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Z IPE Past Papers > 2008 > Flashcards

2008 Flashcards

1
Q

painful lump in groin differentials

A

Femoral hernia, inguinal hernia, femoral artery aneurysm

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2
Q

Tx for H pylori

A

PPI, clarith + amox

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3
Q

INR for surgery?

A

less than 1.5

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4
Q

Tx of constipation and diarrhoea in IBS

A

Constipation - senna

Diarrhoea - loperamide

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5
Q

What would FBCs for celiacs reveal?

A

FBC shows pernicious anemia or iron def anaemia

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6
Q

Findings on urine microscopy for IgA nephropathy

A

Red cell casts

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7
Q

Findings on urine microscopy for ATN

A

muddy brown casts

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8
Q

Screening for acromegaly

A

IGF-1

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9
Q

Tx conservative and definitive for acromegaly

A

○ Conservative - Somatostatin analogues

Definitive - Transphenoidal surgery

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10
Q

Tx of UTI

A

• Uncomplicated - Trimethoprim or nitrofurantoin 3 days

Complicated - Same for 5 days

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11
Q

Advice on avoiding UTI?

A

• Wipe from front to back
• Void post coitus
Wear a condom during sex

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12
Q

Common organism in UTI

A

`e coli

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13
Q

Female Advice on abx use in UTI

A

• Inactivates COCP, use condom

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14
Q

Superior, inferior, anterior and posterior limit of epidural

A

• Superior limit - foramen magnum
• Inferior limit - Sacrococcygeal ligament at S2
• Anterior - posterior longitudinal ligament
Posterior - Ligamentum flavum

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15
Q

Epidural complications

A

• Hypotension
• Infection
• Haematoma
Nerve damage

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16
Q

Alcohol dependency features

A 
Alcohol dependency Features - CANT STOP:
	• C - Compulsion
	• A - Aware of harms but continue
	• N - Neglect of other activities
	• T - Tolerance
	• S - Stopping = withdrawal symptoms
	• T - Time preoccupied with alcohol increases
	• O - Out of control
P - Persistent futile attempts to stop
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17
Q

Section 2 and 3 of MHA

A

2 - up to 28 days. 2 docs one of which is AMHP

3 - up to 6 months. 2 docs one of which is AMHP

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18
Q

Arterial supply of oesophagus, upper middle and lower third

A

Arterial supply:
1. Upper - inferior thyroid artery
2. Middle - aortic branches
Lower - left gastric artery

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19
Q

Oesophageal nerves damaged during surgery

A

Oeseophageal nerves damaged during surgery:
• Recurrent laryngeal
• Superior laryngeal
Phrenic nerve

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20
Q

Co-prescribe with LT steroids?

A

• Bisphosphonates
• PPI
Aspirin

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21
Q

child psych history taking how to?

A 
• Psych hx from child
	• Psych hx from parents
	• Psych hx from school
	• MSE of child
Explore relationship between child and parents.
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22
Q

Qs to differentiate diagnosis in child psych?

A

• Alcohol intake during pregnancy? - ADHD
• Family hx of ADHD? - ADHD
Socialise with others? - Autism

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23
Q

Prognosis of hip fractures in elderly

A

25% mortality in 1 year

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24
Q

Drug Contraindications in asthma

A

Adenosine, NSAIDs, Beta blockers

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25
Q

Complication of supracondylar fracture?

A

• Complication - brachial artery injury

Results in volkmans contracture - Permanent flexion of wrist

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26
Q

What is rockall score and components?

A 
Acute Haemoptysis due to Upper GI bleed:
	• Rockall score for prognosis:
		○ Age
		○ Shock
		○ Comorbs
		○ Diagnosis
Evidence of bleeding
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27
Q

INR required for surgery for warfarinised pts?

A

less than 1.5

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28
Q

Young pt with 1 off micro hematuria. Ix?

A

Reassure

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29
Q

Old man with micro hematuria. Ix?

A

PSA

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30
Q

If lump in throat moves with tongue out?

