AKT Flashcards

1
Q

120mg oral morphine daily dose is equivalent to __mg in a subcut driver

A

60

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2
Q

BNF antibiotic guidelines: mastitis

A

Flucloxacillin

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2
Q

Prediabetic obese class II patients should be considered for which medication

A

Liraglutide

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3
Q

BNF antibiotic guidelines: dental abscess

A

Amoxicillin

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4
Q

Arteriolar narrowing + tortuosity, silver wiring, AV nipping, cotton wool exudates, flame and blot haemorrhages are features of

A

Hypertensive retinopathy

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5
Q

How long is Mirena licensed for use as part of HRT?

A

4 years

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6
Q

_____ may be used in patients with stress incontinence who don’t respond to pelvic floor muscle exercises and decline surgical intervention

A

Duloxetine

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7
Q

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

A

Wilcoxson signed-rank test

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8
Q

Attendance Allowance is a benefit paid to help with personal care due to physical or mental disability to those aged over ___

A

65

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9
Q

UKMEC 3 for COCP if BMI is over ___

A

35

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10
Q

Absolute risk reduction =

A

Experimental event rate - Control event rate

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11
Q

Emergency treatment for acute angle closure glaucoma in primary care is topical ______

A

pilocarpine

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12
Q

Are strawberry naevi present at birth?

A

No

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13
Q

Metformin is contraindicated in those with eGFR <___

A

30

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14
Q

____________ is the only test recommended for H. pylori post-eradication therapy

A

Urea breath test

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15
Q

Palsy results in ptosis, down and out eye, dilated, fixed pupil - which nerve?

A

Oculomotor CN III

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16
Q

Palsy results in defective downward gaze - vertical diplopia - which nerve?

A

Trochlear CN IV

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17
Q

Palsy results in loss of corneal reflex, deviation of jaw to weak side, loss of facial sensation, paralysis of mastication muscles - which nerve?

A

Trigeminal CN V

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18
Q

Palsy results in defective abduction - horizontal diplopia - which nerve?

A

Abducens CN VI

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19
Q

Lesion results in flaccid paralysis of upper + lower face, loss of corneal reflex, loss of taste, hyperacusis - which nerve?

A

Facial CN VII

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20
Q

Lesion results in hypersensitive carotid sinus reflex, loss of gag reflex - which nerve?

A

Glossopharyngeal CN IX

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21
Q

Lesion results in uvula deviating away from site of lesion, loss of gag reflex - which nerve?

A

Vagus CN X

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22
Q

Lesion results in weakness turning head to contralateral side - which nerve?

A

CN XI accessory

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23
Q

Lesion results in tongue deviating towards side of lesion - which nerve?

A

CN XII hypoglossal

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24
Q

Specificity =

A

TN / (TN + FP)

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25
Q

In a woman who has an undiagnosed breast mass continuing the combined hormonal contraceptive pill is classified as UKMEC ___

A

2

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26
Q

If angina is not controlled with a beta-blocker, a longer-acting _____ should be added

A

CCB e.g. amlodipine

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27
Q

What is the first sign of puberty in boys?

A

Increase in testicular volume

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28
Q

Impaired fasting glycaemia (IFG) is defined as a fasting plasma glucose level between ___ mmol/l and ___ mmol/l

A

6.1, 6.9

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29
Q

_______ is a good first line anti-emetic for intracranial causes of nausea and vomiting

A

Cyclizine

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30
Q

Most appropriate study design to investigate an infectious outbreak - ___________

A

Case control study

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31
Q

Type _ error - the null hypothesis is rejected when it is true

A

I

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32
Q

Likelihood ratio for a positive test result =

A

Sensitivity / (1 - specificity)

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33
Q

Best test to measure correlation in parametric (normally distributed) data

A

Pearson’s coefficient

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34
Q

Best test to measure correlation in non-parametric data

A

Spearman’s coefficient

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35
Q

Of the SSRIs, ______ has the highest incidence of discontinuation symptoms

A

Paroxetine

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36
Q

A 21 day progesterone of over ____nmol/l is generally considered to be indicative of ovulation

A

30

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37
Q

Vaccines needed pre-dialysis x3

A

Pneumococcal, influenza, hepatitis B

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38
Q

Positive predictive value =

A

True positives / (True positives + false positives)

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39
Q

Which antibiotic commonly used for treating UTIs may cause peripheral neuropathy?

