mock corrections

Question 1

failed medical management of acute pulmonary oedema?

Answer 1

CPAP airway

Question 2

vitreous detachment , RF’s and presentation

Answer 2

RF’s include diabetes, bleeding disorders
presentation can be with numerous dark spots or floaters in vision if the bleed is smaller

Question 3

mnemonic for Wernicke’s

Answer 3

Confusion
Ataxia
Nystagmus
Ophthamoplegia
PEripheral
Neuropathy

Question 4

trans-tentorial herniation

Answer 4

fixed and dilated pupil with down and out gaze
decreasing consciousness level and intercranial mass

Question 5

Cerebellar tonsillar herniation

Answer 5

Cerebellar tonsillar herniation affects the medulla oblongata and is often a terminal event in an unconscious patient resulting in asystolic cardio-respiratory arrest

Question 6

when is elective endovascular aneurysm repair recommended for AAA

Answer 6

asymptomatic > 5.5
enlarging by > 1cm/ year

Question 7

loop ileostomy

Answer 7

used in the defunctioning of the colon e.g. following rectal cancer surgery in RIF

Question 8

loop colostomy

Answer 8

to defunction distal segment of colon

Question 9

most easily reversible stoma

Answer 9

loop ileostomy

Question 10

complications of cholecystectomy

Answer 10

gallstones
common bile duct injury which presents within the first few days after surgery due to inflammation and scarring

Question 11

neurogenic shock

Answer 11

following spinal cord transection interrupting the autonomic nervous system resulting in either decreased/ increased parasympathetic tone

presents with low hr, flushed peripheries

Question 12

_____________ is a contraindication to circumcision in infancy as the foreskin is used in the repair

Answer 12

hypospadias

Question 13

. A confirmed miscarriage can be diagnosed on ultrasound if there is no cardiac activity and:

Answer 13

The crown-rump length is greater than 7mm OR
The gestational sack is greater than 25mm

Question 14

prophylaxis of sinusitis

Answer 14

intranasal decongestants

Question 15

________can be used to assess the presence of fluid in the abdomen and thorax

Answer 15

FAST scan

Question 16

Thyrotoxic storm is treated with

Answer 16

beta blockers, propylthiouracil and hydrocortisone

Question 17

Suspected PE in pregnant women with a confirmed DVT:

Answer 17

treat with LMWH first then investigate to rule in/out

Question 18

The following drugs may cause urinary retention:

Answer 18

tricyclic antidepressants e.g. amitriptyline
anticholinergics e.g. antipsychotics, antihistamines
opioids
NSAIDs
disopyramide

Question 19

8 reversible causes of cardiac arrest

Answer 19

Hypothermia
Hypoxia
Hypovolaemia
Hypokalaemia / hyperkalaemia / hypoglycaemia
Tension pneumothorax
Toxins
Tamponade
Thrombosis

Question 20

investigations for erectile dysfunction

Answer 20

free testosterone in the morning between 9-11 am

Question 21

Patient >= 60 years old with new iron-deficiency anaemia →

Answer 21

FIT testing before colonoscopy

Question 22

clinical signs is most strongly suggestive of a diagnosis of acute compartment syndrome

Answer 22

pain on passive ankle dorsiflexion

Question 23

s the intervention of choice in patients with malignant distal obstructive jaundice due to unresectable pancreatic carcinoma

Answer 23

biliary stenting

Question 24

anterior uveitis management

Answer 24

steroid eye drops with mydriatic eye drops

Question 25

complication of rapid hyponatraemia correction

Answer 25

central pontine myelinosis

Question 26

complication of rapid hypernatraemia correction

Answer 26

cerebral oedema

Question 27

investigation required before starting anti TNF's

Answer 27

CXR

Question 28

side effects of PPI's

Answer 28

hyponatraemia, hypomagnasaemia osteoporosis → increased risk of fractures microscopic colitis increased risk of C. difficile infections

Question 29

how should human bites and animal bites betreated

Answer 29

co-amoxiclav

Question 30

Whilst a patient is receiving PCA opioids what other medications should be stopped

Answer 30

all other opioids

Question 31

what supplements should be prescribed to the mums of babies with CMPI

Answer 31

calcium and vitamin D

Question 32

management of massive PE

Answer 32

IV heparin

Question 33

life expectancy currently

Answer 33

82 years

Question 34

suspected septic arthritis - negative gram stain

Answer 34

start iv abx

Question 35

what is recommended in the work up for inflammatory bowel disease

Answer 35

stool culture

Question 36

when should activated charcoal be considered in an overdose

Answer 36

1st one hour

Question 37

best investigation to assess acute abdomen post surgery

Answer 37

CT abdomen

Question 38

how to confirm norovirus

Answer 38

viral PCR

Question 39

What is the aim of the cervical cancer screening programme?

