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1MSRA - Learning Points > MCQBANK **Mistakes and Learning Points > Flashcards

MCQBANK **Mistakes and Learning Points Flashcards

1
Q

otitis media with effusion TM appearance

A

air bubbles
air fluid level
bulging

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2
Q

Lambert eaton myasthenic syndrome

A

autoimmune disease again VGCC’s
Spares lung and eyes
Worse in morning, improves with activity

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3
Q

** HIV and MMR vaccine

A

Can still have MMR in HIV as long as not poor immune function

NB// Should not have MMR with undiagnosed neurological condition however.

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4
Q

** Risk factors for infant respiratory distress syndrome

A

Male sex
Premature birth
Maternal diabetes
Multiple pregnancy
C-section rather than vaginal delivery

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5
Q

Haemorrhoid symptoms, precipitating factor, location, grades, management options

A

Painless PR bleeding
Triggered when constipated
Anal pruritis

Most common at 3,7,11 o clock

Grade 1 = inside only
Grade 2 = pops out (e.g when straining) but automatically reduces
Grade 3 = pops out and has to be manually reduced
Grade 4 = Can’t be reduced

Mx options
Non-surgical = rubber band ligation, sclerotherapy, infrared therapy

Surgical = haemorroidectomy

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6
Q

Meckel’s diverticulum = painless rectal bleeding in child (bowel remnant)

A
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7
Q

Complication of entamoeba histolytica GI infection

A

(Obviously causes bloody diarrhoea)

Can also cause amoebic liver abscess

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8
Q

Difference between costochondritis vs Tietze’s syndrome

A

Tietze’s has palpable rib cartilage swelling

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9
Q

Difference between otitis media with effusion vs acute otitis media

A

in OME, patient is systemically well
There is effusion and inflammation in middle ear, in the ABSCENCE OF INFECTION

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10
Q

Most common cause of hearing loss in children

A

OME

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11
Q

Most common type of shoulder dislocation and signs?

A

Anterior shoulder dislocation most common

Caused by fall onto abducted, outward arm (as arm pushed back, the glenoid is pushed anteriorly in shoulder capsule)

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12
Q

2 mechanisms of clavicle fracture usually, and which is most common?

A

Most common = backward and upwards force i.e. falling off horse

Less common = direct clavicular trauma

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13
Q

Function of 4 rotator cuff muscles? What signs on examination?

A

Supraspinatus = abduction first 15 degrees before deltoid takes over

Subscapularis = internal rotation, adduction

Teres minor and infraspinatus = external rotation.

Pain, weakness, crepitus due to friction as loss of stability that comes with rotator cuff muscles, tenderness at subacromial area which is area of rotator cuff insertions

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14
Q

Complications of nasal foreign body?

A

local inflammation

pressure on blood vessels can cause epistaxis

obstruction and inflammation can cause sinusitis

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15
Q

Investigation to diagnose COPD?

A

POST-bronchodilator spirometry, as you’re confirming it is not reversible

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16
Q

Hallmark of genitourinal TB?

A

Sterile pyuria (not this can be caused by many other things though)

Suspect Genitourinary TB in patient with history of repeat UTIs which do not respond to ABx

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17
Q

Most common cause of childhood diarrhoea?

A

Rotavirus

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18
Q

Explain Brown Squared syndrome (including in terms of where tracts cross)

A

corticospinal (motor) and dorsal column (light touch, proprioception, vibration) cross at medulla

spinothalamic cross at sensation level

Hemisection of spinal cord (i.e only one half injured at that level)
causes IPSILATERAL dorsal and corticospinal loss below that level (bc already crossed) and CONTRALATERAL spinothalamic loss below that level (as they have just crossed at that level)

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19
Q

What is the interaction between amlodipine and simvastatin?

A

amlodipine slightly inhibits CYP3A4 enzyme which metabolises simvastatin, so effectively doubles dose of simvastatin

Hence max dose you should prescribe of simvastatin is 20mg when with 10mg amlodipine.

20
Q

When should nausea and vomiting in pregnancy usually resolve by?

