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1
Q

Which antibiotic is associated with tendon disorders?

A

Quinolones eg ciprofloxacin

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2
Q

What is the most common pathogen to cause travellers diarrhoea?

A

E Coli

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3
Q

What is the adverse affect of coprescribing statins with clarithromycin?

A

Rhabdomyolysis

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4
Q

Inability to dorsiflex the ankle and evert the foot + loss of sensation over dorsum of the foot is due to damage to which nerve?

A

Common peroneal nerve
“My foot dropPED = peroneal everts and dorsiflexes”

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5
Q

Inability to plantarflex the ankle and invert the foot is due to damage to which nerve?

A

Tibial nerve

“I can’t TIPtoe” = tibial inverts and plantarflexes

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6
Q

HyperK is associated with metabolic acidosis or alkalosis?

A

Acidosis (hydrogen and potassium ions compete with each other across cell membranes)

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7
Q

Biceps reflex corresponds to which nerve root?

A

C5/6

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8
Q

Triceps reflex corresponds to which nerve root?

A

C7/8

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9
Q

S1/2 nerve root corresponds to which muscle reflex?

A

Ankle reflex

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10
Q

L3/4 nerve roots corresponds to which muscle reflex?

A

Knee

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11
Q

Which anti-TB drug has an adverse effect if peripheral neuropathy?

A

Isoniazid
Due to vitamin B6 deficiency so often coprescribed with pyridoxine

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12
Q

What are some side effects of ACE inhibitors?

A

Cough
Angioedema
HyperK

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13
Q

What dermatome landmark covers the thumb and index finger?

A

C6

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14
Q

Herpes simplex encephalitis commonly affects which region of the brain?

A

Temporal lobes

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15
Q

What are examples of live attenuated vaccines?

A

MY BOOTI

MMR
Yellow fever
BCG
Oral rotavirus
Oral typhoid
Intranasal influenza

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16
Q

What bacteria is the cause of necrotising otitis externa?

A

Pseudomonas aeruginosa

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17
Q

What is the inheritance pattern of haemochromatosis?

A

Autosomal recessive

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18
Q

Which dermatome is responsible for the ring and little finger?

A

C8

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19
Q

Typhoid fever is caused by which bacteria?

A

Salmonella

Constipation more common than diarrhoea

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20
Q

Recent travel history with change in bowel habits and rose spots on the chest is indicative of what?

A

Typhoid (enteric fever)

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21
Q

Carpal tunnel syndrome is characterised by sensory and motor loss where?

A

Lateral 3.5 digits sensory loss
Motor loss to forearm flexors and thumb muscles

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22
Q

Which TB antibiotic treatment is a CYP450 inhibitor?

A

Isoniazid
(I = inhibits, whereas rifAMPicin AMPS up & is a CYP450 inducer)

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23
Q

Argyll Robertson pupil is associated with what causes?

A

Diabetes and syphilis

Aka prostitute pupil
ARP= accommodation reflex present, pupillary reflex and ent

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24
Q

What is the treatment of keratitis?

A

= inflammation of cornea, potentially sight threatening, common in contact lens wearers

Stop wearing contact lenses until resolved, topical antibiotics & cycloplegic for pain relief

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25
Q

What is a Holmes Adie pupil?

A

Benign condition causing a unilateral dilated pupil, usually seen in women
Slowly reactive to accommodation but poor reaction to light

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26
Q

What is cubital tunnel syndrome?

A

Compression of the ulnar nerve (so causes paraesthesia of the 4th & 5th finger), pain often worse when leaning on affected elbow

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27
Q

What is the Simmonds test used to diagnose?

A

Achilles’ tendon rupture

Patient lays prone on bed, calf muscle squeezed and this should cause plantar flexion of the foot (absence of this indicates tendon rupture = positive Simmonds test)

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28
Q

What is the minimum period time a patient should be assessed for after an anaphylactic reaction?

A

6 hours

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29
Q

Dendritic corneal ulcer is characteristic of what?

A

Herpes simplex keratitis

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30
Q

What is the recommended dose of adrenaline to be given during ALS?

A

1mg

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31
Q

What drugs can be used as part of smoking cessation treatment?

A

Bupropion and varenicline
Both contraindicated in pregnancy and breast feeding
Bupropion is CI in epilepsy
Varenicline is used in caution if risk of self harm due to increased suicide risk

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32
Q

What is keratoconjunctivits sicca?

A

Reduced tear formation
Seen in Sjögren’s syndrome
Treat with hypromellose artificial tear drops

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33
Q

What are the reversible causes of cardiac arrest?

