16 December

Question 1

What are clinical features of asbestosis?

Answer 1

Dyspnoea
Clubbing
Bilateral end inspiratory crackles
Normally exposure to building, mining, demolition and pipe fitting

Question 2

What cancers does asbestosis increase the risk of?:

Answer 2

Bronchogenic carcinoma
Gastric/colonic/renal adenocarcinoma
GI lymphoma

Question 3

What is becks triad of cardiac tamponade?

Answer 3

Hypotension
Jugular vein distension
Muffled heart sounds

Question 4

What are features of adhesive capsulitis?

Answer 4

Inflammation of the shoulder capsule
Progressive pain worse at night and on movement then becomes painful at rest
Pain worsened on repeat movement, stress, exposure to cold
Progressive loss of active and passive movements

Question 5

What are features of subacromial bursititis?

Answer 5

Shoulder pain over 60 degree arc

Question 6

What are investigations in secondary amenorrhoea?

Answer 6

FSH/LH
TFTw
Prolactin, osteradiol/testosterone
Pelvic USS

Question 7

What is malunion?

Answer 7

Healing of a fracture in an abnormal positionW

Question 8

What is the management of Bells Palsy?

Answer 8

Oral prednisolone 50mg OD for 10 days if presenting within 72 hours

Question 9

What are clinical features of legionella infection?

Answer 9

Pneumonic - legionaries disease
- cough- green or blood stained sputum
- pyrexia (with bradycardia)
- dyspnoea
- GI symptoms

Non Pneumonic
- influenza, myalgia, fever

Question 10

What is the diagnostic criteria for legionella infection?

Answer 10

Gold standard- isolation/ culture of legionella species
Seroconversion- at leaast 4x in antibody titre
Confirmation L.pneumophilia urinary antigen

Question 11

What is the management of legionella pneumophilia?

Answer 11

Admit to hospital
Abx-macrolides/fluoroquinolines

Question 12

What are features of GU TB?

Answer 12

Increased urinary frequency
Dysuria
Suprapubic pain
Blood/pus in urine
Fever
Painful testicular swelling
Perianal sinus
Genital ulcer
Unexplained infertility

Question 13

What are features of congenital hypothyroidism?

Answer 13

Lethargy
Poor feeding
Constipation
Poor weight gain- symmetrical
Macroglossia
Hypotonic- large fontanelles
Umbilical hernia can be present

Question 14

What are features of growth hormone deficiency?

Answer 14

Reduced height
Fat around trunk
Immature face- prominent forehead
Delayed puberty

Question 15

What are features of corneal abrasion?

Answer 15

symptoms- pain, lacrimation, photophobia, blepharospasm

Diagnosis- fluorescein- green
Treatment- abx (chloraphenicol) to prevent infection

Question 16

What is the management of scabies?

Answer 16

Permethrin 5% cr4eam
Malathion second line

Oral ivermectin for refractory scabies

Question 17

What is pituitary apoplexy?

Answer 17

Sudden bleeding of pituitary tumour
Headache followed by rapid reduction in GCS

Question 18

What are side effects of Trastuzumab?

Answer 18

Can cause cardiotoxic side effects

Question 19

What are side effects of anastrozole?

Answer 19

Osteoporosis- prescribe bisphosphonate with it
For oestrogen receptor positive breast ca

Question 20

What are features of gas gangrene?

Answer 20

Oedema
Sub cutaneous crepitations
systemically unwell

Due to clostridium perfringens

Question 21

What is Disulfiram?

Answer 21

Deterrnt drug which causes unpleasant symptoms if alcohol is drunk such as headache, flushing and palpitations

Question 22

How is malaria diagnosed?

Answer 22

Thick and thin blood films

Question 23

What are signs of malignant hypertension?

Answer 23

BP >180/110 with signs of papilloedema/retinal haemorrhage

Question 24

How is Rheumatic fever diagnosed?

Answer 24

Major
- carditis
-arthritis
-sydenhams chorea
- erythema marginatum
- subcut nodules

Minor
- raised ESR/CRP
- Fever
- Olyarthralige
- Prolonged PR itnerval

2 major or 1 major with 2 minor to diagnose

Question 25

What are complications of CABG>

Answer 25

MYI
Stroke
Coma
Temproary memory loss
Infection
Impaired renal function