SPECIALTIES 2022 Flashcards
(97 cards)
1
Q
- Literally this picture. Baby born 1 day ago, what’s the rash?
Eczema, congenital naevi, erythema toxicum, strep infection
A
erythema toxicum
2
Q
- Sickle cell boy with aplastic anemia. Given bloods. Cause?
Spleen sequestration, sickle cell crisis, Parvovirus B19 (repeat)
A
Parvovirus B19
3
Q
- Neonate had just one episode of billous vomiting. What should be done?
Admit into neonate unit and observe
Reassure and discharge
Paeds assessment
A
Paeds assessment
4
Q
Girl had 80% blasts in the blood, raised WCC, low Plt. Dx?
AML - Acute Myeloid Leukemia
ALL - Acute Lymphoblastic Leukemia (ALL)
CML - Chronic Myeloid Leukemia
CLL - Chronic Lymphocytic Leukemia
aplastic anemia
A
ALL
5
Q
- Girl with all bloods fine except platelets low, afebrile and well in self. What’s the diagnosis? This rash shown and said non blanching, exact picture.
ITP, meningitis, meningococcal septicaemia
A
ITP
6
Q
T1DM DKA first-line management?
Fluid bolus, insulin, glucose, IV dextrose
A
Fluid bolus
7
Q
- Child with this impetigo rash around mouth and groin, what tx would you give? Oral Topical Aciclovir, fusidic acid, oral Aciclovir, oral flucloxicillin
A
topical fusidic acid 1st line according to nice
oral flucloxacillin if unwell
8
Q
Mum brings 2yo to GP 6 hrs after rolling off sofa onto carpeted floor while playing, happy playing now, interacting normally, no cuts bruising or bleeding, ENT exam normal, best management?
Blue lights to hospital
refer to minor injuries
ortho referral to assess fractures
reassure and safety net mum
same day paeds a&e assessment
A
reassure and safety net mum
9
Q
Child with bloody diarrhoea, puffy eyes, puffy face, low hb, hi BR, reticulocytes elevated, lo plt. Urine dip; blood 3+, leukocytes 2+, protein 1+, nitrites neg. What the dx?
HUS
nephrotic syndrome
nephritis
A
HUS
10
Q
Mum with 2 or 3 yo girl in GP/paeds A&E. Caught her attempting to eat chocolates from a box 30 mins ago, not sure if she ate one, took them away and she started screaming, stopped breathing, turned blue and fell to ground and started jerking arms and legs (unclear description), stopped shortly after. Currently child is running around waiting area and looks fine. Whats the most appropriate mx?
Reassure and safety net
stat EEG
refer to routine neuro
on-call paeds
admit for observations overnight
A
Reassure and safety net - breath holding attack
11
Q
- Child is brought in as they have a fever of 37.8 or sth (mild), 12 hours after the Meningiococcal vaccine was given that morning. What do?
A
Paracetamol and safety net
12
Q
- 5/6yo boy brought into GP as he has never had a dry night. Further details about mum trying to cut down drinking too much water before bed etc. What are the next steps?
A
enuresis alarm
13
Q
- Child presenting due to diarrhoea, mum says looks like undigested vegetables in poop.
A
Toddler’s diarrhoea
14
Q
- Child presenting with bump behind ear
A
Mastoiditis
15
Q
- Kid with 2cm mass (inframandibular) on left side, painful – blood film shows: toxic left shift with reactive neutrophilia. (repeat)
Glandular fever, thyroglossal cyst, mumps, lymphadenitis, lymphoma
A
lymphadenitis,
16
Q
- Child had seizure for 5 minutes, stopped when ambulance arrived. Some other stuff not too sure. What should be prescribed?
Buccal midazolam and discharge, ?lorazepam, xx
A
Buccal midazolam and discharge,
17
Q
- Child presenting with symptoms of muscular dystrophy, what should be measured?
A
Creatine kinase
18
Q
- 6yo girl showing sx of precocious puberty. Bone tests show bones are apt for her age/bones are 6 years old (something like that). What is the dx?
Androgen insensitivity syndrome, xx
A
Androgen insensitivity syndrome
19
Q
- 14yo girl, basically needed Tx as an inpatient for anorexia, needed refeeding treatment? How would you give her treatment?
