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Mock 1 Flashcards

1
Q

What is the triad for haemolytic uraemia syndrome?

A

Haemolytic anaemia (normocytic anaemia)
AKI
Thrombocytopaenia

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2
Q

What is the electrolyte balance like in a salt-losing adrenal crisis in CAH?

A

Hyponatraemia
Hyperkalaemia
Metabolic acidosis
Shock and hypotension

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3
Q

What is the management of febrile seizures?

A

Reassurance, patient/parent education and referral to paediatrics

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4
Q

What palsy causes a ptosis and ‘down and out’ pathology?

A

3rd nerve palsy (oculomotor)

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5
Q

What are the ‘sanctuary sites’ in ALL chemo (areas that chemo can’t get to)?

A

Testes and CNS

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6
Q

What antibiotic do many people with Sickle Cell disease have to be on prophylactically due to having had a splenectomy?

A

Penicillin

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7
Q

What is hydroxycarbamide used for in Sickle Cell disease?

A

To prevent vaso-occlusive complications of Sickle Cell disease

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8
Q

Which factor is there a deficiency in Haemophilia A?

A

Factor VIII

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9
Q

Which factor is there a deficiency in Haemophilia B?

A

Factor IX

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10
Q

What are the serious cardiac complications of Kawasaki?

A

Pericardial effusion, myocardial disease, valve damage, coronary aneurysm.
TTE to rule out

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11
Q

What must you always consider in a patient with a high fever and joint pain/mobility problems?

A

Septic arthritis

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12
Q

What is the best way to monitor cancer spread in lymphoma?

A

PET scan

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13
Q

What are the B symptoms of lymphomas?

A

Drenching night sweats
Unexplained weight loss
Unexplained fever

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14
Q

What is the age range for onset of Perthes’ disease?

A

5-10 years old

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15
Q

Which chromosomal syndrome puts you at increased risk of duodenal atresia, with a characteristic double bubble sign on abdominal x-ray?

A

Down’s

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16
Q

What is the difference between schizotypal PD and schizoid PD?

A

Schizotypal is more about magical thinking and delusions of reference whereas schizoid PD is more about isolated, anti-social, indifferent

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17
Q

What type of anti-depressant is Phenelzine?

A

MAO (associated with tyramine rich foods needing to be avoided)

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18
Q

What medication is used in alcohol detox maintenance?

A

Acamprosate and Disulfiram

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19
Q

Which B vitamin is Thiamine

A

B1

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20
Q

What are the symptoms of lithium toxicity?

A

Ataxia, Coarse tremor (fine tremor is just a side effect), seizure, slurred speech, vomiting

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21
Q

How does delirium affect consciousness?

A

Impaired consciousness - whereas consciousness is preserved in dementia

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22
Q

What types of heart defects do patients get in Down syndrome?

A

Tetralogy of allot, AV septal defect, VSD, ASD

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23
Q

What type of heart defect can you see in Turner’s syndrome?

A

Bi-cuspid aortic valve

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24
Q

What is red degeneration of a fibroid?

A

Ischaemia, infarction and necrosis of a pre-existing fibroid
More commonly happens in the second and third trimester due to fibroid outgrowing the blood supply or the uterus changing shape and kinking the arteries

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25
Q

What is the management of PID?

A

Start antibiotics immediately
Prescribe doxycycline, metronidazole and IM ceftriaxone
Leave in any recently inserted coil. If no improvement after 48 hours, remove coil and provide emergency contraception

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26
Q

What is the best way for tracking foetal growth?

A

Foetal abdominal circumference using ultrasound

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27
Q

What class of antibiotic can be used during pregnancy?

A

Cephalosporins

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28
Q

Why should nitrofurantoin be avoided in the third trimester?

A

Risk of haemolytic anaemia in neonate with G6PD deficiency

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29
Q

Why should sulphonamides be avoided in the third trimester?

A

Associated with kernicterus

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30
Q

Why should tetracyclines be avoided in pregnancy?

A

Can cause permanent staining of baby’s teeth and skeletal development problems

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31
Q

Why should trimethoprim be avoided in pregnancy?

A

Folate antagonist so can cause neural tube defects if used in the third trimester

32
Q

What antidepressant can be offered in stress incontinence?

A

Duloxetine

33
Q

What can cause a raised CA125?

A

Adenomyosis
Ascites
Endometriosis
Menstruation
Breast, ovarian or endometrial cancer (but not vulval cancer)
Ovarian torsion
Liver disease
Metastatic lung cancer

34
Q

What is the management of fibroids?

A
  1. Mirena coil
  2. GnRH agonists (induce a menopause state, reducing oestrogen)
  3. Uterine artery embolisation
  4. Endometrial ablation
  5. Hysterectomy
35
Q

What is the diagnostic criteria for chronic pelvic pain?

A

Duration of at least 6 months
Cyclical or continuous

36
Q

What is the management for endometriosis?

A
  1. COCP unless contraindicated
  2. Mirena coil
  3. GnRH agonist
  4. Laparoscopy
  5. Hysterectomy
37
Q

What are some risk factors for ectopic pregnancy?

