Day 5

Question 1

Which antibiotics are most likely to cause pseudomembranous colitis?

Answer 1

Cephalosporins

Question 2

Start IV fluid resuscitation in children or young people with a bolus of __ ml/kg over less than __ minutes

Answer 2

20

10

Question 3

Features of organophosphate poisoning

Answer 3

SLUD
S- alivation
L- acrimation
U- rination
D- efecation/diarrhoea

Question 4

Management of organophosphate poisoning

Answer 4

atropine

Question 5

Haemarthrosis without trauma

Answer 5

haemophilia A and B

Question 6

Features of roseola infantum

Answer 6

• high grade fever which resolves before onset of rash
• trunk and then spread to limbs
• non-itchy maculopapular rash

Question 7

What happens in sick euthyroid syndrome?

Answer 7

everything (TSH, thyroxine, and T3) is low

Question 8

Situations where oxygen therapy should not be used routinely if no evidence of hypoxia

Answer 8

• MI and ACS
• stroke
• obstetric emergencies
• anxiety-related hyperventilation

Question 9

ewings sarcoma

Answer 9

malignant tumour that occurs most frequently in the diaphysis of the pelvis and long bones- onion skin

Question 10

chondrosarcoma

Answer 10

malignant tumour of cartilage, which most commonly affects the axial skeleton and not the diaphysis of long bones. This type of tumour is also more common in middle-age.

Question 11

Giant cell tumour

Answer 11

This is a benign tumour of multinucleated giant cells which occurs most frequently in the epiphyses of long bones and shows a ‘double-bubble’ or ‘soap bubble’ appearance on x-ray. more commonly seen in patients aged 20-40 years old.

Question 12

Osteochondroma

Answer 12

most common benign bone tumour and while it is most in males aged under 20 years old, it often presents with cartilage-capped bony projection on the external surface of a bone

Question 13

Osteosarcoma

Answer 13

This is the most common primary malignant bone tumour and while it also is seen mainly in children and adolescents, it occurs most frequently in the metaphyseal region of long bones prior to epiphyseal closure. It also shows a ‘sunburst’ pattern on x-ray and is most commonly associated with mutations in the retinoblastoma gene (and hence retinoblastoma tumours).

Question 14

What to do if alendronate cannot be tolerated

Answer 14

change to risedronate or etridronate

Question 15

Management of myasthenic crisis

Answer 15

intravenous immunoglobulin, plasma electrophoresis

Question 16

induce remission of Crohn’s disease

Answer 16

Glucocorticoids (oral, topical or intravenous)

Question 17

mpaired hypoglycaemia awareness occurs due to

Answer 17

neuropathy of parts of the autonomous nervous system

Question 18

Management of ascites

Answer 18

• reducing dietary sodium
• fluid restriction sometimes if sodium <125mmol/L
• aldosterone antagonists- spironolactone
• drainage
• prophylactic antibiotics 15g/L or less
• TIPS

Question 19

Peptic ulceration, galactorrhoea, hypercalcaemia

Answer 19

MEN I

Question 20

investigation for leptospira

Answer 20

serology- +ve after 7 days
PCR
culture

Question 21

management of leptospirosis

Answer 21

high-dose benzylpenicillin or doxycycline

Question 22

Features of fragile X

Answer 22

Features in males
> learning difficulties
> large low set ears, long thin face, high arched palate
> macroorchidism
> hypotonia
> autism is more common
> mitral valve prolapse

Question 23

STEMI management: for patients undergoing PCI, following dual antiplatelet therapy, patients are also given …..

Answer 23

unfractionated heparin with bailout glycoprotein IIb/IIIa inhibitor (GPI) if radial access used

Question 24

Most common site of diverticula

Answer 24

sigmoid colon

Question 25

After the first VTE, patients with antiphospholipid syndrome should be on ….

Answer 25

lifelong warfarin

Question 26

hyperpigmentation of the palmar creases

Answer 26

addisons

Question 27

Nicorandil is most useful in the management of:

Answer 27

angina