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MSRA > MCQ Bank 2 > Flashcards

MCQ Bank 2 Flashcards

1
Q

Leading cause of death worldwide for people with HIV (1)
common cause of atypical yeast fungus in HIV (1)

A

TB

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2
Q

atypical opportunistic infection common in HIV

A

pneumocystitis jirovecii (if high viral load and LOW CD4 count –> opportunistic infection)

FUNGUS

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3
Q

Toxoplamsos - how spread

A

Toxoplasma gondii
transmitted through oocysts from undercooked meat/ contaminated vegetables/ cat faeces

can –> focal encephalitis
headaceh, confusion, seizures, motor weakness, fever

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4
Q

Cryptococcus

A

encapsulated fungus from isolated soils and aviation excreta

usually presents with meningitis or meningoencephalitis with fever, malaise, headache

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5
Q

Cytomegalovirus

A

remains latent in infected person following primary infection or can be transmitted from person to person

  • retinitis is most common presentation
    others: colitis, cholangitis, encephalitis, pneumoniti, gastritis
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6
Q

HRT increase risk of what cancers

A

breast cancer and ovarian

(ENDOMETRIAL if oestrogen only)

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7
Q

tetanus prone injuries

A

contaminated wounds
wounds containing foreign bodies
compound fractures
wounds or burns with systemic sepsis
certain animal bites/ scratches

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8
Q

prothrombin complex concentrate e.g. Octaplex - what does it contain

A

1972 factors

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9
Q

INR >8 on warfarin- difference of treatment

A

> 8= stop warfarin, gie oral vit K if risk of bleeding

ACTIVE major bleeding= stop warfarin, give prothrombin complex concentrate, give vit K INTRAVENOUSLY

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10
Q

tired, depression, renal stones, Ca levels high, PTH raised, ALP nromal

A

Primary hyperparathyroidism
usually due to single benign adenoma

most >40 year old women
most asymptomatic

PTH may be normal (inappropriately normal for the level of calcium)

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11
Q

what does raised ALP in hyperparathyroidism suggest

A

non parathyroid hypercalcaemia

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12
Q

high PTH, low Ca, high PO4

A

pseudohypopparathyoirism: unusual collection of developmental and skeletal defects including short stature, round face, shortened fourth metacarpals and other bones, obesity, dental hypoplasia

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13
Q

Shoulder dislocation: anterior or posterior

A

ANTERIOR 95% of the time

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14
Q

Glasgow criteria skin cancer: melanoma

A

3 major:
size, shape, colour

minor:
diamete >7mm, inflammation, oozing/bleeding, itch/odd sensation

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15
Q

Diabetes insipidus

A

thirsty
large amounts of very dilute urine (<300mOsm/kg low osmolarity)
high serum osmolarity

(can be caused but drugs e.g. lithium, demeclocycline)

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16
Q

Diabetes insipides management

A
  1. STOP drugs causing it (lithium, demeclocycline)
  2. THIAZINE DIURETICS which inhibit reabsorption of NaCl in distal renal tubule
  3. NSAIDS (e.g. indomethacin) may reduce volume of urine
  4. SODIUM RESTRICTION
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17
Q

Diabetes insipidus and ADH

A

DECFICIENCY OF ADH

(ADH encourages re-absorption of water –> reduces urine)

can get NEUROgenic DI (deficiency of ADH) or NEPHROgenic DI (insensitivity of kidneys to ADH)

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18
Q

Pseudoobstruction

A

gas in recturn
usually little or no ado pain
elderly and bedridden
colonic obstruction with no mechanical cause

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19
Q

chronic mesenteric ischaemia

A

fear of eating due to postprandial pain
N&V
irregular bowel
50-70yo cardiovascular disease

–> CT

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20
Q

colonic ischaemia

A

sudden onset cramping pain
L side
urgent desire for bowel movement
N&V

–> CT
–>SURGERY emergency

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21
Q

difference femoral aneurysm vs femoral pseudoaneurysm

A

PESUDOANEURYSM
- resent arterial puncutre/ trauma
- may change size with pressure
- iatrogenic, trauma, infection
- FLASE aneurysm (no arterial wall laters involved)
- vascular complication of CARDIAC CATHETERIZATION

ANEURYM
athletrosclereosis
- true aneursm
- uniform, stable
- HTN/ smoking

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22
Q

Syringomyelia

A

fluid filled tubular cavitation within the spinal cord

men
20-30
pain and temperature loss
one side may be more affected than the other
shawl/cape like districtuion
muscle wasting and weakness
progressive condition, no cause

