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Passmed Questions Flashcards

1
Q

Values of impaired glucose toleranve test

A

After 2 hours it increases to 7.8 or higher but below 11.1

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2
Q

Prophylaxis treatment for cluster headache

A

Verapamil

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3
Q

Are c-peptide levels high in type 1 or type 2 diabetes

A

T2DM

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4
Q

1st and second line treatment for muscle rigidity and spasms in MA

A

First line baclofen
Second line gabapentin

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5
Q

What supplements can affect levothyroxine

A

Iron or calcium tablets can affect absorption levothyroxine resulting in low T4 and high TSH

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6
Q

Tamoxifen action

A

Selective oestrogen receptor modulator

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7
Q

what would affect PSA levels and how long should you wait before performing the test ?

A

prostate biopsy - 6 weeks
UTI - 4 weeks
DRE - 1 week
ejaculation and vigorous exercise - 2 weeks

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8
Q

TREATMENT FOR LYME DISEASE IF DISSEMINATED INFECTION

A

Ceftriaxone

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9
Q

single most important indicator for liver transplant in paracetamol overdose

A

PH < 7.3

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10
Q

USS screening in AAA

A

< 4.5 = 12 monthly
4.5 - 5.5 = 3 monthly
>5.4 or rapidly growing aneurysm = rapid referral to vascular

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11
Q

difference in anaemia of chronic disease and iron deficiency anaemia on blood results

A

both low iron and transferrin
iron deficiency has high TIBC
anaemia of chronic disease has low TIBC

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12
Q

what drugs are contraindicated with concurrent use of sidenifil

A

nitrates or nicorandil

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13
Q

what heart condition is associated with turners syndrome?

A

bicuspid aortic valve (ejection systolic murmur)
coarctation of aorta (late systolic)

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14
Q

what’s the most serious long term complications associated with turners syndrome?

A

aortic dilatation and aortic dissection

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15
Q

in what condition should donepezil be avoided?
(also what is donepexzil’s action and what is it used for?)

A

cholinesterase inhibitor
used in alzheimers
increases vagal tone thereby causing bradycardia.
avoided in sick sinus syndrome and other heart conditions

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16
Q

adverse effects of donepezil

A

insomnia
bradycardia

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17
Q

indomethacin or prostaglandin E1 for treatment of PDA

A

indomethacin to close duct
prostaglandin E1 to keep duct open if there is a concurrent congenital heart defect that requires repair

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18
Q

what is the theoretical risk associated with giving the rotavirus too late?

A

intussusception

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19
Q

at how many weeks should the first and second doses of rotavirus be given by

A

1st dose by 14 weeks
2nd dose by 25 weeks (6 months)

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20
Q

what condition is found in 50% of patients with degenerative cervical myelopathy

A

carpal tunnel syndrome

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21
Q

Hg, MCV and reticulocyte count found in sickle cell patients

A

Hg low
MCV normal
reticulocyte high

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22
Q

drugs that can cause pancreatitis

A

azathioprine, mecaptopurine, sodium valproate, furosemide, bendroflumethiazide, pentamidine, steroids
pancreatitis makes anyone furious because its so sore

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23
Q

been abroad recently and presented with constipation and fever

A

typhoid fever (salmonella typhii)

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24
Q

What rise in creatinine and drop in eGFr is acceptable when starting ACE inhibitors

A

20% drop in eGFR
30% rise in creatinine

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25
Q

at what size is a breast fibroadenoma for surgical excision

A

> 3cm

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26
Q

most common causative organism of epididymo-orchitis

A

chalmydia

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27
Q

if antibiotics are required for campylobacter what is abx of choice

A

clarithromycin

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28
Q

1st line imagine for suspected stroke

A

head CT non-contrast

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29
Q

what type of collagen makes up the vitreous humor of the eye

A

type II

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30
Q

what type of collagen makes up the lens of the eye

A

type III

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31
Q

causative organisms of chest infection post influenza infection

A

staph aueus

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32
Q

how to test for the main adverse effect of kawasaki

A

aortic aneurysms - echo

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33
Q

criteria for expectant management in ectopic pregnancy

A

size < 35mm
no symptoms
no foetal heart beat
bHCG < 1000
unruptured

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34
Q

criteria for medical management in ectopic pregnancy

A

size < 35mm
pain
no foetal heart beat
bHCG < 1500
unruptured

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35
Q

criteria for surgical management in ectopic pregnancy

A

size >35mm
pain
foetal heart beat
ruptured
bHCG >5000
intrauterine pregnancy

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36
Q

surgical management for ectopic pregnancy

A

salpingectomy
salpingotomy if risks of infertility such as contralateral tubal damage

