AMK gold (Daire)

Question 1

pneumonias

klebsiella

Answer 1

elderly and alcoholic

caveatting pneumonia on xray

Question 2

pseudomonas pneumonia

Answer 2

CF

bronchiectasis

Question 3

legionella

Answer 3

water tanks (hot tubs)

investigations:
bloods:
hyponatraemia
abnormal LFT
lymphopenia

bedside:
urinary antigens*** (urine sample)

management:
clarithromycin

Question 4

pneumocystis jirovecci

Answer 4

immunocompromised (HIV)
exertional dyspnoea
low sats
inhibits olate
minimal CXRAY findings
dry cough

tx: co trimoxazole

Question 5

OH SHIT

asthma attack

Answer 5

OXYGEN 15L
SALBUTAMOL
HYDROCORTISONE
IPATROIUM
THEOPHYLLINE

Question 6

respiratory pathology buzzwords

barrel chest
whooping cough
green/rusty sputum

Answer 6

barrel chest COPD
whooping cough pertussis
green/rusty sputum pneumonia

Question 7

Paeds

‘barking cough’

Answer 7

croup
rhinovirus, parainfluenza virus, adenovirus, RSV (bronchiolitis if <18M)
treat: rest, O2

Question 8

epiglottis

Answer 8

emergency
stridor, drooling, tripod position
do not open mouth and examine
call for anaesthetic and ENT

rare because of haemophilia influenza vaccine (6 in 1)

Question 9

causes of acute abdominal pain

BIDI

Answer 9

blockadge
inflammation / infection
damage/dysfunction
ischaemia

appendicitis:
1/3 from ASIS to umbilicus
central colicky then sharp RIF

Question 10

where is absorbed where

“I”m on facebook, do joint in”

Answer 10

I
F
B
D
J
I

iron= duodenum
folate = jejunum
B12= ileum

Question 11

anatomical levels

Answer 11

aortic hits = T12 (12 letters)
vena cava= T8
oesophagus = T10

Question 12

C DIFF management

Answer 12

metrondiazole

vancomycin

Question 13

HPV

Answer 13

6 and 11= genital warts

16 and 18= cerivcal cancer

Question 14

dermatology
cellulitis
animal bite
impetigo
bullseye rash

Answer 14

cellulitis= flucloxacillin
animal bite= co amoxcilav
impetigo= staph aureus, topical fusidic acid
bullseye rash= lyme disease

Question 15

cancers

Answer 15

AFP (Alpha FetoProtein) => Liver or germ Cell

CA 153=> Breast Cancer (15 3 Double D rhyme to remember)

Ca 19-9 => Pancreatic Cancer

Ca 125 => Ovarian Cancer

CAE => Colorectal cancer

CD20 => B cells- Non Hodgkin’s Lymphoma
Reed-Sternberg Cells (Owl Face) => Hodgkin’s lymphoma

Philadelphia chromosome [t(9;22)] => Chronic Myeloid Leukaemia

Question 16

ENT

Answer 16

OM- common in children, balding tympanic member.e treat with amoxicillin

OE- swimmers ear. damp, discharge, fluxcloaxicillin

surfers ear- bone due to repeated cold water. surgical removal

cholesteatoma
keratising squamous epithelium in middle of ear
repeated infections
persists, watery and smelly dicharge
surgery

Question 17

common infections

Answer 17

throat- phenoxymethylpenicillin
sinusitis- amoxcillin
periodontal absses- amoxcillin
necrotising gingivitis- metronidazole

Question 18

OD antidotes

Answer 18

paracetemol:
Within 1st hour give Activated Charcoal, N-acetylcysteine

Aspirin: Haemodialysis

Heroin/Opioids: Naloxone

Benzodiazepines: Flumazenil

Tricyclic Antidepressants: IV Bicarbonate

Lithium: Dilute with Saline or Haemodialysis

Warfarin: Vitamin K

Heparin: Protamine sulfate

Beta Blockers: Atropine- fertiliser inhalation/ drinking by farmers child

Methanol: Fomepizole,
Ethanol

Digoxin: Digibind

Carbon Monoxide: High O2 & hyperbaric O2

Cyanide:Hydrocabalamine

Lead:Dimercaprol

Question 19

ECG
tall tented t eaves
no p waves
slurred upstroke, delta wave

Answer 19

1. hyperkalaemia
2. AF
3. wolff-parkinson white syndrome

Question 20

microbiology:

Answer 20

Gram +ve cocci
Strep
Staph

Gram +ve bacillus
Actinomycoses
Bacillus anthrax
Clostridium (C.Diff)
Diphtheria
Listeria

Gram –ve cocci
Neisseria Meningitis
Neisseria Gonorrhoea
Moraxella

Gram –ve bacillus
The Rest

Question 21

MI management

Answer 21

MONA B

morphine
oxygen high flow 15L/min
nitrate (GTN spray)
aspirin and clopidogrel
beta blockers

Question 22

STI’s

Answer 22

BV- loss of lactobacilli, smelly, fishy, high vaginal swab and gram stain. clue cells. tx: metronidazole

chlamydia (CAD)
asymptomatic, yellow/cloudy, NAAT, gram -ve intracellular.
azithromcyin 1g
doxycyline 100mg

gonorrhoea
low abdominal pain, intermenstrual or post coital bleeding, green discharge, NAAT, gram -ve intracellular diplococci. tx: azitrhomcyin 1g and 1g ceftriaxone

trichomoniasis vaginalis
protozoan
itchy/burning, strawberry cervix
green and frothy dischrge
HVS, urine test for men
motile protozoa
tx: metronidazole 

thrush
candida, itchy/burning, white and thick, HVS ,gram stain
hyphae and gram +ve spores
azaleas for tx (fungal)