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1
Q

massive PE on ECG

A

RBBB

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2
Q

raised ICP what findings

A

bradycardia
hypertension with wide pulse pressure

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3
Q

investigation for mycoplasma pneumonia

A

serology

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4
Q

what is cervical excitation seen in

A

PID
ectopic

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5
Q

what drugs are contraindicated in patients with renal artery stenosis

A

ace inhibitors

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6
Q

ABG of PE

A

respiratory alkalosis

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7
Q

long term prophylaxis cluster headache

A

verapamil

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8
Q

halo sign mammogram

A

breast cyst

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9
Q

vertigo, hearing loss, tinnitus and absent corneal reflex

A

vestibular schwannoma

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10
Q

what nerves are affected in vestibular schwannoma

A

V
VII
VIII

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11
Q

anterior cerebral artery stroke

A

leg weakness but not face weakness or speech impairment

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12
Q

first line for spasticity MS

A

baclofen
gabapentin

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13
Q

what diabetes medication is associated with bladder cancer

A

thiazolidinediones

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14
Q

first line treatment for primary dysmenorrhoea

A

NSAID
- mefanamic acid

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15
Q

management of inguinal hernia in infants

A

urgent surgery

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16
Q

raised ICP can cause a third nerve palsy due to

A

herniation

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17
Q

what is a contraindication to circumcision

A

hypospadias

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18
Q

line treatment for ankylosing spondylitis

A

TNF-alpha blocker e.g. infliximab and etanercept

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19
Q

what is released into the blood stream when there is damage to the liver

A

ALT
ALP

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20
Q

what is seen in CXR of patients with aortic dissection

A

widened mediastinum

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21
Q

bite and blister cells are seen in

A

G6PD deficiency

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22
Q

what is most important cause of ventricular tachycardia

A

hypokalaemia

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23
Q

frist line for infertility in PCOS

A

clomifene

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24
Q

management of acute upper urinary tract obstruction

A

nephrostomy

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25
Q

what is given to suppress nausea and vomiting in intracranial tumours

A

dexamethasone

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26
Q

domains used in scoring system for pancreatitis

A

P - PaO2 <8kPa

A - Age >55-years-old

N - Neutrophilia: WCC >15x10(9)/L

C - Calcium <2 mmol/L

R - Renal function: Urea >16 mmol/L

E - Enzymes: LDH >600iu/L; AST >200iu/L

A - Albumin <32g/L (serum)

S - Sugar: blood glucose >10 mmol/L

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27
Q

vision worse going downstairs what nerve

A

trochlear nerve
think 4th nerve palsy

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28
Q

what type of rash can be caused by herpes simplex virus

A

erythema multiform

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29
Q

presentation of acute intermittent porphyria

A

abdominal, neurological and psychiatric symptoms
- abdominal pain
- motor neuropathy
- psychiatric
- hypertension (common)

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30
Q

diagnosis of acute intermittent porphyria

A

urine turns deep red on staining
raised urinary porphobilinogen

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31
Q

management of acute intermittent porphyria

A

avoid triggers

acute attacks
- IV haematin
- IV glucose

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32
Q

lung cancer obstructive or restrictive

A

obstructive

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33
Q

loss of left heart border on CXR is caused by

A

left lingual consolidation (no left middle lobe)

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34
Q

what should be checked before starting terbinafine

A

LFT
then every 4-6 weeks after that

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35
Q

what is rash called in Lyme disease

A

erythema migrans

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36
Q

scalp psoriasis what is 1st line management

A

topical corticosteroids

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37
Q

when do you refer a child for not smiling

A

10 weeks

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38
Q

is bells palsy upper or lower motor neuron

A

lower motor neuron
- so therefore cannot wrinkle their forehead properly (if UMN you can)

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39
Q

what deficiency is nephrotic syndrome associate with

A

antithrombin III

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40
Q

what is mesenteric adenitits presentation

A

presents same as appendicitis but has a recent viral infection
needs no treatment

