Patient with blurring of their vision, red eye and pain.
Patient with oral ulcers, rash on face and pleuritic chest pain. What Ix?
Child stabs himself in the eye with a pencil. He has an irregular pupil, excessive lacrimation, red eye and pain. What suggests a penetration of the globe?
Patient in mid 20s has sore throat, few weeks later gets several discrete scaly lesions over drunk and proximal limbs. What is it?
60 year old male has painless haematuria. Dipstick shows blood ++. What investigation do you need to do?
21 year old girl has acne. Tried a number of treatments but still has comedones. GP prescribes Isoretanoin. What else should you prescribe?
Patient has severe abdo pain. Examination reveals tinkling bowel sounds, AXR shows gas under the diaphragm. What is the cause?
Man worried about his MI risk. He has brother with high cholesterol and MI aged 45. Father died of MI aged 62. He’s a non-drinking non smoker. BMI of 32. What is the most important intervention to reduce risk of MI?
Woman aged 40(ish) with T2DM. Her BMI is 28 and HBA1C is raised (?64). What management plan?
Clear IGTT test results to interpret.
Patient has metaclopramide IV with morphine. 10 minutes later develops upward looking eyes, neck is flexed and agitated. What do you use to treat?
Old lady has fall. Presents with externally rotated and shortened leg. Where is the break?
Head of femur
Neck of femur
. Patient has dry gritty eyes. They are noted to have submandibular swellings. What is the cause?
54 year old lady presents with PV bleed. Hasn’t has period in 3 years. What is the next step in Mx?
Watch and wait
Refer to gynae
Young adult male with back pain for 6 weeks worse in the morning. Has a number of tests, all antibodies return negative. What is the cause?
Mechanical back pain
Patient with diabetes has renal and eye disease. Wakes up at night with leg pain. What is the first line treatment? NB: no option for duloextine (which would be the first line in diabetes)
Patient presents with lung cancer in the left apex. Has Ptosis. What else would you expect from the face?
Young adult male schizophrenic treated with risperidone. Develops bitemporal hemianopia and bilateral nipple discharge. What test would help confirm the diagnosis?
MRI of brain
Old lady is brought in by daughter. She has been deteriorating for 3 days. Has been noticed by neighbours shouting and banging during the night and appears dishevelled. What is the cause?
24 year old male notices a testicular lump 2 weeks ago after a football injury. It is 3cm, in the testicle hard and irregular. It does not trans-illuminate. What is it?
Man has months of dribbling, incomplete voiding. PR shows prostate has one side harder than the other but smooth. His PSA is “significantly” elevated. What is it?
Patient on 40% oxygen has ABG. They have PaO2 - 8, PaCO2 9, pH 7.3, Bicarb normal. What is the first thing you should do? (Patient has COPD)
Patient presents to GP with fine tremor and weight loss after a flu like illness 3 weeks ago. They have a smooth, slightly enlarged goitre. T4 is high, TSH low. Iodine uptake suppressed after 6 hours. What is the cause?
Toxic multinodular goitre
Patient presents with coarse tremor and drowsiness. They have been on stable bipolar treatment for 10 years with Lithium. What test do you need to do first? She has been taking ibuprofen for back pain for last few months. She has been unsteady on her feet. What is the first ix to do?
Patient has T1DM that has been well controlled. He has had vitiligo for 10 years on his arms. He presents gaining weight and drowsy. What test do you need to do?
Finger prick glucose
Patient has leg pain on walking shown to be femoral stenosis. His ABPI is 0.84. What is the best management plan?
Patient has “irregular” heart beat and a mid diastolic murmur. They already have heart failure. What other complication is the biggest long term risk?
Left ventricular hypertrophy
Patient presents with paroxysmal sweating and palpatations. Scan shows isolated adrenal adenoma. What test do you need to do?
Patient is post op. They have been given 5% dex for a 24 hours. Blood tests show low Na and they are now drowsy. Why?
Brain shrinkage (worded better in exam)
Patient is drinking 5-10 units a day. They do not want to stop drinking as they don’t see the point. What is the best way to get them to stop?
Referral to drug and alcohol