Past papers Flashcards
1
Q
First line for haemorrhoids
A
Proctoscope
2
Q
What to remember about haemorrhoids if no visible masses on examination
A
Can be internal haemorrhoids
3
Q
Target glucose in self monitoring throughout the day
A
Waking- 5-7
Before any meal 4-7
90 mins after eating 5-9
4
Q
First line investigation for non severe/systemic constipation
A
Anal manometry
5
Q
First line for AAA
A
US
6
Q
What is arteriography
A
CT angio or MRI angio
7
Q
What do if d dimer comes back as negative in suspected PE
A
Stop anticoagulation and consider other diagnosis
8
Q
What are Hb, MCV and reticulocytes
A
Low Hb
Normal MCV
High reticulocytes
9
Q
What gives headache better on lying down
A
Low ICP such as post LP
10
Q
What can PTH be in primary hyperparathyroidism
A
Normal or high
11
Q
In STEMI where fibrinolysis has been given when should ECG be next repeated
A
2-3 hours
12
Q
Triad for liver failure
A
Encephalopathy
Jaundice
Coagulopathy
13
Q
If patient has impaired GCS/ consciousness what give
A
IM glucagon or IV glucose
14
Q
What is murmur for atrial septal defect
A
Ejection systolic louder on inspiration
15
Q
How can ITP present
A
Petechiae
Easy bleeding like epistaxis and menorrhagia
16
Q
If a patient presents with new onset TB symptoms and was recently started on a drug what would most likely be cause
A
A biologic as causes reactivation
17
Q
After CXR what is next best investigation for lung cancer
A
CT not bronchoscopy
18
Q
Most sensitive test for SLE
A
ANA
19
Q
Main problem of alpha 1 antitrypsin
A
Leads to hepatocellular carcinoma
20
Q
What time frame is necessary for orthostatic hypotension
A
3 mins
21
Q
When investigating neoplastic spinal canal stenosis what is given while waiting for urgent MRI
A
Dexamethasone
22
Q
If patient has acute fast AF and signs of HF what do if BPnormal
A
Still cardiovert as HF indication regardless
23
Q
Most important advice post pneumothorax
A
Stop smoking
24
Q
First line investigation for chronic HF
A
BNP not echo
25
What prophylactic Abx given in COPD
Azithromycin
26
If stage 1 HTN when is only time can give first line meds
```
No cardiac disease
No end organ failure
No renal disease
No diabetes
Q risk less than 10%
```
27
In questions where AF management and has HTN what must bear in mind with BP
Just above 90/60 is concerning
28
What causes high BNP that isnt HF
eGFR less than 60
29
What pH would prompt an acute asthma to go to ICU
Less than 7.33
30
What antibiotic should be avoided in long QT
Clarithomycin
31
Which dementia is associated with MND
Frontotemporal dementia
32
Which meningitis causing organism would stain positive for india ink
Cryptococcus
33
Do you use direct or indirect coombs test for haemolytic anaemia
Direct
| Indirect is for new borns
34
Difference in anaemia between autoimmune haemolytic and hereditary spherocytosis
Anaemia mild in hereditary spherocytosis
35
ABG finding addisons vs cushings/conns
Cushings- metabolic alkalosis
| Addions- metabolic acidosis
36
If has second MI 5-10 days after first what is best blood test to carry out
CK-MB as only high for 3-4 days post MI whereas troponin would still be high
37
3 things that cause widened mediastinum
Goitre
Lymphoma
Thoracic aortic aneurysm
38
Which gastroenteritis has longest incubation period
Giardiasis
39
Which gastroenteritis organism causes steatorrhoea
Giardia
40
How is myxoedema coma treated
IV liothyroxine and hydrocortisone
41
Half life of adenosine
10 seconds
42
How early can alpha 1 antitrypsin be diagnosed
Prenatally
43
Enlarged CKD kidneys causes
HIV
Diabetic
Amyloidosis
PCKD
44
Antibodies found in LEMS
Anti voltage gated calcium channel antibodies
45
Most appropriate way to measure diabetic neuropathy
Monofilament test
46
Causes of gout mnemonic
```
DART
Diuretics
Alcohol
Renal disease
Trauma
```
47
Osteoarthritis arthtrocentesis
Calcium phosophate crystals
| Coffin lid shaped
48
Arhtrocentesis rheumatoid
Cholesterol crystals
| Rhmobic shaped
49
Most common cause of hepatocellular carcinoma UK
Hep B
| Hep C worldwide
50
Most common anaphylaxis trigger in children
Food
51
What is any new LBBB treated as
MI regardless of ST elevation
52
Investigation ordered for aortic dissection
CT angio of chest abdo and pelvis
53
Can a GP prescribe anti epileptics after 1 seizure
No must refer to epilepsy clinic
54
Where does uvula deviate in relation to vagus lesions
Away from side
55
What CN palsy causes vertical diplopia
Trochlear nerve
56
How does hepatomegaly feel in cor pulmonale
Tender
Pulsatile
Smooth
57
2 medications given for hepatic encepahlopathy prophylaxis
Rifaximin
| Lactulose
58
If have nephrotic syndrome then develop haematuria and left sided flank pain what is cause
Renal vein thrombosis
59
What age do men have to be to be reffered for 2ww gastroscopy and colonoscopy with IDA
Any!