A

Age <18 years at first sexual intercourse
Smoking
Multiple sexual partners
IUD
Black race
Prior Fallopian tube surgery
Infertility and using IVF
Age >35 at presentation

38
Q

What is the management for haemorrhagic ovarian cyst?

A

Conservative management under observation (admission)
Monitoring for any signs of torsion, appendicitis, peritonism,

39
Q

What is the management of ovarian torsion?

A

Surgical detorsion or salpingoopherectomy if malignancy, non-viable ovary or involvement of Fallopian tube
Cystectomy or oophoropexy may be helpful in some patients to prevent recurrence

40
Q

What are risk factors for IUGR?

A

Maternal age over 35 years or under 16
Maternal pre-pregnancy BMI of <20
Pre-eclampsia
Trisomy 18
Interpregnancy interval of <6 months

41
Q

What is the management of premature prelabour rupture of membranes?

A

Antibiotics should be given for 10 days or until the woman is in established labour (whichever comes sooner)
PPROM is diagnosed on speculum

42
Q

What happens in androgen insensitivity syndrome?

A

Wolffian ductal structures don’t develop (but testes still do)

43
Q

What is the treatment of chlamydia?

A

Doxycycline 100mg BD 7 days

44
Q

What is the treatment for Gonorrhoea?

A

Ceftriaxone

45
Q

What is the treatment for Trichomonas?

A

Metronidazole

46
Q

What do VDRL and TPHA mean in syphilis investigation?

A

VDRL - whether they have an infection now
TPHA - whether they have been treated in the past

47
Q

What are the complications of chlamydia infection in pregnancy?

A

Chorioamnionitis
Neonatal conjunctivitis
Neonatal pneumonia
PROM

48
Q

What are the features of congenital syphilis?

A

Generalised lymphadenopathy
Hepatosplenomegaly
Rash
Skeletal malformations

49
Q

What are the features of congenital syphilis?

A

Generalised lymphadenopathy
Hepatosplenomegaly
Rash
Skeletal malformations

50
Q

What are some causes of retrograde ejaculation?

A

Bladder neck surgery
Congenital abnormality
Diabetic autonomic neuropathy
TURP

51
Q

How long do migraines normally last?

A

4-72 hours

52
Q

What are some triggers of migraines?

A

Chocolate
Caffeine
Alcohol
Travel
Exercise
COCP

53
Q

What is the prophylaxis for migraines

A

Topiramate or propranolol (propranolol preferred in women of reproductive age due to the teratogenic nature of topiramate). Topiramate can also reduce the effectiveness of hormonal contraceptives

54
Q

What score system is used to assess risk of stroke in someone who has had a TIA?

A

ABCD2 score

55
Q

What score system is used to assess risk of stroke in someone who has had a TIA?

A

ABCD2 score (age over 60, Blood pressure over 140/90 mmHg), Clinical features of TIA, Diabetes, Duration of symptoms

56
Q

What is the CHADSVASC score used to assess?

A

Risk of stroke in AF

57
Q

What type of antipsychotics can cause Parkinsonian side effects?

A

Typical - e.g. haloperidol

58
Q

What medication can be used in ALS?

A

Riluzole - prevents stimulation of glutamate receptors

59
Q

What is the antibiotic given for prophylaxis in close contacts of meningitis?

A

Oral ciprofloxacin

60
Q

What is the difference in clinical features of aortic dissection and MI?

A

Aortic dissection is worst at onset whereas MI gets worse

61
Q

What is the Fleischner sign on CXR

A

Dilated central pulmonary vessel (PE)

62
Q

What is the management of pericarditis?

A
  1. NSAIDs
  2. Low dose Colchicine
63
Q

What is the mechanism of N-acetylcysteine?

A

Replenishes body stores of glutathione
Glutathione is needed to detoxify toxic intermediary products of paracetamol metabolism
Stores of glutathione in the liver are depleted in paracetamol overdose

64
Q

How does caffeine work?

A

Blocks adenosine receptors

65
Q

How does methotrexate work?

A

Competitively inhibits dihydrofolate reductase

66
Q

How does allopurinol work?

A

Inhibits xanthine oxidase

67
Q

How does carbamazepine work?

A

Modulates sodium and calcium channels in hepatocyte cell walls

68
Q

What is used to reverse heparin?

A

Protamine
Although heparin has a short half life so reversal is rarely needed

69
Q

What is used to reverse DOACs?

70
Q

What is used in dabigatran overdose?

A

Idarucizumab

71
Q

What nail sign is seen in iron deficiency anaemia?

A

Koilonychia (thin spoon shaped nails)

72
Q

What is the causative organism in non-Hodgkin’s lymphoma?

A

HTLV1 infection

73
Q

What type of leukaemia is the Philadelphia chromosome associated with?

74
Q

What features would you see on joint fluid aspiration in pseudo gout?

A

Positively birefringent crystals (calcium pyrophosphate crystals)

75
Q

What is the drug target of Clopidogrel?

Phase 3a (12 decks)

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