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3a Mocks > Mocks > Flashcards

Mocks Flashcards

1
Q

What is the triad of haemolytic uraemic syndrome ?

A

AKI, Thrombocytopenia and normocytic anaemia

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2
Q

A 15-year-old girl presents to the GP complaining of a 5-day history of sore throat and headache. She denies any diarrhoea or vomiting. On further questioning, she tells you that she went to a house party last weekend where a few of her friends had a bit of a cough and she wonders if it could be from that. You decide to treat her for a URTI and prescribe her some amoxicillin. The patient has no known drug allergies. 2 days later the girl comes back to the GP complaining of a widespread itchy rash. What is the most likely cause of this?

A

Infectious mononucleosis

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3
Q

When do children receive their MMR vaccine ?

A

1 year and 3 years old

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4
Q

What is the inheritance distribution of congenital adrenal hyperplasia ?

A

Autosomal recessive

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5
Q

What is the pathophysiology of congenital adrenal hyperplasia ?

A

Reduced production of cortisol and aldosterone leads to less Na+ retention and increased K+ retention

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6
Q

What would the presentation of a child in adrenal crisis secondary to CAH be ?

A

Neonate with hyponatraemia, hyperkalaemia and a metabolic acidosis.

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7
Q

Palsy of which nerve results in a ‘down and out’ eye ?

A

Oculomotor nerve

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8
Q

Which nerve is involved in Bell’s Palsy ?

A

Facial nerve (CN7)

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9
Q

What is the alternative name of glandular fever ?

A

Infective mononucleosis (glandular fever)

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10
Q

What is the most common causative organism associated with infective mononucleosis or glandular fever ?

A

Eebstein-barr virus

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11
Q

Name treatments involved in sickle cell

A

Penicillin (as vast majority will have a splenectomy)
Stem cell transplantation
Hydroxycarbamide - used to prevent vaso-occlusive complications of sickle cell disease
Blood transfusions - can be given if severe anaemia

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12
Q

An 11-month-old baby boy presents with extensive bruising and painful, swollen right knee joint, meaning he is now reluctant to move it. A non-accidental injury is ruled out and he is admitted for investigations. His mother takes his temperature regularly and says it has been normal all week. Which would be the most useful first line investigation?

A

Clotting screen

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13
Q

Haemophilia A is a deficiency in which component of the coagulation pathway?

A

Factor 8

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14
Q

Haemophilia B is a deficiency in which component of the coagulation pathway?

A

Factor 9

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15
Q

A 4-year-old girl presents to the GP with a continuous fever which has now lasted 5 days. She is quiet, miserable and does not engage with you. Her eyes look sore and the skin on her fingers appears to be red and peeling off. What is the most likely diagnosis ?

A

Kawasaki disease

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16
Q

What is a risky complication of Kawasaki disease ?

A

Pericardial effusion, myocardial disease, valve damage or coronary artery aneurysm

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17
Q

What investigation could be used to rule out dangerous complications of Kawasaki disease ?

A

Transthoracic echocardiogram (to image heart)

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18
Q

What is the treatment for Kawasaki disease ?

A

High dose aspirin to reduce the risk of thrombosis
IV immunoglobulins to reduce the risk of coronary artery aneurysms

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19
Q

Useful pneumonic for Kawasaki ?

A

CRASH and Burn
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hands (palmar erythema/swelling)
Burn (fever 5 days)

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20
Q

What is the management for upper femoral epiphysis ?

A

Surgical fixation

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21
Q

What investigation can be used to measure the response of Hodgkin’s lymphoma to chemo ?

A

PET scan

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22
Q

Avascular necrosis of the capital femoral epiphysis of the femoral head is also known as Perthes disease. It commonly presents as insidious onset limp with hip or knee pain. In which age group is this most likely to be seen?

A

5–10 years

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23
Q

What are RFs for developmental dysplasia of the hip ?

A

Female (x6 more likely)
Breech birth
High birth weight
Oligohydramnios
Prematurity

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24
Q

A newborn baby develops bilious vomiting in the first few hours after birth. An abdominal x-ray shows a “double bubble” sign. Which genetic condition is this presentation associated with?