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41
Q

what is alprostadil and example of

A

prostaglandin E
keeps PDA open

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42
Q

what causes tonsillar carcinoma

A

HPV - 16 and 18

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43
Q

someone taking haloperidol gets a tremor what is given to treat symptoms

A

procyclidine

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44
Q

what is a common complication of giardiasis treatment

A

lactulose intolerance for up to 6 weeks

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45
Q

medication to reduce disease progression in polycystic kidney disease

A

tolvaptan

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46
Q

poor response to fluid challenge

A

acute tubular necrosis

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47
Q

hernia through hasselback triangle

A

direct inguinal hernia

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48
Q

ongoing vomiting then ripping chest pain, crackling sounds on auscultation is suggestive of

A

Boerhaave syndrome

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49
Q

red currant jelly stool in child

A

intussuception

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50
Q

management of intussuseption

A

rectal air insufflation

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51
Q

coffee bean sign on Xray

A

volvulus

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52
Q

gold investigation for thromboembolic stroke

A

diffusion weighted MRI

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53
Q

parietal lobe damage what finding

A

contralateral visual field

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54
Q

middle cerebral artery controls

A

speech and language

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55
Q

anterior cerebral artery controls

A

foot and lower leg weakness
not speech disturbance

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56
Q

what is a contraindication for thrombolysis

A

BP > 180/110
INR >1.7

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57
Q

r

A
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58
Q

what is malignant hypertermia
what causes it
treatment

A

complication of anaesthetic administration
caused by increase calcium release from sarcoplasmic reticulum

hyperpyrexia and muscle rigidity

dnaltroene (reduced calcium release from sarcoplasmic reticulum)

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59
Q

if 6 weeks until surgery how do you treat iron deficiency

A

oral iron (not IV)

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60
Q

CXR in child showing hyperinflation and fluid in horizontal fissure

A

transient tachypnoea of newborn

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61
Q

inheritance of haemophilia A

A

X linked

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62
Q

investigation for vesicoureteral reflux

A

micturating cystourethrogram

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63
Q

what drug interacts with clarithromycin

A

statin

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64
Q

acute onset, pain, small, fixed oval pupil, ciliary flush

A

anterior uveitis

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65
Q

symptoms of hereditary haemorrhagic telangiectasia

A
  • epistaxis
  • telangiectases (lips, hands, oral cavity)
  • visceral lesion
  • family history

only need 2 of above for diagnosis

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66
Q

unrecordable blood glucose, confusion and abdominal pain

A

DKA

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67
Q

hyperthyroidism with firm nodules what is most likely underlying cause

A

toxic multinodular goitre

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68
Q

auer rods and phi bodies are seen in

A

AML

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69
Q

philadelphia chromosome causes
what is management

A

CML
imatinib

70
Q

what type of anaemia can prosthetic heart valves cause

A

haemolytic anaemia

71
Q

test for hereditary spherocytosis

A

EMA binding test

72
Q

normocytic anaemia, gallstones and family history

A

hereditary spherocytosis

73
Q

management of PE if patient has severe renal failure

A

unfractioned heparin

74
Q

what is benign rolandic epilepsy

A

partial seizures at night

75
Q

metastatic HCC management

76
Q

1st line management IBS with diarrhoea

A

loperamide

77
Q

1st line management IBS with constipation

A

laxatives - e.g. ispaghula husk
avoid lactulose

78
Q

feeling like lump in throat, most discomfort when trying to swallow saliva

A

globus pharyngis

79
Q

oesophageal cancer associated with GORD is most likely to be

A

adenocarcinoma

80
Q

risk for oesophageal candidiasis

A

HIV
steroid inhaler

81
Q

plummer vinson syndrome symptoms

A

triad of:
- dysphagia
- glossitis
- iron deficiency anaemia

82
Q

characteristic side effect of mirtazipine

A

increased appetite

83
Q

what is acute dystonia
and what can cause it

A

sustained muscle contraction e.g. torticollis
antipsychotics

84
Q

what antipsychotic has the most tolerable side effects particularly prolactin levels