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37
Q

pathophysiology of subcortical vascular dementia

A

small vessel disease

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38
Q

CURB scoring

A

confusion (abbreviated mental score 8 or more)
urea >= 7
RR >= 30
BP <= 90 systolic +/or <= 60 diastolic

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39
Q

mode of action of rifampicin

A

inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA

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40
Q

prophylactic medication given in people with varices

A

propanolol is given to prevent variceal bleeding

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41
Q

hydroxychloroquine side effects

A

corneal deposits
‘bulls-eye retinopathy’

42
Q

what DMARD can cause demyelination

A

etanercept

43
Q

drugs that should be avoided whilst breast feeding

A

antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

44
Q

management for gestational diabetes and glucose values associated with treatment options

A

if fasting glucose < 7 then trial of diet and exercise for 1-2 weeks. If this fails then start metformin
if fasting glucose >=7 then start insulin

45
Q

contraindications to sildenafil

A

hypotension
recent stroke or MI
nitrates or or nicorandil

46
Q

treatment for croup

A

emergency treatment - high flow 02 + nebulised adrenaline
management - single dose oral dex regardless of severity

47
Q

treatment for latent TB

A

isoniazid and pyridoxine for 6 months

48
Q

treatment for toxoplasmosis

A

treatment not required in immunocompetent patients
if immunocompromised or complications then treat with pyrimethamine and sulphadiazine for 6 weeks

49
Q

class III vs class IV haemorrhagic shock

A

class III 30-40% blood loss, BP drops, confused, urine 5-15ml, HR > 120

class IV >40% blood loss, BP drops, lethargic, urine < 5ml, HR > 140ml

50
Q

first line treatment for gestational hypertension in a patient with asthma

A

nifedipine

50
Q

prophylactic treatment for household members of a patients with neisseria meningitidis

A

oral ciprofloxacin

50
Q

when can copper IUD be used for emergency contraception

A

5 days after unprotected sex
5 days after first day of ovulation

51
Q

causative organism for measles

A

RNA paramyxovirus

52
Q

normal value of anion gap ?
causes of raised anion gap metabolic acidosis

A

8-14
Lactate: shock, hypoxia
Ketones: DKA, alcohol
urea: CKD
acid: salicyclates, methanol
5-oxoproline: chronic paracetamol use

53
Q

neurotransmitter effects of alcohol withdrawal

A

decreased inhibitory GABA and increased excitatory glutamate

54
Q

extra-articular manifestations of crohns that is related to disease activity

A

arthritis
erythema nodosum
episcleritis
osteoporosis

55
Q

exposure to chickenpox < 20 weeks pregnant. Course of action?

A

if not vaccinated = IVIG
if vacciated = no action
if unsure = immediately arrange for varicella Ab testing

56
Q

exposure to chicken pox >20 weeks pregnant. Course of action?

A

if not vaccinated = IVIG or aciclovir
if vaccinated = no action
if unsure = immediately arrange for varicella Ab testing

57
Q

1st line investigation for suspected prostate cancer

A

multiparametric MRI

58
Q

1st lin emanagement if suspected cows milk protein intolerance

A

switch to extensive hydrolysed formula
if this fails then try amino-acid based formula

59
Q

ramsey hunt syndrome treatmentn

A

steroids + aciclovir

60
Q

monitoring of LFTs when starting a statin

A

at baseline, 3 months, then 12 months

61
Q

first line antihypertensive treatment if < 55

A

ACE inhibitor / ARB

62
Q

first line antihypertensive if diabetic?

A

ACE or ARB

63
Q

first line antihypertensive if > 55

A

CCB

64
Q

first line anti-hypertensive if afro carribean?

