Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 2a > MOCK SAQs > Flashcards

MOCK SAQs Flashcards

1
Q

15 year old girl presents to A+E with vomiting, drowsiness, and Kussmaul’s
respirations. Doctors suspect she has diabetic ketoacidosis.

Name two tests required for the diagnosis of DKA and the results required?

A 
Blood glucose = >11.1mmol/l
Plasma ketones = > 3mmol/l 
Ketonuria = >2+ on dipstick 
Venous pH <7.35
HCO3- = <15.0mmol/l
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

15 year old girl presents to A+E with vomiting, drowsiness, and Kussmaul’s
respirations. Doctors suspect she has diabetic ketoacidosis.

What is the first line of treatment for this patient?

A

IV fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

15 year old girl presents to A+E with vomiting, drowsiness, and Kussmaul’s
respirations. Doctors suspect she has diabetic ketoacidosis.

What disease is DKA a hallmark sign of?

A

Type 1 diabetes meillitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

15 year old girl presents to A+E with vomiting, drowsiness, and Kussmaul’s
respirations. Doctors suspect she has diabetic ketoacidosis.

Name 3 risk factors for DKA?

A
  1. Stopped insulin
  2. Infection
  3. Pancreatitis
  4. Undiagnosed T1DM
  5. MI
  6. Surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

15 year old girl presents to A+E with vomiting, drowsiness, and Kussmaul’s
respirations. Doctors suspect she has diabetic ketoacidosis.

Name 3 complications of DKA?

A
  1. Hypotension
  2. Coma
  3. Cerebral oedema
  4. Hypothermia
  5. Death
  6. DVT
  7. Pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

76 year old female patient arrives in A+E, presenting with chest pain and a history of
previous MI, diabetes mellitus type 2 and hypertension. Their BMI is 32 kg/m^2 and
they have 3 children.

What aspect of their chest pain differentiates pericarditis and an MI?

A

Does NOT radiate to the teeth and jaws in pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

76 year old female patient arrives in A+E, presenting with chest pain and a history of
previous MI, diabetes mellitus type 2 and hypertension. Their BMI is 32 kg/m^2 and
they have 3 children.

Name 4 features elicited on clinical examination that would may you suspect pericarditis?

A
  1. Pericardial rub
  2. Sinus tachycardia
  3. Fever
  4. Effusion signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

76 year old female patient arrives in A+E, presenting with chest pain and a history of
previous MI, diabetes mellitus type 2 and hypertension. Their BMI is 32 kg/m^2 and
they have 3 children.

What would you expect on an ECG of a pericarditis patient?

A

Saddle shaped ST elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

76 year old female patient arrives in A+E, presenting with chest pain and a history of
previous MI, diabetes mellitus type 2 and hypertension. Their BMI is 32 kg/m^2 and
they have 3 children.

How long should colchichine be given for patients who what had acute pericarditis?

A

6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

76 year old female patient arrives in A+E, presenting with chest pain and a history of
previous MI, diabetes mellitus type 2 and hypertension. Their BMI is 32 kg/m^2 and
they have 3 children.

Whist in hospital she develops AF, from into in chadvasc what should be done?

A 
76 = 1 
T2DM = 1
HTN = 1 
Female = 1 
Previous MI = 1 
chadvasc = 5 
anticoagulate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A patient has just had a biopsy of their lymph node due to suspected lymphoma.

What cells would you expect to find on microscopy of a Hodgkins lymphoma?

A

Reed-sternberg cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A patient has just had a biopsy of their lymph node due to suspected lymphoma.

Patient is diagnosed with Non Hodgkins lymphoma - what lymphocyte is affected?

A

B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A patient has just had a biopsy of their lymph node due to suspected lymphoma.

Upon taking history the patient has human herpes virus, which is associated with NHL?

A

Epstein Barr virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A patient has just had a biopsy of their lymph node due to suspected lymphoma.

The patient has all three B symptoms - what are they?

A
  1. Fever
  2. Weight loss
  3. Night sweats §
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A patient has just had a biopsy of their lymph node due to suspected lymphoma.

The patient has pancytopenia - define this?

A

Deficiency of all blood cells
RBC
WBC
platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A patient presents to their doctor with a history of foreign travel, nausea, fever,
malaise, and is mildly jaundiced. You suspect that they have viral hepatitis.

Which form of viral hepatitis is a notifiable disease and to whom should it be reported?

A

Hepatitis A, public health england

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A patient presents to their doctor with a history of foreign travel, nausea, fever,
malaise, and is mildly jaundiced. You suspect that they have viral hepatitis.

Upon a blood test it is found that the patient has Hep B, what was present in the blood to diagnose this?

A

HBsAg OR antiHB antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

A patient presents to their doctor with a history of foreign travel, nausea, fever,
malaise, and is mildly jaundiced. You suspect that they have viral hepatitis.

How is hep B transmitted?

A

Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A patient presents to their doctor with a history of foreign travel, nausea, fever,
malaise, and is mildly jaundiced. You suspect that they have viral hepatitis.

Why is hepatitis D only able to cause disease in those with hep B?

A

Incomplete RNA - needs hep B to assemble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A patient presents to their doctor with a history of foreign travel, nausea, fever,
malaise, and is mildly jaundiced. You suspect that they have viral hepatitis.

Name three management for acute hep B?

A

Avoid alcohol
Vaccinate contacts
Monitor liver function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A 30 year old woman presents to her doctor with fatigue, joint pain, and mouth
ulcers, and photosensitivity. It is found upon testing and further examination that
she has systemic lupus erythematosus (SLE).

Name a gene associated with an increased risk of SLE?

A

HLA 88
HLA DR2
HLA DR3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

A 30 year old woman presents to her doctor with fatigue, joint pain, and mouth
ulcers, and photosensitivity. It is found upon testing and further examination that
she has systemic lupus erythematosus (SLE).

Name four features of SLE that are required for clinical diagnosis?

A

A RASH POINTS AN MD

Arthritis 
Renal disorder 
ANA+ 
Serositis 
Haematological disorder
Photosentitivity 
Oral ulcers
Immunological disorder
Neurological disorder
Malar rash 
Discoid rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A 30 year old woman presents to her doctor with fatigue, joint pain, and mouth
ulcers, and photosensitivity. It is found upon testing and further examination that
she has systemic lupus erythematosus (SLE).

What are two lifestyle changes that can be performed by the patient to reduce symptoms?

A

Decrease sunlight expose
Wear high factor sunblock
Decrease CVS risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A 30 year old woman presents to her doctor with fatigue, joint pain, and mouth
ulcers, and photosensitivity. It is found upon testing and further examination that
she has systemic lupus erythematosus (SLE).

What medications should be given for an acute SLE attack and what route should they be given?

A

IV Cyclophosphamide and prednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

A 35 year old male presents to the sexual health clinic having just changed sexual
partners for a STD check. The results show that he is HIV positive.

Other than sex, how can HIV be transmitted?

A

Mother to child
IV needles
Contaminated blood/oragns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

A 35 year old male presents to the sexual health clinic having just changed sexual
partners for a STD check. The results show that he is HIV positive.

What type of virus is HIV?

A

Retrovirus subgroup lentivirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

A 35 year old male presents to the sexual health clinic having just changed sexual
partners for a STD check. The results show that he is HIV positive.

Untreated this patient will progress to AIDS, what CD4 count is the defining level for an AIDs diagnosis?

A

<200ul

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

A 35 year old male presents to the sexual health clinic having just changed sexual
partners for a STD check. The results show that he is HIV positive.

What is the overall name for treatment given to HIV patients and what subgroups of medications are given - write in gull

A

HAART - highly active antiretroviral therapy

NRTI - nucleoside reverse transcriptase inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Patient presents to GP with severe polyuria and polydipsia.

What aspect on a urine dipstick would indicate that the patient has DI not DM?

A

Glucose negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Patient presents to GP with severe polyuria and polydipsia.

The patient is diagnosed with DI, what test would you run to differentiate cranial and nephrogenic DI? What result would inidicate cranial?

A

IM desmopression test

Urine becomes concentrated in cranial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Patient presents to GP with severe polyuria and polydipsia.

The patient is found to have cranial DI, what class of medication is given and give an example of this?

A

ADH analogue

Desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Patient presents to GP with severe polyuria and polydipsia.

