General Passmed Flashcards
1
Q
What is the first line management for osteoporosis in a patient with stage 4 kidney disease?
A
Denosumab
2
Q
What is the most common virus causing otitis externa?
A
Pseudomonas aeurginosa
3
Q
What are the insulin carbohydrate ratios used for type 1 diabetes?
A
Breakfast: 1unit for 8g carbohydrate
Lunch: 1 unit for 10g carbohydrate
Dinner: 1 unit for 15g carbohydrate
Snacks: 1 unit for 12g carbohydrate
4
Q
What bloods monitoring is required for amiodarone use?
A
TFTs and LFTs every 6 months
5
Q
What thyroid disorder can cause menorrhagia?
A
Hypothyroidism
6
Q
What is the first line treatment for suborrheric dermatitis?
A
Topical ketoconazole
7
Q
What changes on ECG in hypokalaemia?
A
U waves
8
Q
What is cradle cap know as medically?
A
Seborrheric dermatitis
9
Q
What is the required monitoring when lithium doses are changed?
A
One week after dose change then weekly until levels are stable
10
Q
What is firstline medication for lactation suppression?
A
Cabergoline
11
Q
What cardiac defect in child with mother taking lithium?
A
Abstains anomaly
12
Q
What criteria us used to assess for septic arthritis in children?
A
Kocher score
13
Q
What medication reverses the action of midazolam?
A
Flumazenil
14
Q
What antidepressant is used to help mood and increase appetite?
A
Mirtazapine
15
Q
When is baby blood spot screening done after birth?
A
Between day 5-9 of life
16
Q
What is the muscle relaxant of choice for rapid sequence induction?
A
Suxamethonium
17
Q
Can aspirin be taken during breastfeeding?
A
No should be avoided - associated with Reyes syndrome
18
Q
What are the first rank symptoms of schizophrenia?
A
Auditory hallucinations, thought broadcasting, thought withdrawal, delusional perceptions, somatic hallucinations,
19
Q
What is the conversion between codeine and morphine?
A
Codeine to morphine = x0.1
20
Q
What location of ectopic pregnancy is most likely to rupture?
A
Isthmus
21
Q
How many hours after lithium dose should lithium test be taken?
A
12 hours
22
Q
What is an alternative first line medication for OCD treatment thats not an SSRI?
A
Clomipramine - tricyclic
23
Q
What period of pregnancy is Down syndrome nuchal screening done?
A
11-13+6 weeks
24
Q
How long should antidepressants be continued when in remission?
A
6 months
25
How long before conceiving once patient stops methotrexate for RA?
6 months
26
How long is allowed for a category 2 c-section, from decision to birth?
75 minutes
27
What results from the combined test would indicate a high chance of downs syndrome?
Thickened nuchal translucency, increased B-HCG and reduced PAP-A
28
Is an IUS contraindicated in PID?
Yes
29
What are the indications for an ectopic pregnancy to be managed surgically?
Size>35mm or serum B-hCG >5000
30
What is circumstantiality?
Inability to answer a question without giving excessive unnecessary detail
31
What is tangentiality?
Wandering from a topic without referring to it
32
What would a baby who is high risk for hep b need post birth?
Hep b vaccine and 0.5ml of HBIG within 12 hours of birth with a further hepatitis vaccine at 1-2 months and further vaccine at 6 months
33
What are small testes in precocious puberty a causal sign of?
Adrenal cause of symptoms
34
What would you prescribe alongside SSRI and NSAID?
PPI
35
Where is the most likely primary tumour site of a woman with bone metastases?
Breast
36
How do you calculate breakthrough pain med dose?
1/6 of daily med dose
37
What type of cancer does COCP increase the risk of?
Cervical
38
What is the screening tool for post party depression?
Edinburgh Scale
39
What is exon-halos and diaphragmatic hernia associated with in Paeds GI?
Malrotation
40
When can you start taking COCP post birth?
