Key concepts part 5

Question 1

what should be co-administered with isoniazid to prevent peripheral neuropathy?

Answer 1

Pridoxine (vit B6)

Question 2

what are the indications for dialysis?

Answer 2

A - acidosis (<7.1)
E - electrolytes (rapidly rising K) 
I - intoxication 
O - (fluid) overload 
U - uraemia (encephalopathy, pericarditis, neuropathy)

Question 3

how does viral meningitis present on lumbar puncture

Answer 3

clear CSF with lots of lymphocytes and a normal opening pressure

Question 4

what is the most common cuase of viral meningitis

Answer 4

enteroviruses ( cockaskie)

Question 5

what is the MOA of fondaparineux?

Answer 5

activates antthrombin III

Question 6

what drug is used to manage tremor in drug induced parkinsonism?

Answer 6

procyclidine

Question 7

what TB drug is associated with gout

Answer 7

pyrazinamide

Question 8

how does loperamide reduce gastric motility>

Answer 8

stimulating opioid receptors

Question 9

what gene mutation is associated with HNPCC

Answer 9

MSH2/MLH1

Question 10

how does hypoglossal palsy present? and vagus palsy?

Answer 10

Hypoglossal = tongue goes to side of lesion

Vagus = uvula goes ‘uver way

Question 11

what should be reported to the yellow card scheme?

Answer 11

• all adverse reactions to new meds (black triangle)

- all adverse reactions involving children

Question 12

how does the presentation of a bleeding peptic ulcer differ from a perforated peptic ulcer?

Answer 12

bleeding = hypotension and melena 
perforated = peritonitis + hypo + melena

Question 13

what electrolyte pattern is associated with tumour lysis syndrome and what is the prophylactic management?

Answer 13

Hyperkalaemia, hyperphosphatemia, hypocalcaemia

Allopurinol

Question 14

how is bacterial vaginosis managed in pregnancy?

Answer 14

still use oral metronidazole 400mg bd for 7 days

Question 15

what is the management of alcohol withdrawal/delirium tremens?

Answer 15

long acting benzo (chlordiazepoxide, diazepam)

Question 16

what is the most common cuase of occupational asthma

Answer 16

isocyanates

Question 17

what is gallstone ileus

Answer 17

small bowel obstruction secondary to impacted gallstones

Question 18

what is the testing timeline for HIV

Answer 18

initial test then one 12 weeks post exposure

Question 19

what are the anaphylaxis doses across age groups?

Answer 19

under 6 y/old = 150mcg IM
6-11 = 300mcg IM
>11 = 500mcg IM

1 in 1000

Question 20

which diuretic type causes sexual dysfunction?

Answer 20

thiazide like diuretics (indapamide)

Question 21

management of whooping cough

Answer 21

azithromycin or clarithromycin

Question 22

what is the acute liver failure triad?

Answer 22

encephalopathy + jaundice + coagulopathy

Question 23

at what age shoudl you start referring women with a breast lump to the cancer pathway

Answer 23

30

Question 24

what scans can be used to quickly assess the presence of fluid in the abdomne/chest

Answer 24

FAST (USS)

Question 25

what prophylaxis should a HIV patient with CD4 count of less than 200 have

Answer 25

cotrimoxazole for prophylaxis against pneumocystis jirovecci

Question 26

what are the HBA1c targets for patients receiving treatment?

Answer 26

HBA1c <48 for those on lifestyle/monotherapy with non-hypoglycaemic agent

HbA1c <53 for those on monotherapy with hypoglyacemic agent

HbA1c 58 or above needs addition of second drug

Question 27

which SSRI is most commonly associated with prolonged QT

Answer 27

citalopram

Question 28

what drug can be used for acute flares of rheumatoid arthritis?

Answer 28

IM or oral steroids

Question 29

what are some features of absence seizures?

Answer 29

• good prognosis
• typically present age 3-10
• may be triggered by hyperventilation or stress
• has a characteristic EEG image

Question 30

what are the bisphosphonate holiday rules

Answer 30

if been on bisphos for 5 years and are low risk ( ie <75, no steroid use, no fractures while on meds, no hip/vertebral #, normal T score) then can stop the bisphos and review in a couple years

Question 31

hyperthyroid + painful goitre

Answer 31

De Quervians

Question 32

what is the protocol for seizures

Answer 32

1. ABCDE
2. Benzo (ie IV lorazepam - 2x max)
3. phenytoin or phenobarbital
4. no response within 45 mins of onset then induce with GA

Question 33

pepperpot skull

Answer 33

hyperparathyroidism

Question 34

what insulin type do you use for DKA? and for major surgery?

Answer 34

DKA = fixed rate insulin (continue long acting + stop short acting)

Major surgery = variable rate insulin

Question 35

what is the most common cuase of primary hyperparathyroidism

Answer 35

solitary adenoma

Question 36

what drug can be used for acute flares of rheumatoid arthritis?

Answer 36

IM steroids

Question 37

what anticoagulant should be used in patients with mechanical heart valves?

Answer 37

warfarin