In a patient with nephrogenic DI you give them NSAIDs, what is the physiology behind this?

A

Inhibits prostaglandins which stops their inhibition of ADH action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Patient presents to GP with severe polyuria and polydipsia.

Name a risk factor for DI?

A

Family history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

A 53-year-old man presents to his GP with headaches, excessive sweating and
complaining that his wedding ring no longer fits on his finger. Upon examination, he has
enlarged hands and feet, as well as an enlarged jaw. The GP suspects Acromegaly.

Name two causes of acromegaly?

A

Benign Pituitary Tumour (GH secreting)

Ectopic Carcinoid Tumour (GH secreting)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

A 53-year-old man presents to his GP with headaches, excessive sweating and
complaining that his wedding ring no longer fits on his finger. Upon examination, he has
enlarged hands and feet, as well as an enlarged jaw. The GP suspects Acromegaly.

Name 4 other signs of acromegaly?

A
  1. Large tongue
  2. Wide nose
  3. Large supraorbital ridge
  4. Deep voice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

A 53-year-old man presents to his GP with headaches, excessive sweating and
complaining that his wedding ring no longer fits on his finger. Upon examination, he has
enlarged hands and feet, as well as an enlarged jaw. The GP suspects Acromegaly.

Name 2 investigations for acromegaly?

A

Glucose Tolerance Test

MRI of pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

A 53-year-old man presents to his GP with headaches, excessive sweating and
complaining that his wedding ring no longer fits on his finger. Upon examination, he has
enlarged hands and feet, as well as an enlarged jaw. The GP suspects Acromegaly.

Why would measuring plasma growth hormone not be diagnostic?

A
  1. GH is pulsatile

2. GH can be elevated due to stress/pregnancy/puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

A 53-year-old man presents to his GP with headaches, excessive sweating and
complaining that his wedding ring no longer fits on his finger. Upon examination, he has
enlarged hands and feet, as well as an enlarged jaw. The GP suspects Acromegaly.

Name 2 types of drugs used for acromegaly and give examples

A

GH receptor antagonist - sc pegvisomant

Somatostatin analoge - sandostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

Name 2 risk factors for developing mitral valve stenosis?

A

Rheumatic fever

Untreated streptococcus infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

Give two characteristic heart sounds of mitral valve stenosis?

A

Diastolic murmur

Loud opening S1 snap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

What is the gold standard investigation for diagnosing mitral valve stenosis?

A

Echocardiogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

Name 2 classes of drugs and examples that are used for treating mitral valve stenosis?

A

Beta blocker - bisoprolol

Diuretics -furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

Name two surgical interventions for mitral valve stenosis?

A
  1. Percutaneous mitral balloon valvotomy

2. Mitral valve replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

A 47-year-old man presents to A&E with progressive dyspnoea which is worse on
exertion, haemoptysis and malar flush. Following investigations, the doctor suspects
Mitral Valve Stenosis.

What cardiac arrhythmia is often associated with mitral valve stenosis?

A

Atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

What plasma protein transports iron in the blood to the bone marrow?

A

Transferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

Aside form iron deficiency, give some other cause of microcytic anaemia?

A

Thalassaemia

Malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

Two features of microcytic anaemia that would be seen on a blood film?

A

Small RBCs
Pale RBCs - hypochromic
Variation in shape
Variation in size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

Name 2 blood tests that would be carried out to diagnose microcytic anaemia?

A

Serum ferritin
Serum iron
Reticulocyte count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

Name 1 pharmacological treatment for iron deficiency anaemia and give an example?

A

Oral iron

Ferrous sulphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

A 14-year-old female presents to her GP with fatigue, reoccurring headaches and
faintness. Upon examination, she is found to have spoon-shaped nails and angular
stomatitis. Following further investigation, she is diagnosed with Microcytic Anaemia, due to
iron deficiency.

2 side effects of ferrous sulphate?

A

Nausea
Diarrhoea / constipation
Black stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Give 4 causes of gastro-oesophageal reflux disease?

A

Lower oesophageal sphincter hypotension
Hiatus hernia
Slow gastric emptying
Drugs e.g. CCBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Give 2 other symptoms of GORD?

A

Increased salivation

Food/acid regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Name 2 differential diagnoses of GORD?

A

Biliary colic
Peptic ulcer disease
Coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Name 3 lifestyle changes for someone which GORD?

A

Encourage smoking cessation
Weight losss
Small regular meals
Avoid hot drinks/citrus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Name three classes of drugs used for treating GORD and give an example for each?

A

Proton pump inhibitor e.g. Lansoprazole, omeprazole

H2 receptor antagonist e.g. cimetidine

Antacids e.g. gaviscon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

A 23-year-old female presents to her GP with heartburn and increased belching.
Following a focused history, the GP diagnoses her with Gastro-Oesophageal Reflux Disease (GORD).

Give 2 possible complications of GORD?

A

Peptic stricture

Barretts oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

What is the difference between Herberden’s nodes and Bouchard’s nodes?

A

Herberdens = between middle and distal phalanges e.g. distal interphalangeal joint

Bouchards nodes = between proximal and middle phalanges e.g proximal interphalangeal joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

6 joints commonly affected in osteoarthritis?

A 
Interphalangeal 
Carpometacarpal 
Metatarsophalageal joints 
Vertebra 
Hip 
Knee
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

Name three differentials of osteoarthritis?

A

Rheumatoid
Psoriatic
Chronic, tophaceous gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

Name 4 features seen on an xray of osteoarthritis?

A

Loss of joint spact
Osteophytes
Subarticular sclerosis
Subchondral cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

2 Pharmacological treatments of osteoarthritis?

A

Paracetamol

NSAIDS

Dihydrocodeine

Intra-articular corticosteroid injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

A 65-year-old man presents to his GP with joint pain and joint stiffness after rest. Upon
examination, he has limited joint movement and Herberden’s nodes. Following further
investigation, he is diagnosed with Osteoarthritis.

2 surgical treatments for osteoarthritis?

A

arthroscopy
arthroplasy
osteotomy
fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Where is the excess fluid located within the testis?

A

Tunica vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Name three causes of hydrocele?

A 
Patent processus vaginalis 
Testis tumour 
Trauma 
Infection 
Testicular torsion 
Generalised oedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Name two differential diagnoses of hydrocele?

A

Testicular torsion

Strangulated hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Name an investigation that would be carried out to diagnose hydrocele?

A

Scrotal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Name a test that would be done to exclude a malignancy teratoma and confirm hydrocele?

A

Serum alpha-fetoprotein

Serum hCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

A baby is born with a smooth, cystic swelling on his testes, resulting in scrotal
enlargement. The swelling lies anterior and below the testes. Upon investigation, the new-born is diagnosed with Hydrocele.

Give two treatment options for hydrocele?

A

Therapeutic aspiration to remove fluid

Surgical removal of hydrocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

A 67-year-old women presents to A&E with a small, painful ulcer on her leg, which is
worsened when elevated. There is no oedema present. Following further investigation, she is diagnosed with an Arterial Ulcer.

Name two risk factors for arterial ulcers?

A

Atherosclerosis
Smoking
Hypercholesterolaemia
Diabetes Meillitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

A 67-year-old women presents to A&E with a small, painful ulcer on her leg, which is
worsened when elevated. There is no oedema present. Following further investigation, she is diagnosed with an Arterial Ulcer.

What two investigations would be carried out to diagnose arterial ulcer?

A

Doppler ultrasound of leg

Ankle brachial pressure index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

A 67-year-old women presents to A&E with a small, painful ulcer on her leg, which is
worsened when elevated. There is no oedema present. Following further investigation, she is diagnosed with an Arterial Ulcer.

Give 1 treatment option for arterial ulcer?

A

Keep ulcer clean and covered

Analgesic

Vascular reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

A 67-year-old women presents to A&E with a small, painful ulcer on her leg, which is
worsened when elevated. There is no oedema present. Following further investigation, she is diagnosed with an Arterial Ulcer.

Give 4 differences between arterial and venous ulcer?

A

ARTERIAL vs venous

SMALL vs large 
PUNCHED OUT vs shallow 
PAINFUL vs minimal pain 
NO OEDEMA vs oedema 
ABSENT PULSES vs peripheral pulses present
COLD SKIN vs warm skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

Give three main causes of IBS?