60
Main risk factors for toxic mutlinodular goitre
Iodine deficiency
| Elderly
61
Management steps to graves
Beta blockers
PTU or carbimazole
Radioiodine
Thyroidectomy
62
Management of thyroid storm way to remember
4 Ps
63
4 Ps of thyroid storm
Propylthiouracil
Potassium iodide
Propanolol
Pred
64
What is main danger of thyroid storm
AF which can deteriorate into high output HF
65
What iatrogenic methods cause hypothyroidism
Amiodarone
Thyroidectomy
Lithium
66
Management of myxoedema coma
Liothyroxine
IV corticosteroids
Supportive
67
What thyroid cancer is associated with hashimotos
Thyroid lymphoma
68
Which thyroid cancer presents with compression sx
Anaplastic
69
How to remember carcinoid syndrome sx
```
CARC
Cutaneous flushing
Asthmatic wheeze
Right sided mumur
Cramps and diarrhoea
```
70
2 skin changes get in carcinoid
Telengiectasia
| Cutaneous flushing
71
Investigations for carcinoid syndrome
Urinary 5-HIAA
CT/MRI to find tumour
Endoscopy/bronchoscopy for histology
72
4 complications of acromegaly
Diabetes
Cardiomyopathy
Colorectal cancer
HTN
73
First line investigation for acromegaly
Serum IGF-1
74
Second line investigation for acromegaly
OGTT
75
First line for acromegaly
Trans-sphenoidal hypophysectomy
76
Second line management for acromegaly
```
Somatostatin analogues (octreotide)
Growth hormone-receptor antagonist (pegvisomant)
Dopamine agonists (bromocriptine/cabergoline)
```
77
Third line management of acromegaly
Radiotherapy if medical/surgical resistant
78
Hypogonadism in females typical symptoms
```
Delayed puberty
Amenorrhoea
Infertility
Low libido
Night sweats and hot flushes
```
79
Physiological cause of hypogonadism
Pregnancy
80
Primary causes of hypogonadism in females
Turners syndrome
Gonadal damage
PCOS
Primary ovarian failure
81
What is primary ovarian failure
Early menopause
82
What are some causes of gonadal damge
Trauma
Radiotherapy
Autoimmune
83
Causes of secondary hypogonadism in females
```
Kallmans syndrome
Pituitary/hypothalamic failure from tumour/infiltration
Hyperprolactinaemia
Functional- stress, eating disorder
Post OCP
```
84
Infiltrative causes of hypogonadism from pituitary failure
Haemochromatosis
85
Pre pubertal signs of hypogonadism in women
No secondary sexual characteristics and primary amenorrhoea
86
Post pubertal hypogonadism signs
Regression of secondary sexual characteristics- breast atrophy and loss of sexual hair
87
Sign of kallmans as cause of hypogonadism
Anosmia
88
Sign of turners as cause of hypogonadism
Webbed neck
| Short stature
89
Sign of hyperprolactinaemia
Galactorrhoea
| Visual field defects
90
Investigations for primary hypogonadism in females
```
Pregnancy test
Bloods
- oestridol
- LH and FSH
- prolactin
- TFTs
Genetic testing, pelvic MRI/USS
```
91
Investigations for secondary hypogonadism in females
Pituitary function tests, MRI
92
Signs of hypogonadism in males
Delayed puberty
Erectile dysfunction
Infertility
Low libido
93
Primary causes of hypogonadism in men
Klinefelters
Gonadal damage- torsion, irradiation, trauma
Post orchitis from mumps
94
Secondary causes of hypogonadism in men
Kallmans
Pituitary/hypothalamic tumours
Hyperprolactinaemia
Prader willi
95
Post pubertal signs of hypogonadism in men
Hair loss
| Gynaecomastia
96
Pre pubertal signs of hypogonadism in men
```
High pitched voice
Small undescended testicles
Small penis
Decreased pubic and facial hair
Eunuchoid proportions
```
97
Signs of klinefelters as underlying cause of hypogonadism
Low IQ
| Behavioral problems
98
What is LH and FSH in promar hypogonadism
Very high
99
What is LH and FSH in secondary hypogonadism
Very low
100
What is main hormone in female that is reduced in all causes
