Important Facts

Question 1

Important to stop this medication before an endoscopy

Answer 1

Stop PPI/H2 Antagonist 2 weeks for an endoscopy

Question 2

Important to give to patient awaiting results for PE

Answer 2

Give anticoagulants to patients awaiting results of suspected PE

Question 3

Patients require this medication post-ablation

Answer 3

Patients require Apixaban post-ablation

Question 4

Used to treat Torsades de Point

Answer 4

IV Magnesium Sulphate is used to treat Torsades de Point

Question 5

Poor prognostic indicator for patients with ACS

Answer 5

Cardiogenic shock in patients with ACS is a poor prognostic indicator

Question 6

Bone pathology associated with normal blood results

Answer 6

Osteoperosis

Question 7

Treatment for Carpal Tunnel

Answer 7

Trial of conservative treatment of wrist splint +/- steroids FOR mild/moderate symptoms

Question 8

Pharmacological treatment for Raynaud’s

Answer 8

CCBs such as amlodipine or felodipine

Question 9

Tension pneumothorax causes:
a) Hypertension
b) Hypotension
Why?

Answer 9

B - Hypotension
Due to cardiac outflow obstruction

Question 10

Ankylosing spondylitis diagnosis supported by ___ on pelvic XR

Answer 10

Supported by sacro-ilitis

Question 11

Steroids increase risk of ___ in bones

Answer 11

Osteonecrosis

Question 12

____ flexure is most commonly affected in Ischaemic colitis

Answer 12

Splenic flexure is most commonly affected

Question 13

Over 99% of patients are +ve for ____ in SLE

Answer 13

ANA

Question 14

Patients with established CVD (e.g. IHD, stroke, PVD) should take ____

Answer 14

High intensity statin therapy (e.g. Atorvastatin 80mg) regardless of baseline lipid profile

Question 15

Important for diagnosis of Occupational Asthma

Answer 15

Serial peak flow measurements at work and at home

Question 16

_____ should be offered to for patients with newly diagnosed Parkinson’s and it’s alternative treatment is ____

Answer 16

Levadopa - most effective treatment for motor symptoms such as tremor and bradykinesia

Dopamine agonist is alternative treatment such as pramipexole or ropinirole but this is usually for mild symptoms

Question 17

Defective downward gave and vertical diplopia = ____ nerve palsy

Answer 17

4th - Trochlear

Question 18

Defective eye abduction and Horizontal Diplopia = ____ nerve palsy

Answer 18

6th - Abducens

Question 19

Ptosis + ‘down and out’ + dilated fixed pupil = ____ nerve palsy

Answer 19

3rd - Oculomotor

Question 20

Treating Anaemia in CKD

Answer 20

Correct iron deficiency before starting EPO-stimulating agents

Question 21

First-line drug management of VT

Answer 21

Amiodarone
Lidocaine can also be used

Question 22

First-line treatment for absence seizures

Answer 22

Ethosuximide

Question 23

Most common organism causing infective exacerbations of COPD

Answer 23

Haemophilus influenzae

Question 24

Patients with ascites secondary to liver cirrhosis should be given ____

Answer 24

Spironolactone
Preferred diuretic as they combat sodium retention

Question 25

Key finding for Aortic Dissection on CT angiography

Answer 25

False lumen in the ascending aorta

Question 26

Key finding for Aortic Aneurysm in CT Angiography

Answer 26

Ballooning of the aorta

Question 27

Lateral medullary syndrome

Answer 27

Cerebellar signs, contralateral sensory loss and ipsilateral Horner's Shows PICA lesion Ataxia, nystagmus, same side Horner's, opposite side diminished sensation

Question 28

Vitamin ___ is teratogenic in high doses

Answer 28

Vitamin A

Question 29

Motionless staring, Lip-smacking + Post-ictal dysphasia localising features of ____

Answer 29

Temporal lobe seizure

Question 30

First-line management of acute pericarditis

Answer 30

Combination of NSAIDs and Colchicine

Question 31

NSTEMI management depending on GRACE score

Answer 31

If GRACE score is >3%, patient should have coronary angiography within 72 hours

Question 32

First-line + second-line antibiotics for C.diff

Answer 32

Oral Vancomycin Intravenous metronidazole added for life-threatening infection Oral Fidaxomicin is second-line therapy and may also be used for recurrent cases

Question 33

Blood tests to monitor Haemochromatosis

Answer 33

Ferritin and Transferrin

Question 35

How is Anion Gap Calculated?

Answer 35

(Na + K) - (Cl - HCO) Normal range 10-18mmol/L

Question 36

Causes of Normal Anion Gap Metabolic Acidosis

Answer 36

- Gastro bicarbonate loss - Renal tubular acidosis - Drugs (acetazolamide) - Ammonium chloride injection - Addison’s disease

Question 37

Causes of Raised Anion Gap Metabolic Acidosis

Answer 37

- Lactate : shock, hypoxia - Ketones : DKA, alcohol - Urate : renal failure - Acid poisoning : salicylates, methanol

Question 38

Causes of Metabolic Alkalosis

Answer 38

- Vomiting/ aspiration - Diuretics - Liquorice, carbenoxolone - Hypokalaemia - Primary hyperaldosteronism - Cushing’s - Bartter’s - CAH

Question 39

Causes of Respiratory Acidosis

Answer 39

COPD Decompensation in other resp conditions (asthma, pulmonary oedema) Sedative drugs : benzodiazepines, opiate overdose

Question 40

Causes of Respiratory Alkalosis

Answer 40

- Anxiety leading to hyperventilation - Pulmonary embolism - Salicylate poisoning - CNS disorders : stroke, SAH - Altitude - Pregnancy