22/3/22

Question 1

Name an atypical anti-pyschotic drug.

What drug is used when all other types have no effect? Why is it not used first line?

How do these drugs work?

What is the more serious side effect that can happen as a result of anti-pyschotics?

Answer 1

Olanzapine

Clozapine - agranulocytosis

D2 receptor antagonists

Weight gain and sedation 
Neuropletic malignant syndrome
- lead pipe rigidity
- change in conciousness
- increased temp and HR

Question 2

What is the first line treatment for C.diff infection?

What has this recently changed from?

Answer 2

Oral vancomycin

Metronidazole

Question 3

Apart from increasing your risk of C.diff what other side effects does ciprofloxacin have?

Answer 3

Tendonitis

Lengthen QT syndrome `

Question 4

What kind of bug is neissera?

What two types of infection does neissera bug cause

Answer 4

Gram negative diplococci

Gonhorroea
Meningitis

Question 5

What is the MoA of tamoxifen?

If a patient was post-menopausal what would you give them instead?

Answer 5

Selective oestrogen receptor modulator

• ANTAgonises in the boob
• AGonies in the uterus

Anastrozole - aromatase inhibitor

Question 6

Since when does first line invx for breast cancer go from USS to mammogram and why does it change?

Answer 6

35

Younger patients have more dense breast tissue

Question 7

What is triple assessment for breast cancer?

Answer 7

Clinical assessment
Imaging
Biopsy

Question 8

What skin changes would you expect to see with Paget’s Disease of the nipple?

Answer 8

Eczematous changes over the nipple and possible the presence of a breast lump

Question 9

If a patient presents with a breast lump consistent with a presentation of a fibroadenoma but they are >40 and it has grown rapidly in size?

Answer 9

Phyllodes tumour

Question 10

In which 4 situations would you urgentlly refer a patient to secondary care with breast presentation?

Answer 10

• Unexplained breast lump >30
• Unexplained axillary lump >30
• Skin changes suggestive of breast cancer
• Unilateral nipple changes >50

Question 11

Micro-calcifications on mammogram?

Answer 11

Ductal C-I-S

Question 12

Creamy green-brown discharge from nipple?

Answer 12

Duct ectasia

Question 13

What class of antibiotics are used against gram +ve strep?

Answer 13

Penicillin

Question 14

What is the emperical treatment of sepsis before get blood results back?

Answer 14

IV MAG

- metronidazole, amoxicillin and gentamicin

Question 15

A NEWS score above what indicates sepsis?

Answer 15

> 5

Question 16

If give antibiotics with E.coli 0157 what do you put the patient at significant risk of?

What is the big symptom they present with?

Answer 16

HUS

Bloody diarhorrea