MLA PAPERS

Question 1

Average life expectancy UK?

Answer 1

81

Question 2

Management of a PE/

Answer 2

DOAC is first line once diagnosis is suspected

Question 3

Management of a PE if renal impairment is <15?

Answer 3

LMWH or unfractionated heparin or LMWH with VKA

Question 4

Management of a PE with haemodynamic instability?

Answer 4

Thrombolysis

Question 5

Diagnostic investigation for renal stones?

Answer 5

Non-contrast CT KUB
(USS for pregnant women and children)

Question 6

When changing antihypertensives, an increase in serum Cr of what is considered ok?

Answer 6

<30%

Question 7

HbA1c target when DM is managed by lifestyle?

Answer 7

48

Question 8

HbA1c target when DM is managed by metformin?

Answer 8

48

Question 9

HbA1c target when DM is managed by drugs that may cause hypoglycaemia?

Answer 9

53

Question 10

When should SGLT-2 inhibitors be given in addition to metformin?

Answer 10

the patient has a high risk of developing cardiovascular disease (CVD, e.g. QRISK ≥ 10%)
the patient has established CVD
the patient has chronic heart failure

Question 11

Which antidiabetic drugs cause weight gain?

Answer 11

Glitazones

Question 12

Which antidiabetic drugs can cause pancreatitis?

Answer 12

Gliptins

Question 13

Moa of exenatide/liraglutide?

Answer 13

A GLP1 mimetic
Increases insulin secretion and inhibits glucagon secretion

Question 14

Which antidiabetic drugs is best for pts with a high BMI?

Answer 14

GLP1 mimetics e.g. exenatide as they can cause weight loss

Question 15

Moa of DPP-4 inhibitors (gliptins)?

Answer 15

Inhibit DPP4 which increases levels of incretins (GLP1 and GIP) by decreasing their peripheral breakdown

Question 16

What causes a rise in APTT and PT?

Answer 16

Deficiencies of prothrombin, fibrinogen, factor V or factor X
DIC
Liver disease
Very high doses of heparin, warfarin, direct factor Xa inhibitors
Vitamin K deficiency

Question 17

Diagnostic investigation for vestibular schwannoma?

Answer 17

MRI of cerebellopontine angle

Question 18

What is cataplexy?

Answer 18

the sudden and transient loss of muscular tone caused by strong emotion

Question 19

Causes of addisonian crisis?

Answer 19

Sepsis & Surgery - both cause acute exacerbations of chronic insufficiencies
Adrenal haemorrhage e.g. Waterhouse-friderichsen syndrome
Steroid withdrawal

Question 20

Addisons disease investigation?

Answer 20

Short synacthen test ACTH

Question 21

Diagnostic investigation for neoplastic spinal cord compression?

Answer 21

MRI whole spine within 24 hours of presentation

Question 22

What causes SVTs?

Answer 22

Atrioventricualr nodal re-entry tachycardia
Atrioventricualr re-entry tachycardia
Junctional tachycardia

Question 23

Investigations for SAH?

Answer 23

Non-contrast CT head

If done more than 6 hours of Sx onset and normal then do LP at least 12 hours after Sx - look for xanthochromia