passmed mock 1 paper 1

Question 1

physiological nervous system response to increased intracranial pressure

Answer 1

hypertension + bradycardia = Cushing’s reflex

Question 2

PTH in primary hyperparathyroidism

Answer 2

high or INAPROPRIATELY NORMAL !!!!!

Ca is high so PTH should be supressed
(phosphate low)

Question 3

hormone profile in secondary hyperparathyroidism

Answer 3

PTH high
Ca low or normal
phosphate high

vit d = low

(almost always in CKD or vit D def)

Question 4

diagnostic test for guillain barre

Answer 4

lumbar puncture

Question 5

no of doses of lorazepam that can be admistrated in status epilepticus

Answer 5

max of 2 IV benzos 10 mins apart

Question 6

non-fluent speech but comprehension is normal, struggles to repeat phrases - where is most likely site of lesion?

Answer 6

Frontal lobe - Broca’s
(inferior frontal)

wernickes = superior temporal

Question 7

mx of exertional chest pain which is self limiting, also asthmatic

Answer 7

verapamil or diltiazem
(rate-limitng CCB)

Question 8

how long no drive in first unprovoked seizure if brain imaging / EEG normal

Answer 8

6 months

Question 9

diagnostic test for pancreatic ca

Answer 9

high resolution CT

Question 10

protein level suggestive of an exudative pleural effusion

Answer 10

> 30
- cancer
- infection
-PE
- connective tissue - SLE, RA

Question 11

pilocarpine drug type

Answer 11

direct parasympathomimetic

Question 12

management of acute closed glaucoma

Answer 12

pilocarpine + timolol

pilocarpine = pupillary constriction - widens iridocorneal angle, allow humour to drain

betablock = reduce aqueous humour production

Question 13

management of anteroir uveitis

Answer 13

steroid + cycloplegic (dilates pupil) eye drops

urgent ophthalmology review

Question 14

cardiac medication that exacerbates myasthenia

Answer 14

bisoprolol

Question 15

how long must gluten be eaten for before coeliac testing

Answer 15

6wks

Question 16

how long before results are seen when taking finasteride for BPH

Answer 16

6 months

(5-apha reductase inhibitor)

Question 17

mx of pregnant who smoke and want to quit

Answer 17

nicotine replacement therapy

Question 18

mx of cdiff when high temp and looow BP

Answer 18

oral vanc + IV metronidazole

Question 19

management of human bite

Answer 19

co-amoxiclav

Question 20

management of SIADH

Answer 20

fluid restrict

Question 21

criteria for LTOT

Answer 21

pO2 7.3-8 AND one of;
- 2nd polycythaemia
- peripheral oedema (sacral)
- pulmonaryhypertension

Question 22

management of severe alcoholic hepatitis

Answer 22

corticosteroids - prednisolone

Question 23

insulin regime in management of acute DKA

Answer 23

fixed-rate IV insulin AND continue injectable long-acting insulin only

Question 24

Rockall score

Answer 24

used AFTER endoscopy to determine percentage risk of rebleeding + mortality in patients with upper GI bleed

Question 25

Glasgow-Blatchford score

Answer 25

upper GI bleed BEFORE procedure to determine whether patient will be admitted for medical intervention

Question 26

Child-pugh classification

Answer 26

assess severity of liver cirrhosis

Question 27

mx of meds when an addisons patient is ill

Answer 27

double glucocorticoids keep fludrocortisone the same

Question 28

visual defect seen in left temporal lobe lesion

Answer 28

CONTRALATERAL - right Superior homo quadrantopia PITS - parietal-inferior, temporal-superior

Question 29

score used to assess risk of developing a pressure sore

Answer 29

Waterlow score

Question 30

position of trachea in lung collapse

Answer 30

pulled towards opacity (pushed away in pleural effusion)

Question 31

memantine drug type

Answer 31

NMDA receptor antagonist - second line drug mx alzheimers - or in severe disease

Question 32

1st line mx of mild-mod alzheimers

Answer 32

acetylcholinesterase inhibitors - donepezil - galantamine - rivastigmine

Question 33

is bronchiectasis restrictive or obstructive

Answer 33

obstructive as well as - asthma + COPD - bronchiolitis obliterans

Question 34

what should be given to COPD patients with repeated exacerbations

Answer 34

antibiotic AND steroids

Question 35

what drug can cause a neutrophilia

Answer 35

prednisolone lithium

Question 36

factor that suggests diagnosis of delirium rather than dementia

Answer 36

delirium involeves impaired elvel of consciousness (reduced GCS)