Mock 4 Flashcards
What is the second line choice of drug for ADHD?
Lisdexamfetamine
What are the DSM-V 6 criteria for ADHD?
Answers questions prematurely
Always on the go, spontaneously moving around
Losing important things, forgetful
Cannot play quietly
Is William’s syndrome associated with cyanotic heart disease?
No - generally associated with Supravalvular aortic stenosis (not a cause of cyanotic heart disease).
What can be given in an asthma attack if unresponsive to initial management?
IV salbutamol, IV aminophylline or IV magnesium
What are the three descriptive terms for different levels of cryptorchidism (undescended testes)?
Retractile
Palpable
Impalpable
What does: paroxysmal episodes of colicky abdominal pain, where the child is inconsolable and draws their legs up to their abdomen, alongside features of intestinal obstruction suggest?
Intussuception
When does volvulus commonly present?
In the first few days of life
With bilious vomiting and pain that is less classical in description than intussusception
What is the management of choice in most patients with intussusception?
Rectal air insufflation
How does disulfiram work in preventing alcohol consumption?
Deterrent
Why is it recommended to check FBC and iron studies in ruling out organic causes of generalised anxiety disorder?
Anaemia can present with fatigue and palpitations
What is the staging of perineal tears?
First degree tear - perineal skin only
Second degree tear - fascia and muscles of perineum
Third degree (A) tear - fascia and muscles of perineum and <50% of external anal sphincter involved
Third degree (B) tear - fascia and muscles of perineum, and >50% of external anal sphincter involved
Third degree (C) tear- fascia and muscles of perineum, and both external and internal anal sphincters involved
Fourth degree tear - both external and internal anal sphincters completely torn, and anal epithelium involved.
What are the nerve roots for Erb’s palsy (seen in shoulder dystocia)?
C5-6
What is used in a medical abortion?
Mifepristone is used first, followed by misoprostol 36-48 hours later.
What are some symptoms of ovarian neoplasms?
Hirsutism due to testosterone secretion
Acute abdomen due to ovarian torsion
Rupture or haemorrhage
Thyrotoxicosis as in struma ovaria
Amenorrhea
What is haematocolpos?
Accumulation of the blood in the vagina, usually due to an imperforate hymen
What is ovarian hyperthecosis?
The presence of luteineised theca cell nests in ovarian stroma
Closely related to PCOS but with more severe hyperandrogegism and virilisation
V high testosterone concentrations - may exceed 7 mol/L
Accounts for most of the cases of hyperandrogenaemia in postmenopausal women
In what psychiatric condition is suppressed gonadotrophins with low estradiol seen?
anorexia nervosa
What do bat wing opacities on chest x ray represent?
Alveolar oedema
Sudden onset retro-orbital pain with excessive lacrimation and redness with nothing on CT head and other investigations suggests what?
Cluster headache.
Often associated with autonomic symptoms such as ptosis, mitosis conjunctival injection and excessive lacrimation
Affect patients in clusters of 6-12 weeks followed by a period of remission
What is the first line treatment for cluster headaches?
Sumatriptan
High flow oxygen
What is a contraindication of sumatriptan?
Coronary artery disease
What is the name of the connecting structure between the two lateral ventricles and the third ventricle?
Foramina of Monro
What is the name of the connecting structure between the third ventricle and the fourth ventricle?
Cerebral aqueduct
What is the name of the connecting structure between the fourth ventricle and the subarachnoid space?
Foramina of Luschka and Magendie
What is the Motor responses on GCS?
Obeys commands - 6
Localising to pain - 5
Withdrawal from pain - 4
Flexion to pain - 3
Extension to pain - 2
No motor response - 1
Wha tis Uhthoff’s phenomenon?
Small increases in the body temperature can temporarily worsen current or pre-existing signs and symptoms.
What is Charcot’s neurologic triad?
Combination of nystagmus, intention tremor, scanning or staccato speech
Triad is associated with multiple sclerosis
What are Kernig’s and Brudzinskiu’s signs associated with?
Meningitis
What antibodies are detected in 98% of primary biliary cholangitis?
Antimitochondrial antibodies
What are some complications of nephrotic syndrome?
Hypercoagulable state - risk of DVT.PE
Hyperlipidaemia
pleural effusions
Immunocompromised due to loss of immunoglobulins
NOT RISK OF AKI
What is the organism which causes syphilis?
Treponema Pallidum - a spirochaete bacterium
What is the first line treatment in an acute severe flare-up of UC?
IV steroids
What does gram positive diplococci in CSF with a clinical picture of meningitis suggest?
Streptococcus pneumoniae
What are hormone levels like in PCOS?
Raised LH,
Low or normal FSH
TSH may be raised
What is the diagnostic test for acromegaly?
Oral glucose tolerance test
- a glucose load should cause suppression of growth hormone normally, but in acromegaly there is failure of growth hormone suppression. If the lowest value of growth hormone during the oral glucose tolerance test is >1ug/L, acromegaly is confirmed.
Where does the pain radiate in cholecystitis
To between the scapulae
