MLA pass med

Question 1

is transient haematuria normal

Answer 1

yes

Question 2

drugs that can cause red/orange urine

Answer 2

rifampicin

Question 3

test of choice for detecting haematuria

Answer 3

urine dipstick

Question 4

when to urgent refer if present with haematuria

Answer 4

over 45 and unexplained haematuria
and is not a UTI

Question 5

triad of nephrotic syndrome

Answer 5

proteinuria, hypoalbuminaemia and oedema

Question 6

3 primary causes of nephrotic syndrome

Answer 6

minimal change, focal segmental glomerulosclerosis, and membranous nephropathy

Question 7

underlying pathophysiology of nephrotic syndrome

Answer 7

damage to glomerular basement membrane and podocytes

Question 8

how would you quantify proteinuria in nephrotic syndrome

Answer 8

early morning urinary protein:creatinine ratio or albumin:creatinine ratio

Question 9

what predisposed to thrombosis and lowers the total but not free thyroxine levels

Answer 9

nephrotic syndrome

Question 10

most renal stones are what time

Answer 10

calcium oxalate

Question 11

what renal stones can be invisible on X-ray

Answer 11

urate and xanthine

Question 12

stag horn calculi are made of struvite and develop in alkaline urine. what can predispose to them

Answer 12

proteus infection

Question 13

when can urine dipstick be used to diagnose UTI

Answer 13

women under 65

Question 14

what drug may be used for exacerbation of neuropathic pain

Answer 14

tramadol

Question 14

when should you do a urine culture for UTi

Answer 14

in all. men, women over 65, recurrent UTI, pregnant woman

Question 15

what may be used for localised neuropathic pain eg in post herpetic neuralgia

Answer 15

topical capsaicin

Question 16

what is first lien for trigeminal neuralgia

Answer 16

carbamazepine

Question 17

first line drugs for neuropathic pain

Answer 17

amitryptiline, gabapentin, pregablin, duloxetine

Question 18

what receptors do opioids work on

Answer 18

G protein couple receptors so Mu, kappa and delta

Question 19

what are endorphins, dynorphins, and enkephalins

Answer 19

endogenous opioids

Question 20

enkephalin modulates

Answer 20

fight or flight response

Question 21

what phase of metabolism has oxidation, reduction and hydrolysis

Answer 21

1

Question 22

Cytochrome P450 plays a role in

Answer 22

modifying opioids into more water soluble metabolites

Question 23

what should be prescribed for all patients initiating strong opioids

Answer 23

laxatives

Question 24

for palliative care pain relief and no co morbidities prescribes

Answer 24

20-30mg of modified relief morphien with 5mg oral immediate release morphien for breakthrough pain

Question 25

when prescribing morphien for palliative care what should be advised drowsiness if often transient too

Answer 25

nausea is often transient but if persists can prescribe an anti emetic

Question 26

in palliative prescribing the breakthrough dose of morphien is how much of the daily dose

Answer 26

1/6

Question 27

opiods should be used with caution in those with CKD so what should be used if got mild renal impairment and what if severe

Answer 27

mild- oxycodone severe- buprenorphine and fentanyl

Question 28

what can provide quick pain relief for metastatic bone pain

Answer 28

strong opiods

Question 29

in palliative when increasing the dose of pain should be increased by how much

Answer 29

30-50%

Question 30

In addition to strong opioids, bisphosphonates and radiotherapy, --- may be used to treat metastatic bone pain.

Answer 30

denosumab

Question 31

persistent side effect of opiods

Answer 31

constipation

Question 32

transient s/e of opiods

Answer 32

nausea and drowsiness

Question 33

how to convert oral codeine and tramadol to oral morphien

Answer 33

divide by 10

Question 34

---- generally causes less sedation, vomiting and pruritis than morphine but more constipation.

Answer 34

oxycodone

Question 35

divide by what to go from oral to subcut morphine

Answer 35

2

Question 36

what drugs are the most common cause of acute interstitial nephritis

Answer 36

antibiotics

Question 37

what has raised WCC and eosinophils in urine and impaired renal. it gives an allergy picture

Answer 37

acute interstitial nephritis

Question 38

Question 39

rash and fever and on antibiotic therapy may suggest

Answer 39

acute interstitial nephritis

Question 40

AKI is divided into

Answer 40

pre renal intrinsic post renal

Question 41

pre renal causes of AKI

Answer 41

hypovolaemia renal artery stenosis

Question 42

some intrinsic AKI causes

Answer 42

acute tubular necrosis glomerulonephritis

Question 43

post renal causes of AKI

Answer 43

renal stone benign prostatic hyperplasia

Question 44

what drugs can worsen `AKI

Answer 44

NSAIDs anti hypertensives ahminoglycosides eg gentamicin

Question 45

what is done to prevent risk of AKI for those at risk eg if undergoing investigation with contrast

Answer 45

given IV fluids

Question 46

how to detect if kidneys not working properly

Answer 46

reduced urine output rise in potassium, urea & creatinine

Question 47

what can be features of uraemia

Answer 47

pericarditis and encephalopathy

Question 48

what blood test looks at sodium, potassium, urea and creatinine

Answer 48

U&es

Question 49

what stabilises the cardiac membrane in hyperkalaemia

Answer 49

IV calcium gluconate

Question 50

Question 51

what drugs shift potassium from extracellular to intracellular

Answer 51

insulin salbutamol

Question 52

what 3 things removes potassium from the body

Answer 52

calcium resonium , loop diuretics and dialysis

Question 53

pre renal uraemia vs acute tubular necrosis. in pre renal uraemia they hold on to sodium so

Answer 53

pee out less sodium

Question 54

staging AKI 1.5-1.9 x creatinine 2-2.9 x 3+ x

Answer 54

stage 1,2 ,3

Question 55

most common cause of AKI

Answer 55

acute tubular necrosis

Question 56

what is associated with muddy, brown casts in the urine

Answer 56

acute tubular necrosis

Question 57

when to also think of rhabdomyolysis

Answer 57

prolonged epileptic seizure

Question 58

Question 59

what drug can cause rhabdomyolysis

Answer 59

statins

Question 60

creatine how many times above normal suggests rhabdomyolysis

Answer 60

5 times

Question 61

myoglobinuria

Answer 61

dark or reddish brown colour seen in rhabdo