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GP Conditions > Paper 2 > Flashcards

Paper 2 Flashcards

1
Q

Which molecules do MAO-A + MAO-B deaminate?

A

A -> serotonin + catecholamines (adrenaline and noradrenaline)

B -> dopamine and phenylephrine

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2
Q

How does parity affect breast cancer risk?

A

Multiparity is protective against breast cancer

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3
Q

Which derm condition can COCP cause?

A

Erythema nodosum

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4
Q

Why is good oral hygiene advised when taking bisphosponates?

A

Can cause osteonecrosis of the jaw (plus atypical femoral fractures and osteonecrosis of the external auditory canal)

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5
Q

How is ductal carcinoma in situ and no special type breast cancer differentiated?

A

Carcinoma in situ will not have a lump and show calcifications in the breast on imaging.

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6
Q

How is laryngeal cancer recurrence monitored after treatment?

A

Flexible laryngoscopy -> 1st year (every 1-2 months), 2nd year (every 2-3 months), 3rd year (every 3-4), 4th year (every 4-6), >5th year (yearly)

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7
Q

What is the difference in treatments between glottic and subglottic laryngeal malignancies?

A

Glottic/supraglottic -> single modality
Subglottic -> combination therapy

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8
Q
A
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9
Q

Which hormone is produced by decidual cells of the placenta?

A

Relaxin -> hormone which acts to loosen up ligaments to prepare body for birth

(hCG from syncytiotrophoblasts)

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10
Q

Which Hb do sickle cell disease lack?

A

HbA

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11
Q

Why are sickle cell patients given lifelong phenoxymethylpenicillin?

A

If there are repeated episodes of splenic sequestration -> splenic dysfunction and fibrosis -> autosplenectomy -> increased vulnerability to organisms

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12
Q

Give the two biologics used for metastatic III melanoma (N + I)

A

Nivolumab (PD-1 Inhibitor)
Ipilimumab (CTLA-4 inhibitor)

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13
Q

Give the Garden stages for NoF

A

1 - Incomplete, undisplaced
2 - complete, undisplaced
3 - complete, minimally displaced
4 - complete, displaced

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14
Q

What is the criteria for THR + Hemiarthroplasty?

A

Able to live independently previous without significant co-morbidities and can carry out ADLs -> THR (otherwise hemiarthroplasty)

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15
Q

Which patients is IM better in?

A

Younger patients

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16
Q

Give the isoforms for HbA + HbA2 + HbF

A

HbA -> alpha 2 beta 2
HbA2 -> alpha 2 delta 2
HbF -> alpha 2 gamma 2

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17
Q

Menorrhagia -> what is first line hormonal + non-hormonal treatment?

A

Hormonal -> levonorgestrel IUS (min 12M)
Non-hormonal -> Tranexamic acid/NSAID

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18
Q

Which syndrome is associated with PDA?

A

Eisenmenger Syndrome

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19
Q

Hypopigmented ash leaf macules -> diagnosis?

A

Tuberous sclerosis

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20
Q

Bilious vomiting, polyhydramnios, reduced foetal movements, double bubble sign -> diagnosis?

A

Duodenal atresia

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21
Q

Give the correct types of RTA:

1) Hyperkalaemia

2) Hypokalaemia, alkalotic urine, normal anion gap metabolic acidosis

3) Hypokalaemia, rickets/osteomalacia

A

1) 4 - associated with hypoaldosteronism +-aldosterone resistance (drugs that affect RAAS -> epleroenone, ramipril) -> hyperkalaemia and acidosis

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22
Q

Which score is used for appendicitis?

A

Alvarado

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23
Q

What is the O2 threshold for children?

A

<92

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24
Q

What is the most common leukaemia in children?

A

ALL - thrombocytopenia, leukocytosis

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25
Q

What is the most common cytogenic abnormality in ALL?

A

t(12;21)

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26
Q

Give the electrolyte disturbances for tumour lysis syndrome

A

Hyperphosphataemia, hyperkalaemia, hypocalcaemia

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27
Q

What is first line pancreatic cancer investigation?

A

Ab US

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28
Q

Define Whipple’s Procedure

A

Antrum of stomach, head of pancreas, common bile duct and gallbladder

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29
Q

Which protooncogene is mutated in most pancreatic adenocarcinomas?

A

KRAS

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30
Q

Which hormone is produced by the corpus luteum after ovulation? + How does it affect body temperature?

A

Progesterone -> increases

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31
Q

serotonin syndrome -> presented within 1 hour

A

Activated charcoal, IV benzo, fluids, serotonin antagonists (chlorpromazine)

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32
Q

What are the side effects of SSRI? + What can be given prophylactically if the patient is taking NSAIDs?

A

Stomach upset, PPI to protect from stomach ulcers

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33
Q

Which artery does Volkmann’s contracture involve?

A

Brachial artery -> ischaemic necrosis of forearm flexors -> permanent claw hand

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34
Q

Which part of the colon is most commonly affected by Hirschsprung’s?

A

Rectosigmoid

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35
Q

Which fracture is associated with ACL tear?

A

Segond fracture

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36
Q

Give PAIR for seronegative pathologies

A

Psoriatic arthritis
AS
IBD
Reactive arthritis (Reiters)

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37
Q

Which nodules are NF1 associated with?

A

Lisch nodules -> astrocytoma

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38
Q

Which renal pathology shows spikes in GBM?

A

Glomerulonephritis

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39
Q

Which blood test is used for antiphospholipid syndrome?

A

Lupus anticoagulant

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40
Q

Give 1st + 2nd + 3rd line for psoriatic arthritis

A

Naproxen + Methotrexate + Sulfasalazine

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41
Q

What is first line therapy for pregnant with antiphospholipid syndrome?

A

LMWH and aspirin

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42
Q

Smooth tongue, macrocytic anaemia, cognitive decline, ataxia -> which blood test?

A

Vitamin B12 and folate

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43
Q

In Sjogrens, which biopsy is used to test for focal lymphocytic chronic sialadenitis?

A

Labial biopsy

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44
Q

Which subluxation is a complication of RA that can make it difficult to intubate a patient?

A

Atlanto-Occipital

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45
Q

Which antibody is associated with dermatomyositis?

A

Anti-jo1

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46
Q

What is Gottron’s papule associated with?

A

Dermatomyositis

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47
Q

Which part of the brain + ear area do vestibular schwannomas arise?

A

Cerebellopontine angle + internal auditory canal

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48
Q

What is first line for Behcets?

A

Colchicine

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49
Q

What is second line after allopurinol for gout? (F)

A

Febuxostat

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50
Q

What is first line for tumour lysis syndrome?

A

Rasburicase

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51
Q

If painless foot drop is present, other than common fibular nerve palsy -> which other pathology should be considered?

A

CES

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52
Q

Which classification is used for open fractures?

A

Gustilo and Anderson

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53
Q

Which bloods should be monitored for rhabdomyolysis?

A

Myoglobin is nephrotoxic -> monitor U+Es and serum CK

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54
Q

Which contracture is seen post-compartment syndrome + Which grading is used?

A

Volkmann’s Contracture
Tsuge:
Mild - finger flexor
Moderate - wrist and finger flexors
Severe - extensors

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55
Q

Which movement can illicit pain in anterior compartment syndrome?

A

Plantarflexion -> stretches muscles of anterior compartmente

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56
Q

Define delta P in ACS

A

Diastolic pressure - compartment pressure <30mmHg = ACS

Absolute compartment pressure >40mmHg

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57
Q

Multiple fractures with different stages of healing, elevated ALP -> which bone pathology?

A

Paget’s

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58
Q

What is the most common clinical sign of multiple myeloma?

A

Pallor

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59
Q

How does omeprazole affect clopidogrel?

A

Omeprazole inhibits CYP2C19 (P450) which usually activates clopidogrel -> decreases clopidogrel action

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60
Q

Microcytic, hypochromic -> normal/high serum ferritin -> what’s next test + give 3 results

A

DAGT

1) Cold autoantibody -> CHAD (Cold Haemagluttinin Disease)

2) Warm -> autoimmune, drugs, CLL
3) Alloantibody -> transfusion reaction

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61
Q

Haemosiderin deposition, oedema, eczema -> which type of ulcer?

A

Venous

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62
Q

In pathologies with ANA+ve -> Which complement is increased to counteract damage?

A

Complement C3

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63
Q

Fever, ab pain, foul smelling lochia -> diagnosis? + Organism?

A

Post partum infection (GBS)
Strep agalactiase

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64
Q

Bone spicule pigmentation in peripheral retina -> diagnosis?

A

Retinitis pigmentosa -> loss of night vision and peripheral field vision

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65
Q

Which WBC abnormality can sudden withdrawal of lithium cause?

A

Agranulocytosis

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66
Q

Trauma to breast area previously, associated tethering, irregular mass -> diagnosis?

A

Fat necrosis -> dead adipose tissue on biopsy

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67
Q

Give the curative treatment after failed medical management in hip osteoarthritis

A

THR

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68
Q

Bone pain, CNVIII involvement, FH -> diagnosis?

A

Paget’s

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69
Q

Give first line for CML + genetic mutation

A

Imatinib (tyrosine kinase inhibitor
t(9:22) Philadelphia chromosome

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70
Q

What is the most common presentation of a child with Wilm’s tumour?

A

Asymptomatic abdominal mass

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71
Q

What is the second most common sickle cell disease phenotype?

A

HbSC (after HbSS)

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72
Q

If there is a complete miscarriage with TVUS empty uterus and no ectopic, positive beta-hCG -> what are next steps?

A

Repeat urine bhCG in 3 weeks time

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73
Q

What is seen on blood film in HELLP?

A

Schistocytes

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74
Q

Hemiparesis after epileptic seizure -> diagnosis?

A

Todd’s paresis

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75
Q

Which prophylaxis can be used in third stage of labour to prevent PPH?

A

Prophylactic uterotonics
Oxytocin 10 iu

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76
Q

What does fibrillation potentials on EMG suggest?

A

ALS -> spontaneous potentials from denervation

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77
Q

What is the only medication recommended in ALS?

A

Riluzole

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78
Q

Which condition do genes SOD1 and C9ORF72 cause?

A

ALS

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79
Q

Inguinal lymphadenopathy, chlamydia patient, painless pustule -> diagnosis?

A

lymphogranuloma venereum

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80
Q

Keratoderma blenorrhagica is associated with which arthritis?

A

Reactive

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81
Q

What is the investigation for optic neuritis?

A

MRI orbit

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82
Q

No wet nappies for >12h is an indication for what?

A

NG feeding

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83
Q

What is the SADQ-C questionnaire used for?

A

Alcohol dependence

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84
Q

Which genetic mutation is associated with HNPCC/Lynch?

A

MLH1
MSH2

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85
Q

Which agent can be given in methotrexate toxicity?

A

Leucovorin

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86
Q

Give the effects of premature ovarian failure on oestradiol, FSH, LH

A

Decreased estradiol production -> negative feedback -> increased FSH, LH

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87
Q

Give the effect of rifampicin on P450 enzymes + COCP

A

P450 inducer -> increases metabolism of COCP -> caution use if trying to prevent pregnancy

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88
Q

Give the risk of recurrent ectopic after one episode

A

5-20%
(>30% if >2 previous episodes)

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89
Q

Give investigation for Kawasaki + treatment

A

Echo -> coronary artery aneurysm
IVIG, aspirin for prevention of coronary artery aneurysm

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90
Q

What is the difference between critical and acute limb ischaemia

A

Critical >2w chronic

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91
Q

What are Heberden’s nodes caused by?

A

Osteophyte formation at DIPJ

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92
Q

Give the vitamin K dependent clotting factors

A

II, VII, IX, X, Protein C/S

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93
Q

Increased APTT with positive lupus serology -> diagnosis

A

Antiphospholipid Syndrome

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94
Q

What is the most common germ cell tumour in children?

A

Yolk Sac Tumour

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95
Q

What is IM pethidine used for?

A

Long labour without epidural after trying co-codamol and entonox

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96
Q

Rash on hands, feet and face, thrombocytopenia, anaemia and hepatic dysfunction after transplant -> diagnosis?

A

GVHD

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97
Q

Which newborn head bump crosses suture lines?

A

Caput succaedum (scalp oedema)
Cephalohaematoma (subperiosteal bleeding, doesn’t cross)

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98
Q

What is the mechanism of mefenamic acid + tranexamic acid?

A

M -> NSAID, can affect fertility (use tran)
T -> antibrinolytic, inhibits plasminogen to plasmin

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99
Q

Which investigation is used for vWD?

A

Risocetin cofactor activity

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100
Q

Previous PID presenting with RUQ

A

Fitz-Hugh-Curtis Syndrome

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101
Q

What is the management for INR >8 and no bleeding?

A

Stop warfarin and wait until <5, start again at reduced rate

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102
Q

Which syndrome is 47 XXY?

A

Klinefelter Syndrome

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103
Q

Which biologic is second line after NSAID in AS?

A

TNF-alpha inhibitor (e.g. adalimumab)

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104
Q

Which screening is used in PCOS diabetics who are overweight or non-caucasian?

A

OGTT every 1-3 years

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105
Q

Immunocompromised, ear pain, night pain -> diagnosis?

A

Necrotising OE

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106
Q

Give an important complication of OM

A

Mastoiditis

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107
Q

What is an important warning given for glandular fever?

A

Splenomegaly -> avoid contact sports to prevent splenic rupture

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108
Q

Chest pain, subcutaneous emphysema, vomiting -> which triad + syndrome?

A

Mackler’s Triad
Boerrhave Syndrome (spontaneous oesophageal rupture)

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109
Q

Which score is used for MW tear? + Which score requires inpatient endoscopy?

A

Glasgow-Blatchford
>0

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110
Q

What levels is agranulocytosis diagnosed?

A

Neutrophils <1x10^9

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111
Q

What is first line for acute epiglottis?

A

Ceftriaxone

112
Q

Which imaging is used alongside laryngoscopy to diagnose epiglottis? + Which sign is identified?

A

Lateral neck radiograph -> Thumb sign

113
Q

Give the gene + inheritance pattern for haemochromatosis

A

HFE
Autosomal recessive

114
Q

Which side effect can occur if aledronate is not taken properly in the morning before breakfast?

A

Osteonecrosis of the jaw

115
Q

How is Crigler-Najjar and biliary atresia differentiated?

A

C-N -> autosomal recessive, elevated indirect bilirubin due to defect in conjugation gene

BA -> direct bilirubin, hepatomegaly, progressive jaundice

116
Q

Give one situation for early referral to breast clinic before 50

A

If there is a first degree relative with bilateral breast cancer <50

117
Q

Lumpy tender breasts, more painful around menstruation, better mid-cycle, perimenopausal patient -> diagnosis?

A

Fibrocystic

118
Q

When is mammography used vs US?

A

US for <40 due to more dense breast tissue

119
Q

Which type of bacteria are S. pyogenes + S. agalactiae?

A

Pyogenes -> GAS
Agalactiae -> GBS
Both are beta-haemolytic

120
Q

When is amoxicillin given with IV cephalosporins in meningitis?

A

To cover for listeria, usually in children and elderly

121
Q

Give a classic sign + presentation for hereditary haemorrhagic telegiectasia

A

Spots on lips
Epistaxis
Autosomal dominant

122
Q

Give the range to differentiate between medical and expectant management in ectopics

A

<35mm
<5000 hCG

hCG >1500 -> medical (methotrexate)
hCG <1500 -> expectant

123
Q

Is long or short sightedness associated with glaucoma?

A

Hypermetropia
Causes of pupillary dilation (antimuscarinics, e.g. atropine, and sympathomimetics, e.g. phenylephrine)

124
Q

Give the management for rectal cancer with LBO

A

Defunctioning loop colostomy

125
Q

Give a protective factor against AOM

A

Breastfeeding

126
Q

Define the Carhart Notch in audiometry

A

Dip at 2000Hz due to immobilisation of the stapes plate -> seen in otosclerosis

127
Q

Give the surgical procedure for persistent BPPV

A

Posterior canal occlusion

128
Q

What is the most common cause of cholesteatoma?

