Other

Question 1

What is common law?

Answer 1

framework that governs the emergency treatment of patients who refuse treatment

Question 2

what are the features of zinc deficiency?

Answer 2

acrodermatitis: red, crusted lesions - acral distribution, peri-orificial, perianal
alopecia
short stature
hypogonadism
hepatosplenomegaly
cognitive impairment

Question 3

what is refeeding syndrome?

Answer 3

describes the metabolic abnormalities which occur on feeding a person following a period of starvation. Occurs when the extended period of catabolism ends abruptly with switching to carb metabolism

Question 4

what are the metabolic consequences in refeeding syndrome?

Answer 4

hypophosphatemia
hypokalaemia
hypomagnesaemia
abnormal fluid balance

Question 5

in people with AAA what other site is also commonly affected by aneurysms?

Answer 5

popliteal artery

Question 6

what is the most common cause of post-op urinary retention in older men?

Answer 6

benign prostatic hyperplasia

Question 7

what are the complications of central line insertion?

Answer 7

air embolism
bleeding
pneumothorax
infection
phrenic nerve palsy

Question 8

What is the management of hypercalcaemia?

Answer 8

initial management is rehydration with normal saline, typically 3-4 litres/day
following rehydration bisphosphonates may be used - typically take 2-3 days to work
other options include:
- calcitonin - quicker effect than bisphosphonates
- steroids in sarcoidosis
- loop diuretics such as furosemide are sometimes used in hypercalcaemia, particularly in patients who cannot tolerate aggressive fluid resuscitation. However they should be used with caution as they may worsen electrolyte derangement and fluid depletion

Question 9

what is Fournier’s gangrene?

Answer 9

essentially necrotising fasciitis of the perineum
surgical emergency because it can cause rapid and uncontrollable necrosis of tissue and ultimately death by overwhelming sepsis if not treated promptly

Question 10

What are the features of narcolepsy?

Answer 10

Typical onset in teenage years
Hypersomnolence
Cataplexy - sudden loss of muscle tone often triggered by emotion
Sleep paralysis
Vivid hallucinations on going to sleep or waking up

Question 11

What is the management of hypocalcaemia?

Answer 11

severe hypocalcaemia: carpopedal spasm, tetany, seizures or prolonged QT interval requires IV calcium replacement: preferred method is IV calcium gluconate, 10ml of 10% solution over 10 minutes
ecg monitoring recommended

Question 12

What is staph toxic shock syndrome?

Answer 12

severe systemic reaction to staph exotoxins, can be related to infected tampons

Question 13

what are the diagnostic criteria for staph toxic shock syndrome?

Answer 13

• fever: temperature > 38.9
• hypotension: systolic BP < 9-
• diffuse erythematous rash
• desquamation of the rash, especially of the palms and soles
• involvement of 3 or more organ systems e.g. GI (diarrhoea and vomiting), mucous membrane erythema, hepatitis, renal failure, thrombocytopenia, CNS involvement e.g. confusion

Question 14

what is the management of staph toxic shock syndrome?

Answer 14

removal of infection focus e.g. retained tampon
IV fluids
IV antibiotics

Question 15

what acid-base disturbance is seen in ppl with diarrhoea?

Answer 15

normal anion gap metabolic acidosis

Question 16

what might you see on abg in someone with diarrhoea?

Answer 16

normal anion gap metabolic acidosis

Question 17

when can an abortion be carried out?

Answer 17

most can be carried out before 24 weeks of pregnancy
they can be carried out after 24 weeks in very limited circumstances e.g. if the mothers life is at risk or the child would be born with a severe disability

Question 18

what is the social selection/mobility theory?

Answer 18

an individuals health can influence their social mobility and hence their position in the social heirachy

Question 19

what is the positive reinforcement theory?

Answer 19

a response or behaviour is strengthened by rewards, leading to the repetition of a desired behaviour