Oestradiol
101
Serous discharge from breast is what
Intraductal papilloma
102
What causes non infectious mastitis
Duct ectasia
103
How does breast abscess feel
Single red lump
| Fluctuant
104
What is wedge shaped lump on breast
Mastitis
105
Management of non lactating mastitis
Analgesia
| Co-amoxiclav
106
Management of moderate lactating mastitis
Analgesia
Milk removal by hot towel etc
Advise to carry on lactation
Abx if sx dont improve
107
Management of severe lactating mastitis
Breast milk culture and refer to hospital
108
When do you give abx in lactating mastitis
If sx dont improve after 24 hrs
109
Management of breast abscess
Referral to hospital for surigcal drainage urgently
110
How does fat necrosis appear
Skin retraction and thickening
| Irregular shape
111
What gives full feeling in breast
Intraductal papilloma
112
Which atypical pneumonia causes bilateral consolidation
Legionella
113
What do if malignant HTN reading but no signs of organ damage on examination
Bloods, urinalysis, ECG to look for other signs of organ damage
114
What are syndesmophytes seen in
Ank spond
115
Role of calcium resonium in hyperkalaemia management
Removes potassium from body
116
What causes upper bitemporal hemianopia
Pituitary adenoma
117
What causes lower bitemporal hemianopia
Craniopharyngioma
118
Prophylactic abx for encephalopathy
Ciprofloxacin
119
Best investigation for mycoplasma pneumonia
Serology
120
If clopidogrel not tolerated in stroke prevention what is alternative
Aspirin and modified release dipyrimadole
121
What can often appear like someone is appearing drunk
Hypoglycaemia
122
X ray findings of ank spond
subchondral erosions, sclerosis
| and squaring of lumbar vertebrae
123
What is lemon tinge to skin associated with
Perncious anaemia
124
What x ray is done in ank spond
Pelvic
125
What is typically in history if have an aspergilloma
TB as child
126
What does management of HAP depend on
How long in hospital
If under 5 days give co amoxiclav
If over give piperacillin with tazobactam
127
What antithyroid drug can be given while waiting for beta blockers to work if sx bad
Carbimazole
128
Most important drug acute HF
IV furosemide
129
What are lipid rich masses seen on CT of adrenals
Most commonly benign masses
130
Most common inherited condition leading to bleeding
Von wilebrand
131
MOst common extra renal symptoms of PCKD
Liver cysts
132
Which cancer is someone most at risk of with HNPCC that isnt colorectal
Endometrial
133
Management of barretts oesophagus with no dysplasia
Surveillance and high dose PPIs
134
Management of barretts oesophagus with dysplasia
Ablation
135
Management of toxic multinodular goitre
Radioiodine
136
AF rate control in asthmatics
Diltiazem
137
What factors can lower Hba1c
Losing weight
| Poor renal function
138
What is cut off for giving potassium with fluids in DKA and HHS
Only give if potassium less than 5.5
139
When is only time can give IV insulin in DKA
If potasssium greater than 3.5
140
What is charcots joint
Joint in foot that where people lose sensation they walk differently putting further pressure on it that can lead to fractures
141
3 diabetic neuropathies
Peripheral neuropathy
Mononeuropathy
Autonomic neuropathy
142
Examples of diabetic mononeuropathy
Wrist drop
Foot drop
3rd nerve palsy
143
Examples of autonomic neuropathy in diabetes
Dysphagua
Constipation
Bladder dysfunction
Postural hypotension
144
Post renal cause of diabetes insipidus
Ureteric obstruction
145
Treatment for cranial diabetes insipidus
Intranasal desmopressin
146
What should people on desmopressin be told not to do
Not drink large amounts of water
147
How is nephrogenic diabetes inspidus treated
