5 December

Question 1

What is leukoplakia?

Answer 1

Pre malignant condition
White thickening of the oral mucosa that cannot be scraped off

Question 2

What are features of necrotising otitis externa?

Answer 2

Extension of infection from ear canal into mastoid and temporal bones
Pain out of proportion to clinical signs
Facial palsy can be present
Occurs in diabetics and immunosuppressed

Question 3

What is otosclerosis?

Answer 3

Increase in bony turnover in the ear leading to conductive hearing loss

Question 4

What is the management of long term tympanic membrane perforation?

Answer 4

Myringoplasty to improve hearing and prevent further infections

Question 5

What is treatment of acute otitis media?

Answer 5

1) Amoxicillin
2) Co-amoxiclav for resistant H.influenzae

Erythromycin if pen allergic

Question 6

What are features of nasal polyps?

Answer 6

Men >40 associated with asthma, chronic sinusitis and allergic rhinitis

Symptoms- nasal blockage, watery discharge and changes in voice

Treat with steroid nasal drops followed by steroid nasal sprays

Question 7

When should a different diagnosis be considered in children with bronchiolitis?

Answer 7

High fever >39
Persistently focal crackles

Question 8

What is first line management of CHF?

Answer 8

1) Beta blocker and ACEi
2) Aldosterone antagonist

Question 9

What is Puerperal pyrexia?

Answer 9

Temperature >38 within 14 days post partum

Causes
-endometritis- IV abx clindamycin and gent
-UTI
-wound infections
- VTE
-mastitis

Question 10

How can you differentiate between vestibular neuronitis and viral labyrinthitis?

Answer 10

Neuronitis= NO no auditory symptoms

Question 11

What are side effects of alpha 1 antagonists?

Answer 11

Tamsulosin

Dizziness
Postural hypotension
Dry mouth
Depression

Question 12

What are side effects of 5 alpha reducates inhibitors?

Answer 12

finasteride

Erectile dysfunction
Reduced libido
Ejaculation problems
Gynaecomastia

Question 13

What are the most common cardiac complications in Down Syndrome?

Answer 13

1) Arterioventricular septal defect
2) VSD
3) ASD
4) ToF/PDA

Question 14

What are investigations into asthma?

Answer 14

Child <17 Spirometry with bronchodlator reversibility testing
>17 Spirometry with BDR and FeNO testing

Question 15

What is the management of miscarraige <6 weeks?

Answer 15

Expectant miscarriage- repeat urine pregnancy test in 7-10 days

Question 16

What are features of alcohol withdrawal?

Answer 16

Symptoms begin 6-12 hours post last drink
Tremor
Tachycardia
Confusion
Sweating

Question 17

What are features of delirium tremens?

Answer 17

Coarse tremor
Confusion
Hallucinations

Question 18

What is the management of PE in haemodynamic instability?

Answer 18

Thrombolysis e.g. streptkinase

Question 19

What are features of left ventricular wall rupture?

Answer 19

1-2 weeks post MI
Features of cardiac tamponade- acute HF, raised JVP quiet heart sounds

Question 20

What is the management of cluster headaches?

Answer 20

Oxygen and SC triptain

Prophylaxis- verapamil

Question 21

What antibodies are present in gullain Barre syndrome?

Answer 21

Anti ganglioside antibodies

Question 22

What are features of discoid lupus?

Answer 22

Anular erythematous scaly lesions on face/head
Keratin plugs which can be seen by removing superficial scale- carpet tack appearance
Leads to scarring alopecia

Treated with steroids and hydroxychlorquine second line

Question 23

What is the management of scalp psoriasis?

Answer 23

Either potent steroid or vitamin D analogue or coal tar shampoo

If not working then combined steroid and Vit D analogue

Question 24

What is the management of UTI in pregnnacy?

Answer 24

1- nitrofurantoin
2- Amoxicillin or Cefalexin