All

Question 1

Management of a patient who has been diagnosed with an incomplete miscarriage and demonstrates signs of haemodynamic instability

Answer 1

Fluid resus, dilation and curretage

Question 2

Contact lenses, acute onset eye pain, decreased visual acuity

Answer 2

Keratitis

Question 3

Light’s criteria for determining the cause of a pleural effusion.

1. pleural fluid protein/serum protein >0.5
2. pleural fluid LDH/serum LDH >0.6
3. pleural fluid LDH >upper limit (lab dependent)

If one or more of these are present the pleural effusion is an _______ which can be caused by ______
If these are normal then the pleural effusion is an ______ which can be caused by _______

Answer 3

Exudate - infection, malignancy, immunologic process, lymphatic abnormality, inflammation
Trnsudate - imbalances between hydrostatic and oncotic pressures - CCF, cirrhosis, nephrotic syndrome

Question 4

MRCP versus ERCP

Answer 4

MRCP - diagnostic, useful if patient is haemodynamically stable
ERCP - diagnostic and therapeutic, usefull to decompress the biliary system, perform immediately if pt not responding to Abx

Question 5

Melanoma margins based on breslow thickness

Answer 5

In-situ: 5-10mm
Thickness <1mm: 1cm margin
1-4mm: 1-2cm margin
>4mm: 2cm margin

If >0.8mm thickness then consider SLN biopsy

Question 6

Drug used to reverse heparin

Answer 6

Protamine sulphate

Question 7

Cause and treatment of oculogyric crisis

Answer 7

Drugs - antipsychotics, metaclopromide, domperidone

Benztropine

Question 8

Spinal cord compression signs

Answer 8

LMN signs at level of lesion, UMN signs below the lesion

Question 9

Contralateral pure motor weakness

Answer 9

Posterior internal capsule stroke

Question 10

Fast onset cognitive impairment with myoclonus

Answer 10

Cruetzfelter-Jakon disease

Question 11

VDRL + SPHA reactive

Answer 11

Syphilis

Question 12

Imaging findings for intracranial haemorrhage

Answer 12

Extradural - lemon-shaped
Subdural - crescent-shaped
SAH - diffuse

Question 13

Facial weakness, droop, ear discharge - DDx

Answer 13

Stroke - exclude with CT brain

Ramsay-Hunt syndrome - empirial antivirals

Question 14

Initial treatment of superior vena cava obstruction (tumour, goitre)

Answer 14

Corticosteroids - reduce tumour swelling

Then consider radiotherapy, chemotherapy, etc

Question 15

CXR of pleural effusion in a supine patient

Answer 15

Diffuse cloudiness

Question 16

HOCM versus AS murmur

Answer 16

Both ejection systolic at apex

AS radiates to carotida, HOCM does not

Question 17

Hyperkalaemia management

Answer 17

ECG - if normal then consider repeating bloods 
VBG - if considering metabolic acidosis 
1. cacium gluconate IV
2. salbutamol neb
3. IV insulin with glucose
4. bicarbonate IV (if acidosis)
5. dialysis 
6. resonium PR if dialysis is unavailable

Question 18

Hypercalcaemia management

Answer 18

IV fluids and recheck

Bisphosphonates

Question 19

Meningitis treatment

Answer 19

2g ceftriaxone IV

Question 20

Anaphylaxis dose

Answer 20

0.5mL of 1:1000 IM adrenaline