mock reviews2

Question 1

Following panretinal laser photocoagulation complication

Answer 1

up to 50% of patients have a noticeable reduction in their visual field

Question 2

macrolides side effects

Answer 2

prolongation of the QT interval
gastrointestinal side-effects are common. Nausea is less common with clarithromycin than erythromycin
cholestatic jaundice: risk may be reduced if erythromycin stearate is used
P450 inhibitor (see below)
azithromycin is associated with hearing loss and tinnitus

Question 3

GnRH agonists may cause _____

Answer 3

‘tumour flare’ when started, resulting in bone pain, bladder obstruction and other symptom

goserelin

due to the initial increase in testosterone levels before subsequent suppression of testosterone

Question 4

give what with goserelin to prevent tumour flare

Answer 4

bicalutamide
non-steroidal anti-androgen
blocks the androgen receptor

Question 5

_______ first-line in benign prostatic hyperplasia if the patient has troublesome symptoms

Answer 5

Alpha-1 antagonists

5-alpha reductase inhibitors are indicated if the patient has a significantly enlarged prostate

Question 6

IPSS treat score

Answer 6

IPSS ≥ 8

Question 7

give what if there is a mixture of storage symptoms and voiding symptoms that persist after treatment with an alpha-blocker alon

Answer 7

Anti-muscarinic (anticholinergic) medication is appropriate

Question 8

Hepatitis A presents with

Answer 8

flu-like symptoms, RUQ pain, tender hepatomegaly and deranged LFTs

Question 9

nephrotic syndrome criteria

Answer 9

1. Proteinuria (> 3g/24hr) causing
2. Hypoalbuminaemia (< 30g/L) and
3. Oedema

Question 10

minimal change managament

Answer 10

oral corticosteroids: majority of cases (80%) are steroid-responsive
cyclophosphamide is the next step for steroid-resistant cases

Question 11

Mycobacterium tuberculosis meningitis CSF findings

Answer 11

the only bacterial cause of meningitis that normally results in lymphocytes, rather than polymorphs in the CSF

Question 12

Any person on anticoagulants with a head injury must receive a CT head within ______

Answer 12

within 8 hours

Question 13

Painful third nerve palsy =

Answer 13

posterior communicating artery aneurysm

Question 14

thymoma symptoms

Answer 14

distended neck veins and flushed face are likely to be caused by superior vena cava obstruction, which can be a complication of thymomas
hoaresness
chest pain
asymptomatic

Question 15

reducible hernia vs irreducible

Answer 15

reducible = indirect = deep inguinal ring
irreducible = direct

indirect stays IN

try to reduce the hernia and then press on the deep inguinal ring situated on the mid-point of the inguinal ligament. If the hernia stops protruding after this it means that its exit point is the deep inguinal ring, making it an indirect hernia

Question 16

_______–are now standard for the diagnosis and screening of HIV

Answer 16

Combination tests (HIV p24 antigen and HIV antibody)

Question 17

symptoms of HIV seroconversion

Answer 17

(fever, malaise, myalgia)

Question 18

Frontal lobe seizures typically cause

Answer 18

motor symptoms such as jerking of the limb and are associated with Todd’s paresis

Question 19

________ is the first-line management in patients with hypercalcaemia

Answer 19

IV fluid therapy

Question 20

treatmemt of acute glaucoma

Answer 20

medical treatment is required to lower the IOP with more definitive surgical treatment given once the acute attack has settled

Pilocarpine (cholinergic), timolol (beta-blocker), and brimonidine (alpha-agonist) are all used to reduce intra-ocular pressure (IOP), which is compromising the optic nerve

laser peripheral iridotomy

Question 21

All diabetic patients with a urinary ACR of _______ or more should be started on

Answer 21

3 mg/mmol , an ACE inhibitor or angiotensin-II receptor antagonist

Question 22

Statins + ______- an important and common interaction

Answer 22

erythromycin/clarithromycin
rhabdomyolysis

Question 23

_______ is the initial investigation to exclude subarachnoid haemorrhage (SAH

Answer 23

Non-contrast CT head

Question 24

The most common causes of viral meningitis in adults are

Answer 24

enteroviruses eg Coxsackie B virus
enterovirus 71, poliovirus, and coxsackie A virus (associated with hand, foot, and mouth disease