After 6 weeks post birth and at least half bottle fed baby
41
What gender is perthes disease more common in?
5 times more common in boys
42
What medication would you stop in 2nd degree heart block?
Beta blockers, calcium channel blockers
43
What is the medical term for threadworms?
Enterobius Vermicularis
44
What chemo causes low magnesium?
Platinum based chemotherapy
45
What cut off is used to determine iron supplementation postpartum?
100g/L
46
What does hyperhsegmented neutrophils indicate?
Megaloblastic anaemia - B12 or folate deficiency
47
What does a raised immunoreactive trypsinogen indicate?
Need for sweat test - seen in CF
48
What heart defect is seen most common in turners syndrome?
Bicuspid aortic valve
49
What class of medication can cause acute dystonic reaction?
Typical antipsychotics
50
What antipsychotic is best in treating negative symptom schizophrenia?
Clozapine
51
What personality disorder is characterised by liking being on your own and not forming close relationships with others?
Schizoid
52
What procedure is used for intestinal malrotation with volvulus?
Ladd's Procedure
53
What antipsychotic reduces seizure threshold?
Clozapine
54
What genetic disorder causes macrocephaly in males?
Fragile X syndrome
55
What is the difference between knights move and flight of ideas?
Knight's move thinking there are illogical leaps from one idea to another, flight of ideas there are discernible links between ideas
56
What is the calculation for age of corrected premature baby milestones?
Age minus number of weeks they were born early from 40
57
When do you repeat smear if sample is inadequate?
3 months later
58
What is the most common cause of stricter in children?
Laryngomalacia
59
Where in the brain would be significant in dyskinetic cerebral palsy?
Basal Ganglia and substantial nigra
60
what does maternal CMV present in with neonates?
Hearing loss, low birth weight, petechial rash, microcephaly and seizures
61
When should triptans be avoided In patients and why?
Patients taking SSRI's, causes serotonin syndrome
62
Describe alcohol withdrawal in relation to hours after last drink?
Symptoms - 6-12 hours
Seizures - 36 hours
Delirium Tremens - 72 hours
63
What is second line medication for GAD after sertraline?
Duloxetine
64
What medication is used to treat tar dive dyskinesia?
Tetrabenazine
65
What is the most likely cause of umbilical cord prolapse?
Artificial rupture of membranes
66
What genetic condition is associated with neonatal hypotonia?
Trader Wili
67
What is the most likely psychiatric medicine to cause torsades de pointes?
Citalopram
68
What genetic condition can be described as a child having rocker bottom feet?
Edward's syndrome
69
What scale can be used to assess postnatal depression?
Edinburgh scale
70
What are normal lab findings in pregnancy?
Reduced urea, reduced creatine and increased protein urinary loss
71
What is CA15-3 indicative of?
Breast cancer
72
What should be monitored with venlafaxine?
Blood Pressure
73
What should be monitored with citalopram?
ECG - can cause prolongation of QT
74
What is an important contraindication with Ella one?
Patients with asthma should avoid it
75
What is the most common benign ovarian tumour in women under 25?
Dermoid cyst - teratoma
76
What is gold standard investigation for hirchprungs?
Rectal biopsy
77
What BMI indicates the need for a higher dose of folic acid?
Greater than 30
78
What is the first line antidepressants for PPD in breast feeding mothers?
Paroxetine or sertraline
79
What cancer is associated with tamoxifen use?
Endometrial Cancer
80
What is the treatment for vaginal vault prolapse?
Sacrocolpopexy
81
What birth defect can be associated with SSRI use in pregnancy?
Congenital heart defects
82
What is a good anaesthetic agent for harm-dynamically unstable patients?
Ketamine
83
What is a scaphoid abdomen indicative of in a newborn?
Diaphragmatic hernia
84
When would you rescan for a low lying placenta seen at 20 week scan?
32 weeks
85
What is the school exclusion process for hand foot and mouth disease?
