Medicine

Question 1

DVLA instructions after an MI?

Answer 1

cannot drive for 4w

Question 2

how does aspirin work?

Answer 2

• COX inhibitor

- stops platelet aggregation

Question 3

what is a capture beat on ECG?

Answer 3

a normal QRS complex between broad VT complexes

Question 4

where does furosemide act?

Answer 4

on the thick, ascending limb of loop of henle

Question 5

how do statins work?

Answer 5

inhibit HMG CoA reductase

Question 6

causes of AF?

Answer 6

• pneumonia
• MI
• HF
• PE
• hyperthyroidism
• alcohol excess
• endocarditis

Question 7

commonest causative organism in infective endocarditis?

Answer 7

viridans streptococci (staph aureus in IVDU)

Question 8

why is a urine dip needed in infectious endocarditis?

Answer 8

to look for microscopic haematuria

Question 9

signs of aortic regurgitation?

Answer 9

• early diastolic murmur
• collapsing pulse
• wide pulse pressure
• displaced apex beat
• quincke’s sign = nailbed pulsation
• de musset’s sign = bead bobbing

Question 10

how is infective endocarditis diagnosed definitively?

Answer 10

3 blood cultures from 3 sites taken at 3 different times

Question 11

risk factors for infective endocarditis?

Answer 11

• IVDU
• prosthetic valve
• PDA
• VSD
• aortic or mitral disease

Question 12

extra-articular signs of rheumatoid arthritis?

Answer 12

• scleritis
• episcleritis
• lymphadenopathy
• vasculitis
• anaemia
• splenomegaly
• neutropenia
• (felty syndrome)

Question 13

precipitants of gout?

Answer 13

• surgery
• starvation
• dehydration
• alcohol
• trauma
• infection
• aspirin
• purine-rich foods (seafood)

Question 14

investigation for gout / pseudogout?

Answer 14

polarised light microscopy of the synovial fluid

Question 15

crystal responsible for pseudogout?

Answer 15

calcium pyrophosphate

Question 16

risk factors for pseudogout?

Answer 16

• hyperparathyroidism
• haemochromatosis
• osteoarthritis
• ageing
• wilson’s disease

Question 17

rash seen in antiphospholipid syndrome?

Answer 17

livedo reticularis

Question 18

causes of raynaud’s phenomenon?

Answer 18

• raynaud’s syndrome
• SLE
• rheumatoid arthritis
• dermatomyositis
• polymyositis
• polycythaemia vera
• beta blocker use

Question 19

key complication of psoriatic arthritis?

Answer 19

arthritis mutilans

Question 20

features of acromegaly?

Answer 20

• thick, spade-like hands
• increased armspan
• frontal bossing
• wide-spaced teeth
• obstructive sleep apnoea
• macroglossia

Question 21

example of a cANCA +ve small vessel vasculitis?

Answer 21

churg-strauss syndrome

Question 22

example of a cANCA -ve small vessel vasculitis?

Answer 22

henoch-schonlein purpura

Question 23

example of a medium vessel vasculitis?

Answer 23

kawasaki disease

Question 24

preferred antibody to test in pernicious anaemia?

Answer 24

intrinsic factor antibodies

Question 25

scale for obstructive sleep apnoea?

Answer 25

epworth sleepiness scale

Question 26

diabetic pt with complete constipation and vomiting?

Answer 26

autonomic gastropareisis

Question 27

what is used to assess the severity of COPD?

Answer 27

FEV1 (80, 50, 30, <30)

Question 28

changes in T2RF?

Answer 28

low O2, high CO2

Question 29

changes in T1RF?

Answer 29

low O2, normal / low CO2

Question 30

complication of correcting hyponatraemia too quickly?

Answer 30

central pontine myelinosis

Question 31

tension pneumothorax Mx?

Answer 31

needle decompression - insert into 2nd IC space, mid-clavicular line

Question 32

antibodies seen in myasthenia gravis?

Answer 32

anti-MuSK antibodies

Question 33

management of myasthenia gravis?

Answer 33

• pyridostigmine
• neostigmine
• IV immunoglobulins
• carboprost