1000. 22/05/20

Question 1

What is the standard dose of aspirin in an acute coronary event?

Answer 1

300mg

Question 2

What factors worsen ischemia?

Answer 2

Anaemia

Hyperglyceamia

Question 3

Why are U+E’s measured in ACS?

Answer 3

Arrhythmias may be caused by electrolyte abnormality

Question 4

What may liver tests show in ACS?

Answer 4

Congestive picture in CCF

Question 5

What may TFT’s show in ACS?

Answer 5

Hypo- may cause Coronary artery syndrome

Question 6

What are the %P’s of a sexual history?

Answer 6

Partners
Practices
Protection from STD's
Past history of STD's
Prevention of pregnancy

Question 7

What are possible complications of pelvic inflammatory disease?

Answer 7

Tubo-ovarian access
Tubal factor infertility
Ectopic pregnancy
Chronic pelvic pain

Question 8

How do you treat pelvic inflammatory disease?

Answer 8

Ceftriaxone, oral doxycycline, oral metronidazole
Partner tracing and advice
advice on barrier contraception
Full STI screen
Surgery (if not getting better)

Question 9

What are possible causes of intermenstrual bleeding

Answer 9

Contraception
Trauma
Termination of pregnancy/miscarriage
STD's
Abnormalities of reproductive hormones (PCOS)
Stress
VAginal dryness
Cacner, cervical, endometrial, vulval, vaginal
Fibroids

Question 10

What are possible causes of post coital bleeding

Answer 10

Infection
Atrophic vaginitis
Trauma
Polyps
Cervical ectopy
Cancer

Question 11

What are the causes of platelet type bleeding?

How will platelet type bleeding disorders present?

Answer 11

Thrombocytopenia, platelet dysfunction, VW disease

Mucosal (nose, gums) bleeding
Petechiae
Bruising
Persistent bleeding from skin cuts

Question 12

What are the causes of clotting factor bleeding

What are the symptoms of clotting factor bleeding?

Answer 12

Haemophilia

Bruising
Hematomas that are deep (muscle/joints)

Question 13

What are differentials of platelet type bleeding?

Answer 13

Leukemia
Immune thrombocytopenic purpura
VW disease
HUS
Aplastic anemia

Question 14

What is immune thrombocytopenic purpura?

Answer 14

Disorder of the immune system that causes low platelets.

Treated with IVg, immunologics and immunosuppressants

Question 15

What is the correct translocation for the philadelphia chromosome?

Answer 15

T (9,22)

Question 16

What are the five phases of chemotherapy?

Answer 16

Induction
Consolidation
Interim maintenance
Delayed intensification
Maintenance

Question 17

What are the sanctuary sites in ALL?

Answer 17

CNS

Testes

Question 18

What is the definition of neutropenic sepsis?

Answer 18

<0.5x10(^9)/ l

Fever>38

Question 19

What antibiotics should not be used in penicillin

(this list does not include any of the obvious ones that end in -illin) allergy?

Answer 19

Co-amoxiclav
Cefixime
Cefotaxime
Ceftazidimine
Ceftriaxone
Ceftobiprole
Cefuroxime
Aztreonam
Etrapenem
Iminpenem
Meropenem

Question 20

Why would you need to continue IV antibiotics?

Answer 20

Oral route compromised
Continuing sepsis
Special indication (endocarditis, meningitis deep abscess)
febrile neutropenia
Hypotension/shock

Question 21

What are the points to remember with vancomycin?

Answer 21

Take a trough sample within 24-48 hours of starting therapy
Monitor creatinine daily
Record the exact time of all vancomycin samples along with the last time of administration
Reassess the dose and continue or prescribe a dosage change

Question 22

What is the NHS grampian protocol on sepsis?

Answer 22

Standard risk- Tazocin (pen allgy-meropenem)
High risk- tazocin and gent (pen alg- meropenem)
Severe risk- septic shock- meropenem