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23
Q

Donald Duck speech and progressive stiff spastic gone, brisk jaw jerk

A

pseudobulbar palsy (UMN)
occurs in MS, monotornuetron disease, bilateral strokes
difficulty chewing

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24
Q

bells palsy treatment

A

prednisone 10/7

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25
Q

how long to continue oral iron for

A

once Hb normalised plus an additional 3 months

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26
Q

angular stomatitis and blood shot eye - what vitamin deficiency

A

B2 (riboflavin)

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27
Q

pneumonia with bulls myringitis, ad CXR signs more extensive than physical exam suggests

A

Mycoplasma pneumonia

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28
Q

bronchiolitis (respiratory syncytial virus (RSV))- when to do CXR

A

if cornered RE pneumonia / pneumothorax - if no concerns then CXR not needed

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29
Q

commonest cause gastroenteritis in england/wales

A

E coli

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30
Q

acute angle glaucoma management

A

lie face up and head not supported by pillows
AND
pilocarpine eye drops
AND
acetazolamide
AND
laser iridotomy

If primary open angle glaucoma then opthalmologist may start topical prostaglandin analogue or prostamide, topical beta-blocker

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31
Q

most commonest cause travellers diarrhoea

A

E coli

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32
Q

oral anti diabetic drug with greatest risk of hypoglycaemia

A

Sulfonylureas (gliclazide)

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33
Q

mekels diverticulum most common symptom

A

gastrointestinal bleeding

clinically indistinguishable Fromm acute appendicitis
mot common diagnostic tool is technetium-99m pertechnetate scan

managed by surgical resection

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34
Q

what does exercise stress testing test for

A

evaluating the presence of obstruction coronary artery disease (CAD) by assessing hearts response to physical stress and identifying ischaemia

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35
Q

plasma osmolarity

A

2Na + urea + glucose

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36
Q

thumbprint sign on lateral neck XR

A

epiglottis (haemophiliac influenza B)
ages 2-8years
–> cefotaxime + steroids

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37
Q

earliest clinical manifestation of diabetic nephropathy

A

microalbuminuria (raised Cr and urea occurs later)

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38
Q

rectal bleeding with red/purplish pea sized lump at anal margin

A

perianal haematoma

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39
Q

monoclonal protein on serum electrophoresis
bone lesions
renal disease
immunodeficiency
bone pain
anaemia

A

multiple myeloma

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40
Q

thaimine - what viatmin

A

B1

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41
Q

nephrocalcinosis

A

parenchymal calcium deposition in the kidneys –> usually due to hypercalacemia

causes:
malignany
mulitple myeloma
hyperparathyroidism
sarcoidiosis
vitamin D intoxication

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42
Q

Fanconi syndrome

A

disturbance of renal tubular transport

polyuria, bones deformities (rickets/ osteomalacia), glycosuria, photosphauria, renal tubular acidosis type.2

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43
Q

anorexia in terminal cancer- what drug can help with appetite

A

prednisolone

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44
Q

malignant otitis externa

A

pseudomonas aeruginosa

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45
Q

tine capitis/ scalp ringworm

A

final infection of scalp

ORAL GRISEOFULVIN AND KTOCONAZOLE SHAMPOOO

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46
Q

amoebic liver abscess management

A

metronidazole

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47
Q

headaches, palpiutations, diaphoresis, severe HTN (vary in occurrence from monthly to several times per day)

A

pheochromocytoma
A/w MEN IIa, IIb, neurofibromatosis

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48
Q

chronic renal failure- what type of anaemia

A

Normocytic

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49
Q

causes normocytic anaemia

A

liver disease
alcoholism
hypothyroidism
myelodysplaisa
drugs - anticonvulsants

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50
Q

keraatoconus

A

progressive eye condition - dome shaped cornea thins and begins to bulge into cone shape –> blurred vision

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51
Q

pterygium

A

fibrovascular overgrowth of subconjunctival tissue, triangular shape, encroaching onto cornea

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52
Q

gallstone treatment if not fit for surgery

A

ursodeoxycholic acid

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53
Q

philadelphia chromosome

A

chronic myeloid leukaemia CML

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54
Q

Antiemetic:
- functional bowel obstruction
- mechanical bowel obstruction
- hypercalacemia

A

FUNCTIONAL= metoclopramide
MECHANICAL= cyclizine
HYPERCALCAMEIA= haliperidol

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55
Q

what type of nausea is haliperdiol good for

A

METABOLIC

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56
Q

1st line management for ankylosing spondylitis

A

physio/ exercise

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57
Q

de quervains tenosynovitis

A

extensor pollicis breves and abductor policies longs tendons thickened and inflamated

women
30-50y
unaccustomed exercise e.g. rose pruning.
Finkelsteins test: thumb placed in palm of hand and hand is then ulnar deviated –> pain radial styloid

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58
Q

most common conductive hearing loss older children and adults

A

wax
(can swell with swimming/ showering)

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59
Q

Azathioprine and ACEi

A

induces anaemia and severe leukopenia

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60
Q

3yo boy with rash and low grade fever. oval shaped vesicles on palms and soles, and ulcers present in mouth

A

Coxsackievirus A (hand-foot-mouth disease)

lasts for 7 days

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61
Q

thyroid storm management

A

Sx= volume depletion, congestive heart failure, confusion, N&V, agitation

  • cooling
  • correct volume status
  • propylthiouracil
62
Q

waterhouse friderichsen syndrome

A

massive haemorrhage into one of both adrenal glands

usually caused by bacterial infection e.g. meningococcaemia, low BP and shock, disseminated intravascular coagulation –> adrenal insufficiency

63
Q

“good baby”: for feeding, constipations, symetrically poor weight gain, head circumference
facial features coarse
macroglossia
hypotonic
large fontanelles
umbilical hernia

A

congenital hypothyroidism

64
Q

growth hormone deficiency - what test to do

A

GH
then MRI to exclude tumor

65
Q

non haemolytic tranfusion reaction

A

non severe reaction occurring approx 2 hr into a transfusion

66
Q

otic barotrauma

A

pressure –> ear problems
(divers, descent in aircraft)

67
Q

furunculosis

A

infection of hair follicle In distal meats

68
Q

complex febrile seizure

A

partial (focal)
>15 mins duration
reoccurrence within 24hr within same febrile illness
incomplete recovery within 1hr

69
Q

1st line management of rheumatoid arthritis

A

DMARD: methotrexate OR sulfalazine

(steroids to rapidly improve Sx if already receiving DMARD)

70
Q

influenza virus also callled

A

orthomyxovirus (RNA)

71
Q

Viral warts caused by

A

Papovavirus (DNA virus)

72
Q

encapsulated bacteria - splenectomy

A

SHiN SKiS

Streptococcus pneumoniae
Haemophilus menginitidis
Group B strep
Klebsielle pneumoniae
Salmonella typhi

(that’s why they get penumonoccocal vaccine)

73
Q

hallux valgus

A

foot deformity –> big toe going sideways into second toe

74
Q

gout vs pseduogout

A

PSEUDO= POSITIVE birefringent crystals
GOUT= NEGATIVE birefringent crystals

75
Q

Trauma: what scans to do in RTC but well on exam

A

CXR, pelvic XR, lateral cervical spine XR

76
Q

Lachmans test

A

ACL injury

77
Q

Dantron stimulant (or co-dantrusate/ co-danthramer) causes..

A

red urine

78
Q

philadelphia chromosome

A

9 and 22

79
Q

Mydl’s hernia

A

“W” hernia of bowel loops coming through the abdominal wall

80
Q

small tender, tense, red irreducible lump in lower part of abdominal wall on R side of lateral edge of rectus muscle at semilunar line (costal arch to the uric tubercle)

A

Spigelian

81
Q

Neonatal life support: if bradycardia

A

if bradycardia (normal RR=30-40) but all else normal –>
observe and see how they get on

may need ECG +/- atropine

82
Q

normal neonatal values <1

A

RR 30-40
HR 110-160
Systolic 70-90

83
Q

Neonatal life support after delivery:

A
  1. Warm and stimular
  2. Assess colour, tone, breathing, pulse
  3. control airway (Bag-valve-mask)
  4. if no breathing >90 s –> 5 inflation breaths
  5. if no response try jaw thrust, sucking out oropharynx, consider intubation
  6. if HR <60 –> 3:1 chest compressions
  7. Consider epinephrine IV or via ET tube or umbilical venous line
84
Q

Cephalosporins (e.g. cefuroxme) and CKD

A

reduce frequency as renal excreted

85
Q

Furosemide and CKD

A

increase dose size

86
Q

failure to pass meconium during first 48hr of life

A

Hirschsprungs disease

87
Q

2nd/3rd week of life, bloody stools, abdominal distension, distended bowel loops

A

necrotising enterocolitis (NEC)

88
Q

14 year old asylum seeker
nasal discharge
started watery but now blood stained
temp 38.5oC
greyish membrane over pharynx
lymph nodes enlarged and swollen
difficulty swallowing
“bull neck appearance”

A

diphtheria (corynebacterium diphtheria)

at first similar to common cold

89
Q

Diptheria

A

starts like a cold –> bloody cold
–> exotoxin affects other parts of the body e.g. paralysis or cardiac failure

90
Q

Diphtheria management

A

Benzylpenicillin IV then penicillin V for 10-14 days
AND
antitoxic

91
Q

McMurrays test

A

meniscal tears

92
Q

Thomas test

A

fixed flexion of deformity of hip

93
Q

Posterior draw test

A

posterior cruciate ligament injury

94
Q

Maisoneeuve fracture

A

spiral fracture of the upper thirst of the fibula associated with tear of distal tibiofibular syndesmosis and the interosseous membrane - associated tin fracture of mediaul malleolus or rupture of deep deltoid ligament

–> difficult to pick up –> proximal fibular must be examined in all ankle and Xray preformed if tender

95
Q

blast cells

A

ALL
peak 2-4 years old
B cel origin
bone pain, splenomegaly, lymphadenopathy, thymus enlargement, CNS involved
responds well to chemo

96
Q

rust coloured, blood tinged sputum in CAP

A

Strep pneumonia

97
Q

HIV test- when does to test to see if positive

A

3 MONTHS post exposure

98
Q

Central scotoma (loss of central vision)

A

MS, damage to retina (e.g. HTN), toxic substances (methy alcohol, ethambutol, quinine, nutritional deficiencies, vascular blockages)

99
Q

L temporal lobe lesion –> what visual defect

A

RIGHT SUPERIOR homonymous quantranopia

100
Q

patietal lobe lesion –> what visual defect

A

INFERIOR quandrantopia

101
Q

fungal nail infection (Tinea) management
AKA onychomycosis

A

amorolfine

102
Q

head lice management

A

dimeticone - DimetiCONE

103
Q

Risk factors onychomycosis (Tinea fungal nail infection)

A

nail trauma
immunocompromised e.g. diabetes, HIV infection
PVD (peripheral vascular insufficiency)

–> amorolfine nail lacquer
OR
tervinafine (systemic)

104
Q

causative organismi of peitonisllar abscess

A

streptococcus pyogenes

105
Q

25 M
holiday In Thailand
swimming in lakes
headache, mailaise, muscle and joint pains
O/E mild pyrexia, urticarial papular rash on body

A

Schistosomiasis

106
Q

24 W trekking in SA
fever, bloody diarrhoea, abdo pain
O/E diffuse abdo tenderness
US - liver abscess

A

Amoedbiasis

TREAT= metronidazole

107
Q

40 W
has cats
fever, sore throat, malaise
O/E discrete non tender lymphadenopathy

A

Toxoplasmosis

108
Q

25 M progressive hair low vertex area
thinning of hair both temporal areas
3 years
otherwise healthy
pull test -ve

A

androgenetic alopecia

109
Q

80 yo F
FOOSh
“dinner fork deformity”

A

Colles fracture

110
Q

30 F
thumb pain after fall whilst skiing
tenderness over medial portion of base of right thumb
injury to ulnar collateral ligament on thumb
avulsion fracture

A

Bennetts fracture
AKA skiers thumb / Gamekeepers thumb

111
Q

20 M fell off moribike
feel with wrist flexed

A

Smiths fracture
(AKA reverse colles fracture)

112
Q

5th metacarpal neck fracture

A

boxers fracture

113
Q

tobacco-alcohol amblyopia

A

loss of colour vision

114
Q

Mortons neuroma

A

29 F
pain in L forefoot
came on gradually
like electric shock between second and third toes
high heel shoes make it worse

115
Q

Bibasal atelectasis

A

occurs after 48hr post operative
v common
analgesia and physiotherapy

116
Q

paralytic ileus

A

ileus of gut for > 3 days
hypo motility of GI tract in abscence of mechanical bowel obstruction

Different to obstructer due to ABSENT or HYPOACTIVE bowel sounds (obstruction= high pitched sounds)

