Kings 19

Question 1

Photo of hand with lesions

Answer 1

Lichen Planus

Question 2

What causes a lucid interval?

Answer 2

EDH

Question 3

Asthma exas. most likely cause?

Answer 3

Viral infection

Question 4

17 girl visual loss after witnessing RTA

Answer 4

Acute stress reaction?

Question 5

Lung Cancer on CXR and flushing?

Answer 5

5HT from carcinoid

Question 6

SIADH sodium?

Answer 6

hyponatraemia

Question 7

What’s a poor prognostic indicator in a icu pt who’s incubated?!

Answer 7

I went for brainstem reflexes but surely it’s in the Apache II??

Apache ii:
AaDO2 or PaO2 (depending on FiO2)
Temperature (rectal)
Mean arterial pressure
pH arterial
Heart rate
Respiratory rate
Sodium (serum)
Potassium (serum)
Creatinine
Hematocrit
White blood cell count
Glasgow Coma Scale

Question 8

2.5 Cm breast lump encapsulated with a septum excised?

Answer 8

cyst - actually this could be fibroadenoma?

Question 9

Intermittent breast bleeding?

Answer 9

Duct Papilloma

Question 10

Palliative care, breathlessness?

Answer 10

morphine

Question 11

non haemolytic febrile reaction, increase in temp when giving blood products

Answer 11

give paracetamol

Question 12

headache, unilateral poor vision over a few days

Answer 12

glaucoma

Question 13

left red eye and fixed dilated pupil, pain?

Answer 13

glaucoma (uveitis is constricted)

Question 14

treatment for complete heart block

Answer 14

pacing

Question 15

VT on ECG and BP 80/60. Treatment?

Answer 15

Cardioversion

Question 16

Ketones from breakdown of fat or proteins?

Answer 16

fat

Question 17

What artery supplies left colon?

Answer 17

IMA

Question 18

Sever epigastric pain, collapsed, regains conscious after fluid. BP 56/40. What is it?

Answer 18

AAA

Question 19

Woman with palm lacerations. Weak flexion of MCP and PIP middle finger. What is it?

Answer 19

FDS

Question 20

What are the lumbricals?

Answer 20

intrinsic muscles of the hand that flex the metacarpophalangeal joints and extend the interphalangeal joints.

Question 21

haemarthrosis and pain on lateral aspect of knee?

Answer 21

ACL but can be collateral

Question 22

Achilis tendon rupture investigation

Answer 22

USS

Question 23

Ascites and liver failure but no symptoms. Treatment?

Answer 23

Spironolactone/can just fluid restrict

Question 24

Open sucking chest wound and SOB? What is it?

Answer 24

Tension pneumothorax

Question 25

visuospatial problems lobe?

Answer 25

Parietal lobe

Question 26

Delirium treatment?

Answer 26

Lorazepam

Question 27

Diabetes with slurred speech. Most important Ix

Answer 27

BM

Question 28

Repeated Diabetes with slurred speech.

Answer 28

TIA?

Question 29

gram positive cause of pneumonia diplococcus?

Answer 29

S. pneumonia

Question 30

Gram negative diplococcus causes an STI?

Answer 30

Gonorrhoea

Question 31

ECG showing massive tall tented t waves. what is it?

Answer 31

hyperkalemia

Question 32

Elderly lady - new microcytic anaemia (hb 95). low ferritin, normal iron and no other symptoms. refuses endoscopy. What is next option? 1) remove all treatment 2) blood transfusion 3) oral ferrous sulphate 4) CT abdo 5) colonoscopy

Answer 32

CT abdo

Question 33

Pt fluctuating between diarrhoea and constipations. Has irregular eating pattern so is changing it to be more normal. What diet mods can the make to help with symptoms? 1) olive oil and oily fish 2) pulses and legumes 3) whole wheats and whole grains 4) dried and fresh fruit 5) oats and lineseed

Answer 33

oats and lineseed (IBS)

Question 34

65 year old woman from Afghanistan to the UK recently with a hx of HTN and hypercholesterol. Complains of bilateral reduction of visual acuity. Image shown. 1) diabetic maculopathy 2) central retinal artery thrombosis 3) central retinal vein thrombosis 4) HTN retinopathy 5) idiopathic intracranial HTN

Answer 34

probs the HTN one?

Question 35

ECG with tented t waves

Answer 35

hyperkalemia

Question 36

diabetic obese woman with necrotosing fascitis - surgical debridement - hydrocortisone

Answer 36

debridment (though dont know if diff in DM)

Question 37

Lady with recent IV abx for infection. Now c.diff with diarrhoea. What treatment? 1) Clindamycin PO 2) Ciprofloxacin PO 3) Loperamide PO 4) Metronidazole PO 5) Vancomycin IV

Answer 37

met PO

Question 38

Best way for BMI 35 to lose weight pre elective cholecystectomy? 1) Join a gym 2) Advise healthy eating 3) Join a diet support group 4) Reduce salt 5) Get bariatric surgery

Answer 38

healthy eating