2016 1

Question 1

5 short term SE of chemo

Answer 1

N+V
mouth ulcer
aloplecia
fatigue
mouth ulcers

Question 2

MOA odansetron

Answer 2

serotonin antagonist

Question 3

rx of neutropenic sepsis: class, drug, mode

Answer 3

beta lactam monotherapy
piperacillin/tazobactam

(tazocin)
IV!

Question 4

long term side effecft of chemo

Answer 4

infertility

Question 5

investigations of acites

Answer 5

bloods (help find cuase); FBC, U+E, LFT, TFT, clotting

USS-v sesnitive way of assessing ascited. may also show causative pathology

CXR may show pleural effusion, pulm mets or pleural effusion

Question 6

Ix haematuria

Answer 6

send urine for protein:creatinine ratio (PCR) or albumin:creatinine ratio (ACR)

USS renal tract
cystoscopy
CT

Question 7

inherited disease associated with renal cell carcinoma

Answer 7

von-Hippel-Lindau

tuberous sclerosis

Question 8

tumours in von Hippel-Lindau

Answer 8

heamngioblastomas
renal clear cell Ca
phaeochromocytoma
pancreatc endocrine tumour

Question 9

most common histology renal cell carcinoma

Answer 9

clear cell

Question 10

CURB 65 score meaning

Answer 10

0 or 1 - outpatient
2 - inpatient/observation admission
≥ 3 - inpatient.
4-5 -inpatient, consider ICU

Question 11

CURB 65 score meaning

Answer 11

0 or 1 - outpatient
2 - inpatient/observation admission
≥ 3 - inpatient.
4-5 -inpatient, consider ICU

Question 12

common atypical pneumonias

Answer 12

m pneumoniae
c pneumonniae
legionalla pneumophila

Question 13

GMC regulation on personal beliefs and medical practice

Answer 13

You must not express your personal beliefs in ways that exploit pts vulnerability or are likely to cause them distress

if you have a conscientious objection, tlel pt about right to see another dr. do not be judgmental when doing this

musdt not unfairly discrimnaate by allowing personal views to affect professionalrelationships or treatment you rpovide

Question 14

apart from age, sex, fhx and ethnicity, give 4 risk factors for diabetes

Answer 14

gestational diabetes
weight
inactivity
high blood pressure
smoking
PCOS
antipsyhcotics
schizophrenia
bipolar

Question 15

2 pathological features of asthma

Answer 15

bronchial hyperresponsiveness
bronchial inflammation
endobronchial
obstruction (bronchospasm, mucosal oedema, mucus, hypertrophy of smooth muscle cells)

Question 16

2 pathological features of asthma

Answer 16

bronchial hyperresponsiveness
bronchial inflammation
endobronchial
obstruction (bronchospasm, mucosal oedema, mucus, hypertrophy of smooth muscle cells)

Question 17

values that show bronchodilator reversibility

Answer 17

FEV1 (note FEV1!) of 12% or more, together with an increase in volume of 200 ml or more

Question 18

PEF variability =

Answer 18

> 20%

Question 19

FeNO result = positive test?

Answer 19

> 35 ppb

Question 20

what is ABPI?
what do the results indicate?
results of ABPI

Answer 20

note same order as name (AB)
A/B (ankle BP/brachial BP)

> 1.3 = incompressible calcified vessels due to PVD. .,. pressure is low in ankle vessels so result increases
1.0–1.30 = normal value
0.91–0.99 = borderline
0.40– 0.90 = mild to moderate PAD → claudication
< 0.40 = severe PAD → resting pain, gangrene (critical limb ischemia)

Question 21

what is ABPI?
what do the results indicate?
results of ABPI

Answer 21

note same order as name (AB)
A/B (ankle BP/brachial BP)

> 1.3 = incompressible calcified vessels due to PVD. .,. pressure is low in ankle vessels so result increases
1.0–1.30 = normal value
0.91–0.99 = borderline
0.40– 0.90 = mild to moderate PAD → claudication
< 0.40 = severe PAD → resting pain, gangrene (critical limb ischemia)

Question 22

what exactly is inflammed in inflammatory arthritis

Answer 22

synovium (synovial membrane)