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1
Q

legal highs ECG

A

SVT

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2
Q

ECG with U waves, look out for

A

hypokalaemia

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3
Q

hyperK mx

A

Ca gluconate

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4
Q

pic eye in sink

A

pareidolia

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5
Q

guy in underwear, enlarged hands with headache

most likely accompanying symptom + Dx

A

visual disturbance // acromegaly

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6
Q

Tx of CT IC mass w/ symptoms

A

dexamethasone

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7
Q

post-op px with significant blood loss intra-operatively

A

pulm. oedema due to fluid overload

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8
Q

hyperCa anti-emetic of choice

A

haloperidol

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9
Q

pic uterine fibroid. most likely symptom

A

menorrhagia

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10
Q

anti-emetic in gastric stasis

A

metoclopramide (if colicky pain –> hyoscine butylbromide)

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11
Q

suicidal px wants to leave the ward. known hx depression. which MHA?

A

find out if 2 or 3

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12
Q

px with 17-hydroxylase deficiency (congenital adrenal hyperplasia)

A

DDx salt-water crisis from hypertensive encephalopathy (probs this)

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13
Q

when can baby sit unsupported

A

9m

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14
Q

LA to give in hysterectomy

A

bupivacaine (longest acting?)

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15
Q

HbA1C of 50 with no symptoms. next step

A

repeat in 30mins? 1 week?

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16
Q

changes to T1DM insulin prior to surgery

A

reduce by 20% the day before

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17
Q

child w/ constipation where movicol didn’t work

A

lactulose

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18
Q

refractory depression & self neglect mx

A

ECT

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19
Q

OCD px mx

A

ERP

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20
Q

lost sensation in hands & legs after car accident

A

conversion disorder

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21
Q

lady presents to GP with myriad symptoms over 3 years with no findings

A

somatisation

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22
Q

post-depression tx, now wants to work on her problems, dealing with grieving for her deceased mother & improve relationship with children. what therapy

A

interpersonal therapy

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23
Q

guy taking lithium + amitryptilline + SSRI. experience symptoms (tremor, tachycardia)

A

lithium toxicity or serotonin syndrome

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24
Q

prim lady 1hr in 2nd stage labour, baby at -2 station. what next

A

?c-sec

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25
Q

lady ran 2 marathons, lanugo hair

A

anorexia nervosa

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26
Q

px with hashimoto’s. what associated condition?

A

coeliac disease

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27
Q

cancer screened in men

A

bowel

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28
Q

MSM, what tests to do

A

3 site test

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29
Q

pink gram stain diplococci mx

A

IM ceftriaxone (gonorrhoea)

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30
Q

growth chart showing macrosomia. what condition

A

gestational diabetes

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31
Q

perineal tear, muscle involved, sphincter spared

A

2nd degree

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32
Q

male with clear penile discharge. organism

A

candida // chlamydia

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33
Q

picture of laproscopy with adhesions

A

chlamydia or gonorrhoea

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34
Q

gowers positive, inheritance pattern

A

x-linked recessive

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35
Q

candida in pregnancy

A

vaginal clotrimazole

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36
Q

asthmatic lady feeling anxious. ABG shows hypoxia & hypocapnia. asthma or anxiety

A

asthma (hypoxia)

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37
Q

how to alleviate deteriorating COPD with BiPAP

A

probs reduce (see aaqid response)

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38
Q

FBS pH 7.23. what next

A

repeat in 30mins

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39
Q

CKD, got AKI, pH 7.16. what next

A

renal replacement therapy

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40
Q

drug chart filled out wrong, less morphine than needed. what will happen?

A

pain

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41
Q

efast indications

A

penetrating chest trauma etc

NOT DEFINITIVE Dx

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42
Q

endometrial tissue in myometrium

A

adenomyosis

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43
Q

restrictive lung disease O2 support

A

find out

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44
Q

electrolyte to check to prevent seizures

A

sodium vs magnesium

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45
Q

most common TCA SE

A

dry mouth (others include blurred vision, drowsy, tachycardia)

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46
Q

difficulty swallowing from birth

A

laryngomalacia

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47
Q

best anti-depressants for bulimia

A

fluoxetine

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48
Q

tx Duke C bowel cancer

A

adjuvant chemo

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49
Q

started on lithium but then came issues, what med to stop

A

fluoxetine

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50
Q

woman says husband has been replaced

A

copgras

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51
Q

lifestyle protective factor against N/V

A

smoking

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52
Q

overdose with dilated pupils, hypotension, tachycardia

A

TCA

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53
Q

E coli UTI in 5 year old imaging?

