New test

Question 1

Front (Question)

Answer 1

Back (Answer + Explanation)

Question 2

A 48-year-old woman has been taking Zopiclone 15mg at night for 4 years and wants to stop. She has tried tapering but experiences side effects. History: Emotionally unstable personality disorder & alcohol dependency (abstinent 2 yrs). What is the most appropriate initial management plan?

A) Taper to 7.5mg
B) Alternate 7.5mg/15mg
C) Stop completely
D) Refer to specialist services
E) Same-day detox

Answer 2

Answer: D) Refer to specialist services

• Assess suitability before stopping Z-drugs: address underlying depression, anxiety, insomnia.
• Primary care withdrawal only if: compliant, supported, no complex withdrawal history.
• Referral needed for alcohol/drug dependency or psychiatric disorders.
• Unwilling patients: gently explore concerns, consider dose reduction.
• NICE: Dependence/withdrawal meds guidance.

Question 3

55-year-old woman with frontal hair loss, mild scarring, slight itch. Hair pull test negative, no visible follicle openings. What is the most likely diagnosis?

A) Androgenetic alopecia
B) Telogen effluvium
C) Lichen planopilaris
D) Telogen gravidarum
E) Alopecia areata
F) Trichotillomania
G) Frontal fibrosing alopecia
H) Traction alopecia

Answer 3

Answer: G) Frontal fibrosing alopecia

• Affects post-menopausal women
• Frontal and temporal hairline recession; scarring, no follicle openings
• May include itch/soreness
• Autoimmune/inflammatory component
• Progressive, irreversible; treatment may slow progression (e.g. steroids, antimalarials)

Question 4

64-year-old man post-retinal detachment treatment. Which is NOT a risk factor for retinal detachment?

A) Family history
B) Blunt eye trauma
C) Cataract surgery >12 months ago
D) Hypermetropia
E) Choroidal melanoma

Answer 4

Answer: D) Hypermetropia

• Myopia, not hypermetropia, is a risk due to peripheral retinal thinning
• Other risks: family history, blunt trauma, cataract surgery, choroidal melanoma
• Congenital eye conditions and inflammatory/malignant disease also contribute
• Cataract surgery increases risk 9-fold
• Refer to RCOphth guidance on retinal detachment