Mix 2

Question 1

Guttate psoriasis
- precipitation
- presentation
- distribution

Answer 1

Following Strep infection
tear drop (gutta in Latin) shaped
Pink, scaly plaque-like
Over trunk and limbs

Question 2

Endocarditis causes

Answer 2

Infective: Staph aureus, viridans Streptococci, coagulase negative Staph

Inflammatory: Libman-Sacks verrucous endocarditis (SLE)

Malignancy: marantic endocarditis

Question 3

Diabetes when to change drugs

Answer 3

second line HbA1c > 6.5% (48)

Third line HbA1c > 7.5

Metformin stop if eGFR 30 or Cr 150

Question 4

Keloid scar treatment

Answer 4

Intra-lesional steroids eg triamcinolone

Question 5

Cardiac tamponade
- triad
-ECG findings

Answer 5

Beck’s triad:
1. Hypotension
2. Muffled heart sounds
3. Jugular venous congestion

ECG: electrical alterans, low QRS voltage, tachycardia

Question 6

MS spasticity treatments

Answer 6

Baclofen, gabapentin

tizanidine

Question 7

Systemic scleroderma Antibodies

Answer 7

anti-scl70 (anti-topoisomerase)

Question 8

Mixed connective tissue disorder Antibody

Answer 8

Anti-U1RNP

Question 9

Limited cutaneous systemic sclerosis Antibodies

Answer 9

Anti-centromere

Question 10

SLE Antibodies

Answer 10

ANA, anti-smith, anti-dsDNA, anti-phospholipid antibodies

Question 11

Sjogrens antibodies

Answer 11

Anti-SSA/Ro, Anti-SSA/La

Question 12

Limited cutaneous systemic sclerosis AKA

Answer 12

CREST
calcinosis, raynauds, o(E)sophageal dysmotility, sclerodactyly, telangiectasia

Question 13

Fanconi syndrome

Answer 13

Syndrome of inadequate reabsorption of small molecules in proximal renal tubules

Glycosuria, renal acidosis type 2, hypophosphataemic ricketts/osteomalacia

vit D deficiency

Question 14

Fanconi syndrome aetiology
Aka proximal (type 2) renal tubular acidosis

Answer 14

Primary: AD, AR or X-linked

Secondary: Cystinosis

Question 15

Nasopharyngeal carcinoma

Answer 15

EBV association
presents late due to mets usually
BL cervical lymphadenopathy, nasal voice, deafness, nasal obstruction

Question 16

Large rectal bleed commonest cause

Answer 16

Under 60 -> haemorrhoids
Over 60 -> diverticular disease

Question 17

Secondary hyperparathyroidism causes

Answer 17

low vitamin D intake

Chronic kidney disease

Question 18

Felty syndrome SANTA

Answer 18

Splenomegaly
Anaemia
Neutropenia
Thrombocytpoenia
Arthritis (rheumatoid)

Question 19

Tardive dyskinesia

Answer 19

Repetitive, involuntary, purposeless movement
eg: grimacing, lip smacking, tongue out, blinking

Question 20

Persistent ST elevation following MI

Answer 20

Left ventricle aneurysm

Question 21

Anaphylaxis

Observation time

Answer 21

Obverse at least 6 hours (anaphylax-SIX)

Senior review
Consider 3/7 steroids + antihistamine
Consider adrenaline auto-injector
Safety netting
Follow up