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GP Conditions > Paper 1 > Flashcards

Paper 1 Flashcards

1
Q

Which virus causes measles?

A

RNA paramyxovirus

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2
Q

Give the values for M+F for prolonged QTc

A

Males >440, Females >470

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3
Q

What can be given for gynaecomastia in bicalumide prostate treatment?

A

Tamoxifen

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4
Q

What is given for hot flushes in goserelin (LHRH) treatment?

A

Methoxyprogesterone acetate

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5
Q

How many months is TB treatment?

A

6 months -> 2 months isoniazid, rifampicin, pyrazinamide, ethambutol + 4 months isoniazid and rifampicin

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6
Q

Which score is used for melanoma?

A

Glasgow 7 point (major = size, colour and shape)

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7
Q

Which diabetic drug is given if triple therapy has failed and BMI >35?

A

GLP-1 analogue (e.g. exenatide)

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8
Q

What is first line for mild-moderate acne?

A

Topical retinoid

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9
Q

Is long-sightedness or short-sightedness a risk factor for retinal detachment?

A

Short

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10
Q

Which drug is associated with skin necrosis?

A

Warfarin and heparin

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11
Q

Which drugs can induce SLE?

A

Tetracyclines, hydralazine, procainamide

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12
Q

What is the most common + aggressive malignant melanoma?

A

Superficial spreading + Nodular

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13
Q

Which heart defects are paradoxical embolisms associated with?

A

ASD and VSD -> embolus migrates to systemic circulation leading to cerebrovascular events

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14
Q

Describe Kernig’s Sign + associated conditon

A

Flexion of hip and knee to 90 degrees before straightening -> meningeal irritation + meningitis

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15
Q

How should long acting insulin dose be corrected during surgery? (%)

A

80% to prevent rebound hyperglycaemia upon referring

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16
Q

What is the most common source of UTIs?

A

GIT to urethra

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17
Q

What is first line ORAL + TOPICAL AB for acne?

A

Oral -> tetracycline (doxycycline)
Topical -> macrolide (clindamycin)

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18
Q

Define serial ECGs in ACS

A

ECG every 10 minutes

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19
Q

What is the first marker to rise and fall in ACS?

A

Myoglobin

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20
Q

Give MONA for ACS

A

Morphine
O2 (if hypoxic)
Nitrates (GTN)
Antiplatelet therapy (aspirin + clopidogrel -> both 300mg)

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21
Q

What is the difference between LMWH and unfractionated heparin in terms of half life?

A

LMWH has a longer half life -> unfractionated used when wanting to move to Cath labs

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22
Q

Which organ impairment would indicate unfractionated heparin?

A

Renal impairment

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23
Q

What is Tirifoban an example of? (NSTEMI)

A

Glycoprotein IIb/IIIa (acts on another coagulation pathway compared to other drugs)

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24
Q

What is the cause of a mitral regurgitation post-MI?

A

Papillary muscle rupture

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25
Q

What is the most common cause of glandular fever?

A

EBV

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26
Q

What is the anatomy of a Type A Stanford aortic dissection?

A

Proximal to left subclavian artery

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27
Q

What is the initial management for an aortic dissection? + First line?

A

500mL bolus to see if they are fluid responsive + crossmatch and transfuse blood

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28
Q

What does an intimal flap indicate on chest CT?

A

Aortic dissection

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29
Q

What is the blood pressure control drug for aortic dissection? + Target BP?

A

IV labetalol -> 100-120mmHg

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30
Q

Which murmur could occur as a complication if a Type A aortic dissection extends proximally?

A

Mid-diastolic high pitched murmur (aortic regurgitation)

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31
Q

Which complicate triad can an aortic dissection cause?

A

Becks -> muffled heart sounds, high JVP, hypotension

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32
Q

Which hep is more common in MSM without recent travel?

A

Hep B

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33
Q

Which type of disease does pseudoxanthoma elasticum (knees, antecubital fossa) appear?

A

Early coronary artery disease

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34
Q

Alcoholic, pain shortly after eating, elevated AST and ALT, epigastric pain spreading to the back, elevated serum amylase -> what is the likely underlying cause?

A

Acute pancreatitis secondary to gallstones

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35
Q

How does acute pancreatitis cause hypocalcaemia?

A

Fat necrosis and chelation of calcium salts

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36
Q

Which type of pancreatitis is seen as a complication of acute pancreatitis and shows as variable contrast enhancement on CT?

A

Necrotic pancreatitis

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37
Q

Biopsy shows mononuclear cell infiltrates with multinucleated giant cells -> diagnosis?

A

GCA

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38
Q

Give the 369 rule for bowel obstructions

A

Small bowel >3cm
Large bowel >6cm
Caecum >9cm

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39
Q

What is a common immediate ileostomy complication to be aware of?

A

High output stoma (>1.5) -> dehydration and electrolyte abnormalities -> replace fluids and can use anti motility (e.g. loperamide and codeine phosphate)

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40
Q
A
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41
Q

Where does somatostatin and dopamine act in the growth hormone axis?

A

Acts on the pituitary to reduce GH secretion -> give dopamine agonist to treat acromegaly

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42
Q

Give the first line management for acromegaly + prolactinoma

A

Acromegaly (surgical) -> transphenoidal resection

Prolactinoma (medical) -> cabergoline (long acting dopamine agonist)

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43
Q

What type of tumour is choriocarcinoma?

A

Germ cell

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44
Q

Testicular lump, elevated T4, palpitations -> diagnosis?

A

Choriocarcinoma -> bHCG -> increases release of thyroid hormone

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45
Q

What is the cause of toxic multi nodular goitre?

A

Iodine deficiency

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46
Q

How does iodine deficiency cause toxic multi nodular goitre

A

Compensatory TSH -> hyperplasia -> nodule formation -> mutations over time -> becomes independent of TSH

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47
Q

Which antibody other than anti-TSH can be found in Graves?

A

Anti-microsomal (anti-TPO)

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48
Q
A
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49
Q

What is bicuspid aortic valve and hypo plastic aortic arch associated with?

A

Coarctation of the aorta

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50
Q

How does ciprofloxacin affect warfarin? (e.g. while used in Antiphospholipid syndrome)

A

Increases INR

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51
Q

What is the management for subclinical hypothyroidism at first appointment?

A

Repeat TSH in 3 months (2 results required before treatment)

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52
Q

In overt hypothyroidism -> how is levothyroxine dose changed in IHD and pregnancy?

A

IHD -> reduce due to stimulant effects of thyroxine
Pregnancy -> increase dose due to increased metabolic rate

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53
Q

What is first line long acting insulin?

A

Levemir (then Lantus)

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54
Q

Which regimen is given if unable to tolerate basal-bolus?