A

Down syndrome
Double bubble sign is duodenal atresia a rare disorder that children with Down Syndrome are at an increased risk of developing

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25
Q

Typical Features of Down Syndrome

A

Brushfield spots in the iris
Delayed motor milestones
Small ears
Upslanted palpebral features
Single palmar crease

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26
Q

A 32-year-old male presents to his GP with a history of poor relationships due to his belief that every time he turns on the radio, he gets a message to stay indoors. On further discussion, he seems open to the fact that this may not be true. When you are speaking to him, he is quite eccentric in his mannerisms. What is the most appropriate diagnosis?

A

Schizotypal personality disorder

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27
Q

RFs for Delirium

A

Disorientation
UTI
Constipation

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28
Q

Give an example of a drug you would advise a patient to avoid eating cheese with?

A

Phenelizine
MOAi

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29
Q

Name some SSRI’s

A

Fluoxetine
Sertraline
Olanzapine

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30
Q

2nd line mood stabiliser for acute manic or mixed Bipolar disorder

A

Sodium valproate
Note: avoid in women of child bearing age

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31
Q

Features of lithium toxicity

A

Ataxia
Course tremor
Seizure
Slurred speech
Vomiting

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32
Q

What drugs could be used for maintenance of alcohol detoxification 6-12 months after abstinence has started ?

A

Acamprosate
Disulfiram

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33
Q

A patient on the psychiatric inpatient ward is due to be commenced on an alcohol detoxification regime. What is the most appropriate drug to use?

A

Chlordiazepoxide

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34
Q

What should be prescribed during alcohol detox to prevent development of Wernicke’s encephalopathy (and subsequently Korsakoff’s)

A

Thiamine (oral Vit B1)

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35
Q

What are the features of serotonin syndrome ?

A

Neuromuscular excitability
Autonomic dysfunction (hypo or hypertension)
Altered mental state e.g. agitation

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36
Q

ICD-10 Criteria for delirium

A

Impairment of consciousness and attention
Global disturbance in cognition
Psychomotor disturbance
Disturbance of sleep-wake cycle
Emotional disturbance

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37
Q

What congenital heart condition is associated with Turners Syndrome ?

A

Bicuspid aortic valve

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38
Q

What are the health conditions associated with Downs Syndrome ?

A

Heart defects - Tetralogy of Fallot, atrioventricular septal defect
Hearing loss
Visual disturbances - cataracts, strabismus, keratoconus
GI problems - oesophageal/duodenal atresia, Hirschsprung’s disease, coeliac
Hypothyroidism
Haematological malignancies (AML/ALL)
Increased incidence of Alzeimer’s disease

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39
Q

ICD-10 Criteria for Agoraphobia

A

Marked and consistently manifest fear in, or avoidance of a least 2: Crowds, public spaces, traveling alone, travailing away from home
Symptoms of anxiety in the feared situation with at least 2 symptoms present together + 1 symptom of autonomic arousal
Significant emotional distress due to avoidance or anxiety symptoms
Recognised as excessive or unreasonable
Symptoms restricted to a fear situation

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40
Q

Features of Anxious (Avoidant) Personality Disorder

A

Certainty of being liked is needed before becoming involved with people
Restriction to lifestyle in order to maintain security
Inadequacy felt
Embarrassment potential prevents involvement in new activities
Social inhibition

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41
Q

Features of a generalised anxiety disorder

A

Syndrome of ongoing and uncontrollable, widespread worry about many events or thoughts that the patient recognises as excessive and inappropriate
Symptoms must be present on most days for at least 6 months

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42
Q

Features of panic disorder

A

Recurrent episodes of severe panic attacks which are unpredictable and not restricted to any particular situation or circumstance

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43
Q

Features of a social phobia

A

Fear of social situations, which may lead to humiliation, scrutiny by other people, criticism or embarrassment

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44
Q

Miss Swift presents to A&E with sudden onset heart palpitations. On examination, she is sweating profusely and shaking. Her symptoms begin to settle down after a couple of minutes. On questioning, she tells you that she is ‘going through a hard time’ as she has recently broken up with her boyfriend after finding out he was cheating. She has a history of generalised anxiety disorder but said she had been managing her anxiety well, up until the break-up. She says this is the 3Rd time this week that she has had an episode like this, but this was by far the worst. What is the most likely diagnosis?