A

Nitrofurantoin

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40
Q

If the COCP is started within the first __ days of the cycle there is no need for additional contraception

A

5

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41
Q

Impaired glucose tolerance: OGTT 2 hour value between

A

7.8 and 11

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42
Q

Positive likelihood ratio =

A

Sensitivity / (1 - specificity)

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43
Q

Sensitivity =

A

TP / TP + FN

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44
Q

Specificity =

A

TN / TN + FP

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45
Q

Which drug is used for prophylaxis of cluster headaches?

A

Verapamil

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46
Q

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?

A

L3

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47
Q

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?

A

L4

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48
Q

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?

A

L5

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49
Q

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?

A

S1

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50
Q

Number needed to treat =

A

1 / Absolute risk reduction

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51
Q

A haemoglobin cut-off of ___ g/L should be used in the first trimester to determine if iron supplementation should be taken

A

110

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52
Q

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

A

RCT

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53
Q

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

A

Cohort study

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54
Q

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

A

Case-control study

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55
Q

What type of study is this?

Provide a ‘snapshot’, sometimes called prevalence studies

Provide weak evidence of cause and effect

A

Cross-sectional study

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56
Q

The most common organism causing infective exacerbations of COPD is ____________

A

H influenzae

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57
Q

Urea breath test: no antibiotics in past ___ weeks, no antisecretory drugs in past ___ weeks

A

Abx: 4 weeks
Antisecretory: 2 weeks

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58
Q

RA Drug associated with myelosuppression, liver cirrhosis, pneumonitis

A

Methotrexate

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59
Q

RA drug associated with rashes, oligospermia, Heinz body anaemia, ILD

A

Sulfasalazine

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60
Q

RA drug associated with liver impairment, ILD, hypertension

A

Leflunomide

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61
Q

RA drug associated with retinopathy, corneal deposits

A

Hydroxychloroquine

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62
Q

RA drug associated with proteinuria

A

Gold

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63
Q

RA drug associated with proteinuria, exacerbations of myaesthenia gravis

A

Penicillinamine

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64
Q

RA drug associated with demyelination, reactivation of TB

A

Etanercept

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65
Q

RA drug associated with reactivation of TB x 2

A

Infliximab, adalimumab

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66
Q

RA drug commonly associated with infusion reactions

A

Rituximab

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67
Q

75mg of oral morphine is equivalent to ___ mg of subcut oxycodone

A

25

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68
Q

NNT =

A

1 / ARR

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69
Q

Statistical significance test that compares ordinal, interval, or ratio scales of unpaired data

A

Mann-Whitney U test

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70
Q

What is the medical exemption certificate code?

A

FP92A

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71
Q

Fitness to fly after uncoplicated MI

A

7-10 days

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72
Q

Fitness to fly after complicated MI

A

4-6 weeks

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73
Q

Fitness to fly after CABG

A

10-14 days

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74
Q

Fitness to fly after PCI

A

3 days

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75
Q

Fitness to fly after stroke

A

10 days, but if stable 3 days

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76
Q

Fitness to fly after successful drainage of pneumothorax

A

CAA: 2 weeks
BTS: 1 week post-check X ray

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77
Q

Fitness to fly after abdominal surgery

A

10 days

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78
Q

Fitness to fly after laparoscopic surgery

A

24 hours

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79
Q

Fitness to fly after colonoscopy

A

24 hours

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80
Q

Fitness to fly after application of plaster cast

A

24 hours if flight <2h
48 h if flight >2h

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81
Q

Drug monitoring: Amiodarone

A

TFT, U&E, LFT, CXR prior to treatment
TFT, LFT every 6 months

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82
Q

Drug monitoring: Methotrexate

A

FBC, LFT, U&E before starting treatment
Weekly until therapy stabilised
Once stabilised, every 2-3 months

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83
Q

Drug monitoring: Azathioprine

A

FBC, LFT before treatment
FBC weekly for first 4 weeks
FBC, LFT every 3 months

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84
Q

Drug monitoring: Lithium

A

TFT, U&E pre treatment & 6 monthly
Lithium levels weekly until stabilised then every 3 months

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85
Q

Drug monitoring: Sodium valproate

A

LFT, FBC before treatment
LFT ‘periodically’ during first 6 months

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86
Q

Glitazones

A

LFT before treatment & ‘regularly’ during treatment

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87
Q

Statistical test used to compare proportions or percentages e.g. compares the percentage of patients who improved following 2 different interventions

A

Chi-squared test

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88
Q

Dermatome landmarks: Posterior half of the skull

A

C2

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89
Q

Dermatome landmarks: High turtleneck shift

A

C3

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90
Q

Dermatome landmarks: Low-collar shirt

A

C4

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91
Q

Dermatome landmarks: Ventral axial line of upper limb

A

C5

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92
Q

Dermatome landmarks: Thumb + index finger

A

C6

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93
Q

Dermatome landmarks: Middle finger + palm

A

C7

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94
Q

Dermatome landmarks: Ring + little finger

A

C8

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95
Q

Dermatome landmarks: Nipples

A

T4

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96
Q

Dermatome landmarks: inframammary fold

A

T5

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97
Q

Dermatome landmarks: Xiphoid process

A

T6

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98
Q

Dermatome landmarks: Umbilicus

A

T10

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99
Q

Dermatome landmarks: Inguinal ligament

A

L1

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100
Q

Dermatome landmarks: Knee caps

A

L4

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101
Q

Dermatome landmarks: Big toe, dorsum of foot (except lateral aspect)

A

L5

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102
Q

Dermatome landmarks: Lateral foot, little toe

A

S1

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103
Q

Dermatome landmarks: Genitalia

A

S2, S3

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104
Q

Residual weakness after ___ months in Bell’s palsy is an indication for referral to plastics

A

6

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105
Q

Gestational diabetes - insulin should be commenced if fasting glucose level is >= ___ mmol/l at the time of diagnosis

A

7

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106
Q

ECG changes in V1-V4

A

Anteroseptal - LAD

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107
Q

ECG changes in II, III, aVF

A

Inferior - RCA

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108
Q

ECG changes in V1-V6, I, aVL

A

Anterolateral - proximal LAD

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109
Q

ECG changes in I, aVL +/- V5-V6

A

LCx

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110
Q

A second drug should be added in type 2 diabetes mellitus if the HbA1c is > __ mmol/mol

A

58

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111
Q

Which antibiotics may worsen seizure control in epilepsy patients?

A

Ciprofloxacin, levofloxacin

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112
Q

_______ and _______ are the most important antiepileptic drugs to prescribe by brand

A

Phenytoin & carbamazepine

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113
Q

Epilepsy treatment: Generalised tonic clonic seizures

A

M: Sodium valproate
F: lamotrigine or levetiracetam

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114
Q

Epilepsy treatment: focal seizures

A

1st line: lamotrigine or levetiracetam
2nd line: carbamazepine, oxcarbazepine or zonisamide

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115
Q

Epilepsy treatment: absence seizures

A

1st line: ethosuximide
2nd line: M: valproate. F: lamotrigine or levetiracetam.

116
Q

Epilepsy treatment: Myoclonic seizures

A

M: sodium valproate
F: levetiracetam

117
Q

Epilepsy treatment: tonic or atonic seizures

A

M: sodium valproate
F: lamotrigine

118
Q

1st line for thrush in non-pregnant women

A

PO fluconazole

119
Q

3x causes of increased nuchal translucency

A
  • Down’s syndrome
  • Congenital heart defects
  • Abdominal wall defects
120
Q

After using Ellaone (ulipristal), quick starting the COCP should begin after ___ days and barrier contraception used for ___ days

A

5, 7

121
Q

Immunisations: At birth

A

BCG if risk factors

122
Q

Immunisations: 2 months

A

6 in 1 vaccine
Oral rotavirus vaccine
Men B

123
Q

Immunisations: 3 months

A

6 in 1 vaccine
Oral rotavirus vaccine
PCV

124
Q

Immunisations: 4 months

A

6 in 1 vaccine
Men B

125
Q

Immunisations: 12-13 months

A

Hib/Men C
MMR
PCV
Men B

126
Q

Immunisations: 2-8 years

A

Annual flu vaccine

127
Q

Immunisations: 3-4 years

A

4 in 1 (diphtheria, tetanus, whooping cough, polio)
MMR

128
Q

Immunisations: 12-13 years

A

HPV

129
Q

Immunisations: 13-18 years

A

3 in 1 (tetanus, diphtheria, polio)
Men ACWY

130
Q

What is in the 6 in 1 vaccine?

