PASSMED

Question 1

PSC
which cancer is most commonly associated with primary sclerosing cholangitis?

Answer 1

cholangiocarcinoma

Question 2

MEDICATIONS
why should ciprofloxacin not be given to epileptics?

Answer 2

it lowers the seizure threshold

Question 3

HAEMOLYTIC URAEMIC SYNDROME
what is the most useful diagnostic test?

Answer 3

blood film - shows schistocytes

Question 4

HYPOTHERMIA
what is the management of hypothermia in cardiac arrest?

Answer 4

only 3 shocks should be administered before the patient is warmed to 30 degrees

Question 5

ANOREXIA
what is refeeding syndrome?

Answer 5

• caused by sudden introduction of glucose after prolonged starvation
• when glucose is low, cell metabolism slows
• when glucose is reintroduced it causes insulin to be released, which pushes glucose into cells
• causes demand for phosphate, potassium + magnesium
• leads to hypophophataemia, hypokalaemia + hypomagnesaemia

Question 6

AF
how would you manage a patient with stable heart disease with a new diagnosis of AF?

Answer 6

stop clopidogrel
start anticoagulant

Question 7

CARDIAC ARREST
which kind of cardiac arrest can be caused by a penumothorax?

Answer 7

pulseless electrical activity

Question 8

STROKE
how would you manage a patient with very high blood pressure and an ischaemic stroke?

Answer 8

• if blood pressure >185/110, control BP before thrombolysis

Question 9

HERNIA
what is the definition of a hernia?

Answer 9

protrusion of part/whole of an organ or tissue through the wall of the cavity that normally contains it

Question 10

INGUINAL HERNIA
what is the difference between a direct and indirect inguinal hernia in terms of how they enter the canal?

Answer 10

• direct = bowel enters inguinal canal directly through weakness in posterior wall of the canal
• indirect = enters inguinal canal via the deep inguinal ring

Question 11

INGUINAL HERNIA
which type of inguinal hernia is more commonly seen in children and why?

Answer 11

• indirect inguinal hernia
• because of a patent processus vaginalis

Question 12

AGE RELATED MACULAR DEGENERATION
what is the management?

Answer 12

• Anti-vascular endothelial growth factor
• given via intravitreal injections

Question 13

ARTHRITIS
what is the difference between oligoarthritis and polyarthritis?

Answer 13

• oligoarthritis = affects 4 joints or fewer
• polyarthritis = more than 4 joints affected

Question 14

HEP B TESTING
which 2 serological markers are used initially in hep B screening?

Answer 14

HBsAg (Hep B surface antigen)
anti-HBc (Hep B core antibody)

Question 15

HEP B TESTING
which marker gives a direct count of viral load?

Answer 15

HBV DNA

Question 16

HEP B TESTING
what is injected in the Hep B vaccine?

Answer 16

HBsAg (Hep B surface antigen)

Question 17

HEP B TESTING
which Hep B serological marker indicates immunity post vaccination?

Answer 17

Anti-HBs

Question 18

GOUT
what is the crystal composition in gout?

Answer 18

monosodium urate

Question 19

PSEUDOGOUT
what is the crystal composition in pseudogout?

Answer 19

calcium pyrophosphate

Question 20

GOUT
what type of medications is allopurinol?

Answer 20

xanthine oxidase inhibitor

Question 21

BRADYCARDIA
how would you manage bradycardia (give drug and dose)?

Answer 21

1. 500 micrograms atropine IV
2. repeat 500 micrograms atropine IV (repeat if needed until 3mg given)
3. transcutaneous pacing

Question 22

ASTHMA
what is the discharge criteria following treatment for an asthma attack?

Answer 22

• PEFR >75%
• inhaler technique checked
• been stable on their discharge medication (i.e. no nebulisers or oxygen) for 12-24 hours

Question 23

SMOKING
how do you calculate pack years?

Answer 23

1 pack year = 20 cigarettes per day for 1 year