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Year 3 Medicine Leeds > Exam Questions > Flashcards

Exam Questions Flashcards

1
Q

What vitamin deficiencies can cause anaemia?

A

B12, B9 and C

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2
Q

Which substance can be used to achieve the most accurate measurement of the glomerular filtration rate?

A

Insulin

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3
Q

What are the antibodies associated with antiphospholipid syndrome?

A

Lupus anticoagulant, anticardiolipin, anti-beta 2 glycoprotein-1

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4
Q

What are gram negative diplococci indicative of in microscopy of vaginal swab?

A

Neisseria gonorrhoea

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5
Q

What are the common sites of carcinoid tumours?

A

Appendix, ileum, testis, ovary and bronchi

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6
Q

What two medications have shown to improve fatigue in patients with MS?

A

Modafinil and amantadine

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7
Q

What ECG change is indicative of supra ventricular tachycardia?

A

Delta waves - up slant at the beginning of the QRS complex diagnostic of wolf Parkinson white syndrome

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8
Q

What is the first line class of antibiotic used for prostatitis? and give an example

A

Quinolone - ciprofloxacin

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9
Q

What investigation is the most sensitive in diagnosing pancreatic cancer?

A

Endoscopic ultrasound

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10
Q

What is a common cardiac defect in children with downs syndrome?

A

VSD

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11
Q

What is an S4 heart sound and why does it occur?

A

Atrial Gallop - atria contracting forcefully to overcome an abnormally stiff ventricle

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12
Q

What are blue markings on the gums a sign of?

A

Lead poisoning

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13
Q

What results in ectopic ileal, gastric or pancreatic mucosa?

A

Meckel’s diverticulum

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14
Q

What is the treatment for hyperkalaemia + ECG changes?

A

IV calcium gluconate

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15
Q

What movement is typically spared in motor neurone disease?

A

Eye movements usually remain as usual

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16
Q

What is retrosternal, sharp exacerbated chest pain exacerbated by lying flat and relieved by leaning forward a characteristic of?

A

Pericarditis

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17
Q

What are classic findings of aortic sclerosis?

A

Ejection systolic murmur that does not radiate to the carotids with normal S2 pulse character and volume

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18
Q

What antiemetic is contraindicated after gastrointestinal surgery?

A

Metoclopramide

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19
Q

What is the classic triad of primary sjogren syndrome?

A

Dry mucosa especially in the eyes and mouth, fatigue and joint pain

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20
Q

What is the most appropriate management in the treatment of carcinoid crisis?

A

Octreotide - somatostatin analogue

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21
Q

What antibiotic should be avoided with an epileptic patient?

A

Ciprofloxacin

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22
Q

What is the treatment for thyroid storm?

A

Antithyroid medication, potassium iodide, beta blockers and steroids

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23
Q

Why are beta blockers given in thyroid storm?

A

Blocks the conversion of inactive T4 to active T3

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24
Q

What is a common complication of hyperthyroidism?

A

Atrial fibrillation

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25
Q

What are the features of MEN 2A? and why does MEN2b differ?

A

Two or more specific endocrine tumours MEN 2b can be associated with marfans syndrome

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26
Q

What is a common side affect of gliclazide (a sulphonylurea)?

A

Hypoglycaemia and weight gain

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27
Q

What is the antibody present in most diagnosis of hashimotos thyroiditis?

A

Anti-TPO

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28
Q

What common medications can cause hyperprolactinaemia in patients with significant mental health?

A

Risperidone, haloperidol, tricyclics, SSRI

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29
Q

What causes type 2 renal tubular acidosis disorder?

A

Proximal RTA caused by failure of proximal tubular cells to reabsorb filtered bicarbonate leading to acidosis and alkaline urine with associated hypokalaemia - associated with fanconi syndrome

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30
Q

What causes type 1 renal tubular acidosis disorder?

A

Distal tubules being unable to secrete H+ into tubular lumen leading to normal anion gap with hypokalaemia, calcium precipitates and kidney stones form

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31
Q

What causes type 4 renal tubular acidosis disorder?

A

Mineralocorticoid deficiency - hyperkalaemia with normal urinary pH
Also caused by ACE inhibitors and NSAIDs leading to aldosterone resistance

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32
Q

What diabetic medications increase the risk of diabetic ketoacidosis?

A

Sodium-glucose cotransporter 2 inhibitors Dapagliflozin, empagliflozin and canagliflozin

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33
Q

What is the recommended protocol for a patient on warfarin with an INR of 9.1?

A

If INR >8 with minor bleeding, stop warfarin and give intravenous vitamin k

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34
Q

What type of testicular tumour would present with raised B-hcg?

A

Choriocarcinoma - testicular germ cell tumour

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35
Q

What do yolk sac tumours typically show a raised level of?

A

Alpha feta-protein

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36
Q

What is a rare ANCA associated small vessel vasculitis?

A

Microscopic polyangiitis

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37
Q

What medication is associated with widespread downscoping ST segments on ECG?