A

nope

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54
Q

cancer with mets in brain & lungs mx

A

chemotherapy

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55
Q

rectal cancer on chemo, vomit dark blood & not opened bowel or passed flatus

A

large bowel obstruction

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56
Q

cancer most likely to have cause SVCO in non-smoking guy

A

NSC lung cancer

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57
Q

smoker & shipyard worker cancer

A

mesothelioma

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58
Q

inferior STEMI drug to give

A

aspirin

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59
Q

what is used to monitor HIV progression

A

viral load

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60
Q

UTI antibiotic in someone on methotrexate

A

nitrofurantoin (trimethoprim can increase risk of bone marrow suppression)

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61
Q

Squint exam which a picture of how eye is more lateral, does not move when covered. Then the opposite eye when covered moves laterally and bad eye is centred

A

manifest convergent

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62
Q

Down’s neonate not passed meconium after 3 days, best initial investigation

A

abdo XR

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63
Q

Bronchiolitis kid not eating half their feeds and oxygen normal

A

NG tube

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64
Q

Cancer patient with N/V. Lots of nausea and frequently vomiting, which antiemetic

A

haloperidol

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65
Q

N/V cancer patient on morphine

A

levomoprmazine?

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66
Q

initial vs definitive intussusception mx

A

pneumatic reduction –> laparotomy

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67
Q

mirena most common side effect

A

irregular bleeding

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68
Q

Which vaccine not to give in a kid with HIV

A

MMR

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69
Q

Early morning headache in a kid but no tumour on scan

A

idopathic IC HTN

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70
Q

Kid coughing and gets apnoea, lymphocytosis

A

pertussis

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71
Q

Woman had 1 miscarriage, 2 vaginal births, 1 stillborn, 1 LSCS for twins (counts as one) and currently pregnant, what is her gravidity

A

6

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72
Q

Foetus at right occipito anterior, what to do

A

c-sec

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73
Q

Woman just started COCP and now post coital bleeding

A

ectropion

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74
Q

Post-partum contraception

A

nexplanon (?)

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75
Q

Man is dying from cancer and cannot be roused, family there and need DNACPR. who signs?

A

consultant

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76
Q

At what age can a kid draw a square

A

4

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77
Q

Kid with stridor and facial swelling

A

OXYGEN FIRST THEN ADRENALINE

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78
Q

Woman had eye pain and now arm feels like it is burning and loss of gait

A

multiple sclerosis

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79
Q

Woman in shock after giving birth but no blood

A

intraperitoneal haemorrhage vs uterine atony

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80
Q

Which antibiotic to give to a chemotherapy patient with neutropenic sepsis, confirmed to be E coli in bloods and lines have been swabbed

A

tazocin –> meropenem if ESBL

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81
Q

what to give with morphine for cancer px

A

senna (or docusate?)

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82
Q

what to give for breathing problems in cancer

A

morphine

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83
Q

COPD patient in very bad state on non-re-breathe, oxygen unrecordable. what next?

A

ABG

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84
Q

Well’s 3

A

D dimer

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85
Q

Woman felt hot so sat down, then fell and arms twitched, quickly recovered, and now has a headache and vomiting

A

vasovagal syncope (?)

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86
Q

Who consents the patient for an operation

A

anaesthetist

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87
Q

Guy with a head injury, gave Us and Es, what to prescribe

A

mannitol

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88
Q

Guy on bendroflumethazide now has a red, hot swollen ankle

A

gout

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89
Q

Which organism causes aplastic crisis in sickle cell

A

parovirus

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90
Q

Oxygen in hand higher than foot Mx

A

PDA –> give ibuprofen

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91
Q

Patient in a care home acting aggressively over 2 days. what to do

A

(probably) look for organic causes

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92
Q

newest vaccine added to 8 weeks

A

MenB

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93
Q

Pregnant 16-year-old, emergency c-section needed, which type of consent

A

informed verbal

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94
Q

Man with leg weakness and urinary problems, also has high PSA

A

MRI spine

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95
Q

Patient with schizophrenia, never tried medication before, give

A

risperidone

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96
Q

Hydatidiform mole, next step in management

A

surgery

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97
Q

best way to check intubation

A

end tidal CO2

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98
Q

bronchiectasis w/ 84% O2 and not distressed ro cyanosed. which O2 device?

A

24% venturi

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99
Q

fever, jaundice, RUQ pain (charcot’s triad)

A

cholangitis

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100
Q

when to stop breastfeeding before surgery

A

4hrs

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101
Q

pneumothorax leading to shock. cause

A

obstructive (?)

