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AMK style questions > AKT mock 2 > Flashcards

AKT mock 2 Flashcards

1
Q

What is the medication of choice for management of hiccups in palliative care?

A

Haloperidol or chlorpromazine

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2
Q

When is the peak incidence of delirium tremens following alcohol withdrawal?

A

72hrs

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3
Q

What is the first-line treatment for children and adolescents with anorexia nervosa?

A

Family based therapy

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4
Q

When can the copper IUS be inserted for the use of emergency contraception following UPSI?

A

within 5 days after the first unprotected sexual intercourse in a cycle, or within 5 days of the earliest estimated date of ovulation, whichever is later

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5
Q

Which type of malignancy can be associated with EBV?

A

head and neck malignancy, usually nasopharyngeal in origin or lymphoma.

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6
Q

What is the appropriate management for a perforated tympanic membrane caused by barotrauma?

A

Reassure and follow up - will likely resolve after 6-8 weeks

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7
Q

Supplementation with which drug is required prior to surgery for patients taking prednisolone?

A

Hydrocortisone

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8
Q

On a DEXA scan, what it the Z score adjusted for?

A

The Z score is adjusted for age, gender and ethnic factors

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9
Q

What is the initial management for a patient with rheumatoid arthritis?

A

DMARD monotherapy +/- a short-course of bridging prednisolone

methotrexate is the most widely used DMARD.
sulfasalazine
leflunomide
hydroxychloroquine: should only be considered for initial therapy if mild or palindromic disease

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10
Q

What are the appropriate monitoring requirements for patients with RA on methotrexate?

A

Monitoring of FBC & LFTs is essential due to the risk of myelosuppression and liver cirrhosis. Other important side-effects include pneumonitis

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11
Q

What is the appropriate management for a patient with RA that has had inadequate response to at least two DMARDs including methotrexate?

A

TNF-inhibitor eg infliximab

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12
Q

What is the appropriate management short term for acute flares of rheumatoid arthritis?

A

Oral or intramuscular steroids such as methylprednisolone

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13
Q

What is the appropriate treatment for an acute flare of gout?

A

Colchicine (unless severe renal impairment) or NSAIDs (unless asthmatic)

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14
Q

What should be prescribed long term to patients to prevent a gout flare?

A

Allopurinol - requires colchicine/ NSAID cover when starting as may cause acute gout flare

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15
Q

What is the appropriate management for placental abruption, when the foetus is alive and < 36 weeks?

A

fetal distress: immediate caesarean
no fetal distress: observe closely, steroids, no tocolysis, threshold to deliver depends on gestation

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16
Q

What is the appropriate management for placental abruption, when the foetus is alive and > 36 weeks?

A

fetal distress: immediate caesarean
no fetal distress: deliver vaginally

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17
Q

What is the appropriate management for placental abruption, when the foetus is not alive?

A

induce vaginal delivery

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18
Q

Which contraceptive method is associated with weight gain?

A

Depo-provera injection

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19
Q

When is it appropriate to give a woman a cervical smear after she has given birth?

A

Cervical screening in pregnancy is usually delayed until 3 months post-partum unless missed screening or previous abnormal smears

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20
Q

When would it be appropriate not to surgically fix a scaphoid fracture?

A

An undisplaced scaphoid fracture not involving the proximal pole

immobilise wrist either in a Futuro splint or below-elbow cast for a further 6 weeks.

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21
Q

In PTSD, what is the appropriate first line drug therapy if CBT or EMDR therapy are ineffective?

A

Venlafaxine

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22
Q

How might you treat local anaesthetic toxicity?

A

IV 20% lipid emulsion

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23
Q

What is the appropriate antidote for paracetamol poisoning?

A

Activated charcoal if ingested <1hr
N-acetylcysteine (NAC)
Liver transplantation may be req

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24
Q

What is the appropriate antidote for Salicylate poisoning?

A

Urinary alkalinisation with IV bicarbonate
Haemodialysis

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25
Q

What is the appropriate antidote for Opioids/ opiate poisoning?

A

Naloxone

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26
Q

What is the appropriate antidote for benzodiazepine poisoning?

A

Flumazenil (only in severe or iatrogenic overdoses, as seizure risk)

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27
Q

What is the appropriate antidote for Tricyclic antidepressants poisoning?

A

IV bicarbonate may reduce risk of seizures and arrhythmias in severe toxicity

28
Q

What is the appropriate antidote for lithium poisoning?

A

Mild-moderate: Vol resus with normal saline
Severe: Haemodialysis

29
Q

What is the appropriate antidote for warfarin overdose?

A

Vitamin K
Prothrombin complex

30
Q

What is the appropriate antidote for beta blockers?

A

If bradycardic - atropine
In resistant cases, glucagon

31
Q

What is the appropriate antidote for Ethylene-glycol (eg antifreeze)?

A

Fomepizole or ethanol

32
Q

What is the appropriate antidote for methanol poisoning?

A

Fomepizole or ethanol
Haemodialysis

33
Q

What is the appropriate antidote for Organophosphate insecticides poisoning?