A

Eustachian tube dysfunction

129
Q

Which part of the brain is an acoustic neuroma found?

A

Cerebellopontine angle (near facial and trigeminal nerves)

130
Q

What is the most common organism in mastoiditis?

A

Strep pneumoniae

131
Q

What is first line for organophosphate poisoning?

A

Atropine and pralodoxine

132
Q

Give the first line + criteria for treatment in whooping cough

A

Within 21 days
Macrolide (e.g. erythromycin)

133
Q

Give an indication for tacrolimus + class + side effect

A

Renal transplant (with mycophenolate)
Calcineurin inhibitor
Visible tremors

134
Q

Describe benign Rolandic epilepsy

A

Nocturnal seizures with orofacial involvement -> self-limiting

135
Q

Which vitamin deficiency are Bitot’s spots associated with?

A

Vitamin A

136
Q

Which test is used to diagnose vitamin A deficiency?

A

Serum retinol

137
Q

What is the initial management for iron overdose?

A

Bowel irrigation -> Desferroxamine

138
Q

Which type of acid base disturbance is seen in iron overdose?

A

High anion gap metabolic acidosis

139
Q

When is IV methylpredinosolone given in GCA?

A

Where there are visual symptoms

140
Q

Give a complication of GCA other than blindness

A

Aortic aneurysm -> 2 yearly screening

141
Q

What is retinal whitening associated with?

A

Posterior uveitis

142
Q

What is a more renal friendly version of morphine?

A

Oxycodone

143
Q

Give some example of DMARDs

A

Luflonamide, sulfasalazine, methotrexate

144
Q

Young, healthy patient with prolonged periods of refractory seizures -> what is the most common cause?

A

Autoimmune encephalitis

145
Q

How is VTE risk reduced post-TKR?

A

Aspirin 14 days
LMWH 14 days with compression stockings

146
Q

How is VTE risk reduced post-THA?

A

LMWH 10 days and aspirin for following 28 days
LMWH 28 days with compression stockings

147
Q

What is first line for biliary atresia?

A

Kasai procedure

148
Q

Which biomarker is elevated in carcinoid tumours?

A

Chromogranin A

149
Q

What is first line for vWD? + Second line?

A

Desmopressin -> IV vW factor

150
Q

What does HHV 6 cause in children?

A

Roseola infantum

151
Q

How do you differentiate roseola infantum and measles?

A

RI -> rash after fever subsides (chest spreads to neck)
M -> rash comes with fever and coryza prodrome (maculopapular rash spreading from ears down)

152
Q

What paediatric tumour is an elevation in HMA and VMA associated with?

A

Neuroblastoma

153
Q

Persistent fever of unknown origin, negative transoesophageal echo, elevated inflammatory markers, back pain -> investigation + diagnosis?

A

MRI lumbar spine
Discitis

154
Q

Which syndrome is livedo reticularis (netlike rash) associated with?

A

Antiphospholipid

155
Q

What is first line for antiphospholipid syndrome who have had thrombotic events?

A

Warfarin INR 2-3

156
Q

What must be done before surgical excision of phaeochromocytoma? + give a complication if part of this is not followed?

A

Control of BP -> alpha blockade (phenoxybenzamine, phentolamine) + beta blockade

Only beta blockade -> unopposed alpha stimulation -> hypertensive crisis and vasoconstriction

157
Q

Give a specific x-ray finding on X-ray for pseudogout

A

Chondrocalcinosis

158
Q

Which overdose is associated with tinnitus?

A

Aspirin

159
Q

Which cells are seen in CLL?

A

Smudge cells

160
Q

What is the Richter transformation?

A

CLL -> non-Hodgkins lymphoma
Rapidly progressing cervical lymphadenopathy, B symptoms

161
Q

Which cancer does Sjogren’s increase the risk of?

A

Non-Hodgkin’s Lymphoma

162
Q

Give the triad of bloods seen in CML

A

Neutrophilia, thrombocytosis, anaemia

163
Q

What is seen on blood film in HUS?

