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MSRA > Mock Test A > Flashcards

Mock Test A Flashcards

1
Q

Adrenaline dose in Anaphylactic shock <6 months old

A

100 - 150 micrograms
0.1 - 0.15 ml in 1,000

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2
Q

Adrenaline dose in Anaphylactic shock for adults and > 12 years old

A

500 micrograms IM every 5 mins
(0.5ml 1 in 1,000)

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3
Q

Flank discolouration in acute pancreatitis is called

A

Grey-Turner’s sign
Caused by blood vessel auto-digestion by pancreatic enzymes, resulting in retroperitoneal haemoorhage => low Hb

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4
Q

GRACE score (global Registry of Acute Coronary Events)

A

Predicted 6-month mortality:
1.5% or below - lowest
1.5 to 3.0% - Low
3.0 to 6.0% - Intermediate
6.0% to 9.0% - High
over 9.0% - Highest

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5
Q

Scars seen over metacarpophalangeal joints due to fingers scraping front teeth

A

Russell sign seen in Bulimia nervosa during episodes of induced vomiting

Remember: Bulimia nervosa has normal BMI

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6
Q

Kleine-Levin syndrome

A

Irregularly recurring hyPERsomnia
Associated with binge-eating, sexual behaviour disinhibition and mood disorders
Often seen in young males

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7
Q

Transmission of Hepatitis A

A

Faecal oral

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8
Q

Incubation period for Hepatitis A
(RNA picornavirus)

A

2-4 weeks
Benign, self limiting disease
WIth flu-like prodrome

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9
Q

Type of antibiotic class for Clarithromycin

A

Macrolides
Can cause long QT

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10
Q

Macrolides are inhibitor / inductor of cytochrome P450

A

Inhibits

CYP450 enzyme metabolises statins - which means statins concentration rises if we don’t hold statins whilst on macrolides, significantly increases the risk of rhabdomyolysis and myopathy

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11
Q

When should cervical smear be repeated as Test of Cure after CIN treatment

A

6 months

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12
Q

When should referral for colposcopy be made
If inadequate smear result

A

2 consecutive inadequate smears 3 months apart

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13
Q

If routine cervical smear is inadequate, what’s next step

A

Repeat next smear in 3 months time

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14
Q

M rule in primary biliary cholangitis

A

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

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15
Q
  • pruritus
  • fatigue
  • raised ALP on routine LFT
  • hyperpigmentation
  • RUQ pain
  • xanthelasmas, xanthomata
  • cholestatic jaundice

Above are early symptoms of

A

Primary biliary cholangitis (previously biliary cirrhosis)

most probably auto-immune cause
9:1 females to males ratio

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16
Q

Primary Biliary Cholangitis usually associated with what conditions

A

Sjogren’s syndrome (80% of patients)
Rheumatoid arthritis
Systemic sclerosis
Thyroid disease

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17
Q

Pneumothorax can be classed as secondary when there is

A

Some underlying lung disease such as COPD

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18
Q

PTX patient can be considered for discharge if the rim of air is how big in cm

A

< 1cm in secondary pneumothorax (or aspirated and subsequently)
Or <2cm in primary pneumothorax

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19
Q

NAFLD (non-alcoholic fatty liver disease) has LFTs like:

A

Raised ALT > AST

(now most common cause of liver disease in the developed world)
usually seen in fat people
Hepatic manifestation of metabolic syndrome = insulin resistance is key leading to steatosis

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20
Q

Indapamide is what type of diuretic

A

Thiazide diuretic
- causes reduced clearance of lithium

21
Q

What prophylactic antibiotic should you give to families of meningococcal meningitis

A

Oral ciprofloxacin (single dose)
or oral rifampicin (BD for 2 days)

22
Q

Routine recall ages for cervical smear screening >50 years old

A

Every 5 years

23
Q

IM methylprednisolone is indicated for

A

NICE guidelines for acute flare of rheumatoid arthritis

corticosteroids (methylprednisolone) have primarily glucocorticoid effect and result in inhibition of pro-inflammatory cytokine production