117
Q

sjogrens syndrome eye manifestation

A

keratoconjunctivitis sicca
reduced tears, gritty eyes
–> Artificial tears (hypromellose eye drops)

118
Q

28 M excessive sweating, headache, palpitations, BP 240/130

A

phaeochromocytoma

119
Q

30 F BP 220/115
muscle cramps and weakness
K+ 2.2

A

Conns syndrome
(increased aldosterone)

120
Q

45 F headache
visual field deficit
prominent forehead
enlarged tongue
BP 175/105

A

Acromegaly

121
Q

most common type or renal stone

A

calcium oxalate (75%)

122
Q

thiazides and glucose

A

worsen glycemic control

123
Q

25 M
punched in L side of face
can’t open teeth properly
numbness on L side of chin

A

Mental nerve

124
Q

who is MMR contraindicated in

A

undiagnosed neurological condition

CAN HAVE in egg allergy/ HIV

125
Q

NICE: if CCB not tolerated because of oedema..

A

offer thiazine-like diuretic e.g. indapamide

126
Q

nasopharyngeal carcinoma:
what ethnicity
what virus

A

SE asians
Epstein-Barr virus
MRI with gadolinium and fat suppression radiology modality of choice
external irradiation= treatment

127
Q

Pinworm infection

A

Enterobius vermicularis
–> MEBENDAZOLE

128
Q

Thyroglossal cyst vs cystic hygromas vs bronchial cyst

A

Thyroglossal= midline, moves up with tongue sticking out
Branchial= more laterally
Cystic hygromas= posterior triangle

129
Q

cat scratch disease

A

Bartonella henselae
cat scratch –> papule at incoluation site –> solitary lymphadenopathy within 1-2 weeks
(usually sponetansously resollves)

130
Q

H pylori cuases

A
  1. peptic ulcer disease
  2. MALT tumor
  3. gastric adenocarcinoma
  4. Menetriers disease= gastropathy
  5. coronaritis
  6. iron deficiency anaemia
131
Q

Scarlet fever
slapped cheek
hand foot mouth

A

Scarlet fever= Strep pyrogens (strep a)
slapped cheek = parvovirus
hand foot mouth= coxsachievirus

132
Q

oesophageal cancer: initially have problems swallowing..

A

solids then liquids

133
Q

which vaccines contain egg

A

MMRI and influenza
yellow fever

134
Q

Causes UTI in young women

A

E Coli (80%)
Proteus
Klebsiela
Staphylococci saprophyticus

(if abnormalities of urinary tract= pseudomonas aeruginosa and staphylococcus epidermidis)

135
Q

penile fracture

A

traumatic rupture of corpus cavernous –> urological emergency
–> surgical therapy to evacuate the haematoma

136
Q

commonest cause of pain beneath the heel

A

plantar fasciitis

137
Q

left flank mass, left varicocele, haematuria

A

RENAL CANCER
renal cell carcinoma most common in adults
(Wilms tumor most common in kids)

138
Q

Myths about acne

A

not cuased by sunbathing
not cured by drinking water
not contagious
not stres induced
not caused by poor hygiene

MINI PILL MAKES IT WORSE

139
Q

raynauds - treatment if conservative management fails

A

CCBs

140
Q

pseudohypoparathyroisism

A

resistance to PTH
hypokalaemica
hyperphosphataemia
raised PTH
developmental and skeletal defects e.g. short stature, rounded face, shortened hands, random collection

141
Q

40 W with RA presents with severe occur pain and reduced visual acuity

A

scleritis

142
Q

Alport syndrome

A

X lined autosomal recessive
sensorineural deafness, pyelonephritis, haematuria, renal failure

—> dialysis or renal transplant

143
Q

pyelonephritis 1st line treatment

A

cefalexin

144
Q

hyphaema

A

blood in anterior chamber of eye
often post trauma
–> urgent referral to ophthalmologist

145
Q

Subclinical HYPOthyrodisism

A

High TSH, normal T4
(TSH trying to push it up higher as it’s low)

146
Q

IgA antibodies

A

found in tears, digestive tracts, eats, eyes, vagina

147
Q

IgG antibodies

A

most common, fight infection, longer term (IgM first to be made in infection)

148
Q

IgM antibody

A

first to be made in infection
Rheumatoid factor is IgM

149
Q

IgE antibodies

A

react against foreign substances e.g. pollen/ fungus/ spores

150
Q

Gold standard for confirmation of cows milk protein allergy

A

clinical

MSRA (22 decks)

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