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*phase 2a mocks > minerva saq 1 > Flashcards

minerva saq 1 Flashcards

1
Q

acute pancreatitis management

A
  • fluid resuscitation
  • intravenous fluids
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2
Q

what is cullens and grey turners sign

A
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3
Q

acute pancreatitis complications

A

acute kidney injury
death
multi-organ failure
diabetes mellitus
hypoxia
chronic pancreatitis
hyperglycemia

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4
Q

biological features of depression

A
  • Loss of appetite
  • overeating
  • early morning wakening
  • poor memory
  • concentration loss
  • loss of libido
  • insomnia
  • constipation
  • diarrhoea
  • menstrual disturbance
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5
Q

cognitive features of depression

A
  • feeling of being a failure
  • negative thoughts
  • reduced self-esteem
  • reduced confidence (poor memory
  • concentration loss – if not included in answer above) anhedonia
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6
Q

depression assessment tool

A

PHQ 9 (patient health questionnaire 9)

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7
Q

pharmalogical treatment of depression:

Class and name of drug

A

Class – Selective Serotonin Reuptake Inhibiter
Examples - fluoxetine, citalopram, sertraline

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8
Q

depression managements

A
  • Psychological therapy
  • CBT
  • talking therapy
  • counselling
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9
Q

name an anti-rheumatic drug

A

methotrexate

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10
Q
A
  • Ulnar deviation of MCP joints
  • Swan neck deformity
  • Boutonniere deformity
  • Z shape deformity of thumbs
  • MCP joint swelling
  • MCP joint subluxation
  • muscle wasting
  • ulnar deviation
  • joint swelling
  • Z shape deformity
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11
Q

List two features that may be seen on radiographs of patients with rheumatoid arthritis?

A
  • Joint space narrowing
  • periarticular osteopenia
  • juxtaarticular bony erosions
  • subluxation
  • periarticular soft tissue swelling
  • bony erosion
  • osteopenia
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12
Q

what tests are normally ordered along with HIV

A

Every person who has HIV should get tested for HCV. Usually, a person will first get an HCV antibody test. This test checks for HCV antibodies in the blood. HCV antibodies are disease-fighting proteins that the body produces in response to HCV infection.

Hepatitis B (HBV Core Antibody, HBV Surface Antigen); Hepatitis C (Antibody), Syphilis/Treponema screen

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13
Q
A

Cotrimoxazole or septrin

  • Co-trimoxazole is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the urinary tract, ears, and intestines. It also is used to treat ‘travelers’ diarrhea.
  • This is an antibiotic. It is used to prevent and treat a type of chest infection called Pneumocystis Jiroveci pneumonia. You may hear the doctors and nurses referring to this as ‘PCP’ as it was previously called Pneumocystis Carinii pneumonia.
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14
Q

What test would a HIV team use to confirm that the ART is working?

A

Viral load / RNA PCR

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15
Q

preganant patient on ART with HIV
Give resassurances:

A
  • With ART and an undetectable viral load vertical transmission of HIV is very rare (1 mark)
  • First line ART is safe for the foetus (1 mark)
  • Avoidance of breast feeding reduces risk post-partum (1 mark);
  • Normal vaginal delivery is safe (1 mark)
  • Caesarean section is not necessary (1 mark)
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16
Q

test a doctor request to monitor the therapeutic effect of warfarin?

A
  • INR (international normalised ratio)
  • PT (prothrombin time)
  • clotting screen
17
Q

reasons why someone may be over anticoagulated

A
  • Change in medication
  • recent prescription of antibiotics
  • infection
  • liver disease
  • alcohol consumption
  • dietary changes
  • a change in drug metabolism or drug-drug interactions
18
Q

vitamin K dependent clotting factors

A

2, 7, 9, 10

19
Q

list two treatments that should be administered promptly to reverse the anticoagulant effects of warfarin

A
  • Vitamin K
  • Prothrombin complex concentrate or by brand e.g. Beriplex)
  • FFP

Fresh frozen plasma is the fluid portion of a unit of whole blood frozen in a designated time frame, usually within 8 hours. Fresh frozen plasma contains all coagulation factors except platelets.

20
Q
A

The patient has explained the reasons and supporting the patient protects the patient’s autonomy. If the patient has capacity it would not be beneficent or legal to force treatment; that would be causing harm to the patient’s well-being, i.e., maleficence.

Virtue ethics can be considered here- the patient has a right to live by their values. Her quality of life nor what she values (Friendship and music) is not being compromised by her lack of vision as perceived by the patient. (2 Marks)

21
Q
A
  • Patient’s condition
  • likelihood of benefit or effect of planned or proposed treatment
  • patients wishes
  • values and concerns
  • patient’s mental well-being of proposed actions
22
Q

&
What would be the appropriate course of action to take here; as the patient is refusing an effective surgery that will restore vision?

A

Mental Capacity Act

Any answer that indicates respecting the patient wishes but supporting her and exploring any concerns she may have about surgery.

23
Q

alcohol dependence test

A
  • FAST
  • AUDIT
  • CAGE
24
Q

Name and briefly explain the two main types of alcohol or drug dependence.

A

A- Physical dependence (1 mark); Body adapts to presence of the substance and over time needs more and more for same effect (tolerance) OR Stopping use leads to withdrawal symptoms, e.g. runny nose, stomach cramps, muscle aches.

B- Psychological dependence (1 mark); Feeling that life is impossible/challenges cannot be faced without the drug OR Emotional effect: feelings of fear, pain, shame, guilt, loneliness without drug

25
Q

Population based studies of alcohol consumption have identified what is referred to as the ‘Alcohol Harm Paradox’. What does this term refer to?

