4 December

Question 1

What are features of pernicious anaemia?

Answer 1

Lethargy
Pallor
Pins and needles
Mild jaundice
Stomatitis
Atrophic glossitits
Dyspnoea

Question 2

What is diagnostic criteria for IBS?

Answer 2

Symptoms for 6 months
- abdo pain
- bloating
- change in bowel habit
OR

Abdo pain with two of folloing
- passage of rectal mucous
-symptoms worse on eating
- abdominal bloating
- altered passafe of stool

Question 3

What are features of cholecystitis?

Answer 3

RUQ pain
Fever
Murphys sign +ve
Occasionally mild LFT derrangement

Question 4

What are features of Weils disease?

Answer 4

Early phase lasts around a week
- mild fever/flu, subconjunctival redness
Second phase- more severe (Weils disease)
-AKI
-hepatitis, jaundice,hepatomegaly
-aseptic meningitis

Question 5

What can affect 13C urea breath test results?

Answer 5

Abx use within 4 weeks
PPI use within 2 weeks

Question 6

What is the most common cause of travellers diarrhoea?

Answer 6

E.coli

Question 7

What are symptoms of Bacillus cereus?

Answer 7

Food poisonin
Watery diarrhoa
Abdo cramps
6-15 hours post consumption of contaminated food

Question 8

What is the management of H.pylori infection?

Answer 8

Full dose PPI with amoxicillin and clarithromycin

Question 9

What are features of patellar tendonitits?

Answer 9

anterior knee pain worsened by activity
Tenderness along the course of patellar tendon
Pain reporduced on extension of the knee against resistance

Question 10

What are features of mitral stenosis?

Answer 10

Dyspnoea
Haemoptysis
Mid-late diastolic murmur
Loud S1
Opening snap
Malar flush
AF

Question 11

What is the management of tachyarrythmia?

Answer 11

Unstable= DC cardioversion- 3 shocks if unsuccessful amiodarone and then repeat shock

Stable narrow complex- try vagal maneouvres
1) Adenosine 6mg
2) Adenosine 12mg
3) Adenosine 18mg
4) Verapamil or beta blocker

Broad complex- likely VT with pulse
1) Amiodarone

Question 12

What are 2 week wait criteria for bladder ca?

Answer 12

45+ AND
- unexplained haematuria with no infection
-visible haematuria which persists after UTI treated

60+ with
- unexplained non visibile haematuria and either elevated WCC or dysuria

Question 13

What are features of MEN1 mutation?

Answer 13

Hyperparathyroidism
Pituitary tumour
Pancreatic tumour- insulinoma/gastrinoma

Question 14

What are features of MEN2 mutation?

Answer 14

2a) Phaeochromocytoma, hyperparathyroidism, medullary thyroid cancer
2b) phaeochromocytoma, medullary thyroid cancer, marfanoid body habitus and mucosal neuroma

Question 15

What are features of breast fibroadenoma?

Answer 15

young patients
Rubbery, firm and non tender
Highly mobile

Question 16

What is the management of Kawasaki disease?

Answer 16

High dose aspirin and IV immunoglobulins

Question 17

What is the function of the common peroneal nerve?

Answer 17

Motor- foot dorsiflexion and eversion
Sensory- lateral leg and bottom of foot

Question 18

What is the management of pericarditis?

Answer 18

NSAIDS and colchicine

Question 19

What are features of Pneumocystis Jirovecii pneumonia?

Answer 19

Fever, dry cough SOB

CXR- bilateral infiltrates, often pneumothorax

Treat with co-trimoxazole (steroids too if hypoxic), initiate prophylaxis if CD4 <200

Question 20

What is the management of myoclonic seizure?

Answer 20

Valproate
Keppra, if women of childbearing ageW

Question 21

What is the management of a staggered paracetamol overdose?

Answer 21

Commence NAC regardless of concentration

Question 22

What is the management of endocarditis?

Answer 22

Native valve
- Amox and gentamicin initially
- if Staph then fluclox
- if strep then benpen

Prosthetic valve
-Vanc, gent and rifampicin

Question 23

What are side effects of lithium?

Answer 23

Tremor
N&V
Hypothyroidism
Weight gain
Hyperparathyroidism and hypercalcaemia

Question 24

What is meningococcal prophylaxis?

Answer 24

1) Ciprofloxacin
Or rifampicin

Question 25

What is the management of a secondary pneumothorax?

Answer 25

> 2cm or SoB
- chest drain

1-2cm and not SoB
1) Aspiration- admit for obs/O2
2) Chest drain

<1cm- admit for O2 and observation

Question 26

What are features of Fragile X?

Answer 26

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism