24 November

Question 1

What is the initial management of motor neuron disease?

Answer 1

Riluzole
Prolongs life by approx 3 months

Question 2

What is the management of an anal fissure?

Answer 2

Acute
- soften stool, lubricants, topical anaesthetics, analgesia

Chronic
- GTN
if not working after 8 weeks referral for surgery or botox injection

Question 3

What is the most common cause of nephrotic syndrome in adults?

Answer 3

Membranous nephropathy
Anti-phospholipase A2 antibodies may be positive

Question 4

What are causes of focal segmental glomerulosclerosis?

Answer 4

HIV
Heroin use
Alports syndrome

Question 5

What are symptoms of acute angle closure glaucoma?

Answer 5

Severe pain
Loss of vision
Red eye
Semi-dilated non reacting pupil
Systemic upset
Haloes around light

Question 6

How should dose reduction for benzos take place?

Answer 6

Reduce by 1/8 every 2-3 weeks

Question 7

When should dual therapy be started in the initial phase of T2DM?

Answer 7

High risk of CVD or established CVD or chronic heart failure
Metformin plus SGLT2 inhibitor

Question 8

What is the management of Alzheimers?

Answer 8

1st line= donepezil, rivastigmine, galantamine
2nd line= memantine

Question 9

What is the management of beta blocker overdose?

Answer 9

Glucagon

Question 10

What is the management of GAD?

Answer 10

1st line= guided self help or group CBT
2nd line (if 1 ineffective or functional impairment)= High intensity psych intervention or sertraline

Question 11

What is found on miscroscopy of membranous nephropathy?

Answer 11

Spike and dome appearance, thickened basement membrane

Question 12

What is the management of nephrotic syndrome due to membranous nephropathy?

Answer 12

ACEis or ARBs to reduce proteinuria

Question 13

What is Lyme disease?

Answer 13

Due to borrelia burgdorferi
Erythema migrans- target like rash
- arthritis

Treat with PO doxycycline if rash present

Question 14

What are features of seborrhoiec keratosis?

Answer 14

Stuck on appearance of flat or raised wart lesions

Question 15

What is the management of essential thrombocythaemia?

Answer 15

Hydroxycarbamide
Aspirin- if low risk

Question 16

What are features of pityriasis rosea?

Answer 16

Herald patch- single alrge lesion appears
Then multiple well demarcated oval pink lesions on trunk and limb

Question 17

What is conversion disorder?

Answer 17

Loss of motor or sensory dysfunction with indifference to symptoms

Question 18

What are findings in silicosis?

Answer 18

Upper zone fibrosis and egg shell calcification of hilar lymph nodes

Question 19

What are features ot ITP?

Answer 19

Non blanching purpuric rash on limbs
Epistaxis
Bruising
Recent viral infection

managed with prednisolone

Question 20

What are features of serotonin syndrome?

Answer 20

Brisk reflexes, dilated pupils, myoclonus, muscle rigidity, fever, tachycardia, HTN

Question 21

What is the management of restless leg syndrome?

Answer 21

Ropinirole/pramipexole

Question 22

What is the management of falciparum malaria?

Answer 22

Uncomplicated= PO Artemether-lumefantrine

Severe= IV Artesunate
= if parasitaemia >2%, schizonts, cerebral signs, acidosis, hypoglycaemia, Hb <80 or jaundice

Question 23

What is the management of hyperthyroidism in pregnancy?

Answer 23

1st trimester PTU
2/3rd trimester- carbimazole

Question 24

What is the management of diabetes in pregnancy?

Answer 24

Fasting glucose <7
1) Diet
2) Metformin
3) Insulin

Fasting glucose >7= insulin