Extra- passmed

Question 1

Intestinal angina (or chronic mesenteric ischaemia) presentation

Answer 1

Intestinal angina (or chronic mesenteric ischaemia) is classically characterised by a triad of severe, colicky post-prandial abdominal pain, weight loss, and an abdominal bruit - by far the most common cause is atherosclerotic disease in arteries supplying the GI trac

Question 2

Dupuytren’s contracture specific causes

Answer 2

Dupuytren’s contracture has a prevalence of about 5%. It is more common in older male patients and around 60-70% have a positive family history

Specific causes include:
* manual labour
* phenytoin treatment
* alcoholic liver disease
* diabetes mellitus
* trauma to the hand

Question 3

Dupuytren’s contracture features and examination findings

Answer 3

The ring finger and little finger are the fingers most commonly affected

” On examination, there is a palpable nodule in the palm of his hand, and the ring finger is flexed at the proximal interphalangeal joint. Sensation in the palm is intact. He does not report any other symptoms”

Question 4

Dupuytren’s contracture management

Answer 4

consider surgical treatment of Dupuytren’s contracture when the metacarpophalangeal joints cannot be straightened and thus the hand cannot be placed flat on the table

Question 5

LFTs result difference in hepatocellular vs cholesatic disease and paracetamol overdose

Answer 5

Question 6

Cyclizine: use with caution in patients with…

Answer 6

Cyclizine: use with caution in patients with heart failure as it may cause a fall in cardiac output

Question 7

….prophylaxis is recommended in COPD patients who meet certain criteria and who continue to have exacerbations

Answer 7

Azithromycin prophylaxis is recommended in COPD patients who meet certain criteria and who continue to have exacerbations

Question 8

…may arise in a lung cavity that developed secondary to previous tuberculosis

Answer 8

An aspergilloma may arise in a lung cavity that developed secondary to previous tuberculosis

Question 9

aspergilloma definiton
…most commonly secondary to…

Answer 9

An aspergilloma is a mycetoma (mass-like fungus ball) which often colonises an existing lung cavity (e.g. secondary to tuberculosis, lung cancer or cystic fibrosis).

Question 10

aspergilloma symptoms

Answer 10

Usually asymptomatic but features may include
cough
haemoptysis (may be severe)

Question 11

aspergilloma investigations and results

Answer 11

Investigations
* chest x-ray containing a rounded opacity. A crescent sign may be present
* high titres Aspergillus precipitins

“An X-ray is taken which shows a target-shaped lesion in the right upper lobe with air crescent sign present”