A

Diphtheria, tetanus, whooping cough, polio, Hib, Hep B

131
Q

Adverse effects of TB drugs:
potent liver enzyme inducer
hepatitis, orange secretions
flu-like symptoms

A

Rifampicin

132
Q

Adverse effects of TB drugs:
peripheral neuropathy: prevent with pyridoxine (Vitamin B6)
hepatitis, agranulocytosis
liver enzyme inhibitor

A

Isoniazid

133
Q

Adverse effects of TB drugs:
hyperuricaemia causing gout
arthralgia, myalgia
hepatitis

A

Pyrazinamide

134
Q

Adverse effects of TB drugs:
optic neuritis: check visual acuity before and during treatment

A

Ethambutol

135
Q

School exclusion: Scarlet fever

A

24 hours after starting antibiotics

136
Q

School exclusion: Whooping cough

A

2 days after starting antibiotics, or 21 days from onset of symptoms if no abx

137
Q

School exclusion: Measles

A

4 days from onset of rash

138
Q

School exclusion: Rubella

A

5 days from onset of rash

139
Q

School exclusion: Chickenpox

A

Until all lesions crusted over

140
Q

School exclusion: Mumps

A

5 days from onset of swollen glands

141
Q

School exclusion: Impetigo

A

48 h after starting antibiotic treatment, or until lesions are crusted and healed

142
Q

School exclusion: Scabies

A

Until treated

143
Q

________ 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.

A

Chancroid

144
Q

Standard error of the mean =

A

standard deviation / square root (sample size)

145
Q

For patients taking leflunomide, effective contraception is required for at least ______ in women and _______ in men after stopping

A

2 years in women
3 months in men

146
Q

Kallman’s syndrome - LH and FSH and testosterone levels

A

LH & FSH low-normal
Testosterone low

147
Q

Klinefelter’s syndrome - LH & FSH levels

A

Raised

148
Q

Which virus is the trigger for erythema multiforme in over 50% of cases?

A

HSV

149
Q

Relative risk reduction =

A

(CER - EER) / CER

150
Q

DVLA: cardiovascular disorders - elective angioplasty

A

1 week off driving

151
Q

DVLA: cardiovascular disorders - CABG

A

4 weeks off driving

152
Q

DVLA: cardiovascular disorders - ACS

A

4 weeks off
1 week if successfully treated by angioplasty

153
Q

DVLA: cardiovascular disorders - angina

A

Stop if symptoms occur at rest/wheel

154
Q

DVLA: cardiovascular disorders - PPM insertion

A

1 week off driving

155
Q

DVLA: cardiovascular disorders - ICD insertion

A

If prophylactic, no driving for 1 month
If already had sustained ventricular arrhythmia, no driving for 6 months
Permanent ban for group 2 drivers

156
Q

DVLA: cardiovascular disorders - catheter ablation for arrhythmia (successful)

A

2 days off

157
Q

DVLA: cardiovascular disorders - AAA of 6cm +

A

Notify DVLA, needs annual review.
If 6.5cm + - no driving

158
Q

DVLA: cardiovascular disorders - heart transplant

A

No driving for 6 weeks

159
Q

Those with a positive family history of glaucoma should be screened annually from aged __ years

A

40

160
Q

The Hba1c target for patients on a drug which may cause hypoglycaemia (eg sulfonylurea) is ___ mmol/mol

A

53

161
Q

DVLA rules for alcohol misuse

A

6 months

162
Q

DVLA rules for cannabis, amphetamines, ecstasy, LSD - persistent use or dependency

