PP3

Question 1

cluster headache characteristics

Answer 1

daily (in clusters) over weeks

eye symptoms

Question 2

trigeminal neuralgia characteristics

Answer 2

brush teeth, shaving, sharp stabbing pain, last seconds

Question 3

trigeminal neuralgia associated with

Answer 3

multiple sclerosis

Question 4

what is ramsay hunt syndrome

Answer 4

reactivation of VZV in genticulate ganglion of facial nerve –> facial nerve palsy, altered taste, dry eyes, ear rash

Question 5

Ischaemic Collitis, IBD, IBS, Coeliac, Gastroenteritis triad + more specific

Answer 5

Bloating, diarrhoea, urgency (rush to toilet) - young person
Ischaemic Collitis (elderly) + IBD = bloody diarrhoea
Coeliac = steatorrhoea + dermatitis herpetiformis (rash on elbows - extra GI)
Gastroenteritis = acute not long symptoms

Question 6

Investigations of Coeliac disease

Answer 6

1st line: Serology Abs = tissue transglutaminase, anti-endomysial, anti-gliadin abs
GOLD: OGD + duodenal biopsy = subtotal villous atrophy with crypt hyperlasia

Question 7

what can be: Stones, Bones, Abdo groans, Thrones (polyuria, constipation), Pyschic moans due to?

Answer 7

Hypercalcaemia

Which may be due multiple myeloma (CRAB)

Question 8

Microscopy of multiple myeloma

Answer 8

rouleaux formation

Question 9

Microscopy of myelofibrosis

Answer 9

dacrocytes (tear)

Question 10

Microscopy of Chronic Lymphoid Leukaemia

Answer 10

Smear/ smudge cells

Question 11

Microscopy of myelodysplastic syndrome

Answer 11

granulocytes with absent granulation + hypersegmented nuclei

Question 12

Feverish traveller CONDITIONS

Answer 12

TB, malaria, Viral hepititis, gastroenteritis

Question 13

TB triad

Answer 13

productive cough and haemoptysis
erythema nodosum
lupus valgaris

Question 14

Investigations of TB

Answer 14

1st line: sputum for acid fast bacillI using Ziehl-Neelsen stain
GOLD: sputum sample (take 6 wks)
CXR = upper lobe consolidation + bilateral hilar lymphadenopathy
Mantoux test = cannot differ active + latent TB

Question 15

Investigations of Pancreatitis

Answer 15

1st line = Transabdo USS
CT = staging/ MRCP if renal insufficiency coz IV contrast
ERCP = only if have gallstones

Question 16

what is seen with Increase in ICP

Answer 16

Cushing’s reflex = high BP, bradycardia, irregular breathing

Question 17

What is seen in Impaired R ventricular filling (constrictive pericarditis, restrive cardiomyopathy)

Answer 17

Kussmaul sign = increase in JVP with inspiration

Question 18

Triad for cardiac tamponade

Answer 18

Beck’s triad = increase in JVP, muffled heart sounds, decrease BP

Question 19

Cause of malaria

Answer 19

Protazoan = plasmodium (P.falciparum) –> bite of female anopheles mosquito –>infect RBC and replicate inside

Question 20

symptoms of malaria

Diagnosis of malaria

Answer 20

cyclical shiver/ chills –> fever/sweating

microscope blood film = thin (preserve parasites - identify specific), thick (quantify)

Question 21

Use of atropine

Answer 21

increase HR

Tx Heart block

Question 22

Use of Adenosine

Answer 22

Stop SVT

Question 23

Varicocele cause

Answer 23

dilation of pampniform plexus = LHS

scrotum = bag of worms, reducible infertility

Question 24

What can you not get above

Answer 24

injuinal hernia

Question 25

AXR = gas bubble
embryo sign
coffee bean sign

Answer 25

caecal volvulus

sigmoid volvulus