A 
Depression 
Anxiety 
Psychological stress 
Trauma 
Sexual, physical or verbal abuse 
Eating disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

Give two non intestinal symptoms of IBS?

A

Painful periods
Change in urinary frequency/urgency
Back pain
Fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

Name two differential diagnoses for IBS?

A 
Coeliac 
Lactose intolerance 
Bile acid malabsorption 
Inflammatory bowel disease 
Colorectal cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

Name two blood tests that would exclude possible differential diagnoses?

A

ESR / CRP

FBC

tTG - tissue transglutaminase antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

What is the name of the criteria used to diagnose IBS?

A

Rome III diagnostic criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

A 21-year-old female presents to her GP complaining of abdominal pain, bloating and a
change in bowel habit. She notices that her abdominal pain is relieved by defecation.
Following a series of investigations, she is diagnosed with Irritable Bowel Syndrome – D (i.e. IBS with diarrhoea).

What class of drug can be given to relieve bloating and the associated pain?

A

Antispasmodics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

A 23-year-old male presents to A&E with newly developed ventricular tachycardia,
fever and confusion. He is a known intravenous drug user. Following further investigation, he is diagnosed with Infective Endocarditis.

Aside from IVDU, give two other risk factors for for infective endocarditis?

A 
Old age 
Prosthetic valve 
Recent cardiac surgery  
Congenital heart disease
IV cannula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

A 23-year-old male presents to A&E with newly developed ventricular tachycardia,
fever and confusion. He is a known intravenous drug user. Following further investigation, he is diagnosed with Infective Endocarditis.

Name three organisms that can cause infective endocarditis?

A

Staphylococcus aureus

Pseduomonas aeruginosa

Streptococcus Viridans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

A 23-year-old male presents to A&E with newly developed ventricular tachycardia,
fever and confusion. He is a known intravenous drug user. Following further investigation, he is diagnosed with Infective Endocarditis.

Give three other signs of infective endocarditis?

A 
Splinter haemorrhage on beds of fingers 
Embolic skin lesions 
Osler nodes 
Janeway lesions 
Roth spots 
Petechiae 
New valve lesion 
Clubbing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

A 23-year-old male presents to A&E with newly developed ventricular tachycardia,
fever and confusion. He is a known intravenous drug user. Following further investigation, he is diagnosed with Infective Endocarditis.

What is the name of the criteria used to diagnose infective endocarditis?

A

Modified dukes criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

A 23-year-old male presents to A+E with newly developed ventricular tachycardia,
fever and confusion. He is a known intravenous drug user. Following further investigation, he is diagnosed with Infective Endocarditis.

What class of drug is given to treat infective endocarditis and how long are they given for?

A

Antibiotics for 4-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

An 84-year-old women presents to A&E with severe, constant pain in the epigastric and right upper quadrant region. She is nauseous and has vomited twice. Following
investigation, she is diagnosed with a Biliary Colic.

Give two main functions of the liver?

A

Glucose metabolism
Fat metabolism
Detoxification and excretion of billirubin/alcohol/toxins
Protein synthesis: albumin / clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

An 84-year-old women presents to A&E with severe, constant pain in the epigastric and right upper quadrant region. She is nauseous and has vomited twice. Following
investigation, she is diagnosed with a Biliary Colic.

Give two differential diagnoses of biliary colic?

A

Irritable bowel sydrome
Carcinoma on right side of the colon
Renal colic
Defence against infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

An 84-year-old women presents to A&E with severe, constant pain in the epigastric and right upper quadrant region. She is nauseous and has vomited twice. Following
investigation, she is diagnosed with a Biliary Colic.

Give four risk factors for biliary colic?

A

Obese
Female
Fertile
Smoker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

An 84-year-old women presents to A&E with severe, constant pain in the epigastric and right upper quadrant region. She is nauseous and has vomited twice. Following
investigation, she is diagnosed with a Biliary Colic.

What investigations would be carried out for biliary colic?

A

Abdominal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

An 84-year-old women presents to A&E with severe, constant pain in the epigastric and right upper quadrant region. She is nauseous and has vomited twice. Following
investigation, she is diagnosed with a Biliary Colic.

Give two treatment options for biliary colic?

A

Stone dissolution
Shock wave lithotripsy
Laprascopic cholecystomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

During a routine GP appointment, a 42 year old man is found to have a blood
pressure of 156/92mmHg. The GP suspects he has stage 1 essential hypertension.

What is essential hypertension?

A

Hypertension with primary cause unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

During a routine GP appointment, a 42 year old man is found to have a blood
pressure of 156/92mmHg. The GP suspects he has stage 1 essential hypertension.

How might the size of the kidney change with hypertension?

A

Kidney size is reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

During a routine GP appointment, a 42 year old man is found to have a blood
pressure of 156/92mmHg. The GP suspects he has stage 1 essential hypertension.

Give 2 investigations that the GP might request? what are the relevant features?

A

Urinanalysis - protein/albumin:creatinine ratio

Opthamoscopy - retinal haemorrhage

ECG - LV hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

During a routine GP appointment, a 42 year old man is found to have a blood
pressure of 156/92mmHg. The GP suspects he has stage 1 essential hypertension.

Give 5 risk factors of hypertension?

A 
Age 
Black ethnic . origin 
Family histroy 
Overweight 
Sedentary lifestyle 
Smoker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

During a routine GP appointment, a 42 year old man is found to have a blood
pressure of 156/92mmHg. The GP suspects he has stage 1 essential hypertension.

Give four lifestyle modifications for hypertensive patients?

A 
Change diet 
Regular physical excercise 
Reduce alcohol intake 
Lose weight 
Stop smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

A 38 year old woman presents to A&E with hyperpyrexia, tachycardia, and extreme
restlessness. The doctor suspects she is having a thyroid crisis.

What hormonal changes result in a thyroid storm / crisis?

A

Rapid T4 increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

A 38 year old woman presents to A&E with hyperpyrexia, tachycardia, and extreme
restlessness. The doctor suspects she is having a thyroid crisis.

Name 2 things that thyroid storm can progress to if not treated promptly?

A

Delirium
Coma
Death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

A 38 year old woman presents to A&E with hyperpyrexia, tachycardia, and extreme
restlessness. The doctor suspects she is having a thyroid crisis.

Name 3 events which can precipitate a thyroid storm?

A

Stress
Infection
Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

A 38 year old woman presents to A&E with hyperpyrexia, tachycardia, and extreme
restlessness. The doctor suspects she is having a thyroid crisis.

Name three drugs you would give orally to a patient during a thyroid crisis?

A

Oral carbimazole
Oral propanolol
Oral potassium iodide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

A 38 year old woman presents to A&E with hyperpyrexia, tachycardia, and extreme
restlessness. The doctor suspects she is having a thyroid crisis.

How does hydrocortisone work to reverse the thyroid storm?

A

Inhibits peripheral conversion of T4 to T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

A 73 year old woman presents to her GP with a 4 month history back pain,
polydipsia, tiredness, and bruising. Her GP suspects she might have myeloma.

Which cells are affected in myeloma?

A

Plasma cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

A 73 year old woman presents to her GP with a 4 month history back pain,
polydipsia, tiredness, and bruising. Her GP suspects she might have myeloma.

Define monoclonal paraprotein?

A

One immunoglobulin which is excessively produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

A 73 year old woman presents to her GP with a 4 month history back pain,
polydipsia, tiredness, and bruising. Her GP suspects she might have myeloma.

Which type of anaemia is commonly observed in patients with myeloma?

A

Normocytic, normochromic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

A 73 year old woman presents to her GP with a 4 month history back pain,
polydipsia, tiredness, and bruising. Her GP suspects she might have myeloma.

Why do you give bisphosphonates to patients with myeloma?

A

Reduce fracture rates and bone pains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

A 73 year old woman presents to her GP with a 4 month history back pain,
polydipsia, tiredness, and bruising. Her GP suspects she might have myeloma.

How much fluid should myeloma patients drink daily

A

3L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

A 33 year old man attends a routine GP appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Which country has a failed public health initiative resulting in widespread hep C?

A

Egypt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

A 33 year old man attends a routine GP appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Which type of cancer is strongly associated with chronic hepatits?

