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MSRA > MSRA EXAM > Flashcards

MSRA EXAM Flashcards

1
Q

NICE recognise any of the following criteria to diagnose AKI in adults?

A

↑ creatinine > 26µmol/L in 48 hours
↑ creatinine > 50% in 7 days
↓ urine output < 0.5ml/kg/hr for more than 6 hours

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2
Q

MOTOR NEURONE EYE SYMPTOMS?

A

This condition = demyelinating disease of CNS
often presents with optic neuritis = eye pain and a relative afferent pupillary defect (RAPD).

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3
Q

RAPD
relative afferent pupillary defect (RAPD).

A

RAPD is an abnormal finding on the swinging flashlight test where the pupils dilate when light swings from the unaffected to the affected eye. It’s indicative of an optic nerve lesion, such as in optic neuritis - a common early symptom of multiple sclerosis.

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4
Q

Patient >= 60 years old with new iron-deficiency anaemia →

A

FIT TEST THEN urgent colorectal cancer pathway referral

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5
Q

Primary hyperparathyroidism is caused by

BLOODS =

A

excess secretion of PTH resulting in hypercalcaemia

raised calcium, low phosphate

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6
Q

symptomatic features of primary hyperparathyroidism ….

A

‘bones, stones, abdominal groans and psychic moans’

painful bones, kidney stones,

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7
Q

lung abscess features

A

Characterised by swinging fevers, night sweats, pleuritic chest pain, dyspnoea, and cough.

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8
Q

breast cancer medication OR+
pre menopause

post menopause

A

pre-menopause = tamoxifen

post menopause = Anastrozole (aromatase inhibitor)

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9
Q

Osteoarthritis 1st line treatment?

A

paracetamol + topical NSAIDs (if knee/hand) first-line

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10
Q

management post MI?

+ HF or LV dysfunction add..

A
  • dual antiplatelet therapy (aspirin plus ticagrelor)
  • ACE inhibitor
  • beta-blocker
  • statin

.. add aldosterone antagonist eg epelerone (K sparing like spiro)

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11
Q

primary dysmenorrhoea treatment

secondary dysmenorrhoea

A

Offer a trial of mefenamic

2 - refer to gynae as likely underlying cause

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12
Q

COPD management general

A

> smoking cessation advice: including offering nicotine replacement therapy, varenicline or bupropion

annual influenza vaccination

one-off pneumococcal vaccination

pulmonary rehabilitation to all people who view themselves as functionally disabled by COPD (usually Medical Research Council [MRC] grade 3 and above)

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13
Q

COPD INHALER therapy

A

1st line - SABA OR SAMA

2nd line
- if steroid response –> LABA + ICS

  • if no steroid response –> LABA + LAMA
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14
Q

positively birefringent crystals on aspirate?

A

pseudogout = calcium pyrophosphate deposition disease

presents as a monoarticular effusion in a patient RF = disease that disrupt iron and calcium homeostasis.
EG include haemochromatosis, parathyroid disorders, renal impairment, and thyroid dysfunction.

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15
Q

Central retinal artery occlusion

A

sudden, painless vision loss in one eye
poor direct pupillary light response, normal consensual light reaction
Fundoscopic findings - pale and opaque retina with a cherry-red spot

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16
Q

Treatment for onychomycosis.

A

oral terbinafine

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17
Q

Thiazides / Bendroflumethiazide affect which mineral?

A

cause hypercalcaemia (loss of appetite, nausea, fatigue)

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18
Q

Acute presentation of atrial fibrillatio + HISS ->
(HF, ISCHAEMIA, shock, syncope)

A

electrical cardioversion, as per the peri-arrest tachycardia guidelines

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19
Q

Pneumonia follow up ?

A

All cases of pneumonia should have a repeat chest X-ray at 6 weeks after clinical resolution

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20
Q

Pericarditis ECG changes

A

widespread ST elevation

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21
Q

PE ECG

A

Large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III describes the S1Q3T3 pattern,

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22
Q

URTI symptoms + amoxicillin → rash ?

A

glandular fever

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23
Q

Bishop score

A

should be assessed prior to induction of labour
Cervical position (posterior/intermediate/anterior)
Cervical consistency (firm/intermediate/soft)
Cervical effacement (0-30%/40-50%/60-70%/80%)
Cervical dilation (<1 cm/1-2 cm/3-4 cm/>5 cm)
Foetal station (-3/-2/-1, 0/+1,+2)

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24
Q

De Quervain’s tenosynovitis

A

Pain on the radial side of the wrist/tenderness over the radial styloid process

Finkelsteins test = thumb under fingers, ulnar deviation

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25
Q

step down treatment of asthma?

A

aim for a reduction of 25-50% in the dose of inhaled corticosteroids

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26
Q

already taking Ace + B + thiazide and high BP?