A

4 H’s & 4 T’s:

Hypovolaemia, hypothermia, hypo/hyper metabolites, hypoxia

Thrombus, tamponade, toxins, tension pneumothorax

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34
Q

What is the treatment for latent TB?

A

3 months rifampin with isoniazid (& pyridoxine)
Or
6 month isoniazid (with pyridoxine)

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35
Q

Pellagra is due to what deficiency?

A

Vitamin B3 (niacin)

Causes dermatitis, confusion and diarrhoea

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36
Q

Visual loss with a cherry red spot on the macula on fundoscopy is suggestive of what?

A

Central retinal artery occlusion

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37
Q

What breakthrough dose of morphine should be prescribed for a patient on regular slow release?

A

1/6th if total daily dose

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38
Q

What is the dose adjustment to convert from oral slow release morphine to subcutaneous morphine?

A

Divide by two

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39
Q

Abnormal flexion to pain scores what for the Motor part of GCS?

A

Aka decorticate position = 3

6 = follows command, 5= localises to pain, 4= withdraws from pain, 3= and normal flexion, 2= extending to pain, 1= no response

40
Q

Back pain relieved by sitting down or leaning forwards is typical of what pathology?

A

Spinal stenosis

41
Q

In patients with both folate and B12 deficiency, what should be treated first?

A

B12 deficiency treated first to avoid subacute combined spinal cord degeneration

42
Q

What antibiotics can be used as prophylactic for contacts of patients with meningococcal meningitis?

A

Oral rifampicin (2 days) or ciprofloxacin (single dose)

43
Q

Cubital tunnel syndrome will cause paraesthesia in which digits?

A

4th and 5th
Due to ulnar nerve compression, worse when leaning on the elbow

44
Q

How does medical epicondylitis differ from lateral epicondylitis?

A

Lateral: worse on wrist extension and supination of forearm (Tennis elbow)

Medial: worse of wrist flexion and probation of forearm (Golfers elbowp

45
Q

What dose of adrenaline is used in anaphylaxis vs CPR?

A

CPR 1mg

Anaphylaxis 1:1000
>12yo: 500mcg
6-12yo: 300mcg
6mo-6yo: 150mcg
<6mo: 100-150mcg

46
Q

What is the antiemetic of choice in Parkinson’s disease?

A

Domperidone
(Although a dopamine antagonist, it does not cross the blood brain barrier)

47
Q

What are the recommended Adult ALS adrenaline doses in anaphylaxis vs cardiac arrest?

A

Anaphylaxis: 0.5ml of 1:1000 IM
Cardiac arrest: 1ml of 1:1000 or 10ml 1:10,000 IV

48
Q

After how long can IM adrenaline be repeated in anaphylaxis?

A

5 minutes

49
Q

Which chemotherapy agents is associated with peripheral neuropathy?

A

Vincristine

50
Q

Adolescents with knee pain worse after exercise and locking of the joint is typical of what?

A

Osteochondritis dissecans

51
Q

What is the treatment for local anaesthetic toxicity?

A

IV 20% lipid emulsion

52
Q

What is the treatment for salicylate overdose?

A

Urinary alkalinisation with IV sodium bicarbonate

53
Q

Salicylate overdose presents with which acid base disturbance?

A

Mixed respiratory alkalosis and metabolic acidosis

54
Q

Which anti-malarial medication is contraindicated if any past history of psychiatric disorder?

A

Mefloquine

55
Q

What is the antidote for an overdose of a benzodiazepine?

A

Flumazenil

56
Q

What is the antidote for an overdose of tricyclic antidepressants eg amitriptylline?

A

IV bicarbonate

57
Q

What is the antidote for overdose of organophosphate incesticides?

A

Atropine

58
Q

A temporal lobe brain lesion would present with which visual field defect?

A

Superior homonymous quadrantopia

59
Q

What is the inheritance pattern of Huntington’s disease?

A

Autosomal dominant

60
Q

What are some contraindications to statin therapy?

A

Macrolide antibiotics
Pregnancy

61
Q

ACE inhibitors should only be stopped in what % change of creatinine or GFR?

A

If creatinine increases >30%
Or GFR reduces by >25%

62
Q

Facet joint pain of the back is worsened by flexion or extension?

A

Extension (causes the degenerated facet joints to collide, also worse on palpation)

63
Q

Spinal stenosis pain is relieved by which positioning?

A

Leaning forwards (more space in the stenosed spinal canal)

64
Q

How would a needlestick injury from a known HIV positive patient be managed?