Question 25

The radial nerve is at risk in a fracture where

Answer 25

shaft fracture of the humerus

Question 26

use to reduce the redness and flushing in rosacea, specifically for this engagement

Answer 26

an alpha-2-adrenergic agonist is thought to work by constricting facial blood vessels Brimonidine works in 30 mins can result in rebound erythema so dotn use often

Question 27

Central vision loss in individuals with pre-existing dry AMD

Answer 27

is a sign of progression to wet age-related macular degeneration, and fundoscopy would show choroidal neovascularisation can treat with VEGF if wet. no treatment for dry

Question 28

well-defined, deep ulcer on the ventral aspect of the heel -----> think

Answer 28

arterial ulcer pale with dry, cracked skin, suggesting a poor blood supply associated with peripheral arterial disease (PAD)

Question 29

large, shallow painless ulcer, usually on the lower aspect of the legs ------> think

Answer 29

venous ulcer

Question 30

Anti-epileptic drug treatment should not be started before specilaist review except in certain cases, including:

Answer 30

1. Seizure activity observed on EEG 2. Presence of a neurological deficit 3. Presence of a structural brain abnormality 4. Patient, parent or carer considers the risk of a further seizure to be unacceptable

Question 31

Patients who have previously suffered an episode of spontaneous bacterial peritonitis and who have a fluid protein <15 g/l require ______

Answer 31

antibiotic prophylaxis, this is most commonly ciprofloxacin or norfloxacin.

Question 32

If C. difficile does not respond to first-line vancomycin ,________should be used next

Answer 32

oral fidaxomicin

Question 33

________ is a well recognised cause of cholestasis

Answer 33

Co-amoxiclav

Question 34

Bilateral grittiness - think ____

Answer 34

blepharitis bilateral grittiness, sticky eyes, and erythematous eyelid margins hot compresses to soft then eyelid margin, removal of debris with cotton buds dipped in cooled boiled water, and artificial tears if patients report dry eyes.

Question 35

sticky purulent discharge from bilateral red and itchy eyes--- think

Answer 35

bacterial conjunctivitis Topical chloramphenicol drops

Question 36

bilateral red eyes, itchy and swollen, rhinitis and clear discharge ----- > think

Answer 36

allergic conjunctivitis Topical sodium cromoglycate

Question 37

rapid onset unilateral/bilateral blurred vision, photosensitivity, floaters, eye pain, and eye redness. --------- think ???

Answer 37

anterior uveitis Topical steroids

Question 38

All patients with peripheral arterial disease should take ______

Answer 38

clopidogrel and atorvastatin 80 mg

Question 39

presentation of acute limb ischaemia, with the classic '6 Ps':

Answer 39

pain, pallor, pulselessness, paraesthesia, paralysis (weakness), and perishing cold

Question 40

spinal cord compression above L1 causes

Answer 40

UMN signs back pain- may be worse on lying down and coughing lower limb weakness sensory changes: sensory loss and numbness tendon reflexes increased below lesion and absent at level high-dose oral dexamethasone urgent oncological assessment for consideration of radiotherapy or surgery

Question 41

charcot marie tooth features

Answer 41

Distal muscle weakness and atrophy Foot deformities (e.g., pes cavus) Sensory disturbances (numbness, tingling)

Question 42

An ABPI value of >1 can indicate

Answer 42

vessel calcificaiton common in diabetes

Question 43

all patients with a CD4 count ______should receive PCP prophylaxis

Answer 43

< 200/mm³ trimethoprim-sulfamethoxazole (TMP-SMX)

Question 44

what is PCP

Answer 44

Pneumocystis carinii is now referred to as Pneumocystis jiroveci HIV complication Pneumothorax is a common complication exercise-induced desaturation co-trimoxazole IV pentamidine in severe cases

Question 45

Primary open-angle glaucoma is associated with ________field loss

Answer 45

peripheral

Question 46

Macular degeneration is associated with _____ field loss

Answer 46

central

Question 47

risk factors for retinal detachment

Answer 47

diabetes mellitus, ageing, previous eye surgery, and eye trauma, myopia

Question 48

Irradiated blood products are used for

Answer 48

to avoid transfusion-associated graft versus host disease