19.02

Question 1

definition of AKI

Answer 1

↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours

Question 2

Hiccups in palliative care - tx?

Answer 2

chlorpromazine or haloperidol

Question 3

autoimmune hepatitis in a woman px with

Answer 3

amenorrhea

Question 4

timeframe for alcohol excess
1.tremor, sweating, tachycardia, anxiety
2. seizure
3. coarse tremor, confusion, delusions,

Answer 4

1. 6-12h
2. 36h
3. 48-72h

Question 5

pepperpot vs raindrop skull

Answer 5

pepperpot: hyperparathyroid
raindrop: multiple myeloma

Question 6

pyoderma gangrenosum tx

Answer 6

Oral prednisolone

typically presents initially with a small blood blister or red bump before progressing to a large deep violaceous ulcer, commonly affecting the lower limbs. The patient’s background of ulcerative colitis is also a clue to the diagnosis, given inflammatory bowel disease can predispose patients to developing pyoderma gangrenosum.

Question 7

asymptomatic but eGFR stage 1 or stage 1?

Answer 7

do not diagnose CKD

Question 8

_________ are beneficial in proteinuric CKD, regardless of diabetic status

Answer 8

SGLT-2 inhibitors

Question 9

Thyrotoxic storm is treated with beta ______________

Answer 9

blockers, propylthiouracil and hydrocortisone

Question 10

Thyrotoxicosis with tender goitre and raised ESR =

Answer 10

subacute (De Quervain’s) thyroiditis

Question 11

Ix and Tx for osteomyelitis

Answer 11

MRI
fluclox

Question 12

An MSU should be sent for _________ with a suspected urinary tract infection

Answer 12

all women over > 65-years-old

Question 13

___________are symptoms of SSRI discontinuation syndrome

Answer 13

Dizziness, electric shock sensations and anxiety

Question 14

A 62-year-old woman presents to the emergency department with an acute loss of vision, pain, and redness in her left eye. She noticed some eye discomfort and reddening in the morning, which became severe over the next two hours.

She denies trauma and any other visual disturbance. Her past medical history includes osteoarthritis, left eye cataract surgery three days ago, and unremarkable family history.

On examination, the left eye is hyperaemic with hypopyon. Eye movements are painful and visual acuity is severely reduced. The right eye is normal.

What is the most likely diagnosis?

Answer 14

endophthalmitis

an infection of the aqueous and vitreous humour of the eye. This is a rare complication of any eye surgery

Question 15

Patients presenting to primary care who have pneumonia ________________if their CRB-65 score is 0

Answer 15

can usually be managed in the community with oral antibiotics

Question 16

fever, hypotension and a rash → desquamation

Answer 16

Staphylococcal toxic shock syndrome

Question 17

Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes →

Answer 17

? silicosis

Question 18

____________ are a way of reducing the number of sickle red cells and increasing the number of normal red cells, in order to improve oxygenation

Answer 18

Exchange transfusions

Question 19

_________- most commonly causes a cavitating pneumonia in the upper lobes, mainly in diabetics and alcoholics

Answer 19

Klebsiella
‘red-currant jelly’ sputum

Question 20

___________is a key investigation for a suspected perforated peptic ulcer

Answer 20

An erect chest x-ray

Question 21

Do drugs causse upper or lower lobe fibrosis? what causes upper lobe fibrosis?

Answer 21

lower

Radiotherapy may result in radiation pneumonitis, typically causing upper zone lung fibrosis

Question 22

__________ is the investigation of choice for intussusception

Answer 22

Ultrasound

Question 23

Pyloric stenosis - non-bilious vomiting, around 1 month old presentation
Intussusception - bilious vomiting, and 1-3yrs

Question 24

________ are contraindicated in aortic stenosis

Answer 24

Nitrates

Question 25

GCS supraorbital pressure: To be counted as localising, the arm must _________________, else it should be scored as ‘flexing’

Answer 25

be brought above the clavicle

Question 26

pneumonia with target rash + reticular shadowing

Answer 26

mycoplasmaa pneumoniae

Question 27

__________ is the most likely diagnosis in an uncircumcised man, who has developed a tight white ring around the tip of the foreskin and phimosis

Answer 27

Lichen sclerosis

Question 28

lichen Planus

Answer 28

planus: purple, pruritic, papular, polygonal rash on flexor surfaces. Wickham’s striae over surface. Oral involvement common
sclerosus: itchy white spots typically seen on the vulva of elderly women

Question 29

_________ can cause a false negative Mantoux test

Answer 29

Sarcoidosis

Question 30

A non-healing painless ulcer associated with a chronic scar is indicative of

Answer 30

squamous cell carcinoma (SCC)

Question 31

antiviral treatment for human immunodeficiency virus type-1 (HIV-1) and as a monotherapy for hepatitis B virus

Answer 31

Lamivudine