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Flashcards in Kings 2014 (Paper 1) Deck (61)
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1

Patient had hyperthyroidism. Treated with carbimazole. 2 weeks later gets a sore throat. What investigation?

 

Options:
Thyroid scan
FBC
Platelets
Throat swab
?

 

2

28 year old lady with wide based gait and optic neuritis. What is the most appropriate investigation?

 

Options:
CT head
LP
MRI
Muscle biopsy

3

. Patient has had 20mls of lidnocaine 0.5%. Max is 3mg/kg and he weighs 80kg. How much more can you give?

Options:

4

Rugby tackle, anterior dislocation of shoulder. What test do you do before and after relocation?

 

Options:


Radial pulse
BP
Axillary nerve
Radial Nerve

 

5

Patient ex IVDU, want to see if he has chronic Hep C. What test?

 

Options:
Antibody --- Antigen
Assay
PCR

 

6

Semi-dilated pupil, pain, hazy vision, headache, vomiting

 

Options:
Glaucoma

7

Pt has MI, 2 days later new murmur and unwell. Harsh systolic murmur

 

Options:
Papillary muscle rupture
AS

8

What makes someone cool, pale and clamy when unwell? Patient has dropping blood pressure, tachy and in shock. What is the underlying body mechanism for this response?

 

Options:

Sympathetic system activation.
Hypoglycaemia
Sympathetic
Inc ADH
Inc aldosterone
Cortisol

9

Lady with previous mastectomy for Breast Ca 4 years ago. Has become thirsty, polyuria and constipated. Now confused. What has caused it? No focal neurology

 

Options:
Cerebellar mets
Hyponatraemia
Hypercalcaemia
Infection
T2DM

 

10

Child with previous ear infection, now has acute hearing loss and “squishy BOGGY” mass behind ear. LMN signs on affected side of face. What is the cause?

 

Options:
Mastoiditis
Suppurative auricular lymph node
Otitis media

11

40 year old woman is anaemic, raised LDH, raised bilirubin. What test?

 

Options:
 AMA antibody
Direct coombs Liver biopsy
??

 

12

Pt in burning building at home. 3 days later he has flashbacks, nightmares and is upset. Returns to work a week later.

 

Options:
PTSD
Depression
Acute stress reaction
Bereavement reaction
Psychosis

 

13

Patient took a handful of pills with alcohol 2 days ago after an argument, now can't remember what he’s taken. Was on antidepressant medication. LFTs showed liver impairment and raised PT. What has he taken?

 

Options:
Paracetamol
Aspirin,
Fluoxetine,
Amitrytiline
Venlofaxine

14

Angry patient who’s upset with the porters. What do you do?

 

Options:
Answer was “listen, reassure and inform her we will investigate”

 

15

What is the biggest intervention in a young person to reduce overall cancer risk?

 

Options:
Lose weight
Protection during sex
Stop smoking
Alcohol control
Increase exercise

 

16

pt has headache, photophobia, neck stiffness, BP is lowish. What is the most appropriate Rx? Girl with meningitis symptoms what is the first med to give before LP. In hospital give cef, ben pen if in community.

 

Options:
Ceftriaxone
Acyclovir
Fluids

 

17

Child has sore throat. 2 weeks later develops Proteinuria, dehydrated, polyuria, oedema. What is the cause?

 

Options:
IgA nephropathy
Iatrogenic
Post strep
Acute glomerulonephritis

18

Someone has been to Africa. Lost weight and has altered bowel habits. GP thinks he has parasite. What will be raised?

 

Options:
Lymphocytes
Neutrophils
Basophils
Eosinophils
RBC

 

19

Child is unwell with sore throat. RR 40, drooling massively. What is the most immediate risk? Child didn’t have immunisations.

 

Options:
Asphyxia
Aspiration
Septic shock
Heart failure

 

20

Patient has low Na, Low BP, K+ is raised. What is the commonest cause?

 

Options:
Benign Adenoma
Auto immune
SIADH
Congenital adrenal hyperplasia
Overdose

 

21

Old man with thigh pain. Raised ALP, all else is normal. ESR and calcium not raised.

 

Options:
Pagets

22

Man diagnosed with T2DM (not massively raised though). No eye or feet problems. Renal profile is fine. that treatment does he need?

 

Options:

Metformin
Gliclazide
Orlistat
Insulin
DPP4
 

23

Pt has raised BP on ambulatory monitoring. T1DM and proteinuria. What drug do you give?

 

Options:
B-Blocker
ACE
Furosemide
Bendroflumethiazide
Verapamil

 

24

Baby is 7 weeks old. 6 days history of vomiting large amounts after feeding. Otherwise fine, afebrile and appears hungry. What is the cause?

 

Options:
Bowel obstruction
Pyloric stenosis 
Hirschprungs

 

25

Patient has pain on walking. Angio shows calcified distal aorta and femorals on both sides. What is the best Mx?

 

Options:
Stent
Aortic-bifemoral bypass graft
Embolectomy
Aortic endartherectomy

 

26

Old man is anaemic, newly constipated and has had weight loss for 6 months. What has he got?

 

Options:
Sigmoid Ca
Caecal angiodysplasia
Small bowel cancer
Ulcerative colitis
Diverticulitis
NB: Caecal Ca normally causes anaemia, sigmoid Ca often fresher blood. However, caecal not an option in THIS paper (but was in other years so check)

 

27

HIV +ve, has pneumonia, CXR showed ground glass appearance. What do you use to treat?

 

Options:
Doxy
Erythromycin
Gent
Co-trimaxole
Amox

 

28

Patient has RA, has DEX and is -2.8. What is the best treatment option?

 

Options:
Calcium supplements
Vit D
Bisphosphonates
HRT
NB: In reality would be on ADcal D3 + bisphosphonates)

 

29

Lady is pre-op and will need a GA. He has RA in hands, knees, hips and neck. She has HTN (150ish) and T2DM. What is the most important pre-op check?

 

Options:
Cervical XR
FBC
BP monitoring  
Glucose finger prick
ECHO

 

30

Patient has irregular 3cm pigmented lesion on shin with different colours. What is the most important next step?

 

Options:
Take pictures and follow up in 3 months
Scrapings for mycology
Biopsy
ACE level