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General study MD3 > MD1+2 MCQs > Flashcards

MD1+2 MCQs Flashcards

1
Q

Which of the following micro-organisms is LEAST likely to cause acute bacterial meningitis?
Streptococcus pneumoniae Neisseria meningitidis Enterococcus faecalis

A

Enterococcus faecalis

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2
Q

NOT immuno-compromised, NOT pregnant, NO allergies, under 50 ; appropes empirical Rx for acute bacterial meningitis = ?
IV Ampicillin
IV Gentamicin
IV Ceftriaxone

A

IV Ceftriaxone

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3
Q

Which of the following is LEAST likely to cause community acquired pneumonia?
Streptococcus pneumoniae Staphylococcus aureus Mycopalsma
Legionella
Haemophilus In uenzae Chlamydia pneumoniae

A

Staphylococcus aureus

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4
Q

Which organism is NOT covered by Benzyl Penicillin?
Streptococcus pneumoniae Haemophilus In uenzae Pseudomonas Aeuruginosa

A

Pseudomonas Aeuruginosa

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5
Q

Which organism is NOT covered by doxycycline?
Proteus mirabilis
Mycoplasma
Chlamydia pneumoniae Legionella

A

Proteus mirabilis

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6
Q

Which of the following organisms is LEAST likely to cause a urinary tract infection?
Staphylococcus saprophyticus Staphylococcus aureus
Proteus
Klebsiella
Escherichia coli
Enterococcus faecalis

A

Staphylococcus aureus

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7
Q

Which of the following antibiotics would be LEAST reasonable for management of UTI?
Cefalexin
Nitofurantoin
Trimethoprim
Vancomycin

A

Vancomycin

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8
Q

Which of the following organisms is LEAST likely to cause cellulitis?
Streptococcus Pyogenes Klebsiella
Staphylococcus Aureus

A

Klebsiella

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9
Q

30 male (NKDA) presents w progressive R forearm skin redness, discomfort + purulent discharge; inpatient Rx choice = ?
Ceftriaxone
Gentamicin
Metronidazole
Flucloxacillin

A

Flucloxacillin

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10
Q

A 60 year old with acute right upper quadrant pain, fever and jaundice is managed as an inpatient. Which LEAST correct?
Gentamicin covers gram negatives
Ampicillin covers enterococcus
Renal function needs consideration prior to charting of gentamicin
Liver failure can be a consequence of cholangitis
Streptococcus is a common pathogenic organism of the biliary tract

A

Streptococcus is a common pathogenic organism of the biliary tract

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11
Q

Which of the following would be LEAST relevant in the work-up of a patient with working diagnosis bacterial meningitis?
Full Blood Count
Electrolytes, Urea, Creatinine Lipid studies
Coagulation studies
Blood Culture
CRP

A

Lipid studies

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12
Q

Which of the following would be LEAST relevant in the work-up of a patient with working diagnosis bacterial meningitis?
Lumbar Puncture
CT Brain
Chest x-ray
Urine Dipstick
Biliary Ultrasound

A

Biliary Ultrasound

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13
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis pneumonia? Vital signs are deranged.
Full Blood Count
EUC
CRP
Coagulation Studies
Blood Culture
Venous Blood Blood Gas

A

Coagulation Studies

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14
Q

Which of the following would be LEAST relevant in the work-up of pneumonia?
Chest x-ray
CT chest
Urine Dipstick

A

CT chest

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15
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis exacerbation COPD?
Patient is drowsy
Venous Blood Gas
Chest x-ray
FBC
EUC
Troponin
CRP

A

Troponin

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16
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis biliary sepsis?
Lipase
BNP
Venous Blood Gas
LFTs
Biliary Ultrasound
Blood Culture

A

BNP

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17
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis pyelonephritis? Creatinine is normal
Urine dipstick
FBC
EUC
Renal Tract Ultrasound

A

Renal Tract Ultrasound

18
Q

Which of the following would be LEAST relevant in the work-up of peri-wound cellulitis for admission? Normal vitals
Full Blood Count
EUC
Wound swab
Blood culture

A

Blood culture

19
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis septic arthritis?
FBC
EUC
LFTs
Joint aspirate
Joint x-ray
Blood culture

A

LFTs

20
Q

Which of the following would be LEAST relevant prior to emergency cholecystectomy for biliary sepsis?
FBC
EUC
ESR
Coagulation Studies
Group and Hold
LFTs

A

ESR

21
Q

Which of the following would be LEAST relevant in the work-up of working diagnosis PID?
Pelvic Ultrasound
Urine dipstick
FBC
EUC
CRP
Coagulation Studies

A

Coagulation Studies

22
Q

Which of the following is the SOFTEST indication for an ECG?
Chest pain
SOB in patient with T2DM on insulin
Syncope
Peripheral oedema
Epigastric pain
Palpitations