A

Digoxin

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38
Q

What are the typical presenting features of multiple myeloma?

A

Age 72, anaemia, hypercalcaemia, bone pain, renal failure and rouleaux formation on blood film

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39
Q

What histological result is described as a Starry sky?

A

Burkitt lymphoma - non-hodgkin lymphoma

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40
Q

What would be seen on histological swab analysis and first line treatment for trichomoniasis?

A

Motile Flagellated Protozoa - metronidazole 2g PO STAT

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41
Q

What is a side effect of carbimazole that should be treated immediately?

A

Sore throat - presentation of bone marrow suppression causing agranulocytosis potentially leading to sepsis

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42
Q

What is the gold standard investigation for confirming pneumocystis pneumonia?

A

Bronchoalveolar lavage

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43
Q

What is cord sign and what is it a sign of on a CT?

A

Hyper-attenuation within the superior sagittal sinus
Dural venous sinus thrombosis

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44
Q

What is a sign of COPD on chest X-Ray?

A

Flattened semi diaphragms, thin heart and increased number of visible anterior ribs

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45
Q

What deficit is seen in damage to the optic nerve?

A

Monocular visual loss

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46
Q

What deficit is seen in damage to the optic tract?

A

Contralateral homonymous hemianopia

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47
Q

What deficit is seen in damage to the optic chiasm?

A

Bitemporal hemianopia

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48
Q

What deficit is seen in damage to the optic radiation?

A

Contralateral homonymous hemianopia

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49
Q

What antigen is associated with testicular cancer and undescended testis?

A

Lactate dehydrogenase

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50
Q

What medication can make raynauds phenomenon worse?

A

Propanalol

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51
Q

What cancers is MEN2a associated with and what is the inherited gene mutation alongside MEN2a?

A

RET Gene
Medullary thyroid cancers, phaeochromocytoma, parathyroid hyperplasia and adenomas

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52
Q

What is the classic presentation of renal colic?

A

Loin to groin pain, blood and protein in the urine

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53
Q

What is the use function of ALT and ALP?

A

ALT = marker of hepatocellular injury
ALP = useful marker of cholestasis
A greater than 10-fold increase in ALT and a less than 3-fold increase in ALP suggests a predominantly hepatocellular injury.
A less than 10-fold increase in ALT and a more than 3-fold increase in ALP suggests cholestasis.

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54
Q

What can be the causes of isolated rise of ALP?

A

Bony metastases or primary bone tumours
Vitamin D deficiency
Recent bone fractures
Renal osteodystrophy

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55
Q

What investigations are used to assess synthetic liver function?

A

Serum Bilirubin
Serum albumin
Prothrombin time
Serum blood glucose

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56
Q

What are the marker ranges seen in acute hepatocellular damage?

A

ALT: increased 10 fold
ALP: normal or increased 3 fold
GGT: normal or increased 3 fold
Bilirubin: increased 3 fold or 10 fold

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57
Q

What are the marker ranges seen in chronic hepatocellular damage?

A

ALT: normal or increase 3 fold
ALP: normal or increase 3 fold
GGT: normal or increase 3 fold
Bilirubin: normal or increase 3 fold

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58
Q

What are the marker ranges seen in cholestasis?

A

ALT: Normal or increase 3 fold
ALP: increased 10 fold
GGT: increased 10 fold
Bilirubin: increased 10 fold

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59
Q

What can a raised GGT be suggestive of?

A

Biliary epithelial damage
Bile flow obstruction
Response to alcohol and drugs

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60
Q

What antibody is associated with the atopic triad and what type of hypersensitivity reaction is it?

A

IgE - type 1 hypersensitivity

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61
Q

What is the treatment for a male with LUTI?

A

Nitrofurantoin/trimethoprim for 7 days

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62
Q

What is a typical presentation of mitral regurgitation?

A

Breathlessness, fatigue, palpitations, pan-systolic murmur loudest at the apex

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63
Q

What is a typical presentation of aortic regurgitation?

A

Early diastolic murmur, loudest over aortic area
collapsing pulse, wide pulse pressure, displaced apex beat

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64
Q

What is a typical presentation of mitral stenosis?

A

Mid-diastolic murmur, loudest at the apex
Malar flush, tapping apex beat, signs of right sided heart failure

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65
Q

What is a typical presentation of aortic stenosis?

A

Ejection systolic murmur, heard loudest over the aortic area
Syncope, chest pain and breathlessness

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66
Q

What is the CHA2DS2VASC score indicating consideration for anticoagulation for AF?

A

1 for men, 2 for women

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67
Q

Describe mobitz type 1 block?

A

PR interval gradually lengthens before QRS complex is dropped - pattern of progressively longer intervals followed by a skipped beat

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68
Q

What drug is known to have the potential to induce cholestasis?

A

Co-amoxiclav

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69
Q

What is a characteristic of trichomonas vaginalis?

A

Strawberry cervix

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70
Q

What is the first line therapy for longterm management of stable angina?

