passmed cofrections may part 2

Question 1

pulmonary hypoplasia causes

Answer 1

oligohydramnios
congenital diaphragmatic hernia

Question 2

investigationd for ischaemic colitis

Answer 2

ABG - metabolic acidosis, elevated lactate
x-ray may show thumb printing
CT is the gold standard investigation.

Question 3

H influenza associated conditions

Answer 3

Community-acquired pneumonia
Most common cause of bronchiectasis exacerbations
Acute epiglottitis

Question 4

staph aureus associated conditions resp

Answer 4

Pneumonia, particularly following influenza

Question 5

Mycoplasma pneumoniae assoc cpnditions

Answer 5

Atypical pneumonia

Flu-like symptoms classically precede a dry cough. Complications include haemolytic anaemia and erythema multiforme

Question 6

legionella conditions features

Answer 6

Classically spread by air-conditioning systems, causes dry cough. Lymphopenia, deranged liver function tests and hyponatraemia may be seen

Question 7

Mycobacterium tuberculosis presentation

Answer 7

A wide range of presentations from asymptomatic to disseminated disease are possible. Cough, night sweats and weight loss may be seen

Question 8

pompholyx eczema

Answer 8

aka dyshidrotic eczema, vesicular palmar eczema

precipitated by humidity (e.g. sweating) and high temperatures

small blisters on the palms and soles
pruritic
often intensely itchy
sometimes burning sensation
once blisters burst skin may become dry and crack

Management
cool compresses
emollients
topical steroids

Question 9

first-line management of cisplatin nephrotoxicity

Answer 9

involves aggressive hydration with normal saline before, during, and after cisplatin administration to promote diuresis and reduce cisplatin concentration in the tubules. Magnesium supplementation is essential to correct the hypomagnesaemia,

Question 10

induction of labour managmenrt

Answer 10

if the Bishop score is ≤ 6- vaginal prostaglandins or oral misoprostol
mechanical methods such as a balloon catheter can be considered if the woman is at higher risk of hyperstimulation or has had a previous caesarean

if the Bishop score is > 6
amniotomy and an intravenous oxytocin infusion

Question 11

diagnostic criteria of hyperemesis gravidarum

Answer 11

5% pre-pregnancy weight loss
dehydration
electrolyte imbalance

Question 12

liver transplnt criteria for paracetamol overdose

Answer 12

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

Question 13

treatment of TGA

Answer 13

prostaglandins

Question 14

treatment of femoral hernia

Answer 14

surgery for risk of strangulation laparoscopically or via a laparotomy

In an emergency situation, a laparotomy may be the only option

Question 15

primarybhyperaldosteronism featurs

Answer 15

hypertension
hypokalaemia
metabolic alkalasosi

Question 16

exaccerbating factors psoriais

Answer 16

trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

sunlight helps

Question 17

treatment for hypercalcaemia

Answer 17

rehydration with normal saline, typically 3-4 litres/day.
Following rehydration bisphosphonates They typically take 2-3 days to work with maximal effect being seen at 7 days

loop diuertics if cant tolerat fluids
calcitonin - quicker effect than bisphosphonates
steroids in sarcoidosis

Question 18

mech of action of anastrozole

Answer 18

Reduced peripheral synthesis of oestrogen

aromatase inhibitor

Question 19

mech of acrion of tamoxifen

Answer 19

Oestrogen receptor selective antagonism

Question 20

what is ipraptropium

Answer 20

SAMA

Question 21

what is Montelukast

Answer 21

LTRA

Question 22

what is salmeterol

Answer 22

LABA

Question 23

indication for ondansetron

Answer 23

indicated for chemically induced nausea and vomiting, such as those arising from opioid analgesics (e.g., morphine) or chemotherapy agents

Question 24

features of `CF

Answer 24

short stature
diabetes mellitus
delayed puberty
rectal prolapse (due to bulky stools)
nasal polyps
male infertility, female subfertility

Question 25

Eczema herperticum

Answer 25

monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameter severe primary infection of the skin by herpes simplex virus 1 or 2, often seen in children with atopic eczema

Question 26

TCA overdose features ecg

Answer 26

sinus tachycardia widening of QRS prolongation of QT interval Widening of QRS > 100ms is associated with an increased risk of seizures whilst QRS > 160ms is associated with ventricular arrhythmias IV bicarbonate

Question 27

syringomyelia features

Answer 27

'cape-like' distribution of sensory loss (loss of pain and temperature sensation) across the upper body, while proprioception and fine touch are typically preserved MRI in syringomyelia would reveal fluid cysts

