CAP Test 2019 Flashcards
1
Q
What type of vision causes light to be focussed in front of the eye?
A
Myopia
2
Q
Lens used to correct myopia
A
Concave )(
3
Q
Symptoms of renal colic
A
Sudden onset Severe unilateral pain Loin to groin colicky Often assoc with haematuria
4
Q
Symptoms of adenexal (ovarian) torsion
A
Severe intermittent colicky pain
N + V
5
Q
Complications if ovarian torsion not surgically corrected
A
Necrotic (pyrexia)
6
Q
First line investigation for newborn bilious vomit
A
Abdominal x-ray
7
Q
Investigation for suspected pyloric stenosis
A
US - thickened pylorus
8
Q
Baby who is constipated with projectile vomit. Well and eager to feed
A
Pyloric stenosis
9
Q
Hypertensive that causes ankle oedema
A
Ca channel blocker (Amlodipine)
10
Q
First line for paroxysmal AF
A
Betablocker (bisoprolol)
11
Q
Diagnosis of delirium
A
Acute onset plus, inattention with fluctuating course
And one of:
Disorganised thinking
Altered level of consciousness
12
Q
Minimum percentage blood loss in femur fracture
A
30%
13
Q
Position for neonatal x-rays
A
supine
14
Q
Appearance of surfactant deficiency in neonatal x–ray
A
Lung volume reduced
15
Q
In what patient group are breast abscesses common
A
Lactating women
16
Q
What is a galactocoele
A
Painless breast lump secondary to protein plus blocking the outlet of the mammary glands for milk
17
Q
How do fibroadenomas tend to present?
A
Younger women
Mobile smooth breast lumps
18
Q
Risk factors for NEC
A
Intrauterine growth restriction
Absent end diastolic flow at placenta
Prematurity
Hypoxic ischaemic insult
19
Q
Management of infants at risk of NEC
A
Close monitoring
Breast milk as early as poss
Gradual increase in the total volume of enteral feed
20
Q
What do Men B titres show?
A
Reaction to routine childhood vaccinations
21
Q
What test should be done before LP in kids with meningiococcal septicaemia?
A
Clotting screen
22
Q
What marker is raised in GCA?
A
ESR
23
Q
What should be measure prior to lithium prescription?
A
Renal function
24
Q
What hormone triggers ovulation?
A
LH
25
How long after LH surge is ovulation?
24 to 36 hours
26
Where is LH released from?
Anterior pituitary
27
What class of drug is metformin?
Biguanide
28
What hould be added if metformin not enough in T2DM?
Sulphonylurea (Glicazide)
29
When should sulphonylureas not be used?
Risks of hypo too hight
30
If sulphonylureas contraindicated what should be added to metformin in management of T2DM?
Thiazolidinedione (TZD) - e.g. proglitazone
31
Which medication for T2DM causes diarrhoea?
Metformin
32
What does 1:1000 mean in drug dosing?
1g in 1000ml
33
How does memantine work?
Blockade of NMDA-type glutamate receptors
34
What is memantine used in the treatment of?
Dementia
35
Well-defined hair loss with normal underlying skin. Likely diagnosis?
Alopecia areata
36
What are exclamation mark hairs seen in?
Alopecia areata
37
What is aqueous humour produced by?
Cilliary body
38
How is aqueous humour drained?
At the angle of the eye
Through trabecular meshwork
Into the canal of Schlemm's
39
Management of bronchiolitis
Oxygen therapy + NG feeding
40
Distribution of seborrhoeic dermatitis
Eyebrows
Nasolabial folds
Scalp
41
Itchy vesicles on extensor surfaces
Dermatitis herpetiformis
42
Initial management of oesophagitis
PPI
43
Bird beak appearance
Achalasia
44
Management of Achalasia if young and fit
Heller's cardiomyotomy
45
Management of Achalasia if not young and fit
Balloon oesophageal dilatation
46
Management of oesophageal stricture impairing feeding
Oesophageal balloon dilatation
47
Investigation for suspected PE in patient on chemo
CTPA
48
1st line investigation for suspected endometrial ca
US (for endometrial thickness) or pipelle biopsy
49
What can group B strep cause in preterm infants
Neonatal meningitis
50
What is the most common cause of encephalitis in neonates?
Herpes Simplex
51
How is Herpex simplex encephalitis in a neonate seen on imaging?
Inflammation of temporal lobr
52
Cause of CNS infection in neonates, elderly and immunocomprimised
Listeria monocytogenes
53
Food sources of listeria monocytogenes
Soft cheese
| Unpasturised milk
54
Signs of L4 pathology
Absent knee reflex
Weakness in knee extension
Foot drop
55
First line short term post-partum contraception
COCP or POP
56
Investigation of suspected malaria
Thick/thin blood film
57
What is the first line investigation for suspected pneumoperitoneum?
Erect chest x-ray
58
What is the gold standard investigation for pneumoperitoneum?
CT
59
What is the antidote for paracetamol overdose?
Acetylcysteine
60
What information is needed to calculate an acetylcysteine dose?