A

aripiprazole

85
Q

young female develops AKI after initiation of ACE inhibitor

A

fibromuscular dysplasia

86
Q

high plasma osmolality and a low urine osmolality

A

diabetes insipidus

87
Q

vascular surgeries

A

Selected vascular surgeries and related scars
Femero-popliteal bypass scars
Would result in a vertical groin scar and a distal lower limb scar

Femoral-femoral bypass scars
Would result in two vertical groin scars.

Axillo-femoral bypass scars
Would result in a scar over the left pectoral region and left groin.

Ileo-femoral bypass scars
Will result in an oblique scar to access the iliac arteries, and vertical groin scar to access the femorals.

88
Q

what is first line analgesia for mild labour pain

89
Q

what virus causes kaposi’s sarcoma

90
Q

painless ulcer on genitals

A

treponema pallidum (syphilis)

91
Q

how long until progesterone only pill is effective

92
Q

vocal resonance in pneumothorax

93
Q

cause of mumps

A

paramyxovirus

94
Q

clinical presentation of mumps

A

parotitis
orchitis
asceptic meningitis
deafness

95
Q

most common cause of renal artery stenosis in patients over 50

A

atherosclerosis

96
Q

what ECG abnormality can subarachnoid haemorrhage cause

A

torsade des pointes

97
Q

what is trousseau’s sign and what is it associated with

A

migratory thrombophlebitis affecting extremities of body

associated with pancreatic cancer

98
Q

what is a complication of mycoplasma pneumonia

A

cold autoimmune haemolytic anaemia - pain the the toes and low haemoglobin

99
Q

what is given as immunosuppresion post renal transplants

A

tacrolimus

100
Q

management of SIADH

A

fluid restriction

101
Q

investigation for narcolepsy

A

multiple sleep latency EEG

102
Q

mass on tail of parotid gland

A

pleomorphic adenoma

103
Q

what does asymmetrical symptoms in parkinsons suggest

A

that it is idiopathic

104
Q

ground glass appearance on CXR of newborn

A

respiratory distress of newborn

105
Q

common cause of otitis externa

A

pseudomonas auerginosa

106
Q

management of whipples disease

A

extended course of antibiotics (co-trim)

107
Q

investigation to determine underlying cause of AKI

A

urinalysis

108
Q

aspirin overdose ABG

A

respiratory alkalosis then metabolic acidosis
vertigo, tinnitus, abdominal pain

supportive treatment

109
Q

steroid induced hyperglycaemia management

A

gliclazide

110
Q

name of eye drops in sjorgen

A

hypromellose

111
Q

uterus large irregular and firm

112
Q

risk factor for bacterial vaginosis

113
Q

hypotestosteronism what additional investigation is indicated

A

DEXA scan as it is associated with osteoporosis

114
Q

Xray of rickets

A

widened epiphyseal plates

115
Q

what antihypertensive cannot be given with epipen

A

beta blocker

116
Q

patient with aortic dissection who is unstable what imaging

A

echocardiogram

117
Q

what is cut off K+ for adding spironolactone on for BP control

A

> 4.5 cant add

118
Q

what type of stroke causes lock in syndrome

A

basilar artery

119
Q

type 1 diabetic with BMI > 25 what other medication other than insulin should they be offered

120
Q

SLE what investigations initially

A

FBC
U+E and urinalysis
ESR and CRP
ANA
complement - low C3

121
Q

another name for salmonella

A

typhoid fever

122
Q

what are patients with aortic valve infective endocarditis at risk of

A

aortic root abscess formation
ECG - PR interval elongation

123
Q

triad of neuromyelitis optica (Devic’s disease)

