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Question bank questions > Passmed Questions 2.0 > Flashcards

Passmed Questions 2.0 Flashcards

1
Q

when should you give prophylactic abx for spontaneous bacterial peritonitis? what antibiotic would this be?

A

oral ciprofloxacin
if previous SPB infection
ascitic tap protein 15 or less
child pugh 9 or more
hepatorenal syndrome

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2
Q

what condition would over estimate HbA1c?

A

splenectomy due to long half life of RBC

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3
Q

treatment for hiccups in palliative care

A

chlorpromazine or haloperidol

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4
Q

pathophysiology of primary biliary cholangitis

A

interlobula bile ducts become inflammed –> cholangitis –> cirrhosis

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5
Q

ovarian tumour associated with Meig’s syndrome

A

fibroma
(benign tumour)

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6
Q

most common ovarian tumour found in women of reproductive age?

A

follicular cyst

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7
Q

most common ovarian tumour found in young women < 25 years

A

dermoid cyst (teratoma)

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8
Q

precipitating factors for digoxin toxicity

A

hypokalaemia, hypomagnaesaemia
hypercalcaemia, hypernatraemia
low albumin
hypothermia, hypothyroidism
amiodarone, verapamil, diltiazem, ciclosporin, spironolactone, thiazide and loop diuretics
increasing age, renal failure,

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9
Q

HF medications which may precipitate digoxin toxicity

A

spironolactone
loop diuretics
thiazide like diuretics
verapapmil, diltizem

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10
Q

electrolyte abnormalities which could precipitate digoxin toxicity

A

low K, Mg, temp, albumin, thyroid
high Na, Ca

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11
Q

at what fasting glucose should insulin be started immediately in pregnant patients

A

if fast glucose 7 or higher then start insulin
if > 5.6 but < 7 - lifestyle advice + metformin

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12
Q

cancer with raised AFP and bHCG

A

non-seminoma testicular cancer

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13
Q

cancer with raised 15-3

A

breast cancer

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14
Q

bombesin tumour marker

A

gatsric cancer, neuroblastoma, small cell lung cancer

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15
Q

S-100 tumour marker

A

schwannoma, melanoma

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16
Q

treatment for genital warts

A

multiple, non-keratinized: topical popdophyllum
solitary, keatinized: cryotherapy

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17
Q

what is the target time for thrombectomy and thrombolysis in stroke patients

A

thrombolysis - 4.5 hours
thrombectomy - 6 hours

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18
Q

when should bells palsy have urgent referral to ENT

A

no improvement within 3 weeks

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19
Q

features of herpes simplex encephalitis on CT

A

bilateral temporal lobe hypodensities

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20
Q

features of temporal lobe involvement

A

aphasia
hemiparesis
memory impairment

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21
Q

antiemetic used in parkinsons

A

domperidone
acts as dopamine antagonist but doesnt cross BBB so can safely be used in parkinsons

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22
Q

dose of rectal diazepam in seizure emergency

A

< 1 year - 5mg
2-11 years - 5-10mg
11-17 years - 10mg
adult - 10-20mg
elderly - 10mg

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23
Q

does cushings reflex cause wide or narrow pulse pressure

A

wide pulse pressure

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24
Q

what blood test is used to check response to treatment in hashimotos

A

TSH

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25
Q

tear drop poikilocytes on blood film

A

myelofibrosis
megaloblastic anaemia
thalassaemia

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26
Q

fist line treatment for ITP

A

oral prednisolone

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27
Q

blood film feature of DIC

A

schistocytes

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28
Q

what type of cancers are at increased risk with the COCP?

A

breast and cervical

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29
Q

Monomorphic rash with punched out erosions - diagnosis? causative organism? treatment?

A

eczema herpeticum
HSV 1 or 2
admit for IV aciclovir

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30
Q

indications for high dose folic acid in pregnancy

A

taken 3 months prior to conception to 12 weeks pregnancy
either partner has NTD, previous pregnancy with NTD or family history of NTD
diabetes, thalassaemia, coeliac, antiepileptic medications
obsese (BMI 30 or higher)

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31
Q

features on fundoscopy and condition they are found in;
- drusen
- cotton wool spoots
- flame haemorrhages
- AV nicking
- cupping of optic disc

A

drusen - age related macular degeneration
cotton wool spots - HTN, diabetic retinopathy
flame haemorhages - HTN
AV nicking - HTN
- cupping of optic disc - glaucoma

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32
Q

cancers associated with dermatomyositis

A

ovarian and lung cancer

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33
Q

cancer associated with
- migratory thrombophlebitis
- necrolytic migratory erythema
- pyoderma gangrenosum
- tylosis

A

pancreatic
glucaganoma
myeloproliferative disorders
oesophageal

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34
Q

live attenuated vaccines

A

BCG
MMR
oral polio
yellow fever
oral typhoid

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35
Q

treatment for heart block post MI

A

no treatmet if asymptomatic
transcutaneous pacing if symptomatic +/or elderly

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36
Q

drugs that can induce erythema nodosum

A

penicillin
sulphonadmides
COCP

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37
Q
A
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38
Q

good prognostic factors for SCC

A

well circumscribed lesion
< 20mm diameter
<2mm deep
no associated disease

39
Q

surgical margins for excision of SCC

A

if < 20mm then 4mm margin
if > 20mm then 6mm margin

40
Q

what cancer are renal transplant patients at risk of

A

SCC

41
Q

treatment for antiphospholipid syndrome during pregnancy

A

aspirin + LMWH
(LMWH usually continued 6 weeks post partum or until oral anticoagulant can be restarted)

