AKT Flashcards
120mg oral morphine daily dose is equivalent to __mg in a subcut driver
60
BNF antibiotic guidelines: mastitis
Flucloxacillin
Prediabetic obese class II patients should be considered for which medication
Liraglutide
BNF antibiotic guidelines: dental abscess
Amoxicillin
Arteriolar narrowing + tortuosity, silver wiring, AV nipping, cotton wool exudates, flame and blot haemorrhages are features of
Hypertensive retinopathy
How long is Mirena licensed for use as part of HRT?
4 years
_____ may be used in patients with stress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention
Duloxetine
Statistical test that compares two sets of observations on a single sample, e.g. a ‘before’ and ‘after’ test on the same population following an intervention
Wilcoxson signed-rank test
Attendance Allowance is a benefit paid to help with personal care due to physical or mental disability to those aged over ___
65
UKMEC 3 for COCP if BMI is over ___
35
Absolute risk reduction =
Experimental event rate - Control event rate
Emergency treatment for acute angle closure glaucoma in primary care is topical ______
pilocarpine
Are strawberry naevi present at birth?
No
Metformin is contraindicated in those with eGFR <___
30
____________ is the only test recommended for H. pylori post-eradication therapy
Urea breath test
Palsy results in ptosis, down and out eye, dilated, fixed pupil - which nerve?
Oculomotor CN III
Palsy results in defective downward gaze - vertical diplopia - which nerve?
Trochlear CN IV
Palsy results in loss of corneal reflex, deviation of jaw to weak side, loss of facial sensation, paralysis of mastication muscles - which nerve?
Trigeminal CN V
Palsy results in defective abduction - horizontal diplopia - which nerve?
Abducens CN VI
Lesion results in flaccid paralysis of upper + lower face, loss of corneal reflex, loss of taste, hyperacusis - which nerve?
Facial CN VII
Lesion results in hypersensitive carotid sinus reflex, loss of gag reflex - which nerve?
Glossopharyngeal CN IX
Lesion results in uvula deviating away from site of lesion, loss of gag reflex - which nerve?
Vagus CN X
Lesion results in weakness turning head to contralateral side - which nerve?
CN XI accessory
Lesion results in tongue deviating towards side of lesion - which nerve?
CN XII hypoglossal
Specificity =
TN / (TN + FP)
In a woman who has an undiagnosed breast mass continuing the combined hormonal contraceptive pill is classified as UKMEC ___
2
If angina is not controlled with a beta-blocker, a longer-acting _____ should be added
CCB e.g. amlodipine
What is the first sign of puberty in boys?
Increase in testicular volume
Impaired fasting glycaemia (IFG) is defined as a fasting plasma glucose level between ___ mmol/l and ___ mmol/l
6.1, 6.9
_______ is a good first line anti-emetic for intracranial causes of nausea and vomiting
Cyclizine
Most appropriate study design to investigate an infectious outbreak - ___________
Case control study
Type _ error - the null hypothesis is rejected when it is true
I
Likelihood ratio for a positive test result =
Sensitivity / (1 - specificity)
Best test to measure correlation in parametric (normally distributed) data
Pearson’s coefficient
Best test to measure correlation in non-parametric data
Spearman’s coefficient
Of the SSRIs, ______ has the highest incidence of discontinuation symptoms
Paroxetine
A 21 day progesterone of over ____nmol/l is generally considered to be indicative of ovulation
30
Vaccines needed pre-dialysis x3
Pneumococcal, influenza, hepatitis B
Positive predictive value =
True positives / (True positives + false positives)
Which antibiotic commonly used for treating UTIs may cause peripheral neuropathy?
Nitrofurantoin
If the COCP is started within the first __ days of the cycle there is no need for additional contraception
5
Impaired glucose tolerance: OGTT 2 hour value between
7.8 and 11
Positive likelihood ratio =
Sensitivity / (1 - specificity)
Sensitivity =
TP / TP + FN
Specificity =
TN / TN + FP
Which drug is used for prophylaxis of cluster headaches?
Verapamil
Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test
Which nerve root is being compressed?