Deprivation of liberty safeguards, Section 5(2) of MHA, Section 2 MHA, no official holding powers for children <16yo.
A
Section 2 of MHA
20
Q
- Worst prognostic factor of schizophrenia?
male, gradual onset, negative social withdrawal symptoms, positive affective symptoms, university education
A
negative social withdrawal
21
Q
- 23 yo with depression, isn’t sleeping very well. What tx?
Fluoxetine, Paroxetine, Duloxetine, Mirtazapine,
A
Mirtazapine
22
Q
- 22 year old brought in to A&E with 2 week episode of grandiose delusions and persecutory, irritable mood, no insight into condition. PMH for ‘mild depression’ literally had these quotations and significant cannabis use. Physically and verbally aggressive to staff and physically assaulted mother before coming in. What’s the diagnosis?
Drug induced psychosis, schizophrenia, bipolar affective, schizoaffective
A
bipolar affective
23
Q
- 80 something year old man with Alzheimer’s becoming increasingly agitated on the ward and aggressive towards staff – what is the most appropriate next step?
Lorazepam, haloperidol, admit to psych, verbal de-escalation
A
verbal de-escalation
24
Q
- Elderly guy being cared for by daughter, reports forgetfulness, burning things on the stove etc plus all depression sxs like anergia, not going to social clubs. Dx?
Alzheimer’s, Pseudodementia an imperial classic
A
Pseudodementia
25
7. Boy with moderate/severe learning difficulties, depressive sxs like not wanting to eat, trouble sleeping, not wanting to go to day activity centre. Also banging his head against the wall. What's the diagnosis?
Autism, Depressive episode, Hypomania,
, Depressive episode
26
8. Woman presenting with generalised anxiety. What would be first line treatment?
sertraline
27
10. What effect does continued maternal use of sodium valporate have on the fetus? (Idk if this was O&G or Psych)
Seizures, spine, xxx
spina bifida
28
11. Man has been on an antipsychotic 5mg for 3 weeks. Previously tried another antipsychotic but didn’t work. What should be done with regards to his medication?
Continue at same dose, increase dose, decrease dose, try new antipsychotic,
Continue at same dose,
29
1. Woman is 20 weeks, says she’s going to FGM to the child when born because it’s her culture and she’s had it. What is the first/best (?) management?
Safeguarding, give her leaflets, call the police, call social services
safeguarding referral
30
2. Pregnant lady with bullous rash on R forearm, started at umbilicus and spread from there.
Pemphigus gestationis, bullous pemphigoid,
Pemphigus gestationis,
31
2. Hepatitis B serology. Ag +, anti surface antibody +, e antigen – but e antibody +, core antibody + and antigen -. What is status?
Chronic hepatitis, acute hepatitis, acute resolving, previous vaccination, non-infectious carrier
acute resolving,
32
3. 15 yo with menorrhagia. No PMH. Management?
IUS, mefenamic, tranexamic,
IUS
33
5. Woman in labour can feel cord protruding, emergency buzzer pulled, before experienced staff arrive what is best action before the senior staff arrive?
knee chest, replace presenting structure, consent for CS, IM terbutaline,
knee chest
34
6. Woman pregnant RFM at 36w, CTG normal after some time of monitoring, similar episodes at 30, 32 weeks, something like what should you offer now?
Doppler, USS growth scan, induce labour now, c section,
USS growth scan
35
7. Woman has an intrauterine device/system put in. How often does she have to check for the strings?
Every 3m, every 6m, not at all, after coitus (specifically wrote coitus not sex bc idk why), after menstruation
after menstruation
36
8. 63 yo lady just had a vaginal hysterectomy, she works as a carer in a care home. How long does she have to take off work assuming she has no complications?
4w, 6w, 2w, 3m,
6weeks
37
9. 60 yo woman with changes in bowel habits, bloating and other sxs suggestive of ovarian ca. What is the most specific blood test that can be used to support the dx?
AFP, Ca-19.9, Ca-125, amylase, Carcinoembryonic protein
Ca-125
38
10. Percentage increase chance of developing T2DM after having GDM:
5, 30, 50, 80, none
50
39
11. Woman with controlled hypothyroidism presents to GP as just fell pregnant, what should be done about her levothyroxine during pregnancy?
