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Question 1

What can be used to manage itch in biliary tract disease?

Answer 1

Colesytramine

Question 2

What lung cancer is assoc. with non-smokers?

Answer 2

Adenocarcinoma

Question 3

What requires Abx in acute otitis media?

Answer 3

> 4 days of sx
Systemically unwell
High risk of complications
<2yo with bilateral
Tympanic membrane perforated

Question 4

Angina management

Question 5

MI managment - ?prasugrel over ticagreolor

Question 6

Pt presenting with AKI of unknown aetiology - what invx is needed?

Answer 6

Renal tract USS

Question 7

Post-operative ileus
What does mean?
How does it present?
How is it managed?

What is very important to check?

Answer 7

Postoperative ileus = common complication post surgery - reduced bowel peristalsis -> pseudo-obstruction

Abdo bloating + pain
N+V
No flatus

Nil-by-mouth
NG tube if vomiting
IV fluids

Electrolytes - deranged electrolytes can predispose ileus and also be caused by the condition due to abnormal fluid shifts

Question 8

Adrenal insufficency - presentation and management

Question 9

Bitemporal hemianopia affecting upper quadrants more or lower quadrants more - what are the causes?

Answer 9

uPper > = Pituitary tumour
lOwer > = craniOpharyngiOma

Question 10

B-blockers can worsen psoriasis?

Answer 10

True

Question 11

Explain how PTH works?

Explain the difference between primary, secondary and tertirary

Explain what PTH and Ca levels you would find with each type

Answer 11

PTH + vit D -> increase serum Ca

PTH does this by:
= increasing osteoclast activity
= causing renal retention of Ca
= increasing gut absorption (vit D does this too)

Primary - mostly caused by adenomas
Secondary - caused by parathyroid gland hyperplasia in response to one of the mechanisms not working properly e.g. renal failure
Tertiary - as a result of all 4 paratyhyroid glands hyperplasia due to prolonged secondary hyperparathyroidism

Primary
- Increased PTH, increased Ca

Secondary
- increased PTH, normal or low Ca

Tertiary
- increased PTH, normal or high Ca

Question 12

What XR finding is associated with hyperparathyroid?

Answer 12

Pepper pot

Question 13

What is the link between calcium and phosphate?

Answer 13

As calcium increases, phosphate decreases

(phosphate binds to free calcium)

High phosphate also draws calcium from bones

Question 14

What are the sx of hypercalcaemia

Answer 14

Bones, Stones, Abdo groans, Thrones and Pysch overtones

Bony pain
Constipation, nausea, anorexia
Kidney stones
Polydipsia
Depression

Question 15

How long should pt take folic acid for?

Answer 15

First 12 weeks - preventing against neural tube defects so only req. for 1st tri