CAP tests Flashcards
what is a partial agonist
a drug that binds to and activates a given receptor, but only has partial efficacy at the receptor relative to a full agonist
venlafaxine class of drug
SNRI
Ix of a direct trauma to the nose causing a visible deformity
no Ix - for a simple nasal fracture.
how is the Mx of nasal trauma decided
clinical decision whether to manipulate it or not!
what is fetal station in labour
the relationship of the fetal head to the mum’s pelvis
- = above the ischial spines 0 = at the ischial spines \+ = below the ischial spines
when is a mid cavity forceps (Haig Ferguson) delivery appropriate
- the head is 1/5th palpable per abdomen
- the head is not above the ischial spines
- there is rotation of 45 degrees or less
when is a rotational forceps (Kiellands) delivery appropriate
- direct OP and face deliveries
what is the recommended intervention for a choking conscious baby
chest thrusts (not abdo thrusts)
what is a surgeons knot
modification to the reef knot
adds an extra half hitch when tying the first throw
do women need to take vit D 10mcg pre-conception
no, only during pregnancy
is obesity an indication for taking higher dose folic acid
yes, should be on 5mg from 12w pre-conception
Mx of MODY
sulphonylurea
‘all my food has a metallic taste, like someone is tyring to poison me’ - example of?
gustatory hallucination
what is loosening of associations
thought disorder where there is no logical connection between thoughts
what is orange bags used for
non sharp clinical waste
most useful technique when assessing AVPU
talking to the patient
Mx of lithium toxicity if presenting within 1h
gastric lavage
Mx of lithium toxicity if caused by d+v
rehydration (dont need to change lithium dose)
dietary change for secondary prevention of CV disease?
increase intake of omega-3 fatty acids (oily fish)
neurotransmitter most involved in aversive and defensive systems
serotonin
what % of prostate ca patients have locally advanced disease or mets at presentation
65%
is prostate ca associated with BPH?
no
what area of the prostate does prostate ca arise from?
peripheral zone
what directly increases calcium absorption from the gut?
vitamin D
what directly increases calcium reabsorption from the kidneys
calcium
Abx Mx for a patient on chemo being delivered via PICC line admited with spiking temp. Temp decreases when the PICC line is flushed
Teicoplanin - active against aerobic and anaerobic gram +ve bacteria including multi resistant staph
femoral head shows evidence of collapse - Dx?
AVN
you are first on the scene following a collision between two cars in a supermarket carpark - first step?
assess the scene
is it sometimes appropriate to lie to a family member in order to respect patient’s confidentiality requests?
yes
is it appropriate to refuse to speak with an angry relative of a patient?
no - might make them more frustrated - it is only acceptable for hospital staff to not accept verbal abuse
what is the treatable pcm overdose level
over 100mg/L at 6h
what is the most appropriate monitoring option to assess successfulness of pneumonia Tx
resp rate
is CXR a good way to monitor pneumonia Tx a few days after Tx
no - unlikely to resolve within a few days of Tx
is listening to the chest a good way to monitor pneumonia Tx during Tx
no - will take several days to resolve
most common symptom of poorly controlled asthma in children
chronic night cough
most sensitive way to look for a chromosomal imbalance
array CGH
Mx of a hypotensive pt with a normal HR
alpha agonist - metaraminol
adverse effect most likely to be caused by morphine
drowsiness
nerve most at risk during myringoplasty procedure
chorda tympanii (immediately beneath the tympanic membrane)
effect of dalteparin on K levels
hyperkalaemia
A 50-year-old man presents to his General Practitioner with “heartburn,” which he has suffered from for many years and usually self-controls with antacids. However, recently his symptoms have worsened and are disrupting his sleep. He also admits that he occasionally has difficulty swallowing. - Dx?
barretts oesophagus
A 70-year-old man presents to his General Practitioner with difficulty swallowing and pain on swallowing. He has a long history of Barrett’s Oesophagus, but never attended his review appointments. The only alcohol he drinks is a glass of wine at New Year; he has never smoked. - Dx?
adenocarcinoma of the lower 1/3 of the oesophagus
adenocarcinoma arises from what cell type
gland cells
squamous cell carcinoma arises from what cell type
epithelial cells
what type of cancer is more common at the lower 1/3 of the oesophagus
adenocarcinoma
what type of cancer is more common in the upper 2/3 of the oesophagus
squamous cell carcinoma
Mx croup
oral steroids
Mx reactive airways allergy
neb salbutamol
Ix of brain if suspicion of underlying pathology
CT brain
ABG in hyperventilation panic attack
resp alkalosis
PCO2 in severe asthma attack
low
PCO2 in near fatal asthma attack
normal
what group of drug interacts with lithium to reduce its secretion
NSAIDS
complete heart block ECG
no correlation between P waves and QRS complexes
when are patients at highest risk of neuroleptic malignant syndrome
when typical antipsychotics are used and physical restraint has been required
8 y/o girl stopped growing - most likely cause?
hypothyroidism
somatisation definition
multiple recurrent physical symptoms with no structural cause and persistent refusal to accept reassurance of no structural cause
metabolic s/e of carbamazepine
hyponatraemia
phosphate levels in vit D deficiency
low
calcium levels in vit D deficiency
low
alk phos levels in vit D deficiency
high - due to osteoblastic activity
what happens to blood pressure in preg
decreases in 2nd trim - due to expansion of placenta and decrease in peripheral resistance - returns to pre-preg level by third trim
what happens to cardiac output in preg
increases by 30-50%
what happens to GFR in preg
increases by 30-50%
what happens to erythropoiesis in preg
increases by 25%
what happens to tidal volume in preg
increases
what happens to minute volume in preg
increases
what happens to vital capacity in preg
stays the same
The preferred measure of central tendency in a normally distributed data set.
mean
what is neurogenic pruritus
caused by an effect on CNS receptors e.g. renal or liver failure, malignancy
what is a neuropathic pruritus
the nerve receptors themselves are damaged e.g. shingles
what is a pruritoceptive pruritus
physical irritation in the skin causing the itch e.g. insect bite, eczema
cause of pneumonia in an outbreak in a nursing home if received influenza vaccine 5w ago
legionella
Ix of malrotation
upper GI contrast enema
2ndary prevention for a pt who has had a stroke with AF
warfarin or factor Xa inhibitor (apixaban)
what to give a pt before contrast if they are at risk of contrast nephropathy
IV NaCl
78 y/o lady found collapsed at home and been lying on floor all night. has an AKI but CK high but not in range of rhabdo - whats the cause of her AKI?
hypovolaemia - dehydration from lying on floor all night
what CK range is diagnostic of rhabo
> 10,000
which of these is most likely to cause hyponatraemia: amlodipine atenolol doxazosin bendroflumethiazide ramipril
bendroflumethiazide
Ix for suspected cervical spine #
CT scan neck (not cervical spine xray)
presentation of ectopic beats
feels as if heart stops followed by pounding sensation
supraventricular or ventricular ectopic beats - what are more common in young perople
supraventricular
ventilation in obstructive sleep apnoea
CPAP
do all pts with AF get Tx
no - if its an incidental finding and rate not high and CHADSVASc score 0 then no Tx
when is a paralytic ileus most common
after an op
Mx of a paralytic ileus
drip and suck - insert NG tube and fluids
presentation of lymphogranuloma venerum
proctitis and tender lymphadenopathy
what is radiation brachytherapy
internal radiotherapy - radioactive implants are put near to the tumour
Mx gout
- NSAIDs, colchicine
assessing fluid overload - what gives signs of adequate hydration
normal urine output
how to bring someones BP up if their fluid status is fine
vasoconstrictors e.g. noradrenaline/norepiphrenine
Mx of shoulder pain if no Hx of injury and no nerve injury symptoms
refer for physio
which part of the brain is signs of early Alz disease likely to be seen
temporal lobe
what type of analgesia should be avoided for post-ops in patients with severe respiratory disease
opioid - by any route
measurement of carbon monoxide inhalation
carboxyhaemoglobin
further Ix of pt with unprovoked DVT
?underlying malignancy - so do CT abdo pelvis
long term medication for pt with mechanical heart valves
aspirin and warfarin
what is a prospective cohort
following a group of individuals to determine how a factor affects outcomes
what is a retrospective cohort
analysing how a factor has affected outcomes when the event has already happened
screening test for haemochromatosis
transferrin saturation
fasting times for clear liquids and solids pre-op
clear liquids - 2h
solids - 6h
Ix of a non-functioning thyroid nodule
US of neck - cant just leave alone
presentation of epididymal cyst
separate to the testis
can get above it
transilluminates
presentation hyrdocele
surrounds the testis
can get above it
transilluminates
maintenance fluid requirement for someone with underlying cardiac disease
20-25ml/kg
A 62 year old man has acute breathlessness with a weak cough, following a recent viral upper respiratory infection. Over the past 4 months, he has
had double vision, limb weakness and slurred speech when tired. - Dx?
myasthenia crisis
parameter to monitor respiratory function in myasthenic crisis
FVC
most common pathogen in leg cellulitis
s. pyogenes
Mx of superficial thrombophlebitis
naproxen
Mx of venous leg ulcer that is slowly healing with normal ABPI
compression stocking
recurrent candidiasis - what should u test for
diabetes
nephrotic syndrome in adults - what Ix should you do
renal biopsy - need to find cause
ABG in DKA
metabolic acidosis
ABG in methanol overdose
metabolic acidosis
ABG in panic attack
resp alkalosis, with normal O2
ABG in pulmonary embolus
resp alkalosis (as a result of being hypoxic - they hyperventilate)
ABG in vomiting
metabolic alkalosis
