EFA

Question 1

Which of these signs suggest an incompatible blood transfusion?

Bradycardia

Haematuria

Pulmonary Oedema

Splenomegaly

Splinter haemorrhages

Answer 1

Haematuria - ABO incompatibility causes haemolysis

Question 2

Anti-D immunoglobulin:

should be given to all A RhD positive mothers within 72 hours of delivery

should be given to all O RhD positive mothers within 72 hours of delivery

should only be given to RhD positive mothers after their second pregnancy

prevents sensitisation of the mother following placental abruption

prevents future transfusion reactions

Answer 2

prevents sensitisation of the mother following placental abruption

(only RhD negative mothers need Anti D)

Question 3

What does this X ray show?

Answer 3

Diverticular disease

Question 4

An elderly male presented to hospital with pneumonia 2 weeks ago. He had been admitted to hospital and spent 10 days on intensive care. He developed diarrhoea on day 8 and started to become hypotensive. He died on day 10 and a postmortem was carried out.

Below is a gross specimen of his colon:

Which of these treatments could have saved his life?

Oral co-amoxiclav

Oral flucloxacillin

Oral vancomycin

Intravenous flucloxacillin

Intravenous vancomycin

Answer 4

Oral vancomycin- direct action on gut (no systemic bioavailability)

Intravenous vancomycin is for MRSA and not CDiff Colitis

Question 5

Which of the following features suggests Ulcerative colitis?

Cobblestone Mucosa

Inflammation confined to mucosa

Non-caseating granulomas

Skip lesions

Transmural inflammation

Answer 5

Inflammation confined to mucosa

Question 6

Which of the following is the largest risk factor for colonic carcinoma?

Crohn’s disease

Diverticular disease

Irritable bowel syndrome

Peutz Jeghers Syndrome

Ulcerative Colitis

Answer 6

Ulcerative Colitis

Question 7

A 60 year old male presents to ED with hypotension and a rash following a dose of propranolol. You suspect anaphylaxis. What test would you like to perform to confirm your diagnosis?

Blood histamine levels

Drug challenge

Serial mast cell tryptase

Skin prick

Urine prostaglandin D2

Answer 7

Serial mast cell tryptase

Question 8

For which of the following conditions would you choose allogeneic transplantation over autologous transplantation?

Acute leukaemia

Bone marrow failure

Chronic leukaemia

Myeloma

Lymphoma

Answer 8

Bone marrow failure

Question 9

Which of the following would cause a rise in Alkaline Phosphatase (ALP)?

Answer 9

Osteomalacia

Question 10

A 50 year old male presents with a calcium of 3.0mM (normal range 2.2 – 2.6). PTH level is 3pM (normal range 1.1 – 6.8).

What is the likely diagnosis?

Answer 10

Primary hyperparathyroidism