A

Verapamil
Beta blocker or rate limiting calcium channel blocker

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71
Q

What is the most common location for an atrial myxoma to be found in?

A

Left atrium

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72
Q

What is the most likely diagnosis of a small mobile hard breast lump in the breast with no other changes - rapid growth?

A

Phyllodes tumour

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73
Q

What medication can be contraindicated in use of viagra?

A

Nitrates

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74
Q

What antigen is used in colorectal cancer to monitor response to therapy?

A

Carcinoembryonic antigen (CEA)

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75
Q

What genetic mutation is associated with polycythaemia rubra vera?

A

JAK2 (V617F)

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76
Q

What is the Parkinson triad? and What occurs with a vertical gaze palsy added?

A

Tremor, hypertonia and bradykinesia
Progressive supra nuclear palsy - Parkinson plus syndrome

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77
Q

What is the first line investigation to confirm gout?

A

Joint aspiration

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78
Q

What is the classic presentation of menieres disease?

A

Recurrent attacks of vertigo, hearing loss, tinnitus, and sensation of aural fullness

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79
Q

What is a complication of coeliac disease that is thought to normalise within 2 years of a gluten free diet?

A

Small bowel lymphoma

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80
Q

What organism can cause a presentation of target shaped skin lesions?

A

Mycoplasma pneumonia

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81
Q

What is first line treatment for acute angle glaucoma?

A

IV acetazolamide

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82
Q

What is a pearly lesion on the eyelid with ulcerated centre most likely to be?

A

Basal Cell carcinoma

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83
Q

What is the first line treatment for open angle glaucoma and what are some side effects?

A

Latanoprost
Eye colour change, darkened eyelashes

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84
Q

What does pagets disease of the nipple present as?

A

Erythematous and scaly skin around the nipple resembling eczema

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85
Q

What is the first line treatment for absence seizures?

A

Sodium valproate or ethosuximide

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86
Q

What is the first line treatment for focal, tonic-clonic, and atonic seizures?

A

Lamotrigine

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87
Q

What would be seen in joint aspirate of a person with pseudo gout?

A

Positively birefringent rhomboid crystals

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88
Q

What is Waterhouse-friderichensens syndrome and where would you find a haemorrhage on post mortem?

A

Adrenal haemorrhage and consequent adrenal failure

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89
Q

What is a first line treatment for raynauds?

A

Nifedipine - CCB

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90
Q

What is the first line treatment for postural hypotension?

A

Fludrocortisone

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91
Q

What is the most common ecg change seen in pericarditis?

A

ST elevation

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92
Q

What is the first line treatment of dilated cardiomyopathy?

A

ACE inhibitors

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93
Q

Describe IgA nephropathy

A

IgA deposition in the glomeruli - haematuria and hypertension one or two days after URTI

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94
Q

ST elevation in what leads would indicate a lateral MI and what vessel would be occluded in this case?

A

I, AVL, V5, V6
Circumflex

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95
Q

ST elevation in what leads would indicate an inferior MI and what vessel would be occluded in this case?

A

II, III, AVF
Right coronary artery

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96
Q

ST elevation in what leads would indicate an anterior MI and what vessel would be occluded in this case?

A

V1, V2 septal, V3, V4
Left anterior descending

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97
Q

What are the shockable rhythms?

A

Ventricular tachycardia
Ventricular fibrillation
Torsades de pointes - polymorphic VT
Defibrillation

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98
Q

What are the non-shockable rhythms?

A

Pulseless electrical activity
Asystole
Ventricular standstill - p wave no QRS - complete heart block

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99
Q

What is the tumour marker commonly used for pancreatic cancer screening?

A

CA19-9

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100
Q

For temporal arteritis what medications are given until symptoms fully resolve?

A

High dose prednisolone and alendrotnic acid

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101
Q

What is the first line treatment for pseudo gout?

A

NSAIDs - naproxen

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102
Q

What is the first best initial treatment for acute hypertensive emergency?

A

IV labetalol 50mg

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103
Q

What are the ECG features seen in pericarditis?

A

Widespread upsloping saddle-shaped ST elevation, PR depression and downward sloping T-P line (spodick’s sign)

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104
Q

How do you calculate Cha2ds2vasc score?

A

Age = 65(0), 65-74(1), 75+(2)
Sex = F(1)
CHF History = Yes(1)
Hypertension = Yes(1)
Stroke/TIA = Yes(2)
Vascular disease - MI/peripheral artery disease = Yes(1)
Diabetes = Yes(1)

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105
Q

What is the most common pathogen to cause tonsillitis?

A

Group A strep

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106
Q

What results would you expect to see for cranial diabetes insipidus during water deprivation test?

A

Low urine osmolality after water deprivation, normal post desmopressin injection IM

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107
Q

What is the classic presentation of episcleritis?

A

Mild acute onset, unilateral eye pain and redness

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108
Q

How do you calculate CURB-65?

