QUESMED ALL

Question 1

Where does Erb’s palsy affect ?

Answer 1

C5 and C6 myotomes

Question 2

What does Erb’s palsy present with ?

Answer 2

“Waiter’s tip”
Flexed wrist, extended forearm and internally rotated, adducted arm

Question 3

Who does Erb’s palsy affect ?

Answer 3

Newborns, trauma patients, axillary radiotherapy patients (breast cancer)

Question 4

What is Klumpke’s palsy ?

Answer 4

C8-T1 nerve roots with corresponding dermatomal sensory loss, and weakness of the intrinsic muscles of the hand

Question 5

Enzyme associated with erythropoeitic protoporphyria

Answer 5

Ferrochelatase

Question 6

Who is affected by erythropoeitic protoporphyria ?

Answer 6

Baby crying in the sunlight

Question 7

Who is affected by porphyria cutanea tarda ?

Answer 7

Middle aged men with liver disease

Question 8

What is the enzyme associated with porphyria cutanea tarda ?

Answer 8

Uroporphyrinogen decarboxylase

Question 9

Who is affected by acute intermittent porphyria ?

Answer 9

Females around the age of 30 with acute abdomen, mood disturbance, neuro symptoms

Question 10

Enzyme deficiency associated with acute intermittent porphyria ?

Answer 10

Porphobilinogen deaminase

Question 11

First line treatment for rheumatoid arthritis

Answer 11

Methotrexate

(EARLY !! - start methotrexate before joint problems to improve long term outcomes)

Question 12

First line investigation for ankylosing spondylitis ?

Answer 12

X-ray spine and pelvis

(MUST SEE SACROILIITIS)
HLA-B27 is used to support diagnosis but isn’t definitive

Question 13

Definitive management of SUFE

Answer 13

Urgent surgery to pin the femoral head to prevent further slippage

Question 14

Sulfonylureas side effects

Answer 14

Hypoglycaemia + weight gain

Question 15

Pathophysiology of osteogenesis imperfecta

Answer 15

Defect of type I collagen synthesis

Question 16

Type IV collagen disease =

Answer 16

Alport’s syndrome

Anti-GBM disease/Goodpasture’s = alpha 3 subunit of type IV collagen

Question 17

First line test for GCA

Answer 17

ESR

Question 18

Definitive test for GCA

Answer 18

Temporal artery biopsy

Question 19

Ophthalmological side effects of long-term steroid use

Answer 19

Glaucoma, cataracts

Question 20

Mechanism of action of metformin

Answer 20

Increases peripheral insulin sensitivity and hepatic glucose uptake

Question 21

The success of which type of dialysis is dependent on residual renal function ?

Answer 21

Peritoneal dialysis

(Haemodialysis doesn’t require any renal function)

Question 22

Another name for anti-GBM disease

Answer 22

Goodpasture’s

Question 23

Alport’s syndrome mutations

Answer 23

COL4A3, COL4A4, or COL4A5 mutations in type IV collagen

Question 24

Baker’s cyst treatment

Answer 24

No treatment required

Question 25

Autonomic dysfunction of the vagus nerve leading to delayed gastric emptying

Answer 25

Gastroparesis

Question 26

Tenderness elicited over the radial styloid upon ulnar flexion of the wrist with thumb clasp in the palm

Answer 26

Positive Finklestein's test De Quervain's tenosynovitis

Question 27

MOA of sulfonylureas

Answer 27

Depolarise islet cells in the pancreas increasing insulin release

Question 28

Bone pain, headaches and hearing loss with a raised ALP

Answer 28

Paget's disease - prescribe bisphosphonates

Question 29

Imaging for achilles tendinopathy

Answer 29

Ultrasound

Question 30

Hair loss due to chemotherapy

Answer 30

Anagen effluvium

Question 31

Pyoderma gangrenosum treatment

Answer 31

Topical corticosteroids

Question 32

Treatment for severe acne

Answer 32

Topical retinoid, topical benzoyl peroxide and oral doxycycline

Question 33

FBCs for dermatomyositis - what to look for ?

Answer 33

Creatinine kinase (most sensitive indicator of disease and can give an idea of disease activity)

Question 34

Red all over

Answer 34

Erythroderma - usually caused by exacerbation of an existing skin condition like atopic dermatitis

Question 35

Eczema + HSV

Answer 35

Eczema herpeticum

Question 36

Treatment for eczema herpeticum

Answer 36

IV aciclovir