Paper 1 Flashcards
What is the management of prostatitis? (Antibiotic and treatment length)
Ciprofloxacin for 14 days
A 28-year-old lady is reviewed in a follow-up appointment at the sexual health clinic. Twelve months ago she was diagnosed with syphilis and was given intramuscular benzathine penicillin. Blood tests were taken a week prior to the follow-up appointment and the serology results are shown below:
TPHA = positive
VDRL = negative
What is the most likely explanation for the serology results shown above?
Successfully treated syphilis
TPHA always remains positive, VDRL becomes negative
A patient with type 2 diabetes mellitus is started on sitagliptin. What is the mechanism of action of sitagliptin?
DPP4 inhibitor
Gliptins (DPP-4 inhibitors) reduce the peripheral breakdown of incretins such as GLP-1
A 23-year-old male medical student presents to the emergency department with severe right upper quadrant abdominal pain. He describes it as sharp and worse on inspiration. He has been feeling tired and short of breath in the last few days and has a cough productive of purulent, bloody sputum. He has a fever, tachycardia and tachypnoea. He has recently come back from a week-long holiday in which he admits to drinking 15 units of alcohol a day.
What is the most likely cause of his presentation?
Lower lobe pneumonia
Urinary retention can be precipitated by infection of the lower urinary tract
Urinary retention can be precipitated by infection of the lower urinary tract
N, A, A, A, D, M, L, D
Which medications should be withheld during an AKI?
- NSAIDs (except if aspirin at cardiac dose e.g. 75mg od)
- Aminoglycosides (eg, gentamicin)
- ACE inhibitors
- Angiotensin II receptor antagonists
- Diuretics
- Metformin
- Lithium
- Digoxin
A 58-year-old woman with a previous history of tuberculosis in her youth, presents with small volume haemoptysis. She has no other symptoms currently. Her rheumatoid arthritis is well controlled on methotrexate. She is a non-smoker. Her father died of mesothelioma. Examination identifies dullness to percussion at the right upper zone. Observations are within normal limits. Chest X-ray shows a partially-filled cavity with a crescent of air.
What is the most likely diagnosis?
What type of organism causes this condition?
Aspergilloma
Fungus
A 47-year-old man is reviewed in the smoking cessation clinic. What condition would contraindicate the prescription of bupropion? - why?
Bupropion should not be used in a patient with epilepsy as it reduces seizure threshold
A 75-year-old man presents to the emergency department with his partner after a fall. A collateral history is taken. At the time, he tripped over a loose rug and fell, with his head hitting the ground first, and lost consciousness for 2 minutes. On examination, there is upper limb bruising, no neurological deficits, and his Glasgow coma score (GCS) is 15. The patient himself recalls the events prior to and after the fall, and has not vomited or had a seizure since the fall and there are no signs of a skull fracture. He has a past medical history of hypertension controlled with amlodipine.
A CT head should be organised within what timeframe? - what aspect of the history indicates the need for this?
CT head within 8 hours - adult >65y with LOC after the fall
A 42-year-old female has presented with vomiting. She has had multiple episodes of vomiting over the past 3 days and has felt extremely nauseous. In addition to this she describes having a constant headache, and has felt particularly tired. Her past medical history includes depression which is managed with sertraline).
On examination, her pulse is 87 beats per minute, blood pressure 127/76mmHg and oxygen saturations of 98% on air. There is no evidence of peripheral oedema or a raised jugular venous pressure. On auscultation of her chest, heart sounds are normal and the lungs are unremarkable. You send for some investigations which yield the following:
Na+ 122 mmol/L (135 - 145)
K+ 3.8 mmol/L (3.5 - 5.0)
Bicarbonate 27 mmol/L (22 - 29)
Urea 3.1 mmol/L (2.0 - 7.0)
Creatinine 86 µmol/L (55 - 120)
Random Blood Glucose 4.1 mmol/L (4 - 11)
Serum osmolality 263 mOsm/kg (275 - 295)
Urine osmolality 857 mOsm/kg (300 - 900)
What is the most likely diagnosis?
How is this condition treated?
SIADH
Fluid restriction
What condition is described by:
marked hyponatremia alongside a low serum osmolality and high urine osmolality
SIADH
Name the drug classes used for secondary prevention of CVD (eg, following a STEMI)
- Dual antiplatelet therapy (aspirin plus a second agent, eg clopidogrel)
- ACE inhibitor
- Beta-blocker
- Statin
List the ECG findings in hyperkalaemia: (5)
Peaked or ‘tall-tented’ T waves (occurs first)
Loss of P waves
Broad QRS complexes
Sinusoidal wave pattern
Ventricular fibrillation
