Key concepts part 6

Question 1

what is donepezil and what is a common side effect?

Answer 1

it is an anticholinesterase inhibotor used in the management of Alzheimers, and it can lead to 3rd degree heart block

Question 2

what is a common side effect of transtuzumab

Answer 2

heart failure

Question 3

what is the management of a benign Phyllodes tumour

Answer 3

lumpectomy

Question 4

what is the most common and second most common parotid gland tumour?

Answer 4

Pleomorphic adenoma and warthins tumour

Question 5

Low sodium in a euvolaemic patient - what condition should you consider?

Answer 5

SIADH

Question 6

what does India Ink positive stain indicate

Answer 6

crytococcus meningitis (fungi)

Question 7

what thyroid drug is associated with pancytopenia

Answer 7

carbimazole

Question 8

what is the management of benign prostatic hyperplasia

Answer 8

1. alpha blocker 2. finasteride

Question 9

what is a contraindication to alpha blockers?

Answer 9

postural hypotension

Question 10

when is a G6PD enzyme assay used?

Answer 10

to diagnose G6P deficiency - can only be checked 3 months post acute haemolysis (so in acute stage check direct antiglobin test)

Question 11

what investigations can be used to differentiate between the types of leukaemia?

Answer 11

immunophenotyping

Question 12

what organisms does splenectomy increase your risk for

Answer 12

H.influenzae, strep pneumonia, n.meningitidis

Question 13

muddy brown casts

Answer 13

acute tubular necrosis

Question 14

what drug is used in the management of trigeminal neuralgia

Answer 14

carbamazepine

Question 15

how does excessive nitrous oxide inhalation cause subacute degeneration of the cord

Answer 15

nitric oxide reduces bioavailability of vitamin B12 leading to deficiency and thus subacute degeneration of the cord

Question 16

if someone doesnt think their antidepressant is working - how long should it be taken for before deciding to switch them

Answer 16

4-6 weeks

Question 17

what is the management of hypocalcaemia in CKD?

Answer 17

1. reduce phosphate in diet
2. phospahte binders ie sevelamer
3. vitamin D ie calcitriol, alfacalcidol
4. parathyroidectomy in severe cases

Question 18

what are the complications of CKD? (they relate to the function)

Answer 18

1. Hypertension + peripheral/pulmonary oedema (as the kidney regulates fluid levels)
2. hypocalcaemia (as kidney activates vit D)
3. metabolic acidosis (as kidney regulates acid base balance)
4. uraemia, hyperphosphatemia, hyperkalaemia (as kidney removes waste products)
5. anaemia (as kidney produces EPO)

Question 19

what should you do if you need to prescribe an SSRI with an NSAID (inc aspirin)

Answer 19

also prescribe a PPI due to GI bleeding risk

Question 20

what are the tachycardia indications for DC cardioversion?

Answer 20

shock, syncope (actual LOC), MI, severe HF

Question 21

what drug must be stopped temporarily prior to coronary angiography

Answer 21

metformin

Question 22

at what time must all breech babies have a DDH USS?

Answer 22

6 weeks

Question 23

how do you treat diveritculitis?

Answer 23

oral antibiotics at home - if they do not improve within 72hrs then admission to hospital for Iv ceftriaxone and metronidazole is indicated

Question 24

what do you need to give the patient when they are being treated for ascites with large volume paracentesis?

Answer 24

albumin to reduce paracentesis induced circulatory dysfucntion

Question 25

prior to what age is hand preference abnormal in a child?

Answer 25

prior to 12 months could indicate cerebral palsy

Question 26

what is used to suppress nausea and vommiting in a patient with intracranial tumours?

Answer 26

dexamethasone

Question 27

what pH is the cut off for safely using an NG tube?

Answer 27

<5.5 is safe to use, above 5.5 means need CXR to verify tube location

Question 28

what electrolyte disturbance may be seen in acute pancreatitis

Answer 28

hypocalcaemia

Question 29

what is the most common MOA for ankle sprain

Answer 29

inversion injuries

Question 30

what are the ages for cervical screening in Scotland vs rest of UK

Answer 30

rest of UK: every 3 years from 25-49 and every 5 years from 50-64

Scotland: every 5 years from 25-64

Question 31

what is the management of vestibular neuronitis?

Answer 31

prochlorperazine short term and then if condition remains then vestibular rehabilitation exercises

Question 32

at what day and time should lithium levels be checked post dose change

Answer 32

7 days after dose change, 12 hours after last dose

Question 33

which cancer does PSC increase the risk of

Answer 33

cholangiocarcinoma