GP

Question 1

Tx of ADHD

Answer 1

methylphenidate (ritalin)
Dexamfetamine
Atomexetine

Question 2

antibodies in Hashimotos thyroiditis

Answer 2

anti-TPO

Question 3

Causes of primary hypothyroidism

Answer 3

• Hashimoto’s
• iodine deficiency
• Hyperthyroidism Tx (carbimazole, radioactive iodine, surgery)
• Lithium
• Amiodarone

Question 4

causes of secondary hypothyroidism

Answer 4

• Sheehan syndrome
• tumours
• infection

Question 5

TSH/T4 levels in primary and secondary hypothyroidism

Answer 5

primary- raised TSH, low T4

Secondary- low TSH, low T4

Question 6

antibodies in Graves

Answer 6

TSH receptor antibodies

Question 7

features specific to Graves

Answer 7

Diffuse goitre (without nodules)
Graves eye disease
Bilateral exophthalmos
Pretibial myxoedema

Question 8

Tx of hyperthyroidism

Answer 8

carbimazole
radioactive iodine
surgery

Question 9

causes of microcytic anaemia

Answer 9

T – Thalassaemia
A – Anaemia of chronic disease
I – Iron deficiency anaemia
L – Lead poisoning
S – Sideroblastic anaemia

Question 10

causes of normocytic anaemia

Answer 10

blood loss
chronic disease
Aplastic anaemia
haemolytic anaemia
hypothyroidism

Question 11

causes of macrocytic anaemia

Answer 11

folate deficiency

Question 12

Management of a DVT

Answer 12

immediate LWNH (dalteparin/enoxaparin)

long term:

• warfarin
• NOAC/DOAC (apixiban, rivaroxaban)
• LWMH

continue anticoagulation for 3 months

Question 13

Tx of a PE

Answer 13

thrombolysis- LMWH- IV/ central line (altepase/ streptokinase/ tenecteplase)

Question 14

what is glaucoma?

Answer 14

optic nerve damage (and visual field defects) due to high pressure in the eye

Question 15

what is the normal intraocular pressure of the eye

Answer 15

10-21 mmHg

Question 16

what is primary open angle glaucoma?

Answer 16

reduced outflow of aqueous humour through trabecular mesh

slow, chronic onset

Question 17

Tx of primary open angle glaucoma

Answer 17

prostaglandin analogues- lantoprost (eye drops)

Question 18

what is acute angle closure glaucoma?

Answer 18

• sudden rise in intra-ocular pressure

(iris blocks exit for aqeuous humour)

• medical emergency !

-

Question 19

presentation of acute angle closure glaucoma

Answer 19

painful red eye, blurry revision, N+V, headache

fixed dilated pupil

Question 20

Tx of acute angle closure glaucoma

Answer 20

pilocarpine (eye drops)

acetazolamide

Question 21

causes and presentation of anterior uveitis

Answer 21

causes- ankylosing spondylitis, reactive arthritis, UC/Crohn’s

presentation- red, painful eye, photophobia, blurred vision

Question 22

describe the 3 stages of diabetic retinopathy

Answer 22

• background- micro aneurysms (dots)
• pre-proliferative (cotton wool spots)
• proliferative (retinal neovascularisation)

Question 23

presentation of cataracts

Answer 23

• blurred vision
• faded colour vision
• glare

Question 24

management of cataracts

Answer 24

• stronger glasses, brighter lighting

- remove cloudy lens, replace with artificial one

Question 25

presentation of anterior uveitis

Answer 25

• painful red eye
• ciliary flush
• reduced acuity
• lacrimation

Question 26

HIV monitoring

Answer 26

CD4 count- normal is 500-1200 cells/mm3

• under 200 cells/ mm3= AIDS

Viral load- number if copies of HIV RNA per ml of blood

Question 27

Tx of an exacerbation of COPD

Answer 27

• prednisolone

if in hospital:
- nebulised bronchodilators

Question 28

Eradication therapy for peptic ulcers

Answer 28

proton pump inhibitor (e.g. omeprazole) plus 2 antibiotics (e.g. amoxicillin and clarithromycin) for 7 days

Question 29

candida (thrush) of the nipple- cause, presentation (in mother and neonate) and treatment

Answer 29

cause- usually after Abx use

maternal presentation- sore nipples (usually bilateral), tenderness, cracked/flaky areola

neonatal Sx- oral and nappy candidal rash

Treat mum and baby !!
maternal Tx= topical miconazole after each breastfeed

baby Tx= miconazole gel/ nystatin

Question 30

what is a hydrocele and how does it present on examination

Answer 30

• collection of fluid within the tunica vaginalis

presentation:

• palpable testicle within hydrocele
• soft
• irreducible
• no bowel sounds in swelling (differentiates from hernia)
• transillumination

Question 31

what is a varicocele?

Answer 31

• swollen paminiform plexus

Question 32

presentation and examination findings in a pt with a varicocele

Answer 32

presentation:

• throbbing pain worse on standing
• dragging sensation
• fertility problems

O/E:

• scrotal mass- ‘bag of worms’
• worse on standing
• asymmetrical testes

Question 33

what is epididymo-orchitis and what can cause it?

Answer 33

inflammation of epididmyis and testicle

causes:

• E coli
• chlamydia trachomatis
• neisseria gonorrhoea
• mumps

Question 34

presentation of epididymo-orchitis

Answer 34

• testicular pain
• dragging sensation
• swollen testes
• tenderness on palpation
• systemic sx
• urethral discharge (gonorrhoea/ chlamydia)

Question 35

rate control in AF

Answer 35

1- BB (atenolol)
2- rate-limiting CCB- Diltazem
3- Digoxin

Question 36

rhythm control in AF

Answer 36

Cardioversion:
- electrical- DC

• Pharmacological- flecanide/ amiodarone

Question 37

what is the HASBLED score?

Answer 37

calculates risk of major bleeding whilst on anticoagulation

Question 38

staging of CKD

Answer 38

G1 = eGFR >90
G2 = eGFR 60-89
G3a = eGFR 45-59
G3b = eGFR 30-44
G4 = eGFR 15-29
G5 = eGFR <15 (known as “end-stage renal failure”)