Mock 2 Flashcards
What is the dosage for administering insulin IV?
0.1 units/kg/hr
What is mildly raised creatinine indicative of?
Dehydration
What vaccinations are given at 8 weeks?
6-in-1
Rotavirus
Men B
What vaccinations are given at 12 weeks
6-in-1
Rotavirus
Pneumococcal
What vaccinations are given at 16 weeks
6-in-1
Men-B
What vaccinations are given at 1 year?
Men B
Pneumococcal
HiB
Men C
MMR
What drugs can cause Stephen-Johnson syndrome?
Allopurinol
Lamotrigine
Penicillin
Phenytoin
What viral infections can cause Stephen-Johnson syndrome?
Mumps
Flu
HSV
EBV
What is juvenile myoclonic epilepsy characterised by?
Myoclonic jerks up to 2 hours after waking up
Periods of absence
Normal learning
age of onset 10-20 years
What are some complications of chickenpox?
Bacterial superinfection
Cerebellitis
DIC
Progressive disseminated disease
What does CSF look like in bacterial meningitis?
Turbid appearance, raised polymorphs, raised protein, low glucose
What is Scarlet fever caused by?
Group A Strep (strep progenes)
How does Wilm’s tumour present?
Abdo mass and painless haematuria
Average age 5-10 years
What are the clinical features of Noonan syndrome?
Mild learning difficulties
Short webbed neck
Pectus excavatum
Short stature
Congenital heart disease
Facies - broad forehead, drooping eyelids, wide distance between eyes
What are the clinical features of Williams syndrome?
Short stature
Congenital heart disease
Mild-moderate learning difficulties
Facies - broad forehead, short nose, full cheeks, wide mouth
What are the clinical features of Kallman’s syndrome?
Delayed onset of puberty
Reduced sense of smell
Poor balance
Learning difficulties
What are the features of Klinefelter syndrome?
Delayed puberty
Lack of secondary sexual characteristics
Tall stature
Learning disability
What is the rash like in dermatitis herpetiformis?
Itchy, bulls rash affecting usually extensor surfaces, arise on reddened skin, lesions grow in centrifugal pattern
What are first-rank symptoms of schizophrenia/psychosis?
3rd person auditory hallucinations
Delusional perceptions
Somatic passivity (the belief that external forces that control your actions, thought and perceptions)
Thought alienation (insertion, withdrawal, broadcast)
What is procyclidine used for?
Management of extra-pyramidal side effects of anti-psychotics
What is flumazenil used for?
Reverse the sedative effects of benzodiazepines
What is Knight’s move thinking?
Patient’s thoughts move from one topic to another, without any logical connection between them (common in schizophrenia)
What is flight of ideas?
Increased rate of thought and at least some logical links between the frequent changes of topics that a patient is talking about(common in mania and hypomania)
How often should thyroid and renal function be checked in someone taking Lithium?
Every 6 months
What is the second line, non SSRI drug in OCD?
Clomipramine (a TCA)
What does egosyntonic and egodystonic mean?
In keeping with ones beliefs and values vs very different to the patients normal beliefs and values
What does akathisia mean?
Restlessness
What is the first line investigation in males for infertility?
Semen analysis
What is the management for CIN 1 seen on colposcopy?
Discharge and screen again at 12 months in the community
What are risk factors for GBS infection?
Maternal pyrexia
Prematurity
Previous sibling GBS infection
Prolonged rupture of the membranes
What are the features and risk factors of cervical cancer?
Postcoital bleeding
Purulent discharge
Red brown discharge
Aged 45-49
Smoker
Multiple sexual partners
What is the most common type of vaginal cancer?
Secondary (metastatic) vaginal cancer
What are risk factors for placenta praaevia?
Multiple pregnancy
Smoking
Intrauterine fibroids
Maternal age >35
What is the management of asymptomatic bacteria in pregnant women?
Culture and begin culture dependent antibiotic
What is the diagnostic criteria for polyhydramnios?
AFI of >34cm
What is the diagnostic criteria for oligohydramnios?
AFI of <5cm
What is the most common cause of polyhydramnios?
Idiopathic
What are the investigations in a confusion screen?
Chest x ray
CRP
FBC (to look at WCC)
Urinalysis
What are the visual changes in a TACI?
Homonymous hemianopia
What are the features of Horner’s syndrome?
Anhidrosis
Exophthalmos
Miosis
Ptosis
What does mydriasis mean?
Dilated pupil
What is a common cause of Horner’s syndrome?
Pancoast (apical) tumour compressing the sympathetic chain
What is the first line drug for trigeminal neuralgia?
Carbamazepine
What are the triggers of migraine?
CHOCOLATE mnemonic
Chocolate, hangover, orgasm, cheese, oral contraceptive, lie in, alcohol, tumult, exercise
Also: periods, injury, certain sensory triggers, being hungry, smoking
What is ropinirole used for?
Parkinson’s
How does ropinirole work?
Activates dopamine receptors to mimic the action of dopamine
Usually in Paeds, 20ml/kg bolus is administered in shock. In what conditions do you only give 10ml/kg bolus?
DKA and HF (due to fluid overload complications e.g. cerebral oedema)
What is the calculation for non-shocked patients with DKA?
Hourly rate = ((Deficit-initial bolus)/48hr) + Maintenance per hour
If shocked, don’t minus the bolus
Why can SLE be associated with recurrent miscarriages?
SLE is associated with anti phospholipid syndrome, the most important treatable cause of recurrent miscarriage
Think about SLE in any patient with arthralgia and recurrent miscarriages!
What is the management of gestational diabetes?
Fasting glucose of <7mmol/L: trial of diet and exercise. If no improvement in 2 weeks, start metformin
Fasting glucose of 7mmol/L or above: immediate insulin +/- metformin and diet and exercise
What are the electrolyte levels in Conn’s syndrome (primary hyperaldosteronism)?
Hypernatraemia and hypokalaemia
Manage with spironolactone
What is the investigation for renal colic?
CTKUB
What are some drugs that can cause AKI?
NSAIDs
ACEi
CCBs
a-blockers
b-blockers
opioids
Diuretics
Acyclovir
Trimethoprim
Lithium
What is the management of COPD that is steroid responsive?
- SABA or SAMA
- SABA + LABA + ICS
- SABA + LABA + ICS + LAMA
What is the management of COPD that isn’t steroid responsive?
- SABA or SAMA
- SABA + LAMA + LABA