Thiazides or NSAIDS
148
Pulmonary causes of SIADH
Pneumonia
| Bronchiectasis
149
Treatment order to SIADH
Fluid restrict and treat cause
If this doesnt work use demeclocycline
Severe give hypertonic saline
150
What does central pontine myelinolysis lead to
Paralysis
Pseudobulbar palsy
Seizures
151
When only do you give hypertonic saline in SIADH
If reduced GCS or seizing
152
Causes of hypernatraemia
```
Unreplaed water loss like GI losses and sweat
Osmotic diuresis
Diabetes insipidus
Cushings
Conns
Iatrogenic hypertonic saline
```
153
How to treat hypernatraemia
5% dextrose
| 0.9%saline
154
How do pituitary adenomas affect rest of hormones
They compress rest of gland leading to hypopituitarism
155
Causes of hyperprolactinaemia
```
Pregnant
Breast feeding
Prolactinoma
Pituitary adenoma
Primary hypothyroidism
```
156
How does hyperprolactinaemia present in men
```
Loss of libido
ED
Infertility
Gynaecomastia
Effect of mass ie headache blurred vision etc
```
157
How does hyperprolactinaemia present in women
```
Galactorrhoea
Secondary amenorrhoea
Loss of libido
Infertility
Effect of mass ie headache blurred vision etc
```
158
Investigations for hyperprolactinaemia
Pregnancy test
TFTs
Basal serum prolactin
MRI
159
Above what serum prolactin suggests adenoma
6,000
160
First line for prolactinomas
Dopamine agonist- bromocriptine or cabergoline orally
161
How does primary hypothyroidism lead to hyperprolactinaemia
Increases TRH that triggers prolactin release
162
If patient has prediabetes Hba1c what test carry out
fasting glucose- Hba1c isnt as sensitive for DM as fasting glucose
163
Inheritacne of MODY
Dominant
164
When there is raised ICP on one side(right lets say here) and there is a CN palsy what side typically gets affected
The side of bleed
165
What drug can be used in management of severe alcoholic hepatitis
Pred
166
What is double duct sign seen in
Pancreatic cancer
167
Before a gastroscopy how long before should PPIs be stopped
2 weeks
168
If someone presents with acute breathlessness and chest is clear what is most likely diagnosis
PE
169
If DM patient starts seizing after fluid resus what is most likely cause
Cerebral oedema
170
ECG findings in hypothermia
```
bradycardia
'J' wave - small hump at the end of the QRS complex
first degree heart block
long QT interval
atrial and ventricular arrhythmias
```
171
What does a hypodense crescenteric finding on head CT suggest about subdural
That it is chronic
172
What is activated protein C resistance another name for
Factor V leiden
173
If someone is in AF permenantly but is chad vasc of 0 what do
No treatment
174
If CTPA negative and PE suspected what do
Offer proximal leg US
175
If patient experiencing chest pain post PCI still in hospital what offer
CABG
176
Why cant ppl with migraines be given the OCP
Risk of stroke
177
Metabolic predispositions to osteoarthritis
Wilsons
Haemochromatosis
Acromegaly
178
How is diagnosis for osteoarthritis made
If over 45 can be clinical
| If under do X ray
179
What is palindromic rheumatism
short, self limiting episodes of inflammatory arthritis (joint pain, swelling, stiffness) of only a few joints
180
Most common site of purpuric rash in amyloidosis
Periorbital purpura
181
Which signs only occur in AL amyloid
Cardiomyopathy
| Macroglossia
182
Metabolic associations of pseudogout
Acromegaly
Wilsons
Haemochromatosis
Hyperparathyroidism
183
What are crystal arthropathies often preceded by
Infection
| Trauma
184
X ray finding of gout
Rat bite erosions
185
How long does uric acid take to be elevated in gout
4-6weeks
186
3 ways osteomyelitis can be caused
Spread in blood
Continuous spread
Direct inoculation
187