A

Hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

A 33 year old man attends a routine GP
appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Name 2 types of patient that ay have a hepatitis C infection but have a false negative blood result for the HCV antibody?

A

Immunosurpressed

Patients still in the acute infection stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

A 33 year old man attends a routine GP appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Name two first line drugs this patient might be prescribed to treat chronic hepatitis?

A

SC peglyated interferon a

Oral ribavirin

108
Q

A 33 year old man attends a routine GP appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Why can a vaccine for hep C not be developed?

A

Rapid mutations so envelope proteins chage rapidly

109
Q

A 33 year old man attends a routine GP appointment and his blood shows abnormal
transferase values. He has a history of IV drug use. His GP suspects he has hepatitis,
and tests confirm that he has chronic hepatitis C.

Name 2 ways the spread of hepatitis C can be prevented ?

A

Screen blood products

Protection / precaution when handling bodily fluids

110
Q

A 69 year old woman presents to her GP with morning stiffness in her DIP and PIP
joints, hips and knees. The GP observes Heberden’s and Bouchard’s nodes primarily
on her right hand. The GP suspects she has osteoarthritis.

Give three characteristics of osteoarthritis that can be used to differentiate between rheumatoid arthritis?

A

Pattern of joint involvement - asymmetrical

Absence of systemic features

Morning stiffness less than 30 mins

111
Q

A 69 year old woman presents to her GP with morning stiffness in her DIP and PIP
joints, hips and knees. The GP observes Heberden’s and Bouchard’s nodes primarily
on her right hand. The GP suspects she has osteoarthritis.

Three risk factors for osteoarthritis?

A 
Diabetes 
Joint hypermobility 
Age 
Gender - F
Occupation 
Genetic predisp
112
Q

A 69 year old woman presents to her GP with morning stiffness in her DIP and PIP
joints, hips and knees. The GP observes Heberden’s and Bouchard’s nodes primarily
on her right hand. The GP suspects she has osteoarthritis.

Name 4 features you would see on an x ray of a joint affected with osteoarthritis?

A

Loss of joint space
Osteophytes
Subchondral cysts
Subarticular sclerosis

113
Q

A 39 year old man presents to A&E in the at 3am with excruciating loin pain. He is
vomiting and writhing in pain. He notes that he has recently been struggling to pass
urine and feels a burning

2 ways for confirming diagnosis of kidney stones and positive result of them?

A

Ultrasound - visualisation

urine dipstick - haematuria/protein/glucose

114
Q

A 39 year old man presents to A&E in the at 3am with excruciating loin pain. He is
vomiting and writhing in pain. He notes that he has recently been struggling to pass
urine and feels a burning

What type of drug would the doctor prescribe for renal colic and give an example of this drug?

A

Analgesics

IV diclofenac

115
Q

A 39 year old man presents to A&E in the at 3am with excruciating loin pain. He is
vomiting and writhing in pain. He notes that he has recently been struggling to pass
urine and feels a burning

Name three lifestyle modifications that this patient could make to prevent reoccurance of kidney stones?

A 
Overhydrations
Normal / low Ca 2+ intake 
Low sodium diet 
Normal dairy intake 
Reduce BMI 
Reduce animal protein
116
Q

A 39 year old man presents to A&E in the at 3am with excruciating loin pain. He is
vomiting and writhing in pain. He notes that he has recently been struggling to pass
urine and feels a burning

The patients urine is noted to be acidic - what type of stone will only form in acidic urine?

A

Uric acid stones

117
Q

A 58 year old man presents to his GP with increased frequency, urgency, and haematuria.He also reports he hasnt been sleeping very well and has to urinate multiple times in the night, GP suspects benign prostatic hyperplasia.

Which ethnicity is more severly affected by BPH and why?

A

Afro-caribbean men

Higher levels of testosterone

118
Q

A 58 year old man presents to his GP with increased frequency, urgency, and haematuria.He also reports he hasnt been sleeping very well and has to urinate multiple times in the night, GP suspects benign prostatic hyperplasia.

Give three differential diagnoses of BPH?

A 
Bladder tumour 
Bladder stones 
Trauma 
Prostate cancer 
UTI
119
Q

A 58 year old man presents to his GP with increased frequency, urgency, and haematuria.He also reports he hasnt been sleeping very well and has to urinate multiple times in the night, GP suspects benign prostatic hyperplasia.

What is that name of the clinical examination which allows a doctor to palpate the prostate?

A

Digital prostate examination

120
Q

A 58 year old man presents to his GP with increased frequency, urgency, and haematuria.He also reports he hasnt been sleeping very well and has to urinate multiple times in the night, GP suspects benign prostatic hyperplasia.

What would a mid stream urine sample help you exclude from your differential diagnoses?

A

Infection

121
Q

A 58 year old man presents to his GP with increased frequency, urgency, and haematuria.He also reports he hasnt been sleeping very well and has to urinate multiple times in the night, GP suspects benign prostatic hyperplasia.

What protein can someones be raised in BPH?

A

Prostate specific antigen

122
Q

The bacteria appear purple after a gram stain. What does this tell the microbiologist about the bacteria?

A

Gram positive

123
Q

Catalase test is performed on a +ve bacteria and there is a negative result, what family of bacteria is this?

A

Streptococcus is negative on catalase test

124
Q

Upon haemolysis test it is concluded that the bacteria is S.pyogenes or S.agalactiae, what would the agar plate look like? What type of haemolysis?

A

Clear / colourless zone around colonised

Beta haemolysis

125
Q

This bacteria caused a skin infection and thus is lancefield group A, is it S. pyogenes or S. agalactiae?

A

S.pyogenes

126
Q

What is the recommended treated for a confirmed group A streptococci infection?

A

IV benzylpenicillin
IV clindamycin
Urgent surgical exploration with extensive debridement

127
Q

Give three differences between the structure of the cell envelope of gram negative and gram positive bacteria?

A

Gram positive have single cytoplasmic membrane
Gram positive have a large layer of peptidoglycan
Gram positive do not have endotoxin/LPS

128
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

Give two causes of stomach ulcers?

A

NSAIDS
H Pylori
Ischaemia of gastric cells
Too much acid production

129
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

Define ulcer?

A

Breach of the mucosal surface

130
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

What is the gold standard of investigation . for this patient?

A

Endoscopy

131
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

Give three lifestyle adjustments to recommend to the patient?

A

stop smoking
reduce stress
avoid irritating foods

132
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

What drugs are involve in h pyolri treatment

A

Amoxicillin
Clarythromycin
PPi

133
Q

A 66 year old male presents to his GP with recurrent burning epigastric pain. He
notes a significant weight loss and loss of appetite. The GP suspects he has a peptic
ulcer.

If the ulcer causes a haemorrhage, what action must be taken?

A

Surgery

134
Q

A 38-year-old female presents to A&E with hyperthyroidism

Name four symptoms of hyperthyroidism?

A 
Diarrhoea
Weight loss 
Increased appetite 
Sweating 
Palpitations 
Heat intolerance 
Tremour 
Anxiety
135
Q

A 38-year-old female presents to A&E with hyperthyroidism

Name four signs of hyperthyroidism

A 
Tachycardia 
AF 
Thin hair 
Lid lag 
Lig retraction 
Exophthalmos 
Onycholysis 
Nodules 
Bruit
136
Q

A 38-year-old female presents to A&E with hyperthyroidism

After further investigation, she is diagnosed with Grave’s disease, what class of immunoglobulin is involved in Grave’s disease?

A

IgG

137
Q

A 38-year-old female presents to A&E with hyperthyroidism

What is another possible cause of hyperthyroidism?

A

Toxic multinodular goitre

Toxic thyroid adenoma

138
Q

A 56 year old male presents to his GP with sudden onset agonising pain in his metatarsophalngeal joint of the big toe. Doctor suspects gout.

What would the result of polarised light microscopy of the crystals from a joint fluid aspiration be?

A

Negatively

Bifringement

139
Q

A 56 year old male presents to his GP with sudden onset agonising pain in his metatarsophalngeal joint of the big toe. Doctor suspects gout.

Name two risk factors for gout?

A

Reduced urate excretion - elderly, men, HTN

Excess urate production - diet (shellfish), genetics

Associations - CVD, HTN, DM

140
Q

A 56 year old male presents to his GP with sudden onset agonising pain in his metatarsophalngeal joint of the big toe. Doctor suspects gout.

