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1

Definition of sepsis

SIRS with suspected or confirmed site of infection

2

Definition of SIRS

At least 2 of
- Temp less than 36°C or > 38.3°C
- HR > 90
- RR > 20
- Blood glucose > 7.7mmol/L in the absence of known diabetes
- WCC less than 4 or > 12

3

Definition of severe sepsis

Sepsis with end organ dysfunction or hypoperfusion (indicated by hypotension, lactic acidosis or decreased urine output or others)

4

Definition of septic shock

Severe sepsis failed to respond to IV fluids

5

What does aspirin activate?

Anti-thrombin III - forms a complex which then inhibits factor Xa

6

Neonatal resus compressions - when and rate?

Start with 5 ventilation breaths if not improving and HR below 60bpm then 3:1 compression to ventilation

7

Management regarding variceal bleed

FFP and vit K and terlopressin
Propanolol reduce rebleeding

8

Most common cause of gastroenteritis in children

rotavirus

9

What is the most common drug cause of gynaecomastia

Spironolactone

10

What differentiates mania from hypomania

Psychotic delusions

11

Large transilluminating mass in posterior triangle of neck

Cystic hygroma

12

Features of Pneumocystis jiroveci pneumonia

in HIV patients
dry cough and dyspnoea with fever and very few chest signs
pneumothorax is common complication
exercised induced desaturation common

13

Management of PJP infection

co-trimoxazole
IV pentamidine in severe cases
steroids if hypoxic

14

Prevention of PJP infection

prophylaxis to all patients with CD4 count below 200

15

What is orlistat

Pancreatic lipase inhibitor used to help weight loss in obesity
Side effects include fecal urgency and incontinence

16

What type of drugs can cause lithium toxicity

Drugs which affect renal function because lithium is excreted renally

17

Analgesia of choice for renal colic

Diclofenac

18

What is yellow-green vision a feature of

Digoxin toxicity

19

What can cause digoxin toxicity

Hypokalaemia
Renal failure - drugs which affect renal function

20

Unfractioned and LMWH relationship with potassium

Can cause hyperkalaemia

21

Driving after 1st seizure

6 months off

22

Driving after confirmed epilepsy

12 months seizure free

23

Driving after 2 or more seizures with group 2 vehicles (eg. bus, coach lorry)

10 years seizure free

24

Driving after stroke or TIA

1month and may not need to notify DVLA if no residual deficits

25

Driving after syncope

Simple faint - nothing
One off syncope, explained and treated - 4 weeks
One off unexplained - 6months
Two or more - 12 months

26

What pH is non-invasive ventilation good for

Between 7.25-7.35 - below this need invasive

27

First line treatment of BPH

Alpha blockers eg. tamsulosin or alfuzosin

28

Treatment of non-faliciparum malarias?

non-falciparum malarias are almost always chloroquine sensitive

29

Stridor post-thryoidectomy

Think bleed - Owing to the confined space haematoma's may rapidly lead to respiratory compromise owing to laryngeal oedema - need to remove sutures otherwise larynx will get obstructed