27 December #2

Question 1

What is the medical management of abortion?

Answer 1

1) Mifepristone followed by vaginal administration of misoprostol

Question 2

What are the criteria for CT head within 1 hour?

Answer 2

Consciousness level
- GCS <12 during initial assessment
- GCS <15 2 hours post injury
Suspected fracture
Seizure or focal neurology
>1 vomit

Question 3

What is the management of malaria?

Answer 3

Uncomplicated
1) Oral Artemisinin with lumefantrine
2) Quinine plus doxy/clinda

Complicated
1) IV artesunate
2) IV quinine
HDU

Question 4

What are ECG findings in Brugada Syndrome?

Answer 4

Convex ST evelation in V1-3 followed by negative T wave
Partial RBB

Question 5

What is Endophthalmitis?

Answer 5

Post operative complication
presents within 3-7 days post operatively
Painful red eye, discharge and visual impairment

Red eye with hazy cornea
Hypopyon

Question 6

What are features acranial venus thrombosis?

Answer 6

Sudden onset headache
N&V
Papilloedema
Stroke

Question 7

What are features of cavernous sinus thrombosis?

Answer 7

Periorbital oedema
Opthalmoplegia CN6 affected first

Question 8

What is found on stigation of Wilsons disease?

Answer 8

Reduced serum caeruloplasmin
Reduced total copper levels
Increased 24 hour urinary excretion of copper

Treat with penicilliamine or trientine

Question 9

What are features of pituitary apoplexy?

Answer 9

Sudden onset thunderclap headache
Bitemporal superior quadrantanopia
Pituitary failure
- electrolyte abnormalities
- haemodynamic instability

Treat with IV hydrocortisone

Question 10

What are red flags for back pain?

Answer 10

Age >50
Insidious onset
Pain interrupting sleep
Localised Spinal tenderness
Weight loss
Previous Cancer
No improvement within 4-6 weeks
Systemically unwell

Question 11

What are features of Ashermans syndrome?

Answer 11

Intrauterine adhesions which oliterate uterine cavity leading to miscarriage/subfertility

Diagnosed on hysteroscopy and treated with surgical dissection

Question 12

What are clinical features of haemochromatosis?

Answer 12

Fatigue
Erectile dysfunction
Arthraliga
Bronze pigmentation
Diabetes mellitus
Liver- hepatomegaly

Question 13

What are features of CLL?

Answer 13

Often asymptomatic may be detected as incidental lymphocytosis on blood test

Anorexia
Weight loss
Bleeding
Infections

Question 13

What is the management of otitis externa?

Answer 13

Topical steroid and topical abx
Can use topical abx on its own if no oedema or inflammation

Normally gent unless perforated tympanic membrane

Question 14

What screening test must be done before commencing allopurinol?

Answer 14

If african/asian then HLA B5801

Question 15

What are examples of CYP450 inducers?

Answer 15

Phenytoin
Carbmazepine
Rifampicin
Alcohol
Smoking
Sulfonylureas

Question 16

What is the management of ITP?

Answer 16

PO prednisolone

Question 17

What should be co-prescribed with cyclophosphamide?

Answer 17

Mesna
Sodium 2 mercaptoethane sulfonate

Question 18

What is investigation for GH deficiency?

Answer 18

Insulin tolerance test

Question 19

What is the management of PMR?

Answer 19

Prednisolone 15mg OD

Question 20

What is the management of prolactinoma?

Answer 20

Treat medically with dopamine agonists
e.g. bromocriptine/cabergoline

Surgery for those who do not tolerate or fail to respond to medical therapy

Question 21

What are symptoms of TCA overdose and what is the management?

Answer 21

Dry mouth
Dilated pupils
Agitation
Sinus tachy

Severe
- arrythmias e.g. widening QRS, prolonged QT
-seizures
- metabolic acidosis

Treat with IV bicarbonate