MEDICINE

Question 1

NAME CAUSES OF MICROCYTIC ANAEMIA

Answer 1

THALASAEMIA
ANAEMIA OF CHRONIC DISEASE
IRON DEFICIENCY
LEAD POISONING
SIDEROBLASTIC ANAEMIA

Question 2

NAME CAUSES OF NORMOCYTIC ANAEMIA

Answer 2

ACUTE BLOOD LOSS
BONE MARROW FAILURE
CHRONIC DISEASE
DESTRUCTION (HAEMOLYSIS)
RENAL FAILURE

Question 3

NAME CAUSES OF MACROCYTIC ANAEMIA

Answer 3

FETUS
ALCOHOL
THYROID DISEASE (HYPO)
RETICULOCYTOSIS
B12 FOLATE
CIRRHOSIS AND CHRONIC LVER DISEASE

Question 4

TALK THROUGH GCS

Answer 4

Motor response	6. Obeys commands
5. Localises to pain
4. Withdraws from pain
3. Abnormal flexion to pain (decorticate posture)
2. Extending to pain
1. None
Verbal response	5. Orientated
4. Confused
3. Words
2. Sounds
1. None
Eye opening	4. Spontaneous
3. To speech
2. To pain
1. None

Question 5

What is Budd chiari syndrome?

Answer 5

Hepatic vein thrombosis seen usually as a result of haematological malignancy or pro coagualant state (polycythaemia rubra vera, thrombophillia, pregnancy, COCP

• sudden onset severe abdominal pain
• ascites
• tender hepatomegaly

Investigate using USS with doppler

Question 6

What are the causes of upper zone pulmonary fibrosis?

Answer 6

CHARTS
C - Coal worker's pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis

Question 7

What are the causes of lower zone pulmonary fibrosis?

Answer 7

idiopathic pulmonary fibrosis
most connective tissue disorders (except ankylosing spondylitis) e.g. SLE
drug-induced: amiodarone, bleomycin, methotrexate
asbestosis

Question 8

What cells are seen on blood film in CLL?

Answer 8

smudge/smear cells

Question 9

What is seen on biopsy in burkitts lymphoma

Answer 9

starry sky appearance

Question 10

What is seen on blood film in G6PD deficiency?

Answer 10

Heinz bodies/bite cells

Question 11

What is associated with pulsus paradoxus?

Answer 11

Cardiac tamponade

Question 12

What is associated with a bisferiens pulse

Answer 12

Mixed aortic valve disease

Question 13

on a blood film what does haemolysis show?

Answer 13

Helmet cells/schistocytes

Question 14

what is the treatment for a prolactinoma?

Answer 14

dopamine agonist BROMOCRIPTINE

Question 15

What is the medical treatment for acromegaly?

Answer 15

cabergoline (dopamine agonist)

Question 16

What is iron deficiency anaemia associated with?

Answer 16

pencil poikilocytes

Question 17

What triad is associated with cardiac tamponade?

Answer 17

Becks triad
muffled heart sounds
hypotension
raised JVP

ECG showing electrical alternans

Question 18

what is electrical alternans associated with?

Answer 18

ECG changes for cardiac tamponade

Question 19

What is thalasaemia associated with on blood film?

Answer 19

Target cells
Basophilic stippling
heinz bodies

Question 20

What is a quaternary fever associated with

Answer 20

falciprum malariae

Question 21

what is a tertiary fever associated with

Answer 21

falciprum ovale, vivax

Question 22

What is erythema infectiosum?

Answer 22

parvo virus b19 slapped cheek

Question 23

On a blood film what is hyposplenism associated with?

Answer 23

target cells
acanthocytes
pappenheimer bodies
siderotic granules
howell jolly bodies

Question 24

what treatment for non typhoid salmonella?

Answer 24

Ciprofloxacin

Question 25

what is pulsus paradoxus and what is it seen in?

Answer 25

acute asthma, cardiac tamponade | fall>10 systolic on inspiration leads to faint or absent pulse on inspiration

Question 26

What is characteristic of megaloblastic anaemia on a blood film?

Answer 26

hypersegmented neutrophils

Question 27

what are heterophile antibodies associated with?

Answer 27

EBV

Question 28

what is the treatment of acute prostatis

Answer 28

quinolone or trimethoprim

Question 29

what is pulsus alterans associated with?

Answer 29

severe LVH due to the regular alternation of the arterial pulse

Question 30

what is erythema chronica migrans associated with?

Answer 30

Lyme disease

Question 31

Talk about Erwing sarcoma

Answer 31

5-15 small cell tumour commonly in legs or pelvis Patients present with a painful swelling and fever X-ray shows a lytic lesion with onion skinning (laminated periosteal reaction)

Question 32

What is a direct inguinal hernia?

Answer 32

Protrudes directly through weakened area in transversalis fascia (Hesselbachs triangle) MEDIAL to inferior epigastric artery ACQUIRED - smoking (due to cough) - obesity - heavy lifting RARELY STRANGULATES due to wide gap

Question 33

What is an indirect hernia?

Answer 33

travels down the inguinal canal and into the scrotum failure of the process vaginalis to close found in young active men and babies LATERAL to inferior epigastric artery Medial to pubic tubercle can descend into the testicle on coughing and cant palpate upper border

Question 34

3 things about CYSTIC HYGROMA

Answer 34

Transilluminates brightly Fluid filled Posterior triangle

Question 35

What is the most common subtype of ovarian carcinoma and what does it show on biopsy?

Answer 35

Serous cystenocarcinoma -psammo bodies - concentric calcified laminated bodies often bilateral

Question 36

what is another word for teratoma

Answer 36

dermoid cyst

Question 37

when are sensitising miscarriages given anti d?

Answer 37

post 12 weeks | unless uterine vacuation is required

Question 38

what cells are seen in G6DP deficiency?

Answer 38

Bite cells and heinz bodies

Question 39

What cells are seen post splenectomy?

Answer 39

Howell Jolly bodies

Question 40

how to differntiate between CML and CLL

Answer 40

aurer rods in CML

Question 41

What are tear drop poilikocytes associated with?

Answer 41

Myelofibrosis