L3
Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test
Which nerve root is being compressed?
L4
Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test
Which nerve root is being compressed?
L5
Sensory loss posterolateral aspect of leg and lateral aspect of foot
Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test
Which nerve root is being compressed?
S1
Number needed to treat =
1 / Absolute risk reduction
A haemoglobin cut-off of ___ g/L should be used in the first trimester to determine if iron supplementation should be taken
110
What type of study is this?
Participants randomly allocated to intervention or control group (e.g. standard treatment or placebo)
Practical or ethical problems may limit use
RCT
What type of study is this?
Observational and prospective. Two (or more) are selected according to their exposure to a particular agent (e.g. medicine, toxin) and followed up to see how many develop a disease or other outcome.
The usual outcome measure is the relative risk.
Examples include Framingham Heart Study
Cohort study
What type of study is this?
Observational and retrospective. Patients with a particular condition (cases) are identified and matched with controls. Data is then collected on past exposure to a possible causal agent for the condition.
The usual outcome measure is the odds ratio.
Inexpensive, produce quick results
Useful for studying rare conditions
Prone to confounding
Case-control study
What type of study is this?
Provide a ‘snapshot’, sometimes called prevalence studies
Provide weak evidence of cause and effect
Cross-sectional study
The most common organism causing infective exacerbations of COPD is ____________
H influenzae
Urea breath test: no antibiotics in past ___ weeks, no antisecretory drugs in past ___ weeks
Abx: 4 weeks
Antisecretory: 2 weeks
RA Drug associated with myelosuppression, liver cirrhosis, pneumonitis
Methotrexate
RA drug associated with rashes, oligospermia, Heinz body anaemia, ILD
Sulfasalazine
RA drug associated with liver impairment, ILD, hypertension
Leflunomide
RA drug associated with retinopathy, corneal deposits
Hydroxychloroquine
RA drug associated with proteinuria
Gold
RA drug associated with proteinuria, exacerbations of myaesthenia gravis
Penicillinamine
RA drug associated with demyelination, reactivation of TB
Etanercept
RA drug associated with reactivation of TB x 2
Infliximab, adalimumab
RA drug commonly associated with infusion reactions
Rituximab
75mg of oral morphine is equivalent to ___ mg of subcut oxycodone
25
NNT =
1 / ARR
Statistical significance test that compares ordinal, interval, or ratio scales of unpaired data
Mann-Whitney U test
What is the medical exemption certificate code?
FP92A
Fitness to fly after uncoplicated MI
7-10 days
Fitness to fly after complicated MI
4-6 weeks
Fitness to fly after CABG
10-14 days
Fitness to fly after PCI
3 days
Fitness to fly after stroke
10 days, but if stable 3 days
Fitness to fly after successful drainage of pneumothorax
CAA: 2 weeks
BTS: 1 week post-check X ray
Fitness to fly after abdominal surgery
10 days
Fitness to fly after laparoscopic surgery
24 hours
Fitness to fly after colonoscopy
24 hours
Fitness to fly after application of plaster cast
24 hours if flight <2h
48 h if flight >2h
Drug monitoring: Amiodarone
TFT, U&E, LFT, CXR prior to treatment
TFT, LFT every 6 months
Drug monitoring: Methotrexate
FBC, LFT, U&E before starting treatment
Weekly until therapy stabilised
Once stabilised, every 2-3 months
Drug monitoring: Azathioprine
FBC, LFT before treatment
FBC weekly for first 4 weeks
FBC, LFT every 3 months
Drug monitoring: Lithium
TFT, U&E pre treatment & 6 monthly
Lithium levels weekly until stabilised then every 3 months
Drug monitoring: Sodium valproate
LFT, FBC before treatment
LFT ‘periodically’ during first 6 months
Glitazones
LFT before treatment & ‘regularly’ during treatment
Statistical test used to compare proportions or percentages e.g. compares the percentage of patients who improved following 2 different interventions
Chi-squared test