Body weight
61
What time period in acetylcysteine most effective in?
Within 8 hours
62
What time period should activated charcoal be given in in paracetamol overdose/
Within 1 hour
63
When should acetylecysteine be used in paracetamol overdose?
Plasma-paracetamol conc on or above treatment line
presentation 8-24hrs after acute ovrdose of more thn 150mg/kg
64
Whta is the most appropriate first line management for a patient with urinary incontinence with large urinary volumes?
Reduce fluid intake
65
How is urge incontinence managed?
Bladder retraining
Antimuscarinics (e.g. oxybutinin, tolterodine)
B3 agonist (e.g. miraberon)
66
How is stress incontinence managed?
Pelvic floor exercise
| B agonists
67
What causes urge incontinence?
Detrusor overactivity
68
What causes overflow incontinence/
Bladder outlet obstruction (e.g. prostate enlargement)
69
When is mirabegron useful in incontinence management?
Urge incontinence - if there is concern about anti-cholinergic side effects in frail elderly patients
70
Cause of haematuria associated with URTI?
IgA nephropathy
71
In which cardiac patients are NOACs not licensed for use/
Prosthetic heart valves
72
What type of infection is Trichomonas vaginalis?
A protozoal (single cell) parasite
73
What is the genetic abnormality in DiGeorge syndrome?
Deletion in Chromosome 21
74
How does DiGeorge syndrome present clinically?
Recurrent infections (problems in T-cell response)
Cardiac disease
Defects in palate and lip
75
What is chronic granulamtous disease?
Genetically caused immunodeficiency which usually presents in childhood with recurrent infection (including abscess and atypica infections)
76
Clinical features of open angle glaucoma
Raised IOP
Increased disc cupping
field defects
Insidious onset
77
What effect do parasympathetic nerves have on the bladder?
Excited the bladder while relaxing the urethral muscle (voiding)
78
What effect do sympathetic nerves have on the bladder?
Relaxes the detrusor while contracting urethral sphincter (not voiding)
79
Where do afferent stimuli from the destrusor go?
Brainstem
80
Where in the brain controls micturition?
Frontal cortex
81
What test is used to diagnose coeliac disease?
Tissue Transglutamase
82
What patient demographic does dermatomyositis present in?
Women
| 50-70 y/o
83
Clinical presentation of dermatomyositis
Gradual onset proximal muscle weakness
| Purple rash on sun exposed areas
84
What effect does Vit D deficiency have on PTH levels?
PTH levels increase
85
What effect does Vit D deficiency have on calcium and phosphate levels?
Calcium and phosphate levels will be low
86
What effect does Vit D deficiency have on Alk Phos levels?
Alk Phos levels increase
87
Why do Alk Phos levels increase in Vit D deficiency?
Increased osteoblastic activity
88
What is leaden paralysis?
Feeling of heaviness in the legs
89
What are hypersomnia and leaden paralysis symptoms of?
Atypical depression
90
Name 4 complications of meningitis in children
SIADH
Hearing loss
Subdural effusion
Hydrocephalus
91
What is the most common cause of bacterial food poisoning in the UK?
Campylobacter
92
Which bacterial gastroenteritis can lead to haemolytic uraemi syndrome?
E.cli 0157
93
Why should antibiotics be avoided in treating E.coli 0157?
May precipitate onset of HUS
94
How does PTH increase calcium levels?
Directly decreases calcium reabsorption from the kidneys
Increases conversion of Vit D to 1,25 hydroxy vit D which increases calcium reabsorption in the gut
95
What effect do high serum calcium levels have on pTH?
Negative feedback on PTH secretion
96
Which anti-psychotic should be used in pregnancy/
Olanzapine
97
What drug should be used in treatment resistant schizophrenia?
Clozapine
98
Which anti-epileptic drug interacts with lithium?
Carbamazepine
99
What effect do NSAIDs have on lithium>
Decrease lithium excretion
100
Which test in marked out of 100 and is suitable for asessing an lder person who presents with new memory problems?
Adenbrookes
101
Which neurotransmitter is affected in withdrawal from sedative-hypnotic drugs?
GABA
102
Which neurotransmitter is responsible for symptoms in schizophrenia?
Dopamine
103
Which neurotransmitter is low in depressed patients?
5-hydroxytryptamine (serotonin)
104
What measures the degree to which individiuals differ from sample mean?
Standard deviation
105
How are autoimmune blistering disorders diagnosed?
Biopsy and immunofluorescence
106
Why does phenytoin reduce he efficacy of the COCP?
Induces liver enzymes
107
How should patients with GORDs airway be supported during general anaesthesia?
Intubation
108
How is pseudogout diagnosed?
Arthrocentesis - calcium pyrophosphate crystals change colour under polarizing filter with change of the polarization alignment
109
Drug given for patient in AF who is cardiovascularly stable
Amiodarone (rate control)
| B blockers
110
Drug to give patient who is hypotensive with normal heart rate
Noradrenaline (central access)
| Metaraminol (peripheral access)
111
How does epidymo-orchiditis present?
Unilateral
| Acute onset of pain, swelling and tenderness
