?
Women who have reached menopause Over the age of 50 Genetic - BRCA1 & BRCA2 genes Also - TP53 and CHEK 2 genes Family History Previous History of Breast Cancer Dense Breast Tissue High Levels of oestrogen (late menopause/early periods/not having children) Hormone Replacement Therapy Contraceptive Pill Use Overweight/Obese Drinking Alcohol Previous Radiation Exposure
What are the stages of breast cancer?
stage is – the tumour is “in situ” and there’s no evidence of invasion (pre-invasive)
stage 1 – the tumour measures less than 2cm and the lymph nodes in the armpit aren’t affected; there are no signs that the cancer has spread elsewhere in the body
stage 2 – the tumour measures 2-5cm, the lymph nodes in the armpit are affected, or both; there are no signs that the cancer has spread elsewhere in the body
stage 3 – the tumour measures 2-5cm and may be attached to structures in the breast, such as skin or surrounding tissues, and the lymph nodes in the armpit are affected; there are no signs that the cancer has spread elsewhere in the body
stage 4 – the tumour is of any size and the cancer has spread to other parts of the body (metastasis)
What is the action of 5 alpha reductase inhibitors such as finasteride?
Converts testosterone to dihydrotestosterone which is more potent.
What pharmacological treatments can manage BPH?
Alpha Blockers such as tamsulosin PO
5 alpha reductase inhibitors such as finasteride PO
What tablets can be taken to manage asthma?
- Leukotriene receptor antagonists – to stop airways becoming inflamed
- Theophyllines – help widen airways
- Steroid tablets – reduce airway inflammation
What are various grades of M in the TNM scoring system?
Distant metastasis (M)
MX: Metastasis cannot be measured.
M0: Cancer has not spread to other parts of the body.
M1: Cancer has spread to other parts of the body.
When should you consider a PSA test?
- any lower urinary tract symptoms, such as nocturia, urinary frequency, hesitancy, urgency or retentionor
- erectile dysfunctionor
- visible haematuria
What is checked for in the blood of neonates?
Phenylketonuria
Hypothyroidism
Sickle Cell Disease
Which components make up the 6 in one vaccine given at 8, 12 and 16 weeks and where is this administered
Diptheria Tetanus Acellular Pertussis Inactivated Polio Vaccine Haemophilus Influenza B Hepatitis B Administered in the thigh (IM)
What does a short acting inhaler contain?
Usually contain a short-acting beta2-
agonist, such as salbutamol, salmeterol, formoterol, vilanterol.
They widen the airways, making breathing easier.
Used when needed to relieve symptoms quickly, and usually work for no longer than about 15 minutes.
What are some of the differential diagnosis of diarrhoea?
Irritable Bowel Syndrome
Inflammatory Bowel Disease (Crohns Disease and Ulcerative Colitis)
Malabsorption (e.g. coeliac disease or lactose intolerance)
Bowel Cancer, Malignancies, Lymphoma
Infectious Diarrhoea (Viral, foodborn, antibiotic associated, travel related - e. coli, giardia)
Chronic Pancreatitis
Diverticular Disease
Side Effect Of Medication
What is the MRC Dyspnoea Scale?
Breathlessness Scale
1 - Not troubled by breathlessness except for on strenuous exercise
2 - Troubled by shortness of breath when hurrying on the level or going up a slight hill
3 - Walks slower than people of the same age due to breathlessness or has to stop when walking at own pace
4 - Stops for breath when walking about 90m or after a few minutes on the level
5 - Too breathless to leave the house or breathless on dressing and undressing
When should you perform a FBC to test for leukaemia?
Patients with any of the following
- pallor
- persistentfatigue
- unexplainedfever
- unexplained persistent or recurrent infection
- generalised lymphadenopathy
- unexplained bruising
- unexplained bleeding
- unexplained petechiae
- hepatosplenomegaly
When should you definitely refer individuals using a suspected cancer pathway referral(two week wait) when suspecting breast cancer?
If they are aged 30 and over and have an unexplained breast lump with or without pain
or
If They are aged 50 and over with any of the following symptoms in one nipple only:
- Discharge
- Retraction
- Other changes of concern (new NICE recommendation for 2015)
What would be considered a non-urgent breast cancer referral?
People aged under 30 with an unexplained breast lump
with or without pain (new NICE recommendation for 2015).
Which lymphocytes lose balance in asthma due to airway inflammation?
T Helper Cells
Which investigations should be performed in somebody with chronic diarrhoea?
Full Blood Count
Ferritin - important for diagnosing anaemias and thalassaemias
CRP - for detecting causes of inflammation
ESR - helps to diagnose Crohns Disease
Tissue Transglutanimase Endomysial Antibodies IgA or IgG used to detect autoimmune conditions - particularly coeliac
Stool Culture
Faecal Calprotectin
Which immunisations are given to a one year old child (4)?
Hib/MenC (Haemophilus influenzae b [Hib] and meningococcal C vaccine)
PCV (pneumococcal conjugate vaccine)
MenB (meningococcal B vaccine)
MMR (measles, mumps, rubella)
What are the pre-school vaccinations? Given at 3 years and 4 months
DTaP/IPV or dTaP/IPV (diphtheria or low dose diphtheria, tetanus, acellular pertussis, inactivated polio vaccine)
MMR (measles, mumps, rubella vaccine)
When should you definitely refer individuals using a suspected cancer pathway referral (two week wait) when suspecting lung cancer?
- If they have chest Xray findings that suggest lung canceror
- Are aged 40 and over withunexplainedhaemoptysis (coughing up blood)
What is Cryptorchidism and what could it indicate?
Undescended testes, associated with lower fertility, higher risk for testicular tumours, inguinal hernias and torsion - also higher risk of psychological distress
What is the TNM scoring system (Brief overview)?
T – the size of the tumour
N – whether the cancer has spread to the lymph nodes
M – whether the cancer has spread to other parts of the body
How Is Breast Cancer Diagnosed?
Mammogram (X Ray of Breasts) & Ultrasound (if under 35), Biopsy of breast tissue and lymph nodes
CT, CXR & Liver Ultrasound may be required if it is suspected that cancer has spread.
Which vaccine is being offered annually from ages 2-17?
Influenza
What is checked in the 8 week baby check (14)?
Hips - Barlow and Ortolani - looking for DDH Eyes - Inspection & Red Reflex Heart - Colour, Pulses, Heart sounds, Murmurs Size: Head Circumference, Length and Weight Testes (in male) - Check if Descended Fontanelles Palate Spine Abdomen Urine System Passage of Meconium Hearing Locomotion Behaviour
What are the clinical features of Benign Prostatic Hyperplasia?
Frequency of Micturition
Nocturia
Delay in initiation of micturition
Post Void Dribbling
Acute Urinary Retention
Retention with Overflow incontinence (Involuntary release of urine due to an overfull bladder)
Enlarged smooth prostate on rectal examination
What spirometry result would indicate airflow limitation?
FEV1/FVC ratio of less than 70%