Dermatome landmarks: Posterior half of the skull
C2
Dermatome landmarks: High turtleneck shift
C3
Dermatome landmarks: Low-collar shirt
C4
Dermatome landmarks: Ventral axial line of upper limb
C5
Dermatome landmarks: Thumb + index finger
C6
Dermatome landmarks: Middle finger + palm
C7
Dermatome landmarks: Ring + little finger
C8
Dermatome landmarks: Nipples
T4
Dermatome landmarks: inframammary fold
T5
Dermatome landmarks: Xiphoid process
T6
Dermatome landmarks: Umbilicus
T10
Dermatome landmarks: Inguinal ligament
L1
Dermatome landmarks: Knee caps
L4
Dermatome landmarks: Big toe, dorsum of foot (except lateral aspect)
L5
Dermatome landmarks: Lateral foot, little toe
S1
Dermatome landmarks: Genitalia
S2, S3
Residual weakness after ___ months in Bell’s palsy is an indication for referral to plastics
6
Gestational diabetes - insulin should be commenced if fasting glucose level is >= ___ mmol/l at the time of diagnosis
7
ECG changes in V1-V4
Anteroseptal - LAD
ECG changes in II, III, aVF
Inferior - RCA
ECG changes in V1-V6, I, aVL
Anterolateral - proximal LAD
ECG changes in I, aVL +/- V5-V6
LCx
A second drug should be added in type 2 diabetes mellitus if the HbA1c is > __ mmol/mol
58
Which antibiotics may worsen seizure control in epilepsy patients?
Ciprofloxacin, levofloxacin
_______ and _______ are the most important antiepileptic drugs to prescribe by brand
Phenytoin & carbamazepine
Epilepsy treatment: Generalised tonic clonic seizures
M: Sodium valproate
F: lamotrigine or levetiracetam
Epilepsy treatment: focal seizures
1st line: lamotrigine or levetiracetam
2nd line: carbamazepine, oxcarbazepine or zonisamide
Epilepsy treatment: absence seizures
1st line: ethosuximide
2nd line: M: valproate. F: lamotrigine or levetiracetam.
Epilepsy treatment: Myoclonic seizures
M: sodium valproate
F: levetiracetam
Epilepsy treatment: tonic or atonic seizures
M: sodium valproate
F: lamotrigine
1st line for thrush in non-pregnant women
PO fluconazole
3x causes of increased nuchal translucency
- Down’s syndrome
- Congenital heart defects
- Abdominal wall defects
After using Ellaone (ulipristal), quick starting the COCP should begin after ___ days and barrier contraception used for ___ days
5, 7
Immunisations: At birth
BCG if risk factors
Immunisations: 2 months
6 in 1 vaccine
Oral rotavirus vaccine
Men B
Immunisations: 3 months
6 in 1 vaccine
Oral rotavirus vaccine
PCV
Immunisations: 4 months
6 in 1 vaccine
Men B
Immunisations: 12-13 months
Hib/Men C
MMR
PCV
Men B
Immunisations: 2-8 years
Annual flu vaccine
Immunisations: 3-4 years
4 in 1 (diphtheria, tetanus, whooping cough, polio)
MMR
Immunisations: 12-13 years
HPV
Immunisations: 13-18 years
3 in 1 (tetanus, diphtheria, polio)
Men ACWY
What is in the 6 in 1 vaccine?
Diphtheria, tetanus, whooping cough, polio, Hib, Hep B
Adverse effects of TB drugs:
potent liver enzyme inducer
hepatitis, orange secretions
flu-like symptoms
Rifampicin
Adverse effects of TB drugs:
peripheral neuropathy: prevent with pyridoxine (Vitamin B6)
hepatitis, agranulocytosis
liver enzyme inhibitor
Isoniazid
Adverse effects of TB drugs:
hyperuricaemia causing gout
arthralgia, myalgia
hepatitis
Pyrazinamide
Adverse effects of TB drugs:
optic neuritis: check visual acuity before and during treatment
Ethambutol
School exclusion: Scarlet fever
24 hours after starting antibiotics
School exclusion: Whooping cough
2 days after starting antibiotics, or 21 days from onset of symptoms if no abx
School exclusion: Measles
4 days from onset of rash
School exclusion: Rubella
5 days from onset of rash
School exclusion: Chickenpox
Until all lesions crusted over
School exclusion: Mumps
5 days from onset of swollen glands
School exclusion: Impetigo
48 h after starting antibiotic treatment, or until lesions are crusted and healed
School exclusion: Scabies
Until treated
________ is a tropical disease caused by Haemophilus ducreyi. It causes painful genital ulcers associated with unilateral, painful inguinal lymph node enlargement. The ulcers typically have a sharply defined, ragged, undermined border.