A

Panic disorder

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45
Q

What can benzos be prescribed for ?

A

Alcohol withdrawal
Seizures
Severe anxiety
Severe insomnia

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46
Q

MOAi MoA

A

Inactivates the monoamine oxidase enzymes –> these enzymes
oxidize dopamine, noradrenaline, serotonin and tyramine –> inhibition of this oxidation results in increased concentrations of these monoamines –> antidepressant effect

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47
Q

Which receptors do Antipsychotic medications act on ?

A

D2

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48
Q

Mr Porter is a 38-year-old male who was brought to A&E by his wife, who became concerned when her husband started to exhibit some strange eye movements, describing them as slow,continuous, horizontal movements. On examination he is pyrexic with a temperature of 39.5 degrees Celsius, tachycardic and hypertensive. He is sweating profusely and also exhibits extreme rigidity. Mr Porter has a past medical history of schizophrenia and is currently on olanzapine. What condition is Mr Porter presenting with ?

A

Neuroleptic Malignant Syndrome

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49
Q

What results would you expect from investigations for neuroleptic malignant syndrome ?

A

Raised CK (creatine kinase) –> due to muscle rigidity
Raised white cell count
Deranged LFT’s
Acute renal failure –> abnormal U&E’s
Metabolic acidosis –> low pH, low HCO3

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50
Q

What links the RFs for ovarian cancer ?

A

Increased number of ovulations
Therefore, anything which decreases this e.g. Breastfeeding or contraceptives is protective

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51
Q

RFs for Ovarian cancer ?

A

Clomifene (subfertility medication that stimulates ovaries to ovulate)
Early menarche
Age (peaks at 60)
Nullparity

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52
Q

A 15-week pregnant 38-year old woman presents to A&E with severe abdominal pain, a low-grade fever, tachycardia, and vomiting. An ultrasound is performed and confirms a viable intra-uterine pregnancy with a detectable foetal heartbeat. Due to difficulty gaining a history, you only manage to find out that the patient has a history of menorrhagia and difficulty conceiving, and her husband hasn’t noticed her using the bathroom more regularly. What is the most likely cause of this patient’s symptoms?

A

Red degeneration of fibroid

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53
Q

What is red degeneration of fibroid ?

A

Ischaemia, infarction and necrosis of a pre-existing fibroid due to a disrupted blood supply

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54
Q

When is fibroid degeneration most common and why ?

A

More common in the second and third trimester due to the fibroid rapidly outgrowing the blood supply of the uterus changing shape and kinking arteries

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55
Q

What is the management for mild PID ?

A

Swab but give ABs before results back
Doxycycline 100mg twice daily for 14 days (chlamydia)
Metronidazole 400mg TD for 14 days (anaerobes e.g. gardnerella vaginalis)
Ceftriaxone IM ig (gonorrhoea)
If coil in then wait 48 hours if no response them remove

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56
Q

What ways can you measure fetal growth during pregnancy ?

A

Femur length on ultrasound
Foetal abdominal circumference (AC) using ultrasound
Size of uterus on abdominal examination
Palpation of the foetal head on abdominal examination

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57
Q

Which ABs are not safe to prescribe during pregnancy ?

A

Nitrofurantoin
Sulfonamides
Tetracyclines
Trimethoprim

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58
Q

What are the side effects of nitrofurantoin during pregnancy ?

A

Avoid during 3rd trimester
Risk of haemolytic anaemia in neonate with G6PD deficiency

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59
Q

What are the side effects of Sulfonamides during pregnancy ?

A

Avoid in 3rd trimester
Risk of kernicterus

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60
Q

What is kernicterus ?

