Other PPQs Flashcards

1
Q

On newborn check, inverted ankles and plantar flexed, what sign is this?

A

Talipes Equinovarus

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2
Q

7 year old kid headache and secondary nocturnal enuresis. He’s lost 1.5kg. Urine dipstick normal (i.e. no glucose, proteins, blood. Urine specific gravity 1.010 to 1.030) What is the likely diagnosis?

A

Diabetes insipidus

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3
Q

Girl goes to Pakistan. Develops macular rash. High fever for 5 days. HR was 70bpm. Cause?

A

Typhoid

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4
Q

Difficult balance, cannot build block of towers, hyperreflexia (description of ataxic CP). Where is lesion?

A

Cerebellum

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5
Q

Cannot examine ear directly, lump behind ear causing ear to stick out

A

Mastoiditis

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6
Q

Kid with 2cm mass (inframandibular) on left side, painful – blood film shows: toxic left shift with reactive neutrophilia.

A

lymphadenitis

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7
Q

Pic of molluscum, next step?

A

Reassure

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8
Q

You are in GP, Child with mild croup comes in?

A

Dexamethasone + review in 48 hour

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9
Q

Maternal T1DM increases risk of what condition in newborn?

A

Neural tube defects

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10
Q

learn the hearing tests

A

ok

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11
Q

Maintenance fluid to give to kid with diabetes mellitus

A

In DKA: 0.9% saline, not in DKA: 0.9% saline with 5% dextrose

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12
Q

Kid with yellow and grey stools and was like 4 weeks old or something. What do you test for?

A

Conjugated bilirubin levels

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13
Q

Kid who had rashes which had crusted over and he was also scratching them and now he had a fever and cool peripheries. What is the cause for his acute presentation?

A

Varicella zoster viraemia

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14
Q

Another case with an unwell child where chest was clear, had a fever. Lost weight recently. What do you do next?

A

urine dip

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15
Q

Uncle gets TB, kid lives with him, Mantoux test showed a number between 10-14mm for the result. What should you do? Watch and wait, give Isoniazid prophylaxis,

A

Start anti-TB treatment (the kid has TB with those diameters and risk factor of living with someone with TB, plus his age if he’s under 4)

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16
Q

Precocious puberty (5yo and has sparse axillary and pubic hair as well as breast bud development) and high centile growth. parents are along some lower centile. What definitive diagnostic test do you do?

A

Gonadotropin stimulation test

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17
Q

Cerebral Palsy (described hemiplegic weakness with brisk reflexes), what area of the brain is affected?

A

pyramidal tracts

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18
Q

Pic of molluscum, next step?

A

Reassure

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19
Q

9 months old not feeling well, temperature was 38, comes into the GP. What should you do?

A

Go hospital

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20
Q

Newborn with purple spot on face, what is the best approach?

A

Discharge to Gp follow up

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21
Q

Woman with a little bit of pink post-coital bleeding on wiping. Smear is fine, ultrasound is clear. What is the next investigation?

A

Hysteroscopy with biopsy

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22
Q

Twins, presenting twin is breech, other cephalic. How to deliver?

A

Caesarean section

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23
Q

Woman had abdo trauma 32 weeks, had anti-D. Had her anti-D at 28 weeks – what to do next?

A

Kleihauer-Betke test then give anti-D

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24
Q

HIV with undetectable viral load. what is contraindicated in labour? Forceps, ventouse, foetal blood sampling, c section

A

Foetal blood sampling

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25
Q

Woman had an implant inserted but she’s getting it removed. What is the most likely reason why? Weight gain, irregular bleeding, hirsutism

A

Irregular bleeding

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26
Q

Bloods shown with raised LH and FSH and all else normal in couple trying to get pregnant. What is the first question you want to ask the woman?

A

When was last period

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27
Q

Pregnant woman with Gram negative bacilli in urine microscopy. What do you do? Watch and wait, give Amoxicillin, urgent referral, some scans

A

Amoxicillin

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28
Q

Girl with painful periods in the first 2 days of her period ever since menarche, she has heavy bleeding. What is it? Primary dysmenorrhoea, endometriosis, endometrial cyst

A

Primary dysmenorrhoea

29
Q

Woman with painful breast after giving birth. She’s breast-feeding and has an abscess secondary to mastitis. Surgical excision, aspirate and culture, Ciprofloxacin

A

Aspirate and culture

30
Q

What do you do in a woman in labour after 4 hours of checking, she’s 4cm. Vaginal prostaglandin, Cervical sweep, Oxytocin, Ergometrine, ARM

A

Oxytocin?? Query look this up

  • 1st - Membranes intact - ARM (Artificial Rupture of the Membranes) à review in 2 hours
  • 2nd - Membranes ruptured - oxytocin:
    • Increase every 15-30 mins until regular contractions
    • Once regular contractions, review in 4 hours
    • During this phase, the membranes may be intact or may have ruptured
31
Q
  1. HRT question for a menopausal woman with flushes, last period 10m ago. What do you give her? Cyclical combined HRT, oestrogen only HRT, topical HRT, continuous HRT – They called cyclical “sequential” in the exam
A

Cyclical combined HRT

Query??

32
Q

What’s the management for DVT risk in a pregnant woman after an elective Caesarean? LMWH, LMWH and Ted stockings, Ted stockings, Warfarin or something, Aspirin, Aspirin and Ted stockings

A

LMWH and Ted stockings

33
Q

Woman with blocked tubes on hysterosalpingogram, what treatment should you do for fertility? IVF, IUI, ICSI

A

IVF

34
Q

Heavy periods in a girl not yet sexually active. What do you give her? COCP, mefenamic acid, tranexamic acid

A

Tranexamic acid

35
Q

Poorly controlled diabetic mother, her newborn has an abnormal asymmetric Moro reflex - what’s wrong? (secondary to probably shoulder dystocia because of diabetes) HIE, fracture of humerus, brachial plexus injury

A

Brachial plexus injury

36
Q

What do you measure at booking for hepatitis b?

A
37
Q

Woman with endometriosis, had laparoscopic adhesiolysis – developed a whole range of sx - high CRP, low Hb, constipation, bowel sounds absents etc – what’s happened?

A

Perforation

38
Q

Pregnant Woman has pain and bleeding and her abdomen feels ‘woody’ (buzzword)

A

Placental abruption

39
Q

bunch of tests for a woman who couldn’t conceive- all test normal and prolactin raised by like 2 points above normal value what’s most likely cause? Unknown (accounts for 30% of subfertility), prolactinoma (prolactin would be in 1000s), raised testosterone suggests PCOS (LH:FSH ratio>2/3)

A

Unknown (accounts for 30% of subfertility)

40
Q

30 yr woman with first day of last menstrual period on 25th August, 31 day cycles. What is the estimated delivery date? May 30, June 1, June 4, June 8

A

June 1

41
Q

Pregnant woman has scan which shows anencephaly, until when can she have a TOP? Any point during this pregnancy, 24 weeks, 28 weeks, she can’t have one

A

Any point during this pregnancy

42
Q

Hysterectomy yesterday. How long to stay off work for: 48 hours/ 1 week/ 4 weeks/ 3 months

A

4 weeks

43
Q

45F has a radical hysterectomy (Wertheim’s hysterectomy) for CIN. Last cervical smear 2 years ago. When next smear and type? 1 year?, 6 months

A

6 months (vaginal vault smear, no cervical smear because cervix was removed)

Different to 2021 q where hysterectomy was for something else and TAH… or maybe not?? see below:

Where a hysterectomy is carried out for pre-malignant disease of the cervix (CIN) or CIN is found, a vault smear (from the top of the vagina) is taken at six months and 18 months after the operation.

44
Q

16 year old girl suffering from PMS – what is the next step? Ask her to complete a menstrual diary, prescribe long acting progesterone

A

Ask her to complete a menstrual diary

45
Q

Woman has come for a sterilisation, has had protected sex since her last menstruation one week ago, just post-ovulation – Immediate tx? Insert IUD, Cancel surgery, Continue with surgery (so long as sex protected)

A

Continue with surgery (so long as sex protected)

46
Q

Woman has menopausal symptoms and wants to start HRT, last period 6m ago

A

Cyclical HRT (repeat)

47
Q

Woman with dribbling all the time and had to wear a pad – vesicovaginal fistula, overflow incontinence, overactive detrussor

A

Vesicovaginal fistula? (not enough information)

48
Q

Smoker, which extra tests does she require in pregnancy – serial growth scans, nicotine levels

A

Serial growth scans (if she smokes more than 10 per day)

49
Q

Protein 1+ in urine, BP normal, what does she have? Normal pregnancy, pre-eclampsia

A

Normal pregnancy

50
Q

Lady with pain on left breast – mastitis, given antibiotics by GP - what other breastfeeding advice do you give her? Continue breastfeeding from both breasts, continue from affected breast, continue from unaffected breast, express breast milk and discard, stop breastfeeding

A

Continue breastfeeding from both breasts

51
Q

PMB, 5mm endometrial thickness, what do you do next?

A

Pipelle biopsy

52
Q

Woman who has just given birth to 2 day old baby. Her 2 year old son gets chicken pox, women has IgG antibodies. Goes to GP, what should be done? Nothing, test foetal antibodies, give IVIG to baby, give aciclovir to baby

A

Nothing (maternal antibodies present)?

53
Q

Loss of libido. DHx COCP Cetirizine Salbutamol inhaler. What is the cause of loss of libido?

A

Cetirizine

54
Q

Woman with learning difficulties in a care home with change in behaviour: change in feeding time and irritability because the carer that was looking after them has gone suddenly, what’s the diagnosis?

A

Challenging behaviour in reaction to the change

55
Q

Woman with anorexia was admitted and she started eating. Then she gets muscle spasms, and abdominal pain. What’s the most important thing to check for?

A

Low potassium/ refeeding syndrome

56
Q

Drug to give for depression in a man who had a previous MI

A

Sertraline

57
Q

Old age boxer rips out cannula, attacks staff what do you do?

A

Calm him with verbal de-escalation, make him some tea, debrief the nurses, start iv Abx

58
Q

Someone else kicking off and de-escalation has failed, what drugs?

A

Intramuscular Lorazepam

59
Q
  1. Man whose wife died a year ago, has 6 months of low mood, low energy, doesn’t like doing what he used to, getting forgetful, lacking concentration

Severe depression without psychosis, abnormal (prolonged) grief reaction, adjustment disorder with depression, Alzheimer’s

A

Abnormal (prolonged) grief reaction

60
Q

Man on haloperidol gets acute dystonia, give

A

Procyclidine

61
Q

Man works as an IT engineer, doesn’t like sex, or people

A

Schizoid personality disorder

62
Q

Woman blushes in public and becomes very nervous around people

A

Social phobia (repeat, though previous year question asked what was most associated with social phobia – answer was blushing)

63
Q

Patient with Lewy body dementia, given a drug that makes him worse, what drug?

A

Haloperidol

64
Q

A few questions on people with learning disabilities coming in with carers/families and their carers/families disagreeing with the doctor’s plan so what would you do first?

A
65
Q
  1. Man comes requesting for codeine for his back, concerned his painkiller use is spiralling, see some degeneration in his spine on imaging – what do you do?
A

Buprenorphine + addiction clinic referral

66
Q

Man with history of paranoid schizophrenia, his Ix and tests are strongly suggestive of an MI, needs treatment. He has capacity and refuses treatment – what should you do?

A

Respect his wishes if it is a capacitous decision

67
Q

Someone with dilated pupils, urinary retention, obs normal-ish - cause of overdose?

A

tca/amitriptiline

68
Q

Lithium – what do you monitor?

A

Serum Lithium levels, U&Es, BMI, and TFTs every 6 months

69
Q

Man who drinks a bottle of wine a day for the last 10 years, has tried to quit before but failed. Wants to cut down.

A

Initially motivational interviewing, then inpatient chlordiazepoxide when ready to fully quit