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102
Q

elderly man with lower backpain, getting worse, radiates down his leg, taking codeine that worked initially but stopped as causing constipation, what is most worrying about his backachered flag

A

age

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103
Q

old man on diuretics + antihypertensives with high K. Mx?

A

calcium gluconate

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104
Q

tx post-op vomiting

A

ondansetron

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105
Q

Elderly lady with a distal radial fracture, she drank 2 hours ago, best first drug to help with manipulation

A

ketamine

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106
Q

man stabbed and bleeding. how to manage

A

direct pressure

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107
Q

guy took drugs and seized for 30 mins. teeth clenched with blood stained saliva. airway mx?

A

NPA

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108
Q

asthma exacerbation already had salbutamol, ipratropium bromide, oral prednisolone. what’s next?

A

mag sulph

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109
Q

with pneumonia. shocked despite fluids with metabolic acidosis and 38.5C. what next

A

more NaCl?

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110
Q

Teen went to a party and now in ED with dilated pupils and sweaty and agitated, GCS of 4, temp of 40

A

cocaine

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111
Q

man with meningitis. gave fluids. what next?

A

fluids (?)

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112
Q

hyperK tx when ECG changes don’t go away

A

more gluconate

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113
Q

NG tube confirmation

A

aspirate –> advance & aspirate again –> CXR

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114
Q

Man with mets can no longer swallow and was on MST MR and has seizures, what to put in syringe driver?

A

diamorphine and midazolam

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115
Q

Stage 3 CKD and EGFR has dropped. What test to do for CKD

A

albumin:creatinie ratio, creatinine

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116
Q

Old man in a nursing home with temperature and productive cough with coarse crackles. What to prescribe

A

amoxicillin

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117
Q

amitriptyline most common SE

A

dry mouth

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118
Q

Painful, red foot which is itchy. Which antibiotic?

A

flucoxacillin

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119
Q

Old man with heart problems and declining renal function and HTN. Losartan lowers the HTN to 150 but CKD is worse, why?

A

renal artery stenosis (?)

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120
Q

Lady with mets takes co-codamol for bone pain, has MSK pain and N/V, also confused. why?

A

hypercalcaemia

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121
Q

Cancer patient with hyponatraemia and low osmolality. Which cancer?

A

SCLC

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122
Q

Cancer patient on morphine has constipation. Hard and difficult to pass. laxative?

A

movicol

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123
Q

Lady on radiotherapy for lung cancer in lower lobe. Most likely long term side effect?

A

fibrosis (?)

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124
Q

Cancer patient cannot swallow and has seizures so on lavatericetam, on fentanyl patch. What to give?

A

midazolam

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125
Q

Old lady fell, dizzy and unsteady. Positive HINTS test

A

vertigo (?)

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126
Q

Patient with NSC lung cancer with headaches and expressive dysphagia. Possible brain mets, most likely location?

A

parietal (?)

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127
Q

Cancer mets on immunotherapy, has low TSH but high free T4 and normal cortisol

A

thyroiditis (?)

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128
Q

Weight loss, abdo pain in a young woman. Inflammatory markers normal, loose stools but no blood, iron def anaemia. Cause?

A

coeliac (?)

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129
Q

Lady on multiple meds has diarrhoea and vomiting. Which to stop?

A

amitriptylline

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130
Q

Man wants HIV post exposure prophylaxis. When can he have it?

A

within 72 hours for 4 weeks
test at 6 weeks & 4 months

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131
Q

lady previously had GDM. what to do for next pregnancy

A

OGTT at 16w

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132
Q

40 weeks pregnant. Contractions but 2cm dilated. What stage is she?

A

stage 1

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133
Q

Heartburn in pregnancy. Which hormone caused it?

A

progesterone

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134
Q

29 weeks pregnant in pain, rigid abdomen. Fetal HR is 60

A

emergency c-sec

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135
Q

Best test for chlamydia

A

VV NAAT

136
Q

Induced labour at 41 weeks and fully dilated. Pathological CTG. Fetus is in occipito-transverse position and at ischial spine

A

FBS (?)

137
Q

Had an emergency C section, lochia is normal but abdo is tender and she is shocked. Why?

A

intraperitoneal haemorrhage

138
Q

HIV patient on anti retrovirals and viral count below 50. What should his wife do?

A

too low to transmit (?)

139
Q

Labour for 1hr, needs forceps after abnormal CTG. Baby’s head can be seen. Which analgesia?

