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1
Q

What are the three parts of a health economic evaluation

A

Structure process outcome

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2
Q

Health needs assessment

A

epidemiological, comparative corporate

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3
Q

healthcare economic efficacy

A

cost per natural unit gained

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4
Q

maxwell’s dimensions of quality

A

effectiveness, acceptability, efficiency, access, equity and relevance

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5
Q

remission in crohns

A

Azathioprine

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6
Q

Post viral gastro-enteritis complication

A

lactose intolerance

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7
Q

Cushing’s test

A

overnight low dose dexamethasone test

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8
Q

toddler, undigested food, normal centiles

A

Toddler’s diarrhoea

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9
Q

Rapid sequence induction muscle relaxant

A

Suxamethonium

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10
Q

primary post-partum haemorrhage most likely cause

A

atonic uterus

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11
Q

atonic uterus tx

A

syntometrine

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12
Q

Newborn hearing screening

A

otoacoustic emission

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13
Q

Skin cancer in immunosuppressed

A

Squamous cell carcinoma

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14
Q

known or suspected lung cancer next inv

A

contrast-enhanced CT scan of the chest, liver and adrenals.

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15
Q

Prophylaxis with abx for bites

A

A human bite that has drawn blood or broken the skin in a high-risk individual

A cat bite that has drawn blood or appears to be deep

A dog bite that has caused considerable tissue damage or is contaminated

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16
Q

Pulsus parodoxus sign of?

A

cardiac tamponade

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17
Q

Drug before beta blocker in pheochromocytoma

A

Phenoxybenzamine or other non-selective alpha blocker

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18
Q

Dermatitis herpetiformis

A

Dermatitis herpetiformis is an autoimmune blistering skin disorder associated with coeliac disease. It is caused by deposition of IgA in the dermis.

Features
itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

Diagnosis
skin biopsy: direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

Management
gluten-free diet
dapsone

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19
Q

Length of VTE prophylaxis following VT

A

provoked (e.g. recent surgery): 3 months

unprovoked: 6 months

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20
Q

Duchenne muscular dystrophy diagnosis

A

Was muscle biopsy, now genetic testing

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21
Q

acute haemolytic reaction

A

fever, abdominal pain, tachycardia, tachypnoea and hypotension

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22
Q

Incontinence management

A

urge incontinence: bladder retraining

stress incontinence: pelvic floor muscle training

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23
Q

urge incontinence management

A

Bladder retraining
Antimuscarinics such as oxybutynin
Mirabegron - beta 3 agonist if concerned about anticholinergic effects