A

Brain damage occurring from a toxic level of unconjugated bilirubin in a newborns blood
Complications include cerebral palsy and hearing loss

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61
Q

What are the side effects of tetracyclines during pregnancy ?

A

Permanent staining of babies teeth and problems with skeletal development

62
Q

What are the side effects of trimethoprim pregnancy ?

A

Folate antagonist and so can cause neural tube defects if used in the 1st trimester

63
Q

What is first line treatment for urge incontinence ?

A

Bladder retraining

64
Q

What is first line for stress incontinence ?

A

3 months of pelvic floor training

65
Q

What is second line treatment for stress incontinence ?

A

Duloxetine
Surgery

66
Q

What is second line treatment for urge incontinence ?

A

Oxybutynin

67
Q

What can cause a raised CA125 level ?

A

Adenomyosis
Ascites
Endometriosis
Menstruation
Breast/ovarian cancer
Ovarian torsion
Endometrial cancer
Liver disease and metastatic lung cancer

68
Q

What would be prescribed before a patient were to have surgery for fibroids?

A

GnRH agonists -
Reduces the chance of bleeds

69
Q

What is the medication could you use in treatment for fibroids <3cm ?

A

COCP

70
Q

Why is COCP use contraindicated for use before, during and after surgery ?

A

Increased risk of VTE

71
Q

What is the first line intervention for fibroids ?

A

Mirena coil

72
Q

What surgical (kinda) intervention could be used to treat fibroids ?

A

Uterine artery embolisatio

73
Q

What type of contraception should be avoided by pts who are >35 and smoke ?

A

COCP

74
Q

Janet, a 40 year old female, is a long term smoker. She is usually fit and well and has been trying to manage her endometriosis pain with NSAIDs but does not feel this is working as well as it used to. Given Janet’s age and smoking history what treatment is most appropriate to start?

A

Progesterone IUD

75
Q

A 29 year old female attends A&E with pelvic discomfort and amenorrhoea for six weeks. Her pregnancy test is positive. On examination her pulse rate is 72 bpm and her blood pressure is 115/80 mmHg. An ultrasound scan shows an empty uterus, with normal adnexae. Her serum beta human chorionic gonadotrophin (beta hCG) level is 950 mIU/mL. Which is the single most appropriate next step in management?

A

Repeat beta-hCG test after 48 hours

76
Q

In a pregnancy of unknown location what would a 48h repeated beta-hCG value that has doubled mean ?

A

Intrauterine pregnancy

77
Q

In a pregnancy of unknown location what would a 48h repeated beta-hCG value that has increased but not doubled mean ?

A

Indicates ectopic and further monitoring

78
Q

In a pregnancy of unknown location what would a 48h repeated beta-hCG value that has halved mean ?

A

Miscarriage

79
Q

Factors that increase the risk of ectopic pregnancy ?

A

Smoko
Multiple sexual partners
IUD use
Prior fallopian tube surgery
Infertility and using in vitro fertilisation
Age <18 at first sexual intercourse
Black race
Age > 35 at presentation

80
Q

A 21 year old woman has acute onset of pain in her right iliac fossa pain. She has marked tenderness upon palpation in this area, some voluntary guarding, but no rebound tenderness. She has not vomited and denies feeling nauseous. Her temperature is 37.2°C, her pulse rate is 80 bpm, and her blood pressure is 115/80 mmHg. Her pregnancy test is negative. An ultrasound scan shows a 7 cm right-sided haemorrhagic ovarian cyst with no free fluid. Which is the single most appropriate initial management?

A

Admit her with a view to conservative management

81
Q

What are risk factors for intrauterine growth restriction (IUGR)?

A

Maternal age over 35 years
Maternal pre-pregnancy BMI of <20
Pre-eclampsia
Trisomy 1

82
Q

Following the diagnosis of preterm prelabour rupture of the membranes for how long should ABs be prescribed for ?

A

10 days

83
Q

What investigations would you request in order in investigate the cause of amenorrhoea ?

A

Androgen levels
FSH and LH
Oestrogen
Thyroid function tests

84
Q

What is the pathophysiology of androgen insensitivity syndrome

A

A mutation in the androgen receptor gene causes resistance to androgens in the target tissues

85
Q

What are the classic presenting features of chlamydia ?