A

6 months

162
Q

DVLA rules for alcohol dependency

A

1 year

163
Q

DVLA rules for heroin, cocaine, methadone - persistent use or dependency

A

1 year

164
Q

Cyclophosphamide adverse effects x3

A

Haemorrhagic cystitis
Myelosuppression
Transitional cell carcinoma

165
Q

Bleomycin adverse effect x1

A

Lung fibrosis

166
Q

Doxorubicin adverse effect x 1

A

Cardiomyopathy

167
Q

Methotrexate adverse effects x 4

A

Myelosuppression
Mucositis
Liver fibrosis
Lung fibrosis

168
Q

5-FU adverse effects x 3

A

Myelosuppression
Mucositis
Dermatitis

169
Q

6-mercaptopurine adverse effect x 1

A

Myelosuppression

170
Q

Cytaribine adverse effect x 2

A

Myelosuppression
Ataxia

171
Q

Vincristine adverse effects x 2

A

Peripheral neuropathy (reversible)
Paralytic ileus

172
Q

Vinblastine adverse effect x 1

A

Myelosuppression

173
Q

Docetaxel adverse effect x 1

A

Neutropaenia

174
Q

Irinotecan adverse effect x 1

A

Myelosuppression

175
Q

Cisplatin adverse effects x 3

A

Ototoxicity
Peripheral neuropathy
Hypomagnesaemia

176
Q

Hydroxyurea adverse effect x 1

A

Myelosuppression

177
Q

Cannabis and lysergide are examples of schedule ___ drugs

A

1

178
Q

Diamorphine, morphine, pethidine, amphetamine and cocaine are examples of schedule ___ drugs

A

2

179
Q

Barbiturates, buprenorphine, midazolam, temazepam, tramadol, gabapentin, pregabalin are all examples of schedule __ drugs

A

3

180
Q

Benzodiazepines (except midazolam and temazepam) and zolpidem, zopiclone are examples of schedule ___ drugs

A

4(1)

181
Q

Androgenic and anabolic steroids, hCG and somatropin are examples of schedule ___ drugs

A

4(2)

182
Q

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

A

5

183
Q

A prescription for controlled drugs in schedules 2, 3 and 4 is valid for ____ days

A

28

184
Q

Malaria prophylaxis - which drug?
SE: GI upset
Start 1-2 days before travel
Stop 7 days after travel

A

Atovaquone + Proguanil (Malarone)

185
Q

Malaria prophylaxis - which drug?
SE: headache
Taken weekly, CI in epilepsy
Start 1 week before travel
Stop 4 weeks after travel

A

Chloroquine

186
Q

Malaria prophylaxis - which drug?
SE: photosensitivity, oesophagitis
Start 1-2 days before travel
Stop 4 weeks after travel

A

Doxycycline

187
Q

Malaria prophylaxis - which drug?
SE: Dizziness, neuropsychiatric disturbance
Taken weekly. CI in epilepsy.
Start 2-3 weeks before travel
End 4 weeks after travel

A

Mefloquine (Lariam)

188
Q

Management of warfarin: high INR
5.0-8.0, no bleeding

A

Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose

189
Q

Management of warfarin: high INR
INR 5.0-8.0, minor bleeding

A

Stop warfarin
Give IV vitamin K 1-3mg
Restart when INR <5.0

190
Q

Management of warfarin: high INR
INR >8.0, no bleeding

A

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

191
Q

Management of warfarin: high INR
INR >8, minor bleeding

A

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

192
Q

Management of warfarin: high INR
Major bleeding

A

Stop warfarin
Give intravenous vitamin K 5mg
Prothrombin complex concentrate - if not available then FFP

193
Q

Treatment of latent TB

A

6 months isoniazid

194
Q

Type __ error - the null hypothesis is accepted when it is false

A

II

195
Q

Patients with clinical signs of heart failure and raised BNP greater than _____ pg/ml should have an echo within 2 weeks

A

400

196
Q

Flashes of light (photopsia) - in the peripheral field of vision
Floaters, often on the temporal side of the central vision

Typical presentation of..

A

Posterior vitreous detachment

197
Q

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….

A

Retinal detachment

198
Q

Large bleeds cause sudden visual loss
Moderate bleeds may be described as numerous dark spots
Small bleeds may cause floaters

Typical presentation of….