A

Confusion - AMTS <8
Urea >7mmol/L
RR>30
BP - <90 systolic or <60 diastolic
65> age

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109
Q

What is the firstling treatment for Crohn’s disease?

A

Azathioprine

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110
Q

What is a common side effect of long term steroid use?

A

Reduced proximal strength - myopathy induction

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111
Q

What medication can induce both hypo and hyperthyroidism?

A

Amiodarone

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112
Q

What blood level is likely to be significantly elevated in eosinophilic granulomatosis with polyangiitis?

A

Eosinophils

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113
Q

What is the management of supra ventricular tachycardia when vasovagal manoeuvres have not been successful?

A

IV adenosine

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114
Q

What is the most common organism to cause encephalitis?

A

Herpes Simplex Virus

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115
Q

What marker present in CSF is indicative of subarachnoid haemorrhage?

A

Xanthochromia

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116
Q

When is complete heart block diagnosed?

A

What there is no relationship between p waves and QRS complexes

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117
Q

What is nitrous oxide known to deplete?

A

B12 levels

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118
Q

What medication is used for rate control in atrial fibrillation when the patient also has heart failure?

A

Digoxin

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119
Q

What is a pancoast tumour and what symptoms would you see if it was right sided?

A

Tumour of the lung apex usually adenocarcinoma
Can interrupt the sympathetic nerve therefore disrupt supply to eye and facial muscles - ptosis, miosis and anhidrosis

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120
Q

What factor would make a patient eligible for lung reduction surgery for COPD?

A

Predominant upper lobe emphysema

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121
Q

What is a common drug used in psoriasis management?

A

Ciclosporine

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122
Q

What skin condition is associated with TB?

A

Erythema nodosum

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123
Q

What is the treatment for actinic keratosis?

A

Topical 5-fluorouracil

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124
Q

What is fusic acid used to treat?

A

Bacterial skin infections - impetigo/cellulitis

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125
Q

What is yellow frothy vaginal discharge a sign of?

A

Trichomoniasis

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126
Q

What is koebner’s phenomenon?

A

Formation of skin lesion at a prior injury site

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127
Q

What is the antibody seen in myasthenia gravis?

A

Post synaptic acetylcholine receptors

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128
Q

What is the most common mouth cancer?

A

Squamous cell carcinoma

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129
Q

What are the three cardinal features of Menieres disease?

A

Tinitus, deafness and vertigo

130
Q

What is a cholesteatoma?

A

Growth of keratinising squamous cells forming in the attic of the ear, produce chronic foul smelling discharge

131
Q

What type of medication is midodrine?

A

alpha-1-agonist - used for postural hypotension

132
Q

What is chonedrocalcinosis indicative of?

A

Pseudogout

133
Q

What is dresslers syndrome?

A

Secondary pericarditis occurring 1-6 weeks post MI, pleuritic chest pain, low grade fever and pericarditis, worse lying down can show widespread st elevation on ECG
Treat with aspirin

134
Q

What condition of hearing loss allows hearing to improve when there is background noise?

A

Otosclerosis

135
Q

What is a classic presentation of acoustic neuroma?

A

Unilateral deafness, vertigo and left sided lesions of cranial nerves V, IX and X

136
Q

What are steps 1,2 and 3 of the WHO pain ladder?

A

1 - NSAID of paracetamol ( contraindicated in liver impairment)
2 - Codeine/dihydrocodeine
3 - Oral morphine

137
Q

What are the features of CREST syndrome?

A

Raynaud’s phenomenon, oesophageal dysmotility, sclerodactyly, calcinosis, telangiectasia

138
Q

What is typical presentation of reactive arthritis?

A

Dysuria, arthralgia and iritis

139
Q

What is a cobblestone ulcer appearance diagnosis of? Also associated inflamed mucosa with interspersed regions of normal mucosa?

A

Crohn’s

140
Q

What are the values of eGFR for chronic kidney disease stages 1,2, 3a,3b, 4 and 5?

A

1 - <90
2 - 60-89
3a - 45-59
3b - 20-44
4 - 15-20
5 - <15

141
Q

What are the classic symptoms of polymyalgia rheumatica?

A

Shoulder and hip girdle stiffness and pain

142
Q

What medication is used for paracetamol overdose?

A

N-acetylcysteine - for staggered overdose or present later than 1 hour after taking
Activated charcoal - presentations within 1 hour of overdose

143
Q

What hypertension medication should be stopped during hyperkalaemia treatment?

A

Ramipril - causes increase potassium

144
Q

What antidepressant should be stopped during treatment of hyponatraemia?

A

Sertraline / SSRIs

145
Q

What is the classic presentation of myasthenia gravis?

A

Fatiguable weakness that improves upon rest

146
Q

What is a bulls eye rash indicative of?

A

Lymes Disease

147
Q

What is first line treatment of rhabdomyolysis?

A

IV fluids

148
Q

What is Becks triad and what is it used to indicate?

A

Cardiac Tamponade
Distended Neck veins
Low BP
Muffled heart sounds

149
Q

What is the conversion rate for oral morphine to subcutaneous?