A

16-20 weeks

21
Q

What can be used to alleviate N+V in pregnancy?

A

Ginger
Wrist acupuncture
Antihistamines
Phenothiazines

22
Q

What fractures are typical of a fall from height (i.e. axial loading injury)?

A

spinal compression
upper femur (pelvic)
calcaneal (NB// distally spreading bruising on plantar aspect foot = MORDOR sign)

23
Q

Different types of sections??

A

Section 5(2) and 5(4) for patients voluntarily attending hospital (i.e ED)
5(2) is for doctors - 72hrs
5(4) for nurses - 6hs

2 = 28 days, for assessment
3 = 6 months for treatment

135 = private property extraction
136 = police in public

24
Q

Most common cause of otitis media?

A

RSV most common overall

Most common bacterial are HMS

25
Q

What is Samter’s triad?

A

Nasal polyps, asthma, sensitivity to aspirin

26
Q

Difference in symptoms between fibroadenoma and breast cyst?

A
27
Q

Symptoms of chronic supporative otitis media?

A
28
Q

How long after MI can you shag again?

A
29
Q

How long after MI can you return to work?

A
30
Q

How long after MI can you drive if had PCI?

A

1 week

31
Q

Normal physiological changes in pregnancy?

A

Increased stroke volume and HR slightly

BP falls initially

Increase in tidal volume
(A RISE IN RR IS NOT NORMAL HOWEVER)

32
Q

Most common cause of perennial allergic rhinitis?

A

House dust mite

(perennial = all year around)

33
Q

Abx if pyelonephritis treated in community (i.e. when low risk)?

A

Cefalexin

34
Q

MRC dyspnoea scale grades 1-5

A

Shortness of breath

1- only on strenuous activity
2 - on walking uphill
3 - has to walk slower
4 - has to stop at 100m
5 - can’t leave house

35
Q

Difference between PD and Dementia with Lewy body

A

PD motor then after at least a year, you get dementia issues

DLB, there isn’t this gap

36
Q

Which lung cancer type releases PTHrp and causes hypercalcaemia?

A

Squamous cell

37
Q

Symptoms of cholesteatoma?

A

attic crust
leaky ear discharge, smelly
as it invades can cause episodes of vertigo (inwards) and TM perforation (outwards)

38
Q

Management of bronchiolitis in hospital?

A

Ensuring adequate oxygenation and hydration

(Pavalazimumab is prophylaxis only and not given during)

39
Q

Progressive weakness whistling and sucking straw?

A

Fascioscapulohumeral dystrophy

40
Q

E.Coli is the most common bacteria in UTIs. As a side fact, which bacteria is also common in sexually active women?

A

Staphylococcus saprophytic

41
Q

Which pulmonary complication does methotrexate cause? How do you treat it?

A

Pneumonitis (dry cough, dyspnoea, bibasaliar crackles, +/- fever)

Treatment is stop methotrexate and treat with prednisolone

42
Q

Which drug classes are used to treat BPH?

A

5 alpha reductase inhibitors (finasteride)

alpha BLOCKERS (tamsulosin - relaxes the smooth muscle around prostate, allowing better passage of urine)

43
Q

Example of acne treatment safe in pregnancy?

A

Topical benzoyl peroxide

44
Q

What is Brugada syndrome, what does ECG show and what is management?

A

Autosomal dominant heart condition causing defective sodium channels, which predisposes to life-threatening ventricular arrhyhthmias.

ECG shows coved ST elevation followed by T wave inversion in any of V1-3.

Management is with ICD which helps identify and cardiovert/defibrillate the tachyarrhythmias.

45
Q

Most common type of childhood epilepsy?

A

Benign Rolandic epilepsy

Focal motor aware seizures, usually affecting face (as this corresponds to Rolandic area), that occur infrequently at night-time and usually resolve by the age of 16.

As in the name, benign, so treatment not needed.

46
Q

SSRIs you can use in breastfeeding?

A

Sertraline or paroxetine

47
Q

Treatment of nasal polyps?

A

Intranasal steroids for 3 months

1MSRA - Learning Points (20 decks)

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