A

Mixed insulin regimen

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55
Q

Give examples of rapid + short + intermediate + long acting insulin

A

Rapid (2-5h) -> novorapid, humalog

Short (5-9h) -> humulin S, actrapid

Intermediate (12-24h) -> humbling I, Insulinatard

Long (16-42h) -> Levemir, Lantus

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56
Q

What happens if 1L NaCl 0.9% stat is given above systolic 90?

A

Central pontine myelinolysis
Cerebral oedema

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57
Q

Which 2 drugs are indicated in pregnant diabetes?

A

Insulin, metformin

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58
Q

After metformin -> what is the HbA1C threshold before starting another diabetic drug?

A

58mmol/L

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59
Q

Most common cause of SBO?

A

Adhesions (following previous surgery)

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60
Q

What is the first line diagnostic + staging investigation for oesophageal cancer?

A

Diagnostic -> endoscopy and biopsy
Staging -> CT CAP

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61
Q

3 months haematuria, flank pain, mass, dragging feeling in testicle -> diagnosis + why does it cause dragging sensation?

A

RCC -> left RCC due to varicocoele formation -> left RCC invades renal vein causing back pressure -> varicocele (right sided drain into IVC and does not cause varicocele)

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62
Q

How does GCA cause vision loss?

A

Invasion into short ciliary arteries -> anterior ischaemic optic neuropathy

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63
Q

Give the first line for extracapsular NOF for subtrochanteric + intertrochanteric

A

Intertrochanteric -> Dynamic hip screw
Subtrochanteric -> IM nail

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64
Q

Asymptomatic gallstones -> diagnosis?

A

Reassurance

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65
Q

Which enzyme is produced by vibrio cholera? + how does this cause watery diarrhoea?

A

Adenylate cyclase -> adenylate cyclase -> increase in cAMP -> inhibits chloride secretion + sodium reabsorption in intestinal lumen -> watery diarrhoea

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66
Q

Struvite crystals, urine pH >7 -> which renal pathology? + which bacteria?

A

Urease producing bacteria -> stag horn calculi

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67
Q

Which 2 genes are associated with coeliac?

A

HLA-DQ2
HLA-DQ8

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68
Q

Which drug class is most associated with ATN?

A

Sulfa- drugs

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69
Q

Which ACR ratio indicates CKD?

A

ACR >3, 2 eGFR reading 3 months apart

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70
Q

As part of a renal transplant -> tacrolimus -> what is a common peripheral side effect?

A

Tac flap

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71
Q

Which electrolyte disturbance is commonly seen in AKI?

A

Hyperkalaemia

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72
Q

what is the leading cause of death in CKD?

A

Cardiovascular disease

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73
Q

Give the triad for Alport’s Syndrome + inheritance pattern

A

Frank haematuria, ophthalmology, sensorineural hearing loss + X-linked

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74
Q

Which nephritic pathology does heroin use increase the risk of?

A

Focal segmental glomerulosclerosis

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75
Q

Hypocomplementenemia + tram track on microscopy, BBV, SLE -> which nephrotic pathology? + type

A

Type 1 membranoproliferative glomerulonephritis

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76
Q

How does nephrotic syndrome affect calcium?

A

Hypocalcaemia -> loss of albumin (main calcium transporter) = less circulating calcium

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77
Q

Which bacteria is associated with aspiration pneumonia?

A

Klebsiella

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78
Q

Give the NT-proBNP thresholds for ECHO in HF

A

> 400 -> 6 weeks
2000 -> 2 weeks

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79
Q

First line infective endocarditis AB

A

Amoxicillin

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80
Q

Give the empirical AB for native + prosthetic valve

A

Vanc
Gent
Rifampicin

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81
Q

Give the ABPI range for PAD

A

0.5-0.9

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82
Q

Which electrolyte is deficient in hyperthyroidism?

A

Calcium

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83
Q

Which investigations after thyroid antibodies?

A

Technecium uptake scan

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84
Q

Heterogenous uptake on technecium scan suggests which type of hyperthyroidism?

A

Toxic multi nodular goitre

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85
Q

Which liver marker is elevated in hyperthyroidism?

A

ALP

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86
Q

During a thyroidectomy -> inferior thyroid artery is ligated -> what is this a branch of?

A

Thyrocervical trunk

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87
Q

Give the management for cerebral toxoplasmosis in HIV

A

Pyrimethamine
Sulfadiazine

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88
Q

Which cancer is associated with AIDS?

A

Anal

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89
Q

Which vaccination is safe in HIV?

A

MEN ACWY

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90
Q

Which GI pathology is crypt hyperplasia associated with?

A

Coeliac

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91
Q

Which GI pathology is associated with reduced goblet cells on microscopy?

A

UC

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92
Q

Which guideline is used for severity of UC? + Give range for mild + moderate/severe

A

Truelove + Witts

Mild: >4 (Rectal mesalazine)

Moderate/Severe: 4-6 (IV corticosteroids to induce remission)

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93
Q

4 Weeks have passed since starting rectal mesalazine for a UC flare -> there has been no improvement -> what can be added as second line?

A

Rectal corticosteroids

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94
Q

Which derm condition is associated with mother/herald patch?

A

Pityriasis rosea

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95
Q

What do Kerley B lines represent?

A

Interstitial oedema

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96
Q

What does a globular heart represent?

A

Pericardial effusion

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97
Q

Which syndrome is montelukast associated with?

A

Churg-Strauss (eosinophilia, vasculitic rash, peripheral neuropathy, respiratory symptoms)

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98
Q

Give the mechanism of carvedilol

A

alpha and beta receptor antagonist

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99
Q

Give an example of an angiontensin 2 inhibitor

A

Losartan

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100
Q

Which complement is low in MPGN?

A

C3 Complement

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101
Q

Which syndrome starting with R causes thyroid hormone resistance?

A

Refetoff Syndrome

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102
Q

Which vitamin deficiency can lead to an accumulation of undifferentiated kertinocytes in striatum spinosum?

A

Vitamin A

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103
Q

Clusters of gram positive cocci -> which organism?

A

Staph aureus

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104
Q

Why is metoclopramide avoided in Parkinson’s?

A

It is a D2 receptor antagonist -> worsen Parkinson motor

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105
Q

Vision loss, dementia, cherry red macula, GM2 gangliosides -> diagnosis

A

Tay-Sachs Syndrome

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106
Q

Dementia, myoclonus, prion -> diagnosis

A

Creutzfeld-Jakob Disease

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107
Q

SLE/Sjogrens/systemic sclerosis, mottled skin, reticulated patches, worse in cold -> diagnosis

A

Lived reticular

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108
Q

Give the class of bromocriptine + how does it affect prolactin

A

Dopamine agonist -> decreases prolactin

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109
Q

Which side BBB + axis deviation means right heart disease?

