Peer Teaching Mock 2 Questions Flashcards
1
Q
- What is the aim of the cervical cancer screening programme ?
A
- Screen for HPV
- Screen for abnormal cells indicative of pre-invasive (dyskaryosis) disease
2
Q
- How regularly are cervical screenings conducted ?
A
- Every 3 years in 25-49 year olds
- Every 5 years in 50-64 year olds
3
Q
- RFs for cervical cancer ?
A
- Multiple sexual partners
- Younger age at first intercourse
- Non-attendance at smears
- Immunosuppression
- Oral contraceptives
- Higher parity
- Tobacco use
- Deprivation
4
Q
- What would one see on speculum examination that could suggest malignancy ?
A
- Ulceration
- Visible mass
- Inflammation and bleeding
5
Q
- What are RFs for bacterial vaginosis ?
A
- Excessive vaginal cleaning
- Multiple sexual partners
- Smoking
- Recent antibiotic treatment
- Copper coli
6
Q
- How best should a 70 yo with urinary symptoms be investigated and why ?
A
- Urine culture and sensitivities
- NICE does not recommend doing urinary dipstick in women over the age of 65
7
Q
- What are the criteria of a CURB score ?
A
- Confusion
- Urea >7 (mmol/L)
- RR >30
- BP 90/60
- Age >65
8
Q
- What blood tests would be requested as part of a confusion screen ?
A
- FBC
- CRP/ESR
- Folate and B12
- U&Es
- HbA1c
- Calcium
- LFTs and TFTs
9
Q
- What is the most common type of leukaemia in children and what condition is it associated with ?
A
- Acute lymphoblastic leukaemia
- Down syndrome
10
Q
- What type of adult leukaemia is associated with the Philadelphia chromosome ?
A
- Chronic myeloid leukaemia
11
Q
- What leukaemia is associated with Auer Rods and Blast cells ?
A
- Acute myeloid leukaemia
12
Q
- What genetic mutation is the Philadelphia chromosome ?
A
- Translocation of chromosomes 9 and 22
13
Q
- How should leukaemia be investigated ?
A
- FBC
- Peripheral blood film
- Bone marrow biopsy
14
Q
- What is a common complication of treatment of chemotherapy for leukaemia ?
A
- Tumour lysis syndrome
15
Q
- What is the age of incidence of leukaemia ?
A
ALL: 0-14
- AML: 14-39
- CML: 40-59
- CLL : 60+
16
Q
- Hyperthyroid signs
A
- Fine tremor
- Palmar erythema/warm sweaty hands
- Tachycardia
- Atrial fibrillation
- Pretibial myxedema
- Lid retraction/lid lag
- Exophthalmos
- Acropachy
17
Q
- What is the most serious side effect of carbimazole ?
A
- Bone marrow suppression leading to pancytopenia and agranulocytosis
18
Q
- What signs might suggest a patient is suffering from bone marrow suppression secondary to carbimazole ?
A
- Bruising
- Mouth ulcers
- Sore throat
- Fever
- Malaise
- Non-specific illness
19
Q
- RFs for placental abruption ?
A
- PMHx
- Pre-eclampsia
- Abnormal lie of baby
- Age of mother > 40
- Abdominal trauma
- Smoking or cocaine use
- Multiple pregnancy
- Gestational diabetes
20
Q
- What are differentials for placental abruption ?
A
- Placenta praevia
- (Vasa praevia)
21
Q
- What are features of an Apgar score ?
A
- Appearance/body colour
- Pulse rate
- Grimace/reflex irritability
- Activity/muscle tone
- Respiratory effort
22
Q
- What are activities of daily living ?
A
- Bathing/shower
- Toileting
- Getting dressed/grooming
- Walking
- Eating meals/feeding
- Transferring/moving from bed to chair/standing from sitting
23
Q
- Which type of laxatives should be avoided in constipation secondary to opioid induced ?
A
- Bulk forming e.g. ispaghula husk
24
Q
- What laxatives should be offered for opioid induced constipation ?
A
- Osmotic e.g. Laxido or macrogol
- And stimulant laxative e.g. senna
25
25. What are symptoms of issues of urinary voiding ?
- Hesitancy
- Weak or intermittent stream
- Splitting
- Spray
- Straining
- Incomplete emptying
- Terminal dribbling
26
26. What are symptoms of issues of urinary storage ?
- Urgency
- Frequency
- Nocturia
- Incontinence
27
27. Which validated screening tool is used to evaluate LUTS and give a symptom score?
- International prostate symptom score ?
28
28. 1st line investigation for prostate cancer ?
- Used to be biopsy but is now multiparametric MRI
29
29. What is the most common site of prostate cancer metastasis ?
- Bone
30
30. What is the name for when a child becomes irritable, struggles with his breathing, and then his lips turn blue ?
- Tet spells
31
31. What anatomical abnormalities make up TOF ?
- Pulmonary stenosis
- Right ventricular hypertrophy
- Ventricular septal defect
- Overriding aorta
32
32. What pregnancy test would you offer to a women to screen for Down’s syndrome ?
- Combined test
33
33. What would suggest Down’s on a combined test ?
- Thickened nuchal translucency
- Reduced PAPPA
- Raised beta-HCG
34
34. What test would you offer a pregnant woman to confirm Down’s
diagnosis from the screening tests during pregnancy?