A

entonox (?)

140
Q

T sign seen on US at dating scan

A

monochorionic diamniotic twin pregnanc

141
Q

Lady diagnosed with chlamydia and is 12 weeks pregnant. What to prescribe?

A

azithromycin

142
Q

Man was with a man that had gonorrhoea and no condoms. What next?

A

first void chalmydia/gonorrhea NAAT

143
Q

Ovarian cysts on US, 9cm complex but asymptomatic. BMI of 31, regular menstrual cycle. What next?

A

repeat US in 4 months

144
Q

16 year old boy with cystic fibrosis is vomiting and has abdo pain. Poor weight gain/unable to feed, abdo distension., poor compliance/unable to tolerate creon. Most likely cause?

A

pancreatic endocrine dysfunction

145
Q

Weaning advice sought, baby has eczema and mum has nut allergies. When can they have nuts?

A

wait until child is 6 months

146
Q

4 year old girl has 6 week history of bone pain, easy bruising

A

ALL

147
Q

DDx 13 year old girl has weight gain, tiredness, constipated. Sister has T1DM

A

autoimmune hypothyroidism

148
Q

12 year old boy has change in personality and frontal lobe headache, had a seizure. What investigation?

A

CT head

149
Q

Term baby girl has a systolic murmur on lower left sternal edge on newborn screening. Bilateral femoral pulses present. Cause?

A

VSD

150
Q

5 year old constipated since being weaned at 6 months. Drinks a lot, has learning difficulties. Cause?

A

hypercalcaemia

151
Q

13 month old girl is allergic to eggs and on high dose steroids. Why can she not get MMR vaccine?

A

high dose steroids

152
Q

8 year old boy in ED is sick and drowsy. Headaches for 3 days, struggles to stay awake or wake up. Mum also has headaches and is also tired. Cause

A

CO poisoning

153
Q

Patient has signs of hypercalcaemia, confirmed by U&E’s, most appropriate initial treatment

A

fluids

154
Q

Woman had foul green discharge, no change in partner, treatment

A

metronidazole

155
Q

At what age can a child draw a circle

A

3 years

156
Q

Guy presenting to ED with signs of alcohol withdrawal, admits to being heavy drinker but hasn’t drank in 2 days cause his friend was staying with him, most appropriate management

A

admit for detoxification

157
Q

Cognitive assessment for women with worsening memory in GP

A

6-CIT

158
Q

Patient just had TIA, scores 2 on ABCD2. Mx

A

aspirin 300mg

159
Q

Guy that had a fall, was shocked, had cold peripheries, hypotensive despite 3000 ml of fluids, ECG normal, most likely shock

A

haemorrhagic

160
Q

5 year old girl had first UTI and responded well to antibiotics within 48 hours, investigations

A

none needed

161
Q

Patient with first rank symptoms presenting at 20 years old, no prev psych medication, what would you start him on

A

risperidone

162
Q

Guy had bowel cancer, removed in surgery and was found to have Duke’s C, next management

A

adjuvant chemo

163
Q

ICU bradycardia mx

A

adrenaline

164
Q

In the WHO checklist, who checks the person’s name tag

A

person anaesthetising the patient

165
Q

FBS of 7.2

A

recheck in 30 mins

166
Q

Guy is on section 2 but is running out, needing on going treatment for his schizophrenia but wants to go home

A

admit under section 3 of MHA

167
Q

Vaginal tear in vaginal mucosa, but internal anal sphincter and perineal muscles in tact

A

grade 1

168
Q

Woman with advanced cancer with brain mets has a lot of nausea, worse in the morning

A

cyclizine

169
Q

Guy taking max dose of co-codamol and ibuprofen but not helping with the pain, what would you do

A

stop co-codamol & start MST

170
Q

important fact about timing of prinzmetal angina

A

doesn’t happen during exercise

171
Q

cause of elevated CK in heroin withdrawal

A

rhabdomyolysis

172
Q

Guy feels like insects are crawling on his skin. this is called

A

tactile hallucination

173
Q

Woman being treated with breast cancer radiotherapy, develops symptoms of pleural effusion (dull to percussion) management

A

talc pleurodesis

174
Q

diabetic foot infection mx

A

flucloxacillin –> macrolide/doxycycline

175
Q

woman heard a sound in the bus and said it felt ‘outside her brain’

A

pseudohallucination

176
Q

kid having hallucinations post-op

A

ketamine

177
Q

coughing after intubation - agent

A

glycopyrellate (dries mouth) / sugammadex / neostigmine

178
Q

70 something year old woman with bleeding, most appropriate tests

A

USS (?)

