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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
What is a Holmes Adie pupil?
Benign condition causing a unilateral dilated pupil, usually seen in women Slowly reactive to accommodation but poor reaction to light
26
What is cubital tunnel syndrome?
Compression of the ulnar nerve (so causes paraesthesia of the 4th & 5th finger), pain often worse when leaning on affected elbow
27
What is the Simmonds test used to diagnose?
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)
28
What is the minimum period time a patient should be assessed for after an anaphylactic reaction?
6 hours
29
Dendritic corneal ulcer is characteristic of what?
Herpes simplex keratitis
30
What is the recommended dose of adrenaline to be given during ALS?
1mg
31
What drugs can be used as part of smoking cessation treatment?
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
32
What is keratoconjunctivits sicca?
Reduced tear formation Seen in Sjögren’s syndrome Treat with hypromellose artificial tear drops
33
What are the reversible causes of cardiac arrest?
4 H’s & 4 T’s: Hypovolaemia, hypothermia, hypo/hyper metabolites, hypoxia Thrombus, tamponade, toxins, tension pneumothorax
34
What is the treatment for latent TB?
3 months rifampin with isoniazid (& pyridoxine) Or 6 month isoniazid (with pyridoxine)
35
Pellagra is due to what deficiency?
Vitamin B3 (niacin) Causes dermatitis, confusion and diarrhoea
36
Visual loss with a cherry red spot on the macula on fundoscopy is suggestive of what?
Central retinal artery occlusion
37
What breakthrough dose of morphine should be prescribed for a patient on regular slow release?
1/6th if total daily dose
38
What is the dose adjustment to convert from oral slow release morphine to subcutaneous morphine?
Divide by two
39
Abnormal flexion to pain scores what for the Motor part of GCS?
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
Back pain relieved by sitting down or leaning forwards is typical of what pathology?
Spinal stenosis
41
In patients with both folate and B12 deficiency, what should be treated first?
B12 deficiency treated first to avoid subacute combined spinal cord degeneration
42
What antibiotics can be used as prophylactic for contacts of patients with meningococcal meningitis?
Oral rifampicin (2 days) or ciprofloxacin (single dose)
43
Cubital tunnel syndrome will cause paraesthesia in which digits?
4th and 5th Due to ulnar nerve compression, worse when leaning on the elbow
44
How does medical epicondylitis differ from lateral epicondylitis?
Lateral: worse on wrist extension and supination of forearm (Tennis elbow) Medial: worse of wrist flexion and probation of forearm (Golfers elbowp
45
What dose of adrenaline is used in anaphylaxis vs CPR?
CPR 1mg Anaphylaxis 1:1000 >12yo: 500mcg 6-12yo: 300mcg 6mo-6yo: 150mcg <6mo: 100-150mcg
46
What is the antiemetic of choice in Parkinson’s disease?
Domperidone (Although a dopamine antagonist, it does not cross the blood brain barrier)
47
What are the recommended Adult ALS adrenaline doses in anaphylaxis vs cardiac arrest?
Anaphylaxis: 0.5ml of 1:1000 IM Cardiac arrest: 1ml of 1:1000 or 10ml 1:10,000 IV
48
After how long can IM adrenaline be repeated in anaphylaxis?
5 minutes
49
Which chemotherapy agents is associated with peripheral neuropathy?
Vincristine
50
Adolescents with knee pain worse after exercise and locking of the joint is typical of what?
Osteochondritis dissecans
51
What is the treatment for local anaesthetic toxicity?
IV 20% lipid emulsion
52
What is the treatment for salicylate overdose?
Urinary alkalinisation with IV sodium bicarbonate
53
Salicylate overdose presents with which acid base disturbance?
Mixed respiratory alkalosis and metabolic acidosis
54
Which anti-malarial medication is contraindicated if any past history of psychiatric disorder?
Mefloquine
55
What is the antidote for an overdose of a benzodiazepine?
Flumazenil
56
What is the antidote for an overdose of tricyclic antidepressants eg amitriptylline?