A

thyroglossal cyst

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31
Q

3 differentials if lump in throat moves on swallowing

A

goitre, thyroglossal cyst, branchial cyst

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32
Q

Most common complication of anterior dislocation?

A

Re-dislocaiton in future.

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33
Q

Absolute and relative contrindication for renal transplant?

A

Absolute - malignancy, persistent alcohol abuse

Relative - chronic liver disease, treated malignancy

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34
Q

Pt with kidney organ rejection is at risk of?

A

Graft host disease, HTN

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35
Q

S&S of cauda equina

A

Fecal + urinary incontinence, severe back pain and leg pain, gait disturbance, saddle anasthesia, sexual dysfunction

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36
Q

Lifestyle advice for eczema?

A

Avoid wool, have cotton clothing, avoid scratching, stay away from allergens, dont use soap

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37
Q

Detox drug for alcoholics and advice with it?

A

Chlordiazepoxide - Need to wean off drug as sudden stopping can cause withdrawal symptoms.

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38
Q

Symptoms of hyperventilation

A

Parasthesia, palpitations, dyspnoea, choking sensation, dizziness

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39
Q

Anxiety symptoms

A

Hyperventilation, dry mouth, palpitations, sweating, N&V

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40
Q

Red eye in ankylosing spondylitis?

A

Uveitis

41
Q

Cubital tunnel syndrome sx?

A

Compression of ulnar nerve - tingling in 4th and 5th finger. Worse when elbow resting on firm surface or flexed for extended periods.

42
Q

Cubital tunnel ix?

A

USS of cubital tunnel. EMG (electromyography)

43
Q

Which MSK condition associated with UC?

A

Ankylosing spondylitis

44
Q

Acute confusion in withdrawal of alcohol cause and tx?

A

Delirium tremens. Thiamine, chlordiazepoxide, haloperidol

45
Q

How does alcohol make CNS more excitable?

A

alcohol causes downregulation of GABAR therefore less inhib receptors and CNS hyper-excitable

46
Q

Causes of bronchiectasis

A

pneumonia, TB, AIDS, CF, Kartagener, whooping cough

47
Q

Main function of biceps?

A

Supination of forearm.

48
Q

2 muscles which aid in supination?

A

brachialis and brachioradialis

49
Q

how would you manage biceps tendon rupture

A

analgesia + surgical tendon repair

50
Q

Long term effects of biceps tendon rupture

A

pain in biceps, reduced strength in flexion and supination

51
Q

2 ways to repair a hernia

A

suture repair, laparascopic mesh repair, open mesh repair

52
Q

2 complications of hernia repiar

A

recurrence, SSI, chronic pain

53
Q

2 things to confirm a hernia?

A

reducability, cough impulse

54
Q

Tx of venous ulcer?

A

conservative - exercise, elevate legs, emollient for eczema.

Surgery - ablate varicose veins

55
Q

Hardened skin in venous ulcer?

A

lipodermatosclerosis

56
Q

Ix for chronic limb ischemia?

A

ABPI, doppler USS, CVS risk assessment (lipids)

57
Q

environmental RFs for ADHD

A

Premature birth, Prenatal tobacco, non intact family, FHx of antisocial behaviour

58
Q

Name 3 hypoglycemics and their mechanisms

A

Metformin - Reduce liver gluconeogenesis and increase insulin sensitivity

SGLT2 inhibitor - inhibits glucose reuptake in kidneys

Sulfonylureas - Increase insulin sensitivity and insulin release.

59
Q

Tx of Hyperosmolar hyperglycemic state

A

• LMWH
• Saline fluids
• Replace potassium
ONLY USE INSULIN IF BM NOT FALLING WITH ABOVE

60
Q

Possible complications of pneumonia

A

Sepsis, pleurisy, lung abscess

61
Q

3 public health measures to treat TB

A

Contact tracing, Ensuring adherence with directly observed therapy, reminder letters and texts

62
Q

5 things to arranging a blood transfusion?

A

Group and save + cross match.
Ensure correct pt and blood package.
Does pt need irradiated or CMV negative blood?

63
Q

Methotrexate monitoring?