179
Q

How long to give PEP for after baby is born

A

6 weeks

180
Q

Which cancer would you screen for in men

A

colorectal

181
Q

Patient on lithium and TCA, recently prescribed fluoxetine, becomes agitated, high temp, restless and tremors

A

serotonin syndrome

182
Q

Guy compliant with his olanzapine for 3 months, but not working, what would you do

A

oral haloperidol (?)

183
Q

Young guy type 1 diabetic passed out after a night out. metabolic cause

A

hypoglycaemia

184
Q

Young guy went to sleep after night out, when he went to pee he passed out. cause

A

vasovagal

185
Q

Pregnant lady with gestational diabetes, presents at 34 weeks with baby in 95th percentile, management (she wanted a vaginal delivery)

A

discuss c-sec (?)

186
Q

Lady on carbamazepine, doesn’t want IUD anymore, what next contraception

A

injection (?)

187
Q

Long term ventilation in ICU, wean off ventilator with

A

tracheostomy

188
Q

What is most likely stopping this from being a day case🡪 lives alone, ASA grade 2, diabetes, age > 65, laparotomy

A

laparotomy

189
Q

Vaginal tear, through to perineal muscles and <50% of internal anal sphincter

A

3a

190
Q

Just been on COCP, same partner for the past 2 years, developed PCB

A

ectropion (?)

191
Q

Mother has CF and dad is a carrier, likelihood of child having it

A

50%

192
Q

What vaccinations at 3 months

A

6-in-1 // menB // PCV

193
Q

thought this wife was replaced by someone else

A

copgras delusion

194
Q

depression Screening for lady in GP with low mood

A

PHQ-9

195
Q

Schizophrenia patient, been on medication, hallucinations are gone but now apathy, lack of motivation, withdrawn, cause

A

negative symptoms of schizophrenia

196
Q

Nurse that had bad experience with needle and now has phobia, affecting her job, best management

A

exposure & response therapy

197
Q

Definitive diagnosis for COPD patient that had sudden onset pleuritic chest pain and breathlessness, no change in his normal cough

A

CTPA (PE)

198
Q

Woman had forceps delivery, presents few days later with abdo pain, offensive lochia

A

endometritis

199
Q

Guy that is on meth/coke says he wants support to stop taking drugs immediately, tried before but had unpleasant withdrawal symptoms, what would you do

A

community addiction services

200
Q

Girl has always had really heavy periods, so has her mom and sister, what investigation would be most important

A

coagulation screen (von willebrand)

201
Q

Diabetic with hypertension, recently started on 2.5 mg Ramipril, during follow up he still has high blood pressure, what would be the most appropriate investigation

A

U&ES (?)

202
Q

What is true about ambulatory blood pressure

A

must take reading morning and evening

203
Q

4 day old baby has not passed meconium, you are suspecting features of down’s syndrome, most appropriate investigation

A

abdo XR

204
Q

Patient presents with difficulty swallowing due to pain, with central lung cancer invading the mediastinum, recently had radiotherapy, now has thrush in his mouth, what is the most likely cause of his dysphagia

A

thrush

radiotherapy induced oesophagitis?, extrinsic pressure on oesophagus, invasion into oesophagus

205
Q

Patient that has mesothelioma died, what would you tell his family

A

death needs to be transferred to coroner

206
Q

Patient that was on chemo now has burning on hands and feet

A

hand-foot syndrome

207
Q

Man with COPD given oxygen 35%. ABG showed mild respiratory acidosis. Oxygen was 13kpa (Normal)
What is the next initial management?

A

NIV (if there’s also T2RF)

208
Q

Boy had terrible headache that last for 6 hours. Has to sleep it off before gets better

A

migraine (triptan if >12)

209
Q

Lady with cognitive impairment, difficulty finding words + blind. Which is the best test for her

A

6-CIT

210
Q

Woman under rapid sequence induction, then muscle twitches. what agent

A

suxamethonium

211
Q

Man given conscious sedation for reduction of shoulder. Then had pinpoint pupils & – RR. agent

A

fentanyl

212
Q

Lady put under this drug to sleep. Sudden hypotensive, and pulse not palpable

A

propofol

213
Q

Patient is under GA. Then developed hypotension with rash. I think normal HR or could be low

A

adrenaline

(dantrolene for malig. hyperthermia)
(metaraminol with high HR)

214
Q

Patient came in with agitation and back pain after collapse. Patient was tachy and hypotensive. What is your initial bedside management

A

12 lead ecg (?)

