Patient had hyperthyroidism. Treated with carbimazole. 2 weeks later gets a sore throat. What investigation?
28 year old lady with wide based gait and optic neuritis. What is the most appropriate investigation?
. Patient has had 20mls of lidnocaine 0.5%. Max is 3mg/kg and he weighs 80kg. How much more can you give?
Rugby tackle, anterior dislocation of shoulder. What test do you do before and after relocation?
Patient ex IVDU, want to see if he has chronic Hep C. What test?
Semi-dilated pupil, pain, hazy vision, headache, vomiting
Pt has MI, 2 days later new murmur and unwell. Harsh systolic murmur
Papillary muscle rupture
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?
Sympathetic system activation.
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
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?
Suppurative auricular lymph node
40 year old woman is anaemic, raised LDH, raised bilirubin. What test?
Direct coombs Liver biopsy
Pt in burning building at home. 3 days later he has flashbacks, nightmares and is upset. Returns to work a week later.
Acute stress reaction
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?
Angry patient who’s upset with the porters. What do you do?
Answer was “listen, reassure and inform her we will investigate”
What is the biggest intervention in a young person to reduce overall cancer risk?
Protection during sex
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.
Child has sore throat. 2 weeks later develops Proteinuria, dehydrated, polyuria, oedema. What is the cause?
Someone has been to Africa. Lost weight and has altered bowel habits. GP thinks he has parasite. What will be raised?
Child is unwell with sore throat. RR 40, drooling massively. What is the most immediate risk? Child didn’t have immunisations.
Patient has low Na, Low BP, K+ is raised. What is the commonest cause?
Congenital adrenal hyperplasia
Old man with thigh pain. Raised ALP, all else is normal. ESR and calcium not raised.
Man diagnosed with T2DM (not massively raised though). No eye or feet problems. Renal profile is fine. that treatment does he need?
Pt has raised BP on ambulatory monitoring. T1DM and proteinuria. What drug do you give?
Baby is 7 weeks old. 6 days history of vomiting large amounts after feeding. Otherwise fine, afebrile and appears hungry. What is the cause?
Patient has pain on walking. Angio shows calcified distal aorta and femorals on both sides. What is the best Mx?
Aortic-bifemoral bypass graft
Old man is anaemic, newly constipated and has had weight loss for 6 months. What has he got?
Small bowel cancer
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)
HIV +ve, has pneumonia, CXR showed ground glass appearance. What do you use to treat?
Patient has RA, has DEX and is -2.8. What is the best treatment option?
NB: In reality would be on ADcal D3 + bisphosphonates)
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?
Glucose finger prick
Patient has irregular 3cm pigmented lesion on shin with different colours. What is the most important next step?
Take pictures and follow up in 3 months
Scrapings for mycology