Medicine Flashcards
What QRISK2 score requires a patient to be started on statins?
A) 5% B) 7% C) 10% D) 12.5% E) 15%
C) 10%
Which antibiotic should be used to treat a recurrent episode of C. diff infection (<12 weeks)
A) ciprofloxacin B) co-amoxiclav C) fidaxomicin D) prednisolone E) vancomycin
C) fidaxomicin
Next step in management for C diff for a patient not responding PO vancomycin?
A) IV vancomycin B) IV vancomycin + IV fidaxomicin C) IV vancomycin + IV metronidazole D) PO vancomycin + IV metronidazole E) PO vancomycin + PO fidaxomicin
D) PO vancomycin + IV metronidazole
Management of patient with INR 6.1
A) oral vitamin k 5mg and continue warfarin at lower maintenance dose
B) give half the usual dose for 5 days then continue as normal
C) oral vitamin K 5mg and stop warfarin for 2 days
D) withhold 2 doses of warfarin and reduce subsequent maintenance dose
E) admit to hospital until inr normal
D) withhold 2 doses of warfarin and reduce subsequent maintenance dose
Treatment for torsades de pointes?
A) IV naloxone B) IV MgSO4 C) DC cardioversion D) IV amiodarone E) IV verapamil
B) IV MgSO4
COPD management in patient unresponsive to salbutamol inhaler A) LTRA B) Theophylline C) LABA + ICS D) LABA + LAMA E) LABA + LAMA + ICS
D) LABA + LAMA
3 day history of bloody diarrhoea and fever, stool samples have grown salmonella. Which abx?
A) metronidazole B) doxycycline C) clarithromycin D) ciprofloxacin E) amoxicillin
D) ciprofloxacin
HIV patient suffering with seizures - brain CT shows single lesion with homogenous enhancement, thallium SPECT scan shows increased uptake (positive). Most likely cause of symptoms?
A) cryptococcus B) CNS lymphoma C) CNS tuberculosis D) HIV encephalitis E) Toxoplasmosis
B) CNS lymphoma
A patient with a subarachnoid haemorrhage may become haemodynamically unstable - ECG feature?
A) no p waves B) peaked t waves C) polymorphic ventricular tachycardia D) normal E) prolonged qrs duration and s wave in v1
C) polymorphic ventricular tachycardia
What medication would be used first line to induce remission in an acute flare of Crohn’s disease?
A) azathioprine and sulfasalazine B) azathioprine only C) glucocorticoids and sulfasalazine D) glucocorticoids only E) sulfasalazine and infliximab
D) glucocorticoids only
After a stroke, a patient is suffering with speech, language and swallowing. She then becomes increasingly SOB, has developed a cough and is pyrexial. What will most likely be seen on the CXR?
A) raised left hemidiaphragm B) bilateral pleural effusion C) consolidation in right lung D) consolidation in left lung E) tracheal deviation to the right
C) consolidation in right lung
What ECG abnormality is seen with hypercalcaemia?
A) long PR interval B) short PR interval C) long QT interval D) short QT interval E) depressed T waves
D) short QT interval
T1DM patient presents with 6W history of worsening hbA1c, nausea, bloating and vomiting. Most likely cause?
A) gastropareses B) crohns C) ulcerative colitis D) IBS E) gastric cancer
A) gastropareses
80y/o M, persistent back pain, bony tenderness in thoracic spine, restricted range of movement, blood tests show raised calcium and leucopenia. Next most appropriate action?
A) measure serum PTH B) urgent protein electrophoresis and bence jones protein testing C) refer to physio D) urgent spine MRI E) appropriate analgesia
B) urgent protein electrophoresis and bence jones protein testing
66 y/o male with hypertension and hypokalaemia- abdo CT shows bilateral adrenal enlargement and adrenal vein sampling demonstrates production of excess aldosterone bilaterally. Most appropriate treatment?
A) chemotherapy B) IV hydrocortisone C) radiotherapy D) spironolactone E) surgery
D) spironolactone
52y/o M presents with central chest pain and vomiting - has drunk a bottle of vodka. There is mild crepitus in epigastric region.
A) Inferior MI B) Anterior MI C) pancreatitis D) boerhaave syndrome E) Mallory Weiss tear
D) boerhaave syndrome
A 52 y/o F presents with weakness and pins and needles in her right hand. O/E she has wasting of the thenar eminence associated with sensory loss to palmar aspect of lateral (radial) 3 fingers. Which nerve is affected?
A) common peroneal nerve B) median nerve C) radial nerve D) anterior interosseous nerve E) ulnar nerve
B) median nerve
A man is seen in diabetic food clinic with a chronic ulcer on his leg. It is well demarcated with no sensation at the base of the ulcer. The ulcer has grown the same bacteria from multiple swabs during the last 5 months. Patient is systemically well. The base of the ulcer is wet with a pale green slough over it and smells damp and offensive. Which organism is responsible?
A) pseudomonas aeruginosa B) streptococcus pyogenes C) staphylococcus aureus D) clostridium perfringens E) klebsiella pneumoniae
A) pseudomonas aeruginosa
In the GP, patient presents with symptoms suggestive of Graves’ disease. Along with referral to endocrinology, which medication should the GP commence?
A) bisoprolol B) carvedilol C) iodine D) propranolol E) propylthiouracil
D) propranolol
Risk of long term PPI use?
A) MI B) stroke C) fractures D) liver impairment E) diabetes
C) fractures
68 y/o M has ischaemic stroke with occlusion of proximal anterior circulation 5 hours ago, most appropriate management?
A) aspirin B) clopidogrel C) endoxaban D) thrombectomy E) thrombolysis
D) thrombectomy
Which medication should be avoided in a patient with HOCM?
A) amiodarone B) atenolol C) disopyramide D) ramipril E) verapamil
D) ramipril
Which medication increases the risk of a patient developing intracranial hypertension?
A) ferrous sulphate B) lymecycline C) paracetamol D) progesterone only pill E) salbutamol
B) lymecycline
75 y/o M presents to his GP with a resting tremor in right hand which disappears on movement and stiffness in fingers. No cerebellar signs and neurology is otherwise normal. History of hypertension for which he takes amlodipine.
Next step in management?
A) refer to neurology B) refer for nerve conduction studies C) start on propranolol D) do nothing and monitor E) start on levodopa
A) refer to neurology