215
Q

Confirming death after auscultating hear sounds

A

Pupillary reflex

216
Q

Patient present with dysuria, loin pain and fever vs Patient present with dysuria and fever

A

ciprofloxacin (pyelo) vs trimethoprim (UTI)

217
Q

Co-codamol 30/500 not helping

A

Change to 20mg BD morphine but stop co-codamol

218
Q

Patient with Left sided HF on ramipril, bisoprolol etc asked what med to give next?

A

spironolactone

219
Q

What hormone dominates proliferative stage of menstrual cycle?

A

progesterone or oestrogen? (looks like oestrogen)

220
Q

Guy wants to commit suicide and is leaving what would you do?

A

Section 5(2)

221
Q

Guy with down’s lost mother 12 months ago + put tin in microwave and caused fire. Dx

A

alzheimer’s (?)

222
Q

Patient with thoughts of wanting to spit in other peoples food. Sister has schizo what medication to give?

A

quetiapine

223
Q

Child with bouts of coughing + lymphocytosis

A

pertussis

224
Q

Lady with incontinence when coughing/sneezing + does not reach toilet in time

A

mixed

225
Q

Stroke patient how long after to review?

A

6 months then annually

226
Q

Woman with fight with boyfriend and blindness one eye

A

conversion disorder

227
Q

Confirming a death central pulse and cardiac auscultation already done?

A

pupillary response

228
Q

Patient with polyuria + abdo pain + thirst asked what you would measure?

A

serum Ca (?)

229
Q

Patient with discharge etc + going to start on antibiotics. Which organisms to cover?

A

chlamydia, gonorrhoea, anaerobes

230
Q

Pus cells + diploccoci + Green/yellow discharge

A

gonorrhoea

231
Q

amenorrhoea. uterus + ovaries not present USS

A

genitourinary malformation

232
Q

rash in child that goes over nappy and skin folds

A

candida

233
Q

Child with hypotonia and poor feeding at birth but now hyperphagia

A

prader-willi (imprinting)

234
Q

15 year old pre-pubertal + skeletal survey 13 year olds

A

constitutional delay

235
Q

paeds Headache one side + blurred vision + has to sleep after

A

migraine

236
Q

Child headache morning last two months + CT normal

A

non-organic/benign raised hypertension

237
Q

Child vomiting + losing weight + squint

A

brain tumour

238
Q

diarrhoea in dementia patient

A

donepezil (haloperidol?)

239
Q

antidepressant with SE agranulocytosis

A

mitrazepine

240
Q

Patient mood up and down periods of elation and depression

A

cyclothymia

241
Q

do not take this with lithium

A

ibuprofen/NSAIDs

242
Q

likely risk of IVF

A

multiple pregnancy

243
Q

A man came in to GUM clinic. He had been having rectal pain, discharge (bleeding) and tenesmus for a week. He had a few casual male partners

A

gonorrhoea

244
Q

A 7-year-old girl was brought in to the GP clinic by her mother. The girl had been suffering for 6 weeks of pain in her joints. Her mother also noticed that she had been more tired than usual for the past couple of weeks. There was also some rashes noticed by her mother. There was no abdominal pain or any change in the urine.
Upon examination, you noticed that she looked pale, and there were rashes on her body.

What is the most likely diagnosis?

A

ALL

245
Q

A 10-weeks pregnant lady came in to EPAU after she noticed some spotting this morning. She denied any pain in her abdomen. On transvaginal USS, no intrauterine pregnancy was seen. There was also no free fluid and no adnexal mass seen.

What is your next step of management?

A

check bHCG level

246
Q

The midwife was examining a lady’s perineum after her vaginal delivery. The midwife noticed that the lady had perineal tear involving the whole thickness of the external anal sphincter. The internal anal sphincter was intact.

What is the degree of the perineal tear?

A

3B

247
Q

A 5-day-old baby was brought in to your clinic by his parents after they noticed some rash on his body. He was otherwise well and did not have any other symptoms

A

erythema toxicum

248
Q

A girl came in with round raised lesions on her skin, which were painful to touch. Mother reported that her daughter had just finished a course of antibiotics for her sore throat

A

erythema multiforme

249
Q

A man with HIV who had not been complying to his antiretroviral therapy came in with dry cough which started few weeks ago. Chest Xray showed no significant finding

A

Pneumocystisis jiroveci

250
Q

A man with HIV noticed some purple-coloured lesions on his skin and inside his mouth