A
  • optic neuritis
  • transverse-myelitis
  • positive NMO-IgG (antibody targeting aquaporin 4)
124
Q

management of Devic disease

A

immunosuppresion

125
Q

criteria for liver transplant in paracetamol OD

A

pH <7.3
INR > 6.5
creatinine >300

126
Q

when can you start COCP after birth

127
Q

when is review for undescended testes

128
Q

can amiodarone cause hyperthyroid or hypothyroid

A

hypothyroid

129
Q

1st line management for lyme disease

A

oral doxycyline

investigation - blood test serology

130
Q

what criteria for PCOS

131
Q

lights criteria for pleural effusion

A

This states that an effusion is an exudate if: the pleural fluid to serum protein ratio is >0.5, the pleural fluid to serum LDH ratio is >0.6, or the pleural fluid LDH is >2/3 the upper reference limit for serum LDH.

132
Q

what stroke occurs due to uncontrolled hypertension

A

pontine haemorrhage

133
Q

what overdose causes a widened QRS

A

tricyclic antidepressant
- IV bicarbonate

134
Q

what does VSD increase risk of

A

endocarditis

135
Q

fragile X

A

learning difficulty
macrocephaly
long face
large ears

136
Q

noonan syndrome

A

webbed neck
pectux excavatum
short stature
pulmonary stenosis

137
Q

generalised lymphadenopathy with palpable mass in left hypochondriac region (spleen)

A

infectious mononucleosis

138
Q

pancreatitis imaging

A

early ultrasound

139
Q

what contraception is safe to offer with HRT

A

progesterone only

140
Q

what is investigation for NAFLD

A

enhanced liver fibrosis blood test
after finding on ultrasound

141
Q

do you stop ACE inhibitor before surgery

142
Q

antifreeze antidote

143
Q

elderly, particularly women, airway compromise (stridor) and dysphagia

A

anaplastic carcinoma

144
Q

is presbycusis high frequency or low frequency

A

high frequency hearing loss
sensorineural hearing loss

145
Q

what do you add to angina after bisoprolol

A

amlodipine

146
Q

clue cells are seen in

A

bacterial vaginosis

147
Q

what complication does bacterial vaginosis cause in pregnancy

A

preterm rupture of membranes

148
Q

what is important to monitor after paracetamol overdose

149
Q

when do you double dose of emergency contraception

A

BMI >26 or weight >70kg

double levonelle

150
Q

what type of pulse seen in PDA

A

collapsing pulse

151
Q

pernicious anaemia predisposes to

A

gastric cancer

152
Q

what causes TURP syndrome

A

irrigation with glycine during TURP

153
Q

microcephaly association

A

fetal alcohol syndrome

154
Q

serum copper in Wilsons

155
Q

can you see haemoptysis in mitral stenosis

156
Q

management of SAH

A

nimodipine

157
Q

subdural haemorrhage management

A

Burr hole evacuation

158
Q

what parkinsons medication do you not give to patients with history of addiction

A

dopamine agonists e.g. bromocryptine

159
Q

investigation in TIA

A

urgent carotid doppler study
diffusion weighted MRI

160
Q

widespread convulsion without conscious impairment is likely to be

A

psychogenic non-epileptic seizure
- pseudoseizure

161
Q

loss of corneal reflex think

A

acoustic neuroma

162
Q

what is a trigger for cluster headaches

163
Q

management of focal seizure (Jacksonian march)

A

levetiracetam

164
Q

haemorrhagic stroke what should you start

A

labetolol - BP control is vital

165
Q

management of crohns with perianal fistula

A

oral metronidazole

166
Q

HNPCC associated with

A

pancreatic cancer

167
Q

lemon tinge to skin is associated with

A

pernicious anaemia

168
Q

what drug can induce cholestasis

169
Q

management of cushing syndrome

A

metapyron
ketaconazole

170
Q

management of nephrogenic diabetes insipidus

A

thiazides - chlorothiazides

171
Q

hernia below and lateral

172
Q

when are lithium levels checked

A

12 hours post dose

finals (25 decks)

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