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General study MD3 > MD1+2 MCQs > Flashcards

MD1+2 MCQs Flashcards

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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

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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

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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

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

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

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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

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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

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

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A

Severe Thrombocytopenia

25
Which of the following is LEAST likely to cause a cardiac arrest? Severe STEMI Severe Pulmonary Embolism Cadiac Tamponade Severe Diverticulitis
Severe Diverticulitis
26
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:
Ceftriaxone
27
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:
Amoxicillin and/or doxycycline Streptococcus, Haemophilus, Chlamydia, Legionella, Mycoplasma
28
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:
Gentamicin plus Ampicillin plus Metronidazole
29
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?
Flucloxacillin
30
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?
Infective discitis following bacteraemia in the setting of recreational IVDU Staphylococcus aureus
31
What are the tests to assess the severity of GI bleeding
CBC: Hb, Hct, platelet count Coagulation panel BMP: Increased BUN/Cr ration suggests a brisk Upper GI bleed
32
Causes of Hyponatremia
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
Symptoms of hyponatremia
Can be acute or chronic Nausea Headache Confusion
34
What might cause a falsely low serum sodium concentration (pseudohyponatremia)
Conditions with very high protein: multiple myeloma Conditions with very high glucose levels: DKA
35
Stages of hyperkalemia on ECG
Peaked T waves Prolonged PR interval Widened QRS/conduction blocks
36
Causes of hyperkalemia
Renal failure Rhabdomyolysis Medications: Potassium-sparing diuretics (Spironolactone, ACE-Is, NSAIDs and digoxin) Hypoaldosteronism Hypocortisolism Acidosis Cell breakdown
37
Conditions associated with AST
Viral hepatitis Minor fatty liver disease Extrahepatic causes Cholestasis
38
Conditions associated with AST>ALT LFT results
Alcoholic hepatitis Decompensated cirrhosis, hepatocellular carcinoma Liver metastases Muscle damage MI
39
Universal RBC donor blood type
O negative
40
Universal RBC recipient blood type
AB negative
41
Universal FFP recipient blood type
O
42

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