A

2:1

150
Q

What type of arthritis is associated with skin and nail changes?

A

Psoriatic arthritis

151
Q

What is the first line medication for hypertension if the patient is above 55 and has diabetes?

A

Ramipril/ACE inhibitor

152
Q

What are yellow plaques and inflammation of bowel mucosa indicative of and how is it treated?

A

Clostridium Difficile
Vancomycin

153
Q

What are epithelial crescents in the glomeruli indicative of?

A

Rapidly progressive glomerularnephritis

154
Q

What are J waves on ECG associated with diagnosis?

A

Hypothermia

155
Q

What is a urea breath test used for?

A

To rule out H.Pylori in cases of dyspepsia which hasn’t improved with lifestyle measures and antacids

156
Q

What is a sharp p wave indicative of?

A

Atrial flutter

157
Q

What presents as a stormy sunset on fundoscopy?

A

Central retinal vein occlusion

158
Q

What medication can never be prescribed with verapamil and why?

A

Beta blockers, causes complete heart block

159
Q

What would an ischaemic stroke in the right posterior cerebral artery present as visually?

A

Left homonymous hemianopia with macular sparing

160
Q

Where would a lesion be seen presenting as right homonymous hemianopia with macular sparing?

A

Left occipital cortex lesion

161
Q

Where would a lesion be seen in right and left homonymous hemianopia?

A

Left and right middle cerebral arteries

162
Q

What is the treatment for pneumocystis pneumonia?

A

Co-trimoxazole

163
Q

What is a renal stone likely made up of if it is radiolucent?

A

Uric acid

164
Q

When is a Parkinson tremor worse?

A

At rest

165
Q

What does hyperaldosteronism usually present as?

A

Mineralocorticoid excess, hypertension that is resistant to multiple agents and hypokalaemia, muscle weakness

166
Q

What is given for tricyclic antidepressant overdose?

A

Sodium bicarbonate

167
Q

What is a surgical third nerve palsy with pupillary involvement caused by?

A

Posterior communicating artery aneurysm

168
Q

What blood level would be raised in statin induced myopathy?

A

Creatine kinase

169
Q

What ophthalmology condition is associated with autoimmune conditions?

A

Episcleritis

170
Q

What are the common causes of sensory peripheral neuropathy?

A

Alcohol toxicity, b12/Folate deficiency, Chronic Renal Failure, Diabetes, vasculitis

171
Q

What is the first line treatment for tornadoes de pointes?

A

Magnesium sulphate

172
Q

What coagulation factors are blocked by warfarin?

A

II, VII, IX, X

173
Q

What clotting factor is haemophilia A associated with?

A

VIII

174
Q

Describe how to calculate the Glasgow score for pancreatitis

A

P - PO2 <8Kpa
A - Age>55
N - Neutrophils WCC 15x109/L
C - Calcium <2mmol/L
R - Renal Function Urea>16mmol/L
E - Enzymes LDH>60iu/L or AST>200iu/L
A - albumin <32g/L
S - Sugar glucose>10mmol/L

175
Q

What does a LABA have to be prescribed with?

A

Inhaled corticosteroid

176
Q

What blood results would you expect to see with primary hyperaldosteronism?

A

Hypernatraemia, hypokalaemia, raised bicarbonate

177
Q

What antibodies are linked to hashimotos thyroiditis?

A

Thyroid peroxidase antibodies

178
Q

What is the treatment for TB?

A

RIPE
Rifampicin
Isoniazid
Pyridoxine
Ethambutol

179
Q

What heart murmur is pan systolic heard loudest in inspiration over the lower sternal edge border?

A

Tricuspid Regurgitation

180
Q

What are the manoeuvres used to examine vertigo and then treat?

A

Examination: Dix-hallpike
Treatment: Emply manoeuvre

181
Q

What are the typical features of chronic pancreatitis?

A

Epigastric pain radiating to the back
Exacerbated by fatty foods + alcohol
Relieved by sitting forwards
Associated with steatorrhoea, weight loss and diabetes

182
Q

What are auer rods on blood film indicative of?

A

Acute myeloid leukaemia

183
Q

What is associated with a bird beak appearance of the oesophagus?

A

Alchalasia

184
Q

What test would be done for confirmation and diagnosis of cystic fibrosis?

A

Sweat test - sweat chloride level >60 mEq/L

185
Q

What HLA is associated with ankylosing spondylitis?

A

HLA-B27

186
Q

What is the first line treatment for idiopathic or viral pericarditis?

A

Colchicine and ibuprofen

187
Q

What is the classic triad of normal pressure hydrocephalus?

A

Urinary incontinence, dementia and gait abnormality

188
Q

If a patient presents to the GP with a dry cough after starting an ACE what medication do you switch it to?

A

Angiotensin Receptor blocker

189
Q

What is the ecg abnormality seen in hypercalcaemia?

A

Shortening of the QT interval

190
Q

What heart failure medication is known to cause ototoxicity?