A

RBBB + LAD

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110
Q

Which hep is porphyria cutanea tarda, lichen plants, cryoglobulinaemia, B cell lymphoma associated with?

A

Hep C (Cryo)

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111
Q

Which 2 catecholamines can nerve endings make?

A

Noradrenaline
Dopamine

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112
Q

Which hep is associated with polyarteritis nodosa?

A

Hep B

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113
Q

Which arteritis affects the aortic arch and branches?

A

Takayasu’s

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114
Q

Which type of haemorrhage is seen in shaken baby syndrome?

A

Subdural haemorrhage

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115
Q

How does secondary hypothyroidism (e.g. pituitary adenoma) affect follicular cells?

A

Atrophy due to decreased production of TSH

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116
Q

Which type of liver disease are Mallory bodies seen in?

A

Alcoholic liver disease

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117
Q

What does absent GAD and low C-peptide (what does this mean?) indicate?

A

T1D -> low C-peptide due to decreased endogenous production of insulin

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118
Q

How does urease-producing bacteria affect urine?

A

Proteus mirabilis -> urease hydrolyses urea to ammonia and CO2 -> increases pH of urine -> growth of struvite crystals

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119
Q

Which type of nephropathy are Kimmelsteil-Wilson lesions associated with?

A

Diabetic nephropathy

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120
Q

Diffuse alveolar infiltrate, pink frothy sputum, chest pain

A

Legionella pneumophilia

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121
Q

Which stone is the most radio-opaque? + Common?

A

Calcium phosphate
Calcium oxalate

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122
Q

Give the values for high + low SAAG + examples of each

A

> 11g/dL -> constrictive pericarditis
<11g/dL -> pancreatitis, malignancy

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123
Q

Give the criteria for asthma exacerbation discharge

A

PERF >75%
Review inhaler technique
Review take home plan
Inform GP for community review within 48 hours

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124
Q

Hyperinflated lung fields on CXR -> Which resp?

A

COPD

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125
Q

What is the mechanism of GLP-1 Mimetics?

A

Mimics incretin -> incretin’s target tissue is beta cells in the pancreas -> stimulate insulin release

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126
Q

What is the mechanism of DPP4-inhibitor?

A

Inhibits DPP4 (breaks down incretin) to allow for incretin’s action on increasing insulin production

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127
Q

What is the first line for COPD? + Give mechanism

A

Ipratroprium bromide (bronchodilator) -> inhibits ACh at muscarinic receptors -> decrease cGMP -> dilates vessels in airways by decreasing smooth muscle

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128
Q

Which antibiotics is used in MRSA in renal insufficiency?

A

Linezolid

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129
Q

Which nerve innervates soft palate, pharynx, larynx? + Which side is the lesion if the uvula is deviated to the right?

A

Vagus
Left

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130
Q

Define Marjolin ulcer

A

Malignant change in a longstanding wound/scar

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131
Q

Give the electrolyte disturbance in RFS

A

Hypophosphataemia, hypokalaemia, hypomagnesaemia

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132
Q

Which deficiency causes wet beriberi? + Give pathophysiology

A

Thiamine deficiency
Affects CVS -> high CO despite RVF

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133
Q

Which peripheral sign can indicate Peutz-Jeghers?

A

Hyperpigmented lips, mouth and other areas

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134
Q

What is Curschmann’s spiral pathognomic for?

A

Asthma

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135
Q

Which organism is linked with CF TB?

A

Pseudomonas aeruginosa

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136
Q

Which tumour arises from the dura mater? + which histology feature?

A

Meningioma
Psammoma body

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137
Q

Which type of renal malignancy is associated with schistosomiasis?

A

Squamous cell carcinoma

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138
Q

Which malignancy can a mutation in CDK2A cause?

A

Malignant melanoma

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139
Q

Which murmur can an aortic dissection cause?

A

Aortic regurgitation if the dissection extends proximally to involve the aortic valve

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140
Q

Which complement is involved in membranoproliferative glomerulonephritis Type II?

A

C3

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141
Q

What is the most common secondary cause of FSGS?

A

HIV

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142
Q

Which vasculitic disease is associated with c-ANCA?

A

Granulomatosis w/polyangiitis

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143
Q

How does a PPI affect Cl- production in the gastric lumen?

A

PPI decreases H+ exchange through Na+/K+ ATPase -> more Cl- available and not used for HCl production -> less Cl secretion through negative feedback

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144
Q

Which area of the GIT is the most common for spontaneous perforation?

A

Duodenum, usually due to ulceration

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145
Q

What is the most common subtype of prostate cancer?

A

Testicular lymphoma

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146
Q

Which neurotransmitter is linked with Alzheimers?

A

Low levels of acetylcholine

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147
Q

What is first line for pertussis?

A

Erythromycin

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148
Q

Which antibiotic can cause a metallic taste?

A

Metronidazole

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149
Q

What is firs line for HF?

A

NT-ProBNP

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150
Q

Give an example of Vaughn-William I + II

A

I -> sodium channel blocker
II ->

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151
Q

Cerebellar symptoms, quadriparesis/hemiparesis, reduced consciousness -> which artery?

A

Vertebrobasilar

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152
Q

Which vision loss is seen with PCA stroke?

A

Contralateral homonymous hemianopia with macular sparing

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153
Q

Which diabetic drug can be a rare cause of pancreatitis?

A

DPP4-inhibitor (e.g. sitagliptin)

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154
Q

Give the Ig status for acute + chronic Hep B infection

A

Acute IgM > IgG
Chronic IgG > IgM

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155
Q

What is a congenital cause of aortic stenosis? + which other heart pathology is this associated with?

A

Bicuspid valve
Co-arctation of aorta

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156
Q

Give the 2 most common organisms in acute cholangitis

A

E.coli
Klebsiella

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157
Q

Give first line for ascending cholangitis

A

IV Co-amoxiclav (or cefuroxime/metronidazole) for 5-7 days then ERCP 48h after starting AB to clear any obstructions

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158
Q

If ERCP is not available -> what is second line?

A

Percutaneous transhepatic cholangiography

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159
Q

Most common organism in bronchiectasis

A

H. influenzae

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160
Q

Which enzyme can lead to emphysema?

A

Alveolar macrophages and neutrophils release macrophages which releases elastase -> if uncontrolled (e.g. through smoking) -> alveolar destruction -> dilatation of air sacs and destruction of alveolar walls

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161
Q

Severe psoriatic exacerbation, febrile, 90% scale red patches -> treatment?

A

Methotrexate

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162
Q

What is mandatory prior to starting isotretinoin in females?

A

Contraception due to teratogenicity

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163
Q

Give the criteria for surgery in EDH

A

Midline shift >5mm
Volume >30cm3
EDH thickness >15mm
GCS<8
Neurological deterioration

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164
Q

What does aspirin inhibit? + what does this mediate?

A

Inhibits COX1 predominantly -> medicates thromboxane A2 -> disrupts TXA2-mediated platelet aggregation

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165
Q

Give the effects of carbamazepine on U+E

A

Hyponatraemia
SIADH

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166
Q

Which type of bacteria poses the most risk for patients with hyposplenism

A

Encapsulated

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167
Q

5-HIAA, facial flushing, diarrhoea, bronchospasm -> diagnosis? + Which heart valve pathology is most common?

A

Carcinoid tumour
Tricuspid regurgitation

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168
Q

Which syndrome demonstrates necrolytic migratory erythema which is pathognomic?

A

Glucagonoma Syndrome (pancreatic tumour that overproduces glucagon)
Associated with mild diabetes, anaemia

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169
Q

Give the pathology of diabetic nephropathy starting from hyperglycaemia

A

Hyperglycaemia promotes the glycosylation of efferent arteriole surface -> hyaline arteriole sclerosis -> hyperfiltration in the glomerulus and mesangial cell expensation -> over time leads to reduced filtration and leakiness

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170
Q

Which cells are preferentially lost during cerebellar degeneration from chronic alcohol abuse?

A

Purkinje cells

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171
Q

Which agent can be given in beta blocker overdose?

A

Glucagon
+ IV fluids for hypotension, atropine for bradycardia

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172
Q

Which meningitis is common in immunocompromised patients? + Which staining is used?

A

Cryptococcal (TB or fungi)
India ink negative stain -> encapsulated organisms

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173
Q

Young, ophthalmological pathologies, frank haematuria -> which syndrome? + Which gene and inheritance pattern?

A

Alport Syndrome
COL4A5
X-linked

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174
Q

Young, episodic chest pain at rest and night -> diagnosis?

A

Prinzmental angina

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175
Q

Meningitis with hyponatraemia and hyperkalaemia, adrenal haemorrhage on imaging -> diagnosis?

A

Waterhouse-Friedrichsen Syndrome

176
Q

How long to wait before H. pylori test after PPI trial?

A

2 weeks

177
Q

Which blood group increases the risk of peptic ulcers?

A

O

178
Q

How do NSAIDs cause gastric ulcerations?

A

Inhibit COX-1 -> reduction in prostaglandins -> reduction in gastric mucus secretion

179
Q

Ataxia, dysarthria, loss of reflexes, kyphoscoliosis, positive Babinski, young, autosomal recessive, GAA repeat mutation in FXN -> diagnosis?

A

Friedrich’s Ataxia

180
Q

What is the most common cause of death in Friedrich’s?

A

HOCM

181
Q

Herald patch, previous sore throat, widespread rash -> diagnosis?

A

Pityriasis rosea

182
Q

Which organism is most associated with pityriasis rosea?

A

HHV 6/7

183
Q

What is start if stroke symptoms has an onset <4.5h? + what must be ruled out? + target BP?

A

Thrombolysis
Non-contrast CT to rule out haemorrhage
180/110

184
Q

Is aspirin 300mg or thrombolysis given first?

A

If thrombolysed -> give aspirin and anti platelet therapy the following day

185
Q

Give the time period for thrombectomy + two stroke areas indicating thrombectomy

A

<24h
Proximal anterior
Posterior circulation stroke

186
Q

Which monoclonal antibody is used for recurrent C.diff?

A

Bezlotoxumab

187
Q

What should be suspended from C.diff infection?

A

PPI

188
Q

Which carcinoma arises from Kulchistsky cells?

A

SCLC

189
Q

Give some autonomic dysregulation symptoms in LES

A

ED, postural hypotension, dry mouth

190
Q

Give the NT-proBNP values for transthoracic ECHO in 2w + 6w

A

> 2000 pmol/L -> 2 weeks
400 pmol/L -> 6 weeks

191
Q

Give the ABCDE CXR in HF

A

Alveolar oedema
B lines (Kerley)
Cardiomegaly
Dilated upper lobe vessels
Effusion

192
Q

Why is bisoprolol preferred over atenolol?

A

Bisoprolol is more cardioselective and results in better outcomes in HF patients

193
Q

As 3rd line therapy -> when can’t ivabradine be used?

A

HR <75

194
Q

What % reduction is acceptable in CKD when using ACEI?

A

25

195
Q

First line test for female + male gonorrhoea + chlamydia + trichomoniasis

A

Male -> FVU, NAAT chlamydia, gonorrhoea, culture trich
Fem -> Swab

196
Q

Which arthritis is more commonly associated with chlamydia?

A

Reactive -> can’t see, pee or climb a tree

197
Q

What is the most common renal manifestation of SLE?

A

Type IV diffuse proliferative glomerulonephritis

198
Q

Intense thirst, polyuria, weakness, takes lithium for Bipolar -> diagnosis?

A

Nephrogenic DI from chronic lithium use

199
Q

Which clinical sign is a strong indication of lithium toxicity?

A

Hyperreflexia

200
Q

Which cancer can haemodialysis cause?

A

RCC

201
Q

How can RCC cause vaircoele? + which side?

A

Left sided varicoele from left RCC compression of the left renal vein

202
Q

Which type of effusion does HF cause?

A

Transudative

203
Q

Which triad is seen in asthma-exacerbated respiratory disease?

A

Samter’s Triad -> aspirin sensitivity, nasal polyps, bronchial asthma

204
Q

What is ninetadanib and perfenidone used for? + Give FVC requirements for perfenidone

A

Both are anti-fibrotic for IPF
FVC 50-80%

205
Q

What is the most common type of MODY? + Which gene is affected?

A

Type 3
Hepatocyte nuclear factor-1-alpha

206
Q

Which hypersensitivity is Grave’s disease?

A

Type 2
Specific antibody against antigen

207
Q

What is sacubitril valsartan indicated for? + What does it replace in therapy?

A

3rd line option for HF (along with ivabradine and digoxin [with AF])
Replaces ACEI when used

208
Q

Give the first line for GBS

A

IVIG for 5 days

209
Q

Give the 3 times to take a serum tryptase after an anaphylactic reaction

A

Immediately
1h
24h

210
Q

What is given after an anaphylactic for patients to take home?

A

2 adrenaline autoinjectors

211
Q

Give the tests for contact and food reactions

A

Contact -> patch
Prick - food

212
Q

Give 3 criteria for blood transfusion in context of anaemia

A

Hb <70
Hb <80 + cardiac
Active bleeding

213
Q

Which staging is used for colorectal carcinoma?

A

Dukes criteria

214
Q

Which investigation for suspected bladder cancer?

A

Cystoscopy

215
Q

What is 5-fluorouracil used for?

A

Renal SCC (esp in mets)

216
Q

Which blood test is used for neuroleptic malignant syndrome?

A

Serum creatine kinase

217
Q

What is the initial management for NMS?

A

Rapid fluid resus to prevent AKI secondary to rhabdomyolysis

218
Q

What class is dantrolene? + Give 2 conditions it’s used for

A

Muscle relaxant -> reduces metabolic demand

Malignant hyperthermia
NMS

219
Q

Stiff shoulder with pain, limited external rotation -> what is a risk factor?

A

Diabetes

220
Q

Single unprovoked seizure, type 2 license for work -> how long to stay off the road?

A

5 years seizure free

221
Q

Give the class of donepezil

A

Acetylcholinesterase inhibitor -> boosts cholinergic neurotransmission in Alzheimers (used for symptomatic relief)

222
Q

Give the histological changes after MI

A

Neutrophil invasion (6-12h)
Macrophages (24-72h)
Granulation tissue (1-2w)

223
Q

Give the chelating agent for iron overdose

A

Desferrioxamine

224
Q

Give the changes in potassium during rhabdomyolysis

A

Increases (along with CK)

225
Q

What are rose spots associated with?

A

Typhoid (high fever, bloody diarrhoea)

226
Q

Which vaccine is given coeliac disease?

A

Pneumococcal due to functional hyposplenism

227
Q

What is the most common cause of SAH?

A

Trauma

228
Q

Which medication is given once SAH is diagnosed?

A

Nimodipine (CCB) to prevent vasospasm
Generally given for 3 weeks

229
Q

Which vasopressor + anti-arrhythmic is given during resuscitation + when?

A

1mg Adrenaline, 300mg amiodarone
End of 3rd CPR cycle

230
Q

What is first line for cluster headache?

A

Subcutaneous sumatriptan, high flow O2

231
Q

Give the mechanism of triptans

A

5HT-1B/D agonists for vasoconstriction

232
Q

What is the prophylaxis for cluster headaches?

A

Verapamil

233
Q

Give the triad name for iliac artery occlusion giving symptoms of thigh/buttock claudication, absent or reduced femoral pulse, ED

A

Leriche Syndrome

234
Q

Which condition has the 3 stages: catarrhal, paroxysmal, convalescent

A

Whooping coughWhich

235
Q

Which marker is raised in any germ cell tumour? + When do AFP + bhCG raise?

A

LDH rises in any tumour
AFP -> Yolk sac, teratomas
bHCG -> seminomas, choriocarcinoma

236
Q

Which cancer arises from inhibition of p53 and rb TSGs?

A

HPV inhibits p53 and rb
-> CIN

237
Q

What is first line treatment for fast AF?

A

IV fluids

238
Q

Redcurrant jelly sputum, upper lobe, gram negative rod, incompetent swallow -> which organism pneumonia?

A

Klebsiella pneumoniae

239
Q

What is first line for Alport’s (X-linked)?

A

ACEI

240
Q

Give first line + second line for stable angina

A

1 -> bb OR non-dihydropyridine
2 -> beta blocker and dihydropyridine CCB

241
Q

Give a rate control + rate limiting option for AF in haemodynamically stable patients

A

Rate control -> BB (bisoprolol)
Rate limiting -> diltiazem

242
Q

Give the effects on BP + HR from complete section at cervical level + give pathophysiology

A

Hypotension
Bradycardia
Loss of sympathetic function, unopposed parasympathetic function leading to bradycardia and hypotension

243
Q

Why is CT chest important in myasthenia gravis?

A

10% have thymoma, 70% have thymic hyperplasia

244
Q

Which stains are used for SCC + BCC?

A

SCC -> EMA
BCC -> Cytokeratin

245
Q

What is the Leser-Trelat sign associated with?

A

Seborrheoic keratoses (gastric cancer)

246
Q

What is first line for CRVO?

A

Fluorescein angiography

247
Q

What is first line for CRVO? + flashing floaters after, which complication has occurred?

A

Intravitreal VEGF inhibitor
Retinal detachment

248
Q

Which asthma drug can reduce seizure threshold?

A

Theophylline

249
Q

What is the most common cause of Addison’s worldwide?

A

TB

250
Q

What is the electrolyte disturbance in Addisonion crisis?

A

Hyponatraemia, hyperkalaemia, metabolic acidosis

251
Q

How is NMS and SS differentiated by pupils + reflexes

A

SS -> dilated pupils, hyper-reflexia
NMS -> normal pupils, hypo-reflexia

252
Q

Which lung cancer is associated with HPOA?

A

Hypertrophic osteoarthropathy (onion skin on x-ray) -> SCC

253
Q

Which lung cancer is associated with early metastases to the brain?

A

SCLC

254
Q

What is the time criteria for CKD?

A

3 months

255
Q

What is first line for UTI in children?

A

Co-amoxiclav
Cephelexin

256
Q

Which hep infection is lichen planus associated with?

A

Hep C

257
Q

What is the overall most common cause of tonsillitis?

A

Rhinovirus
(GAS for bacterial cause)

258
Q

How is aortic sclerosis and stenosis differentiated?

A

Stenosis has no radiation to the carotids

259
Q

Which malignancy is lichen planus associated with?

A

SCC of the skin

260
Q

Which side of the heart is louder during expiration?

A

More blood flow in left side as pulmonary flow increases due to less expansion of lungs

261
Q

What is the most common cause of status epilepticus in children + adults?

A

Adults -> epilepsy (poor compliance)
Children -> febrile convulsions

262
Q

When is IM benzylpenicillin given in community for meningitis?

A

Meningococcal suspected -> rash, signs of sepsis

263
Q

Give upper zone causes of fibrosis

A

Sarcoidosis
Coal miner pneumoconiosis
Ankylosing spondylitis
Silicosis
Hypersensitivity pneumonitis
CF

264
Q

What is the most common cause of fibrosis? + which zone

A

IPF -> lower zone
Asbestosis
Drugs -> methotrexate, amiodarone, bleomycin
Radiation
Rheumatoid -> SLE, RA

265
Q

Which organism causes pneumococcal meningitis? + which type of haemolysis?

A

Strep pneumonia (gram positive coccus)
Alpha

266
Q

What is first line gastric + oesophageal varices?

A

Sclerotherapy -> gastric
Band ligation -> Oesophageal

267
Q

How do burns + raised ICP cause ulcers?

A

Burns -> hypovolaemia causes reduced perfusion to stomach lining -> Curling Ulcer

Raised ICP -> increased vagal stimulation -> increased gastric acid secretion -> Cushing ulcer

268
Q

What is Rigler’s sign indicative of?

A

Gas on either side of bowel wall -> Large pneumoperitoneum

269
Q

What is the most common cause of acute pancreatitis?

A

Gallstones

270
Q

How do NSAIDs exacerbate asthma?

A

COX inhibitor -> leukotriene synthesis increases -> bronchoconstriction

271
Q

Give the treatment for mild + moderate + severe acne rosacea (worsens in sunlight, onset with stress, butterfly distribution, worse with vasodilators (e.g. amlodipine)

A

Briminodine
Metronidazole
Oxytetracycline

272
Q

What the medical management of thyroid storm? + which effect does it induce?

A

Lugol’s solution -> Wolff-Chaikoff effect (contains iodine but inhibits thyroid hormone production by inhibiting iodine organification)

273
Q

Give the 2 antibiotics given in acute cholecystitis

A

Cefotaxime
Metronidazole
to cover gram positive, negative and anaerobes

274
Q

What primary prevention can be given in Lynch syndrome?

A

Aspirin

275
Q

Why is flexible sigmoidoscopy not preferred in diverticulitis?

A

Risk of perforation is increased due to false lumens (diverticulae)

276
Q

Which arrhythmia can MR cause?

A

AF

277
Q

Which medication is given for metallic heart valves?

A

Vitamin K antagonist -> Warfarin

278
Q

How do you differentiate orbital cellulitis + peri orbital abscess?

A

Orbital cellulitis causes visual disturbances

278
Q

Which imaging is gold standard for optic neuritis?

A

MRI orbit with contrast

278
Q

What is P-mitrale associated with?

A

MR

279
Q

What is the most common cause worldwide of hypothyroidism?

A

Iron Deficiency (Hashimoto’s in developed world)

280
Q

Which type of cells are over expressed in asthma?

A

T-helper type 2 cells

281
Q

Which cancer is Hashimoto’s associated with?

A

Non-Hodgkin’s Lymphoma

282
Q

How does an ACEI cause a dry cough?

A

ACE normally breaks down bradykinin (causes bronchoconstriction)
-> ACEI -> reduces degradation and bradykinin accumulates in upper and lower respiratory tracts

283
Q

What is the most common cause of mesenteric ischaemia?

A

Embolus in SMA, most due to AF

284
Q

Give a body part involved in essential tremor + how is ET affected with alcohol and benzodiazepines use?

A

Head
Improves

285
Q

Which type of sepsis does agranulocytosis lead to?

A

Neutropenic

286
Q

What is the advice for flying post-pneumothorax?

A

Fly 1 week after post-check CXR

287
Q

Give the management for both ureteric and renal <5mm stones + ureteric >10mm + renal 10-20 + renal >20mm

A

Watchful waiting
Uteroscopy
EWSL
PCNL

288
Q

What is the treatment for active cancer after PE?

A

LMWH for 6 months

289
Q

What is the limit for statins before discontinuing?

A

3x upper limit of ALT/AST

290
Q

Which shoulder pathology is hypothyroidism a risk factor?

A

Adhesive capsulitis

291
Q

Give the 3 phases of adhesive capsulitis

A

Freezing 2-9 months - pain
Frozen 4-12 months - restricted movement
Thawing 12-24 months - gradual improvements

292
Q

Which nerve palsy is seen in Lyme disease?

A

Early disseminated -> facial nerve

293
Q

Give a cardio manifestation of Lyme disease

A

AV block

294
Q

What biologic is first line for metastatic seminoma?

A

Cisplatin - platinum based therapy

295
Q

What ECG changes is seen in tricyclic antidepressant?

A

QRS widening

296
Q

Give the triad seen in HUS from E.coli O157 shiga toxin

A

Thrombocytopenia, haemolysis and renal failure

297
Q

What is the gold standard investigation for bronchiectasis?

A

CT Thorax

298
Q

Give the gold standard investigation for bullous pemphigoid (bullae, does not affect mouth)

A

Skin biopsy with direct immunoflourescence

299
Q

In DKA -> what are the ranges for K+ for treatment?

A

> 5.5 nothing
3.5-5.5 40mmol/2h K+
<3.5 -> ITU/HDU consideration

300
Q

What is the signet ring sign indicative of on a CT chest?

A

Bronchiectasis from multiple dilated bronchi

301
Q

What medication change should take place if patient has long term HF not controlled properly and has LVEF <35%

A

Switch ACEI to ARB

302
Q

Which type of rash is seen in rheumatic fever?

A

Erythema marginatum

303
Q

Give the mechanism of metronidazole + effectiveness on aerobic organisms

A

Reduced by anaerobic only -> disrupts DNA replication
Ineffective against aerobic

304
Q

Give 2 investigations for long QT syndrome

A

ECG
Holter

305
Q

What is first line for long QT syndrome? + refractory?

A

Beta blocker and lifestyle
ICD

306
Q

What is first line for Bell’s palsy?

A

Oral prednisolone

307
Q

What the management for:

1) 5-8 INR, no bleeding
2) >8, no bleeding

A

1) Withold 1-2 doses
2) 1-5mg oral vitamin K

308
Q

What is the blood test for sarcoidosis?

A

Serum ACE (elevated)

309
Q

What is the pathophysiology of hypercalcaemia in sarcoidosis?

A

Increase in alpha-1-hydroxylase -> activates vitamin D

310
Q

How do opioids cause respiratory depression?

A

Mu receptors cause medullary diminished central response to hypercapnia and hypoxia

311
Q

Give the first line medical treatment for achalasia

A

Long acting nitrate
CCB (nifedipine)

312
Q

Which imaging is used in acute diverticulitis?

A

CT abdo pelvis

313
Q

What is the metabolic cause of DKA?

A

Unopposed lipolysis and oxidation of FFAs -> ketoacidosis

314
Q

What is the most common organism in adult conjunctivitis?

A

Adenovirus

315
Q

Diverticulitis -> bubbles in urine -> which complication?

A

Colovesical fistula

316
Q

How is retrobulbar optic neuritis differentiated?

A

Normal optic disc on fundoscopy with eye pain and vision loss

317
Q

Which supplement is given with methotrexate?

A

Folic acid

318
Q

How to differentiate between myxoedema criss + thyroid storm?

A

Myxoedema -> hypothermia <35.5
Thyroid storm >40

319
Q

Which antibodies can cross placenta and cause neonatal lupus leading to complete heart block with SLE mother?

A

Anti-Ro

320
Q

What is the most common type of renal complication in SLE

A

Diffuse proliferative glomerulonephritis

321
Q

What is required immediately if Torsades de Pointes is detected?

A

Magnesium sulphate

322
Q

Which condition affects desmoglein-1?

A

Staph aureus -> impetigo

323
Q

Which tumour marker is elevated in non-seminamatous testicular cancer?

A

APC

324
Q

What is the most likely complication of chronic pancreatitis?

A

Oteoporosis

325
Q

Give the treatment for cellulitis with facial involvement

A

Co-amoxiclav
or Erythromycin with metronidazole

326
Q

Which serious skin condition can occur following varicella?

A

Nec fasc
T1 = polymicerobial
T2 = strep pyogenes
T3 = marine
T4 = fungal

327
Q

What can a left sided varicoceole indicate?

A

left sided RCC

328
Q

Which CT chest finding will you find with RCC?

A

Canonball metastases

329
Q

What is intravesical mitomycin C given for?

A

Post-surgery TURBT for bladder cancer

330
Q

How to differentiate between CES and spinal cord mets?

A

CES -> LMN signs only

331
Q

Which reflex outcomes differentiates CES and CMS

A

CMS -> knee reflex preserved, ankle lost
CES -> both lost

332
Q

What is the gold standard for anti-GBM? + What is a key finding?

A

Renal biopsy
Crescenteric glomerulonephritis

333
Q

Tender singular goitre -> diagnosis?

A

Subacute granulomatous goitre (de Quervains)

334
Q

Give the calculation for estimated serum osmolality

A

(2*Na) + urea + glucose

335
Q

Pleural thickening, chest pain, weight loss -> diagnosis?

A

Pleural mesothelioma

336
Q

Which bloods is used for diagnosing NMS?

A

Serum creatine kinase

337
Q

Which lung cancer is associated with SVCO?

A

SCLC

338
Q

Which cancer risk increases in acromegaly?

A

Colorectal

339
Q

What is first line for serotonin syndrome?

A

Cyproheptadine

340
Q

Give a notable side effect of GLP-1 mimetic and DPPIV-inhibitors

A

Acute pancreatitis

341
Q

Which antibiotic is given second line for acne with history of DVT?

A

Lymecycline

342
Q

Epigastric pain improves after eating -> where is the location of the ulcer?

A

Duodenum

343
Q

Which endocrine complication can occur from use of lithium?

A

Hypothyroidism

344
Q

What is the most common organism in encephalitis + first line?

A

HSV
IV acyclovir

345
Q

What is first line for SCLC + NSCLC?

A

Chemotherapy with radiotherapy
Surgical resection

346
Q

CXR -> cough, dyspnea, lower lung base bullae, young -> diagnosis?

A

A1AT

347
Q

What does a testicular blue dot sign indicate?

A

Torsion of testicular appendage (cremasteric reflex preserved)

348
Q

How does ARB cause hyperkalaemia?

A

ARB blocks production of aldosterone -> less excretion of K+

349
Q

COPD not managed with bronchodilator -> which FEV1 value for next line + What is next line?

A

<80
Inhaled tiotroprium (LAMA) combined with salmeterol (LABA)

350
Q

What is the significance of folliculitis on chest with other infective symptoms?

A

Late stage HIV -> HIV serology

351
Q

Which cancer is actinic keratoses associated with?

A

SCC

352
Q

When is septic shock diagnosed?

A

Severe sepsis + hypotension + raised lactate despite fluid resus

353
Q

Which type of glomerulonephritis can IgA develop into?

A

Rapidly progressive -> loss of eGFR 50% or 50% crescent formation <3M

354
Q

What prophylaxis is required after splenectomy?

A

Daily Pen V

355
Q

What is first line for P.falciparum? + Give the triad + when is step down started?

A

IV artesunate
Hypotension, hypoglycaemia, parasitaemia >10%
step down to oral at <1%

356
Q

Which RTA is hypergammaglobulinaemia associated with?

A

RTA (Type 1) - Fanconi -> distal RTA
Hypokalaemia, hypophosphataemia,

357
Q

COPD exacerbation, life threatening features -> tried nebulised salbutamol and hydrocortisone -> next steps?

A

40mg prednisolone, admit to hospital, review in the morning

358
Q

SIADH -> what is first line?

A

Fluid restriction

359
Q

Good response to synacthen test -> what does this rule out?

A

Addison’s

360
Q

Bronchiectasis, pseudomonas aeruginosa infections, resistance to fluoroquinolone -> what is the next management?

A

Trial nebulised colistin and chest physio

361
Q

Swelling, dull dragging pain in scrotum -> diagnosis?

A

Varicocoele

362
Q

Which vitamin D supplement does not require kidney hydroxylation?

A

Alfacalcidiol (1-hydroxycholecalciferol)

363
Q

Which endocrine pathology is associated with congestive cardiac failure?

A

Myoedema (hypothyroidism)

364
Q

Which HSV is more common in viral meningitis?

A

HSV2 > HSV1

365
Q

What is the most common bacterial meningitis in neonates?

A

GBS

366
Q

What is contraindicated in ACS if hypotensive?

A

GTN

367
Q

How is a posterior STEMI seen on ECG? + Which artery?

A

Reciprocal only ST depression V1-4
Posterior descending branch of RCA

368
Q

Painless indurated penile ulcer -> diagnosis?

A

Syphilis (trepenoma pallidum)

369
Q

How is primary and secondary Conn’s differentiated?

A

Primary -> increase aldosterone, negative feedback = low renin
Secondary -> inappropriate activation of RAAS -> increases both

370
Q

What is Virchow’s node significant for?

A

Upper GI malignancy

371
Q

Close contacts with what can cause which parasitic encephalitis?

A

Toxoplasmosis

372
Q

Define decubitus angina

A

Angina symptoms on laying flat

373
Q

Give the ECG change in prinzmental angina

A

Transient ST elevation due to coronary artery vasospasm

374
Q

Which drug can cause coronary artery spasms?

A

Cocaine

375
Q

How to know if fibrinolysis has worked?

A

1 hour ECG afterwards for STEMI

376
Q

What is a good agent to use to reduce resp rate and breathlessness without causing hypoxia or hypercapnia?

A

IV morphine

377
Q

What can ventricular wall aneurysms (persistent ST elevation) lead to?

A

Stroke due to thrombi formation from turbulent blood flow in ventricle

378
Q

Give the effect of hypoparathyroidism on phosphate and calcium

A

Low calcium, high phosphate

379
Q

Give the BM targets for fasting after waking + before meals

A

Fasting BM after waking = 5-7
Before meals = 4-7

380
Q

What is first line septic shock?

A

IV adrenaline/noradrenaline infusion

381
Q

After fluid resus, when is insulin given in HHS?

A

Ketosis

382
Q

Why is ketosis seen less in HHS?

A

There is more circulating insulin -> drives glucose into cells -> turns off ketotic pathways

383
Q

What is first line medical management in phaeochromocytoma?

A

Alpha blocker (phenoxybenzamine) then beta blocker

384
Q

Give the genetic mutations for MEN1 + MEN2

A

MEN1
RET

385
Q

What does the liver increase the production of in compensation for hypoalbuminaemia? + how does this affect the blood?

A

Clotting factors
Hypercoagulability (plus loss of antithrombin III in urine)

386
Q

Which type hypersensitivity reaction is acute interstitial nephritis?

A

Type IV

387
Q

What causes prinzmental angina?

A

Coronary spasm

388
Q

After GTN and non-dihydropyridine CCB -> what is second line? + for asthma?

A

Switch verapamil to dihydropyridine and BB

Asthma -> avoid beta blockers -> ivabradine

389
Q

Which histological type carries the worse prognosis and progression to end stage renal disease in FSGS?

A

Collapsing type

390
Q

How does CKD cause bone and joint pain with reduced mobility?

A

CKD -> reduced 1-alpha hydroxylase -> reduced activation of vitamin D (active form = 1,25-dihydrocholecalciferol)

391
Q

Why is there crepitus on palpation of MRSA severe cellulitis?

A

Nec fasc from anaerobic organisms causing gas

392
Q

How would you treat A1AT?

A

Like COPD

393
Q

Which 2 enzymes is implicated in A1AT? + Therefore, what does A1AT deficiency lead to?

A

Inhibit protease
Prevents neutrophil elastase from breaking down elastin

-> Alveolar destruction and emphysema

394
Q

Which other system can A1AT affect?

A

Liver -> cirrhosis -> scleral icterus

395
Q

Which imaging for diagnosing PSC?

A

MRCP

396
Q

Are intra or extra hepatic ducts affected in PSC + PBC?

A

PSC -> inside and outside
PBC -> inside only

397
Q

Which dermatological pathology is associated with Parkinson’s?

A

Seborrhoeic dermatitis

398
Q

How do you differentiate white out in pleural effusion and total lung collapse?

A

Lung collapse -> towards white out
Pleural effusion -> away

399
Q

Which blood gas will primary hyperaldosteronism show?

A

Metabolic alkalosis (from loss of H+ with K+)

400
Q

What type of diet is required power bowel resection?

A

High protein
Low fat

401
Q

What is seen in LHF + Pulmonary hypertension for mPAP + pCWP?

A

PH -> >20mmHg mPAP, normal pCWP
LHF -> increase both

402
Q

How does alcohol affect magnesium?

A

Decreases (which decreases potassium)

403
Q

How is SJS and TEN differentiated?

A

SJS <10% skin involvement
TEN >30%

Both have mucosal involvement

404
Q

If T1D not well controlled, how much is the increase in long acting and short acting?

A

Both 10%

405
Q

What is the first line for pancreatic head tumour?

A

Whipple’s (pancreatoduodenectomy)

406
Q

Give a dermatological condition associated with otitis externa and blephritis

A

Seborrhoeic dermatitis

407
Q

Give the bowel screening programme

A

Over 60 to 74, every 2 years, qFIT

408
Q

What can guttate psoriasis turn into?

A

Plaque psoriasis

409
Q

What is the reversal agent for beta blockers?

A

Glucagon

410
Q

What is given in long term + short term serotonin syndrome?

A

Long term -> cyproheptadine
Short term -> benzo

411
Q

Which bundle branch + fascicular blocks causes LAD + RAD?

A

LAD -> left anterior fascicular block, LBBB + inferior MI
RAD -> left posterior fasciular block + lateral MI

412
Q

Tonsillitis can cause which type of psoriasis?

A

Guttate psoriasis

413
Q

Which derm condition is associated with a herald patch?

A

Pityriaisis rosea

414
Q

Give the target + step up targets in diabetes after metformin has not managed?

A

Target = 53
Step = 58

415
Q

Which lobe is the most commonly affected by aspiration pneumonia?

A

RLL

416
Q

Give the UTI treatment course for non-pregnant + pregnant + male

A

Non-pregnant - 3 days (7 days if catheterised)
Pregnant and male - 7 days

417
Q

Give the AB for pyelonephritis in mild-moderate non pregnant + pregnant + severe

A

Mild-moderate non pregnant -> cefalexin, co-amox
Pregnant - cefalexin
Severe - IV co-amoxiclav +/- gentamicin

418
Q

Give the timing for CT head for:
GCS<12
GCS<15 in 2 h
Open or depressed skull fracture
Basal skull fracture
>1 vomiting
Focal neurological deficit

+

> 65
Bleeding disorders
Dangerous mechanism
30 minutes retrograde amnesia

A

1h

8h

419
Q

Wickhams striae, Koebnar, itchy rash on wrist, URTI, oral mucosal involvement -> diagnosis?

A

Lichen planus

420
Q

What is first line for arteriovenous malformation in kidneys?

A

Embolisation

421
Q

IgA deposition in dermal cells on immunofluorescence, papules and vesicles -> diagnosis? + management?

A

Dermatitis herpetiformis
Dapsone

422
Q

Give the 4 symptoms of pellagra + which vitamin?

A

B3 (niacin)
Diarrhoea, dermatitis, depression, dementia

423
Q

Polymorphic VT -> what is first line?

A

IV magnesium sulphate 2g

424
Q

What are 2 side effects of oral iron?

A

Black stools
Constipation

425
Q

Give 2 complications 24-48h after + before + after 4 weeks pancreatitis

A

24-48 -> necrotising pancreatitis
Before -> peripancreatic fluid
After -> pseudocyst

426
Q

How to calculate 24h insulin?

A

Weight x 0.5-0.75

427
Q

Which Duke stage requires adjuvant chemotherapy?

A

Duke C (regional lymph node involvement)

428
Q

Give the surgical repair for a large direct inguinal hernia + bilateral

A

Large direct -> open mesh repair
Bilateral -> lap mesh repair

429
Q

What is the next step if recent stroke/TIA or >75 in massive PE?

A

Treatment dose LMWH

430
Q

Diabetic, IVDU, recurrent abscess -> what should be considered when selecting an antibiotic?

A

MRSA

431
Q

Younger, fever, rash, gram negative diplococci -> diagnosis?

A

Gonococcal

432
Q

What rhythm can chronic MR cause?

A

AF due to chronic remodelling of LA which disrupts electrical activity of SAN

433
Q

What does portal hypertension indicate?

A

Portal hypertension (transudative)

434
Q
A

GP Conditions (5 decks)

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