2012

Question 1

commonest cause of mitral sten

Answer 1

rheumatic fever

Question 2

how does mitral stenosis cause AF

Answer 2

volume and pressure of blood in LA increases
atrium larges
causes AF

Question 3

starling forces in heart failure

Answer 3

increased hydrostatic pressure in vessels (pressure build up)
low oncotic pressure in veseels due to low albumin

Question 4

4 main risk factors for pancreatitis

Answer 4

GET S
gallstones
ethanol
trauma - incl ERCP
SMOKING!!

Question 5

what is the Allen’s test checking

Answer 5

adequate collaterals!
(hyperaemia of WHOLE hand on release of one artery)
checks both are patent and providing collateral blood supply

Question 6

4 main risk factors for pancreatitis

Answer 6

GET S
gallstones
ethanol
trauma - incl ERCP
SMOKING!!

Question 7

what is the Allen’s test checking

Answer 7

adequate collaterals!
(hyperaemia of WHOLE hand on release of one artery)
checks both are patent and providing collateral blood supply

Question 8

drug used to treat hypercalcaemia?

drug MOA? inhibitis osteoclastic boen resorption

Answer 8

(NB IV 0..9% saline 4-6 L in 24 hr)

IV zolindronate

Question 9

investigation to dx addison’s

Answer 9

short synacthen (synthetic ACTH) test -->
plasma cortisol is measured before and 30 minutes after giving IM Synacthen 250ug

Failure for cortisol to rise of >420nmol/L at 30 minutes post Synacthen indicates Addison’s disease

Question 10

define hospital acquired infection

Answer 10

-infections acquired in hospital or healthcare service unit
-1st appears >=48h after admission OR
within 30 days of discharge
-unrelated to original illness that brings pt to hospital
-not present at time of admission

Question 11

how to prevent spread of infection

Answer 11

isolation
gown and gloves
hand washing
appropriate and prompt use of Abx

Question 12

define hospital acquired infection

Answer 12

-infections acquired in hospital or healthcare service unit
-1st appears >=48h after admission OR
within 30 days of discharge
-unrelated to original illness that brings pt to hospital
-not present at time of admission

Question 13

how to prevent spread of infection

Answer 13

isolation
gown and gloves
hand washing
appropriate and prompt use of Abx

Question 14

3 mark question why chosen SSRI

Answer 14

i think the ans could be

1st line drug, lower side effect profile than others, relatively safe in overdose

Question 15

labile mood and weight loss

Answer 15

hyperthyroidism

frontal lobe brain tumour

Question 16

causes of thrombocytopenia

Answer 16

aplastic anaemia
MDS
leukaemia
ITP
things with splenomegaly (porthal hypertesnsion, cirrhosis, myelofibrosis, viral infections e.g. CMV, EBV

Question 17

complications of infectious mononucleosis

Answer 17

encephalitis, meningoencephalitis, seizures, optic
neuritis, sudden sensorineural hearing loss, idiopathic
facial palsy, and Guillain-Barré syndrome

haemolytic anaemia (3%) and thrombocytopenia
(25-50%),

myocarditis, pericarditits

pancreatitis,
interstitial pneumonia, rhabdomyolysis,

Question 18

pathophysiology of splenomegaly

Answer 18

• Congestive, by pooled blood (e.g., portal hypertension)
• Infiltrative, by invasion by cells foreign to the splenic environment (e.g., metastases, myeloid neoplasms, lipid storage diseases)
• Immune, by an increase in immunologic activity and subsequent hyperplasia (e.g., endocarditis, sarcoidosis, rheumatoid arthritis)
• Neoplastic, when resident immune cells originate a neoplasm (e.g., lymphoma)

Question 19

signs of EBV on mouth eaxm

Answer 19

exudate

petechiae on roof of mouth (sometimes)

Question 20

pathophysiology of splenomegaly

Answer 20

Congestive, by pooled blood (e.g., portal hypertension)
Infiltrative, by invasion by cells foreign to the splenic environment (e.g., metastases, myeloid neoplasms, lipid storage diseases)
Immune, by an increase in immunologic activity and subsequent hyperplasia (e.g., endocarditis, sarcoidosis, rheumatoid arthritis)
Neoplastic, when resident immune cells originate a neoplasm (e.g., lymphoma

Question 21

look at the levels of burns

Answer 21

-

Question 22

treatment of thrombocytopenia EBV

Answer 22

IV steroids if severe

Question 23

fhx chronic leukaemia

Answer 23

CLL - 2-4x more likely

CML - FHx not relevant