MSCAA papers

Question 1

mx of renal stones with hydronephrosis?

Answer 1

decompress with nephrostomy

Question 2

mx of asystole/PEA?

Answer 2

adrenaline 1mg

Question 3

difference between pupils in uveitis and glaucoma?

Answer 3

uveitis= small pupil
glaucoma= semi-dilated pupil

Question 4

what parameter needs to be measured in a house fire?

Answer 4

carboxyhaemoglobin

Question 5

dx for mechanical heart valves?

Answer 5

warfarin and aspirin

Question 6

features of oesophageal rupture?

Answer 6

Suspect in patients with severe chest pain without cardiac diagnosis and signs suggestive of pneumonia without convincing history, where there is history of vomiting

Question 7

feature of fibrocystic disease?

Answer 7

pain associated with menstrual cycle

Question 8

tx of prolactinomas?

Answer 8

cabergoline (dopamine agonist)

Question 9

what is haemochromatosis?

Answer 9

AD disorder of iron metabolism resulting in iron accumulation
high transferrin, high ferritin and iron, low TIBC
causes DM, fatigue, stigmata of chronic liver disease
tx= venesection

Question 10

heart problem from cocaine?

Answer 10

coronary artery spasm

Question 11

mx of paralytic ileus?

Answer 11

make NBM and insert NG tube

Question 12

what is lymphogranuloma venereum?

Answer 12

proctitis and lymphadenopathy in MSM

Question 13

cause of IgA nephropathy?

Answer 13

visible haematuria a few days after URTI

Question 14

drug to give when confused and agitated when dying?

Answer 14

midazolam

Question 15

which lobe sees the first changes in Alzheimer’s disease?

Answer 15

temporal lobe

Question 16

what to give in TCA overdose?

Answer 16

IV sodium bicarb

Question 17

antihypertensive to give in T1DM?

Answer 17

ACEi

evidence of renal function protection

Question 18

side effects of ACE inhibitors?

Answer 18

cough: Thought to be due to increased bradykinin levels
angioedema: may occur up to a year after starting treatment
hyperkalaemia
first-dose hypotension: more common in patients taking diuretics

Question 19

what drug can cause pulmonary fibrosis?

Answer 19

amiodarone

Question 20

features of SIADH?

Answer 20

hyponatraemia- dilutional
concentrated urine
confusion
hypertension
overload

Question 21

maintenance fluids in an adult (with and w/o cardiac disease)

Answer 21

without cardiac disease- 30-40ml/kg

with cardiac disease- 20-25ml/kg

Question 22

features of myasthenia gravis?

Answer 22

double vision
limb weakness
slurred speech when tired

Question 23

what to measure for resp function in myasthenic crisis?

Answer 23

FVC <1L

Question 24

what is ADPKD associated with?

Answer 24

SAH (need LP)

Question 25

1st line for delirium?

Answer 25

haloperidol (unless parkinsons then lorazepam)

Question 26

what electrolyte abnormality needs to be ruled out in polydipsia and polyuria?

Answer 26

hypercalcaemia

Question 27

what to give before giving IV contrast to a patient with CKD?

Answer 27

volume expand with 0.9% saline to prevent contrast nephropathy

Question 28

diagnostic investigation for primary sclerosing cholangitis?

Answer 28

MRCP