A

FBC, LFT, U&E

64
Q

Which Hep most associated with travelers?>

A

Hep A

65
Q

Most common Hep in the world and in the UK?

A

UK - Hep C

World - Hep B

66
Q

Tx of prolapsed disc

A

Physio, analgesia, exercises

67
Q

What dose of adrenaline for cardiac arrest and for anaphylaxis

A

500mcg - anaphylaxis

Cardiac arrest - 1mg

68
Q

Specific complications of THR

A

Dislocated, bleeding, fracture of bone, DVT, infection

69
Q

Surgical intervention for pancreatitis and gastric ulcer

A

Ulcer - clipping of blood vessels

Pancreatitis - ERCP

70
Q

SSRI side effects

A

Increase risk of suicide, Serotonin syndrome, Insomnia, Dry mouth

71
Q

OCD sx?

A

Frequently perform tasks to seek relief from obsession related anxiety

72
Q

Tx of psoriasis - 2 topical 1 oral

A

topical - calcitriol, steroids

oral - methotrexate

73
Q

2 rheum causes of raynauds

A

SLE, RA, sjogrens

74
Q

2 complications of scleroderma causing SOB

A

HF, ILD, esophageal dysmotility leading to aspiration pneumonia

75
Q

4 drugs causing lung disease

A

Trimethoprim, methotrexate, sulfasalazine, nitrofurantoin

76
Q

3 things to determine severity of UC

A

blood in stool? Amount of times going to toilet? Systemic symptoms?

77
Q

3 extra intestinal manifestations of UC?

A

Arthritis, pyoderma gangrenosum, erythema nodosum

78
Q

Chronic deformity seen in supracondylar fracture?

A

Gunstock deformity

79
Q

Risks of BAL

A

Risk of aspiration pneumonia, pneumonitis, pneumothorax

80
Q

common causes of frank haematuria

A

renal stones, UTI, ATN, renal cell carcinoma, BPH, pyelonephritis

81
Q

What other organ would polycystic kidney affect and patho?

A

Liver - genetic

82
Q

MoA of digoxin?

A

Positive ionotropy by increasing amount of calcium in cells. slows conduction through AV node.

83
Q

Management of digoxin OD

A

IV fluids, activated charcoal, digoxin immune fab

84
Q

BP targets for diabetics and non diabetics

A 
Clinic Targets:
	• Non Diabetic:
		○ <80 - <140/90
		○ >80 - <150/90
	• Diabetic:
		○ No organ damage - 140/80
		○ Organ damage - 130/80
85
Q

Imaging order for cancers

A

Xray, CT, Biopsy

86
Q

How would you manage SIADH?

A

Treat underlying, fluid restrict

87
Q

Ix for nerve problems

A

Xray and nerve conduction study

88
Q

Tx of aortic stenosis

A

replace or balloon valvuloplasty or treat HF secondary to stenosis

89
Q

Antibody most specific for SLE
Antibody most sensitive
Monitoring for SLE

A

specific - anti-SM
Sensitive - ANA
Complement 3+4 - monitoring

90
Q

Sign of compartment syndrome?

A

Pain out of proportion to injury

91
Q

2 complications of hep c

A

cirrhosis, hcc

92
Q

Hep c tx and ADR

A

interferon and ribavirin - fever, fatigue

93
Q

3 things other than bloods as pre op assessment

A

blood pressure, ECG, CXR, height and weight

94
Q

Test to do prior to treating venous insufficiency and what reading needed?

A

ABPI more than 0.8

95
Q

Indications for hemodialysis

A

AEIOU - Acidosis, Electrolytes, Intoxication (esp lithium), Overload of fluid, Uremia

96
Q

HTN non pharm treatment

A

Low salt diet, do exercise, reduce caffeine, less alcohol, balanced diet

97
Q

Diagnosis of pituitary adenoma

A

Hormone levels and MRI pituitary gland

98
Q

Most common finding for PE?

A

Tachypnoea

99
Q

Name 2 types of xray shoulder views

A

axillary, Y view

Z IPE Past Papers (1 decks)

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