A

Schistocytes

164
Q

What does apple green befireringance on Congo red stain signify?

A

Amyloidosis

165
Q

What is the follow-up post pregnancy in complete hydatiform mole?

A

6-8 weeks serum beta-hCG

166
Q

What is first line in low risk choriocarcinoma (following complete hydatiform mole)?

A

Methotrexate

167
Q

Which drugs are associated with osteomalacia?

A

Anticonvulsants -> induce P450 -> metabolises vitamin D

168
Q

Alcohol induced cervical lymphadenopathy pain -> which malignancy?

A

Hodgkins

169
Q

What is first line for tumour lysis syndrome?

A

Rasburicase -> converts uric acid to inactive form

170
Q

Which histology is pathognomic for Hodgkin’s?

A

Reed Sternberg

171
Q

Which syndrome is associated with psoriatic arthritis?

A

Metabolic syndrome

172
Q

Give classification for acute limb ischaemia + stage for viable + non-viable + management

A

Rutherford -> 1,2 = viable (revascularisation), 3 = non-viable (amputation)

173
Q

What is a common complication of revascularisation?

A

Limb reperfusion injury from increased pressure due to O2 free radicals and inflammatory mediators

174
Q

Which cancer risk increases in mono (EBV)

A

Nasopharyngeal carcinoma

175
Q

Give a common renal complication of diffuse systemic sclerosis

A

Renal crisis -> hypertension ,reduced urine output, acute renal failure

176
Q

What does evidence of haemotympanum signify? + what is indicated?

A

Basal skull fracture (panda eyes, CSF rhinorrhoea, Battle sign) -> immediate CT head

177
Q

What do elevated VMA levels show in children? + which scan confirms diagnosis?

A

Neuroblastoma
Metaiodobenzylguanidine scan (MIBG)

178
Q

Give the pathophysiology of hypocalcaemia in tumour lysis syndrome

A

Release of phosphates -> hyperphosphataemia -> phosphates bind with free serum calcium -> hypocalcaemia

179
Q

Why is allopurinol given prophylactically for tumour lysis syndrome?

A

Prevents rise in uric acid

180
Q

Multiple tender ulcers on preputial skin on penis following sexual intercourse -> diagnosis?

A

Herpes simplex

181
Q

Exaggerated lumbar lordosis, palpable depression above L5, low back pain that improved with rest -> diagnosis?

A

Spondylolitheasis

182
Q

How many months should a child be sitting unsupported?

A

7 months

183
Q

How many months should a child be able to feed themselves and say at least 2 words?

A

12 months

184
Q

Which fibroid location can cause urinary frequency?

A

Subserosal fibroids

185
Q

Define red degeneration

A

Uterine fibroids that grow rapidly during pregnancy causing pain and a low-grade fever due to a surge in sex hormones

186
Q

Which congenital syndrome is associated with ToF?

A

DiGeorge (22q11 deletion) - CATCH22

187
Q

Give a temporary measure for ToF whilst awaiting surgery

A

Blalock Shunt -> connects pulmonary and subclavian artery to ensure perfusion to pulmonary circulation

188
Q

What is the definitive management for Hirschprung?

A

Ano-rectal pull through

189
Q

Which leukaemia shows gum hyperplasia?

A

AML

190
Q

What is the reversal agent for factor Xa inhibitors (DOACs)?

A

Adexanet alfa

190
Q

Give a subtype of AML with t(15;17) and is associated with DIC

A

Acute promyelocytic leukaemia

191
Q

What secondary malignancy is associated with retinoblastoma?

A

Osteosarcoma

192
Q

Why does total IgA need to be taken for coeliac?

A

Some patients are IgA deficient

193
Q

How does dopamine affect renal artery flow?

A

Renal artery vasodilator

194
Q

Clonal B cell population, ATM mutation, Del(13q14) -> which leukaemia?

A

CLL

195
Q

What is the main cause of cramps in haemodialysis?

A

Fluid depletion leading to reduced perfusion of muscles

196
Q

Which hormone is protective against endometrial cancer?