Discontinue levothyroxine, Decrease dose to 75mg, Continue 100mg dose, increase dose
increase
40
12. Woman presents requesting emergency contraception. Had unprotected sex 90+ hours ago. On day 16 of 28 day cycle. What is most appropriate?
Levonorgestrel, IUD, IUS, Ullipristal acetate, COCP
IUD
41
13. Women recently underwent LLETZ for CIN(1 or 2?), when should next smear be?
6 months, 12 months, 3 years, 5 years
6 months
42
14. Pregnant woman had fall, fell on abdomen, Well in herself, no bruising or haemorrhage. Third pregnancy, is Rhesus negative. What should be done?
Give anti-D now, give anti-D at 28 weeks, no need for anti-D, xxx
Give anti-D now
43
15. Woman with bleeding, pain, and woody uterus. CTG showed fetal tachycardia. Dx?
Vasa praevia, placental abruption, placental praevia
placental abruption
44
16. Pregnant woman with swelling in lower leg. Some other details. What should be done?
Give LMWH in case of DVT, wait for scans, xxx
Give LMWH in case of DVT,
45
17. Pregnant woman presents with itching, husband mentions she’s looking yellow. Dx?
Obstetric cholestasis
46
18. Girl has regular sex for 3 months but no kid yet. How much longer should she try before further investigations should be done?
9 months, 6 months, 12 months, 15 months, 21 months
9 months
47
9 months, 6 months, 12 months, 15 months, 21 months
19. Best test for predicting preterm labour? Unsure of what details were included.
Cervical length, foetal fibronectin
foetal fibronectin
48
20. Woman with some symptoms, gave serum levels - LH, FSH and testosterone high. LH:FSH 3:1. Dx?
PCOS
49
21. Post-menopausal woman with dyspareunia and some other sx? Likely dx?
Atrophic vaginitis
50
1. Neonate, no femoral pulses, hepatomegaly, blue. Dx?
Coarctation of the aorta
51
2. 16yo boy presents with itchy rash started back of trunk and has spread. Picture included. No other symptoms. Dx?
pityriasis rosea
52
3. Molluscum contagiosum rash pic, what is management?
conservative
53
4. Was given this exact image with the top filled in with the date being 21 June 2022 (exam date was 23 June 2022 therefore 2 days old). BR measured in neonate to be 300. What tx do you give?
Phototherapy
54
4. Child being exclusively fed bottle feed at 2 months. Starts crying during AND after feeds, arches back. Dx? CMPA, GORD
gastro-oesophageal reflux
55
5. Child < 1 y, screaming crying, mass felt in abdomen. Dx?
Intussusception
56
6. 6yo child disruptive at school and at home since 2 months ago, previously described as a ‘model child’. Dx? Disruptive home life
classic ADHD
disruptive home life/adjustment disorder
57
7. X-ray image shown of pneumonia. 5 y/o Child, had a fever and BP okay, unsure on the resp rate being normal. What drug and what route?
PO amoxicillin
58
8. Single best bedside investigation for child in seizure, benzos given
temperature
59
10. Child comes from birthday party with wheezing and rash, name route and medication.
IM Adrenaline
60
11. Small child with UTI, name test where dye is injected into urinary tracts to visualise them
Micturating cystourethrogram
61
12. Girl with barking cough and stridor. What is the scoring system for this condition?
Westley croup score
62
13. Mum comes in with child, she saw him swallow a 20p coin in the garden 30 mins ago, no choking, coughing, blood etc. Whats the best investigation?
XRay
63
14. Child with sxs of falling over in playground, confused some other stuff. What the best ix?
MRI head? CT Head?
CT Head
64
15. Child presenting with vomiting, bloods indicating hypochloremic hypokalaemic metabolic alkalosis. Dx?
Pyloric stenosis
65
16. Child presenting with barking cough, other croup symptoms. What is management?
Dexamethasone
66
17. Mum worried about 9mo child’s milestones. Is able to sit upright without support, able to pull himself up but can’t walk. When is the limit for when the child should be brought in for paeds assessment? Give your answer as X months
18 months
67
18. Perianal itching especially at night. What’s the best treatment option?
Mebendazole
68
apparently ppl said it was wet wild wobbly from quesmed
normal pressure hydrocephalus
69
2. 53year old has 2 year belief his neighbour is poisoning his water. No thought disorder, hallucinations or anything else. All clear on investigations, multiple presentations. What’s the diagnosis?