A

kaposi sarcoma

251
Q

A man with HIV is complying well with his antiretroviral treatment. He noticed that his face had become flatter and the circumference of this abdomen had increased

A

lipodystrophy

252
Q

A young man came in complaining of blood in his urine. Upon questioning, he admitted that he had been taking an illegal drug

A

ketamine

253
Q

A man was found unconscious and cyanosed in the park. When he woke up, he admitted that he had been taking a drug prior to the episode

A

heroin

254
Q

A young lady was brought in to the A&E by her friends. Upon arrival, she was tachycardic, tachpnoeic and hyperthermic. Her friends told you that they were having a party beforehand, where the patient had been taking a drug. She reportedly was telling her friend that she felt great after taking the drug, and that she loved all of them and would like to spread her love

A

ecstasy

255
Q

A man came in to your clinic after being persuaded by his friends who were concerned that he had been acting strangely. When asked, he admitted that he had been isolating himself and feeling paranoid of other people. He admitted that he had been using a Class B drug

A

cannibis

256
Q

A man came into your clinic seeking advice. He admitted that he had taken the medications prescribed for his sleep and anxiety more than what he should be taking. He said that he had a seizure after he stopped taking this medication

A

diazepam

257
Q

A patient with depression is about to be started on a medication by his psychiatrist. He was told that he should not eat cheese or drink wine or have maritime while he is no this medication

A

phenelzine (MAOIs)

258
Q

A patient with depression is about to be started on new medication by his psychiatrist. He was told that the medication could make him drowsy and gain weight. He was also told to seek medical help immediately if he is having infection as the medication can sometime change his white blood cell level

A

mitrazepine

259
Q

BV in pregnancy management

A

are u sure metronidazole?

260
Q

what can you ask a 2 year old to draw

A

line

261
Q

MRC dyspnoea scale grades: Gets breathless walking on flat

A

4

262
Q

Guy was going for operation, friend left him alone, smoker, took a drink of water 4 hours ago. Which factor was most likely to make you delay op

A

chest infection

263
Q

Vague question about lady whose husband had had a change in character: become shaky, withdrawn and a bit slower on metoclopramide. What was his gait likely to be?

A

festinating (shuffling)

264
Q

16 year old girl comes in because she believes she was sexually assaulted, who would you refer her to for examination?

A

forensic

265
Q

Most appropriate psych test for lady with change of behaviour in GP surgery

A

6-CT

266
Q

Treatment of hydatidiform mole

A

refer to trophoblastic centre

267
Q

Person had renal failure, history of renal stones, had to determine what tests to do to start immediate management

A

CT-KUB (or USS?)

268
Q

Young Child keep vomiting, they have been tried on gaviscon, what would you use next

A

thickener

269
Q

Elderly gentleman with back pain – collapse a couple of hours ago – now: hypotensive, tachycardic etc which test bedside test would you do for immediate management

A

USS

270
Q

Woman was recording thoughts about things that upset them in daily life. Had a social phobia and went to a party to see if people would talk to her, what form of psych treatment was she doing

A

systemic desensitisation

271
Q

How long would you give a lady PEP for after she’s just delivered

A

4 weeks

272
Q

Woman fight with boyfriend and gets blindness in one eye

A

conversion disorder

273
Q

shock with cool pale peripheries

A

hypovolaemic // cardiogenic // obstructive

274
Q

Click heard at apex for patient who is a smoker and has breathlessness: Diagnosis

A

pneumothorax

275
Q

Occipital headache, photophobic, N&V what investigation

A

CT head

276
Q

some milestones

A

A. Girl who can understand no, can sit unsupported
B. Child stoops down, Hand transference
C. 4 year old girl hopping on one foot for 2 seconds, draw a square etc
D. 50 words
E. 2-4 word sentences

277
Q

Breast cancer asymptomatic found on screening

A

surgery?

278
Q

diabetic nephropathy tx // renal artery stenosis tx

A

ACEi or ARB // angioplasty & stenting

279
Q

polycystic kidney disease tx

A

dialysis –> transplant

280
Q

best chlamydia test

A

VV NAAT

281
Q

what class is Psilocybin

A

A

282
Q

At what age can a child hold up a cup to drink?

A

9 months?

283
Q

duration of pancuronium

A

long acting non-depolarising

284
Q

anesthetic agent used instead of propofol for RSI

A

Thiopentone

285
Q

mechanism non-depolarising muscle relaxants

A

Compete with acetylcholine for nicotine receptors

286
Q

BV tx pregnancy

A

metranidazole? –> clindamycin –> erythromycin

287
Q

when can a child eat with a spoon

A

we’ll see

288
Q

Man in ICU for 2 weeks on mechanical ventilation – why?

