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Question 1

triptans contraindications + SE

Answer 1

contraindication - ischaemic heart disease cerebrovascular disease

SE
- tightness throat + chest
- tingling, heaviness

Question 2

subarachnoid haemorrhage complications

Answer 2

rebleed - in first 12hrs
hydrocephalus
vasospasm - 7-14days after onset
SIADH - hyponatraemia
seizures

Question 3

mononeuritis multiplex

Answer 3

simultaneous/sequential involvement of individual non-contiguous nerves
- patern of involvement asymmetrical
- loss of sensory + motor function of multiple non-contagious nerves

Question 4

seizures and driving

Answer 4

1st/isolated seizure/no structural abnormalities/EEG findings -> 6months

established epilepsy -> 12months seizure free

Question 5

stroke/TIA + driving

Answer 5

stroke - 1 month off driving

multiple TIAs over short period of time - 3months + onform DVLA

Question 6

neuropathic pain mx

Answer 6

amitriptyline
duloxetine
gabapentin

(if one doesnt work try another)

Question 7

types of bipolar

Answer 7

1 - one episode of mania

2 - depression with hypomania

Question 8

hypomania vs mania

Answer 8

mania >=7days

hypomania - 4days of less severe symptoms which dont impact on fucntioning

Question 9

serotonin syndrome

Answer 9

excess serotonin in synaptic cleft - most often caused by taking a combo of SSRI + MAOI (left of meds they take both)

triad
1. neuromuscular excitation - hyperflexia, clonus, myoclonus
2. altered mental status - delirium agitation, insomnia
3. autonomic dysregulation - tachycardia, increase temp

**prolonged fever - rhabdo, metabolic acidosis, renal failure

Question 10

what part of the brain does addiction act on

Answer 10

mesolimibic pathway to mediate pleasure (positive reinforcement)
- overstimulation, decrease in dopamine receptor expression

Question 11

wernickes vs korsakoffs

Answer 11

wernickes
- acute thiamine def.
- ataxia, nystagmus, confusion

korsakoffs
- chronic thiamine def
- dementia

Question 12

what antidepressants are excreted in breast milk

Answer 12

all of them !
- SSRIs + tricyclics show decreases levels
– **except fluoxetine

can still give just monitor baby

Question 13

landmark fr pudendal nerve bloack

Answer 13

ischial tuberosity

Question 14

when would you give duloxetine in urinary incontinence

Answer 14

stress incontinence who dont respond to pelvic floor exercises + decline surgery

Question 15

chorioamnitis presentation

Answer 15

uterine tenderness
foul smellling discharge
fetal tachycardia

(UTI/STI would have hx of dysuria)

Question 16

when would oxybutynin for urinary incontinence not be given

Answer 16

in frail old ladies

• solifenacin, tolterodine, mirabegran

Question 17

when is POP considered a missed pill

Answer 17

> 3hrs late (27hrs since last)

take missed ASAP
take next at usual time
*condoms should be used for 48hrs

Question 18

what does angiotensin II do

Answer 18

vasoconstricts (not renin)