Y3 SAQ Examplify mock Flashcards by Kim lam

Initial management of OA apart from analgesia?

Mobility aids
Physio
Steroid joint injection
Weight loss

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Why would a spinal anaesthetic be preferred to a general anaesthetic?

Lower cost
Better post-op pain scores
Allergy to general anaesthetic
Contra-indication to general anaesthetic e.g COPD

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Which two anatomical layers is spinal anaesthetic injections between?

Arachnoid mater and pia mater

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How do LMWHs work?

Inhibition of clotting factor Xa and/or thrombin

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Which nerve damage will result in foot drop?

Common peroneal

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Common peroneal is responsible for sensation where?

Dorsum of the food and lateral leg

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Malignant diseases for which obesity is a risk factor?

Breast
Ovarian
Endometrial
Bowel

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Non-malignant diseases for which obesity is a risk factor?

T2DM
HTN
IHD
Stroke
OA
OSA

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Benefits of exercise in obese patient?

Increase BMR
Reduce risk of diabetes
Reduce risk of cardiovascular disease
Improve mood/ self-esteem

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Which behavioural theory describes the influence of friends and family on health-related behaviours?

Social learning theory

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Radiological findings of rheumatoid arthritis?

L – loss of joint space
E – erosions (junta-articular bony erosions)
S – soft tissue swelling
S – soft bones (osteopenia)

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Clinical signs seen in RA?

Ulnar deviation of digits
Swan neck deformity
Boutonniere deformity
Z- thumb deformity

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Extra- articular features in RA?

Dry eyes
Episcleritis
Scleritis
Dry mouth
Pleurisy
Lung nodules
Interstitial lung disease
Lymphadenopathy
Enlarged spleen
Tendinitis
Peripheral neuropathy (eg Carpal tunnel syndrome)

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Questions to ask in suspected hernia?

Is it reducible?
Any similar lumps anywhere?
Any skin changes?
Vomiting or change in bowel habit?

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Differentials for groin lump?

Saphena varix
Lymphadenopathy
Lipoma
Sebaceous cyst
Femoral artery aneurysm

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What is the surface anatomy landmark for the deep inguinal ring?

Halfway between the ASIS and pubic tubercle

Anaesthesia used for inguinal hernia repair?

Spinal or local

Risks of laparoscopic hernia repair?

Conversion to open repair
Damage to surrounding structures (blood vessels, bladder or bowel)
Urinary retention

Behavioural strategies to manage children’s constipation?

Scheduled toileting - encourage child to open bowels at pre-planned intervals.

Use of bowel habit diary

Use encouragement and rewards systems - e.g. star charts

Address potential social/ psychological problems

What to prescribe child with simple contipation without faecal impaction?

Macrogol (e.g. Movicol, Cosmocol, Laxido)

Role of a health visitor?

Offer support and encouragement to families through the early years from pregnancy and birth to primary school.

What makes an association more likely to have a causal effect?

The 95% Confidence intervals for the odds ratio do not include the null value of 1

(If 1 is in the confidence interval than it is not significant)

Questions to ask about heavy, painful periods?

Sexual history
Pattern of pain
Associated symptoms
Exploration of abnormal bleeding

Contra-indications for COCP?

Migraine with aura
Previous history of thrombosis
Hx of breast cancer
Obesity (BMI >35)
Other medication which interacts

Advice/info for patients regarding COCP?

How/when to start Missed pill advice Interaction with abx Effect of vomit/diarrhoea on efficacy Potential side effects Does not protect against STIs

Contraindications to Dix-Hallpike test

MSK problems - back or neck pain Carotid sinus syncope

BPPV cause and mechanism

Small fragments of debris are deposited in the inner ear. When your head is still the fragments still at the bottom of the canal. Head movement will sweep the fragments along the fluid-filled canal This sends confusing messages to the brain causing vertigo.

What process within the arterial tree allows for improvement of intermittent claudication (with exercise and walking through the pain)?

Development of collateral vessels

Pharmacological mechanism and therapeutic action of aspirin?

Irreversible COX inhibitor, prevents platelet aggregation

Where in the lower limbs does rest pain most typically occur? (PAD)

Toes Foot Forefoot

Why does the affected leg/foot appear redder after leg raise in PAD?

Severe Ischaemia - leads to local vasodilator release, this increases the perfusion of the ischaemic foot.

How is pain in ureteric colic and peritonitis different?

Peritonitis - movement worsens pain, patient will lie very still Ureteric colic - patient writhes/moves around, can't get comfortable

Ureteric colic diagnostic test?

CT KUB

What is hydronephrosis?

Dilation of the renal pelvic/ calyceal system From hydrostatic pressure/ urinary tract obstruction

Long term management of COPD?

Annual flu vaccine Pneuococcal vaccine (One dose only) Rescue pack Regular COPD review Review of inhaler technique Pulmonary rehabilitation Optimise current meds

Two tests before commencing TB therapy?

LFTs and visual acuity testing

What treatment is used in diabetes insipidus when someone has hypernatraemia?

Fluid replacement Desmopressin

Risks of not treating hypernatraemia in patient?

Death Stroke Thrombotic episode LOC Seizures Worsening hypernatraemia