17 December #2

Question 1

What are features of klebsielle pneumoniae?

Answer 1

Redcurrant jelly sputum
Chills
Confusion
High fevers
Cavitation of upper lobes on CXR

Question 2

What are side effects of Pyrazinamide?

Answer 2

Arthraliga
Hyperuricaemia
Rashes
Hepatitis

Question 3

What are potential benefits of breast feeding babies?

Answer 3

May reduce risk of acute or chronic infections including LRTI/UTI
Allergic reactions including asthma
Type 1 IDDM
IBD
RA

Question 4

Patient presents with painful genital ulcer and swollen inguinal lymph nodes that are tender. What is the likely diagnosis?

Answer 4

H. ducreyi causes chancroid

Question 5

What are features of Chlamydia trachomatis?

Answer 5

Painless genital ulcer
Painful lymphadenopathy or abscesses

Question 6

When should people with stage 1 hypertension be referred to specialist?

Answer 6

Aged <40 with no evidence of target organ damage, CV disease, Renal disease, diabetes

Question 7

What are features of typohoid fever?

Answer 7

1st week- GI symptoms (abdo pain and constipation), blanching rash
2nd week- splenomegaly and bradycardia
3rd week- abdo distension, pea soup diarrhoea
4th week- if surviving symptoms resolve

Gold standard for diagnosis is culture

Question 8

What are features of anterior should dislocation?

Answer 8

History of trauma
Arm at side of body in external rotation
Anterior bulge in thinner patients

Question 9

What are features of rotator cuff tear?

Answer 9

Reduced range of motion
Weakness
Crepitus
Tenderness over the cuff

Question 10

What are features of TCA overdose?

Answer 10

Dilated pupils
Dry mouth
Drowsiness
Tachycardia
Urinary retention
Increased reflexes
Extensor plantar responses

Severe overdoses- fitss/coma/arrythmia

Question 11

What is the management of BPH?

Answer 11

Aplha 1 adrenergic anatagonists e.g. tamsulosin- relaxes smooth muscle to help urine flow
5 aplha reductase inhibitors e.g. finasteride- helps slow growth of prostate

Surgery
Transurethral microwave therotherapy
Transurethal needle ablation
TURP

Question 12

What investigations of infertility are completed?

Answer 12

Men- sperm analysis

Women- mid luteal phase progesterone (day 21 of 28 day cycle of day 28 of 35 day cycle)
FSH/LH on day 2-4 cycle

Question 13

What are side effects of Isoniazid?

Answer 13

Peripheral neuropathy- prevent with Vitamin B6
Agranulocytosis
Liver enzyme inhibitor
Hepatitis

Question 14

What are features of Scleritis?

Answer 14

Common in women in 4th-5th decade of life
Severe pain
Change in vision
Focal or diffuse redness

Question 15

What are symptoms of Glucagonoma?

Answer 15

Diabetes
Dermatosis
DVT
Depression
(Diarrhoea and decreased weight)

Question 16

What are features of pseudohypoparathyroidism?

Answer 16

Resistance to PTH
Hypocalcaemia
Hyperphosphataemia
Raised PTH levels
Short statue
Rounded face
Shortened 4th metacarpals and other bones

Question 17

What is Chvostek sign?

Answer 17

Seen in hypoclacaemia
Abnormal reaction to the stimulation fo the facial nerve- tap angle of the jaw facial nerves on the same side of the face will contract

Question 18

What is Syringomyelia?

Answer 18

Fluid filled tubular cavitation of spinal cord

Loss of pain and temperature sensation- shawl or cape like distribution

Seen in men aged 20-30