A

Loop Diuretics

191
Q

What is an example of a medication that can cause Syndrome of Inappropriate ADH Release (SIADH)

A

SSRI - sertraline

192
Q

What would you see on a bone profile on an osteoporotic patient?

A

Normal levels of: calcium, phosphate, alkaline phosphate and PTH

193
Q

What are the two most common valves in infective endocarditis?

A

Tricuspid and Mitral

194
Q

What is the most common cause of spontaneous intracerebral haemorrhage?

A

Hypertensive vasculopathy

195
Q

What are signet ring cells found on biopsy indicative of?

A

Gastric adenocarcinoma

196
Q

What is the statin dose for secondary prevention of cardiovascular disease?

A

80mg

197
Q

What is the triad for haemolytic uraemia syndrome?

A

Raised creatinine, haemolytic anaemia and thrombocytopenia

198
Q

What is the most common cause of encephalitis and the treatment given?

A

HSV - IV acyclovir

199
Q

What is a peripheral neuropathy that has a strong association with diabetes?

A

Mononeuritis Multiplex

200
Q

What are gottrons papules a sign of?

A

Dermatomyositits

201
Q

What is given in a case of aspirin overdose?

A

IV sodium bicarbonate

202
Q

What are alpha blockers used for along side BPH and what may a side effect be if the patient is also taking an antihypertensive?

A

Drop in blood pressure as alpha blockers can also be used to treat high blood pressure

203
Q

How many half lives of a drug does it take to reach a steady state?

A

4-5

204
Q

What bacteria is the most common cause of food poisoning in the UK and how does it arise?

A

Undercooked chicken
Campylobacter jejuni

205
Q

What does clostridium perfringens infection result from?

A

Incubation of 12-24 hours, source is red meat and gravy

206
Q

What is the bacteria in rice that can cause food poisoning and the time frame after eating it?

A

Bacillus cereus
30 mins - 6 hours after eating

207
Q

What does a rubbery non tender lymph node in the neck indicate?

A

Hodgkin Lymphoma

208
Q

What is a crescent shaped area on head CT indicative of?

A

Subdural haematoma

209
Q

What is the treatment for acute diverticulitis?

A

Fluids and antibiotics

210
Q

How long does a person have to have depressive symptoms to be diagnosed with depression?

A

2 weeks

211
Q

What is a double heart border a sign of?

A

Pneumomediastinum

212
Q

What can isoniazid cause as a side effect?

A

Drug induced lupus

213
Q

What is charcots triad and what is it used to diagnose?

A

Fever, jaundice, epigastric pain
Ascending cholangitis

214
Q

What is the initial treatment of lymes disease when a patient is stable?

A

Oral doxycycline 14-21 day course

215
Q

What medication is given for grade 2 oesophageal varicies?

A

Non- selective beta blocker

216
Q

What is the first line prevention for cluster headaches?

A

Verapamil

217
Q

What blood results if raised would indicate sarcoidosis?

A

ESR and hypercalcaemia

218
Q

Where are femoral hernias typically found?

A

Inferiorlateral to pubic tubercle

219
Q

Where are inguinal hernias typically found?

A

Superiormedial to pubic tubercle

220
Q

What are the two medications for the first line treatment of gout?

A

Colchicine and NSAIDs however NSAIDs are contraindicated in renal disease

221
Q

What is the primary site of metastasis of renal cancer?

A

Blood

222
Q

What medication is indicated to reduce cerebral oedema in hepatic encephalopathy?

A

IV mannitol

223
Q

What amount of glucose would be given to an unconscious patient with IV access who has a bm of 1.7 mmol/L?

A

100ml of 20% glucose IV

224
Q

What is the concentration of adrenaline given in anaphylaxis?

A

1:1000
500microgramms
IM

225
Q

What would an aspirin overdose present as and what is the treatment?

A

Respiratory alkalosis
Metabolic Acidosis
Activated charcoal if ingested <1 hour previous
Fluids
Sodium bicarbonate
Potassium chloride

226
Q

What would methylmalonic acid and anti-intrinsic factor antibody be used to assess and why?

A

Measure of functional B12 status - can be used to help diagnose pernicious anaemia when serum B12 is normal

227
Q

What is the difference between Supraventricular tachycardia and atrial fibrillation on ECG?

A

Both are narrow complex tachycardia with no p waves
Key difference is AF is irregular rhythm whereas SVT is regular

228
Q

What stage of sympathetic transmission does cocaine interfere?

A

Reuptake of noradrenaline into presynaptic neurone

229
Q

What blood test is the most sensitive for acute pancreatitis?

A

Lipase

230
Q

What medication is used to treat a tricyclic overdose?

A

Intravenous bicarbonate

231
Q

What are the lobes causing superior vs inferior homonymous quadrantonopias?

A

Parietal- Inferior
Temporal - Superior
PITS

232
Q

What type of dementia causes a personality change and what would be seen histologically in the persons brain?

