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Mock Flashcards

1
Q

Common SE of tamoxifen

A

Hot flushes

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1
Q

Dose for croup

A

0.15mg /kg

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2
Q

Most common SE of POP

A

Irregular bleeding

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3
Q

Mx of guttae psoriasis

A

Reassure and mx if symptoms

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4
Q

Diagnosing stage 1 and 2 CKD

A

eGFR >90
60-90
AND
either proteinuria or abnormal renal US

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5
Q

Abx RF for c diff

A

Clinda
Cephalosporin
Cipro

NOT CLARI

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6
Q

When to start alendronic acid

A

Start alendronate in patients >= 75 years following a fragility fracture, without waiting for a DEXA scan

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7
Q

Increasing metformin doses

A

Metformin should be titrated slowly, leave at least 1 week before increasing dose

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8
Q

Cavitating lesion in diabetic patient

A

Klebsiella

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9
Q

IIH sx

A

The presentation of headaches and bilateral papilloedema (blurred optic discs) without focal neurological signs, normal blood pressure, and absence of fever in an obese young woman

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10
Q

Triptan MOA

A

Specific 5-HT1 agonist

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11
Q

Red flags for back pain

A

Thoracic pain
Age <20 or >55 years
Non-mechanical pain
Pain worse when supine
Night pain
Weight loss
Pain associated with systemic illness
Presence of neurological signs
Past medical history of cancer or HIV
Immunosuppression or steroid use
IV drug use
Structural deformit

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12
Q

HIV +ve wanting to breastfeed

A

Not recommended

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13
Q

When to start on NAC immediately

A

patients who present 8-24 hours after ingestion of an acute overdose of more than 150 mg/kg of paracetamol even if the plasma-paracetamol concentration is not yet available
patients who present > 24 hours if they are clearly jaundiced or have hepatic tenderness, their ALT is above the upper limit of normal

A staggered overdose is defined as ‘ingestion of a potentially toxic dose of paracetamol over more than one hour’

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14
Q

Bloody diarrhoea , RIF pain

A

Campylobacter

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15
Q

Recurrent otitis externa following numerous antibiotic treatment

A

Candida infection

topical clotrimazole

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16
Q

Patient >= 60 years old with new iron-deficiency anaemia

A

FIT test

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17
Q

Anticoagulation for new AF causing stroke

A

Anticoagulated 2w after event

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18
Q

Pneumothorax mx

A

no or minimal symptoms → conservative care, regardless of pneumothorax size
symptomatic → assess for high-risk characteristics

high-risk characteristics are defined as follows:
haemodynamic compromise (suggesting a tension pneumothorax)
significant hypoxia
bilateral pneumothorax
underlying lung disease
≥ 50 years of age with significant smoking history
haemothorax
if no high-risk characteristics are present, and it is safe to intervene, then there is a choice of intervention:
conservative care
ambulatory device
needle aspiration
if high-risk characteristics are present, and it is safe to intervene → chest drain

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19
Q

Inadequate smear

A

if smear inadequate then repeat in 3 months

If again- colposcopy

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20
Q

How often do you repeat adrenaline in anaphylaxis

A

5 mins

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21
Q

When to give prophylaxis azithromycin in COPD

A

COPD who have had >3 exacerbations requiring steroid therapy and at least one exacerbation requiring hospital admission in the previous year.

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22
Q

When can you not take COCP after pregnancy

A

6 weeks if BF

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23
Q

Aspirin in BF

A

CI

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24
Q

When to refer for an ovarian cyst

A

> 35 yo
5cm

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25
Q

Anti emetic for hyperemesis

A

Cyclizine

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26
Q

ECV

A

36 if null
37 if multi porous

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27
Q

Perineal tear

A

2nd perineal
3a EAS
b >50% EAS
3x IAS

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28
Q

When to admit for BP in preg

A

> 160/100

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29
Q

Mx of ectopic

A

> 35mm
5000
Surgical

<1500 medical

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30
Q

Keratitis sx

A

red eye, photophobia, pain and gritty sensation. Wearing contact lenses

31
Q

Ant uveitis sx

A

Acute
Photophobia
Blurred vision
Red eye
Blurred vision

32
Q

Chronic open angle glaucoma

A

Peripheral vision loss gradual
decreased visual acuity
optic disc cupping

33
Q

Retinal detachment

A

include flashes of light or floaters

Dense shadow that starts peripherally progresses towards the central vision

34
Q

Methotrexate monitoring

A

FBC
LFT
U+E

35
Q

Azathioprine monitoring

A

FBC
LFT

36
Q

Lithium monitornig

A

Lithium
TFT
U+E

37
Q

Glitazone monitoring

A

LFT

38
Q

Thiazide SE

A

Gout
* Hypokalaemia
* Hyponatraemia
* Impaired glucose tolerance

39
Q

CCB SE

A
  • Headache
  • Flushing
  • Ankle oedema
40
Q

Dig SE

A

confusion, yellow-green vision
arrhythmias (e.g. AV block, bradycardia)
gynaecomastia

41
Q

Drugs causing dig toxicity

A

amiodarone, quinidine, verapamil, diltiazem, spironolactone ciclosporin.

thiazides and loop diuretics

42
Q

SE of glitazones

A

Weight gain
Fluid retention
Liver dysfunction
Fractures

43
Q

SE of gliptins

A

Pancreatitis

44
Q

SE of sulfonylureas

A

Hypoglycaemic episodes
Increased appetite and weight gain
Syndrome of inappropriate ADH secretion
Liver dysfunction (cholestatic)

45
Q

Drug interacting with azathioprine

A

Allopurinol

46
Q

Cipro SE

A

Lower seizure threshold
Tendon damage
Lengthen QT

47
Q

What precipitates lithium toxicity

A

diuretics (especially thiazides), ACE inhibitors/angiotensin II receptor blockers, NSAIDs and metronidazole.

