Progress test

Question 1

What is the target of Infliximab?

Answer 1

A chimeric antibody against TNF-alpha

Question 2

What is a standard fluid you might give to an unwell patient in hospital?

Answer 2

0.9% NaCL

Question 3

A lady has been in a RTA and is unconscious. Surgery is needed. Do you…

• Get the consultant to consent for her
• Ask her next of kin to consent
• Wait until she responds
• Do the surgery without consent

Answer 3

No consent needed

Question 4

What neurotransmitter is implicated in OCD?

Answer 4

Serotonin = 5 HT

Question 5

What effect does Clarithromycin have on a patient taking warfarin?

Answer 5

Increases anticoagulant effect - INF increase - Increase bleeding risk

Question 6

What drug type is haloperidol?

Answer 6

Anti-psychotic

Question 7

Why might someone on anti-psychotics be given Procyclidine?

Answer 7

An anti-cholonergic.

To treat drug induced Parkinsonian and Akathisia side effects of anti-psychotics.

Question 8

What is in the morning after pill?

Answer 8

high dose oral progesterone

Question 9

A patient has psoriasis. Name 3 signs you might find.

Answer 9

Plaques
Swelling joints
Nail dystrophy - pitting, onchylysis

Question 10

If a patient has persistent swallowing problems, what is a good investigation?

Answer 10

Upper GI endoscopy

Question 11

If someone has a thyroid problem, which is the most useful thryoid level to test?

Answer 11

Plasma TSH

Question 12

A patient has had an MI and is now in complete heart block. Which vessel is affected?

Answer 12

Right coronary

Question 13

Someone has Left visual field loss in both eyes, but the centre of their vision is ok. Where is the damage?

Answer 13

R occipital lobe

Question 14

On biopsy if the liver this is seen, what is the disease?

Multiple epitheloid granulomata and ventral acellular necrosis.

Answer 14

TB liver

Question 15

What is the risk to the newborn of taking fluoxetine in pregnancy?

Answer 15

Persistent pulmonary hypertension of the newborn.

Question 16

What is effected in haemophilia A?

Answer 16

a deficiency in functional factor VIII - so it can’t activate Factor X.

Question 17

What clotting test will be prolonged in Haemophilia A?

Answer 17

APTT will be prolonged

Question 18

What should you do if someone presents with a breast lump?

Answer 18

A triple assesment - Examination, imaging (mammography of US of under 35), fine needle biopsy

Question 19

What is a probable side effect if someone is having radiotherapy to their bronchus?

Answer 19

Oesophagitis

Question 20

What is Olanzapine for?

Answer 20

Anti-psychotic used in Schizophrenia.

Question 21

A patient takes Olanzapine for the first time, he becomes feverish, he develops muscle rigidity and his conscious level is impaired. You notice he has also become incontinent. What complication has he developed?

Answer 21

Neuroleptic malignant syndrome.

Question 22

An 8 year old with pneumonia. What is a common bacterial causative agent?

Answer 22

Strep Pneumoniae

Question 23

When someone is warfarinised, what is a usual INF target?

Answer 23

2.5

Question 24

For what conditions might you so a plasma cortisol and an adrenocorticotropic hormone (ACTH) level test?

Answer 24

Cushings disease (high, high)
Adrenal tumour (High, low ACTH)
Addisons disease (low cortisol, high ACTH)
Hypopituitiarism (low, low)

Question 25

What is the risk of relapse of thyrotoxicosis after successful treatment and stopping medication?

Answer 25

50%

Question 26

What is the indication of an endarterectomy?

Answer 26

90% occlusion of the carotid | Symptoms of curtain coming down over the eye

Question 27

What hormone can be tested to indicate the menopause?

Answer 27

FSH level is high

Question 28

What are high levels of Anti-neutrophil cytoplasmic antibodies (ANCAs) associated with?

Answer 28

Systemic vasculitis, small vessel vasculitis, eg. Wegners.

Question 29

A patient with renal artery stenosis will have what changes to pasma renin activity?

Answer 29

Activity will be increased

Question 30

A patient has weakness of wrist extension and reduced sensation to the back of their hand between the thumb and index finger. What nerve may be injured?

Answer 30

Radial nerve

Question 31

A patient has diarrhoea. She has just returned from Thailand. Her Hb is low, and eosinophils are high. What may be the causitive agent?

Answer 31

A Hookworm

Question 32

A lady 38 weeks gestation has severe pre-eclampsia. What is the management?

Answer 32

Mg sulphate - reduce seizure risk | Delivery of baby

Question 33

What are the catagorise of GCS?

Answer 33

``` Eyes: Spontaneous - 4 To sound - 3 To pressure - 2 None - 1 ``` ``` Verbal: Orientated - 5 Confused - 4 Words - 3 Sounds - 2 None - 1 ``` ``` Motor: Obey commands - 6 Localising - 5 Normal flexion - 4 Abnormal flexion - 3 Extension - 2 None - 1 ```

Question 34

What process is increased in diabetic ketoacidosis?

Answer 34

Increased lipolysis

Question 35

What is a hormonal side effect of carbamazipine?

Answer 35

Can cause SIADH | An anticonvulsant

Question 36

Someone has ?SAH. The CT head taken rapidly looks ok. What do you do next?

Answer 36

Do a LP

Question 37

A patient with HIV has a very low CD4 count. There is a mass in the brain. What may be causing it?

Answer 37

Primary cerebral lymphoma

Question 38

What can occur if sodium valporate is taken in pregnancy?

Answer 38

Spina bifida

Question 39

What is wrong and what is the treatment? | Pt presents with throbbing head ache, they have pulsatile temporal arteries. They have a raised ESR.

Answer 39

Temporal arthritis | Predinisalone

Question 40

A fracture to the anterior or posterior ribs most suggests non accidental injury?

Answer 40

Posterior ribs.

Question 41

A diabetic with cellulitis is most likely infected with what organism?

Answer 41

Step Pyogenes

Question 42

What may someone with uncontrolled coeliac disease be more at risk of?

Answer 42

Small bowel lymphoma