Name one precipitating factor of gout?

A 
Trauma 
Surgery
Starvation 
Infection 
Diuretics
141
Q

A 56 year old male presents to his GP with sudden onset agonising pain in his metatarsophalngeal joint of the big toe. Doctor suspects gout.

What is the most common drug given as prophylaxis for gout and what enzyme does it inhibit?

A

Allopurinol

Xanthine oxidase

142
Q

A 56 year old male presents to his GP with sudden onset agonising pain in his metatarsophalngeal joint of the big toe. Doctor suspects gout.

Differential of pseudogout - caused by deposition of a different crystal - what joint is most commonly affected and what crystal?

A

Calcium pyrophosphate

Knee

143
Q

A 19 year old girl presents to her GP practice after experiencing fatigue, lethargy, and dyspnoea. GP notices that she has angular stomatis and koilonychia. Blood tests confirm anaemia

What is that cause of anaemia and what classification is it?

A

Iron deficiency - angular stomatis and koilonychia are specific signs of IDA

Microcytic anaemia

144
Q

A 19 year old girl presents to her GP practice after experiencing fatigue, lethargy, and dyspnoea. GP notices that she has angular stomatis and koilonychia. Blood tests confirm anaemia

A different cause of anaemia is B12 deficiency anaemia, Where is B12 absorbed and what is it bound to?

A

Terminal ileum

Intrinsic factor

145
Q

A 19 year old girl presents to her GP practice after experiencing fatigue, lethargy, and dyspnoea. GP notices that she has angular stomatis and koilonychia. Blood tests confirm anaemia

A cause of B12 deficiency anaemia is pernicious anaemia, what causes the B12 . deficiency in pernicious anaemia?

A

Atrophic Gastritis

146
Q

A 19 year old girl presents to her GP practice after experiencing fatigue, lethargy, and dyspnoea. GP notices that she has angular stomatis and koilonychia. Blood tests confirm anaemia

B12 deficiency anaemia has specific neurological signs - give 3 examples?

A

Any 3 from

  • Irritability
  • Depression
  • Psychosis
  • Dementia
  • Paraesthesia
  • Peripheral neuropathy
147
Q

A 45 year old man presents to A+E with a fever and a new murmur, the doctor suspects infective endocarditis,

What is the most common cause of infective endocarditis?

A

Streptococcus viridans

148
Q

A 45 year old man presents to A+E with a fever and a new murmur, the doctor suspects infective endocarditis,

Blood cultures are taken to aid diagnosis of infective endocarditis. The blood is normally a sterile site, name three other sterile sites?

A

CSF
Pleural fluid
Peritoneal cavities
Joints

149
Q

A 45 year old man presents to A+E with a fever and a new murmur, the doctor suspects infective endocarditis,

Blood cultures undergo gram testing and stain purple, after further testing the blood cultures are catalase negative and coagulase negative?

A

Purple = gram postive
Catalase negative = staphylococcus
Coagulase negative = S.aureus

150
Q

A 45 year old man presents to A+E with a fever and a new murmur, the doctor suspects infective endocarditis,

To aid diagnosis, modified Duke’s criteria is used, name one major and two minor criteria?

A

Major

  • Blood cultures +ve >12 hours apart
  • Evidence of endocardial involvement

Minor

  • Fever >38C
  • Vascular phenomena (janeaway lesions)
  • Evidence from immunology (roth spots, olser nodes)
  • Risk groups (prosthetic valve)
151
Q

A 33 year old presents to her GP with a lump in her right breast.

All breast lumps should undergo triple assessment, what are the three aspects of triple assessment?

A

Clinical examination

Radiology

Histology/cytology

152
Q

A 33 year old presents to her GP with a lump in her right breast.

Name three differential diagnoses of breast lump which are benign?

A

Fibroadenoma
Breast cysts
Infective mastitis
Duct ectasia

153
Q

A 33 year old presents to her GP with a lump in her right breast.

After referral, the patient is diagnoses with breast cancer which is localised and the lump will be removed by wide local excision. In order for surgery to be performed, the patient must consent, what are the three principles of informed consent?

A

Given voluntarily

By someone who has capacity

By an individual who has been fully informed about the issue

154
Q

a 33 year old presents to her GP with a lump in her right breast.

Screening for breast cancer is given to women age 43-73 every 3 years, the screening involves a 2-view mammography. What type of prevention is this?

A

Secondary prevention

155
Q

A 21 year old woman presents to A+E as she is unable to control her movements, and her friends have noticed she is starting to slur her words. Additionally she has noticed a marked reduction in her memory. On examination she has a greenish brown tinge around her cornea.

What is the diagnosis and what is this a disorder of?

A

Wilsons disease

Copper excretion

156
Q

A 21 year old woman presents to A+E as she is unable to control her movements, and her friends have noticed she is starting to slur her words. Additionally she has noticed a marked reduction in her memory. On examination she has a greenish brown tinge around her cornea.

What is the name given to the greenish brown tinge around her cornea?

A

Kayser Fleischer Rings

157
Q

A 21 year old woman presents to A+E as she is unable to control her movements, and her friends have noticed she is starting to slur her words. Additionally she has noticed a marked reduction in her memory. On examination she has a greenish brown tinge around her cornea.

A different disorder haemochromatosis leads to iron deposition in the organs. What gene mutation causes haemochromatosis and what inheritance pattern is it?

A

HFE gene

Autosomal recessive

158
Q

A 21 year old woman presents to A+E as she is unable to control her movements, and her friends have noticed she is starting to slur her words. Additionally she has noticed a marked reduction in her memory. On examination she has a greenish brown tinge around her cornea.

There is a different condition, haemochromatosis, give 2 signs and 2 symptoms of this?

A

Signs

  • Bronze pigmentation
  • Hepatomegaly
  • Signs of chronic liver disease

Symptoms

  • Tiredness
  • Arthralgia
  • Erectile disfunction
159
Q

A 37 year old female presents to A+E with pylonephritis, she is not pregnant

What is the classical triad of symptoms for pylonephritis?

A

Midstream specimen of urine culture

160
Q

A 37 year old female presents to A+E with pylonephritis, she is not pregnant

A urine dipstick is performed, what who main results will be increased in pyelonephritis?

A

Nitrates

Leukocytes

161
Q

A 37 year old female presents to A+E with pylonephritis, she is not pregnant

What antibiotics should be given to this patient?

A

Ciprofloxacin or Co-amoxiclav

162
Q

A 37 year old female presents to A+E with pylonephritis, she is not pregnant

Name four risk factors for UTIs?

A 
Female 
Sexually active 
Urinary incontinance 
Faecal incontinance 
Constipation
Dehydration 
Urinary obstruction
163
Q

A 61 year old male presents to his GP practice with constricting central chest pain that is relieve with rest.

What is the most likely diagnosis?

A

Stable angina

164
Q

A 53yr old Caucasian man has his blood pressure taken by his GP. The reading is 156/98 mmHg. The GP tells him he has hypertension

What is the WHO definition of hypertension?

A

140/90 mmHg

165
Q

A 53yr old Caucasian man has his blood pressure taken by his GP. The reading is 156/98 mmHg. The GP tells him he has hypertension

GP is worried about end organ damage - give an example of a finding that indicates end organ damage?

A

Retinopathy, proteinuria

166
Q

A 53yr old Caucasian man has his blood pressure taken by his GP. The reading is 156/98 mmHg. The GP tells him he has hypertension

List three lifestyle modifications for the management of hypertension?

A
  1. Smoking cessation
  2. Weight loss
  3. Exercise
  4. Reduce fat in diet
  5. Reduce salt in diet
  6. Reduce alcohol intake
167
Q

A 53yr old Caucasian man has his blood pressure taken by his GP. The reading is 156/98 mmHg. The GP tells him he has hypertension

What would be the first line drug for this patient and give an example?

A

Class: ACEi becase <55 and caucasian

Example: Ramipril

168
Q

A 53yr old Caucasian man has his blood pressure taken by his GP. The reading is 156/98 mmHg. The GP tells him he has hypertension

Hypertension can lead to malignant hypertension - give an example for for this?

A

Markedly raised diastolic BP

169
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

Name two other symptoms of hyperthyroidism?

A 
Diarrhoea 
Tremor 
Palpitations 
Loss of concentration 
Heat intolerance
170
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

Give two signs of hyperthyroidism?