48
Q

Discontinuation syndrome sx

A

increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia

49
Q

When can thrombectomy be extended to

A

An extended target time of 6-24 hours may be considered if there is the potential to salvage brain tissue

50
Q

Genital wart treatment

A

multiple, non-keratinised warts: topical podophyllum
solitary, keratinised warts: cryotherapy

51
Q

Mx of after 28/40 weeks, if a woman reports reduced fetal movements and no heart is detected with handheld Doppler

A

US

52
Q

When do you not require tetanus booster despite dirty injury

A

If 5 vaccines <10 yrs

53
Q

mild anaemia with a disproportionate microcytosis and a raised haemoglobin A2

A

B thalassaemia trait

54
Q

Ramsay Hunt

A

Aciclovir and pred

55
Q

Long term tx of psoriasis

A

Topical Vit D

56
Q

Past due date Bishop score <8

A

Membrane sweep

57
Q

Bishop score <6

A

vaginal prostaglandins or oral misoprostol

> 6 amniotomy and an intravenous oxytocin infusion

58
Q

Reactive arthritis sx

A

Triggered by distant gastrointestinal or urogenital infections. This usually presents with the triad of polyarticular arthralgia, urethritis and uveitis

59
Q

Acute limb ischaemia mx

A

urgent management is IV heparin and vascular review

60
Q

Dermatomyositis sx and ab

A

Skin features
photosensitive
macular rash over back and shoulder
heliotrope rash in the periorbital region
Gottron’s papules - roughened red papules over extensor surfaces of fingers

proximal muscle weakness +/- tenderness

ANA+
Anti Jo

61
Q

UGI sx from alendronatre

A

Risendronate

62
Q

Sjrogren ab

A

Positive anti-Ro and anti-La antibodies

63
Q

Sickle cell osteomyelitis

A

Salmonella non typhi

64
Q

Pantar fascitis sx

A

The pain is usually worse around the medial calcaneal tuberosity.

Pain is worse when you ask them to walk on their toes.

65
Q

CT head <1hr

A

GCS < 13 on initial assessment
GCS < 15 at 2 hours post-injury
suspected open or depressed skull fracture
any sign of basal skull fracture (haemotympanum, ‘panda’ eyes, cerebrospinal fluid leakage from the ear or nose, Battle’s sign).
post-traumatic seizure.
focal neurological deficit.
more than 1 episode of vomiting

66
Q

Neuro driving rules

A

first unprovoked/isolated seizure: 6 months off

stroke or TIA: 1 month off driving

67
Q

Cardio driving

A

angioplasty (elective) - 1 week off driving
CABG - 4 weeks off driving
acute coronary syndrome- 4 weeks off driving
1 week if successfully treated by angioplasty

68
Q

Gynaecomastia causes

A

spironolactone (most common drug cause)
cimetidine
digoxin
finasteride

69
Q

Impaired glucose

A

Fasting - 6.1- 7

Tolerance - 7.8-11.1

70
Q

PPI prior to OGD

A

2 weeks stop

71
Q

Painful genital ulcer

A

Painful- H ducreyi - chancroid

72
Q

Angina mx

A

Beta blocker/CCB - verapamil or diltiazem

still symptomatic after monotherapy with a beta-blocker add a calcium channel blocker and vice versa

If unable to tolerate CCB
a long-acting nitrate
ivabradine
nicorandil
ranolazine

73
Q

Adrenaline vs amiodarone ALS

A

Adrenaline
adrenaline 1 mg as soon as possible for non-shockable rhythms
during a VF/VT cardiac arrest, adrenaline 1 mg is given once chest compressions have restarted after the third shock
repeat adrenaline 1mg every 3-5 minutes whilst ALS continues

amiodarone 300 mg should be given to patients who are in VF/pulseless VT after 3 shocks have been administered.
a further dose of amiodarone 150 mg should be given to patients who are in VF/pulseless VT after 5 shocks have been administered
lidocaine used as an alternative

74
Q

Asthma

A

a low-dose inhaled corticosteroid (ICS)/formoterol combination inhaler to be taken as needed for symptom relief
Low dose mart
mod dose mart
check the fractional exhaled nitric oxide (FeNO) level if available, and the blood eosinophil count NICE
if either of these is raised, refer to a specialist in asthma care
if neither FeNO nor eosinophil count is raised, consider a trial of either a leukotriene receptor antagonist (LTRA) or a long-acting muscarinic receptor

75
Q
A
76
Q
A

MSRA (11 decks)

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