A

weening off PEEP

289
Q

when do you give syntometrine IM

A

3rd stage labour

290
Q

what is lymphogranuloma venereum

A

chlamydia STI common in MSM

291
Q

Testicular cancer with distant mets tx

A

primary chemo?

292
Q

how does anorexia affect periods

A

hypothalamic dysfunction

293
Q

Reversal of intraoperative bradycardia caused by drugs

A

glycopyrollate

294
Q

medications irritant to be given as SC

A

Diazepam, chlorpromazine and prochlorperazine

295
Q

Why do we perform the GUTHRIE test?

A

better outcome if treated early

296
Q

MRI showing demyelinated areas in brain

A

MS

297
Q

Woman with diplopia, has had several episodes of muscle weakness in past

A

myasthenia gravis

298
Q

painless vs painful ulcer

A

syphillus vs herpes

299
Q

Child with abdo pain and fever, recently had ‘cold’

A

pyelonephritis

300
Q

Prostate ca and back mets

A

palliative RT

301
Q

Sclc with mets

A

CT then RT

302
Q

Nsclc mets to liver

A

surgery

303
Q

cervical cancer

A

surgery and RT or combination

304
Q

7yr old girl having to use salbutamol everyday, takes ICS regularly

A

add salmeterol

305
Q

risk of developing seizure from febrile convulsion

A

2.5%

306
Q

78yr old man with a physical comorbidity begins experiencing hallucinations and accusing wife of being unfaithful, treatment of which physical comorbidity could this be SE of

A

parkinson’s

307
Q

Baby check, all normal kicking and has urinated and passed meconium in first 24hrs, except dimple lower back

A

USS?

308
Q

Someone sitting in a corner responding to visual hallucinations, what drug did he take

A

psilocybin mushrooms

309
Q

drug that ++ BP but causes reflex bradycardia

A

metaraminol

310
Q

non-depolarising muscle relaxant used in RSI

A

vecruronium

311
Q

drug that ++ BP & HR

A

ephedrine

312
Q

non-depolarising muscle relaxant used in liver/renal transplant

A

atracurium

313
Q

what is true regarding ambulatory BP monitoring

A

measure BP in morning and evening

314
Q

leading cause of direct death in pregnant women

A

suicide

315
Q

at what age can a child rollover

A

6 months (?)

316
Q

wegners granulomatosis antibodies

A

ANCA

317
Q

differentiate MG from MS

A

gravis - gets worse with movement
syndrome: gets better with movement

318
Q

hepB transmission

A

blood borne

319
Q

one sign of global impairment in pseudodementia

A

“i don’t know” to all questions

320
Q

ABCD2 score interpretation for high risk

A

> 4 - high risk, immediate assessment
6 - risk of stroke within next week

321
Q

correction for gestation age in prem is not required when

A

after 2 years

322
Q

airways for burns victim

A

Intubate ASAP. Can use Sux for RSI first 72 hours but not after that because of risk of hyperkalaemia

323
Q

Why is it important to intubate a burns victim ASAP

A

before oedema blocks airways

324
Q

What airway to use if airway obstructed by oedema in burns victim?

A

tracheostomy

325
Q

Consultant attempting to get an ET tube in, is unsuccessful as he can only partially see vocal cords - what is the next step in getting a definitive airway for this patient?

A

bougie

326
Q

dx tracheo-oesophageal fistula

A

barium swallow

327
Q

polyhydramnios, and after birth the infant is bubbly because saliva cannot be swallowed

A

oesophageal atresia

328
Q

anaemia associated with renal failure/EPO issues

A

Normocytic normochromic anaemia

329
Q

common causes of absent red reflex

A

congenital cataracts, retinal detachment, vitreous haemorrhage and retinoblastoma.

330
Q

most common tx for SCLC

A

chemotherapy

331
Q

Patient had a stoke 30years ago - what would you expect their gait to be like?

A

hemiplegic

332
Q

In surgical correction of TGA, are the coronary arteries swapped around as well

A

yes

333
Q

90% pregnancy DVTs happen in

A

Left leg (& above the knee)

334
Q

feeling more sedated on venlafaxine, how to overcome that

A

increase dose as it gets less sedative with higher doses

335
Q

Girl has diarrhoea and vomiting, recently been on a camping trip. What has she most likely caught

A

hep A

336
Q

long acting LA agent

A

bupivacaine

General knowledge (1 decks)

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