A

The Alcohol Harm Paradox refers to observations that lower socioeconomic status (SES) groups consume less alcohol than higher SES groups but experience greater alcohol-related harm/problems

26
Q

Give two examples of population level approaches to primary prevention of harmful drinking in the UK:

A
  • ‘Know your limits’ binge drinking campaign
  • Drinkaware - Alcohol labelling
  • ‘THINK!’ drink driving campaign developed by the Department of Transport
  • Restriction on alcohol advertising by Ofcom.
  • TV ad campaign warning of danger of ‘just one more drink’
  • Minimum pricing in Scotland
27
Q
A

Answers: Benign prostatic enlargement or benign prostatic obstruction, benign prostatic hyperplasia

Answers: Award 1 mark for any of the following - detrusor failure/ age-related detrusor dysfunction, anterior prostate cancer, prostate cancer

Answers: Award I mark for any of the following: urine dipstick or Mid-Stream Urine sample
For blood/ infection – Award 1 mark for any of the following: serum creatinine, renal function, full blood count, prostate specific antigen, PSA, eGFR

Class: Alpha-adrenoceptor blocker (Example - Tamsulosin, Doxazosin, Alfuzosin)
Class: 5-alpha-reductase inhibitor (Example- Finasteride, Dutasteride)

Transurethral resection of prostate (TURP) or laser prostatectomy or retropubic prostatectomy/ enucleation.

28
Q

List four features on clinical examination which could be suggestive of diagnosis of hypothyroidism?

A

Bradycardia, Goitre, dry skin, brittle hair, Weight gain, slowed speech and movements, dry skin, jaundice, pallor, brittle or thinning hair, hair loss, dull facial expression, neck swelling, periorbital puffiness, hoarseness, macroglossia, decreased blood pressure, oedema of limbs, myxedema, nonpitting edema, hypothermia, pitting oedema of lower limbs, hyporeflexia with delayed relaxation, ataxia, slow reflexes

29
Q

drug treatment for hypothyroidism

A

Levothyroxine, thyroxine, thyroxine replacement therapy

30
Q

List three possible causes of any patient developing hypothyroidism

A

Radioactive iodine
Post-partum
Thyroiditis
Anti-thyroid drugs
Medications e.g. lithium therapy
Iodine deficiency
Genetic
Tumour
Postpartum thyroiditis
Drug induced

31
Q
A

Answers: Award 1 mark for any of the following - Did you get any warning, how long did you lose consciousness for, did you bite your tongue, did you wet yourself?

Answers: Award 1 mark for any of the following -Were the eyes open or closed, how quickly did she come round again, were there any limb movements?, if described pattern – symmetrical or asymmetrical, tonic-clonic or not

Answers: Award 1 mark for any of the following: previous head injury, underlying brain disease, fever, history of fits, born at full term, have they taken any drugs/alcohol (1 mark)

Answers: Award 1 mark for any of the following: normal, bitten tongue, confusion, incontinence, loss of memory

Answers: Award 1 mark for any of the following: EEG, MRI – brain or head, CT Scan Head, CT brain

32
Q
A

Explanation: The case describes a case of community-acquired pneumonia. The patient has stayed away from home and is likely at risk of Legionellosis. The confusion, hyponatraemia, renal impairment and multi-lobar pneumonia all make Legionella pneumophila pneumonia more likely than other options but do not of themselves exclude other causes of severe pneumonia such as S. pneumoniae. The question also gives enough information to allow risk stratification with the CURB65 score.

Answers: Award 1 mark for any of the following: CURB65 score, CRB-65, Pneumonia severity index (PSI) or other international severity score

Answers: Award 1 mark for any of the following: Hospital in-patient, critical care unit, intensive care unit
(Accept critical care unit as although the CURB-65 score isn’t quite at that level he is hypoxic).
Do not accept “at home”.

Answers: Award 1 mark for any of the following; Sputum culture, Gram stain, Blood culture, urine for Legionella or pneumococcal antigen, serology for atypical causes of pneumonia.

a. Amoxicillin, ampicillin, cefuroxime, penicillin, Augmentin, co-amoxiclav
b. Ciprofloxacin, levofloxacin, moxifloxacin, clarithromycin, azithromycin, doxycycline, erythromycin
Allow one mark for each option in a. and one for each in b. Do not allow two from the same group.

Answers: Award 1 mark for any of the following. Time spent staying away from home, feature of atypical pneumonia, hyponatraemia, confusion, renal impairment, raised creatinine, raise urea accepted only features from this patient

Answer: Award 1 mark for Public Health Department

Answer: Award 2 mark for any of the following. Older age, immunocompromised, chronic heart or lung disease, haemodialysis, diabetes mellitus, outbreaks related to contaminated water cooling towers, plumbing sources or water supplies in hospital or hotels, Homeless, CF chronic lung disease, travel abroad.

33
Q
A

Answers: Award 1 mark for any of the following: ECG and Troponin

Answers: Award 1 mark for any of the following- acute coronary syndrome or myocardial infarct (event of either type)
Do not accept angina

Answers: Award 1 mark for any of the following - acute atherosclerotic plaque rupture (1 mark) with superimposed thrombosis and acute luminal narrowing (1 mark)

Answers: Award 1 mark for any of the following – Aspirin, Clopidogrel, prasugrel, ticagrelor, P2Y12 inhibitor, Analgesia e.g. diamorphine / morphine, anti-emetics

Answers: Award 1 mark for investigation - Invasive coronary angiography (1 mark) Treatment- Award 1 mark for any of the following - percutaneous or surgical revascularisation, coronary bypass surgery

*phase 2a mocks (18 decks)

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