No need to stay off school
86
What brain damage is present in spastic cerebral palsy?
Upper motor neurones in the periventricular white matter
87
How do NSAIDs affect bone healing?
Slow it down
88
What is the time frame for review of a patient under 25 started on an SSRI?
Review after 1 week
89
What is the SSRI choice for a patient with unstable angina?
Sertraline
90
What are the first rank symptoms of schizophrenia?
Auditory hallucinations:
- hearing thoughts spoken aloud
- hearing voices referring to himself / herself, - made in the third person
- auditory hallucinations in the form of a commentary
Thought withdrawal, insertion and interruption
Thought broadcasting
Somatic hallucinations
Delusional perception
Feelings or actions experienced as made or influenced by external agents
91
What is the school exclusion criteria for roseola infantum?
No exclusion required
92
What is a side effect of etomidate to be aware of?
Adrenal suppression
93
How long can a pregnancy test be positive for following termination of pregnancy?
4 weeks
94
What is the name of the childhood heart murmur that is described as a continuous blowing noise heard below clavicles?
Venous hum
95
What is the association between smoking and hyperemesis?
Decreases incidence
96
Within how long should a category 2 c section be done?
75 mins
97
Within how long should a category 1 c section be done?
30 mins
98
What investigation would you not do in meningococcal septicaemia?
Lumbar puncture
99
What is the management of a patient with ventricular tachycardia who is harm-dynamically stable?
Amiodarone
100
What is the management of mania if patient is already on sertraline?
Stop sertraline and add an antipsychotic for example olanzapine
101
How long should magnesium infusion be fore after eclamptic seizure?
24 hours after last seizure
102
What is the cut off for iron supplementation post partum?
100
103
When in sle/antiphospholipid syndrome pregnant women take aspirin and how much?
75mg from 12 weeks until birth
104
What is a complication in a foetus with alpha thalasaemia?
Hydrops fetalis
105
In tof what determines the clinical severity?
Degree of pulmonary stenosis
106
What is the condition associated with infantile spasms?
West Syndrome
107
What is the most common side effect of ADHD medication?
Stunted growth
108
What is a big risk factor for placental abruption?
Polyhydramnios
109
How should long acting insulin be changed prior to surgery?
Reduced by 20%
110
What baby weight is macrosomia?
4 kg +
111
When is anaemia screening done in pregnancy?
Booking appointment and at 28 weeks
112
What is the difference between bipolar type 1 and 2?
Type 1 - full mania lasting 7 days
Type 2 - hypomania
113
What are the risks of using ondansetron in pregnancy?
Small risk of cleft lip/palate if used in first trimester
114
What is the school exclusion for rubella?
5 days from onset of rash
115
What is the school exclusion for scarlet fever?
24 hours after antibiotics
116
What is the school exclusion for whooping cough?
2 days after antibiotics
117
What is the school exclusion for measles?
4 days from onset of rash
118
What is the school exclusion for mumps?
5 days from onset of swollen glands
119
What is the school exclusion for impetigo?
Until lesion is crusted and healed or 48 hours after commencing antibiotic treatment
120
What type of gait may a child with developmental dysplasia of the hip have?
Trendelenburg
121
What is the electrolyte acid base imbalance seen in pyloric stenosis?
Hypochloremic, hypokalaemic metabolic alkalosis
122
What type of vaccine is rotovirus?
Oral Live attenuated vaccine
123
What electrolyte disturbance can suxemethonium cause?
Hyperkalaemia
124
What happens to blood pressure in pregnancy?
Falls in first half of pregnancy before rising to pre-pregnancy levels before term
125
What age would you expect infantile colic to improve by?
6 Months
126
What signs in the eyes can be seen in Kawasaki?
Conjunctival injection
127
What is a muscarinic antagonist used in urge incontinence if bladder retraining is unsuccessful?
Tolterodine, oxybutynin and solifenacin
128
What would abstains anomaly be described as on echocardiogram?