A

Frontal Lobe dementia - Tau bodies

233
Q

Where in the brain would an injury result in homonymous hemianopia?

A

Occipital

234
Q

What symptoms make up a Total anterior circulation stroke?

A

All 3 of:
- Unilateral and or sensory deficit of the face, arm and leg
- Homonymous hemianopia
- Higher cerebral dysfunction - dysphasia, visuospatial disorder

235
Q

What symptoms make up a partial anterior circulation stroke?

A

Two of:
- Unilateral and or sensory deficit of the face, arm and leg
- Homonymous hemianopia
- Higher cerebral dysfunction - dysphasia, visuospatial disorder

236
Q

What symptoms would diagnose a posterior circulation stroke?

A

1 of:
- Cranial nerve palsy and contralateral motor/sensory deficit
- Bilateral motor/sensory deficit
- Conjugate eye movement disorder
- Cerebellar dysfunction
- Isolated dysfunction - ataxia, nystagmus, vertigo
- Isolated homonymous hemianopia or cortisol blindness

237
Q

Which TB medication causes toxic optic neuropathy?

A

Ethambutol

238
Q

What bacteria is the most common to cause an infective exacerbation of COPD?

A

Haemophilus Influenzae

239
Q

What antibodies would be present in primary biliary cholangitis/cirrhosis?

A

Antimitochondrial antibodies

240
Q

What antibodies are present in dermatomyositis and polymyositis?

A

Anti-Jo antibodies

241
Q

What disease is associated with anti centromere antibodies?

A

CREST syndrome

242
Q

What electrolyte abnormality is the most important direct consequence of refeeding syndrome ?

A

Hypophosphataemia

243
Q

What are the features of multiple myeloma?

A

CRAB
Calcium - raised
Renal failure
Anaemia
Bone lesions

244
Q

What pattern of oedema is associated with nephrotic syndrome ?

A

Scrotal and occular oedema

245
Q

What is the management of molluscum contagiosum?

A

Watch and wait

246
Q

What is the most common tumour of the parotid gland ?

A

Pleomorphic adenoma

247
Q

What part of the QRS complex is used for synchronisation?

A

R wave

248
Q

What medication is used for migraine prophylaxis?

A

Propranolol

249
Q

What is the score used to assess pancreatitis?

A

Modified Glasgow coma score

250
Q

What ecg change is seen in myocarditis?

A

T wave inversion, ST changes and sinus tachycardia

251
Q

What is given to treat an acute flair up of MS to reduce the severity olf attack?

A

IV methylprednisolone

252
Q

What can give urine a very red appearance after a fall with a long lie?

A

Myoglobinuria

253
Q

What type of brain haemorrhage is associated with autosomal dominant polycystic kidney disease?

A

Subarachnoid

254
Q

What herpes virus is most likely to form cold sores on the lips/mouth?

A

HSV1

255
Q

What herpes virus is most likely to form ulcers on the genitals?

A

HSV2

256
Q

How would molluscum contagiosum be described?

A

Small round pearly lesions with a central area of umbilication

257
Q

What are the normal ECG intervals?

A

R-R = 0.6-1.2 seconds
PR = 120-200 milliseconds

258
Q

What medication is useful in the treatment of involuntary fasciculations seen in Huntingtons?

A

Tetrabenazine

259
Q

What is flumnazenil used for?

A

Reverse action of benzodiazepines

260
Q

What is ancanthosis nigricans associated with?

A

Insulin resistance and stomach cancer

261
Q

What skin condition is associated with IBD?

A

Pyoderma Gangrenosum

262
Q

What is a ‘bamboo spine’ on X-ray indicative of?

A

Ankylosing spondylitis

263
Q

What method is used to decrease confounding variables in research ?

A

Randomisation

264
Q

What is the time frame from onset of stroke symptoms to thrombolysis ?

A

4.5 hours

265
Q

What medication is used for urge incontinence?

A

Oxynbutynyn

266
Q

What medication is used for stress incontinence?

A

Duloxetine

267
Q

What is a classic distinguishing feature of bacterial conjunctivitis?

A

Purulent discharge

268
Q

What cell is type 4 hypersensitivity mediated by?

A

T-lymphocytes

269
Q

What investigation would be used for PE if the patient has kidney disease?

A

VQ scan

270
Q

What is used as treatment for hepatic encephalopathy?

A

Lactulose

271
Q

What is the treatment for acute angle closure glaucoma?

A

Pilocarpine 4% eye drops

272
Q

What are urinary bence jones proteins a sign of?

A

Multiple myeloma

273
Q

What common side affect are calcium channel blockers known to have?

A

Leg swelling

274
Q

What is the preffered treatment for subarachnoid haemorrhage from burst PCA aneurysm?

A

Endovascular coiling

275
Q

What heart affect is strongly associated with cocoaine use?

A

Coronary artery vasospasm

276
Q

What tb medication causes changes to urine and sweat colour?

A

Rifampicin

277
Q

What bacteria causes rheumatic fever?

