passmed all (2)

Question 1

Reason for: Isolated fever in well patient in first 24 hours following surgery?

Answer 1

Physiological response to operation/surgery

ddx: wound infection: but symptoms would come after 48 hours post-op.

Question 2

Women having medical management of a miscarriage should be offered ? (as well as vaginal misoprostol: with no cardiac activity)

Answer 2

Antiemetics and pain relief

Question 3

when is warfarin preferred over DOAC?

Answer 3

• prosthetic valve
• antiphospholipid syndrome
• upper GI bleed

Question 4

Most sensitive and specific lab finding for diagnosis of liver cirrhosis in those with chronic liver disease?

Answer 4

Thrombocytopenia (platelet count <150,000 mm^3) is the m
- NB: platelet and clotting factors effected

Question 5

ukmec 4 eg. condition CI COCP?

Answer 5

Positive antiphospholipid antibodies (e.g. in SLE) is UKMEC 4 for the COCP

Question 6

what medication is associated with Achilles tendon rupture?

Answer 6

Ciprofloxacin

Question 7

what is given to treat: von willebrand and haemophilia?

Answer 7

Desmopressin
- because it stimulates release of Von-Willebrand factor from endothelial cells.

Question 8

another name for Buerger’s disease?

Answer 8

Thromboangiitis obliterans:
presents with: Raynaud’s + extreme ischaemia

Question 9

L sided homo hemianopia?

Answer 9

Homonymous hemianopia
incongruous defects: lesion of optic tract
congruous defects: lesion of optic radiation or occipital cortex
macula sparing: lesion of occipital cortex
opposite side as affected

Question 10

Treatment for chronic heart failure?

Answer 10

ABC
- 1st) Ace-inhibitor
- 2nd) beta blocker
- 3rd) Spironolactone

Question 11

common cause of unilateral conductive hearing loss?

Answer 11

Ear wax build up

NB: Age-related hearing loss and Noise-related hearing loss are both types of sensorineural hearing loss.

Question 12

Medication to stop before surgery (Anaesthetics)

Answer 12

Advise women to stop taking their COCP/HRT 4 weeks before surgery
eg. Femoston

Question 13

SSRI of choice in children and teens (includes if patient is 16 years old).

Answer 13

Fluoxetine is the SSRI of choice in children and adolescents.

Question 14

Depression + mania symptom management: (if already on sertraline) ?

Answer 14

STOP sertraline, (lithium takes long to work, therefore not good for emergency symptom management) but lithium can take up to 2 weeks to become effective, so a second-generation antipsychotic (eg. Olanzapine) would be used first. Lithium would be used if the response to the antipsychotic is inadequate.

Question 15

1st c -section mother: what mode of delivery is optimal for 2nd child?

Answer 15

Planned Vaginal birth after Caesarean (VBAC) is an appropriate method of delivery for pregnant women at >= 37 weeks gestation with a single previous Caesarean delivery. (70-75% have successful delivery)

Question 16

Fibroadenoma mx. if experiencing discomfort, pain and more than 3cm in size?

Answer 16

Refer patient for surgical excision.

Question 17

PPROM: (preterm prelabour rupture of membranes)= management?

Answer 17

In preterm prelabour rupture of membranes, antenatal corticosteroids (IM steroids) should be administered to reduce the risk of respiratory distress syndrome

Question 18

Name of transfusion management in sickle cell crisis? (with high reticulocytes)

Answer 18

give Exchange transfusion

Question 19

SUFE surgical management?

Answer 19

Internal Fixation

Question 20

Fitz-Hugh Curtis Syndrome:

Answer 20

Pelvic inflammatory disease may progress to perihepatitis, characterised by RUQ pain
(Underlying cause= Chlamydia/STI)

Question 21

Anaesthetics: Dropping oxygen saturations following intubation

Answer 21

Oesophageal intubation:
Endotracheal tube is most likely accidentally placed down oesophagus

Question 22

Tamoxifen side effects:

Answer 22

• VTE
• Endometrial cancer

NB: Anastrozole side effects: is osteoporosis (think because post-menopause)

Question 23

Pseudomonas Aeruginosa mx. in cystic fibrosis young child?

Answer 23

Oral Ciprofloxacin: must treat this over bronchiectasis chest physiotherapy first.

Question 24

what is Pyogenic Granuloma

Answer 24

Pyogenic granuloma

Trauma is a common precipitant of pyogenic granuloma and contact bleeding and ulceration are common.

Question 25

Abx treatment for legionella pneumonia?

Answer 25

Macrolides such as cLarithromycin are used to treat Legionella

Question 26

Hypercalcaemia + bilateral hilar lymphadenopathy, what diagnosis?

Answer 26

Sarcoidosis

Question 27

Primary Hyperaldosteronism (conn’s): most likely cause?

• NB: presents with= very high BP and Hypokalaemia

if palpitations then ddx= Phaeochromocytoma

Answer 27

1) bilateral adrenal hyperplasia
2) Adrenal adenoma

Question 28

Urinary incontinence + gait abnormality + dementia = ? diagnosis

Answer 28

normal pressure hydrocephalus

Mx: is Ventriculoperitoneal shunting

Question 29

Heart failure + reduced ejection fraction (if continue to have symptoms) mx? (if already on ACE-i and BB), next line?

Answer 29

Offer a mineralcorticoid receptor antagonist (spironolactone), in addition to an ACE inhibitor (or ARB) and beta-blocker, to people who have heart failure with reduced ejection fraction if they continue to have symptoms of heart failure.
not furosemide

Question 30

Rheumatic fever:

Answer 30

Presentation of a preceding sore throat, migratory joint pains involving large joints such as knees, hips and ankles, pink ring-shaped lesions on the trunk (erythema marginatum), and jerking movements of the face and hands (Sydenham chorea) are all characteristic features of rheumatic fever.

Question 31

Management of spasticity in MS?

Answer 31

Baclofen and Gabapentin= 1st line

Question 32

diabetes medication: for high bmi patient?

Answer 32

SGLT-2 inhibitors have the beneficial side effect of weight loss in patient with T2DM

Question 33

what condition will show: Extremely high-voltage QRS complexes?

Answer 33

Left ventricular hypertrophy (LVH).

Question 34

Tender goitre (thyroid) what condition?

Answer 34

Subacute De quervain’s thyroiditis

If NON-tender goitre + raised free T4+ low TSH= Graves disease

Question 35

Side effects of thiazide diuretics?

Answer 35

All thiazide-related diuretics commonly result in:
- Hyponatraemia
- Hypokalaemia
- Hypercalcaemia
- Hypocalciuria.

Question 36

what investigation should all TIA patients have?

Answer 36

Should have an urgent carotid doppler unless they are not a candidate for carotid endarterectomy.