Delusional disorder
70
3. Best opiate replacement (OST) for 6 week pregnant lady on a menagerie of other drugs
Buprenorphine
71
4. Lady with depressive symptoms gained weight, lethargic, can’t focus. Investigation to exclude diagnosis?
TFTs
72
5. 22yo uni student recently started on sertraline goes to a party, ends up in A&E sweaty tremulous, gave obs etc. most likely dx?
Serotonin syndrome
73
6. 43F in mental health ward, a new antipsychotic started recently, sweaty feverish hypertensive hyporeflexia. Dx?
Neuroleptic Malignant Syndrome
74
7. Lady w schizophrenia and actively psychotic declines some physical health intervention, which is the best framework (“act”) to provide treatment under?
MCA 2005
75
8. Man has worsening asthma, some other stuff. Admits to illicit drug use. Brought in by a friend who reports not acting himself, elated mood, v v confident. Which drug?
cocaine
76
9. Guy on drugs, depressed mood, paranoid, slow, etc. what drug?
Cannabis
77
10. Man comes to GP with true elbow pain after injury or sth. GP does tests and says its minor but pt wants more as he is convinced it is elbow bone cancer. What dx?
Hypochondriasis
78
11. Guy with multiple sxs for 5 years like nasal congestion, some others. Believes they are due to a dental work he got done 5 years ago and now has mercury poisoning. Has been around the block with specialist tests and also tried some sketchy remedies himself but to no avail. Whats the dx?
somatisation
79
12. What medication causes gynecomastia in this patient taking these 4 drugs:
rosuvastatin, lamotrigine, Clopidogrel, amitryptilline
non but maybe amytriptilline
80
13. Women presenting with hyperreflexia, tremor etc, what drugs did she likely overdose on?
sertraline or lithium
81
14. Female refugee brought children over a few months back from war zone. Easily triggered, flashbacks etc. What dx?
Post-traumatic stress disorder
82
15. Elderly woman worsening memory. Has had instances where she was found talking to old friends and family who have passed away. What dx?
Alzheimers Dementia
83
16. Another question describing a man with PTSD. What is the first step in mx?
Trauma focussed cognitive behavioural therapy
84
1. Post-menopausal woman, pink-red spotty bleeding itchy vulva, no abnormalities seen on speculum. Dx?
vulval cancer
85
2. Woman with painful blisters on vagina what treatment?
oral aciclovir
86
3. Baby felt on examination to have the fontanelle with 4 suture lines coming out of it at 12 o’clock, what position is the baby?
Occiput posterior
87
4. Catheter out after hysterectomy, how many hours until urination?
6 hours
88
5. 65F medium size multi loculated cyst on USS, next investigation?
CA125 if not done already or pelvis MRI
89
6. Incomplete miscarriage at 9 weeks, HR high BP low, ?pain/temperature, what is best management?
Evacuation of Retained Product of Conception
90
7. Serial growth scans of twins. One twin is growing substantially bigger than the other. What's the phenomenon called?
Twin to Twin Transfusion Syndrome
91
8. Woman with itchy vagina, white plaque rash. What is it?
Lichen sclerosus
92
9. At how many X completed weeks of pregnancy should a postdates baby pregnant lady be offered induction of labour? Write your answer as X completed weeks
41 weeks
93
10. Pregnant lady with constipation, having bleeding PR especially on wiping, bright red and painful defacation. What is it?
anal fissure
94
11. Older lady comes in with feeling of bearing down. She needs to digitate her vagina to defacate every time. Name which exact type of vaginal prolapse she has?
Rectocele
95
12. Women had had previous miscarriage, where Trisomy 21 found at ?16 weeks. Now pregnant again, wants to know what testing she can have for Down’s syndrome
NIPT
96
13. Showed image like below with arrow pointing to ‘rash’. What is it?
Acanthosis nigricans
97
14. 60 year old woman with PMB and superficial dyspareunia, what is the most likely diagnosis?
atrophic vaginits