A

Streptococcus pharyngitis

278
Q

What is the most common type of melanoma?

A

Superficial

279
Q

What bacteria is causative of guillan barre syndrome?

A

Campylobacter jejuni

280
Q

What is important testing to be completed before biologics initiation?

A

Quantiferon test for TB

281
Q

What electrolyte disturbance can be seen with PPI use?

A

Hyponatraemia and hypomagnesemia

282
Q

What is the treatment pathway for a patient that is haemodynamically unstable with broad complex ventricular tachycardia?

A

Synchronised DC shocks followed by Amiodarone

283
Q

What medication can be used to manage beta blocker overdose?

A

Glucagon

284
Q

Describe secondary hyperthyroidism

A

High TSH, T3 and T4
Feedback loop to reduce TSH has been lost

285
Q

How can pancreatic abscess and pancreatic pseudocyst be differentiated?

A

Pseudocyst 4 weeks post pancreatitis
Abscess 3 weeks post pancreatitis

286
Q

What other electrolyte abnormality is seen alongside severe hypokalaemia?

A

Hypomagnesiaemia

287
Q

What is coffee bean sign indicative of?

A

Sigmoid volvulus

288
Q

What is the most likely organism to cause haemolytic uraemic syndrome?

A

E.Coli

289
Q

What is first line treatment for trigeminal neuralgia?

A

Carbemapezine

290
Q

What is the staging system for melanoma called?

A

Breslow

291
Q

What medication is given in severe hypoglycaemia?

A

IV 10% Dextrose

292
Q

What is a factor that gives a better prognosis for ALL?

A

Hyperdiploid Blast cells

293
Q

What is the most common visual defect for optic neuritis?

A

Central scotoma

294
Q

What is the management of a non-haemolytic transfusion reaction?

A

Slow down transfusion and add paracetamol

295
Q

What lobes of the brain are brocas and wernickes areas?

A

Brocas - frontal
Wernickes - temporal

296
Q

What is the treatment regime for acute limb ischaemia?

A

Intravenous heparin bolus followed by infusion
Then urgent embolectomy if required

297
Q

What is riglers sign/double wall sign of the bowel indicative of?

A

Pneumoperiteneum
Both sides of the bowel wall are visualised

298
Q

What is the treatment for acute ottitis externa?

A

Acetic acid drops

299
Q

What medication can be given during cardiac arrest if amiodarone isn’t present?

A

Lidocaine

300
Q

What is the most common ECG change in acute PE?

A

Sinus Tachycardia

301
Q

What dermatological condition is described as having a christmas tree pattern of distribution?

A

Pityriasis rosacea

302
Q

What opthalmology condition is characterised by mild photophobia and blurred vision alongside wearing contact lenses and the management?

A

Bacterial keratitis
Topical broad spectrum antibiotics and urgent opthalmology refferal

303
Q

What test is used to identify haemolytic anaemia?

A

Direct Coombs test

304
Q

What is the first line treatment for autoimmune haemolytic anaemia?

A

Corticosteroids

305
Q

What is the inheritance pattern of polycystic kidney disease?

A

Autosomal dominant

306
Q

What are the histological features of barrets oesophagus?

A

Columnar epithelium in the gastro-oesophageal junction with evidence of metaplasia

307
Q

What tests should be performed before starting statins?

A

Thyroid function tests - hypothyroidism is an irreversible cause of high cholesterol

308
Q

What is the mechanism of action of viagra?

A

cGMP activation

309
Q

What is the mechanism of action of viagra?

A

cGMP activation

310
Q

What conditions is adenosine contraindicated in?

A

Asthma, COPD, third degree heart block, decompensated heart failure

311
Q

What level of blood pressure is contraindicated in thrombolysis?

A

180/110 and above

312
Q

Which lobe in the brain would a seizure present with fidgeting ie playing with clothes and lip smacking?

A

Temporal lobe

313
Q

Which lobe in the brain would a seizure present with fidgeting ie playing with clothes and lip smacking?

A

Temporal lobe

314
Q

Which lobe in the brain would a seizure present with visual hallucinations and temporary blindness?

A

Occipital

315
Q

Which lobe in the brain would a seizure present with uncontrollable extreme emotions, todds paralysis and urinary incontinence post seizure?

A

Frontal Lobe

316
Q

Which lobe in the brain would a seizure present with tingling, numbness or auditory hallucinations?

A

Parietal Lobe

317
Q

If a hernia protrudes on coughing when there is a hand between the pubic tubercle and ASIS what type of hernia does it indicate?

A

Direct inguinal hernia

318
Q

What is the first line treatment in myasthenia gravis?

A

Cholinesterase inhibitor

319
Q

What does rusty sputum colour indicate?

A

Pneumococcal Pneumoniae

320
Q

What is the composition of a staghorn renal calculus?

A

Striuvate

321
Q

What investigation is used to diagnose optic neuritis?

A

MRI

Year 3 Medicine Leeds (15 decks)

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