A 
Tachycardia 
Lid lag 
Lid retention 
Thin hair 
Onycholysis 
Exophalmos
171
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

In primary hyperthyroidism, what would the results of thyroid function tests be?

TSH
T3/T4

A

TSH - Decreased

T3/T4 - Increased

172
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

Name the class of drug she would be prescribed and give and example?

A

Class - thioaminde

Example - carbimazole

173
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

What is the most serious side effect of this medication?

A

Agranulocytosis

174
Q

A 36 year old woman presents to her GP worried about weight loss, sweating and increased anxiousness. Her GP refers her to an endocrinologist as he suspects she has
Hyperthyroidism.

Name the autoimmune disease that can be a cause hyperthyroidism?

A

Graves’ disease

175
Q

A 75yr old woman presents to her GP with ‘stomach pain’, nausea and a loss of appetite. The GP refers her for an endoscopy due to her age - he suspects a peptic ulcer.

Give two causes of peptic ulcer disease?

A 
NSAIDS
Helicobacter Pylori 
Ischaemia 
Increased stomach acid 
Alcohol
176
Q

A 75yr old woman presents to her GP with ‘stomach pain’, nausea and a loss of appetite. The GP refers her for an endoscopy due to her age - he suspects a peptic ulcer.

What type of vomit is seen in peptic ulcer disease?

A

Coffee ground haematemesis

177
Q

A 75yr old woman presents to her GP with ‘stomach pain’, nausea and a loss of appetite. The GP refers her for an endoscopy due to her age - he suspects a peptic ulcer.

Apart from endoscopy, name two other investigations for peptic ulcer disease?

A

Urea breath trest
Stool antigen test
IgG antibodies

178
Q

A 75yr old woman presents to her GP with ‘stomach pain’, nausea and a loss of appetite. The GP refers her for an endoscopy due to her age - he suspects a peptic ulcer.

Name 4 red flag symptoms of GI cancer?

A 
Unexplained weight los 
Blood in stool 
Family history of bowel cancer 
Change in bowel habit 
Anaemia 
Raised inflammatory markers
179
Q

A 75yr old woman presents to her GP with ‘stomach pain’, nausea and a loss of appetite. The GP refers her for an endoscopy due to her age - he suspects a peptic ulcer.

This drug is due to stomach acid, give two drugs and examples that could be used to treat this?

A

H2 antagonist - Ranitidine

PPi - Lansoprazole

180
Q

A 76yr old woman presents to her GP with pain and stiffness in her hands. Her GP suspects that she has osteoarthritis.

Is osteoarthritis degenerative or inflammatory?

A

Degenerative

181
Q

A 76yr old woman presents to her GP with pain and stiffness in her hands. Her GP suspects that she has osteoarthritis.

Name a joint deformity that you would expect to see on the hands of someone with osteoarthritis?

A

Herbdens nodes

Bouchards nodes

182
Q

A 76yr old woman presents to her GP with pain and stiffness in her hands. Her GP suspects that she has osteoarthritis.

Name four things you would expect to see on an x ray of osteoarthritis?

A

Loss of joint space
Ostephytes
Subchondral sclerosis
Suchondral cysts

183
Q

A 76yr old woman presents to her GP with pain and stiffness in her hands. Her GP suspects that she has osteoarthritis.

Give 1 lifestyle, 1 medical and 1 surgical treatment of osteoarthritis?

A

Lifestyle: weight loss, physio, excercise, walking aids

Medical: NSAIDs, DMARDs, Steroid injections

Surgical: arthroplasty, fusion, arthroscopy, osteotomy

184
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have testicular torsion.

What would you expect the affected testis to be like?

A

Hot
Swollen
Tender
High

185
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have testicular torsion.

A doppler ultrasound is done and reveals that the bloods supply is normal, it is now believed he has epidydmo-orchitis. What other symptom would you expect?

A

Dysuria

Fever

186
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have testicular torsion.

A doppler ultrasound is done and reveals that the bloods supply is normal, it is now believed he has epidydmo-orchitis. What could of caused this?

A

E. Coli, N. gonorrhoea, Chlamydia trachomatis

187
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have testicular torsion.

What investigations would you carry out if it was suspected he had epidydmo-orchitis

A

1st catch urine sample

STI testing

188
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have epidydmo-orchitis.

What treatment would you give - give examples?

A

Antibiotics

Doxycycline - because under 35

189
Q

A 17yr old boy presents at A&E with sudden pain in his left testis. He is suspected to have epidydmo-orchitis.

What treatment would you give if gonorrhoea was suspected?

A

Ceftriaxone

190
Q

A 53yr old woman is referred to a specialist breast clinic after she had a lump picked up on her latest screen.

What is the age range for breast cancer screening in the UK?

A

50-70

191
Q

A 53yr old woman is referred to a specialist breast clinic after she had a lump picked up on her latest screen.

What is the name of the screening procedure for breast cancer?

A

Mammography

192
Q

A 53yr old woman is referred to a specialist breast clinic after she had a lump picked up on her latest screen.

How often do women within the age range have a breast cancer screening?

A

Every three yearts

193
Q

A 53yr old woman is referred to a specialist breast clinic after she had a lump picked up on her latest screen.

Name 2 pros and 2 cons of screening programs?

A

Pros: prevent suffering, improved prognosis with early identification, early treatment cheaper

Cons: False positives= unessesary anxiety, false negatives = reduced awareness / overly relaxed

194
Q

A 73 year old man presents to his GP with weight loss and night sweating. His GP notices that he also has lymphadenopathy and is concerned that he may have Lymphoma.

Lymphoma can be divided into 2 classifications, what are they?

A

Hodgkins and Non Hodgkins

195
Q

A 73 year old man presents to his GP with weight loss and night sweating. His GP notices that he also has lymphadenopathy and is concerned that he may have Lymphoma.

The patient is referred for lymph node biopsy which shows characteristic cells of Hodgkins lymphoma, what are these cells called?

A

Reed Sternberg

196
Q

A 73 year old man presents to his GP with weight loss and night sweating. His GP notices that he also has lymphadenopathy and is concerned that he may have Lymphoma.

What type of imagine would you do to stage this cancer?

A

Full body CT or PET scan

197
Q

A 73 year old man presents to his GP with weight loss and night sweating. His GP notices that he also has lymphadenopathy and is concerned that he may have Lymphoma.

What classification is used for staging Hodgkins lymphoma?

A

Ann-Arbour Classification

198
Q

A 73 year old man presents to his GP with weight loss and night sweating. His GP notices that he also has lymphadenopathy and is concerned that he may have Lymphoma.

What treatment is used for stage 1-2 Hodgkins lymphoma?

A

Short course chemotherapy followed by radiotherapy

199
Q

A 42 year old man goes to his GP as he’s been feeling very ‘down’ after losing his job. He says that he doesn’t like to socialise with his friends anymore as he’s embarrassed. The GP is worried that he may be suffering from depression.

Name a questionnaire that the GP may use with the patient to assess the presence /severity of the depression?

A

PHQ-9

200
Q

A 42 year old man goes to his GP as he’s been feeling very ‘down’ after losing his job. He says that he doesn’t like to socialise with his friends anymore as he’s embarrassed. The GP is worried that he may be suffering from depression.

Name three lifestyle modifications that can help with depression?

A

Exercise

Reduce drinking / drug use

Reduce stress

More sleep

Healthy eating

Weight loss

Meditation

201
Q

A 42 year old man goes to his GP as he’s been feeling very ‘down’ after losing his job. He says that he doesn’t like to socialise with his friends anymore as he’s embarrassed. The GP is worried that he may be suffering from depression.

Name 2 non pharmalogical treatments for depression?

A

CBT

Interpersonal therapy

Mindfulness

Electroconvulsive therapy

202
Q

A 42 year old man goes to his GP as he’s been feeling very ‘down’ after losing his job. He says that he doesn’t like to socialise with his friends anymore as he’s embarrassed. The GP is worried that he may be suffering from depression.

The GP prescribes an SSRI, give an example of an SSRI, the mechanism and a side effect?

A

Example: sertraline, fluoxetine, vortioxetine

Mechanism: Blocks the uptake of serotonin, prolongs action in brain

Side effects: nausea, headache, dry mouth, sexual dysfunction

203
Q

What metabolic product is in excess in gout?