A

Progesterone

197
Q

Give the management for endometrial hyperplasia without cellular atypia

A

6 month surveillance
then trial progesterone (IUS Mirena)

198
Q

Which scan should be considered in children with recurrent UTIs?

A

DMSA scan for renal scarring due to recurrent UTIs

199
Q

Which antibiotic classes block 30s subunit?

A

Tetracyclines
Aminoglycosides

200
Q

What should be given alongside potassium replacement in hypokalaemia?

A

Hypomagnesaemia can be a culprit -> magnesium aspartate to retain potassium

201
Q

What is given for menopausal symptoms with no uterus?

A

Oestrogen-only HRT

202
Q

How to differentiate between sequential and continuous combined HRT?

A

<12 months symptoms -> sequential

203
Q

How do you differentiate myelodysplasia and AML?

A

Bone marrow biopsy <20% blast cells

204
Q

Which SSRI can be stopped immediately?

A

Fluoxetine due to long half life

205
Q

Which drug class increases the risk of serotonin syndrome with SSRI?

A

Sumatriptan

206
Q

What can CML transform into?

A

ALL, AML -> check blood cell count for blast cells

207
Q

Which genetic mutation is myelofibrosis associated with?

A

JAK2

208
Q

How is primary and secondary PCV differentiated?

A

Primary -> decreased erythropoietin
Secondary -> increased

209
Q

What is the first line for PCV?

A

Aspirin
Weekly phlebotomy

210
Q

What is a prognostic marker for Ewings?

A

LDH

211
Q

What is given first line for antiphopholipid syndrome during pregnancy?

A

Aspirin
LMWH

212
Q

When is oral olseltamavir given for influenza A?

A

At risk groups presenting within 48h of symptom onset

213
Q

Give a first line prophylaxis for Menieres

A

Betahistine

214
Q

Which ENT cancer is HPV associated with?

A

SCC oropharynx

215
Q

What is first line for finger flexion deformity?

A

Physio
Finger splint to allow tendon to heal

216
Q

What is first line for classical Hogkin’s?

A

Chemotherapy

217
Q

What is a hallmark marker in tumour lysis syndrome?

A

Urate

218
Q

Lymphocytosis, thrombocytopenia, normocytic anaemia, reduced reticulocyte -> which diagnosis?

A

ALL

219
Q

What is given long term for hereditary spherocytosis?

A

Folic acid

220
Q

Which organism is associated with aplastic crisis after splenectomy?

A

Parvovirus B19

221
Q

What is seen on ECG in West Syndrome (Saalam attacks, head, neck and trunk contractions)?

A

Hypsarrythmia

222
Q

What is seen on histology for both DIC and TTP?

A

Schistocytes

223
Q

Which type of hypersensitivity reaction is hyper acute rejection?

A

Type 2

224
Q

Most important HLA alleles to match in transplant?

A

HLA-A, HLA-B, HLA-DR

225
Q

Why does

A
226
Q

How is scleritis and episcleritis differentiated?

A

Topical phenylphrine

227
Q

What is the most common causative organism in lichen planus? + what can it change to?

A

Longstanding cases can change into SCC

228
Q

When is jaundice always pathological in newborns?

A

Within 24h -> sepsis, severe haemolysis

229
Q

Give 2 causes of physiological jaundice (enzyme + blood)

A
  1. Reduced activity of UGT -> decreased efficiency of bilirubin conjugation
  2. Foetal RBC have shorter half life
230
Q

How is thalassaemia and iron deficiency anaemia differentiated in bloods?

A

Thalassaemia -> Low Hb, low MCV, normal RBC
Iron deificiency anaemia -> low all three

231
Q

How is vWD differentiated with clotting screen?

A

vWD (platelet adhesion and VIII activity) has normal clotting screen

232
Q

What is seen on blood smear in AML vs ALL?

A

AML -> blast cells
+ leukocytosis, thrombocytopenia

233
Q

How do you differentiate physiological jaundice and breast milk jaundice?

A

Physiological -> few days
Breast milk -> few weeks

234
Q

How to differentiate TRALI and TACO?

A

TRALI only has respiratory distress
TACO -> fluid overload symptoms

235
Q

What is the pathophysiology of haemolytic transfusion reaction + febrile + allergic reaction?

A

Haemolytic -> immune against donor RBC, ABO incompatibility

Febrile -> Antibiodies against donor leukocytes

Allergic -> Plasma proteins

236
Q

Which 2 diseases is pyoderma gangrenosum associated with?

A

IBD
RA

237
Q

When is 6 in 1 vaccine given?

A

8, 12, 16 weeks

238
Q

Which type of anaesthetics is malignant hyperthermia associated with?

A

Inhaled

239
Q

What is first line for fibroids without surgery?

A

Selective progesterone receptor modulator (e.g. ulipristal acetate)

240
Q

What is required pre-intubation in OSA and obesity?

A

Pre-oxygenation 100%

241
Q

Which condition is scleritis associated with?

A

RA

242
Q

What is the first line antihypertensive agent in pregnancy?

A

Nifedipine

243
Q

Which two blood tests are required before starting lithium?

A

U+Es
TFTs

244
Q

Palliative analgesia with renal impairment -> which analgesia?

A

Oxycodone (hepatic excretion)

245
Q

Pes planus, PMP22 gene mutation -> diagnosis?

A

Charcot Marie Tooth disease -> hereditary motor and sensory neuropathy

246
Q

Give the weeks for the closure of the anterior + posterior fontanelles

A

Anterior - 7-18 months
Posterior - within 2 months

247
Q

Which 2 syndromes are port wine stains associated with?

A

Sturge-Weber -> too many capillaries in meninges
Klippel-Trenauney -> limb hypertrophy,

248
Q

What is the newborn hearing test? + Second line?

A

Otoacoustic emission test
Auditory Brainstem response test

249
Q

Which type of hypersensitivity is ITP?

A

Type 2 -> IgG against platelets

250
Q

Hair on end, Howell Jolly body, target cell -> diagnosis?

A

beta-thalassaemia

251
Q

What is the gold standard for beta thalassamia major?

A

Hb electrophoresis

252
Q

What is the only curative option for beta thalassaemia major?

A

Stem cell transplant

253
Q

Which supplement is given with blood transfusion?

A

Folate

254
Q

What is given with blood transfusion to prevent haemochromatosis?

A

Desferroxamine

255
Q

What is SPINK1 + MYH-7 associated with?

A

SPINK1 -> acute pancreatitis
MYH-1 -> HOCM

256
Q

How long for chronic suppurative OM?

A

> 2 weeks

257
Q

What is the long term risk for depo-vera contraception?

A

BMD loss

258
Q

psoriasis -> later develops synovitis -> next step?

A

Urgent referral to rheum

259
Q

Which STI is tabes dorsalis associated with?

A

Syphilis

260
Q

What is the newborn chest compression ratio?

A

3:1

261
Q

What is the advice for impetigo in terms of contamination?

A

48h of AB
Crusted over

262
Q

What is the incubation of chickenpox? + advice for school?

A

21 days
Off school until last lesion has crusted over

263
Q

What prophylaxis is given for CF?

A

Flucloxacillin for staph aureus

264
Q

For palliative nausea with raised ICP -> which antiemetic is used?

A

Cyclizine plus steroids

265
Q

Which antiemetic post op?

A

Ondansetron

266
Q

How is EDD calculated?

A

LMP 1st day + 1 year, 7 days - minus 3 months

267
Q

What is a common side effect of cisplatin?

A

Peripheral neuropathy

268
Q

What is the ratio for oral:SC morphine?

A

2:1

269
Q

How do you calculate breakthrough after converting to SC morphine?

A

1/6 of 24h requirement

270
Q

Baby has SVT arrhythmia -> what is first step?

A

Ice water submersion

271
Q

Which anaemia is associated with basophilic granules?

A

Sideroblastic anaemia

272
Q

What blood result can linezolid cause?

A

Thrombocytopenia

273
Q

Which investigation is used to diagnose PE in sickle cell disease?

A

V/Q Scan

274
Q

What investigation to check before starting ondansetron?

A

ECG (prolongs QT)

275
Q
A

GP Conditions (5 decks)

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