General Medicine

Question 1

Polygonal, violaceous papules on flexor aspect of forearm is most likely to be?

Answer 1

Lichen planus
- T-cellmediated auto-immunedisorderin which inflammatory cells attack an unknownproteinwithin the skin and mucosalkeratinocytes

Question 2

Conductive hearing loss, tinnitus and positive family history makes you think of?

Answer 2

Otosclerosis

Onset is usually at 20-40 years - features include:
• Conductive deafness
• Tinnitus
• TM - usually normal tympanic membrane; but 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia
• Positive family history

Question 3

Which is 1st line fluid solution in septic adult patient with AKI

Answer 3

Plasmalyte
- Less RRT requirement, hyperK and acidosis with balances crystalloid (vs. normal saline)