Mock 3 Flashcards
What are some complications of nephrotic syndrome?
Hypercholesterolaemia (cholesterol correlates inversely with the serum albumin level)
Thrombosis
Risk of infection (particularly capsulated bacteria such as Pneumococcus)
Hypovolaemia
Where is the rash in HSP?
Buttocks, extensor surfaces of the arms and legs and ankles
Trunk usually spared!
At what point on the FeverPAIN score would you consider an immediate antibiotic prescription?
4 or 5
What does a Naevus flammeus birth mark look like?
Port-wine stain
What is the difference between Naevus flammeus and cavernous haemangioma (strawberry naevus)?
Naevus flammeus is present from birth and grows with the infant, whereas cavernous haemangioma is not present at birth but appears in the first month of life.
What is erythema toxicum?
Neonatal urticaria. Common, appearing at 2-3 days of age, white pinpoint papule at the centre of an erythematous base, concentrated on trunk
What do Mongolian blue spots look like and where are they?
Blue bruise-like macular discolouration at the base of the spine and on the buttocks
What is first line for faecal impaction in children?
Macrogol laxative e.g. movicol
What is Sandifer syndrome?
GI symptoms and neuro features
Linked with GORD
Prevalence 18-36 months
Spasmodic torticollis and dystonia
Treat GORD or other underlying cause
Is GORD associated with non-bilious vomiting or bilious vomiting?
Non-bilious
What is the prognosis and management of ITP?
Can reassure parents that ITP will spontaneously resolve within 6-8 weeks
If specialist thinks the platelet count needs to be raised - can give prednisolone.
Splenectomy should only be considered if there is a case of life-threatening bleeding, or if a child has severe, chronic and unremitting IP for 12-24 months with severe symptoms
What is the first line treatment for a patient under 2 years of age with bilateral acute otitis media?
5 day course of amoxicillin
What is the procedure to treat Hirschsprung’s called?
Swenson
What is the wedge excision used for treatment of?
Meckel’s diverticulum
Is Tetralogy of Fallot cyanotic or acyanotic?
Cyanotic
Pansystolic mumur heard loudest at the lower left sternal edge is associated with what defect?
VSD
Continuous machinery murmur typically heard at the upper-left sternal border is associated with what defect?
PDA
Ejectionm systolic murmur heard loudest tat the upper-left sternal border is associated with what defect?
ASD
Harsh ejection systolic murmur heard loudest over the upper-left sternal angle is associated with what defect?
Tetralogy of Fallot
Murmur heard on the back between the scapula is associated with what defect?
Coarctation of the aorta
Polydactyly is associated with which Trisomy?
Trisomy 13 (Patau’s)
Does Prader Willi syndrome have hypotonia or hypertonia?
Hypotonia
Macrocephaly is a feature of which genetic syndrome?
Fragile X
Macrognathia (undersized lower jaw) is a feature of which trisomy?
Edwards’ (trisomy 18)
Pectus excavatum is a feature of which genetic syndrome?
Noonan
What is the first line treatment in Alzheimer’s
Donepezil
What is the mechanism of Donepezil?
Acetylcholinesterase inhibitor
What is the second line treatment for Alzheimers?
Memantine
What is the mechanism of Memantine?
NMDA receptor antagonist
How long is N-acetylcysteine given over?
Over 1 hour. Given it a total dose that is divided into three consecutive intravenous infusions
What is given in paracetamol overdose within 1 hour of indigestion?
Activated charcoal
Do people have increased hunger or decreased hunger in cocaine withdrawal?
Increased hunger
How long is the first phase of cocaine withdrawal?
24 hrs
How long is the second phase of cocaine withdrawal?
up to 10 weeks
How long is the final phase of cocaine withdrawal?
up to 6 months
When are women offered a blood test to check for anaemia?
Booking visit and 28 week appointment
What is the name of the test which determines how much anti-D is required?
Kleinhauer
What is the range for a normal foetal baseline heart rate?
110-160
What is a normal baseline variability on CTG?
Vary between 5 and 25 beats per minute
Are decelerations normal or abnormal
Abnormal
What is the first line treatment for pre-eclampsia and hypertension in pregnancy?
Labetalol
BUT Nifedipine if asthmatic!!
Do you still have to use contraception if you are on HRT?
For up to 2 years after your last period if under 50 and 1 year after if over 50
Is alpha or beta thalassaemia a major cause of foetal hydrops?
Alpha
What are non immune causes of foetal hydrops?
Severe anaemia - congenital parvovirus B19 infection, alpha thalassaemia major, massive materno-feto haemorrhage
Cardiac abnormalities
Chromosomal - trisomy 13, 18, 21, or Turners
Infection - toxoplasmosis, rubella, CMV, varicella
Twin-Twin transfusion syndrome
What are non immune causes of foetal hydrops?
Severe anaemia - congenital parvovirus B19 infection, alpha thalassaemia major, massive materno-feto haemorrhage
Cardiac abnormalities
Chromosomal - trisomy 13, 18, 21, or Turners
Infection - toxoplasmosis, rubella, CMV, varicella
Twin-Twin transfusion syndrome
Chorioangioma
What is the most common cause of anaemia in pregnancy?
Iron deficiency
What is first line management for heavy menstrual bleeding?
Levonorgestrel-releasing intrauterine system
What is the preferred method of induction?
Vaginal PGE2
Is previous multiple pregnancy a risk factor for placenta accreta?
No
What is the management for obstetric cholestasis?
Ursodeoxycholic acid
Is placenta praaevia a risk factor for abnormal lie?
Yes
What is the blood pressure cut off for stage 1 hypertension to be treated pharmacologically in people under 60?
135/85
What is the holding time of a Section 5(4)?
6 hours by a nurse
AWhen do you consider giving anti-D?
Rhesus neg mother and Rhesus pos father and after 10 weeks
What does the QRISK score calculate?
A person’s risk of developing a heart attack or stroke over the next 10 years. If greater than 10%, prescribe statin
What do you do if a patient’s BP is over 180/120?
Refer immediately for specialist same day assessment. Or if there are signs of retinal haemorrhage and or Papiloedema or life-threatening symptoms or suspected pheochromocytoma
What does hypermetropia mean?
Long sightedness. Can cause a convergent squint
What is the first line management of COPD?
SABA and SAMA (Salbutamol and Ipratropium bromide).
What is the second line management of COPD?
Consider an ICS too if steroid responsive or has asthmatic features.
OR LAMA (Tiotropium) and LABA (Salmeterol)
Theophylline only in severe
What is heparin contraindicated in?
Bacterial endocarditis
How does Salmetarol work?
LABA - stimulation of G protein-coupled receptors causing smooth muscle relaxation and bronchodilation
How does gastric cancer present?
Palpable mass in the abdomen, with ascites and dysphagia
