mock 14

Question 1

main side effect of verapamil

Answer 1

ankle swelling

Question 2

SOB symptoms

Answer 2

• DYSPNOEA
• PAROXYSMAL NOCTURNAL DYSPNOEA
• ORTHOPNOEA

a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.

Orthopnea is a medical term to describe shortness of breath that occurs while lying flat and is relieved by sitting or standing

Question 3

heart failure pharmacoglogical interventions

Answer 3

ACEI and CCB

Question 4

HF - dont do

Answer 4

restrict salt intake and fluid

no smoking and alcohol

Question 5

X ray changes that may be seen in a patient with COPD

Answer 5

• BARREL CHEST
• FLATTENED HEMIDIAPHRAGM(s)
• CARDIOMEGALY OR SMALLER LOOKING HEART

Question 6

COPD first line meds

Answer 6

SALBUTAMOL (1), A SHORT ACTING BETA-2 AGONIST (1) TAKEN AS AN INHALER INTRANASALLY

Question 7

COPD measuring scale

Answer 7

MRC DYSPNOEA SCALE

Question 8

COPD complications

Answer 8

IECOPD, BRONCHIECTASIS, COR PULMONALE, LUNG CANCER

Question 9

Name 2 causes of an AKI of

Prerenal origin

Intrarenal origin

Postrenal origin

Answer 9

• Anaemia, Hypovolemia; shock, heart failure, drugs (NSAIDs)
• Interstitial nephritis, tubular nephritis, glomerulonephritis, nephrotoxins
• Obstructions: renal stones, indwelling catheters, BPH

Question 10

asterixis causes

Asterixis is a clinical sign that describes the inability to maintain sustained posture with subsequent brief, shock-like, involuntary movements.

Answer 10

• Chronic CO2 retention
• hepatic encephalopathy/liver failure

Question 11

RHABDOMYOLYSIS

Answer 11

Question 12

most common cause of primary hyperparathyroidism

Answer 12

PARATHYROID ADENOMA

Question 13

name 4 causes for a raised serum calcium.

Answer 13

• CKD
• MYELOMA
• MALIGNANCY/BONE METASTASES
• VITAMIN D DEFICIENCY
• DEHYDRATION
• DRUGS (E.G. THIAZIDE DIURETICS, LITHIUM)
• SARCOIDOSIS
• NEOPLASTIC SYNDROMES (SQUAMOUS CELL LUNG
  CA)

Question 14

symptoms of hypercalcaemia

Answer 14

• kidney stones
• WEAK BONES
• PSYCHEDELIC MOANS/ DEPRESSIVE Sx
• ABDOMINAL GROANS/CONSTIPATION
• decreased muscle tone.

Question 15

hypercalcaemia ecg

Answer 15

short QT interval

Question 16

Name and explain 3 signs you may elicit when taking the patient’s history and on examination

Answer 16

• LHERMITTE PHENOMENON (neck flexion = electric shock)
• UHTHOFF’S PHENOMENON (burning
  after heat exposure e.g. shower)
• OPTIC NEURITIS (painful red eye + sensitive to red)
• INTERNUCLEAR OPHTHALMOPLEGIA (impaired lateral gaze)
• UMN SIGNS (hyperreflexia/Babinski +ve/hypertonia)

Question 17

What cell is targeted in the pathological process?

Answer 17

OLIGODENDROCYTES

Question 18

This patient describes widespread pain due to his symptoms. Which neurological tract is responsible for carrying pain afferent fibres to the CNS?

Answer 18

spinothalamic

Question 19

List 2 Biologics that may be used to prevent further attacks of MS

Answer 19

BETA INTERFERON and MONOCLONAL Abx

Question 20

What diagnostic criteria is used to make a MS diagnosis, and what does it constitute?

Answer 20

• MCDONALD CRITERIA
• requiring 2 OR MORE ATTACKS
• DISSEMINATED IN TIME AND SPACE