Obs/Gynae/Psych/Crit Care/FNM/Derm/Stats

Question 1

Antibody which causes neonatal heart block in pregnant women with lupus

Answer 1

Anti-Ro (SSA) Anti-La (SSB)

Question 2

enzyme deficiency causing acute fatty liver disease of pregnancy

Answer 2

Fetal long-chain deficiency (LCHAD)

Question 3

Trimester in which acute fatty liver disease of pregnancy occurs

Answer 3

3rd trimester

Question 4

Cause of pruritis/RUQ pain in 2nd and 3rd trimester with NORMAL ultrasound liver.

Answer 4

Intrahepatic cholestasis of pregnancy

Question 5

nausea + vomiting + ketonuria + elevated liver enzymes in 1st trimester pregnancy

Answer 5

Hyperemesis gravidarum

Question 6

Biggest predictor of IBD in pregnancy

Answer 6

Disease activity at conception

Question 7

Lung function parameter most effected in pregnancy

Answer 7

Residual volume/ Functional residual capacity

Question 8

Management of asymptomatic Factor V Leiden (no VTEs) in pregnancy

Answer 8

Risk assessment and surveillance ultrasounds

Question 9

Reason for testing TSHR antibodies in pregnant women with graves disease in 3rd trimester

Answer 9

Predict risk of neonatal graves

Question 10

Reason for tight BSL control in Gestational diabetes

Answer 10

Significantly increased risk of macrosomia and neonatal adiposity, even with slight elevations in fasting glucose levels.

Question 11

When to avoid low tidal volume NIV in ARDs

Answer 11

Any type of cerebral insult due to risk from hypercapnia

Question 12

P value definition

Answer 12

Of observing a result at least this magnitude due to chance.

Question 13

Management of severe hyponatremia <130 with symptoms, post prolonged exercise.

Answer 13

hypertonic 3% saline.

Question 14

Complication of correcting hyponatremia too quickly

Answer 14

osmotic demyelination syndrome.

Question 15

Protective factor in paracetamol poisoning

Answer 15

ACUTE alcohol consumption (chronic is a risk factor). Reduces the risk of paracetamol induced hepatitis by reducing the toxic metabolites made by the liver.

Question 16

Difference between hypochondriac and somatisation disorder

Answer 16

somatisation = symptoms 
hypochondriac = no symptoms

Question 17

Mechanism of Lithium in diabetes insipidus

Answer 17

Chronic lithium ingestion can lead to resistance to ADH, resulting in polyuria and polydipsia in up to 20 to 40 percent of patients. Lithium enters the principal cells of the collecting duct through epithelial sodium channels in the luminal membrane. It then accumulates in these cells and interferes with the ability of ADH to increase water permeability.

Lithium is detected as sodium in the body. When sodium is high then there is increased sodium/lithium excretion and vice versa.

Question 18

DMARDs with highest risk of SCC

Answer 18

Azathioprine, Cyclosporin

Question 19

Mx of Catatonia

Answer 19

Benzodiazepines

ECT

Question 20

Normal changes to respiration in pregnancy

Answer 20

1. Increased oxygen consumption
2. increased tidal volume
3. Decreased residual volume

Question 21

What is the molecule required in paracetamol to convert the toxic metabolite NAPQI into a non-toxic form?

Answer 21

Glutathione (provided by NAC infusion as liver has a limited supply)

Question 22

Enzymes which act on paracetamol

Answer 22

CYP2E1
CYP3A4
enzymes for sulfation and glucuronidation

Question 23

Cardiac infiltrate caused by CLOZAPINE

Answer 23

Eosinophils

Question 24

Lead time vs length time bias

Answer 24

Lead time bias - A screening program incorrectly seems to increase survival as the condition is picked up earlier.

Length time bias - It is less aggressive disease with longer durations that are picked up on screening programs. Therefore screening seems to improve survival.