Question 28

MS MRI findings

Answer 28

multiple white matter lesions, particularly in a periventricular or juxtacortical distribution

Question 29

Lichen planus

Answer 29

purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham's striae over surface. Oral involvement

Question 30

giardiasis infcetion

Answer 30

flagellate protozoan Giardia lamblia swimming in lake, travel, male male sex often asymptomatic, steatorrhoea bloating, abdominal pain, lethargy, flatulence, weight loss, malabsorption and lactose intolerance can occur stool antigen detection assay treatment is with metronidazole

Question 31

Acute dystonia secondary to antipsychotics is usually managed with

Answer 31

procyclidine

Question 32

switch from fluoxetine to another SSRI or TCA or venlafaxine

Answer 32

withdraw then leave a gap of 4-7 days (as it has a long half-life) before starting a low dose of the alternative SSRI Switching from citalopram, escitalopram, sertraline, or paroxetine to another SSRI direct switch is possible

Question 33

switch from an SSRI to a tricyclic antidepressant (TCA)

Answer 33

cross taoering recommended an exception is fluoxetine

Question 34

treatment of alcohol withdrawal

Answer 34

long-acting benzodiazepines e.g. chlordiazepoxide or diazepam. Lorazepam may be preferable in patients with liver cirrhosis or impairemnt. Typically given as part of a reducing dose protocol patients with a history of complex withdrawals from alcohol (i.e. delirium tremens, seizures, blackouts) should be admitted to hospital for monitoring until withdrawals stabilised

Question 35

mirtazapine mech of action

Answer 35

blocking alpha2-adrenergic receptors, which increases the release of neurotransmitters. Noradrenergic and specific serotonergic antidepressants (NaSSAs)

Question 36

alternative to SSRI in OCD

Answer 36

Clomipramine a tricyclic antidepressant (TCA)

Question 37

SSRI discontinuation sydnrome features

Answer 37

increased mood change restlessness difficulty sleeping unsteadiness sweating gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting paraesthesia

Question 38

alochol withdrawal timings

Answer 38

symptoms: 6-12 hours seizures: 36 hours delirium tremens: 72 hours

Question 39

inidcations for ECT

Answer 39

treatment resistant severe depression manic episodes an episode of moderate depression know to respond to ECT in the past life threatening catatonia

Question 40

PHQ 9 severity scrore

Answer 40

0-4 no depression identified 5-9 mild depression 10-14 moderate depression 15-19 moderately severe depression 20-27 severe depression

Question 41

acute stress vs PTSD

Answer 41

Acute stress disorder is defined as an acute stress reaction that occurs in the 4 weeks after a traumatic event, as opposed to PTSD which is diagnosed after 4 weeks

Question 42

Smoking cessation can cause a ______in clozapine blood levels

Answer 42

rise

Question 43

myxoedmic coma symptoms

Answer 43

altered mental status, hypothermia, bradycardia, and hypotension give IV thyroxine and hydrocortisone ( to prevent adrenal crisis which can be triggered by thyroxine treatment due to its role in cortisol clearance.)

Question 44

amiodarone side effects

Answer 44

Brady Tried Taking Some Pretty QT Live Photos of Me but I NEU theyd be Corny toxic queen D, asszoles Bradycardia Thyroid Thrombophlebitis Slate grey appearance Pulmonary fibrosis/ pneumonitis long QT Liver dysfunction/hepatitis Photosensitivity Myopathy Neuropathy Injection site reactions Corneal deposits

Question 45

An ____ in creatinine to _____ and an ______ in K+ to _____is acceptable after starting an ACE inhibitor

Answer 45

increase, up to 30% from baseline, increase, up to 5.5mmol/L significant renal impairment may occur in patients who have undiagnosed bilateral renal artery stenosis

Question 46

webers syndrome featurs

Answer 46

Ipsilateral CN III palsy Contralateral weakness of upper and lower extremity

Question 47

Posterior inferior cerebellar artery (wallenberg, lateral medullary syndrome) features

Answer 47

Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus

Question 48

anterior inferior cerebellar artery stroke (lateral pontine) featurs

Answer 48

Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus ipsilateral facial paralysis and deafness AICA- L-ACIA-F. facial paralysis and deafness

Question 49

indications for mastectomy over wide local excision

Answer 49

Multifocal tumour Central tumour Large lesion in small breast DCIS > 4cm