20/05

Question 1

Long term prophylaxis of cluster headache

Answer 1

verapamil

Question 2

management of acute cluster headache

Answer 2

100% oxygen

subcutaenous triptan

Question 3

Names of SGLT2 inhibitors

Answer 3

dapagliflozin

Question 4

MOA of SGLT2 inhibitors

Answer 4

prevent the resorption of glucose from the proximal renal tubule, resulting in more glucose being secreted from the urine

Question 5

side effect of SGLT2 inhibitors

Answer 5

thrush

Question 6

1st line treatment for ITP

Answer 6

oral prednisolone

Question 7

when is pulmonary stenosis louder?

Answer 7

inspiration

Question 8

ejection systolic murmurs

Answer 8

louder on expiration

• aortic stenosis
• HOCM

Louder on inspiration

• pulmonary stenosis
• atrial septal defect

TOF

Question 9

holosystolic murmur

Answer 9

mitral/tricuspid regurgitation
- tricuspid regurg becomes louder during inspiration
VSD

Question 10

late systolic murmur

Answer 10

mitral valve prolapse

coarctation of aorta

Question 11

early diastolic murmus

Answer 11

aortic regurg

graham-steel (pulmonary regurg)

Question 12

mid-late diastolic murmur

Answer 12

mitral stenosis

austin flint

Question 13

continuous murmur

Answer 13

PDA

Question 14

features of phaeochromocytoma

Answer 14

hypertension
headaches
palpitations
sweating
anxiety

Question 15

tests for phaeochromocytoma

Answer 15

24hr urine collection of metanephrines

Question 16

management of phaeochromocytoma

Answer 16

• alpha blocker (phenoxybenzamine)

- beta-blocker

Question 17

treatment of pneumonia in children

Answer 17

amoxicillin

macrolides added if no response

macrolides if mycoplasma or chlamydia

Question 18

regurgitation of foul smelling liquid

Answer 18

pharyngeal pouch

Question 19

renal failure, sensorineural hearing loss, ocular abnormalities

Answer 19

alports

Question 20

side effect of hydroxychloroquine

Answer 20

severe and permanent retinopathy

Question 21

Raised ALP in presence of normal LFTs

Answer 21

bone cancer/mets

Question 22

assessment of frailty

Answer 22

gait speed, self reported health status, PRISMA- 7

Question 23

management of perthes

Answer 23

• keep femoral head in acetabulum: cast, braces
• if less than 6 years old= observation
• older= surgical management with moderate results
• operate on severe deformities

Question 24

most common causes of cardiac arrest in children

Answer 24

respiratory

Question 25

management of gonorrhoea if cannot use IM ______

Answer 25

if cant use IM ceftriaxone, then a combination of oral cefixime + oral azithromycin

Question 26

hyponatraemia
hyperkalaemia
hypoglycaemia

Answer 26

addisonian crisis

Question 27

cause of addisonian crisis

Answer 27

sepsis or surgery causing an acute exarbation of chronic insufficiency

adrenal haemorrhage eg Waterhouse-friderichsen syndrome (fulminant meningococcemia)

steroid withdrawal

Question 28

management of addisonian crisis

Answer 28

hydrocortisone 100mg im or iv

1 litre normal saline infused over 30-60mins or with dextrose if hypoglycaemic

continue hydrocortisone 6 hourly until patient is stable
no fludrocortisone is required because high cortisol exerts weak mineralocorticoid action

oral replacement may begin after 24 hours and be reduced to maintenance over 3-4 days

Question 29

Type 1 respiratory failure

Answer 29

low pO2, no CO2 retention

Question 30

Type 2 respiratory failure

Answer 30

low pO2, high pCO2

Question 31

contraindication to triptan use

Answer 31

cardiovascular disease

Question 32

treatment for vestibular neuronitis

Answer 32

vestibular rehabilitation exercvises

Question 33

horizontal nystagmus

Answer 33

vestibular neuronitis

Question 34

features of vestibular neuronitis

Answer 34

• recurrent vertigo attacks lasting hours or days
• nausea and vomiting may be present
• horizontal nystagmus is usually present
• no hearing loss or tinnitus

Question 35

causes of raised prolactin - the p’s

Answer 35

pregnancy

prolactinoma

physiological

polycystic ovarian syndrome

primary hypothyroidism

phenothiazines, metoclopramide, domperidone

Question 36

hyperarrhythmia on EEG

Answer 36

infantile spasms (West’s syndrome)