15/2

Question 1

renal impairment breakthrough pain relief

Answer 1

sublinguinal fentayl

Question 2

VBG for anxeity attack

Answer 2

resp alkalosis with normal O2

Question 3

mx of primary hyperPTH

Answer 3

surgery - parathyroidectomy

if CI - calcimimetic - mimics action fo calcium on tissues by allosteric activationof calcium-sensing receptor

Question 4

most common cause of pyelonephritis

Answer 4

E.coli

Question 5

diarrhoea, lethargy, bloating, flatulence, steatorrhoea, recent travel…

Answer 5

Giardiasis

Question 6

menstrual and thyroid

Answer 6

hyperthyroid - oligomenorrhoea, amennorhoea

hypo - menorrhagia

Question 7

features of beta thalassaemia major

Answer 7

microcytic anaemia
FTT and splenomegaly
HbA2 and HbF raised
HbA absent

Question 8

normal pressure hydrocephalus presentation

Answer 8

urinary incontinence
gait abnormality
dementia

Question 9

T vs Z score - dexa

Answer 9

T score - compazred to young healthy population

Z score - age, sex, ethnicity

Question 10

cause of progressive multifocal leukoencephalopthy

Answer 10

JC virus or BK virus

Question 11

fourth nerve palsy - present

Answer 11

trochlear nerve - CN IV
supplies superior oblique - depresses eye and moves inward
vertical diplopia (reading or going downstairs)
subjective tilting of objects - head tilt
affected eye appears upwards and out

Question 12

fasting glucose VS impaired glucose tolerance

Answer 12

fasting - 6.1-7

IGT 7.8-11.1

Question 13

causes of raised prolactins - 6Ps

Answer 13

Pregnancy
prolactinoma
physiological
PCOS
primary hypothyroidism
phenothazines, metoclompramide, domperidone

Question 14

metabolic disturbance in cushinga

Answer 14

hypokalaemic metabolic alkalosis

Question 15

max metformin dose

Answer 15

1mg BD

Question 16

dx - sickle cell

Answer 16

haemoglobin electrophoresis

Question 17

features - polcythaemia vera

Answer 17

triggered by hot bath
raised haematocit, plt raised
jak2 mutation