A

if K under 4.5- –> add K sparing

27
Q

first-line treatment for Pneumocystis jiroveci pneumonia (PJP) in HIV-positive patients

A

co-trimoxole

28
Q

supplements in pregnancy?

diabetic?

A

400mcg folic acid first 12 weeks and vitamin D all pregnancy

diabetic 5mg folic acidall pregnancy and vit d

29
Q

polycythaemia vera

A

Raised haemoglobin, plethoric appearance, pruritus, splenomegaly, hypertension

30
Q

intussusception
syx?

exam sign

imaging?

A

inconsolable crying + episodic vomiting , draw knees up

sign
sausage-shaped mass is palpable in the right upper quadrant.

USS

31
Q

moderate asthma

A

PEFR 50-75% best or predicted
Speech normal
RR < 25 / min
Pulse < 110 bpm

32
Q

severe asthma

A

PEFR 33 - 50% best or predicted
Can’t complete sentences
RR > 25/min
Pulse > 110 bpm

33
Q

life threatening asthma

A

PEFR < 33% best or predicted
Oxygen sats < 92%
‘Normal’ pC02 (4.6-6.0 kPa)
Silent chest, cyanosis or feeble respiratory effort
Bradycardia, dysrhythmia or hypotension
Exhaustion, confusion or coma

34
Q

prolactinoma treatment

A

bromocriptine

35
Q

Silicosis?
job
where lung changes?

A

Mining occupation, upper zone fibrosis, egg-shell calcification of hilar nodes

36
Q

what drug to avoid in bowel obstruction?

A

Metoclopramide

37
Q

Best SSRI post MI?

A

Sertraline

38
Q

VTE treatment?

A

DOAC
provoked (e.g. recent surgery): 3 months
unprovoked: 6 months

39
Q

ARMD
WET VS DRY

A

Wet age-related macular degeneration is characterised by choroidal neovascularisation (vessels)
Dry age-related macular degeneration is characterised by drusen

40
Q

Doxorubicin side effects

A

cardiotoxicity eg congestive heart failure

41
Q

Who should be offered statins?

A

offered to people who have a 10% or greater 10-year risk of developing cardiovascular disease
/ all those with Cerebrovascular disease eg prior TIA/ MI / stroke/ peripheral vascular disease

42
Q

type 1 diabetics general HbA1c target?

A

target of 48 mmol/mol (6.5%) should be used

43
Q

Age of Adrenaline dose anapphylaxis

< 6 months

6 months - 6 years

6-12 years

Adult and child +12

A

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

150 micrograms (0.15 ml 1 in 1,000)

300 micrograms (0.3ml 1 in 1,000)

500 micrograms (0.5ml 1 in 1,000)

44
Q

OCP and surgery?

A

cease intake of the pill 4 weeks pre op to reduce risk PE

45
Q

oral glucose tolerance test (OGTT)

DM

impaired glucose tolerance

impaired fasting glucose fasting

A

DM = fasting > 7.0, random > 11.1 - if asymptomatic need two readings

impaired glucose tolerance
when an OGTT 7.8 - 11.1 mmol/l.

6.1 - 7.0 mmol/l

46
Q

oesophageal cancer
adenocarcioma

squamous cell

A

adeno -RF GORd/ barrets most common UK

squamous cell - RF smoking, alcohol

47
Q

URTI symptoms + amoxicillin → rash

A

?glandular fever

48
Q

raised d dimer but no DVT in USS?

A

stop apixaban and schedule a repeat ultrasound in 1 week.

49
Q

shockable
non shockable

A

shock- VF / pulseless VT
non shock -PEA / asystole

50
Q

ethambutol syx

A

optic neuritis
if occurs stop

51
Q

cocaine + MI

A

tx with benzodiazepam

52
Q

?DVT
steps >2
or under 2

A

> 2 USS in 4 hours - if cant do that then d dimer and anticoag apixiban

under 2 = d dimer

53
Q

isoniazid
se
tx prevent

A

se = peripheral neuropathy
prevent with pyridoxine (Vitamin B6)

54
Q

combination drugs can potentially cause profound bradycardia and asystole ?

A

Beta-blockers combined with verapamil

55
Q

test for addisons disease?

A

short synacthen

56
Q

mild croup

A

NO stridor at rest
moderate vs severe = admit

57
Q

reynauds
tx
makes worse

A

tx = nifedipine
propranolol makes worse

58
Q

All patients with peripheral arterial disease should take

A

clopidogrel 75mg and atorvastatin 80mg

59
Q

C diff
abx make worse?
abx treats it?

A

make worse - clindamycin
tx - vancomycin

60
Q

> = 75 years + following a fragility fracture ?

A

Start alendronate before scan

61
Q

threadworm tx?

A

mebendazole to patient and all family

62
Q

hyperthyroid cause
hypothyroid cause

A

hyperthyroid = graves or toxi multinodular

hypothyroid
hashimotots (non tender)
subacute thyroiditis (de queverains) = tender
iodine def

63
Q
A

MSRA (17 decks)

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