A

Monosodium Urate

204
Q

Gout can be due to over production or under-excretion, give an example of both?

A

Over production: Alcohol, excess meat, fructose sweetened drinks, hyperlipidaemia

Under excretion : Alcohol, renal impariement, hypertenion, insulin resistance

205
Q

What is the pathonomic sign of chronic gout?

A

Tophaceous gout

206
Q

A joint fluid aspirate was taken and looked at under a polariser, what would be seen?

A

Negatively Birefringent Needles

207
Q

A drug given for gout targets a key enzyme in the production of uric acid. Name the drug class and give an example?

A

Xathine oxidase inhibitors

Allopurinol

208
Q

A 45 year old man presents with increasing abdominal distension. Clinical
examination of the abdomen demonstrates tense ascites as a result of chronic liver
disease

List two clinical signs other than abdominal distension that would help confirm the presence of ascites?

A

Shifting dullness

Flank dullness

Fluid thrill

Bulging flanks

209
Q

List three clinical signs of chronic liver disease that may be found on examination of the hands?

A 
Finger clubbing 
Palamar erythema 
Jaundice 
Spider naevi 
Easy bruising
210
Q

List two investigations to further investigate the cause of ascites?

A 
Ascitic tap 
Ultra sound of abdomen 
Pertioneal tap 
CT abdomen 
LFTs
211
Q

List three complications that can arise as a result of chronic liver disease?

A 
Variceal bleed 
GI bleeding 
Portal hypertenison 
Malnutrition 
HCC
Spenomegaly
212
Q

A 35-year-old female presents to her GP with fatigue, weight loss, anxiety and eye
changes. After some tests she is diagnosed with Graves disease and treated for it.

What is the pathophysiology of Grave’s disease?

A

Autoantibodies attack TSH receptor stimulating them to increase T3/T4

213
Q

A 35-year-old female presents to her GP with fatigue, weight loss, anxiety and eye
changes. After some tests she is diagnosed with Graves disease and treated for it.

What is the eye pathology of Grave’s disease and give two components of it?

A

Thyroid eye disease

Optic nerve straightened 
Upper eyelid retraction 
Lid lag 
Periorbital swelling 
Conjunctival oedema
214
Q

A 35-year-old female presents to her GP with fatigue, weight loss, anxiety and eye
changes. After some tests she is diagnosed with Graves disease and treated for it.

Name the treatment regime for Grave’s and a drug used for each step?

A

Block and replace

Carbimazole, levothyroxine

215
Q

A 35-year-old female presents to her GP with fatigue, weight loss, anxiety and eye
changes. After some tests she is diagnosed with Graves disease and treated for it.

What are the remission rates for Grave’s disease?

A

30-50%

216
Q

A 60-year-old male attends A&E with crushing chest pain that is radiating down his
left arm. After an ECG he is diagnosed with a STEMI of the right coronary artery
(RCA).

What does STEMI stand for?

A

ST elevation myocardial infarction

217
Q

A 60-year-old male attends A&E with crushing chest pain that is radiating down his
left arm. After an ECG he is diagnosed with a STEMI of the right coronary artery
(RCA).

What % of the population have their posterior descending artery supplied by RCA?

A

85%

218
Q

A 60-year-old male attends A&E with crushing chest pain that is radiating down his
left arm. After an ECG he is diagnosed with a STEMI of the right coronary artery
(RCA).

Which nerve root is responsible for the radiation of pain down his left arm?

A

T1

219
Q

A 60-year-old male attends A&E with crushing chest pain that is radiating down his
left arm. After an ECG he is diagnosed with a STEMI of the right coronary artery
(RCA).

What will be seen on the ECG, in which leads to diagnose an infarct in the RCA?

A

ST elevation!!

In leads aVF, II, III

220
Q

A 60-year-old male attends A&E with crushing chest pain that is radiating down his
left arm. After an ECG he is diagnosed with a STEMI of the right coronary artery
(RCA).

Give two pathological findings that may be seen later on the ECG?

A

Bundle branch blocks

Pathological Q waves

Arrhythmias

221
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

What type of organism causes malaria?

A

Protozoa

222
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

What other symptom will he definitely have if its malaria?

A

Fefver

223
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

What is the diagnostic tool for malaria?

A

Thick and thin blood films

224
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

Give three complications of malaria?

A 
Pulmonary oedema
Anaemia
Renal failure 
Thromocytopenia
Sepsis 
Coma
225
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

What is the curative treatment for malaia and what route is it given?

A

IV artesunate

OR

IV Quinine + doxycycline

226
Q

A 22 yr old male has been admitted to hospital with myalgia, diarrhoea and
vomiting, after recently returning from volunteer work in Africa. His doctors suspect
malaria.

Name a species that can cause a relapse of treated malaria?

A

Plasmodium ovale or vivax

227
Q

A 50 yr old man with jaundice and abdomen distension is referred for chronic liver
failure.

Give 4 functions of the liver?

A 
Glucose metabolism 
Fat metabolism 
Protein synthesis 
Defence against infection 
Detoxification 
Excretion
228
Q

A 50 yr old man with jaundice and abdomen distension is referred for chronic liver
failure.

What type of jaundice is this?

A

Hepatic

229
Q

A 50 yr old man with jaundice and abdomen distension is referred for chronic liver
failure.

Give two possible causes of inherited liver failure?

A

Haemochromatosis
Wilsons
Alpha-1-antitrypsin deficiency

230
Q

A 50 yr old man with jaundice and abdomen distension is referred for chronic liver
failure.

What is the name of his abdominal distension and how can it be treated?

A

Ascites

Fluid retstriction, salt restriction, TIPS, albumin

231
Q

A 50 yr old man with jaundice and abdomen distension is referred for chronic liver
failure.

Give a complications of liver failure that causes haematemesis?

A

Variceal haemorrhage

or portal hypertension

232
Q

A 67 year old male presents with a hot, red, painful, swollen, first metatarsophalangeal joint that appeared suddenly over night.

Define inflammation?

A

Local physiological response to tissue injury

233
Q

A 67 year old male presents with a hot, red, painful, swollen, first metatarsophalangeal joint that appeared suddenly over night.

Give three outcomes of acute inflammation?

A

Resolution
Suppuration
Repair
Chronic inflammation

234
Q

A 67 year old male presents with a hot, red, painful, swollen, first metatarsophalangeal joint that appeared suddenly over night.

Give three differentials for this man?

A

Gout
Pseudogout
Septic arthritis

235
Q

A 67 year old male presents with a hot, red, painful, swollen, first metatarsophalangeal joint that appeared suddenly over night.

What is your first line of investigation?

A

Aspirate the joint

236
Q

A 10 year old female is referred to you for AKI, you do some urgent tests including an ECG.

To be an AKI, how should her creatinine of changed compared to the last 48hours?

A

Risen by 50%

237
Q

A 10 year old female is referred to you for AKI, you do some urgent tests including an ECG.

What complications are you looking for with the ECG and how do you treat AKI?

A

Hyperkalemia

Insulin 
Dextrose
IV fluids 
Calcium gluconate 
Salbutamol
238
Q

A 10 year old female is referred to you for AKI, you do some urgent tests including an ECG.

Give three renal causes of AKI?

A 
Glomeruolonephritis 
Malignant hypertension 
Vascular occlusion 
Vasculitis 
Haemolytic uraemic syndrome
239
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA).

What group of conditions is giant cell arteritis within?

A

Large vessel vasculitis

240
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA).

Which specialty should the GP refer her to?

A

Rheumatology

241
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA).

What is the gold standard investigation?

A

Temporal Artery Biospy

242
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA).

What is the emergency complication associated with GCA and who should she be referred to for this?

A

Arteritic anterior ischaemic optic neuropathy

Opthalmology

243
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA)

What treatment should she be started on promptly and give an example of this?

A

Corticosteroids - prednisolone

244
Q

A 55-year-old female presents to her GP with headache, scalp tenderness and pain
when eating. The GP suspects Giant Cell Arteritis (GCA).

What type of headache is this and give an example of another type?

A

Secondary

Meningitis
Subarachnoid haemorrhage
Brain tumour

245
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

Give two types of benign breast lump?

A

Fibroadenoma

Cyst

246
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

What gene mutation is linked to a family history of breast cancer?

