other

Question 1

Diagnostic tests asthma

Answer 1

fractional nitric oxide testing
spirometry FEV1/FVC <80% +/- bronchodilator reversibility >15%
variable peak flow readings (look for >20% variability)

Question 2

Medical management of angina

Answer 2

sublingual GTN
Beta blocker
low dose aspirin
statin
control hypertension

Question 3

definitive diagnoses for

1. breast cancer
2. lung cancer
3. prostate cancer
4. bowel cancer

Answer 3

1. punch biopsy
2. bronchoscopy and biopsy
3. transrectal biopsy
4. flexi sig/colonoscopy and biopsy

Question 4

absolute contraindications for COCP

Answer 4

• age >35 and >15 cigarettes
• hx of VTE
• migraines with aura
• previous CVS disease/TIA/liver disease
• hx of hormone dependent cancer
  (also avoid if BMI >35 and risk factors for VTE/arterial disease)

Question 5

how long do you need additional contraception for after emergency contraception

Answer 5

levonelle- 7 days if COCP or 2 days if POP

Ella-one- use barrier contracep until next period

Question 6

treatment for primary hypercholesterolaemia

Answer 6

ezetimibe

Question 7

Differentials for TATT

Answer 7

• Anaemia
• hypothyroidism
• diabetes
• insomnia
• depression
• chronic fatigue syndrome
• early pregnancy
• rule out cancer*

Question 8

copper coil contraindications

Answer 8

• suspected pregnancy
• PID
• cervical/endometrial cancer
• trophoblastic disease
• cervical/uterine abnormalities

Question 9

abx for

1. campylobacter
2. shigella
3. cholera
4. giardiasis
5. norovirus

Answer 9

1. cipro
2. cipro
3. tetracyclines
4. metronidazole
5. none- rehydration

Question 10

describe action of

1. mebeverine
2. loperamide
3. Amitriptyline (for IBS)
4. linaclotide

Answer 10

1. antispasmodic for bloating etc
2. antidiarrhoeal for short term relief
3. for diarrhoea and abdo pain
4. mod-severe constipation (new drug)

Question 11

what is achalasia

Answer 11

degeneration of the myenteric ganglion cells in the oesophagus- presents with progressive worsening of dysphagia (solids - liquids)

Question 12

Plummer-vinson syndromw

Answer 12

• dysphagia
• iron deficiency anaemia
• glossitis
• oesophageal webs

Question 13

how is a diagnosis of reflux oesophagitis made

Answer 13

oesophageal pH monitorine <4

Question 14

role of haemaglutinin and neuramnidase in the influzena virus

Answer 14

H- anchors virus to cell

N- digests mucus to allow host cell invasion- inhibited by tamiflu and relenza

Question 15

when can neuramnidase inhibitors be given

Answer 15

Relenza and tamiflu
in pandemic
only in first 24hrs of illness
as prophylaxis in high risk groups post exposure

Question 16

when are abx given for otitis media

Answer 16

not routine only if

• under 3 months
• systemically unwell
• high risk due to other illnesses
• under 2yrs with bilateral sx
• perforation/otorrhoea

Question 17

Repeated OTITIS media in adults?

Answer 17

nasopharyngeal carcinoma

Question 18

when to suspect mastoiditis

Answer 18

> 10d discharge

sx of mastoid tenderness, pain, swellin