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Mock answers I got wrong > Medics Hockey Phase 2a SBA > Flashcards

Medics Hockey Phase 2a SBA Flashcards

1
Q

Jerry is a 76 year old man who has been brought to A&E by his husband after he noticed Jerry was unable to walk, had left-sided arm and leg weakness and slurred speech.
Jerry has a past medical history of type 2 diabetes mellitus and hypertension. He also drinks 3 cans of lager per day and has been a smoker for 25 years.

Following some investigations, the doctors diagnose Jerry with an ischaemic stroke. Which of the following vessels is the most likely to have been occluded?

right anterior cerebral artery
left anterior cerebral artery
right middle cerebral artery
left middle cerebral artery
posterior cerebral artery

A

right middle cerebral artery

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2
Q

What is the way to remember the 6 steps taken for sepsis?

A

BUFALO
Blood cultures
Urine output monitoring
Fluids
Antibiotics
Lactate
Oxygen
(Give 3 things, take 3 things)

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3
Q

What is the correct advise for a metered dose inhaler?

A

Shake your inhaler before use
Wait 30-60 seconds between puffs
Rinse your mouth after using your inhaler
Breath in slowly and steady for 3-5 seconds until your lungs feel full

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4
Q

What screening tool would be appropriate to use to aid your diagnosis for major depressive disorder?

A

PHQ-9

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5
Q

What is GAD-7 screening tool for?

A

Generalised anxiety disorder

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6
Q

What is AUDIT screening tool for?

A

alcohol dependence

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7
Q

What is CAGE screening tool for?

A

alcohol dependence

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8
Q

What is PDSS screening tool for?

A

Panic disorder severity scale

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9
Q

Which cancers commonly metastasise to lung?

A

Kidney cancer
Breast cancer
Bowel cancer
Prostate cancer

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10
Q

The four quadrants approach (Jonsen et al 1982) identifies four distinct areas which can be applied to clinical scenarios in order to identify, assess and resolve ethical issues. What are they?

A

Medical indications
Patient preferences
Quality of life
Contextual features

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11
Q

What are the TSH and T3, T4 levels for Hashimoto’s thyroiditis?

A

Primary hypothyroidism
High TSH
Low T3/4

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12
Q

What are the TSH and T3, T4 levels for secondary hypothyroidism?

A

Low TSH
Low T3/T4

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13
Q

What are the TSH and T3, T4 levels for Grave’s disease?

A

Primary hyperthyroidism
Low TSH
High T3/T4

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14
Q

What are the TSH and T3, T4 levels for secondary hyperthyroidism?

A

(pituitary/hypothalamus):
high TSH
high T3/4

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15
Q

Which pattern recognition receptors (PRRs) is able to detect the flagellin of certain bacteria?

A

TLR5

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16
Q

Which pattern recognition receptors (PRRs) is able to detect gram positive bacteria?

A

TLR2

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17
Q

Which pattern recognition receptors (PRRs) is able to detect dsRNA virus?

A

TLR3

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18
Q

Which pattern recognition receptors (PRRs) is able to detect lipopolysaccharide gram negative bacteria?

A

TLR4

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19
Q

Which pattern recognition receptors (PRRs) is able to detect ssRNA virus?

A

TLR7

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20
Q

Which pattern recognition receptors (PRRs) is able to detect dsDNA virus?

A

TLR9

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21
Q

Which pattern recognition receptors (PRRs) is able to detect C-reactive protein?

A

CRP

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22
Q

What is the treatment for diffuse cutaneous systemic sclerosis?

A

Anti-topoisomerase-1 antibodies (anti-SCL 70)

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23
Q

what is meant by ‘potentiation’ in regard to 2 drugs being used in conjunction?

A

the effect of one drug is greater than expected, but the other remains normal

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24
Q

Which drug class works by inhibiting the 14a-sterol demethylase intermediate in the pathway of cholesterol and ergosterol production?

A

Azoles

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25
Q

Which of the following is not a symptom usually associated with ankalosing spondylitis?

Achilles and heel pain
Red, sore eyes
Lower back stiffness
Swollen fingers
Skin rash

A

Skin rash

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26
Q

What is the correct order for bloods?

A

aerobic cultures, anaerobic cultures, U&E, FBC

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27
Q

Which of the following is a cause of type 1 resp failure?

Opioid overdose
Guillain-Barre syndrome
Traumatic spinal cord injury
Hypothyroidism
Pulmonary embolism

A

Pulmonary embolism
Rest are type 2

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28
Q

What is the first line medication for depression?

A

selective serotonin reuptake inhibitor

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29
Q

What is the 3rd medication for COPD?

