Mixed PT Questions

Question 1

Drug-induced cholestatsis causes

Answer 1

COCP
Fluclox, co-amox and erthyromycin
Anabolic steroids e.g. testosterone
phenothiazines: chlorpromazine,
sulphonylureas

Question 2

Budd-Chiari syndrome Sx triad + Causes

Answer 2

Hepatic vein thrombosis
Abdo pain (severe, acute)
Ascites (abdo distension)
Tender hepatomegaly

Causes: polycythemia rubra vera
Thrombophilia
Pregnancy
COCP

Question 3

Neuropathic pain Mx

Answer 3

D- duloxetine
G- gabapentin
A- amitriptyline
P- pregabalin

Question 4

Cluster headache Sx + Mx

Answer 4

Sx: episodic, intense, unilateral eye pain, lacrimation, restless
Mx: subcut sumatriptan and O2 therapy

Question 5

Carcinoid syndrome Sx, Ix + Mx

Answer 5

-Flushing
-Diarrhoea
-Bronchospasm
-Hypotension
-Can get other molecule release e.g. ACTH and GHRH

Ix: urinary 5-HIAA, plasma chromogranin A y

Mx: somatostain analogues e.g. octreotide

Question 6

Pulmonary function test interpretation

Answer 6

Obstructive: FEV1 reduced, FVC reduced/n FEV1/FVC- reduced
Asthma, COPD, Bronchiectasis
Restrictive: FEV1 reduced,FVC- reduced, FEV1/FVC- normal or increased
Pulmonary fibrosis, asbestosis, sarcoidosis, ARDS/IRDS, Kyphoscoliosis/AS, NMD, obesity

Question 7

Alcohol withdrawal questions

Answer 7

CAGE/ ORBIT

Question 8

Sarcoidosis Sx

Answer 8

-acute: erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, -polyarthralgia
-insidious: dyspnoea, non-productive cough, malaise, weight loss
-ocular: uveitis
-skin: lupus pernio
-hypercalcaemia

Question 9

Persistent productive cough +/- haemoptysis in a young person with a history of respiratory problems

Answer 9

Bronchiectasis

Question 10

Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes, weight loss

Answer 10

silicosis

Question 11

Generalised tonic-clonic Tx

Answer 11

Males: sodium valporate
Females: lamotrigine or levetiracetam

Question 12

Focal seizures Mx

Answer 12

First line: lamotrigine
Second line: carbamazepine

Question 13

Absence seizures (petit mal)

Answer 13

First line: ethosuximide
Second line-
Male: sodium valporate
Female: lamotrigine

Question 14

Myoclonic seiziures Sx

Answer 14

males: sodium valporate
females: levetiracetam

Question 15

Myasthenic crisis Mx

Answer 15

Plasmapheresis and IV Ig

Question 16

Trousseau’s sign

Answer 16

carpopedal spam with blood pressure monitoring- hypocalcaemia

Question 17

Sickle cell crisis

Answer 17

Analgesia, O2, fluids

Question 18

AML vs Non-Hodgkin lymphoma test results

Answer 18

AML: complication of polycthaemia rubra vera (high hb)
Non-Hodgkin: increased WBC and lymphocytes but normal neutrophils

Question 19

AKI vs CKD US

Answer 19

CKD: most patients have bilateral small kidneys
(exceptions: diabetic neuropathy, APCKD, HIV associated nephro)

Question 20

Small cell, squamous cell and adenocarcinoma

Answer 20

1. Small cell: ADH, ACTH (cushings esque) and Lambert-Eaton syndrome
2. Squamous cell: PTH-rp (hypercalcaemia), clubbing
3. Adenocarcinoma: gynaecomastia

Question 21

Stroke prevention

Answer 21

Clopidogrel
Aspirin (if clop contra)

Question 22

Cluster headache prophylaxsis

Answer 22

Verapamil