Mixed

Question 1

Elevation is which ECG leads indicates an MI on the anterior, septal, lateral or inferior surfaces of the heart?

Answer 1

Anterior: V1-6
Inferior: II, III, aVF
Lateral: I, aVL,
Septal: V2-4

Question 2

Which medication improves survival in congestive heart failure?

Answer 2

ACE inhibitors (lisinopril)

Question 3

What is the first assessment done of an acutely unwell patient?

Answer 3

ABCDE

Question 4

What is the best blood to be given to increase clotting when the liver is damaged?

Answer 4

Fresh frozen plasma - contains all the clotting factors

Question 5

What acutely reverses the effect of warfarin (when fit K ineffective)?

Answer 5

PCC (prothrombin clotting complex)

Question 6

Which parts of the respiratory tree have no cartilage?

Answer 6

Bronchioles + alveoli

Question 7

What are the palpable components of the larynx?

Answer 7

Hyoid, cricoid, thyroid

Question 8

What is the blood supply to the diaphragm?

Answer 8

Branches of thoracic aorta

Question 9

What is the management of oesophagitis?

Answer 9

PPI (omeprazole)

Question 10

What is ranitidine used to treat?

Answer 10

Stomach/intestinal ulcers,

GORD

Question 11

What is used to treat benign oesophageal strictures?

Answer 11

Dilation of oesophagus (prevent the symptom of dysphagia) - balloon dilation

Question 12

What is the permanent treatment of achalasia if young and fit?

Answer 12

Myotomy (Hellers cardiomyotomy)

Question 13

What is the first line management of ascites?

Answer 13

Paracentesis (first line relief), then medicinal management (spironolactone)

Question 14

What is the treatment for primary biliary cirrhosis and auto-immune hepatitis?

Answer 14

PBC: urseodeoxycholic acid

Auto-immune: prednisolone

Question 15

What investigation is done for norovirus?

Answer 15

PCR (as is a virus)

Question 16

What investigation is done for diarrhoea of bacterial source (inc food poisoning)?

Answer 16

Stool culture

Question 17

Which form on influenza causes pandemics?

Answer 17

Influenza A

Question 18

How is coeliac screened for and diagnosed?

Answer 18

Screening: TTG (tissue transglutaminase)
Diagnosis: duodenal biopsy

Question 19

What is macrocytic anaemia and what test is used to diagnose it?

Answer 19

Not enough haemoglobin in the blood due to decreased blood cells (large red blood cells)
Diagnosis: Schillings test

Question 20

What antibiotic is used to treat pseudomonas aeruginosa?

Answer 20

Ciproflaxacin

Question 21

What factor other than weight is a the best predictor of CVS risk?

Answer 21

Waist circumference

Indicates visceral fat

Question 22

What is the MUAC (mid upper arm circumference) used to indicate?

Answer 22

BMI (malnutrition)

Question 23

How many pulmonary arteries and veins are there passing through the hilum?

Answer 23

1 pulmonary artery

2 pulmonary veins

Question 24

What separates the lobes of the lungs?

Answer 24

Infolding of VISCERAL pleura

Question 25

What bones form the nasal septum?

Answer 25

Vomer bone + perpendicular bone of ethmoid

Question 26

Which bone of the skull do 2 of the muscles of mastication attach to?

Answer 26

Sphenoid bone | Lateral (open) and medial (close) pterygoid

Question 27

Which bacterium is the most common cause of food poisoning?

Answer 27

Campylobacter

Question 28

What is meckels and how can it present?

Answer 28

Congenital diverticulum | Presents in young patients - can be as malaena

Question 29

Which blood test indicates sickle cell anaemia?

Answer 29

Full blood count

Question 30

What investigation shows emboli in intestinal arteries?

Answer 30

CT angiography

Question 31

What is the cause of most congenital abnormalities?

Answer 31

Unknown

Question 32

How is type 1 or type 2 respiratory failure identified?

Answer 32

ABGs

Question 33

What is the somatic sensory and the somatic motor innervation of the face?

Answer 33

Somatosensory: Trigeminal nerve Somatomotor: Facial nerve

Question 34

What is the most inferior bilateral branches of the abdominal aorta?

Answer 34

Gonadal = L2 | L1: SMA, L1-2: renal, L2: gonadal, L3: IMA, L4: aortic bifurcation

Question 35

What white blood cells are present in rash?

Answer 35

Is an allergic reaction so eosinophils/basophils

Question 36

What white blood cells are present in bacterial and viral infections?

Answer 36

Bacterial: neutrophils Viral: lymphocytes

Question 37

What is the process for translation of an ECG?

Answer 37

1. Name and DOB 2. Time taken 3. Calibration (25mm/sec, 1cm/mV) 4. Axis 5. Rhythm strip a) electrical activity present b) Regular/irregular c) HR d) P waves present e) PR interval 0.12-0.2ms f) QRS complexes present g) QRS <3 boxes 6. ST elevation or T wave depression

Question 38

If Gamma GT is raised alone what can this be due to?

Answer 38

Alcohol

Question 39

What can raise ALP?

Answer 39

Vit D deficiency, Bone disorders (mets), Pregnancy, Biliary tree damage

Question 40

Which clinical sign can pulmonary hypertension cause?

Answer 40

Elevated JVP

Question 41

What murmur is associated with a ventral septal defect?

Answer 41

Pansystolic murmur (the quieter the murmur the larger the defect)

Question 42

What is a paraneoplastic syndrome of adenocarcinoma in the lung?

Answer 42

Gynaecomastia

Question 43

What type of lung cancer causes hypercalcaemia?

Answer 43

SCC

Question 44

Which type of lung cancer causes Lambert-Eaton myasthenia syndrome?

Answer 44

Small cell carcinoma

Question 45

What symptoms (2) are associated with right sided heart failure?

Answer 45

JVP and ankle oedema

Question 46

What is the symptom of pulmonary oedema?

Answer 46

Breathlessness when lying flat

Question 47

What is the CXR sign of a pleural effusion?

Answer 47

Blunting of the costophrenic recess

Question 48

How is the axis determined from an ECG?

Answer 48

NORMAL: II is the most upright QRS RIGHT: III = up, I = -ve (RVH) LEFT: I = up, II/III = -ve

Question 49

What antibodies are detected in primary biliary cirrhosis and auto-immune hepatitis?

Answer 49

PBC: AMA (anti mitochondrial antibodies) AIH: ASMA (anti smooth muscle antibodies)

Question 50

Heart failure on which side causes ankle oedema and which side causes pulmonary oedema?

Answer 50

Right heart failure = ankle oedema | Left heart failure = pulmonary oedema

Question 51

Of sympathetic and parasympathetic stimulation, which causes erection and which causes ejaculation?

Answer 51

Erection: parasympathetic Ejaculation: sympathetic