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1
Q

3 cyanotic CHD?

Mx?

A

TGA, ToF, hypoplastic L heart

PG infusion - alprostadil

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2
Q

Features of moderate dehydration

A

Sunken font and eyes, reduced skin turgor, CRT 2-5s, fewer wet nappies

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3
Q

Features of severe dehydration

A

Absent tears, tachycardia, hypotension, shock, CRT>5 secs, oliguria

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4
Q

RED NICE traffic light system

A

<3m and >38C, RR>60, focal neuro signs, status, neck stiffness, grunting, reduced skin turgor, severe indrawing

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5
Q

DOLS 3 things it ensures

A

Regular review - less restrictive option, best interests, right to appeal

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6
Q

DOLS 3 things needed

A

Lack capacity, under continuous supervision, can’t leave

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7
Q

Congenital Rubella syndrome

A

Sensorineural deafness, eye defects, heart (PDA, PS)

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8
Q

CURB65 - measures and tx

A

Confusion, urea >7, RR>30, BP<90/60, >65 years
1- oral amox
2 - oral clarithro+amox
3- IV clarithromycin and amoxicillin

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9
Q

Centor criteria and tx if positive

A

Temp>38, no cough, tonsillar exudate, C lymphadenopathy

Tx - PenV or clarithromycin

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10
Q

1st trimester - what test to estimate dates?

A

Crown rump length

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11
Q

US sign in monochorionic and dichorionic

A

Mono-T

Di-lamda

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12
Q

Placenta accrete
Placenta increta
Placenta percreta

A

A- attached to myometrium
I-invade myometrium
P-invade all through myo and to neighbouring organs

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13
Q

Spinal shock sx

A

Decreased reflexes, AD

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14
Q

Dementia investigations

A

CT head, Addenbrookes, B12/folate, FBC, alcohol, HIV, TFT, lipids/ glucose (vascular), infxn (delirium)

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15
Q

Gentamicin organs it affects

A

Neuro/ears (CN 8) and kidney

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16
Q

Downs complications

A

Biliary atresia, Hirschprungs, recurrent otitis media, leukaemia, hearing and vision loss, LD, AVSD

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17
Q

Ix in febrile seizures

A

EEG, CT head, infective cause, LP (exclude meningitis)

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18
Q

Ix in neonatal jaundice

A

TFT, LFTs, Coombs test, blood film, total serum BR, Rhesus and ABO

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19
Q

What leads to desquamation in toxic shock syndrome?

A

Exfolative toxin of s.aureus leads to peeling skin

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20
Q

2 causes of purpuric rash?

A

HSP, N. meningitides

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21
Q

COPD first line tx

A

Stop smoking, pulmonary rehab, flu vacc

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22
Q

Signs of TB on CXR?

A

Perihilar and mediastinal enlarged LN, pleural effusion, upper lobe cavitation and consolidation

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23
Q

Tx of TB and complication of each

A

Rifampacin -red urine
Isoniazid - P neuropathy
Pyrazinamide - gout
Ethanbutamol - neuritis

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24
Q

Ix for TB?

A

IGRA - IFN gamma release assay
Sputum culture
Mantoux test/ tuberculin skin test
HIV test (don’t give BCG)