A

CCB

65
Q

first line antihypertensive if > 55 with diabetes

A

ACE inhibitor

66
Q

wolf parkinson white features

A

accessory pathway in conduction leading to atrio-ventricular re entry tachycardia. Can lead to VF.
right axis deviation if left sided accessory pathway and vice versa

short PR interval, wide QRS with slurred upstroke ‘delta wave’

67
Q

associations with Wolf-parkinson white syndrome

A

hocm
ebsteins anomaly
mitral valve prolpase
thyrotoxicosis
secundum ASD

68
Q

1st line treatment for capillary haemangioma

A

propranolol

69
Q

1ts, 2nd, 3rd and 4th line treatment for psoriasis

A

1st line - once daily topical steroid and vit D analogue
2nd line - twice daily vit D analogue
3rd line - twice daily topical steroid or coal tar
4th line - phototherapy or MTX

70
Q

treatment in heart failure to improve mortality after all medical options have been optimised

A

cardiac resynchronised therapy (if qrs > 120 OR ejection fraction < 35%)
LVAD or transplant if young

71
Q

treatment for moderate-severe pustular acne rosasea?

A

ivermectin + doycycline

72
Q

treatment for otitis externa

A

mild - topical acetic acid 2% spray
modera/severe (discharge, hearing loss, lymphadenopathy, debris) = topical antibiotic + topical steroid

73
Q

drugs that can cause galactorrhoea

A

metoclopramide
domperidone
phenothiazines (i.e. chlorpromazine)
haloperidol
very rare: SSRIs, opioids

74
Q

treatment for lichen planus

A

topical clobetasone

75
Q

congenital condition with rocker bottom feet and overlapping fingers

A

edward syndrome (trisomy 18)

76
Q

small eyes and polydactyly

A

patau syndrome

77
Q

learning difficulties and macrocephaly

A

fragile X

78
Q

micrognathia, posterior displacement of tongue, cleft palate

A

pierre-robin syndrome

79
Q

supravalvular aortic stenosis, hypercalcaemia, short stature, learning difficulties

A

williams syndrome

80
Q

when is the OCP, POP, IUD, mirena and nexplanon effective

A

IUD - immediately
POP - 2 days
COCP, implant, injection and mirena (IUS) - 7 days

81
Q

with diagnosis of chlamydia, what partners should you notify?

A

symptomatic men - all partners past 4 weeks
women + asymptomatic men - past 6 months

82
Q

what condition should ullipristal be used with caution in

A

asthma

83
Q

antiphospholipid findings on blood test

A

prolonged APTT
thrombocytopenia

84
Q

what artery is affected if there is complete heart block after an MI

A

right coronary artery

85
Q

induction of labour if bishop score < 6

A

vaginal prostaglandin or oral misoprostol
(cervical balloon may be inserted if previous c-section or risk of hyperstimulation)

86
Q

induction of labour if bishop score < 6

A

amniotomy or iV oxytocin infusion

87
Q

red, painful eye with small pupil, ciliary flush

A

anterior uveitis

88
Q

red, painful eye with mid-dilated pupil, haloes

A

acute angle closure glaucoma

89
Q

abx of choice for dental abscess

A

amoxicillin

90
Q

abx of choice for mastitis whilst breast feeding

A

flucloxacillin

91
Q

chocolate ovarian cyst

A

endometriotic cyst

92
Q

criteria for stage 1, 2, and 3 AKI

A

stage 1
- rise in creatining >26 in 24 hours or > 1.5x baseline in 7 days. or < 0.5ml/kg/hr for 6 hours

stage 2
- creatinine 2-2.5x baseline
- urine < 0.5ml/kg/hr > 12 hours

stage 3
- creatinine > 3.5x baseline or > 354
- urine < 0.3ml/kg/hr 24 hours or anuric for 12 hours

93
Q

calcium and phosphate in rhabdomylysis

A

hypocalcaemia
hyperphosphataemia
(calcium binds to myoglobin)

94
Q

cervical cancer screening

A

25-49 -> every 3 years
50-64 -> every 5 years

95
Q

first line treatment for syphillis

A

IM benzathine penicillin

96
Q

decreases BNP levels

A

Beta blockers
Obesity
ACE inhibitors
ARB
Aldosterone inhibitors

97
Q

what anti-diabetic medication is contraindicated in heart failure

A

pioglitazone
causes fluid retension and worsens HF

98
Q

what medication is given to someone post-MI with reduced LVEF

A

aldosterone antagonist e.g. spironolactone

99
Q

biochemical effects of tumour lysis syndrome

A

high potassium and phosphate
low calcium

100
Q
A

Question bank questions (3 decks)

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