Question 25

Drug for prevention of pre-eclampsia

Answer 25

Aspirin

Question 26

Management of Narcolepsy in pregnancy

Answer 26

Napping

Question 27

Benefit of buprenorphine over methadone in addiction medicine

Answer 27

Buprenorphine has a ceiling to its sedative and analgesia effects

Question 28

Why does morphine need to be avoided in renal failure

Answer 28

Build up of the morphine metabolite (not morphine itself) MG6 - causes sedation (and mild analgesia)

Question 29

Ferritin aim in pregnancy

Answer 29

> 30

Question 30

Spirometry changes in pregnancy

Answer 30

reduced FRC and RV (breathe out further)

Question 31

Asthma drug which increases risk of preterm delivery

Answer 31

Steroids | - risk also increased by generally poorly controlled asthma

Question 32

Effect of dialysis on pregnant women with ESKD

Answer 32

more dialysis = better outcomes. | - more frequent = better BP control and lower pre-eclampsia

Question 33

Drug which reduces the risk of pre-eclampsia

Answer 33

aspirin

Question 34

Definition of Pre-eclampsia

Answer 34

hypertension with other organ involvement

Question 35

Diastolic BP aim in pregnancy

Answer 35

80 - 85

Question 36

Systolic BP aim in pregnancy

Answer 36

110 -140

Question 37

Cause of sudden death/ arrest in labor/ post partum

Answer 37

amniotic fluid pulmonary embolism

Question 38

Management of cholestasis of pregnancy

Answer 38

ursodeoxycholic acid

Question 39

Histology of IgG4 disease

Answer 39

lymphoplasmacytic tissue infiltration and storiform fibrosis

Question 40

T test

Answer 40

compares the means of two independent groups with normal distributions and continuous data. It is called ANOVA test if it is 3 or more groups.

Question 41

ANOVA test (AKA analysis of variance)

Answer 41

compares the means of three or more independent groups with normal distributions and continuous data.

Question 42

Mann Whitney U test

Answer 42

compares the means of two independent groups, with or without normal distributions Use wilcoxon test if the groups are paired (eg test and control groups)

Question 43

Chi squared

Answer 43

compares two NOMINAL groups (eg age and grey hair) to see if they are associated

Question 44

Spearman test

Answer 44

Compares two ORDINAL tests to assess for association (eg amount of smoking and number of lung cancers)

Question 45

Anti-epileptic that does not work for alcohol withdrawal seizures

Answer 45

Phenytoin

Question 46

Difference between delirium tremens and alcoholic hallucinosis

Answer 46

Alcoholic hallucinosis - 12-24hrs after last drink | Delirium tremens - 2-5 days after last drink

Question 47

Antipsychotic most likely to cause hyperprolactinemia

Answer 47

Risperidone

Question 48

Anti-dopaminergic SE

Answer 48

``` Euphoria Agitation Dystonia's Akathisia Parkinsonism Hyperprolactinemia ```

Question 49

Anti -Serotonin related SE

Answer 49

``` Headache Nausea Insomnia Agitation Sexual dysfunction ```

Question 50

Anti-Noradrenaline related SE

Answer 50

Postural hypotension Agitation Euphoria

Question 51

Antipsychotics with highest risk of extrapyramidal SE

Answer 51

1. Haloperidol 2. Chlorpromazine 3. Depots

Question 52

Antipsychotic causing worst postural symptoms

Answer 52

1. Chlorpromazine | 2. Clozapine

Question 53

Antipsychotic LOWERING prolactin level

Answer 53

Aripiprazole

Question 54

Antipsychotic with lowest weight gain risk

Answer 54

Haloperidol

Question 55

Antipsychotics with high weight gain risk

Answer 55

Olanzepine Quetiapine Clozapine

Question 56

Antipsychotic with long QT

Answer 56

Amisulpride | Ziprasidone

Question 57

Effect of steroids in septic shock

Answer 57

NO mortality benefit