2017

Question 1

40 year old premature ovarian failure and wanted medication to deal with the symptoms of menopause. What would you prescribe her?

Answer 1

Combined HRT or COCP

Question 2

Woman is pregnant and HIV negative at booking but her partner is HIV positive - what do you do?

Answer 2

Start her on antiretroviral therapy, retest her in 2 weeks

Question 3

What signifies onset of active labour?

Answer 3

Os is 4cm

Question 4

Woman has cervical cancer, is a smoker, hasn’t had a smear for 8 years - what is the most likely contributing factor?

Answer 4

Smokes 20 cigarettes a day

Question 5

37 year old coming to the GP with a background of polycystic ovarian syndrome wanting to review her contraception. She wants to have the COCP. Which of the following is an absolute contraindication to the pill?

Answer 5

Passmed:
more than 35 years old and smoking more than 15 cigarettes/day
migraine with aura
history of thromboembolic disease or thrombogenic mutation
history of stroke or ischaemic heart disease
breast feeding < 6 weeks post-partum
uncontrolled hypertension
current breast cancer
major surgery with prolonged immobilisation

Question 6

Woman with white discharge and itch. Which treatment?

Answer 6

Oral Fluconazole, Topical Clotrimazole

Question 7

Pregnant woman with itchy feet, what investigation?

Answer 7

Liver function tests/serum bile acids

Question 8

Couple seen in subfertility clinic and the female and male investigations are given (with normal ranges for sperm count, FSH etc etc). Results show azoospermia. How should they be managed?

Answer 8

Intracytoplasmic sperm injection

Question 9

Cyst contains hair and teeth

Answer 9

Teratoma

Question 10

Ground glass appearance

Answer 10

Endometrioma

Question 11

Woman has pain before periods and has been subfertile, cyst found on ovary

Answer 11

Endometrioma

Question 12

Post menopausal woman has bleeding

Answer 12

Endometrial cancer

Question 13

Green discharge

Answer 13

Trichomonas

Question 14

White discharge

Answer 14

Candida

Question 15

A newborn appears to be in severe respiratory distress and appears blue. Despite being given high flow O2, his saturations remain at 65%.
What is the next best step to take with regards to his management?

Answer 15

Infusion of Prostaglandin

Question 16

Drug treatment for ADHD

Answer 16

methylphenidate
atomoxetine
dexamfetamine

Question 17

3 months old baby with signs of HF, systolic murmur that radiates over the praecordium

Answer 17

VSD

Question 18

What is the most important thing to look at in follow up of HSP?

Answer 18

Urine protein and RBC

Question 19

15 year old boy with short stature. Passing urine 10 times a day with no dysuria. Pale with heart rate at 78bpm, blood pressure at 158/88 and respiratory rate at 14. What is the likely diagnosis?

Answer 19

Chronic renal failure

Question 20

6 year old child with 24 hour history of left peri-orbital swelling. Had an upper respiratory tract infection last week. Left proptosis, visual acuity was normal and had a fever of 38.9. What is the best diagnostic investigation?

Answer 20

CT of nasal orbits

Question 21

Boy with itchy bottom, what do you prescribe?

Answer 21

mebendazole

Question 22

Child in A&E with asthma attack, was given puffs of salbutamol. Now has a quiet chest, what do you do?

Answer 22

Call for senior help

Question 23

Child with 6m of loose stools. Passed one hard blood streaked stool 10 days ago. What investigation?

Answer 23

None

Question 24

Infant with episodes of throwing arms forward with fists clenched.

Answer 24

infantile spasms

Question 25

Mother worried about 2.5 or 3 year old child’s bed wetting. Dry by day, wets bed at night. What to do?

Answer 25

Reassure

Question 26

Child with fever of 39, high resp rate, nurse says chest is clear, what investigation do you do?

Answer 26

Urinalysis

Question 27

Child with fever, white exudate on one tonsil, diagnosis?

Answer 27

Quinsy (peritonsillar abscess)

Question 28

Child with episodes of smelling strange things, hard to communicate with during these episodes, falls asleep for an hour after and doesn’t remember anything. Diagnosis?

Answer 28

Focal seizure

Question 29

Mother worried 5 year old? son has autism. Which would most support a diagnosis of autism?

Answer 29

child didn’t speak first words until 2 years old and goes to a speech and language therapist

Question 30

Mother complains her young child is a fussy eater. She eats soft foods and drinks a lot of milk. Also has been feeling tired recently. Diagnosis?

Answer 30

Iron deficiency anaemia

Question 31

Baby is almost a month old and jaundiced. Parents say has been jaundiced since day 2. Stools are grey or white. Diagnosis?

Answer 31

Biliary atresia

Question 32

4 year old girl with a high fever that was followed by a rash which has small white dots on a red base. What is the most likely Dx?

Answer 32

Chicken pox?

Question 33

Nappy rash with satellite lesions

Answer 33

Topical clotrimazole

Question 34

Nappy rash sparing flexures

Answer 34

Zinc and castor oil

Question 35

Impetigo

Answer 35

Topical fusidic acid (local) | Oral antibiotic e.g. fluclox (extensive/bullous)

Question 36

Chicken pox

Answer 36

Do nothing

Question 37

Child suffers from fever. The fever disappears but she has now developed a rash. She subsequently has febrile convulsions.

Answer 37

Roseola

Question 38

Mother with cold sores has been kissing her child who has a background of eczema?

Answer 38

HSV/eczema herpeticum

Question 39

Child has an URTI 2 weeks ago. Has now developed a rash over the back of the legs along with joint and abdominal pain.

Answer 39

HSP

Question 40

Post partum depression

Answer 40

Psychological therapies

Question 41

16yo having sex with 12 yo

Answer 41

Call police

Question 42

Woman comes in with a pneumothorax and said her husband kicked her and has previously hurt their baby too. Baby is currently at home with him - what do you do?

Answer 42

Call police

Question 43

Woman who had FGM when she was 6 and is not pregnant and said she definitely won't do on her daughter - what do you do?

Answer 43

Police – not necessarily, carry out risk assessment Carry out a risk assessment Refer to social services/police if 1+ are present from the following: - Woman already has daughters who have undergone FGM - Woman or woman’s partner/family requesting reinfibulation following childbirth - Woman is considered to be a vulnerable adult and therefore issues of mental capacity and consent should be considered if she is found to have FGM - Woman says that FGM is integral to cultural or religious identity - Family are already known to social care services – if known, and you have identified FGM within a family, you must share this information with social services

Question 44

Boy always playing video games from teenage years, not interested in other people threatening to kill himself?

Answer 44

Schizoid PD