December

Question 1

HNPCC causes what cancers most commonly?

Answer 1

Colorectal and endometrial

Question 2

Patient is on metformin, has poorly controlled type 2 diabetes and a background of CVD. Add what medication?

Answer 2

SGLT-2 (has proven cardiovascular benefits)

Question 3

Diabetes with high BMI what medication can help with weight loss?

Answer 3

GLP-1
“aglutide”

Question 4

MOA of dabigatran, rivaroxaban, heparin, warfarin.

Answer 4

Dabigatran is a direct thrombin inhibitor.

Rivaroxaban is a direct factor Xa inhibitor. Apixaban is also a direct factor Xa inhibitor.

Heparin activates antithrombin III.

Warfarin inhibits clotting factors II, VII, IX and X.

Question 5

Reed sternberg cells =

Answer 5

Hodgkin’s lymphoma

Question 6

First line medication for constipation

Answer 6

Bulk-forming laxative first-line, such as ispaghula.

Question 7

Macrogol is what type of laxative?

Answer 7

Osmotic

Question 8

1st and 2nd line for BV

Answer 8

1st Metronidazole
2nd topical clindamycin

Question 9

Sensorineural hearing loss + renal failure =

Answer 9

Alport’s syndrome

Question 10

Regular broad complex tachycardia with no adverse features give…?

Answer 10

Amiodarone (300mg IV)
In adverse features, you shock

Question 11

Close contact of meningococcal meningitis give…

Answer 11

Oral ciprofloxacin or rifampicin is used as prophylaxis for contacts of patients with meningococcal meningitis

Question 12

Management of unilateral glue ear in an adult:

Answer 12

Unilateral glue ear in an adult needs evaluation for a posterior nasal space tumour.

Question 13

Haemorrhage 5-10 days after tonsillectomy management?

Answer 13

Haemorrhage 5-10 days after tonsillectomy is commonly associated with a wound infection and should therefore be treated with antibiotics

Question 13

When treating OCD, compared to depression, the SSRI usually requires a higher dose and a longer duration of treatment (at least 12 weeks) for an initial response

Answer 13

OCD give sertraline higher dose, be patient for longer to benefit.

Question 13

Avoid what BP medication in gout?

Answer 13

Thiazide like diuretics should not be used in patients with gout as they can exacerbate the condition.

Question 14

CML or AML?

Answer 14

1. Look at lymphocytes
2. Look at WBC
3. Others hint (blast cell/ bands)

Example
1.Low Lymphocytes -> the answer should be AML or CML
2. WBC > 100 -> Chronic causes so Consider CML (rule out AML)
3. Presence of bands cell -> confirm CML

*blast -> Acute
*bands -> Chronic

Question 14

What gene is present in 95% of cases of CML?

Answer 14

Philadelphia chromosome

Question 14

Striking the triceps tendon with a tendon hammer. Which nerve (and its nerve root) are you testing?

Answer 14

C7 Radial Nerve

The radial nerve innervates the triceps muscle. It is primarily derived from the C7 nerve root.

Question 14

Renal colic, ultrasound shows stone is under 10mm manage how initially?

Answer 14

Tamsulosin

NICE recommend alpha blockers are considered for distal ureteric stones less than 10 mm in size

Question 15

People with coeliacs should recieve what vaccine?

Answer 15

People with coeliac disease receive the pneumococcal vaccine due to hyposplenism.

Question 15

1st and 2nd line management of angina:

Answer 15

If angina is not controlled with a beta-blocker, a longer-acting dihydropyridine calcium channel blocker should be added

Question 16

On examination what movement elicit pain in medial epicondylitis?

Answer 16

Medial epicondylitis is typically aggravated by wrist flexion and pronation.

Question 17

Causes of cerebellar disease:

Answer 17

PASTRIES
Posterior fossa tumour
Alcohol
Multiple sclerosis
Trauma
Rare causes
Inherited
Epilepsy
Stroke

Question 18

What can be used to rule out a PE?

Answer 18

PERC test