Main risk factors for osteomyelitis
```
IVDU
Immunosuppression
DM
Sickle cell
Cellulitis
Ulcers
Penetrating injury
Surgery
```
188
If have sickle cell what is cause of osteomyelitis
Salmonella
189
In children what bones are typically affected in osteomyelitis
Long bones
190
In adults what bones are typically affected in osteomyelitis
Vertebrae
191
Invesitigations for osteomyelitis
Bloods- WCC,CRP,ESR
XR/MRI
Bone/swab/ blood culture
192
What is best imaging for osteomyelitis
MRI
193
What is seen on imaging of osteomyelitis
Darkened in affected areas
| Periosteal thickening
194
How long does it take for osteomyelitis imaging signs to be seen
2 weeks
195
What do you get brittle slow growing toe nails in
Intermittent claudication
196
What does atrophic skin occur in
CLI
197
When is IC pain worse
When walking uphill
198
Investigations for PVD
```
Bloods- glucose, lipids
ECG
ABPI
Duplex scan
Magnietic resonance angiography
```
199
What is beneficial about magnetic resonance angiogram in PVD
Is no contrast
200
Normal ABPI
.9-1.2
201
CLI ABPI range
Less than .5
202
First line for leriche syndrome
CT angio
203
Which ulcers have pale base from grey granulation tissue
Arterial
204
Ulcer night pain worse supine
Arterial
205
What are edges in arterial ulcers
Well defined
206
Ulcer that is itchy and swollen
Venous
207
What are 4 signs of venous ulcers
Lipodermatosclerosis
Atrophie blacnhe
Haemosederin deposition
Stasis eczema
208
What is atrophie blanche
Area of white shiny atrophie skin
209
Gold standard investigation for arterial and venous ulcer
Duplex USS
210
Why would you biopsy venous ulcer
If possibility of marjolins ulcer
211
What is a marjolin ulcer
One where a squamous cell carcinoma develops from areas of chronnic inflammation
212
Management plan for venous ulcers
Gradeed compression stocks with greatest pressure distally
Debride and clean
Abx if infeted
Moisturising cream
213
If want to treat venous ulcers with compression stockings first what must do
Exclude DM, neuropathy and PVD
214
How is a AAA defined
Enlargement of arota greater than 3cm or 50% of previous size
215
What is a false aneurysm
Tear in tunica intima leading to false lumen like in dissection
216
Whatvare 2 true aneursysms of AAA
Fusiform
| Saccular
217
What is difference between saccular and fusiform aneurysms
Fusiform is distended on both sides but saccular only 1
218
Symptoms of AAA
Normally asymptomatic but can have back or tummy pain
219
Symptoms of ruptured AAA
Sudden pain anywhere in back or tummy
Shock
Syncope
220
Sign on examination of burst AAA
Grey turners sign
221
Sign on examination of AAA
Pulsatile and expansile mass on palpation
| Abdominal bruit
222
First line investigation for AAA
US
223
First line investigation for ruptured AAA
CT angio
224
Investigation done for ruptured AAA if allergic to contrast or renal impairment
MR angion
225
What does murmur heard on back suggest
Aortic dissection
226
What is crack cocaine often a risk factor for
Aortic dissection
227
Diagnostic test for aortic dissection
CT angio
228
Definition of varicose veins
Subcutaneous permenantly dilated venis over 3mm
229
Main risk factors for varicose veins
Age
Female
Obestiy
White
230
What causes 98% of varicose veins
Idiopathic valvaular incompetence
231
How can secondary causes of varicose beins be classified
Venous outflow obstruction
DVT
AV malformations
232
Venous outflow obstruction causes of varicose veins
Pregnancy
Ascites
Ovarian cysts
Pelvic malignancy
233
Symptoms of varicose veins
Visible dilation of veins
Leg aching on standing
Swelling and itching
Can bleed
234
When are varicose veins most painful and visible
On standing
235
First line investigation for varicose veins
