last minute exams - to learn!

Question 1

side effect of tamoxifen

Answer 1

hot flushes

Question 2

most common organism for infective exacerbation of COPD is….

Answer 2

H. influenza

Question 3

what type of cough would you get for:
- whooping cough
- croup

Answer 3

whoop - PO macrolide

barking - STAT dex or INH steroid

Question 4

tx of guttate psoriasis

Answer 4

no benefit to start abx
therefore, give reassurance and topical treatments if the lesions are symptomatic

Question 5

treatment of actinitic keratosis

Answer 5

fluorouracil cream
topical diclofenac
topical imiquimod
cryotherapy
curretage and cautery

Question 6

causes of raised prolactin

Answer 6

pregnancy
prolactinoma
physiological
PCOS
primary hypothyroidism
phenothiazine
metocloPramide
domPeridone

Question 7

acute ACS and coccaine use - what else to give apart from ACS treatment?

Answer 7

benzodiazepine IV

Question 8

if both vitamin B12 and folate levels are low, which one to treat first>

Answer 8

vitamin B12

Question 9

organism for recurrent otitis externa

Answer 9

candida

Question 10

patient who has AF and stroke at the same time - when to start anticoagulation?

Answer 10

2 weeks post-admission

Question 11

which drug should be avoided with SSRI?

Answer 11

Triptans

Question 12

what is the symptom found in SSRI dicontinuation syndrome?

Answer 12

diarrhoea
electric shock sensations
anxiety
dizzyness

Question 13

which antidepressant has more sedative effect in lower dose but this disappears in higher doses?

Answer 13

mirtazepine

Question 14

tx of panic disorder

Answer 14

SSRI

Question 15

which HTN-drug can cause digoxin toxicity?

Answer 15

thiazide, loop diuretics, ciclosporin, amiodarone, calcium-channel blocker (verapamil, diltiazem), spironolactone

Question 16

Heroin can cause what complication?

Answer 16

VTE

Question 17

St John’s Wort is a CYP what?

Answer 17

inducer

Question 18

Poisoning - what is the antidote?
Organophosphate poisoning
Iron
Antifreeze
digoxin
ecstasy
Beta-blocker
Aspirin/Salicylate
TCA
lithium
lead
cyanide

Answer 18

Organophosphate: atropine
Iron: dexferrioxamine
Antifreeze: fomepizole
digoxin: digibind
ecstacy: supportive, dantrolene for hyperthermia only
beta-blocker: atropine -> glucagon
ASpirin/salicylate: urine alkalinisation with IV bicarb -> haemdialysis (pul oedema, acidosis)
TCA: IV bicarb
lithium - IV fluids -> haemdialysis
lead: dimercaprol, calcium edetate
cyanide: hydroxycobalamin, also combination of amyl nitrite, sodium nitrite, and sodium thiosulfate

Question 19

what symptom can you find in organophosphate poisoning?

Answer 19

SLUD
salivation, lacrimation, urination, defaecation

bradycardia, hypotension
small pupils (miosis)

tx: atropine

Question 20

Ehtylene glycol VS methanol poisonin

Answer 20

EG: tx: fomepizole

Methanol: tx: fomepizole/ethanol -> HD

Question 21

coccaine toxicity - ?PC

Answer 21

hyperthermia, psychosis, metabolic acidosis, rhabdomyolysis, seizures, hypertonic, hyperreflexic, dilated pupils, hypertension

chest pain -> MI

tx: benzodiazepine

Question 22

drug causing lung fibrosis

Answer 22

amiodarone
bleomycin
methotrexate
sulfasalazine
nitrofurantoin
bromocriptine
cabergoline
pergolide

Question 23

what drug will most likely exacerbate lithium toxicity?

Answer 23

thiazide
ACEi
ARB
NSAIDs
metronidazole
dehydration
renal failure

PC: blurred vision, tremor, hyperreflexia, d&v, abdo pain, seizures

Tx: IVI -> HD

Question 24

which NSAID is contraindicated in any cardiovascular disease?

Answer 24

diclofenac

Question 25

Lyme disease - how lonng treatment?

Answer 25

14 days doxycycline
IV ceftriaxone if disseminated

Question 26

campylobacter - tx?

Answer 26

clarithromycin

Question 27

first line for GAD

Answer 27

sertraline

Question 28

SSRI should be avoided with warfarin/heparin due to…

Answer 28

increased risk of bleeding

Question 29

what med to start if patinet cannot take 2 antipsychotic

Answer 29

clozapine