A

ICS

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30
Q

Which is not a symptom of hyperparathyroidisim?

loin to groin severe pain
nausea and vomiting
constipation
muscle weakness
parasthesia

A

parasthesia
(hypo)

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31
Q

What is the way to remember risk factors for atrial fibrillation?

A

SMITH (sepsis, mitral valve pathology, ischaemic heart disease, thyrotoxicosis, hypertension)

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32
Q

What is an appropriate test for a 6 month old baby with low weight, cough, wheeze, cough and prolonged jaundice

A

CF most likely so sweat test if heel prick test not done then sweat test

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33
Q

Which of the following is not a type of complementary and alternative medicine?

Acupuncture
Osteopathy
Homeopathy
Aromatherapy
Flexopathy

A

Flexopathy

34
Q

What is the treatment for rate control for atrial fibrillation?

A

Beta-blocker / CCB / digoxin

35
Q

What is the treatment for rhythm control for atrial fibrillation?

A

Amiodarone / flecainide

36
Q

Which area of the heart and coronary artery do leads II, III and avF correspond to?

A

Inferior and right coronary artery

37
Q

What fracture is it where the leg is characteristically shortened and externally rotated?

A

Neck of femur fracture

38
Q

Describe the pathophysiology behind front-temporal dementia

A

degeneration of the frontal and temporal lobes due to intracellular collections of tau protein (Pick bodies) and TDP 43

39
Q

Which HLA genes are associated with coeliac disease?

A

HLA-DQ2

40
Q

What scoring systems assesses the severity of the pancreatitis?

A

Glasgow Severity Assessment Score

41
Q

What cells are seen in Chronic Lymphoblastic Leukaemia?

A

Smudge cells

42
Q

What is a side effect commonly associated with the use of Nifedipine?

A

Ankle swelling

43
Q

Which growth medium is most appropriate for culturing a fungal organism?

A

Sabouraud agar

44
Q

What is naproxen?

A

An NSAID

45
Q

What condition is likely?

56 year old Bill is admitted to EMU with haematemesis and melaena. He previously worked in construction and takes regular medication for back pain. He smokes (1 pack per week) but does not drink alcohol. Blood tests show anaemia (Hb 64)

A

Upper GI bleed
(possibly due to overuse of NSAIDS)

46
Q

What is the mechanism of pernicious anaemia?

A

Autoimmune destruction of gastric parietal cells stops the production of intrinsic factor needed for B12 absorption

47
Q

What is the mnemonic to remember risk factors for acute pancreatitis?

A

IGETSMASHED
Idiopathic
Gallstones
Ethanol
Trauma
Steroids use
Mumps
Autoimmune
Scorpion stings
Hyperglycaemia
ERCP
Drugs

48
Q

What is seen on Xray for ankylosing spondylitis?

A

squaring of the vertebral bodies
subchondral sclerosis
syndesmophytes
joint fusion

49
Q

Rhinorrhoea, miosis, ptosis and lacrimation are most associated with what type of headache?

A

Cluster headache

50
Q

Which of the following is not a type of primary brain tumour?

Astrocytoma
Oligodendroglioma
Ependymoma
Meningioma
Ewing sarcoma

A

Ewing sarcoma

51
Q

Which drug works by interfering with the synthesis of folic acid?

A

trimethoprim

52
Q

What is 1st line treatment for DVT?

A

DOAC such as rivaroxiban or apixaban

53
Q

Palpation of the right upper quadrant on inspiration causes severe pain is what sign and positive in what condition?

A

Murphy’s sign
Acute cholecystitis

54
Q

What is the MRC Dyspnoea scale?

A

0 - breathless with strenuous exercise
1 - short of breath hurrying on level ground or walking up a slight hill
2 - on level ground walking slower than others the same age or having to stop for breath
3 - having to stop after 100 yard or a few minutes for breath
4 - too breathless to leave the house or breathless when dressing/undressing

55
Q

Which plasmodium parasites causes the most severe type of malaria?

A

Plasmodium falciparum

56
Q

Which of the following conditions is not a common cause of diarrhoea?

Inflammatory bowel disease
Coeliac disease
Irritable bowel syndrome
Pseudomembranous colitis
Diverticulosis

A

Diverticulosis
Usually constipation

57
Q

What is the treatment for uncomplicated lower urinary tract infection (NO fever, medical history, flank pain etc.)?

A

Treatment is usually a 3 day prescription of Nitrofurantoin or trimethoprim

58
Q

Describe the order of asthma treatment

A

SABA (reliever) eg. salbutamol
ICS (preventer) eg. beclometasone
+- LTRA eg. montelukast
+- LABA (but if using in children then stop LTRA) eg. salmeterol

59
Q

Patient flexes his wrists his hands begin to move up and down. What is this a sign of?

A

Decompensated alcohol-related liver disease

60
Q

Which of the following is not found in an atherosclerotic plaque?