A

4 weeks of PEP
Serological testing at 12 weeks after

65
Q

A lesion affecting the optic chias causes which visual field defect?

A

Bitemporal hemianopia

66
Q

A lesion affecting the left optic tract will cause which visual field defect?

A

Affects left nasal & right temporal fields hence a right homonymous hemianopia

67
Q

What is the management for anterior uveitis?

A

Urgent Ophthalmology referral
Topical steroids and cycloplegic drops (eg atropine to dilate the eye)

68
Q

Which myotome is involved in dorsiflexion of the foot?

A

L5

69
Q

Where is the sensory distribution of the L4 dermatome?

A

Inner lower leg and medial malleolus

70
Q

What is the dermatome distribution of the S2 dermatome?

A

Posterior thigh

71
Q

What is the dermatomal distribution of the heel?

A

S1

72
Q

The presence of which type of hepatitis B IgG is only present is the person has previously been infected (ie cured)?

A

Anti- HBc IgG
(Antibodies against the CORE antigen are only present if person was actually infected, a vaccine has antibodies against the surface antigen only - anti-HBs IgG)

73
Q

Following a TIA, what should a patient be advised regarding driving?

A

If symptom free after 1 month they can drive again
No need to inform DVLA

74
Q

What is the first line antiplatelet in peripheral arterial disease?

A

Clopidogrel

75
Q

Carbamazepine is a CYP450 inducer or inhibitor?

A

Inducer

76
Q

What are some examples of CYP450 inducers?

A

PC BRASS

Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol (chronic use)
Sulphonyureas
St Johns wart

77
Q

How does an upper brachial plexus injury differ from a lower brachial plexus injury?

A

Upper: Aka Erb’s palsy, waiter tip, arm adducted and internally rotated with elbow extended and wrist flexed
Damage to C5 and C6 nerve roots

Lower: Aka Klumpke’s palsy, claw hand deformity (IP joints flexed)
Damage to C8 and T1 nerve roots

78
Q

What affect do thiazide diuretics have on serum calcium levels?

A

Cause hypercalcaemia by increasing calcium reabsorption

79
Q

Which cytotoxic agent is associated with lung fibrosis?

A

Bleomycin

80
Q

What is the antidote for an overdose of beta blockers?

A

Atropine
If resistant: glucagon

81
Q

Flumazenil is the antidote for overdose of which class of medications?

A

Benzodiazepines

82
Q

Which is the antidote for organophosphate poisoning?

A

Atropine

83
Q

Adverse effects of which class of medications can cause increased pigmentation of the eye and increased eyelash length?

A

Prostaglandin analogues eg latanoprost

84
Q

What is pinguecula?

A

Benign conjunctival nodule, usually on the nasal side, more prevalent in tropical climates (correlates with UV exposure)

(Pinguecula don’t grow over the cornea whereas pterygium do)

85
Q

Which movement is the L5 movement responsible for?

A

Dorsiflexion of the foot and the great toe

86
Q

Which myotome is responsible for finger abduction?

A

T1

87
Q

What is the antidote for methanol poisoning?

A

Fomepizole or ethanol

88
Q

IV bicarbonate is used as the antidote for overdose of which class of medication?

A

Tricyclic antidepressant

89
Q

What is the management of salicylate overdose?

A

Urinary alkalinisation with IV bicarbonate
Or haemodialysis

90
Q

What symptoms dose salicylate toxicity present with?

A

Nausea and vomiting and tinnitus

(Mixed respiratory alkalosis and metabolic acidosis)

91
Q

What class of medication is indapamide?

A

Thiazide like diuretic

92
Q

What class of medication is losartan?

A

Angiotensin receptor blocker

93
Q

What are examples of angiotensin receptor blocker medications?

A

Candesartan
Losartan

94
Q

When should amiodarone be given in CPR?

A

If in VF or pulseless VT, give 300mg after 3 shocks have been given

Further 150mg dose can be given after 5 shocks

95
Q

What is the management of tachycardia in an unstable patient?

A

Synchronised DC cardioversion
Up to 3 shocks

96
Q

How is a narrow complex tachycardia managed?

A

If regular: 1st line is vagal manoeuvres, 2nd line is adenosine (6mg IV bolus, then 12mg, then 18mg)

If irregular: presume AF, give beta blocker and consider digoxin/ amiodarone, also DOAC if >48hrs

97
Q

What is the management of a broad complex tachycardia?

A

If regular and patient is stable, Amiodarone 300mg IV bolus then an infusion
Irregular: if torsades de pointes given IV magnesium sulphate

MSRA (15 decks)

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