Mock 5 Flashcards
What is the most common presentation of varicoele?
Aysmptomatic
What is talengiectasia?
Dilated or broken blood vessels located near the surface of the skin or mucous membranes
Give 4 side effects of topical corticosteroids
Acne
Striae
Talangiectasia
Skin thinning
If a patient presents with severe croup or does not respond to oral dexamethasone, what should you do?
Give oxygen and nebulised adrenaline
How does acamprosate work?
It reduces alcohol craving by enhancing GABA transmission
How does disulfram work?
It causes a build-up of acetaldehyde on consumption of alcohol causing unpleasant symptoms such as flushing, headache and anxiety.
How does naltrexone work?
It acts as an opioid antagonist to reduce the pleasurable effect of alcohol
What is the only absolute contraindication of ECT?
Raised intracranial pressure
What can happen if a pt takes St Johns Wort and an SSRI?
Serotonin syndrome
How long does it take for serotonin syndrome to develop?
develops over 24 hours
How long does it take for neuroleptic malignant syndrome to develop?
Over days to weeks
What is dyspraxia?
A problem with a person’s motor skills
What are more likely to cause behavioural disinhibition, long acting or short acting benzodiazepines?
Short acting benzodiazepines
What are the symptoms of neuroleptic malignant syndrome?
Mnemonic - FEVER Fever Encephalopathy Vitals unstable Elevated enzymes Rigidity of muscles
What can cause neuroleptic malignant syndrome?
Starting on a new antipsychotic
What abnormality is most likely to be seen if sodium valproate is used in pregnancy?
Hypospadias
What are the 4Ts of Primary PPH?
Tone
Trauma
Thrombin
Tissue
What is the inheritance pattern in Marfan’s syndrome?
Autosomal dominant
What is the 1st line surgical intervention in PPH?
Intrauterine balloon tamponade
What does the POP increase the likelihood of?
Ectopic pregnancy
What is the imaging investigation for ovarian cancer?
USS abdomen and pelvis
What BMI is associated with increased risk of endometriosis?
Low BMI
What should you do after full history and examination in the initial assessment of menorrhagia?
FBC to look for iron deficiency anaemia
What can be used to treat both gonorrhoea and chlamydia?
Azithromycin 1g stat PO
What is used to treat trichomonas vaginalis?
Metronidozole
What is used to treat candida?
Fluconazole
What is used to treat chlaymdia AFTER positive NAAT testing?
Doxycycline
What does n.gonorrhoea look like on microscopy?
Gram negative diplococci
What does chlamydia trachomatis look like on microscopy?
Gram negative rod shapes
What exercise can cause erectile dysfunction?
Cycling - the seat puts constant pressure on the perineum and this can slow blood flow and lead to ED
What is 1st line in reducing malignant compression of the spinal cord?
High does dexamethasone (16mg)
What is the definitive management of malignant compression?
Surgical decompression
What investigation confirms the diagnosis of pituitary tumour?
CT Head
How long does optic neuritis take to resolve?
Days-weeks
Give some symptoms of optic neuritis
Optic disc swelling
Phosphenes
Retro-orbital Pain
Unilateral Presentation
What does a positive dix-hallpike maneuver suggest?
Benign Paroxysmal positional vertigo
What is the presentation of Brown-Sequard Sydrome?
Hemisection of the spinal cord causes:
- Paralysis and loss of proprioception and vibration on the SAME SIDE of the lesion
- Lack of pain and temperature on the OTHER SIDE of the lesion
The best analogy for this is that the afferent fibres for pain and temperature turn onto a different road early on and then run into a traffic jam. Of course pain and temperature is spared on the ipsilateral side, because they leave the road early and avoid the traffic jam, thus reaching the cortex.
Describe features seen in benign essential tremor
Bilateral
Worse when stretching arms out
Better with alcohol
What is 1st line in improving benign essential tremor?
Propanolol
If a patient is still seizing after 2 doses of lorazepam/diazepam, what should you do?
Give IV Phenytoin
How should aldendonic acid be taken?
PO, whilst standing/sitting upright for at least 30 minutes.
Before breakfast, on an empty stomach
What should be given 1st line to all patients with symptomatic heart failure to reduce morbidity and mortality?
ACEi and Beta Blocker
How often should you take alendronic acid?
Once weekly
Why do people taking alendronic acid need to stay upright for 30 minutes after taking it?
It can cause oesophagi’s
What is a contraindication to aspirating joints in A&E?
Having prosthetic joints. It should only be done by an orthopaedic surgeon in theatre due to risk of infection
What is 1st and 2nd line in preventing gout?
- Allopurinol
2. Febuxostat
What is the best course of action in symptomatic gallstones?
Laparoscopic cholecystectomy
What is the best course of action in asymptomatic gallstones?
Observation
What LFT picture is seen in alcoholic liver disease?
↑AST +↑ALT with an AST/ALT ratio of 2:1
In patients with alcoholic liver disease, AST level is almost always elevated (usually above ALT level). The classic ratio of AST/ALT >2 is seen in about 70% of cases (A). Reversal of the ratio, ALT > AST, suggests concomitant presence of viral hepatitis or possibly non-alcoholic fatty liver disease as the major cause of liver injury in alcoholic patients
Give 3 common bacteria that cause COPD exacerbations
Moraxella catarrhalis
Haemophilus influenza
Streptococcus pneumonia
