Medicine

Question 1

First line treatment of SVT (fluttering in chest, tachycardia)

Answer 1

Carotid sinus massage (valsalva manoeuvre to stimulate vagus nerve!)

Question 2

Test for carcinoid syndrome

Answer 2

24hr urine 5-HIAA

Question 3

Medication to calm carcinoid syndrome

Answer 3

Octreotride

Question 4

Which side of the heart does carcinoid affect?

Answer 4

Right side

Question 5

Which valves are affected in carcinoid syndrome

Answer 5

Tricuspid insufficiency

Pulmonary stenosis

Question 6

Which scoring system for NSTEM?

Answer 6

GRACE

Question 7

Management of ACS

Answer 7

300mg aspirin stat
Oxygen
Morphine if severe pain

Question 8

GI bleed can raise which electrolyte?

Answer 8

Urea

Because it’s like a big meal

Question 9

How long do cluster headaches last for?

Answer 9

15min - 2hr

Question 10

Opioid that you can use in neuropathic pain

Answer 10

Tramadol

Question 11

Pneumonia in alcoholic

Answer 11

Klebsiella

Question 12

Gallbladder removal leading to runny poo, what’s the problem and what’s the treatment?

Answer 12

Too much bile acid
Use bile acid sequestration with cholestyramine
Chole!

Question 13

Post operative breathlessness DDx

Answer 13

PE 
Atelectasis (collapsed airways due to bronchial secretions/intubation)

Question 14

Mx of atelectasis

Answer 14

Position pt upright 
Chest physiotherapist (breathing exercises)

Question 15

Management of cluster headache (behind eye, excessive lacrimation)

Answer 15

High flow oxygen

Triptans

Question 16

Persistent ST elevation post MI
No chest pain
Tiredness
Signs of heart failure

Answer 16

Left ventricular aneurysm

Question 17

Child with recurrent infections and anaemia, worried about X. What should you do?

Answer 17

Leukaemia (ALL)

FBC in <48hr

Question 18

Symptoms of leukaemia

Answer 18

Pallor
Persistent fatigue 
Unexplained fever
Infections 
Generalised lymphadenopathy 
Unexplained bruising and bleeding 
Persistent bone pain

Question 19

Throat surgery complications

Answer 19

Laryngeal nerve damage
Bleeding -> can cause airway compromise, need to remove the sutures to relieve pressure!
Damage to parathyroid glands can cause hypocalcaemia

Question 20

What do you do with patients on anticoagulants that present with TIA/stroke symptoms?

Answer 20

Immediate scan to rule out haemorrhage

Question 21

Barium swallow for persistent heartburn shows fungus above the diaphragm, what is this?

Answer 21

Hiatus hernia (usually sliding)

Question 22

PR interval in WPW

Answer 22

Shortened

Question 23

Features on ECG for Wolff Parkinson White

Answer 23

Short PR interval
Slurred upstroke = delta wave
Can rapidly develop into VF

Question 24

Patient with suspected pancreatitis, what do you do about their food and fluids?

Answer 24

If they are hungry, they can eat

They need aggressive fluid therapy

Question 25

Blue hands in the cold, lymphoma Hx =>

Answer 25

Cold AIHA

Basically, an autoimmune haemolytic disease that will cause a macrocytic anaemia

Question 26

What are the 2 types of AIHA?

Answer 26

Warm and cold