A

Yellow discharge
Red cervix on speculum
Some bleeding intermenstrual or post-coital
Painful sex
Painful urination

86
Q

What is first line treatment for chlamydia ?

A

Doxycycline 100mg PO BD for 7 days

87
Q

What is first line treatment for gonorrhoea ?

A

Ceftriaxone 1g single IM dose

88
Q

What would differentiate gonorrhoea from chlamydia ?

A

Gonorrhoea has purulent vaginal discharge and doesn’t usually cause post-coital bleeding

89
Q

What is first line treatment for thrush ?

A

Clotrimazole

90
Q

What medication would you use to treat trichomonas ?

A

Metronidazole

91
Q

What are the features of trichomonas infection ?

A

Profuse, foul smelling green discharge and vulval itching

92
Q

A 30-year-old male, presents with pain on passing urine and a clear urethral discharge for the past week. He has recently had unprotected sex with a new male partner, who he thinks might have chlamydia. What would be the most appropriate test to confirm the diagnosis of chlamydia?

A

First catch urine sample for nucleic acid amplification test (NAAT)
Note: if NAAT is positive for gonorrhoea then a urethral swab is needed for culture to identify sensitivity before starting treatment

93
Q

Why can you not culture chlamydia ?

A

Chlamydia is an obligate intracellular organism so cannot be cultured and would not be visible on microscopy

94
Q

What kind of organism would you see under microscopy that would make you suspect gonorrhoea ?

A

Gram negative diplococci

95
Q

Emily, a 23 year old lady, visited your GP clinic 3 weeks ago concerned about a lesion on her vulva which has since resolved. However, she complains that over the past 2 weeks she has been experiencing symptoms of headaches and blood in her urine which don’t seem to be going away. On examination, you notice a mucocutaneous rash on her trunk, palms and the soles of her feet as well as inguinal lymphadenopathy. What could be causing her symptoms?

A

Secondary syphilis

96
Q

What are the signs and symptoms associated with secondary syphilis ?

A

Maculopapular rash
Condylomata lata - grey wart like lesions around the genitals and anus
Low-grade fever
Neurological symptoms - neurosyphilis
Lymphadenopathy
Alopecia
Oral lesions
Glomerulonephritis

97
Q

What sexual disorder is associated with psychiatric conditions and their treatments ?

A

Hypoactive sexual desire disorder

98
Q

What are the 2 tests used in the diagnosis of syphilis ?

A

VRDL - looks for non-specific enzymes which are produced in active syphilis infection
Specific treponemal antibody test (TPHA) look for IgG which remains after treatment to confer immunity

99
Q

For the 2 investigations for syphilis what would you expect to see indicating a pt that has previously been treated for syphilis ?

A

VRDL negative
TPHA positive

100
Q

Name complications associated with chlamydia infection in pregnancy

A

Chorioamnionitis (acute inflammation of the membranes and chorion of the placenta)
Neonatal conjunctivitis
Neonatal pneumonia
Prelabour rupture of membranes

101
Q

What infection during pregnancy is associated with risk of neonatal meningoencephalitis

A

Group B strep

102
Q

What are features of congenital syphilis?

A

Generalised lymphadenopathy
Hepatosplenomegaly
Rash
Skeletal malformations

103
Q

What are causes of superficial dyspareunia?

A

Genital herpes
Lichen sclerosus
Thrush
Vaginismus

104
Q

What can cause of retrograde ejaculation?

A

Bladder neck surgery
Congenital abnormality
Diabetic autonomic neuropathy
Transurethral resection of the prostate

105
Q

What is hypospadias and how can it be corrected ?

A

A birth defect where the opening of the urethra is not located at the tip of the penis
Corrected using the foreskin

106
Q

Typical Feature of Migraines

A

Can last between 4-72 hours
It can be associated with nausea
It can be associated with photophobia
It is characteristically unilateral

107
Q

Zoe is a 24-year-old female patient who has experienced at least 2 migraines per month over the past 4 months. This is really starting to affect her work, and she’s worried that she might lose her job if she keeps having to take sick days. What is the most appropriate prophylactic treatment for migraines to start Zoe on?