Duplex US
236
Conservative management of varicose veins
Compression stockings
Weight loss
Leg elevation
237
Endo vascular treatment of varicose veins
Radiofrequency ablation
Endovenous laser ablation
Microinjection scleropathy
238
Surgical management of varicose veins
Stripping of the long saphenous vein
Saphenofemoral ligation
Avulsion of varicosities
239
Complications of varicose veins
Venous ulcers
Stasis eczema
Lipodermatosclerosis
Haemosederin deposition
240
Signs on examination of varicose veins
Veins feel hard or tender
| Bruits
241
What is tap test
Used in varicose veins
| Tap VV distally and will feel thrill over saphenofemoral junction
242
Odonyphagia in HIV patient
Candidiasis
243
First line investigation for people with stable chest pain
CT angio
244
Most common cause of meningitis in middle aged person
Strep pneumonia
245
What is new test used to diagnose hereditary spherocytosis
EMA binding test
246
Who does type 2 AIH occur in
Children
247
Dactylitis in an arthritis history of hands
Psoriatic arthritis
248
If have addisons and are ill what is done to hydrocortisone and fludrocortisone dose
Hydro x2
| Fludro keep the same
249
Which lymphoma is coeliac associated with
Enteropathy associated T cell lymphoma
250
Which lymphoma is H pylori infection associated with
MALT lymphoma
251
Which underlying disease can lead to a false mantoux test when have TB
Sarcoidosis
252
Which virus most commonly causes meningitis
Cockasackie B
253
What does diarrhoea worse around periods suggest
IBS from stress
254
What is needed to diagnose TLS
Arrythmia
High creatinine
Seizure
255
What do to antiplatelets if someone has stable CVD then develops AF
Stop clopidogrel and start DOAC
256
What scar is made in whipple procedure
Rooftop
257
Most significant determinant of c diff disease
WCC
258
If someone has steatorrhoea post cholecystectomy what is treatment
Cholestyramine
259
What can differentiate on presentation pancreatic cancer from PSC or PBC
Appetite
260
Some common triggers of ulcerative colitis
NSAIDS
Abx
Smoking cessation
261
In crohns refractory to steroid treatment what drug is used
Infliximab
262
What is excessive salivation associated with
Wilsons
263
Which other cancer in men can HNPCC be linked to
Renal
264
Gastroenteritis organism if person has been in swimming pools
Giardia
265
Gastroenteritis organism if steatorrhoea
Giardia
266
What is used to determine severity of liver cirrhosis
Child pugh
267
Caecal volvulus management
Right hemicolectomy
268
Rfs for caecal volvulus
Pregnancy
| Adhesions
269
Treatment for mild/moderate UC
Rectal aminosalicylate
270
What does double target sign on CT suggest
Liver abscess
271
What is bleeding gums seen in
Vit C deficiency
272
Which cancer will PSC cause in questions
Cholangiocarcinoma
273
Which cancer other than gastric will cause sister mary joseph node
Cholangiocarcinoma
274
What is given first line to someone with
Bulk forming laxatives
275
What vitamin deficiency affects acclimatisation to light
Vitamin A
276
First line for alcohol withdrawal
Benzodiazepine
277
What vitamin defiency presents with mass bleeding in infancy
K
278
Conditions associated with NF1
Phaeos
| Scoliosis
279
Most common non motor feature of parkinons
Depression
280
If gastroenteritis doesnt disappear after 2 weeks what investigation is done next
Stool sample
281
What is seen on CT of pyelonephritis
Gas
282
What congenital kidney defect leads to hypercalciurua
Medullary sponge
283
If there is an acute badder obstruction what would be seen on imaging of KUB
Bilateral hydronephrosis
284
What test would you carry out to confirm T2DM in a symptomatic patient
Random gluocse
285