Chancroid
Standard error of the mean =
standard deviation / square root (sample size)
For patients taking leflunomide, effective contraception is required for at least ______ in women and _______ in men after stopping
2 years in women
3 months in men
Kallman’s syndrome - LH and FSH and testosterone levels
LH & FSH low-normal
Testosterone low
Klinefelter’s syndrome - LH & FSH levels
Raised
Which virus is the trigger for erythema multiforme in over 50% of cases?
HSV
Relative risk reduction =
(CER - EER) / CER
DVLA: cardiovascular disorders - elective angioplasty
1 week off driving
DVLA: cardiovascular disorders - CABG
4 weeks off driving
DVLA: cardiovascular disorders - ACS
4 weeks off
1 week if successfully treated by angioplasty
DVLA: cardiovascular disorders - angina
Stop if symptoms occur at rest/wheel
DVLA: cardiovascular disorders - PPM insertion
1 week off driving
DVLA: cardiovascular disorders - ICD insertion
If prophylactic, no driving for 1 month
If already had sustained ventricular arrhythmia, no driving for 6 months
Permanent ban for group 2 drivers
DVLA: cardiovascular disorders - catheter ablation for arrhythmia (successful)
2 days off
DVLA: cardiovascular disorders - AAA of 6cm +
Notify DVLA, needs annual review.
If 6.5cm + - no driving
DVLA: cardiovascular disorders - heart transplant
No driving for 6 weeks
Those with a positive family history of glaucoma should be screened annually from aged __ years
40
The Hba1c target for patients on a drug which may cause hypoglycaemia (eg sulfonylurea) is ___ mmol/mol
53
DVLA rules for alcohol misuse
6 months
DVLA rules for cannabis, amphetamines, ecstasy, LSD - persistent use or dependency
6 months
DVLA rules for alcohol dependency
1 year
DVLA rules for heroin, cocaine, methadone - persistent use or dependency
1 year
Cyclophosphamide adverse effects x3
Haemorrhagic cystitis
Myelosuppression
Transitional cell carcinoma
Bleomycin adverse effect x1
Lung fibrosis
Doxorubicin adverse effect x 1
Cardiomyopathy
Methotrexate adverse effects x 4
Myelosuppression
Mucositis
Liver fibrosis
Lung fibrosis
5-FU adverse effects x 3
Myelosuppression
Mucositis
Dermatitis
6-mercaptopurine adverse effect x 1
Myelosuppression
Cytaribine adverse effect x 2
Myelosuppression
Ataxia
Vincristine adverse effects x 2
Peripheral neuropathy (reversible)
Paralytic ileus
Vinblastine adverse effect x 1
Myelosuppression
Docetaxel adverse effect x 1
Neutropaenia
Irinotecan adverse effect x 1
Myelosuppression
Cisplatin adverse effects x 3
Ototoxicity
Peripheral neuropathy
Hypomagnesaemia
Hydroxyurea adverse effect x 1
Myelosuppression
Cannabis and lysergide are examples of schedule ___ drugs
1
Diamorphine, morphine, pethidine, amphetamine and cocaine are examples of schedule ___ drugs
2
Barbiturates, buprenorphine, midazolam, temazepam, tramadol, gabapentin, pregabalin are all examples of schedule __ drugs
3
Benzodiazepines (except midazolam and temazepam) and zolpidem, zopiclone are examples of schedule ___ drugs
4(1)
Androgenic and anabolic steroids, hCG and somatropin are examples of schedule ___ drugs
4(2)
Schedule __ includes preparations which because of their strength are exempt from the vast majority of CD requirements other than retention of invoices e.g. codeine, pholcodine, oramorph 10mg/5mL
5
A prescription for controlled drugs in schedules 2, 3 and 4 is valid for ____ days
28
Malaria prophylaxis - which drug?