A

Propranolol
Topiramate can be used but is teratogenic

108
Q

What are the components of the ABCD2 score to calculate the risk of stroke in patients with TIA ?

A

Age > 60
BP > 140/90
Clinical features of TIA
Duration
DM

109
Q

What is CHADSVASC used to calculate ?

A

Risk of stroke for patient in AF

110
Q

In patients who have had a TIA, when is a carotid artery endarterectomy clinically indicated?

A

When the carotid stenosis is >70 and the patient is not severely disabled

111
Q

Typical features of Parkinson’s

A

Cogwheel rigidity
Resting tremor
Bradykineseia
Postural instability
Hypomimia
Hypophonia

112
Q

Which psychiatric medication is the most likely cause of Parkinsonism symptoms as a side effect?

A

Haloperidol

113
Q

What medication, which works by preventing stimulation of glutamate receptors, can be given to patients with amyotrophic lateral sclerosis to prolong their life?

A

Riluzole

114
Q

What is the most common cause of meningitis in neonates?

A

Group B strep

115
Q

What is the most common cause of meningitis in ages 0-3 months

A

E.coli
Listeria monocytogenes

116
Q

What is the most common cause of meningitis in ages 3-6 months

A

Haemophilius influenza
Neisseria meningitidis
Strep pneumoniae

117
Q

For those who have been in close contact within 7 days before onset of a patient with confirmed bacterial meningitis, which antibiotic should they be given?

A

Oral ciprofloxacin or rifampicin (ciprofloxacin is preferred)

118
Q

If a patient is in a pre-hospital setting and meningococcal disease is suspected then what AB can be given and by what route ?

A

IM benzylpenicillin can be given

119
Q

At which spinal level does the aorta terminate/branch ?

A

L4

120
Q

What vessels does the aorta become after it bifurcates at L4 ?

A

Left and right common iliac arteries

121
Q

If a patient suffers from foot drop and weak dorsiflexion, it may indicate there is spinal nerve root compression of which nerve?

A

L5

122
Q

What are the features typical of a non-epileptic seizure ?

A

Arms flexing and extending and pelvic thrusting
Eyes are usually closed
Seizure >30 minutes
Symptoms wax and wane throughout the seizure
Sudden drop to the ground

123
Q

How is a non-epileptic attack different to an epileptic attack ?

A

Eyes open in epileptic seizure but closed in non-epileptic
Epileptic seizure is usally ~5 mins where non-epileptic can last often ~>30 mins
Symptoms in NEA usually wax and wain whereas epileptic follow a set pattern e.g. tonic-clonic

124
Q

An 80-year-old woman is admitted to hospital following a fall at home after getting up from her chair. She describes feeling light-headed at the time of the fall, and states this often happens when she stands up. You suspect orthostatic hypotension. What finding on examination would allow you to make a diagnosis of orthostatic hypotension?

A

Systolic drops >20 when going from sitting/lying to standing
Lay/sit for 5 mins to assess baseline, get them to stand and measure BP after 1 min and 3 min.
If drop of more than >20 then pt has postural hypotension

125
Q

How does an aortic dissection differ from an MI on presentation ?

A

AD pain with peak at onset whereas MI pain will build
AD pain will migrate caudally
AD will also feature weak left sided pulse (due to involvement of subclavian artery)
AD pain is tearing

126
Q

What would you likely see on investigating a PE ? X-ray, ECG and BG

A

Fleischner sign on CXR
Sinus tachycardia on ECG
ST depression on ECG
Type 1 respiratory failure

127
Q

First line treatment for pericarditis ?

A

NSAIDs (aspirin, ibuprofen and naproxen)

128
Q

What is the mechanism of action of N-acetylcysteine in the treatment of paracetamol overdose?

A

Replenishes body stores of glutathione

129
Q

What can be given to reduce the effect of heparin ?

A

Protamine

130
Q

What can be given to reduce the effect of warfarin ?

