Mon

Question 1

first degree heart block

Answer 1

prolonged conduction of electrical activity through the AV node

PR interval >200ms.

no treatment

Question 2

second degree heart block

Answer 2

Mobitz Type I and Mobitz Type II

Question 3

Mobitz Type I

Answer 3

reversible conduction block at the AV node

progressive lengthening of the PR interval

no QRS

Question 4

treatment of Mobitz Type I

Answer 4

symptoms -

stop bb/ccb/digoxin

atropine

Question 5

Mobitz Type II sign and treatment

Answer 5

broad QRS

pacemaker

Question 6

when is thrombolysis indicated

Answer 6

<4.5h

no signs of haemorrage

Question 7

what do you do when haemorrage on ct

Answer 7

refer to neuro

Question 8

acute pancreatitis symptoms

Answer 8

epigastric pain radiating to back

vomiting

Question 9

Central retinal artery occlusion

Answer 9

history of atheromatous disease and sudden, painless, unilateral vision loss

cherry red spot

Question 10

treatment of Central retinal artery occlusion

Answer 10

Ocular massage – to dislodge the embolu

Vasodilation with isosorbide dinitrate

Anterior chamber paracentesis – to help dislodge the embolus

Question 11

acute pancreatitis investigations

Answer 11

serum amylase

Question 12

Anti-Glomerular Basement Membrane disease/goodpastures

Answer 12

rapidly progressive glomerulonephritis by IgM antibodies attacking lungs and kidneys

Question 13

treatment of Anti-Glomerular Basement Membrane disease/goodpastures

Answer 13

plasma exchange- removing antibodies

immunosuppression with high-dose oral prednisolone and cyclophosphamide

Question 14

how to assess melanoma

Answer 14

A = asymmetry
B = border
C = colour
D = diameter
E = evolution

Question 15

CURB-65 score

Answer 15

Confusion +/-
Urea >7
Respiratory Rate >30
Blood pressure: systolic < 90 or diastolic <60
More than 65 years old

Question 16

CAP treatment

Answer 16

amoxicilin

clarithromycin/doxy

Erythromycin for pregnancy

Question 17

what drugs can cause postural hypotension

Answer 17

Tamsulosin- for benign prostatic hyperplasia

anti hypertensives

Question 18

Cerebral palsy early symptoms

Answer 18

‘scissor’ gait

Question 19

causes of conjugated hyperbilirubinaemia/jaundice

Answer 19

CF- meconium illeus

biliary atresia

Question 20

causes of unconjugated hyperbilirubinaemia/jaundice

Answer 20

gilberts

breast milk jaundice

Question 21

signs of nephritic syndrome

Answer 21

Haematuria and Hypertension

Question 22

signs of nephrotic syndrome

Answer 22

oedema

proteinuria

hypoalbuminaemia

Question 23

Perthes disease

Answer 23

avascular necrosis of the femoral head in children

Question 24

Perthes disease signs and symptoms

Answer 24

gradual onset limp and hip pain and knee pain

Question 25

Perthes disease management

Answer 25

less than 50% of the femoral head involvement conservative severe instances may require a plaster cast/ osteotomy

Question 26

Alcoholic hepatitis sign

Answer 26

more ALT than AST

Question 27

fanconi syndrome

Answer 27

defect in the proximal convoluted tubule (PCT) causing impaired resorption causing renal T2 tubular acidosis

Question 28

Renal Tubular acidosis type 1

Answer 28

reduced H+ secretion in the distal convoluted tubule

Question 29

fanconi syndrome signs

Answer 29

glucosuria and proteinuria and acidic pH

Question 30

Renal tubular acidosis type 1 signs

Answer 30

pH >5.5 and low K and bicarb

Question 31

absolute indication for renal replacement therapy

Answer 31

hyperkalaemia, metabolic acidosis, pulmonary oedema pericarditis, encephalopathy and seizures

Question 32

Gilbert's syndrome

Answer 32

impaired bilirubin metabolism mild jaundice that worsens with fasting, illness, and stress UDP-glucuronosyltransferase

Question 33

treatment for hypertension in patients over 55 years with no T2 diabetes

Answer 33

amlodipine

Question 34

mitral regurgitation sign

Answer 34

pan-systolic murmur best heard over the apex most likely cause by mitral valve prolapse

Question 35

wrist drop with triceps weakness

Answer 35

Radial (at the axilla)

Question 36

biliary atresia signs and sypmptoms

Answer 36

prolonged jaundice dark urine and pale stools

Question 37

carcinoid syndrome

Answer 37

rare, slow-growing neural crest tumours that secrete serotonin in appendix and small intestine

Question 38

carcinoid tumour symptoms

Answer 38

abdominal pain, diarrhoea, flushing, wheezing, and pulmonary stenosis

Question 39

indication of liver transplant after paracetamol overdose

Answer 39

Arterial pH < 7.3 24 hours after ingestion prothrombin time >100s creatinine > 300umol/L and grade III or IV encephalopathy

Question 40

COPD treatment

Answer 40

SAMA/SABA +LABA+LAMA (no asthma) +LABA + ICS (asthma) +ICS

Question 41

5HT antagonist and when use

Answer 41

Ondansetron- anti emetic Acute gastroenteritis, post-op, radiotherapy- or chemotherapy-induced

Question 42

Cyclizine type of drug

Answer 42

H1 receptor antagonist

Question 42

Domperidone, metoclopramide type of drugs

Answer 42

D2 receptor antagonist

Question 43

anti emetic for palliative care and type of drug

Answer 43

Hyoscine hydrobromide anti muscarinic

Question 44

which hepatitis leads to acute liver failure

Answer 44

A and E

Question 45

which hepatitis leads to chronic liver failure

Answer 45

B and C can only get D if have B

Question 46

where do you feel pulse for in unresponsive infant

Answer 46

carotid brachial

Question 47

Wilson's disease what is is

Answer 47

recessive 10-20 yo copper

Question 48

symptoms of wilsons

Answer 48

depression, loss of memory and delusions, neurological symptoms include tremor, dysarthria and dystonia hepatitis

Question 49

treatment of wilsons

Answer 49

D-penicillamine and trientine-chelators zinc salts

Question 50

sign of lung cancer

Answer 50

protein

Question 51

Benign prostatic hypertrophy symptoms

Answer 51

urinary retention bilateral hydronephrosis

Question 52

when is IV adrenaline and IV amiodarone given in CPR

Answer 52

after the 3rd shock in a shockable rhythm

Question 53

what do you give to asthmatic patient to slow HR

Answer 53

Verapamil 2.5 - 5mg

Question 54

Hydrocele complication if no surgery within 1-2 years

Answer 54

indirect inguinal hernia as process vaginalis doesn't close

Question 55

Ischaemic hepatitis

Answer 55

hepatic injury secondary to acute hypoperfusion of the liver

Question 56

Ischaemic hepatitis signs

Answer 56

hypotensive/ cardiac arrest. raised ALT normal ALP and bilirubin

Question 57

diazepam overdose symptoms

Answer 57

resp depression, confusion and cerebellar symptoms such as nystagmus and ataxia

Question 58

aspirin overdose symptoms

Answer 58

tinnitus and confusion

Question 59

what type of organism is sickle cell disease patient most susceptible to for osteomyelitis

Answer 59

Salmonella typhi