Lipids
Smooth muscle cells
foam cells
macrophages
plasma cells

A

Plasma cells

61
Q

What is the diagnosis for young, chest pain, crunching snow sound on auscultation?

A

Pericarditis

62
Q

What is the 1st line treatment for pericarditis?

A

The treatment for pericarditis is high dose NSAIDs/Aspirin + colchicine

63
Q

Which of the following is not a symptom of Parkinson’s disease?

hypomimia
resting tremor
asymmetrical reduced arm swing
cog wheel rigidity
chorea

A

chorea
huntington’s

64
Q

Which of the following antibodies is associated with coeliac disease?

ADAMTS13
Anti-cyclic citrullinated peptide antibody
Anti-nuclear antibody
Anti-liver kidney microsomal-1 antibody
Tissue Transglutaminase antibody

A

Tissue Transglutaminase antibody

65
Q

Which of the following clotting factors is part of the extrinsic pathway in the coagulation cascade?

Factor XII
Factor IX
Factor VIII
Factor XI
Factor VII

A

factor 7

66
Q

Which of the following is not a factor which influences a patient’s perception of risk?

lack of personal experience with the problem

belief that is is preventable by personal action

belief that if it has not happened by now it is not likely to

belief that the problem is infrequent

belief that the problem doesn’t affect the patient because they partake in positive health behaviours

A

belief that the problem doesn’t affect the patient because they partake in positive health behaviours

67
Q

Which of the following hepatitis’ is a patient likely at risk from with IV drug use?

A

Hep A, B and C

68
Q

Which of the following conditions is not an AIDS-defining illness?

Pneumocystis jirovecii pneumonia
Cryptococcal meningitis
Non-hodgkin lymphoma
Cervical cancer
Pertussis

A

Pertussis

69
Q

What is the diagnosis for severe untreated Addison’s disease presents to hospital with palpitations, vomiting and fatigue. An ECG is done which shows hyper acute tented T waves and a wide QRS complex?

A

Hyperkalemia severe

70
Q

What is the treatment for severe hyperkalaemia?

A

insulin (cells take in K+), dextrose, calcium gluconate (protect heart) and salbutamol (shift K+ to intracellular)

71
Q

What is the diagnosis for the following?

54 year old Jane has come to the diabetic foot clinic as she has noticed some redness and shape change in her left foot.
Upon examination, Jane has a 10mm necrotic ulcer on her 3rd distal phalanx, with approximately 5mm redness surrounding it.
The doctor decides to x-ray her foot which shows an ill-defined periosteum of the 3rd distal phalanx, significantly different to her x-ray 3 months ago which was normal

A

Osteomyelitis

72
Q

What is the most common cause for osteomyelitis?

A

Staphylococcus Aureus

73
Q

Which enzyme is responsible for the conversion of purines to uric acid?

A

xanthane oxidase

74
Q

What is the diagnosis?

drowsy, have a reduced respiratory rate and although conscious are responding very slowly. Their pupils are small and do not change when you shine a pen torch in their eyes. The patient is known to be homeless, and you can see track marks on their forearms

A

Opioid overdose

75
Q

What is the treatment for opioid overdose?

A

Naloxone (opioid antagonist)

76
Q

What is seen on ECG for DKA

A

Hyperkalaemia
Loss of P waves, wide QRS, tall tented T waves, prolonged PR interval

77
Q

What are the shapes of Subarachnoid haemorrhage, Subdural haemorrhage and Extradural haemorrhage on CT?

A

Star
Crescent
Lentiform

78
Q

What is the mnemonic to remember congestive heart failure symptoms?

A

SOB AS FAT
SOB
ankle swelling
fatigue

79
Q

What is the treatment for congestive HF?

A

ABAL
1. ACE inhibitor
2. Beta Blocker
3. Aldosterone antagonist
4. Loop diuretic
+- hydralazine & isorbide denigrate, digoxin, ivabradine

80
Q

What is the ABCD2 score for strokes?

A

Age 60+ 1
BP >140/90 1
Clinical - speech only 1, speech with muscular weakness 2
Diabetes 2, Duration >60mins 2, <60mins 1

81
Q

How to calculate units of alcohol?

A

ABV (%) x volume (ml)) / 1000

82
Q

What is the mnemonic to remember risk factors for osteoporosis?

A

SHATTERED FAMILY
Steroids
Hyperparathyroidism/Hyperthyroidism
Alcohol
The family history
Testosterone (low)
Early menopause
Renal/liver failure
Erosive/inflammatory bone disease (RA)
Diabetes/vitamin D/dietary calcium
BMI (low)
Older age
No movement
Eating disorder
Smoking/female Sex
Family history

Mock answers I got wrong (6 decks)

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