What is it called when get cushings following removal of adrenals
Nelson syndrome
286
What are faggot cells seen in
APML
287
What blood cancer is downs a risk factor for
AML
288
Risk factors for non hodgkins lymphoma
Sjogrens
289
How is lymphoma staged
Ann arbor
290
What is seen on bone marrow aspirate of myeloma
Plasma cells of over 10%
291
What is MGUS
Premalignant condition where get accumulation of some plasma cells but no CRAB features
292
Primary vs secondary myelodysplasia
Primary is intrinsice BM problem
| Secondary radiation and chemo
293
What is tetany caused by
Hypocalcaemia
294
How to diagnose haemophilia
Factor assay that will distinguish A from B
295
What is difference between acute overt and chronic non overt DIC
Acute occurs in sepsis and leads to depletion of of plts and clotting factors so is bleeding
Chronic non overt they dont get used up so compensatory mechanisms mean factors are replaced leading to more clotting than bleeding
296
What Vwb disease presents with normal vwb levels
Type 2
297
Levels of vwb factor in all 3 types
T1- reduced levels of normal vwf
T2- normal levels of defective vWF
T3- complete lack of vwf and factor 8
298
What is MCV in SCD
Normal
299
Clotting factor affected in Haemophilia A vs B
A 8
| B 9
300
Inheritance of types of VWB
1 and 2 dominant
| 3 recessive
301
What condition changes threshold of Hb for transfusion
ACS
| Makes it 80 instead of 70
302
If flu and fever are present what does this suggest about SCD patients exacerbation
Parvovirus leading to aplastic crisis
303
Young person with IDA what should be screened for
Coeliac
304
Anaemia in young person from northern europe
HS
305
What causes erythema infectiosum
Parvovirus B19
306
What is progression in richters transformation
CLL to diffuse large b cell NHL
307
Most common contaminated infection for platelet transfusions
Bacterial
308
Meningitis with CN involvement
Listeria
309
What is dextrocardia on ECG
Inverted p waves
310
At what temperature can patients in VF/VT be shocked
Above 30
311
If topical 5-ASA dont work to begin with in moderate UC what do next
Oral 5-ASA then if this doesnt work add oral pred
312
Which pneumonia leads to reactivation of HSV
Strep pneumonia
313
Which organism would lead to sepsis pneumonia after a splenectomy
Pneumococcal
314
AF rate management if NBM
Metoprolol
315
Order of most common cushings causes
Exogenous steroids
Cushings disease
Adrenal tumour
Ectopic ACTH
316
Order to cushings investigations
24 hour cortisol/ low dose dexamethasone
Midnight ACTH
High dose dexamethasone/petrosal venous sampling
317
Alternative test to high dose dexamethasone
petrosal venous sampling
318
2 associations of phaeochromocytoma
Von hippel landau
| MEN 2
319
Diagnostic criteria for PCOS
Diagnostic criteria (2 out of 3):
Amenorrhoea/Oligomenorrhoea
Clinical or biochemical hyperandrogenism
Polycystic ovaries on USS
320
What is a decubitus ulcer
Pressure ulcer
321
When cant you give IM glucagon
Alcohol
322
What are seizure auras
Actually seizures- if have grand mal after aura is secondary tonic clonic
323
If someone on chemo presents severely with sepsis what is most important first investigation
FBC- neutropenia
324
What does parallel lines on CXR suggest
Bronchiectasis
325
How does myeloma increase stroke risk
Paraproteinaemia
326
First line investigation for metastatic prostate cancer
MRI
327
What give if elderly with varicella zoster
Oral aciclovir
328
What give if elderly with disseminated varicella zoster
IV aciclovir
329
What can cause a rapid drop in plts after heparin treatment
Heparin induced thrombocytopenia
330
What can happen when shingles reactivated in facial distribution
Conjunctivitis
