Passmed

Question 1

What is stigaliptin?

Answer 1

DDP-4 inhibitor

Question 2

How do you investigate diabetes insipidus?

Answer 2

water deprivation test

Question 3

What is the 1st line drug for hypertension in diabetes?

Answer 3

ACEi or A2RBs - regardless of age

Question 4

In gestational diabetes, what happens if blood glucose targets are not met with metformin or diet?

Answer 4

add insulin (short acting)

Question 5

What are the sick day rules for T1DM?

Answer 5

Aim to drink 3L of fkuid
Check blood glucose more regularly
Measure ketones
Do not substitute main meals for sugar containing foods

Question 6

What is the treatment for myxoedemic coma (in hypothyroidism)?

Answer 6

IV thyroxine and hydrocortisone

Question 7

What is the risk of over replacement with thyroxine?

Answer 7

osteoporosis

Question 8

What can affect the absorption of levothyroxine?

Answer 8

Iron and calcium carbonate tablets

Question 9

What are the features of a myxoedemic coma (hypothyroidism)?

Answer 9

Hypothermia, hyporeflexia, bradycardia, seizures

Question 10

What are the features of pernicious anaemia?

Answer 10

Lethargy, pallor, SOB

Neurological - peripheral neuropathy, subacute combined degeneration of the spinal cord and neuropsychiatric disorders (progressive weakness, ataxia and paresthesia), memory loss, poor concentration, confusion, depression, irritability

glossitis, described as a red and enlarged tongue

Question 11

Features of primary hyperaldosteronism

Answer 11

hypertension, hypernatraemia, and hypokalemia

Question 12

What is given before an appendicectomy?

Answer 12

Prophylactic IV abx

Question 13

What is the 1st line investigation for appendicitis in a female?

Answer 13

US abdo

Question 14

What sign is classic of early appendicitis?

Answer 14

Peri umbilical pain

Question 15

How does a ruptured AAA present?

Answer 15

Shock - low BP, tachycardia

Abdo pain radiating to back

Pulsatile mass

Question 16

How does a complete hydatidiform mole present?

Answer 16

Uterus greater than expected

Abnormally high bhCG

Question 17

How does diverticulitis present?

Answer 17

Left lower quadrant pain (iliac fossa)

Low grade fever

Elderly patient

Hx of chronic constipation predisposes

Blood in stools

Raised inflammatory markers

Question 18

What causes pancreatitis?

Answer 18

Alcohol, gallstones, drug induced (mesalazine) for UC

Question 19

What is the presentation of mesenteric infarction?

Answer 19

Sudden onset severe abdo pain

Raised WCC and lactate

Hypertension, T2DM, AF risk factors

Question 20

What does an unrecordable blood glucose mean and when is this seen?

Answer 20

High blood sugar

DKA in children - drowsy and confused

Question 21

What is the significance of the whirlpool sign?

Answer 21

Seen on US - characteristic of ovarian torsion or volvulus

Question 22

What are the features of an Addisonian crisis?

Answer 22

Hyponatraemia
Hyperkalaemia
Hypoglycaemia

Surgery - precipitate acute adrenal deficiency

Unable to have steroids for prolonged period e.g. for polymyalgia rheumatica

Question 23

What is characteristic of a ruptured ovarian cyst?

Answer 23

Sudden onset unilateral pelvic pain precipitated by strenuous activity or intercourse

Question 24

How does an iliopsoas abscess present?

Answer 24

Fever

Pain on movement on hip joint

IV drug user

Question 25

What are the classic sx of IBS?

Answer 25

Abdominal pain
Bloating
Change in bowel habit