Right atrial hypertrophy and the septal and posterior leaflet of the tricuspid valve attached to the right ventricle
129
What is the likely quadruple results seen in pateaus?
Decreased AFP
Decreased Unconjugated oestriol
Decreased hCG
Increased Inhibin A
130
What can ssri cause ie electrolyte imbalance especially in elderly?
Hyponatraemia
131
What is adenosine use contraindicated?
Patients with asthma - causes bronchospasm
132
What dose of adenosine is used in stable patients with svt?
6mg
133
What is the triad associated with phaeochromocytoma and what medication would be given prior to surgery ?
Headache, sweating and palpitations
Phenoxybenzamine
134
What is the first line management for cluster headaches?
Triptans and high flow oxygen
135
What is the management of a patient in ventricular tachycardia that has not responded to DC cardio version and adrenaline?
300mg Amiodarone initially then 150mg bolus
136
What is the first line medication for spasmodic pain in cancer patients?
Diazepam
137
What vaccines are offered in pregnancy between week 16 -32?
Influenza and pertussis
138
What is the earliest time an LP can be done after onset of subarachnoid haemorrhage?
12 hours
139
What type of hypersensitivity is anaphylaxis?
Type 1
140
What is used to stage endometrial and ovarian cancers?
FIGO staging
141
What is CIN3 also known as and how would you describe the histological findings?
Carcinoma in situ
The full thickness of the cervical epithelium is affected by abnormal cells
142
What is the most common cause of gastroenteritis?
Rotavirus
143
144
What medication is given to elderly patients with urge incontinence?
Mirabegron
145
What's the first line antiemetic for intracranial associated disease?
Cyclizine
146
In paediatric asthma what is the next addition after montelukast?
Salmeterol and stop montelukast
147
What can Long term use of atypical antipsychotic lead to?
High glucose/diabetes
148
What enzymes can be used to assess pancreatitis diagnosis with later presentation?
Lipase
149
What are the classic symptoms of seretonin syndrome?
Triad of mental status changes, autonomic hyperactivity, and neuromuscular abnormalities
150
What is the rate insulin should be given in dka?
0.1 units/kg/hour
151
How can smoking affect clozapine level in the body?
Cessation increases level
152
What genetic condition is associated with neonatal hypotonia?
Prader will
153
What is the quadruple result for Edwards syndrome?
↓ AFP
↓ oestriol
↓ hCG
↔ inhibin A
154
How would rubella be described?
Developed a pink maculopapular rash initially on the face before spreading. Suboccipital lymph nodes are also noted
155
How could scarlet fever be described?
Fever and a sore throat. Examination reveals tonsillitis and a furred tongue with enlarged papillae. There is a blanching punctate rash sparing the face
156
What are the downs results for quadruple test?
↓ AFP
↓ oestriol
↑ hCG
↑ inhibin A
157
What is the first line treatment of manic episode?
Quetiapine
158
What type of cancer is superior vena cava obstruction most likely in?
Lung cancer
159
What is the mechanism of action of atypical antipsychotics?
Dopamine antagonists
160
What medication overdose is associated with wide QRS on ecg?
Tricyclic antidepressant
161
What are the common drugs that can precipitate digoxin toxicity?
Thiazides, amiodarone, calcium channel blockers, and quinidine.
162
What is the dose of adrenaline used in cardiac arrests?
1mg
163
What antiemetics can be used in Parkinson's patients?
Cyclizine and ondansetron
164
What BMI indicates the need for oral glucose tolerance test in pregnancy?
Over 30
165
How long after the start of phototherapy for high bilirubin do you check the bill levels again?
4-6 hours
166
If a patient presents to gp with suspected meningitis what do you do?
Give IM benzylpenicillin and send to hospital
167
What is the treatment for thyrotoxic storm if pregnant over 16 weeks?
Carbimazole
168
How long after surgery can you restart cocp?
2 weeks
