Key concepts part 1

Question 1

persistent unexplained hoarseness in someone over 45

Answer 1

urgent ENT referral

Question 2

what investigation should all patients with suspected pericarditis have

Answer 2

Transthoracic echo

Question 3

what is the investigation of choice for suspected aortic dissection

Answer 3

CT angio

Question 4

when should you use rhythm control to treat AF

Answer 4

if there is co-existent heart failure, first onset AF or obvious reversible cause

Question 5

what is beck’s triad?

Answer 5

hypotension, raised JVP, muffled heart sounds

characteristic of tamponade

Question 6

which artery is involved in a lateral MI

Answer 6

left circumflex

Question 7

widespread systolic murmur, hypotension, pulmonary oedema post MI

Answer 7

rupture of papillary muscle

Question 8

what electrolyte/ABG findings are typical of cushings?

Answer 8

hypokalaemia metabolic alkalosis

Question 9

what HBA1c is diagnostic of diabetes mellitus?

Answer 9

48 or above

Question 10

whats an important complication of fluid resus in DKA especially in young patients?

Answer 10

cerebral oedema

Question 11

how does Hashimotos present and what antibody is it associated with?

Answer 11

hypothyroidism + goitre + anti-TPO

Question 12

anti- TPO

Answer 12

Hashimotos

Question 13

TRAB antibodies

Answer 13

Graves

Question 14

new onset dysphagia management

Answer 14

red flag - urgent endoscopy regardless of age or other symptom

Question 15

secondary prophylaxis of hepatic encephalopathy

Answer 15

lactulose + rifaximin

Question 16

in which IBD do you get increased goblet cells

Answer 16

crohn’s disease

Question 17

what is the diagnostic investigation of choice for pancreatic cancer?

Answer 17

high resolution CT

Question 18

what test is used in autoimmune haemolytic anaemia

Answer 18

coombs’ test

Question 19

what electrolyte imbalance is caused by SIADH

Answer 19

hyponatraemia

Question 20

when is hypertonic saline indicated

Answer 20

in patients with acute, severe, symptomatic hyponatraemia (<120)

Question 21

what is a key complication of nephrotic syndrome?

Answer 21

increased risk of thromboembolism due to loss of antithrombin III and plasminogen in the urine

Question 22

describe broca’s dysphasia

Answer 22

broken, non fluent speech, normal comprehension, repetition impaired

Question 23

how long do the clusters of cluster headaches typically last

Answer 23

4-12 weeks

Question 24

if clopidogrel is contraindicated, what is the long term secondary prevention of stroke?

Answer 24

aspirin plus modified release dipyramidole lifelong

Question 25

which cancer is associated with gynaecomastia?

Answer 25

adenocarcinoma of the lung

Question 26

what do you do in secondary pneumothorax less than 1cm

Answer 26

admit for 24 review and give O2

Question 27

what is the management of displaced intracapsular hip fracture?

Answer 27

hemiarthroplasty or total hip replacement

Question 28

back pain with previous history of cancer

Answer 28

red flag and urgent refferal

Question 29

what is the most common cause of septic arthritis

Answer 29

staph aureus overall but consider n.gonorrhoea in young adults who are sexually active

Question 30

patient with organic foreign body in eye (ie grass seed) management

Answer 30

urgent referal to ophthalmology for assessment (due to infection risk)