A

Vitreous haemorrhage

199
Q

Drug used to treat cognitive symptoms in mild to moderate Alzheimer’s dementia

A

Rivastigmine

200
Q

Emergency IM Benzylpenicillin dose: < 1 year

A

300mg

201
Q

Emergency IM Benzylpenicillin dose: 1-10 years

A

600mg

202
Q

Emergency IM Benzylpenicillin dose: >10 years

A

1200mg

203
Q

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

A

Paranoid

204
Q

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

A

Schizoid

205
Q

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

A

Schizotypal

206
Q

Positive HCV RNA indicates

A

Acute infection

207
Q

In hepatitis B, ______ is the first marker to appear and causes the production of anti-HBs

A

HBsAg

208
Q

In hepatitis B, _____ normally implies acute disease (present for 1-6 months)

A

HBsAg

209
Q

In hepatitis B, if _______ is present for > 6 months this implies chronic disease

A

HBsAg

210
Q

In hepatitis B, _______ implies immunity (either exposure or immunisation). It is negative in chronic disease

A

Anti-HBs

211
Q

In hepatitis B, _______ implies previous (or current) infection, it appears during acute or recent hep B and is present for about 6 months

A

Anti-HBc

212
Q

In hepatitis B, ______ results from breakdown of core antigen from infected liver cells and is therefore a marker of infectivity

A

HbeAg

213
Q

NICE guidelines suggest referring to a nephrologist from primary care if eGFR falls below ____ or progressively by > ____ in a year

A

30, 15

214
Q

If an LNG-IUS is inserted on day ____-____ of cycle no additional contraception required

A

1-7

215
Q

IM adrenaline dose for anaphylaxis: <6m

A

100-150 micrograms (0.1-0.15mL 1 in 1000)

216
Q

IM adrenaline dose for anaphylaxis: 6m-6y

A

150 micrograms (0.15mL 1 in 1000)

217
Q

IM adrenaline dose for anaphylaxis: 6-12 years

A

300micrograms (0.3mL 1 in 1000)

218
Q

IM adrenaline dose for anaphylaxis: >12 years

A

500 micrograms (0.5mL 1 in 1000)

219
Q

Form completed when life expectancy is <12 months, allows fast-track benefit payments

A

SR1

220
Q

First line treatment for Parkinson’s disease if the motor symptoms are not affecting the quality of life

A

dopamine agonist (non-ergot derived e.g. ropirinole), levodopa or monoamine oxidase B (MAO-B) inhibitor

221
Q

60mg of subcutaneous diamorphine is equivalent to ______mg of oral morphine

A

180 mg

222
Q

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

A

8-14

223
Q

An induction-maintenance regime of oral _______should be considered for recurrent vaginal candidiasis

A

fluconazole

224
Q

75mg oral morphine is equivalent to __mg oral oxycodone

A

50

225
Q

Patients with acute severe hyponatraemia (serum sodium concentration of less than ___ mmol/L) should be urgently admitted to hospital

A

125

226
Q

Consultation models:
initiating the session
gathering information
building the relationship
giving information, explaining and planning
closing the session

A

Calgary Cambridge

227
Q

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)

A

Stewart - patient centred clinical method

228
Q

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

A

Pendleton

229
Q

Consultation models:
interviewing and history-taking
physical examination
diagnosis and problem-solving
patient management
relating to patients
anticipatory care
record keeping

A

Fraser

230
Q

Consultation models:
connecting
summarising
handing over
safety netting
housekeeping

A

Neighbour

231
Q

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

A

Tuckett

232
Q

Consultation models:
management of presenting problems
management of continuing problems
modification of help-seeking behaviour
opportunistic health promotion

A

Stott and Davis

233
Q

A period of ___ weeks is typically used to assess response to treatment in patients with mild-moderate flares of ulcerative colitis

A

4

234
Q

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)

A

Nominal

235
Q

Data types:
Observed values can be put into set categories which themselves can be ordered (for example NYHA classification of heart failure symptoms)

A

Ordinal

236
Q

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)

A

Discrete

237
Q

Data types:
Data can take any value with certain range (for example weight)

A

Continuous

238
Q

Data types:
Data may take one of two values (for example gender)

A

Binomial

239
Q

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)

A

Interval

240
Q

Childhood infections:
Fever initially
Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
Systemic upset is usually mild

A

Chickenpox

241
Q

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

A

Measles

242
Q

Childhood infections:
Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular

A

Rubella

243
Q

Patients cannot drive for __ months following a first unprovoked or isolated seizure if brain imaging and EEG normal