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25
Signs and symptoms of hyperthyroidism?
Diarrhoea, tachycardia, eye signs, tremor, hyperreflexia, goitre, weight loss, menorrhagia, mania, heat intolerance, palpitations, sweating
26
Signs and symptoms of hypothyroidism?
Constipation, weight gain, proximal myopathy, pretibial myxoedema, fatigue, cold intolerance, oligomenorrhoea, hyporeflexia, bradycardia
27
Teratogenic medications
Warfarin, statins, Na valproate
28
Complications of placental abruption?
DIC, Sheehan's syndrome, Rh sensitisation, neonatal hypoxia, renal failure, shock
29
US signs of Ova malignancy?
Solid, bilateral, septate, increased vascularity
30
Ix in suspected ovarian cancer?
TVUS, FBC, CA125 (+99), pelvic XR, PET scan, hCG
31
Pre-eclampsia ix?
Fundoscopy, BP, urine dip, TA US, CTG, Pr:Cr ratio, reflexes (increased), UA doppler
32
Severe features of pre-eclampsia
Pul oedema, RUQ pain, IUGR, oliguria (risk of stroke)
33
Tubal patency Ix
HyCoSy - hysterosalpingo contrast sonography
34
Types of schizophrenia
``` Please help cats run +o Paranoid (most common) Hebephrenia Catatonia Transient Simple Residual Organic ```
35
Can you treat someone's rash under section 2?
No - only if secondary to MH condition
36
3 FGA
haloperidol, flupenthixol, chloropromazine
37
2 depression scores
PHQ-9 - 2 screening qs - in last month how often have you felt down/ depressed/ hopeless, anhedonia Becks depression inventory
38
Psycho tx for OCD?
Mindfulness, ERP (exposure response prevention), CBT
39
3 examples of features of ADHD?
Hyperactivity - can't sit still, runs, climbs over things, restless Impulsivity - poor road safety, interrupts others, blurts things out Inattention - can't follow instructions, loses things, can't finish homework
40
SE of metoclopramide?
DA antagonist - parkinsonian
41
Paracetamol overdose ix?
Urine drug screen, alcohol (carbohydrate deficient transferrin), LFTs, coagulopathy, ABG, glucose
42
Features of comprehensive geriatric assessment?
Bio - medications review Psycho - psychologist Social Functional
43
What is the rule of rescue?
Ethical imperative to save endangered life where possible - even if money might be better spent to prevent disease
44
Types of neglect?
``` Her name means poo Human error Neglect Misconduct Poor performance ```
45
Types of error
``` Bravado Lack of skill Poor teamwork Sloth Playing the odds System error Loss of perspective Ignorance ```
46
Cumulative incidence definition
Accumulated risk over time - risk of person will be affected by an event during the time period New cases/size of pop at risk at start
47
Incidence rate definition
New cases in time period/ person-time
48
Triangle of confounding, exposure, outcome
Exposure to outcome, with confounding above and arrows down to both
49
Bridging the gap in intention to action in TPB
``` SAPPI Self-relevance Anticipated regret Perceived control Prep action Implementation intentions ```
50
Reporting never event
NRLS - national reporting and learning system StEIS - strategic executive information system CQC visit and money penalty
51
System approach
Look at system - situations and factors likely to lead to error and change underlying system of care
52
2 SEs of ACEi, BB, statins, ARB, CCB
BB - impotence, bradycardia, sleep disturbance ACEi - cough, angioedema Statins - myopathy, D&V CCB - flushing, ankle oedema
53
Structure
What is there e.g. number of A&E beds
54
Process
What is done e.g. number of patients seen in 1 hour
55
Outcome
change attributable to intervention Mortality, PROM, QoL, morbidity 4ds - dissatisfaction, death, disability, discomfort
56
Types of qualitative data
Interviews, review of documents, focus groups, observations
57
Types of quantitative data
Routinely collected data, review of records, surveys, epidemiological studies
58
Schizophrenia blood tests?
Glucose, LFTs, TFTs, Ca, drug toxicology, alcohol - carbohydrate deficient transferrin
59
Olanzapine review tests
BP, ECG, weight
60
Schizo psych mx
CBT, family therapy, psychodynamic
61
What is most common organism in childhood pneumonia?
RSV (s.pneumoniae bacterial)
62
GBS CSF changes
high protein, normal WCC and glucose
63
bugs that cause GBS
campylobacter, CMV, EBV, mycoplasma
64
tx of GBS
IvIg and plasma exchange
65
Prophylaxis of migraine
BB | Topiromate/ sodium valproate
66
Define evaluation
An assessment of if a service achieves its objectives - relevance, effectiveness and impact of its activities
67
Why is health outcome not ideal?
Time lag, relies on quality of data, hard to show cause +effect, large sample size needed
68
TST complications?
weight gain, polycythaemia, sleep apnoea
69
Causes of muscle weakness?
MND, statins, steroids, malnutrition, ca
70
2 tx for IUGR
betamethasone | MgSO4 - neuroprotective

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