24
Q

Treatment for flare of ulcerative colitis (mild -> systematically well)

A

Topical (rectal) mesalazine -> Oral aminosalicylate -> oral steroids

25
Q

Examples of aromatase inhibitor used in oestrogen receptor positive breast cancer

A

Anastrozole, Letrozole

Reduces peripheral oestrogen synthesis

Be careful of osteoporosis! needs DEXA scan prior to starting

26
Q

SERM (selective oestrogen receptor modulators) mechanism of action

A

Tamoxifen
Acts as oestrogen receptor antagonist and partial agonist

27
Q

Adverse effects of SERM (eg Tamoxifen)

A

Menstrual disturbances (vaginal bleeding, amenorrhoea)
Hot flushes
VTE
Endometrial cancer

28
Q

Poorly controlled hypertension already on ACE inhibitor we should add

A

Thiazide diuretic (indapamide) or CCB

29
Q

Hypertension in age <55 or T2DM we should start with

A

ACE inhibitor or ARB

30
Q

Hypertension in >55 years or Afro-Carribbean we should start with

A

CCB

Becoz ACE inhibitors have reduced efficacy in black patients

31
Q

Max dose of ramipril

A

10mg OD

32
Q

Clozapine in schizophrenia

A

Should be added on if not responded to at least 2 antipsychotics

Remember agranulocytosis & neutropaenia!

33
Q

Anticoagulation in AF post-stroke: when should we start?

A

Should be started in 2 weeks post-stroke in the absence of haemorrhage
Give antiplatelet therapy in the interim

34
Q

Iron deficiency anaemia in patient aged >50 suspect which type of cancer?

A

Colorectal cancer

35
Q

BTS guidelines for emergency oxygen therapy in COPD Co2 retainers says

A

Hypoxia kills.
GIve 15L/min in non-rebreathe for those who are critically ill then wean later once stable.

36
Q

Biopsy reults of breast tissue: local area of epithelial proliferation in large mammary ducts

A

Duct papilloma
hyperplastic lesions rather than malignant or premalignant

37
Q

Paget’s disease of breast is

A

intraductal carcinoma
Reddening and thickening of nipple/areola

38
Q

Meconium ileus common presents in when hours of life

A

24-48 hours of life
abdominal distension and bilious vomiting
(more common in cystic fibrosis)

39
Q

Abdominal XR shows double bubble sign in neonates means

A

Duodenal atresia
- bilious vomiting @ few hours after birth is a symptom
- high incidence in downs syndrome

40
Q

Mebendazole is first-line treatment for

A

Threadworms

41
Q

Conductive hearing loss can be tested by Rinne or Weber’s ?

A

Rinne’s
normal is - air conduction > bone conduction

42
Q

Sensorineural hearing - Weber’s ringing loudest in one side means

A

The loudest side is the one working

43
Q

Acute epiglottis is caused by what bacteria

A

Haemophilus influenza type B

  • stridor
  • drooling of saliva
  • high temperature
  • tripod position

‘Thumb sign” on xray

44
Q

Uncomplicated perforated tympanic membrane, child systematically well, what do we do?

A

Leave it and will usually heal in 6-8 weeks
Avoid getting water in ear during this time
May prescribe antibiotics

45
Q

Malignant otitis externa is extension of infection into the bony ear canal and soft tissues deep to the bony canal. Whom is this condition mostly seen in?

A

Elderly diabetics
Will need treatment with IV Abx

46
Q

How is haemophilia inherited?

A

X-linked recessive
In females - they must either receive two copies of faulty X gene (X carrier from mum and X from dad who is also a haemophiliac) or is Turner’s syndrome

47
Q

1-week history of flu like prodrome, headaches, lethargy and muscle aches then onset of diarrhoea including right lower abdominal pain and bloody diarrhoea is likely diagnosis of?

A

Campylobacter jejuni gastroenteritis

48
Q

In patients with vitamin B12 and folate deficiency, which one must be treated first?

A

VItamin B12 must be replaced first

To avoid subacute combined degeneration of spinal cord

MSRA (2 decks)

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