Phase 4 random extras

Question 1

describe the different types of lung cancer and a memorable feature of each

Answer 1

SCLC - bad, rarer, diffuse at presentation

NSCLC:

• adenocarcinoma [non-smokers]
• SCC [PTH secreting, airways]
• large cell - fast growing`

Question 2

heart murmurs louder of inspiration or expiration indicates what and why?

Answer 2

inspiration exacerbates right sided murmurs due to inrcease in venous return

exp exacerbates left sided murmurs, due to decrease in venous return

Question 3

testicular teratoma, seminoma, lymphoma. Usual age of presentation and whether they get gynaecomastia or not

Answer 3

teratoma - young men, yes gynaecomastia

seminoma - 40s, yes gynaecomastia

lymphoma - 40+, no gynaecomastia

Question 4

how does DKA affect Na+ levels

Answer 4

hyponat

Question 5

acute asthma Mx pneumonic

Answer 5

“O SHIT ME”

O2
Salb nebs
Hydrocort IV
Ipratropium nebs
Theophilline IV
Mg IV
Escalate!

Question 6

palpable location of femoral vs inguinal hernia

Answer 6

femoral inferior and lateral to pubic tubercle

An inguinal hernia would produce a lump above and medial to the pubic tubercle.

Question 7

Erythema of the overlying skin in hernia means what

Answer 7

occurs in strangulation and is a sign of poor outcome.

Question 8

which hernia occurs most frequently in elderly multiparous women and has a male:female ratio of 1:4

Answer 8

femoral

Question 9

why should you not treat hypokalaemia in a patient who has just had dialysis?

Answer 9

95% of body potassium is in the intracellular fluid

takes a while after dialysis [removal of blood K+] for cell potassium to move into blood

treating post-dialysis hypokalaemia will rapidly result in hyperkalaemia!

Question 10

24 yr old with headache worsened over 3 days, worse in the morning. Neck stiffness, mild photophobia. Takes COCP, recently had amoxi for sinus infection. Diagnosis?

Answer 10

cavernous sinus thrombosis [complication of sinus infection]

Question 11

which anti-epileptic can induce a PCOS-like syndrome?

Answer 11

sodium valproate

Question 12

1st line treatment for lyme disease

Answer 12

Doxycycline

Question 13

what is a compound fracture?

Answer 13

open/ bone lacerates soft tissue and protrudes through skin

Question 14

give the different types of laxatives and an example of each

Answer 14

stimulant -senna
osmotic - lactulose, movicol
stool softener -docusate sodium
bulk forming - ispaghula husk

Question 15

how do you calculate ABPI ? what is normal and what value is PAD

Answer 15

ankle / brachial

1-1.2 normal
0.5-0.9 PAD

Question 16

in intermitent claudicatiion, calf pain vs buttock suggests disease in which vessels?

Answer 16

calf -femoral

buttock - iliac

Question 17

2 aspects of having a valve replacement that interfere with having a dental operation

Answer 17

endocarditis risk

on anticoag!

Question 18

what causes the blind spot?

Answer 18

The natural blind spot (scotoma) is due to lack of receptors (rods or cones) where the optic nerve and blood vessels leave the eye

Question 19

MRSA abx

Answer 19

vancomycin IV