A

Vitamin K
Berryplex

131
Q

What kind of results would be seen in a B12 deficiency anaemia ?

A

Low Hb, high MCV and MCH and may be sufficient to cause pancytopenia (platelets also low)

132
Q

What medications would you give in heart failure ?

A

ABAL
ACE inhibitor e.g. ramipril
Beta Blocker e.g. bisoprolol
Aldosterone antagonists e.g. spironolactone
Loop diuretics e.g. furosemide

133
Q

How does spironolactone work ?

A

Aldosterone inhibitor which acts as a potassium-sparing diuretic

134
Q

What medications would you give following MI and cathlab treatment ?

A

ACEi + Beta Blocker + Statin + Aspirin + Clopidogrel

135
Q

What is a handy way to remember post ACS medical management ?

A

Block An ACS
(BBs, ACEi, Aspirin, Clopidogrel and Statin

136
Q

What is koilonychia and what can cause it ?

A

Thin spoon shaped nails
Iron deficiency anaemia, protein deficiency, DM or connective tissue disease

137
Q

Complications of T2DM

A

Diabetic neuropathy causing foot ulceration and potentially amputation
Diabetic retinopathy
Increased susceptibility to infection
Increased risk of dementia

138
Q

What thyroid problem can commonly present in pregnancy ?

A

Grave’s disease - a form of hyperthyroidism where circulating antibodies activate thyroid stimulating hormone receptors

139
Q

What are the features of Grave’s ?

A

Bulging eyes - Exophthalmos
Pregnancy
Increased Appetite
Tremor
Heat intolerance

140
Q

First line medication for pre-eclampsia ?

A

Labetalol

141
Q

Gwendolyn is a 23-year-old university student. She has come to the GP as she’s been feeling more tired recently and has started to feel self-conscious about it as several people have commented that she looks pale and worn out. She tried to give blood recently but was unable to. She has no other diseases and has had no changes in bowel pattern. She also wants to ask about trying a contraceptive pill to help manage heavy periods. She eats a vegetarian diet and uses replacement B12 and folate supplements, but does not like legumes or lentils. What findings would you expect on an FBC and blood film?

A

The pt is suffering from iron deficiency anaemia due to low iron intake and increased iron loss
Iron deficiency anaemia is a microcytic anaemia where the mean cell volume and haemoglobin are reduced
Thus low HB and low MCV

142
Q

What type of leukaemia is associated with the Philadelphia chromosome ?

A

Chronic myeloid leukaemia

143
Q

What joints are commonly affected in osteoarthritis ?

A

Hips
Knees
Distal interphalangeal (DIP) joints in the hands
Carpometacarpal (CMC) joints at the base of the thumb
Lumbar spine
Cervical spine (cervical spondylosis)

144
Q

Which joints are commonly effected in rheumatoid arthritis

A

Metacarpophalangeal (MCP) joints
Proximal interphalangeal (PIP) joints
Wrist
Metatarsophalangeal (MTP) joints (in the foot)
Typically symmetrical distal polyarthritis
Very rarely impacts the DIPJ

145
Q

What condition is associated with joint pain affecting the spin in ascending order ?

A

Ankylosing spondylitis

146
Q

Which condition is associated typically with pain of the first metatarsophalangeal joint ?

A

Gout

147
Q

How will pesudogout appear ?

A

Negatively Birefringent needles

148
Q

How will staph aureus appear ?

A

Gram positive cocci

149
Q

Definitive investigation in IBD

A

Ileocolonoscopy (taking biopsies from terminal ileum and affected colonic areas)

150
Q

Causes of liver failure

A

Paracetamol overdose
Hepatitis A
Pre-eclampsia developing into HELLP syndrome
Fructose intolerance

151
Q

Phil, a 67-year-old man has a complex past medical history of cardiovascular disease, peripheral arterial disease and a recent ischaemic stroke. He is taking a large number of medications including aspirin and clopidogrel as part of dual antiplatelet therapy. Which of the options below correctly describes the targets of these respective medications?

A

COX-1 and P2Y12

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