MICA

Question 1

how to approach hyponatraemia

Answer 1

remember pseudohyponaetraemia (if sugar, protein and cholesterol low)

Question 2

What are causes of SIADH

Answer 2

lung: small cell, pneumina
brain: lesion
drugs: SSRI, carbamazepine

Question 3

What are reasons fro admission with SIADH

Answer 3

symptomatic or hypovalaemic

Acute or severe hyponatraemia below 125

Question 4

What is the treatment for SIADH

Answer 4

stop the drugs

Question 5

how do you manage hyperthyroidism

Answer 5

FIRST line Carbimazole - started by specialist

bone marrow suppression (presents sore throat do a FBC)

propylthiouracil - started by specialist

second line - due to liver failure (first line if pregnant)

beta blocker

LONG TERM
radioidine

Surgery

Question 6

AF management

Answer 6

HIGH Risk

pulse over 150

hypotension

loss of consciousness

chest pain

syncope

severe shortness of breathlessness

Question 7

Diagnostic criteria of type 2 diabetes

Answer 7

Hba1c over 48

asymptomatic more than one test

symptomatic one

DON’t use in children pregnant or FBC abnormalities

Question 8

Treatment of AF if non highr risk

Answer 8

New- cardioversion and anticoagulation

Not new- rate control (BB or CBB or digoxin)

anticoagulate

asses for underlying causes (bloods, tapes and ECho)

Question 9

are all target Hba1c targets the same?

Answer 9

no

Question 10

What are 4 diabetes drugsand their main side effects

Answer 10

Metformin

Sulphanyleureas

Question 11

What are long term problems of diabetics

Answer 11

Macr

neuropathy:

retinopathy:

Nephropathy:

Question 12

what are risk factors for osteoporosis

Answer 12

steroid use

smoking

etoh

inactivity

menopause

conditions (rheum, eno, GI)

Question 13

which patients should get a dexa scan?

what is the risk score?

Answer 13

FRAX score

over 50 - go straight

Question 14

who doesn’t need to even have a dexa scan

Answer 14

patients with hip fractucres

Question 15

whatis the management of osteoporosis?

Answer 15

weight bearing exercise

balanced diet

Vit D

bone sparing treatments

HRT

Question 16

how do you take your bisphophonates?

Answer 16

empty stomach - 30min before eating

with a glass of water

stand for a while afterwards

Question 17

what could bad red flag causes of back pain be?

Answer 17

Question 18

How do you differentiate a cauda equina vs. spinal cord compression

Answer 18

cauda equina - lower motor

cord compression - upper motor neurone lesion

Question 19

WHat is the immidiate management of Caudia equina or spinal cord compression

Answer 19

both send for emergency spine MRI

Question 20

What are differentials for an acute unilateral limb swelling

Answer 20

dvt

bakercyst

cellulitis

compartement syndrome

trauma

haematoma

Question 21

What are chronic causes of a swollen limb

Answer 21

haemosidderi deposits

venous insufficiency

secondary lymphaedema (compression of lymph further up)

Question 22

What are differentials of anacute bilateral limb swellling

Answer 22

acute heart failure

bilateral DVT

Question 23

What are chornic causes of a chronic swollen lim bilaterally

Answer 23

heart failure

insufficiency

Primary lymphaedema

Question 24

WHat are associated symptoms and signs

Answer 24

pain

skin changes

systemic feature

pitting and non pitting

Question 25

whem do you use antiplatelets and anticoagulants?

Answer 25

Question 26

what things do you need to ask in a collpse story

Answer 26

**before**: well before hand what were they doing any preceding symptoms **during:** tongue biting, incontinence, lost consciousness, head in jury **after** post ictal recovery duration weakness, speech difficulty

Question 27

What areinvestigation you want to do ona person that has fainted

Answer 27

observation examination lying and standing BP FBC ECG 24h tape tilt test

Question 28

what are causes of syncope?

Answer 28