PassMed Learnings

Question 1

What is a SE of Mirtazipine?

Answer 1

Increased appetite

Question 2

Which antipsychotic can cause agranulocytosis?

Answer 2

Clozapine

Question 3

What non-emergency situation is tranexamic acid prescribed in?

Answer 3

Menorrhagia

Question 4

Causative organism of whooping cough?

Answer 4

Bordatella pertussis

Question 5

What is the management of whooping cough?

Answer 5

Macrolide abx

clarithromycin, eyrthromycin, azithromycin

Question 6

Presentation of whooping cough?

Answer 6

2-3 days coryzal sx then…

Proxysmal cough - usually worse at night
Inspiratory whoop
Vomitting
Apnoea

Question 7

What is the therapeutic range for lithium

Answer 7

0.1-1.0mmol/L

Question 8

A bipolar patient you are managing needs an increased dose of lithium. You start this, when should you monitor it’s effect?

Answer 8

1 week later

When stable within therapeutic range then monitor every 3 months

Question 9

Give several causes of hyperkalaemia?

Answer 9

“AAA”

AKI, Acidosis (metabolic), Addison’s

Question 10

Name several medications which can cause hyperkalaemia

Answer 10

Potassium-sparing diuretics / spironolactone
ACEi / ARB
Beta blockers / Heparin

Question 11

How can corticosteroids effect glucose control?

Answer 11

Corticosteroids worsen diabetic control due to anti-insulin effects

Oppose action of insulin and stimulate hepatic gluconeogenesis

Question 12

Name an antepartum haemorrhage cause which is painless?

Answer 12

Placenta praevia

“PPP” Placenta Praevia Painless

Question 13

Having a scarred uterus (e.g from multiple previous ceasarian sections) is a risk factor for what pregnancy complication?

Answer 13

Uterine rupture

Question 14

Presentation:
35 wks pregnant, severe continuous abdo pain, PV bleed 1hr ago but now stopped.

O/E firm, v.tender, woody uterus.
Obs: 102bpm, BP 98/65, pale clammy.
Pale, clammy

Give likely diagnosis and clues?
Justify why it is unlikely to be… labour? placenta praevia?

Answer 14

Diagnosis= placental abruption
Clues= continuous abdo pain, signs of shock but little evidence of bleeding (?concealed), woody uterus

Not labour because here the pain is continuous whereas in labour it comes in waves

Not placenta praevia because this is typically painless

Question 15

What is placental abruption?

Answer 15

A cause of antepartum haemorrhage resulting from separation of a normally sited placenta from uterine wall,

Question 16

What are three features which may indicate hashimoto’s thyroiditis?

Answer 16

Presentation of hypothyroidism
Goitre- firm, non-tender
Anti-thyroid peroxidase antibodies

Question 17

Patient presents with a painful goitre, signs of hypothyroidism and a raised ESR, likely cause?

Answer 17

de Quervain’s thyroiditis (AKA subacute)

Question 18

First-line treatment of syphilis?

Answer 18

IM benzylpenicillin

Question 19

Vit B12 deficiency, folate deficiency and alcohol excess are all causes of what type of anaemia?

Answer 19

Macrocytic anaemia

Question 20

Patient has iron deficiency anaemia. What is transferrin?On investigation what do you expect the result of transferrin to be?

Answer 20

Transferrin carries iron around in blood

In iron deficiency, transferrin increases to try and maximise transport of what little iron there is

Question 21

In anaemia of chronic disease what happens to levels of transferrin?

Answer 21

Transferrin reduces.

Body’s response to harmful pathogen- reduce iron available to pathogens for metabolism

Question 22

Give 2 examples of causes of microcytic anaemia?

Answer 22

Iron deficiency

anaemia of chronic disease

Question 23

What are the 2 key principles of managing a patient with AF?

Answer 23

Rate/rhythm control

Reduce stroke risk

Question 24

How is rate control achieved for patients with AF?

Answer 24

Give BBlocker or CCB (diltiazem)

Question 25

What precautions must be made before rhythm control management of AF is done?

Answer 25

Switching from AF to sinus rhythm is the highest risk of embolism –> stroke

ptx must have had short duration of sx (<48hrs) or be anticoagulated for a period of time before cardioversion