Passmed February

Question 1

What is the long-term management of a provoked PE?

Answer 1

1st line: Apixaban for 3 months
2nd: LMWH

Question 2

What is the long-term management of an unprovoked PE?

Answer 2

Apixaban/rivaroxaban for 6 months

Question 3

What is the management of PE with haemodynamic instability?

Answer 3

Thrombolysis

Question 4

What is the first line drug used to manage COPD?

Answer 4

SABA (salbutamol, terbutaline) or SAMA (ipratropium)

Question 5

What are the NICE criteria for determining if a COPD patient has asthmatic features?

Answer 5

previous asthma
high eosinophil count
variation in FEV1
diurnal variation in PEF

Question 6

What is the second line treatment for COPD in someone without asthmatic features?

Answer 6

Add LABA and LAMA (switch SAMA to SABA)

Question 7

What is the second line treatment for COPD in someone with asthmatic features?

Answer 7

Add LABA and ICS (switch SAMA to SABA)

Question 8

Give an example of a LABA

Answer 8

salmeterol, formoterol

Question 9

Give an example of a LAMA

Answer 9

Tiotropium

Question 10

What is the first line treatment of hypertension in diabetics?

Answer 10

ACE-I (prils) or ARBs (sartans)

Question 11

What enzyme levels are elevated following an anaphylaxis episode?

Answer 11

tryptase (take baseline sample, then second sample after 1-2 hrs)

Question 12

How much adrenaline do you give an adult in anaphylaxis?

Answer 12

500ug (0.5ml 1 in 1000)

Question 13

What are the two main causes of hypercalcaemia?

Answer 13

primary hyperparathyroidism, malignancy (myeloma, bone mets)

Question 14

What are the common signs of subacute combined degeneration of the spinal cord?

Answer 14

distal sensory loss/tingling, absent ankle jerk, gait abnormalities, brisk knee jerk

Question 15

What causes subacute combined degeneration of the spinal cord?

Answer 15

B12 deficiency - can be from recreational NO ingestion

Question 16

How do you tell if it is type one diabetes of the young vs DMT2

Answer 16

c peptide is low in type 1 because 1 is lower than 2
c peptide is high in type 2 because 2 is higher than 1

Question 17

How is C-peptide involved in diabetes

Answer 17

C-peptide is a precursor of insulin, and because there’s basically no insulin in type 1 the C-peptide would be low, and vice versa?

Question 18

What are the four parts to the centor criteria?

Answer 18

• temperature > 38
• tender anterior cervical lymphadenopathy
• absence of a cough
• exudate on tonsils
  (TATE)

Question 19

What antibiotics are used for a strep throat?

Answer 19

• phenoxymethylpenicillin
• (clarithromycin if pen allergic)
  7 or 10 days

Question 20

At what age would the average child start to say ‘mama’ and ‘dada’?

Answer 20

9-10 months

Question 21

At what age do children ask ‘what’ and ‘who’ questions?

Answer 21

3 years

Question 22

At what age do children ask ‘why’, ‘when’ and ‘how’ questions?

Answer 22

4 years