A

BRCA1 / BRCA2

247
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

What are the components of a triple assessment?

A

Clinical assesment
Mammogram
Biospy

248
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

What staging is used for breast cancer?

A

TNM

249
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

What drug will she be offered for her tumour as she is premenopausal and how does it work?

A

Tamoxifen

Competitive inhibitor of oestrogen

250
Q

A 33-year-old female visits her GP worried about breast cancer. She has no children,
has been taking the combined oral contraceptive pill since the age of 15 and has a BMI of 26. She has no family history of breast or ovarian cancer. You refer her to
oncology where she is diagnosed after a triple assessment with an ER positive
tumour.

At what age does the national breast screening program begin?

A

50

251
Q

A 52-year-old man visits his GP worried about recent problems with his ‘water
works’. His father had prostate cancer and he requests a screen for prostate cancer
as he has heard of PSA testing on the news.

Give 5 of the wilson and junger screening criteria?

A
  1. Natural progression of disease should be well understood
  2. There should be a detectable early stage
  3. Treatment at an early stage should be of more benefit than at a later stage
  4. A suitable test should be devised for early stage
  5. The test should be acceptable
  6. Benefits should outweigh costs
252
Q

A 52-year-old man visits his GP worried about recent problems with his ‘water
works’. His father had prostate cancer and he requests a screen for prostate cancer
as he has heard of PSA testing on the news.

Give three reason for a raised PSA other than prostate cancer?

A

BPE
Old age
Recent ejaculation
Prostate cancer

253
Q

A 52-year-old man visits his GP worried about recent problems with his ‘water
works’. His father had prostate cancer and he requests a screen for prostate cancer
as he has heard of PSA testing on the news.

What is the diagnostic test for prostate cancer and what is the grading system used for this?

A

Prostate biopsy

Gleason grading system

254
Q

A 21 year old female presents to her GP with non-specific symptoms of dysuria and
discharge. After taking a detailed sexual history you instruct her to take vaginal
swabs for N. Gonorrhoea and Chlamydia tachomatis. Her sexual contacts are traced.

How will gonorrhoea be seen under a microscope when gram stained?

A

Gram negative diplococci

255
Q

A 21 year old female presents to her GP with non-specific symptoms of dysuria and
discharge. After taking a detailed sexual history you instruct her to take vaginal
swabs for N. Gonorrhoea and Chlamydia tachomatis. Her sexual contacts are traced.

How will chlamydia be seen on agar plate and why?

A

No growth because only grows inside cells

256
Q

A 21 year old female presents to her GP with non-specific symptoms of dysuria and
discharge. After taking a detailed sexual history you instruct her to take vaginal
swabs for N. Gonorrhoea and Chlamydia tachomatis. Her sexual contacts are traced.

What type of prevention is partner notification?

A

Secondary

257
Q

A 21 year old female presents to her GP with non-specific symptoms of dysuria and
discharge. After taking a detailed sexual history you instruct her to take vaginal
swabs for N. Gonorrhoea and Chlamydia tachomatis. Her sexual contacts are traced.

Give three reasons for partner notification?

A

Break chain of transmission

Prevent reinfection of index patient

Prevent complications of untreated infection

258
Q

A 21 year old female presents to her GP with non-specific symptoms of dysuria and
discharge. After taking a detailed sexual history you instruct her to take vaginal
swabs for N. Gonorrhoea and Chlamydia tachomatis. Her sexual contacts are traced.

What sample will be taken from her male contacts?

A

First void urine

259
Q

A 60-year-old male with known co-morbidities visits his GP wanting to find out how he can improve his health as he is worried about his heart. He has a triad of impaired glucose metabolism, central obesity and hyperlipidaemia. He also smokes but is
thinking about stopping.

Define comorbidity?

A

Coexistance of 2 or more diseases

260
Q

A 60-year-old male with known co-morbidities visits his GP wanting to find out how he can improve his health as he is worried about his heart. He has a triad of impaired glucose metabolism, central obesity and hyperlipidaemia. He also smokes but is
thinking about stopping.

What syndrome does he have with his triad of conditions?

A

Metabolic sydrome

central obesity, impaired glucose metabolism and hyperlipidaemia

261
Q

A 60-year-old male with known co-morbidities visits his GP wanting to find out how he can improve his health as he is worried about his heart. He has a triad of impaired glucose metabolism, central obesity and hyperlipidaemia. He also smokes but is
thinking about stopping.

What stage of the transtheoretical behaviour change model is he at?

A

Contemplation

262
Q

A 60-year-old male with known co-morbidities visits his GP wanting to find out how he can improve his health as he is worried about his heart. He has a triad of impaired glucose metabolism, central obesity and hyperlipidaemia. He also smokes but is
thinking about stopping.

What are the components of primary care brief advice should he of recieved about smoking in the past?

A

Ask
Advise
Assist

263
Q

A 22-year-old man presents to his General Practitioner with a two-week history of pain
and swelling of the proximal interphalangeal joint (PIPJ) of his left index finger. There
is no history of trauma. On examination, there is a mildly-tender fusiform swelling of the PIPJ of left index finger and a fusiform swelling of the PIPJ of the right second toe. The overlying skin is slightly erythematous and feels warm.

The GP notes that the patient also has some pitting of his nails. She also asks the
patient if they have any skin rashes.

The GP is concerned that the patient may have developed psoriatic arthropathy

Describe two characteristic features of the skin rash seen in psoriatic arthropathy?

A

Itchy

Skin may be thickened under plaque

Deep red colour with a silvery surface scale

Hidden sites include behind ears, nails, navel

Distributed on scalp, trunk, extensor surfaces of limbs (elbow/knees)

264
Q

A 22-year-old man presents to his General Practitioner with a two-week history of pain
and swelling of the proximal interphalangeal joint (PIPJ) of his left index finger. There
is no history of trauma.

On examination, there is a mildly-tender fusiform swelling of the PIPJ of left index
finger and a fusiform swelling of the PIPJ of the right second toe. The overlying skin is
slightly erythematous and feels warm.

The GP notes that the patient also has some pitting of his nails. She also asks the
patient if they have any skin rashes.

The GP is concerned that the patient may have developed psoriatic arthropathy

State two features in the pattern of joint involvement of psoriatic arthritis that would help distinguish it from rheumatoid?

A

Dactlylitis
Distal interphalangeal joint involvemnt
Spinal / axial involvment
Enthesitis

265
Q

A 22-year-old man presents to his General Practitioner with a two-week history of pain
and swelling of the proximal interphalangeal joint (PIPJ) of his left index finger. There
is no history of trauma.

On examination, there is a mildly-tender fusiform swelling of the PIPJ of left index
finger and a fusiform swelling of the PIPJ of the right second toe. The overlying skin is
slightly erythematous and feels warm.

The GP notes that the patient also has some pitting of his nails. She also asks the
patient if they have any skin rashes.

The GP is concerned that the patient may have developed psoriatic arthropathy

What immunological compound is rheumatoid factor?

A

Anti IgG

266
Q

A 22-year-old man presents to his General Practitioner with a two-week history of pain
and swelling of the proximal interphalangeal joint (PIPJ) of his left index finger. There
is no history of trauma.

On examination, there is a mildly-tender fusiform swelling of the PIPJ of left index
finger and a fusiform swelling of the PIPJ of the right second toe. The overlying skin is
slightly erythematous and feels warm.

The GP notes that the patient also has some pitting of his nails. She also asks the
patient if they have any skin rashes.

The GP is concerned that the patient may have developed psoriatic arthropathy.

The patient starts taking diclofenac, what class of drug is this?

A

Non Steroidal Ani Inflammatory Drug

267
Q

A 22-year-old man presents to his General Practitioner with a two-week history of pain
and swelling of the proximal interphalangeal joint (PIPJ) of his left index finger. There
is no history of trauma.

On examination, there is a mildly-tender fusiform swelling of the PIPJ of left index
finger and a fusiform swelling of the PIPJ of the right second toe. The overlying skin is
slightly erythematous and feels warm.

The GP notes that the patient also has some pitting of his nails. She also asks the
patient if they have any skin rashes.

The GP is concerned that the patient may have developed psoriatic arthropathy

What enzyme does diclofenac inhibit?

A

Cyclooxygenase-1

Phase 2a (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions