AKT mock 1 Flashcards by Alice Crocker

What organisms are capable of causing post splenectomy sepsis?

Streptococcus pneumoniae
Haemophilus influenzae
Meningococci

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What is the thrombylitic window for ischaemic stroke and what medication should be delivered within this?

4.5 hrs - should be given alteplase

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What medication should be given if someone is identified to have an ischaemic stroke and is outside the thombolysis window?

Aspirin

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What does obstructive lung disease show on lung function tests?

FEV1 - significantly reduced
FVC - reduced or normal
FEV1/FVC ratio - reduced

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What does restrictive lung disease show on lung function tests?

FEV1 - reduced
FVC - significantly reduced
FEV1/FVC ratio - normal or increased

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What are some examples of obstructive lung disease?

Asthma
COPD
Bronchiectasis

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What are some examples of restrictive lung disease?

Pulmonary fibrosis
Asbestosis
Sarcoidosis
ARDS
Neuromuscular disorders
Severe obesity

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What scoring system is used to identify patients at risk of pressure sores?

Waterlow score

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Damage to the temporal lobe causes what visual field defect?

Contralateral superior homonymous quadrantanopia

(Temporal on Top)

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Damage to the parietal lobe causes which visual field defect?

Contralateral inferior homonymous quadrantanopia

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Damage to the occipital lobe causes which visual field defect?

Contralateral homonymous hemianopia with macular sparing

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if asthma is not controlled by a SABA (salbutamol) what is the appropriate next step in management?

Add low dose ICS

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What has features of sudden painless loss of vision and severe retinal haemorrhages on fundoscopy?

Occlusion of the central retinal vein

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What presents with microaneurysms, dot and blot haemorrhages, hard exudates, and cotton wool spots?

Diabetic retinopathy

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What presents with sudden painless vision loss and a pale retina with a cherry-red spot at the fovea on examination?

Occlusion of the central retinal artery

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What is the mechanism of action of memantine?

NMDA receptor antagonist

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If a patient presents with a fever on alternate days after having travelled abroad, what are they likely to have contracted?

Malaria

(will also see headache, myalgia, hepatomegaly)

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Which disease presents with a febrile phase, a critical phase (including abdominal pain, vomiting and tachypnoea) and then finally a recovery phase?

Dengue fever

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What symptoms would an acute hep B infection present with?

Anorexia, nausea and right upper quadrant pain

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How does typhoid fever initially present?

Starting with week one the patient will have a dry cough, fever, epistaxis and malaise.

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What drug from the following can cause hyponatraemia?

A. Tolvaptan
B. Omeprazole
C. Ranitidine
D. Metformin
E. Phenytoin

Omeprazole

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How would you differentiate meningitis and encephalitis?

Cerebral function usually remains normal in a patient with meningitis while in encephalitis, however, abnormalities in brain function are a differentiating feature, including altered mental status.

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How is encephalitis managed?

prompt treatment with aciclovir by intravenous infusion should be started to cover herpes simplex virus (HSV) -1 infection.

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When using an inhaler, for a second dose how long should you wait before repeating?

30 secs

Which type of dementia demonstrates a stepwise progression?

Vascular dementia

What is the antibiotic of choice in a patient with cellulitis who is penicillin allergic?

Clarithromycin

What is the first line antibiotic of choice in patients with mild to moderate cellulitis?

Flucloxacillin

What is the antibiotic of choice for patients with severe cellulitis?

IV ceftriaxone

What is the antibiotic of choice for patients with cellulitis who are pregnant?

Erythromycin

A 28-year-old patient presents to the emergency department with a right red eye and sensitivity to light that started 1 hour ago. Examination of the right eye reveals a painful, red eye, with a small and irregularly-shaped pupil. Examination of the left eye is unremarkable. The patient is referred to ophthalmology. What is the likely diagnosis?

Anterior Uveitis

How is anterior uveitis managed?

steroid + cycloplegic (mydriatic) drops

What lab results are suggestive of a transudative pleural effusion?

Protein = low LDH = low

What lab results are suggestive of an exudative pleural effusion?

Protein = high LDH = high

What causes a transudative pleural effusion?

CHF, cirrhosis, nephrotic syndrome, PE, hypoalbuminemia

What causes an exudative pleural effusion?

Pneumonia, cancer, TB, viral infection, PE, autoimmune

In combined folate and B12 deficiency, which should be replaced first?

Replace B12 then folate

What is the mainstay management of severe alcoholic hepatitis?

Steroids eg prednisolone

What is the appropriate management for a tachyarrythmia where the patient is haemodynamically unstable (systolic less than 90)?

DC cardiovert

At what rate should potassium be replaced when prescribing fluids?

1mg/kg/hr

What is the diagnostic test used for guillan barre syndrome?

LP - shows elevated protein and normal WCC

What is the antibiotic of choice for both human and animal bites?

Co-amoxiclav

Which medication commonly exacerbates plaque psoriasis?

Beta blockers

Where is brocas area?

Frontal lobe

Where is wernike's area?

Temporal lobe

What are the features of brocas aphasia?

Speech generation impaired but comprehension in tact

What are the features of wernike's aphasia?

Speech generation in tact but comprehension impaired

What is the initial emergency management of acute angle closure glaucoma?

Direct parasympathomimetic and beta-blocker eye drops

What class of drugs should be avoided in myasthenia gravis?

Beta blockers

What is the most common cause of peritonitis secondary to peritoneal dialysis?

Staphylococcus epidermidis

What medications should you give for secondary prevention following an ACS?

A - ace inhibitor B - beta blocker C - cholesterol (statin) D - dual antiplatelet (aspirin + another)

What is the appropriate management for a patient with SVT who is in shock?

DC cardiovert

What medication is used as first line to prevent angina attacks?

Beta blocker or CCB eg verapamil

What is the next appropriate management step for patients with asthma who aren’t responding to medical treatment and are becoming acidotic?

Intubate and ventilate

What is the appropriate antibiotic regime for patients with life threatening c.diff?

IV metronidazole and oral vancomycin

After a first unprovoked or isolated seizure, if brain imaging and EEG are normal, how long should the patient abstain from driving?

6mths

How long can finasteride for BPH take to produce results?

6mths

In patients with T2DM, what medication should be prescribed if they develop CVD or chronic HF?

Dapagliflozin

How long do patients need to eat gluten for before testing for coeliac disease?

6 weeks