29 December

Question 1

What are features of primary biliary cirrhosis?

Answer 1

Fatigue
Pruritis
Steatorrhoea
Jaundice

O/E
- xanthelasma
- skin hyperpigmentation
- hepatomegaly
- splenomegaly

Anti-mitochondrial antibodies
Alleviate symptoms
Liver transplant= only cure

Question 2

What are side effects of hydroxychlorquine?

Answer 2

Ocular toxicity
- whorl like cornea deposits
- bulls eye macular lesion

Question 3

What are side effects of Sulfaasalazine?

Answer 3

Oligospermia
SJS
Pneumonitis
Myelosuppression
Megaloblastic anaemia
Heinz body anaemia
Can colour tears

Question 4

What is the mode of action of COCP?

Answer 4

Prevention of ovulation- acts on hypothalamo pituitary ovarian axis
Also changes cervical mucous, endometrium and tubual motility

Question 5

What is the mode of action of IUS

Answer 5

Changes to cervical mucous
Endometrial changes- atrophy

Question 6

What is the mode of action of POP (excluding desogesterol)

Answer 6

Thickens cervical mucous
Suppresses ovulation
Endometrial ovulation
Reduction in cilia activity

Question 7

What is the mode of action of Ulipristal acetate?

Answer 7

Delays ovulation for at least 5 days

Question 8

What is the mode of action of Levonorgestrel?

Answer 8

Delays ovulation- prevents follicular rupture and leads to luteal dysfunction

Question 9

What are extraintestinal features of IBD?

Answer 9

Arthritis
Erythema nodosum
Episcleritis
Osteoporosis
Uveitis
Clubbing
Primary sclerosing cholangitis

Question 10

What is the cervical cancer screening results?

Answer 10

If at colposcoy cytology normal repeat smear at 12 months

• if HPV negative- return to normal recall
• if HPV positive and cytology normal repeat in 12 months
  -> if HPV negative at 24 months return to normal recall
  -> if HPV positive at 24 months- colposcopy

Question 10

What are features of lung abscess?

Answer 10

Fever
Cough-productive of bad smelling sputum
Night sweats
Anorexia
Weight loss

CXR- air fluid level

Question 11

What CXR findings may be present in Epiglottitis?

Answer 11

Thumbprint sign

Question 12

What are features of penile fracture?

Answer 12

Snapping sound during intercourse
Eggplant deformity
Blood at meatus if urethra injured
Haematuria/dysuria/retention

Question 12

What are investigations of penile fracture?

Answer 12

Retrograde urethrography
If uncertain- MRI

Surgical management

Question 13

Which lung cancer is most associated with hypercalacemia?

Answer 13

Squamous cell

Question 14

What are features of McCune Albright Syndrome?

Answer 14

Unilateral cafe au lait spots
Precocious puberty
Polyostotic fibrous dysplasia leading to fractures

Question 15

What are features of a sebaceous Cyst?

Answer 15

Occur more on scalp, neck and back
Blocked hair follicule and have a punctum

Question 16

What are features of Alport Syndrome?

Answer 16

X linked
Sensorineural deafness
Ocular abnormalities
Nephritis

Question 17

What are features of choriocarcinoma?

Answer 17

Secretes HCG
Responds to methotrexate chemotherapy

Question 18

What are features of pleomorphic adenomas?

Answer 18

Middle aged
Slow growing painless lump
Risk of CNVII damage

Question 19

What are features of anaplastic carcinoma of thyroid?

Answer 19

Rapidly progressing
Craggy thyroid lump with early lymph node involvement
Often symptoms of hoarseness of stridor

Seen in older patients