IV bicarbonate
57
What is the antidote for overdose of organophosphate incesticides?
Atropine
58
A temporal lobe brain lesion would present with which visual field defect?
Superior homonymous quadrantopia
59
What is the inheritance pattern of Huntington’s disease?
Autosomal dominant
60
What are some contraindications to statin therapy?
Macrolide antibiotics Pregnancy
61
ACE inhibitors should only be stopped in what % change of creatinine or GFR?
If creatinine increases >30% Or GFR reduces by >25%
62
Facet joint pain of the back is worsened by flexion or extension?
Extension (causes the degenerated facet joints to collide, also worse on palpation)
63
Spinal stenosis pain is relieved by which positioning?
Leaning forwards (more space in the stenosed spinal canal)
64
How would a needlestick injury from a known HIV positive patient be managed?
4 weeks of PEP Serological testing at 12 weeks after
65
A lesion affecting the optic chias causes which visual field defect?
Bitemporal hemianopia
66
A lesion affecting the left optic tract will cause which visual field defect?
Affects left nasal & right temporal fields hence a right homonymous hemianopia
67
What is the management for anterior uveitis?
Urgent Ophthalmology referral Topical steroids and cycloplegic drops (eg atropine to dilate the eye)
68
Which myotome is involved in dorsiflexion of the foot?
L5
69
Where is the sensory distribution of the L4 dermatome?
Inner lower leg and medial malleolus
70
What is the dermatome distribution of the S2 dermatome?
Posterior thigh
71
What is the dermatomal distribution of the heel?
S1
72
The presence of which type of hepatitis B IgG is only present is the person has previously been infected (ie cured)?
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
Following a TIA, what should a patient be advised regarding driving?
If symptom free after 1 month they can drive again No need to inform DVLA
74
What is the first line antiplatelet in peripheral arterial disease?
Clopidogrel
75
Carbamazepine is a CYP450 inducer or inhibitor?
Inducer
76
What are some examples of CYP450 inducers?
PC BRASS Phenytoin Carbamazepine Barbituates Rifampicin Alcohol (chronic use) Sulphonyureas St Johns wart
77
How does an upper brachial plexus injury differ from a lower brachial plexus injury?
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
What affect do thiazide diuretics have on serum calcium levels?
Cause hypercalcaemia by increasing calcium reabsorption
79
Which cytotoxic agent is associated with lung fibrosis?
Bleomycin
80
What is the antidote for an overdose of beta blockers?
Atropine If resistant: glucagon
81
Flumazenil is the antidote for overdose of which class of medications?
Benzodiazepines
82
Which is the antidote for organophosphate poisoning?
Atropine
83
Adverse effects of which class of medications can cause increased pigmentation of the eye and increased eyelash length?
Prostaglandin analogues eg latanoprost
84
What is pinguecula?
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
Which movement is the L5 movement responsible for?
Dorsiflexion of the foot and the great toe
86
Which myotome is responsible for finger abduction?
T1
87
What is the antidote for methanol poisoning?
Fomepizole or ethanol
88
IV bicarbonate is used as the antidote for overdose of which class of medication?
Tricyclic antidepressant
89
What is the management of salicylate overdose?
Urinary alkalinisation with IV bicarbonate Or haemodialysis
90
What symptoms dose salicylate toxicity present with?
Nausea and vomiting and tinnitus (Mixed respiratory alkalosis and metabolic acidosis)
91
What class of medication is indapamide?
Thiazide like diuretic
92
What class of medication is losartan?
Angiotensin receptor blocker
93
What are examples of angiotensin receptor blocker medications?
Candesartan Losartan
94
When should amiodarone be given in CPR?
If in VF or pulseless VT, give 300mg after 3 shocks have been given Further 150mg dose can be given after 5 shocks
95
What is the management of tachycardia in an unstable patient?
Synchronised DC cardioversion Up to 3 shocks
96
How is a narrow complex tachycardia managed?
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
What is the management of a broad complex tachycardia?
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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