- Chronic villus sampling
- Amniocentesis
35
35. What medication can be used in polycystic kidney disease ?
- Tolvaptan
36
36. What symptoms would suggest smoke inhalation ?
- Burning sensation in nose or throat
- Productive cough
- Stridor, dyspnoea and SOB
- Wheezing, horse voice
- Cyanosis
- Tachypnoea
37
37. What effect does carbon monoxide have on the oxyhaemoglobin dissociation curve and how does this cause symptoms of carbon monoxide poisoning?
- Carbon monoxide has a greater affinity for haemoglobin than oxygen (so readily
- binds to Hb)
- Causing the curve to shift to the left
- Left shift → increased affinity of haemoglobin for oxygen / so haemoglobin holds onto
- oxygen more tightly
- Reducing the release of oxygen to tissues, causing hypoxia and the associated symptoms
38
38. What is the definition of a hernia ?
- Protrusion of part or whole of an organ or tissue through the wall of the cavity that normally contains it
39
39. What is the difference between a direct and indirect inguinal hernia ?
- Direct inguinal hernias – the bowel enters the inguinal canal directly through a weakness in the posterior wall of the canal whereas indirect hernias the bowel enters the inguinal canal via the deep inguinal ring
40
40. What are common types of hernia seen in infants
- Indirect inguinal hernia
- (Occur because of a) patent processus vaginalis
41
41. What are the complications of an incarcerated/irreducible hernia ?
- Obstruction and strangulation
42
42. What is the pathology of wet macular degeneration ?
- WET – neovascular – new choroidal blood vessels formation
- Leakage of serous fluid and blood which can result in rapid loss of vision
43
43. What medication and what route is wet macular degeneration managed ?
- Anti-vascular endothelial growth factor
- Intravitreal injection
44
44. What is the triad of shaken baby syndrome ?
- Retinal haemorrhages
- Subdural haematoma
- Encephalopathy
45
45. What are RA x-ray changes ?
- Loss of joint space
- Juxta-articular osteoporosis
- Soft-tissue swelling
- Periarticular erosions
- Subluxation
46
46. Typical features of RA presentation ?
- Swollen, painful joints in hands and feet
- Stiffness worse in the morning
- Gradually gets worse with larger joints becoming involved
- Presentation usually insidiously develops over months
- Positive squeeze test – discomfort on squeezing across the metacarpal or metatarsal joints
47
47. What are late features of RA ?
- Swan neck
- Boutonniere deformity
48
48. What is fine line antibody investigation for RA and which AB is more specific ?
- Rheumatoid factor
- Anti-CCP
49
49. What are the medical terms for a hip replacement ?
- Total hip arthroplasty
- Hemiarthroplasty
50
50. Name 3 features of skin lesions that are suggestive of chronic plaque psoriasis ?
- Raised clearly defined plaques
- Found on the extensor surfaces/elbows + knee/trunk/scalp
- Symmetrically distributed
- Pink or red erythematous violet or grey in pigmented skin
- Silvery scales
- Itch
- Auspitz sign – pinpoint bleeding if scale removed
51
51. Which type of psoriasis presents with a ‘’rain drop appearance’’ – multiple small scattered scaly papules ?
- Guttate psoriasis
52
52. Reasons to refer to a dermatologist for psoriasis ?
- Suspected generalised pustular psoriasis (emergency)
- Suspected erythrodermic psoriasis (emergency)
- Uncertainty about diagnosis
- Extensive involvement (more than 10%)
- Moderate or severe disease
- Resistance to topical drug treatments in primary care
- Significant impact on physical, psychological or social wellbeing
53
53. What is the difference between the terms ‘oligoarthritis’ and ‘polyarthritis’ ?
- Oligoarthritis affects 4 joints for fewer
- In polyarthritis more than 4 joints are involved
54
54. Nail signs for psoriatic arthritis
- Nail pitting
- Onycholysis
55
55. Name the difference between mania and hypomania ?
- Mania must have lasted for at least 6 weeks whereas in hypomania they only have to lasted for 4 days
- A manic episode includes psychotic features (delusions/hallucinations)
- A manic episode is severe enough to cause marked impairment in social or occupation functioning or necessitate hospitalisation
56
56. What is section 4 of the mental health act ?
- Allows the emergency detainment for the purpose of assessment for a duration of up to 72 hours
- The application can be made by the nearest relative or an Approved Mental Health Professional and must be supported by one doctor
57
57. When is lithium monitored when initiating treatment ?
- Weekly until concentrations are stable
58
58. How long after taking a dose should lithium levels be checked ?
- 12 hours post-dose
59
59. What 2 serological markers are used initially in Hep B screening ?
- HBsAg
- Anti-HBc
60
60. What serological marker gives a direct count of viral load ?
- HBV DNA
61
61. What is injected in Hep B vaccine ?
- HBsAg
62
62. Which forms of hepatitis can be vaccinated against ?
- Hep B
- Hep A
63
63. What investigations should a patient have post seizure ?
- EEG
- MRI head
- Blood glucose
- FBC U&Es
64
64. What are gout crystals composed of ?
- Monosodium urate
65
65. What are pseudogout crystals composed of ?
- Calcium pyrophosphate
66
66. 1st line for acute gout ?
- NSIADs or colchicine
67
67. 1st line and 2nd to prevent gout attacks ?
- Allopurinol (Xanthine oxidase inhibitor)
- Febuxostat
