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Past Papers | Sarah Yasmine > 2017 > Flashcards

2017 Flashcards

1
Q

40-year-old farmer has wheeze for a few weeks. Normal CXR. Diagnosis?

A

Aspergillosis (normal and eventually bronchiectasis)

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2
Q

Transfusion reaction - fever, other obs normal, transfusion stopped. What next?

A

Check bag against patient details

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3
Q

Mid-diastolic murmur

A

Mitral stenosis 


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4
Q

Patient on warfarin for AF has INR of 3.3, falls and found on CT to have intracerebral haematoma - warfarin stopped and been given Vit K, what next?

A

Prothrombin Complex

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5
Q

Lady with palmar erythema, raised ALT, raised bilirubin, strongly positive ANA?

A

AI Hepatitis

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6
Q

Haematemesis and abdo pain, BP 120/80, HR >100 (what was the actual HR?) What do you give IV whilst waiting for endoscopy?

A

IV crystalloid

  • IV terlipressin (in variceal bleeding – can do that first)
  • IV PPI (in upper GI bleed) – NO do endoscopy FIRST
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7
Q

Small cell lung ca, hilar LN, no distant mets - what treatment?

A

Chemo

SCLC

 Usually disseminated @ presentation

 Some benefit c¯ chemo

Palliative Care

 Analgesia: opiates for pain and cough

 Radiotherapy: haemoptysis, bone or CNS mets

 SVCO: dex + radio or intravascular stent

 Persistent effusions: chemical pleurodesis

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8
Q

Public health question: 200 pts in 2 month period out of 10,000 people get influenza. They ask how many people out of 100,000 in one month period get infection?

A

1000

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9
Q

Patient has bad claudication and can only walk 10m. Distal aorta and both iliac vessels occluded. What do you do?

A

Aorto-Bifemoral

Indications for bypass:

  • V. short claudication distance (e.g. <100 m)
  • Affecting QoL
  • Rest Pain develops
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10
Q

Lady has surgery 4 days ago, after she was given multiple bags of 5% dextrose. Now she is drowsy. What’s the mechanism?

A

Cerebral Oedema

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11
Q

Guy gets claudication in calf. Where is the block?

A

Calf = superior femoral

Buttock = iliac

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12
Q

Lady with RA and purple nodule on shin ulcerating with raised edges. Dx?

A

Pyoderma Gangrenosum

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13
Q

Guy with prostate ca has back pain and bone scan shows increased uptake in spine, how to help with pain?

A

Radiotherapy

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14
Q

Some woman with folate and iron deficiency. Some unstated bowel symptoms following bouts of gastroenteritis as a child. What ix do you do?

A

Anti TTG abs

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15
Q

Post partum breast feeding lady with red tender breast, no mass. What do you do?

A

Flucloxicillin

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16
Q

What does a triple assessment consist of?

A

Clinical exam + imaging + core biopsy. (Imaging in <35 is USS, >35 is mammogram)

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17
Q

Old guy with bacteruria grown from catheter. What do you do?

A

Treat if symptomatic

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18
Q

Smoker has lung cancer near right bronchus removed with raised calcium, what will histology show?

A

SCC

  • Non-Small Cell Lung Cancer*
  • ·* SCC: 35%
  • § Highly related to smoking
  • § Centrally located
  • § PTHrP → ↑ Ca2+
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19
Q

What is a feature of reactive arthritis other than arthritis, urethritis etc?

A

Keratoderma blenhorrhagicum (yellow lesions on soles of feet)

20
Q

Idiopathic Intracranial Hypertension

A
  • headache, blurred vision, papilloedema, blind spot, 6th nerve palsy
  • RFs = obese, female, pregnant, OCP, tetracycline, vitamin A, lithium
  • Mx = WEIGHT LOSS, acetazolamide (diuretic - inactivates carbonic anhydrase), topiramate (weight loss too), repeated LP, surgery
21
Q

40 year old banker has headaches which have led to taking ibuprofen and paracetamol daily. No neuro or eye signs. No weight loss.

A

Advise to stop taking meds and reassess in a month

22
Q

Someone has hearing changes, haemoptysis, nasal discharge, renal problems. CXR shows 3 cavitated lesions?

A

Wegener’s Granulomatosis

23
Q

49 yo lady with 2 month history of diffuse thyroid swelling and intense sweating at night

A

Graves

24
Q

Test for gestational diabetes

A

Oral glucose tolerance test at 28 weeks

25
Q

Thyroid function low TSH, High T4- post URTI, reduced iodine uptake, hyperthyroid. Cause?

A

Viral thyroiditis (de quervains)

26
Q

Patient has bowel operation 4 days ago, has not opened bowels for 24 hours. Distended with scant bowel sounds. Cause?

A

Small bowel obstruction (tinkling bowel sounds = high pitched)

27
Q

Patient with symptoms of guarding, peritonism, what test?

A

Erect CXR 


28
Q

Patient with symptoms of bowel obstruction - what test?

A

Supine AXR

29
Q

Patient has been generally unwell for a week. Now has dysuria and is going frequently. Later on, she gets more unwell and has really bad loin pain. What’s wrong?

A

Pyelonephritis

30
Q

80 year old with essential hypertension and peripheral vascular disease. What meds?

A

Nifedipine, Amlodipine, Felodipine
(dihydropyridine CCBs) = affects peripheral vascular smooth muscle > myocardium

31
Q

Testicular pain in a sexually active 18 year old. Management?

A

Take to theatre

32
Q
A
33
Q

Someone has AF and has a cold pale leg. It’s been 6 hours. Mx?

A

Amputate (> 6 hours – but otherwise embolectomy w fogarty catheter)

34
Q

Lady with flushing, pustular rash, telangectasia on her face?

A

lupus pernio (sarcoidosis)

35
Q

Gentlemen with bald head, lumpy hyperkeratotic lesions on scalp. What is he at risk of?

A

SCC

36
Q

Guy with pale stools, abdo pain. Xray shows area of calcification.

A

Dx - decrease in exocrine pancreatic function. Chronic Pancreatitis.

37
Q

Guy who was lifting heavy things. Now just lumbar pain. Mx?

A

Symptom control with NSAID

38
Q

Patient with 3 weeks of fevers, cough, feeling unwell. On exam: dull percussion, absent Vocal Resonance, reduced expansion?

A

Empyema

(vocal resonance increases in consolidation and decreases in effusion)

39
Q

What vitamin you have to give somebody when starting TB treatment?

A

Pyridoxine (B6)

40
Q

Somebody comes in to A&E with drug resistant TB, where do you keep them?

A

Negative pressure room + respiratory measures for staff (allows air into room but not out)

41
Q

Somebody with features of UC - how do you investigate?

A

flexible sigmoidoscopy

42
Q

Pt with known renal cell cancer now gets swollen legs and distended veins below umbilicus what’s the diagnosis?

A

Obstruction of IVC

43
Q

Some guy with obstructive features, long term smoker. Dx?

A

Chronic Bronchitis

44
Q

20 year old female, walks in, has 2yr history of intermittent diarrhoea, IDA, aphthous ulcers, raised ESR. Dx?

A

Coeliac

45
Q

A man with stab injury to the back - hemisection of the cord. Where would he lose pain sensation from?

A

. Contralateral spinothalamic

46
Q

An ECG shows STEMI in leads V4-V6 and I, AvL - where is the infarct?

A

Antero-lateral (circumflex)

Past Papers | Sarah Yasmine (5 decks)

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