SE: GI upset
Start 1-2 days before travel
Stop 7 days after travel
Atovaquone + Proguanil (Malarone)
Malaria prophylaxis - which drug?
SE: headache
Taken weekly, CI in epilepsy
Start 1 week before travel
Stop 4 weeks after travel
Chloroquine
Malaria prophylaxis - which drug?
SE: photosensitivity, oesophagitis
Start 1-2 days before travel
Stop 4 weeks after travel
Doxycycline
Malaria prophylaxis - which drug?
SE: Dizziness, neuropsychiatric disturbance
Taken weekly. CI in epilepsy.
Start 2-3 weeks before travel
End 4 weeks after travel
Mefloquine (Lariam)
Management of warfarin: high INR
5.0-8.0, no bleeding
Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose
Management of warfarin: high INR
INR 5.0-8.0, minor bleeding
Stop warfarin
Give IV vitamin K 1-3mg
Restart when INR <5.0
Management of warfarin: high INR
INR >8.0, no bleeding
Stop warfarin
Give vitamin K 1-5mg by mouth, using the intravenous preparation orally
Repeat dose of vitamin K if INR still too high after 24 hours
Restart when INR < 5.0
Management of warfarin: high INR
INR >8, minor bleeding
Stop warfarin
Give intravenous vitamin K 1-3mg
Repeat dose of vitamin K if INR still too high after 24 hours
Restart warfarin when INR < 5.0
Management of warfarin: high INR
Major bleeding
Stop warfarin
Give intravenous vitamin K 5mg
Prothrombin complex concentrate - if not available then FFP
Treatment of latent TB
6 months isoniazid
Type __ error - the null hypothesis is accepted when it is false
II
Patients with clinical signs of heart failure and raised BNP greater than _____ pg/ml should have an echo within 2 weeks
400
Flashes of light (photopsia) - in the peripheral field of vision
Floaters, often on the temporal side of the central vision
Typical presentation of..
Posterior vitreous detachment
Dense shadow that starts peripherally progresses towards the central vision
A veil or curtain over the field of vision
Straight lines appear curved
Central visual loss
Typical presentation of….
Retinal detachment
Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters
Typical presentation of….
Vitreous haemorrhage
Drug used to treat cognitive symptoms in mild to moderate Alzheimer’s dementia
Rivastigmine
Emergency IM Benzylpenicillin dose: < 1 year
300mg
Emergency IM Benzylpenicillin dose: 1-10 years
600mg
Emergency IM Benzylpenicillin dose: >10 years
1200mg
Which personality disorder?
Hypersensitivity and an unforgiving attitude when insulted
Unwarranted tendency to questions the loyalty of friends
Reluctance to confide in others
Preoccupation with conspirational beliefs and hidden meaning
Unwarranted tendency to perceive attacks on their character
Paranoid
Which personality disorder?
Indifference to praise and criticism
Preference for solitary activities
Lack of interest in sexual interactions
Lack of desire for companionship
Emotional coldness
Few interests
Few friends or confidants other than family
Schizoid
Which personality disorder?