A

6

244
Q

DVLA: established epilepsy/multiple unprovoked seizures

A

may qualify for a license if they have been free from any seizure for 12 months

245
Q

DVLA: withdrawal of epilepsy medication

A

Should not drive whilst anti-epileptics are being withdrawn and for 6 months after last dose

246
Q

DVLA: simple faint

A

No restrictions

247
Q

DVLA: single episode syncope, explained and treated

A

4 weeks off

248
Q

DVLA: single episode syncope, unexplained

A

6 months off

249
Q

DVLA: 2 or more episodes of unexplained syncope

A

12 months off

250
Q

DVLA: craniotomy

A

1 year off

251
Q

DVLA: multiple TIAs over a short period

A

3 months off, inform DVLA

252
Q

1st line treatment for chlamydia

A

7 day course of doxycycline

253
Q

Type of burn:
Red and painful, dry, no blisters

A

Superficial epidermal

254
Q

Type of burn:
Pale pink, painful, blistered, slow capillary refill

A

Partial thickness - superficial dermal

255
Q

Type of burn:
Typically white but may have patches of non-blanching erythema. Reduced sensation, painful to deep pressure.

A

Partial thickness - deep dermal

256
Q

Type of burn: white ‘waxy’/brown ‘leathery’/black. No blisters. No pain.

A

Full thickness

257
Q

Type of ovarian pathology most commonly associted with Meig’s syndrome

A

Fibroma

258
Q

Which laxative should be avoided in IBS?

A

Lactulose

259
Q

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

A

7.3, 8

260
Q

A normal ABPI is between ____ and ____

A

0.9, 1.2

261
Q

How potent is the steroid cream?

Hydrocortisone 0.5-2.5%

A

Mild

262
Q

How potent is the steroid cream?

Betamethasone valerate 0.025% (Betnovate RD)

Clobetasone butyrate 0.05% (Eumovate)e

A

Moderate

263
Q

How potent is the steroid cream?

Fluticasone propionate 0.05% (Cutivate)

Betamethasone valerate 0.1% (Betnovate)

A

Potent

264
Q

How potent is the steroid cream?

Clobetasol propionate 0.05% (Dermovate)

A

Very potent

265
Q

First line drugs for restless legs

A

Dopamine agonists e.g. pramipexole, ropinirole

266
Q

______________ can be prescribed for 7 days during an acute attack of Meniere’s diseas

A

Prochlorperazine

267
Q

Aim for a __ week break in between courses of topical corticosteroids in patients with psoriasis

A

4

268
Q

Haemophilia A affects which clotting factor?

A

VIII

269
Q

Haemophilia B affects which clotting factor?

A

IX

270
Q

First line insulin for adults with T2DM

A

Isophane insulin

271
Q

A recurrent episode of C. difficile within ___ weeks of symptom resolution should be treated with oral fidaxomicin

A

12

272
Q

2 doses of the hep A vaccine can confer immunity for ___ years

A

20

273
Q

The most common post-surgical complication seen in cataract surgery is ______

A

posterior capsular thickening

274
Q

NICE recommends a 2-step approach to TB diagnosis, with a Mantoux test followed by ________ if Mantoux is positive

A

interferon gamma assay

275
Q

What 2 blood tests should be started before starting isotretinoin?

A

LFTs, lipids

276
Q

MODY with symptoms - 1st line drug is

A

gliclazide (or other sulfonylureas)

277
Q

Management for essential tremor if beta blockers are contraindicated

A

primidone

278
Q

Osteomalacia causes calcium to be _____ and ALP to be ______

A

low, high

279
Q

Patients with severe hypercalcaemia (>____) should have same day admission to hospital

A

3.5

280
Q

The optimal time to check urate is - weeks after an acute attack of gout resolves

A

2-4

281
Q

In paget’s disease, calcium is _____ whilst ALP is ______

A

normal, raised

282
Q

Peak flow variability over ____% suggests a diagnosis of asthma

A

20

283
Q

3x antibiotic options for acute rhinosinusitis

A

Phenoxymethylpenicillin, doxycycline, clarithromycin

284
Q

codeine should not be used for children under the age of ___ for any reason

A

12

285
Q

a gynae referral should be made for patients with suspected premature ovarian failure under the age of ___

A

40

286
Q

people can fly if their Hb is over __

A

80

287
Q
A