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24
Q

stress incontinence

A

Pelvic floor muscle training
Surgery
Duloxetine

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25
nipple candidiasis
miconazole cream for the mother and nystatin suspension for the baby
26
Statin monitoring
LFTs at baseline, 3 months and 12 months
27
Pityriasis versicolor
superficial cutaneous fungal infection patches may be hypopigmented, pink or brown (hence versicolor) ketoconazole shampoo
28
leptospirosis
rat urine. renal failure. lower back pain, fever, myalgia, fatigue, jaundice and a subconjunctival haemorrhage
29
Carcinoid syndrome
flushing (often earliest symptom) diarrhoea bronchospasm hypotension right heart valvular stenosis (left heart can be affected in bronchial carcinoid) other molecules such as ACTH and GHRH may also be secreted resulting in, for example, Cushing's syndrome pellagra can rarely develop as dietary tryptophan is diverted to serotonin by the tumour
30
Carcinoid syndrome management
urinary 5-HIAA plasma chromogranin A y somatostatin analogues e.g. octreotide diarrhoea: cyproheptadine may help
31
Wilson's disease test
Ceruloplasmin
32
Leriche syndrome
1. Claudication of the buttocks and thighs 2. Atrophy of the musculature of the legs 3. Impotence (due to paralysis of the L1 nerve)
33
Beck's triad
Pericarditis - hypotension, raised JVP, muffled ehart sounds
34
Dressler's syndrome
Post MI pericarditis
35
Most common pericarditis
Coxsackievirus B
36
Peripheral Arterial Disease features
``` Pain Pallor Pulseless Paralysis Paraesthesia (abnormal sensation or “pins and needles”) Perishing cold ```
37
Compartment syndrome features
P – Pain “disproportionate” to the underlying injury, worsened by passive stretching of the muscles P – Paresthesia P – Pale P – Pressure (high) P – Paralysis (a late and worrying feature)
38
Compartment syndrome test
Needle manometry
39
Drug to avoid with lithium
NSAIDS | Diuretics
40
Define status epilepticus
A seizure lasting 30 mins or more (although treat as status even if over 5 mins)
41
Immediate bedside test for status epilepticus
BM
42
A and E management of status epilepticus
Lorazepam IV
43
Other anti-epileptics in status epilepticus
Phenytoin, Phenobarbitol or diazepam
44
Seizure in alcoholic what treatment to give
Thiamine, and glucose if you can
45
Causes of seizure
``` Alcoholic withdrawal Infection Cancer Brain haemorrhage Febrile convulsions Hyponatraemia Epilepsy ```
46
Addison's treatment
Hydrocortisone, Glucose, Fluids - may need hyperkalaemia
47
CAP with erythema multiforme organism
Mycoplasma pneumoniae
48
Status epilepticus management in the community
Status Epilepticus Management: ``` Oh My Lord Phone the Anaesthetist O - O2 M - Buccal Midazolam or Rectal Diazepam L - IV Lorazepam P - IV Phenytoin A - Rapid induction of Anaesthesia ```
49
double duct sign indicates?
Pancreatic cancer
50
Wernicke's encephalopathy
Confusion, ataxia, nystagmus + ophthalmoplegia
51
toxic multinodular goitre nuclear scintigraphy
patchy uptake
52
Graves disease scintigraphy
diffuse enlargement of both thyroid lobes, with uniform uptake throughout
53
most common cause of hyperthyroidism.
Graves disease
54
psoas sign
positive in appendicitis
55
Hyperacute transplant rejection mechanism
Hyperacute transplant rejection is caused by pre-existing antibodies against ABO or HLA antigens
56
life-threatening Clostridium difficile infection treatment
ORAL vancomycin and IV metronidazole
57
Polycythaemia blood sign
isolated rise in haemoglobin
58
Autonomic dysreflexia spinal cord level
T6 level and above
59
C. difficile treatment if not responsive to vanc
oral fidaxomicin
60
acute ischaemic stroke who present within 4.5 hour mx
thrombolysis AND thrombectomy
61
Malignant hyperthermia treatment
IV dantrolene therapy
62
Cause of pneumaturia
enterovesical fistula
63
AAA surgical intervention criteria
Surgery is only indicated in those who are symptomatic, or asymptomatic with an AAA larger than 4cm which has grown by more than 1 cm in 1 year, or asymptomatic and 5.5 cm or larger. Surgery is also indicated for a ruptured AAA. He does not meet any of these criteria.
64
Parsonage - Turner syndrome description
This is a peripheral neuropathy that may complicate viral illnesses and usually resolves spontaneously.
65
Migraine tx
acute: triptan + NSAID or triptan + paracetamol prophylaxis: topiramate or propranolol
66
EGFR change referral guidelines
NICE guidelines suggest referring to a nephrologist from primary care if eGFR falls below 30 or progressively by > 15 in a year
67
Essential tremor features
postural tremor: worse if arms outstretched improved by alcohol and rest most common cause of titubation (head tremor)
68
Essential tremor tx
propranolol is first-line | primidone is sometimes used
69
Bile-acid malabsorption tx
cholestyramine
70
iliopsoas abscess presentation
Back pain, loin radiation, fevers
71
Polymyositis common presentation
Raised CKs and malignancy

Finals (18 decks)

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