Ideas of reference (differ from delusions in that some insight is retained)
Odd beliefs and magical thinking
Unusual perceptual disturbances
Paranoid ideation and suspiciousness
Odd, eccentric behaviour
Lack of close friends other than family members
Inappropriate affect
Odd speech without being incoherent
Schizotypal
Positive HCV RNA indicates
Acute infection
In hepatitis B, ______ is the first marker to appear and causes the production of anti-HBs
HBsAg
In hepatitis B, _____ normally implies acute disease (present for 1-6 months)
HBsAg
In hepatitis B, if _______ is present for > 6 months this implies chronic disease
HBsAg
In hepatitis B, _______ implies immunity (either exposure or immunisation). It is negative in chronic disease
Anti-HBs
In hepatitis B, _______ implies previous (or current) infection, it appears during acute or recent hep B and is present for about 6 months
Anti-HBc
In hepatitis B, ______ results from breakdown of core antigen from infected liver cells and is therefore a marker of infectivity
HbeAg
NICE guidelines suggest referring to a nephrologist from primary care if eGFR falls below ____ or progressively by > ____ in a year
30, 15
If an LNG-IUS is inserted on day ____-____ of cycle no additional contraception required
1-7
IM adrenaline dose for anaphylaxis: <6m
100-150 micrograms (0.1-0.15mL 1 in 1000)
IM adrenaline dose for anaphylaxis: 6m-6y
150 micrograms (0.15mL 1 in 1000)
IM adrenaline dose for anaphylaxis: 6-12 years
300micrograms (0.3mL 1 in 1000)
IM adrenaline dose for anaphylaxis: >12 years
500 micrograms (0.5mL 1 in 1000)
Form completed when life expectancy is <12 months, allows fast-track benefit payments
SR1
First line treatment for Parkinson’s disease if the motor symptoms are not affecting the quality of life
dopamine agonist (non-ergot derived e.g. ropirinole), levodopa or monoamine oxidase B (MAO-B) inhibitor
60mg of subcutaneous diamorphine is equivalent to ______mg of oral morphine
180 mg
COCP: If two pills are missed, between days_____ of the cycle, no emergency contraception is required, as long as the previous 7 days of COCP have been taken correctly
8-14
An induction-maintenance regime of oral _______should be considered for recurrent vaginal candidiasis
fluconazole
75mg oral morphine is equivalent to __mg oral oxycodone
50
Patients with acute severe hyponatraemia (serum sodium concentration of less than ___ mmol/L) should be urgently admitted to hospital
125
Consultation models:
initiating the session
gathering information
building the relationship
giving information, explaining and planning
closing the session
Calgary Cambridge
Consultation models:
exploring both the disease and the illness experience
understanding the whole person
finding common ground
incorporating prevention and health promotion
enhancing the doctor-patient relationship
being realistic (with time and resources)
Stewart - patient centred clinical method
Consultation models:
define the reason for the patient’s attendance (ideas, concerns and expectations)
consider other problems
with the patient, choose an appropriate action for each problem
achieve a shared understanding of the problems with the patient
involve the patient in the management and encourage him/her to accept appropriate responsibility
use time and resources appropriately
establish or maintain a relationship with the patient which helps to achieve the other tasks
Pendleton
Consultation models:
interviewing and history-taking
physical examination
diagnosis and problem-solving
patient management
relating to patients
anticipatory care
record keeping
Fraser
Consultation models:
connecting
summarising
handing over
safety netting
housekeeping
Neighbour
Consultation models:
the consultation is a meeting between two experts
doctors are experts in medicine
patients are experts in their own illnesses
shared understanding is the aim
doctors should seek to understand the patient’s beliefs
doctors should address explanations in terms of the patient’s belief system
Tuckett
Consultation models:
management of presenting problems
management of continuing problems
modification of help-seeking behaviour
opportunistic health promotion
Stott and Davis
A period of ___ weeks is typically used to assess response to treatment in patients with mild-moderate flares of ulcerative colitis
4
Data types:
Observed values can be put into set categories which have no particular order or hierarchy. You can count but not order or measure this data (for example birthplace)
Nominal
Data types:
Observed values can be put into set categories which themselves can be ordered (for example NYHA classification of heart failure symptoms)
Ordinal
Data types:
Observed values are confined to a certain values, usually a finite number of whole numbers (for example the number of asthma exacerbations in a year)
Discrete
Data types:
Data can take any value with certain range (for example weight)
Continuous
Data types:
Data may take one of two values (for example gender)
Binomial
Data types:
A measurement where the difference between two values is meaningful, such that equal differences between values correspond to real differences between the quantities that the scale measures (for example temperature)
Interval
Childhood infections:
Fever initially
Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
Systemic upset is usually mild
Chickenpox
Childhood infections:
Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots (‘grain of salt’) on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
Measles
Childhood infections:
Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular
Rubella
Patients cannot drive for __ months following a first unprovoked or isolated seizure if brain imaging and EEG normal
6
DVLA: established epilepsy/multiple unprovoked seizures
may qualify for a license if they have been free from any seizure for 12 months
DVLA: withdrawal of epilepsy medication
Should not drive whilst anti-epileptics are being withdrawn and for 6 months after last dose
DVLA: simple faint
No restrictions
DVLA: single episode syncope, explained and treated
4 weeks off
DVLA: single episode syncope, unexplained
6 months off
DVLA: 2 or more episodes of unexplained syncope
12 months off
DVLA: craniotomy
1 year off
DVLA: multiple TIAs over a short period
3 months off, inform DVLA
1st line treatment for chlamydia
7 day course of doxycycline
Type of burn:
Red and painful, dry, no blisters
Superficial epidermal
Type of burn:
Pale pink, painful, blistered, slow capillary refill
Partial thickness - superficial dermal
Type of burn:
Typically white but may have patches of non-blanching erythema. Reduced sensation, painful to deep pressure.
Partial thickness - deep dermal
Type of burn: white ‘waxy’/brown ‘leathery’/black. No blisters. No pain.
Full thickness
Type of ovarian pathology most commonly associted with Meig’s syndrome
Fibroma
Which laxative should be avoided in IBS?
Lactulose
LTOT is indicated for COPD patients with PaO2 < ____kPa when stable.
This cut off is extended to <___kPa when one of the following is present:
- secondary polycythaemia
- pulmonary hypertension
- peripheral oedema
7.3, 8
A normal ABPI is between ____ and ____
0.9, 1.2
How potent is the steroid cream?
Hydrocortisone 0.5-2.5%
Mild
How potent is the steroid cream?
Betamethasone valerate 0.025% (Betnovate RD)
Clobetasone butyrate 0.05% (Eumovate)e
Moderate
How potent is the steroid cream?
Fluticasone propionate 0.05% (Cutivate)
Betamethasone valerate 0.1% (Betnovate)
Potent
How potent is the steroid cream?
Clobetasol propionate 0.05% (Dermovate)
Very potent
First line drugs for restless legs
Dopamine agonists e.g. pramipexole, ropinirole
______________ can be prescribed for 7 days during an acute attack of Meniere’s diseas
Prochlorperazine
Aim for a __ week break in between courses of topical corticosteroids in patients with psoriasis
4
Haemophilia A affects which clotting factor?
VIII
Haemophilia B affects which clotting factor?
IX
First line insulin for adults with T2DM
Isophane insulin
A recurrent episode of C. difficile within ___ weeks of symptom resolution should be treated with oral fidaxomicin
12
2 doses of the hep A vaccine can confer immunity for ___ years
20
The most common post-surgical complication seen in cataract surgery is ______
posterior capsular thickening
NICE recommends a 2-step approach to TB diagnosis, with a Mantoux test followed by ________ if Mantoux is positive
interferon gamma assay
What 2 blood tests should be started before starting isotretinoin?
LFTs, lipids
MODY with symptoms - 1st line drug is
gliclazide (or other sulfonylureas)
Management for essential tremor if beta blockers are contraindicated
primidone
Osteomalacia causes calcium to be _____ and ALP to be ______
low, high
Patients with severe hypercalcaemia (>____) should have same day admission to hospital
3.5
The optimal time to check urate is - weeks after an acute attack of gout resolves
2-4
In paget’s disease, calcium is _____ whilst ALP is ______
normal, raised
Peak flow variability over ____% suggests a diagnosis of asthma
20
3x antibiotic options for acute rhinosinusitis
Phenoxymethylpenicillin, doxycycline, clarithromycin
codeine should not be used for children under the age of ___ for any reason
12
a gynae referral should be made for patients with suspected premature ovarian failure under the age of ___
40
people can fly if their Hb is over __
80
