8/06

Question 1

regular monitoring methotrexate

Answer 1

LFTs

Question 2

local anaesthetic toxicity

Answer 2

20% lipid emulsion

Question 3

colles fracture

Answer 3

FOOSH
dorsally displaced radius
dinner fork deformity

Question 4

bennetts fracture

Answer 4

intra-articular fracture at the base of the thumb metacarpal
punching injury

Question 5

smiths fracture

Answer 5

fall backwards onto a flexed wrist
volar angulation of the distal radius fragment (garden spade deformity)

Question 6

pericarditis tx

Answer 6

NSAID/colchicine

Question 7

hypercalcaemia initial tx

Answer 7

IV fluids

Question 8

diabetets insipidus osmolalities

Answer 8

high plasma
low urine

Question 9

what finding indicates CKD rather than AKI

Answer 9

hypocalcaemia

Question 10

safe to continue in AKI

Answer 10

• Paracetamol
• Warfarin
• Statins
• Aspirin (at a cardioprotective dose of 75mg od)
• Clopidogrel
• Beta-blockers

Question 11

should be stopped in AKI as may worsen renal function

Answer 11

• NSAIDs (except if aspirin at cardiac dose e.g. 75mg od)
• Aminoglycosides
• ACE inhibitors
• Angiotensin II receptor antagonists
• Diuretics

Question 12

Should be stopped in AKI as increase risk of toxicity but doesnt actually worsen renal function

Answer 12

• Metformin
• Lithium
• Digoxin

Question 13

stage 1 AKI

Answer 13

creatinine 1.5-1.9 x baseline

Question 14

stage 2 AKI

Answer 14

creatinine 2-2.9 x baseline

Question 15

stage 3 AKI

Answer 15

creatinine 3 x baseline

Question 16

calcium gluconate effect

Answer 16

stabilises cardiac membrane, does not lower potassium levels

Question 17

risk of using NaCl for fluid therapy in large volumes

Answer 17

hyperchloraemia metabolic acidosis

Question 18

tx of hypertension in CKD

Answer 18

ACEi

Question 19

T1 resp failure

Answer 19

hypoxia without hypercapnia

Question 20

T2 resp failure

Answer 20

hypoxia with hypercapnia

Question 21

minimal change glomerulonephritis tx

Answer 21

prednisolone

Question 22

minimal change glomerulonephritis tx

Answer 22

prednisolone

Question 23

acute tubular necrosis finding

Answer 23

low urine osmolality and high urine sodium

Question 24

tx of MRSA pre-op

Answer 24

nasal mupirocin + chlorhexidine to the skin

Question 25

Ethylene glycol toxicity

Answer 25

fomepizole

Question 26

osteosarcome

Answer 26

Codman triangle (a triangular area of new subperiosteal bone) with an associated sunburst appearance

Question 27

prolonged diarrhoea ABG

Answer 27

metabolic acidosis with hypokalaemia

Question 28

what change in nephrotic syndrome predisposes to VTE

Answer 28

loss of anti-thrombin III

Question 29

positive immunohistochemistry for PLA2

Answer 29

membranous glomerulonephritis

Question 30

blood stained nipple discharge in younger women

Answer 30

intraductal papilloma

Question 31

HHS tx

Answer 31

IV 0.9% sodium chloride and thromboprophylaxis

Question 32

If a secondary pneumothorax > 2cm and/or the patient is short of breath

Answer 32

chest drain first line (not aspiration)

Question 33

first line analgesics for neuropathic pain

Answer 33

amitriptyline, duloxetine, gabapentin or pregabalin

Question 34

first line analgesics for neuropathic pain

Answer 34

amitriptyline, duloxetine, gabapentin or pregabalin

Question 35

pituitary tumour sight

Answer 35

bitemporal hemianopia

Question 36

which ovarian tumours are assoc with endometrial hyperplasia

Answer 36

granulosa cell tumours

Question 37

sign to differentiate between organic and non-organic lower leg weakness

Answer 37

hoovers

Question 38

acute asthma mx

Answer 38

1. Oxygen 2. Salbutamol nebulisers 3. Ipratropium bromide nebulisers 4. Hydrocortisone IV OR Oral Prednisolone 5. Magnesium Sulfate IV 6. Aminophylline/ IV salbutamol

Question 39

1st line tx of hypercalcaemia

Answer 39

fluids

Question 40

mx of post op ileus

Answer 40

nil by mouth and NG tube

Question 41

which abx should be avoided in pts taking valproate

Answer 41

ciprofloxacin as it lowers seizure threshold

Question 42

strongest RF for anal cancer

Answer 42

HPV infection

Question 43

anti mitochondrial antibody

Answer 43

primary biliary cholangitis

Question 44

H pylori eradication therapy

Answer 44

lansoprazole + amox + clari

Question 45

signs of R sided heart failure

Answer 45

raised jvp hepatomegaly peripheral oedema

Question 46

when should people with CKD be prescribed an ACEi

Answer 46

ACR >30

Question 47

acute limb ischaemia tx

Answer 47

analgesia, IV heparin and urgent vascular review for surgery

Question 48

cervical cancer first mets

Answer 48

pelvic lymph nodes along the iliac arteries