Answer 39

screen for HPV- abnormal cells indicative of pre-invasive dyskaryosis

Question 40

Name three blood tests that would be requested as part of confusion screen

Answer 40

FBC - CRP/ESR - Folate - B12 - U&Es - HbA1c - Calcium - LFTs - TFTs

Question 41

why is a repeat CXR recommended in mx of pneumonia in older persons

Answer 41

check for malignancy

Question 42

genetic mutation of the Philadelphia chromosome?

Answer 42

Translocation of chromosomes 9 and 22

Question 43

Apart from the Philadelphia chromosome, what other chromosomal abnormality predisposes children to this form of leukaemia?

Answer 43

Trisomy 21

Question 44

Name 2 options that can be offered for definitive management of hyperthyroidism

Answer 44

Radioiodine therapy Thyroidectomy

Question 45

Which zone of the prostate is primarily affected in prostate cancer?

Answer 45

Peripheral zone

Question 46

What imaging is used as the first-line investigation for suspected prostate cancer?

Answer 46

Multiparametric MRI

Question 47

Prostate cancer is diagnosed through biopsies of prostatic tissue, which are used to calculate a ‘Gleason score’. How is the Gleason score calculated?

Answer 47

The two most common tumour patterns across all samples are graded based on their differentiation The sum of the two grades is the Gleason score

Question 48

role of tolvaptan in PKD

Answer 48

reduces the growth rate of cysts

Question 49

cause of low Hb in CKD

Answer 49

Anaemia of chronic disease due to reduced EPO production

Question 50

Name the most common cause of chronic kidney disease in the UK

Answer 50

T2DM

Question 51

Parkland formula for burns

Answer 51

4ml x body weight (kg) x total body surface area affected (%)

Question 52

What effect does carbon monoxide have on the oxyhaemoglobin dissociation curve and how does this cause symptoms of carbon monoxide poisoning?

Answer 52

carbon dioxide = greater affinity for Hb than O2 so it binds to O2 curve shifts from right to left, which makes Hb hold on to oxygen more causing hypoxia

Question 53

direct inguinal hernia

Answer 53

bowel enters the inguinal canal directly through weakness in posterior wall

Question 54

indirect hernia

Answer 54

bowel enters inguinal canal through the deep inguinal ring

Question 55

which hernia is most commonly seen in infants and why

Answer 55

indirect inguinal hernia due to a patent processus vaginalis

Question 56

which nerve is damaged intra-operatively in hernia surgery

Answer 56

ilioinguinal

Question 57

What is the difference between the terms ‘oligoarthritis’ and ‘polyarthritis’?

Answer 57

Oligoarthritis affects 4 or fewer / affects 2-4 joints In polyarthritis, more than 4 joints are involved

Question 58

which serological markers are used in hep B screening

Answer 58

HBsAg and anti HBc

Question 59

which marker gives a count of viral load

Answer 59

hepatitis B virus DNA

Question 60

what is injected in hep B vaccine

Answer 60

HBsAg - hep B surface antigen

Question 61

which hep B serological marker indicates immunity post vaccination

Answer 61

Anti HBs - hepatitis B surface antibody

Question 62

what forms of hepatitis can be vaccinated against -

Answer 62

Hep A

Question 63

dog bite prophylaxis

Answer 63

co-amoxiclav

Question 64

trachea pulled towards the white out

Answer 64

pneumonectomy complete lung collapse pulmonary hypoplasia

Question 65

class of drugs useful in overactive bladder

Answer 65

antimuscarinics

Question 66

no jaundice - bile stones which duct

Answer 66

cystic duct

Question 67

PPROM which steroid

Answer 67

dexamethasone

Question 68

symptoms of mania in primary care

Answer 68

refer urgently to primary care

Question 69

indications for thoracotomy in haemothorax

Answer 69

> 1.5 L blood loss losses of > 200 ml / hour for 2 hours

Question 70

agonal breathing

Answer 70

can occur in the first few minutes after a cardiac arrest

Question 71

woman with bone metastases- origin

Answer 71

breast

Question 72

Most common tumour causing bone metastases

Answer 72

prostate breast lung

Question 73

side effects of heparins

Answer 73

heparin induced thrombocytopenia

Question 74

which medications can precipitate digoxin toxicity

Answer 74

thiazide diuretics

Question 75

Patients with long saphenous vein superficial thrombophlebitis should have

Answer 75

ultrasound to exclude DVT

Question 76

_________is usually indicated in patients with acute, severe, symptomatic hyponatraemia (< 120 mmol/L)

Answer 76

Hypertonic

Question 77

codeine to morphine

Answer 77

divide by 10

Question 78

hpw is hydrocortisone given in Addisons

Answer 78

split with majority in 1st half of the day