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Question 1

Medical treatment of H.pylori?

Answer 1

H. pylori eradication:
PPI + amoxicillin + clarithromycin, or
PPI + metronidazole + clarithromycin

Question 2

What is the usual iron profile in hereditary haemochromatosis?

Answer 2

Raised transferrin saturation and ferritin, with low TIBC is the characteristic iron study profile in haemochromatosis

Question 3

How do you calculate units of alcohol?

Answer 3

Alcohol units = volume (ml) * ABV / 1,000

Question 4

3 features of a aplastic sickle cell crisis?

Answer 4

1. caused by infection with parvovirus
2. sudden fall in haemoglobin
3. bone marrow suppression causes a reduced reticulocyte count

Question 5

Symptoms of acute chest crisis (sickle cell)?

Answer 5

dyspnoea, chest pain, pulmonary infiltrates, low pO2

the most common cause of death after childhood

Question 6

What is a sequestration crisis?

Answer 6

sickling within organs such as the spleen or lungs causes pooling of blood with worsening of the anaemia
associated with an increased reticulocyte count
Occurs in sickle cell

Question 7

What are the 5 sickle cell crises?

Answer 7

1. thrombotic, ‘painful crises’
2. sequestration
3. acute chest syndrome
4. aplastic
5. haemolytic

Question 8

ECG findings of hypertrophic obstructive cardiomyopathy?

Answer 8

left ventricular hypertrophy and deep ST depression and T-wave inversions consistent with hypertrophic obstructive cardiomyopathy.

Question 9

What are the thresholds of gestational diabetes in the fasting glucose and 2hr glucose tests?

Answer 9

fasting glucose is >= 5.6 mmol/L

2-hour glucose is >= 7.8 mmol/L

Question 10

what is the management of gestational diabetes based on fasting glucose?

Answer 10

If <7mmol/L then diet and exercise

If >7mmol/L then insulin (+/- metformin)

Question 11

What is a serious but rare adverse effect of lamotragine therapy?

Answer 11

Steven Johnson syndrome

Question 12

What are the symptoms of Steven-Johnson syndrome?

Answer 12

SJS usually develops up to two months after starting an anti-convulsant. Usually there is a prodromal illness which resembles a viral upper respiratory tract infection or ‘flu-like illness’. After this, there is a rapid onset of a painful red skin rash which starts on the trunks and extends abruptly onto the face and limbs. Interestingly, this rash rarely affects the scalp, palms or soles.

Question 13

What are the 2 classes of hip fracture?

Answer 13

Intra-capsular and extra-capsular

Question 14

Which manoeuvre is diagnostic in BPPV?

Answer 14

Dix-hallpike manoeuvre

Question 15

which clotting factor is impaired in haemophillia A?

Answer 15

VIII

Question 16

Which clotting factor is there a deficit of in haemophillia B?

Answer 16

IX

Question 17

What does normal PT but prolong APTT suggest?

Answer 17

Haemophillia A

Question 18

What are the classical blood test findings for gilbert’s syndrome?

Answer 18

normal LFTs but raised bilirubin. Jaundice