A

Peripheral oedema

23
Q

Working diagnosis of paediatric neisseria meningitidis CNS sepsis. Which of the following is LEAST time critical?
CT Brain
Support with oxygen as needed
Support with NG or IV fl uid including glucose as needed Antibiotics

A

CT Brain

24
Q

Which of the following is LEAST likely to cause a cardiac arrest
Severe Hypoxia
Severe Hypovolaemia
Severe Thrombocytopenia Severe Hyperkalaemia
Tension Pneumothorax
Severe Hypokalaemia

A

Severe Thrombocytopenia

25
Q

Which of the following is LEAST likely to cause a cardiac arrest?
Severe STEMI
Severe Pulmonary Embolism Cadiac Tamponade
Severe Diverticulitis

A

Severe Diverticulitis

26
Q

A 30 year old female presents to ED with 3 days worsening headache, photophobia,
neck stiffness and fever.
She is assessed to be septic on work-up. The patient has no allergies.
Based on the likely source of sepsis according to cluster of symptoms what would be
appropriate empirical antibiotic management:

A

Ceftriaxone

27
Q

A 60 year old male presents to ED with worsening productive cough, pleuritic chest
pain, shortness of breath and fever.
He is assessed to be septic on work-up. The patient has no allergies.
Empirical management based on source corresponding to presentation would
include two antibiotics covering which five organisms:

A

Amoxicillin and/or doxycycline

Streptococcus, Haemophilus, Chlamydia, Legionella, Mycoplasma

28
Q

A 50 year old female with known pancreatic cancer and past biliary stent placement
presents to ED with 5 days worsening right upper quadrant abdominal pain, jaundice
and fever. The patient has no known drug allergies.
On the presumption of sepsis, based on the presentation plus normal renal function
what would be the most likely empirical antibiotic management prior to any
indicated intervention:

A

Gentamicin plus Ampicillin plus Metronidazole

29
Q

A 20 year old male presents with worsening confluent erythema over his right lower
limb which is judged to be infective in nature and requiring admission to hospital. He
has no prior history of MRSA. He has no allergies. What would be the most
appropriate choice of antibiotic therapy?

A

Flucloxacillin

30
Q

A 42-year-old male with past history of recreational IV drug use presents to the ED
with back pain and fever; no other symptoms of infection.
Chest is clear to auscultation, abdomen is soft to palpation and there is no audible
cardiac murmur; no abnormal neurology at lower limbs, no evidence of sphincteric
dysfunction.
There is focal tenderness at T11 and T12 on vertebral column palpation. There is no
renal angle tenderness.
Blood culture yields positive for staphylococcus aureus subsequently on the ward.
What is the likely diagnosis and most common causative agent?

A

Infective discitis following bacteraemia in the setting of recreational IVDU

Staphylococcus aureus

31
Q

What are the tests to assess the severity of GI bleeding

A

CBC: Hb, Hct, platelet count
Coagulation panel
BMP: Increased BUN/Cr ration suggests a brisk Upper GI bleed

32
Q

Causes of Hyponatremia

A

Hypervolemic: Inappropriate upregulation of RAAS (and ADH) ie. HF, cirrhosis
Hypovolemic: Setting of appropriate upregulation of RAAS (and ADH) i.e. Addisonian crisis
Euvolemic: SIADH
Nutritional intake
Excessive water intake
Losses (sweat, diarrhoea)
Medications (thiazide diuretics)

33
Q

Symptoms of hyponatremia

A

Can be acute or chronic
Nausea
Headache
Confusion

34
Q

What might cause a falsely low serum sodium concentration (pseudohyponatremia)

A

Conditions with very high protein: multiple myeloma
Conditions with very high glucose levels: DKA

35
Q

Stages of hyperkalemia on ECG

A

Peaked T waves
Prolonged PR interval
Widened QRS/conduction blocks

36
Q

Causes of hyperkalemia

A

Renal failure
Rhabdomyolysis
Medications: Potassium-sparing diuretics (Spironolactone, ACE-Is, NSAIDs and digoxin)
Hypoaldosteronism
Hypocortisolism
Acidosis
Cell breakdown

37
Q

Conditions associated with AST<ALT LFT results

A

Viral hepatitis
Minor fatty liver disease
Extrahepatic causes
Cholestasis

38
Q

Conditions associated with AST>ALT LFT results

A

Alcoholic hepatitis
Decompensated cirrhosis, hepatocellular carcinoma
Liver metastases
Muscle damage
MI

39
Q

Universal RBC donor blood type

A

O negative

40
Q

Universal RBC recipient blood type

A

AB negative

41
Q

Universal FFP recipient blood type

A

O

42
Q
A

General study MD3 (8 decks)

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