A

Atropine

34
Q

What is the appropriate antidote for digoxin toxicity?

A

Digoxin specific antibody fragments

35
Q

What is the appropriate antidote for iron toxicity?

A

Desferrioxamine

36
Q

What is the appropriate antidote for lead toxicity?

A

Dimercaprol
Calcium edetate

37
Q

What is the appropriate antidote for carbon monoxide poisoning?

A

100% oxygen
Hyperbaric oxygen

38
Q

What is the appropriate antidote for cyanide poisoning?

A

Hydroxocobalamin

39
Q

What blood profile is seen in DIC?

(platelets, fibrinogen, PT & APTT, fibrinogen degradation products)

A

↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products = raised D dimer

40
Q

What are the rules regarding methotrexate and pregnancy?

A

Both men and women need to wait 6 months after stopping methotrexate before conceiving

41
Q

What treatment is first-line for acute stress disorders?

A

Trauma-focused cognitive behavioural therapy

42
Q

A 3-year-old boy is brought to the emergency department with difficulty breathing. Since this morning, he has developed a fever (38.3ºC) and become progressively short of breath. On examination, he appears unwell with stridor and drooling. His past medical history is otherwise unremarkable.

What is the diagnosis and most likely causative organism?

A

Acute epiglottis - Haemophilus influenzae B

43
Q

What is the adjuvant hormone treatment of choice for post-menopausal women with ER +ve breast cancer?

A

Anastrozole

44
Q

What is the adjuvant hormone treatment of choice for pre-menopausal women with ER +ve breast cancer?

A

Tamoxifen

45
Q

What is the adjuvant hormone treatment of choice for women with HER2 +ve breast cancer?

A

Herceptin

46
Q

What results are suggestive of down’s syndrome?

(HCG, PAPP-A and nuchal translucency)

A

↑ HCG, ↓ PAPP-A, thickened nuchal translucency

47
Q

Which medication is generally first line to manage secretions in palliative care?

A

Hyoscine hydrobromide or hyoscine butylbromide

48
Q

What is the mechanism of action of Hyoscine hydrobromide or hyoscine butylbromide?

A

Muscarinic receptor antagonist

49
Q

What are the features of kawasaki disease?

A

acute febrile illness lasting over 5 days, bilateral non-purulent conjunctivitis, unilateral cervical lymphadenopathy, a polymorphic rash, and mucosal erythema with a strawberry tongue. Swelling of the hands and feet can occur in the acute stage with desquamation in the second week. Coronary aneurysms can develop in up to one-quarter of untreated patients.

50
Q

Which antiemetics increase gastric motility?

A

metoclopramide and domperidone

(do not use metaclopramide in complete bowel obstruction, gastrointestinal perforation, or immediately following gastric surgery)

51
Q

Which antiemetics work best for chemically mediated nausea and vomiting?

A

ondansetron, haloperidol and levomepromazine

52
Q

Which is the antiemetic of choice in raised intracranial pressure?

A

cyclizine

53
Q

What is the medication of choice for nausea caused by vestibular disfunction?

A

cyclizine

54
Q

What investigation do all breech babies require after birth?

A

All babies breech at or after 36 weeks gestation require USS for DDH screening at 6 weeks regardless of mode of delivery

55
Q

What is the referral criteria for patients with suspected breast cancer?

A

aged 30 and over and have an unexplained breast lump with or without pain or

aged 50 and over with any of the following symptoms in one nipple only: discharge, retraction or other changes of concern

56
Q

What is the time window post UPSI that Levonorgestrel (Levonelle) must be used to be effective?

A

Must be taken within 72hrs unprotected sex

If pt vomits within 3hrs, repeat dose

57
Q

What is the time window post UPSI that Ulipristal (EllaOne) must be used to be effective?

A

30mg dose taken within 120hrs unprotected sex

58
Q

What are the cautions associated with Ulipristal (EllaOne)?

A

Wait 5 days before restarting hormonal contraception, barrier methods until then.
Caution in pts with severe asthma
Can be used more than once in a cycle
Delay breastfeeding for 1wk

59
Q

What is the recommended management for a breast fibroadenoma?

A

usually treated conservatively, surgical excision is usual if >3cm

60
Q

What does a McMurray’s test suggest?

A

meniscal tear in the knee

61
Q

What is the appropriate management for a SUFE?

A

Internal fixation

62
Q

What is the name given to the condition that describes progression of PID to perihepatitis?

A

Fitz-Hugh-Curtis syndrome

63
Q

What is the appropriate treatment for pregnant women with candidiasis (White ‘curdy’ vaginal discharge with pH <4.5)?

A

Clotrimazole pessary

64
Q

If a pregnant woman reports reduced foetal movements, what is the most appropriate first step?

A

handheld Doppler should be used to confirm fetal heartbeat as a first step

65
Q

What is the analgesic drug of choice in palliative patients with severe renal impairment (eGFR<30ml/min)?

A

Fentanyl

66
Q

What is the analgesic drug of choice in palliative patients with mild to moderate renal impairment?

A

Oxycodone

AMK style questions (8 decks)

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