42
Q

whats the most common cardiac abnormality found in downs syndrome

A

AVSD
(endocardial cushion defect)

43
Q

wells score criteria

A

bed bound >3 days or recent major surgery in past 12 weeks
leg swelling >3cm
previous DVT/PE
tachycardia (HR > 100)
active cancer
collateral superficial veins
entire leg swollen
pitting oedema
tenderness along deep venous system
differential diagnosis unlikely

if > 2 then USS
if < 2 then d-dimer

44
Q

medication used to prevent;
- calcium stones
- urate stones
- oxalate

A

calcium stones - thiazide like diuretics
urate stones - allopurinol oral bisophosphonate
oxalate - pyridoxine, cholestyramine

45
Q

1st line treatment for renal stones

A

<5mm and asymptomatic - watch and wait
5-10mm - shockwave lithotripsy
10-20mm - SWLT or ureteroscopy
> 20mm - percutaneous nephrolithotomy

if pregnant –> SWLT contraindicated

46
Q

1st line treatment for ureteric stones

A

<10mm - SWLT +/- alpha blockers
10-20mm - ureteroscopy

47
Q

acute heart failure with hypotension management

A

1st line - HDU for inotropic support
2nd line - vasopressors
3rd line - mechanical circulatory assistance i.e. intra aortic balloon counterpulsation or LVAD

48
Q

treatment for magnesium sulphate induced respiratory depression

A

calcium gluconate

49
Q

most common congenital heart disease in new born and at 1-2 months age

A

new born - transportation of great arteries
if 1-2 months of age - tetralogy of fallot

50
Q

mode of action of bupropion

A

used for smoking cessation
norepinephrine-dopamine reuptake inhibitor and nicotinic antagonist

51
Q

mode of action of varenicline

A

used for smoking cessation
partial nicotinic receptor agonist

52
Q

colorectal screening

A

FIT test every 2 years people aged 50-74 in scotland ,60-74 years in england

53
Q

when do you refer patients with sciatica +/- known disc prolapse to neurosurgery

A

after 4-6 weeks of conservative management

54
Q

most common infective organism in bronchiectasis

A

H. influenzae

55
Q

indications for surgery in bronchiectasis

A

uncontrollable haemoptysis
localised disease

56
Q

rules for pregnancy women unvaccinated against Rubella during pregnancy

A

MMR live attenuated so not given during pregnancy
can be given in post-natal period
advise to keep away from people who may have rubella

57
Q

breast lump with green discharge

A

mammary duct ectasia

57
Q

irregular breast lump in obese lady with skin tethering

A

fat necrosis

58
Q

discrete, non-tender lump in breast of 20 year old

A

fibroadenoma

59
Q

lumpy tender breasts which may become painful during menstruation

A

fibroadenosis (fibrocystic disease)

60
Q

breast lump associated with bloody stained nipple discharge

A

ductal pappiloma

61
Q

night blindness and tunnel vision?

A

retinitis pigmentosa

62
Q

how should you alter long acting insulin on the day of surgery

A

reduce dose by 20%

63
Q

what is an acceptable level of PSA post prostatectomy?

A

undetectable
any level of PSA should require urgent referral to oncology

64
Q

1st line management in paediatrics with constipation?

A

advice on diet and exercise + movicol paediatric plain

65
Q

drug causes of lung fibrosis

A

amiodarone
bleomycin, busulphan
sulfasalazine, MTX
cabergoline, bromocriptine, pergolide
nitrofurantoin

66
Q

whats the most appropriate test to confirm h.pylori eradication after completing treatment

A

urea breath test

67
Q

main indication for placing chest drain in pleural infections

A

purulent discharge
growth of organisms
PH < 7.2

68
Q

1st, 2nd and 3rd line treatment for anal fissure

A

1st: increase dietary fiber, bulk forming laxatives or lactulose if not tolerated
2nd: topical GTN, topical diltiazem if GTN not tolerated
3rd: if fails after 8 weeks of treatment the consideration of referral for surgical management - sphincterectomy or botulinum toxin

69
Q

pregnant and exposed to chickenpox. Not symptomatic. Dont know if they have previously had chickenpox. What do you do?

A

check varicella IgG Ab

70
Q

pregnant and exposed to chickenpox. Symptomatic. What do you do?

A

discuss with Obs and Gynae

71
Q

pregnant and exposed to chickenpox. Asymptomatic. Previously had chickenpox. What do you do?

A

Reassure

72
Q

1st, 2nd, 3rd and 4th degree perineal tears

A

1st degree: superficial no muscle involvement
2nd degree: injury to perineal muscle
3rd degree: tear of the anal sphincter complex
4th degree: tear of anal sphincter complex and rectal mucosa

73
Q

WHO categories of obese on BMI ranges

A

BMI 30 - 34.9 obese type I
BMI 35-39.9 obese type II
BMI 40 and above obese type III

74
Q

what type metabolic abnormality does cushings cause

A

hypokalaemia metabolic alkalosis

75
Q

XR features of perthes disease

A

early: widened joint space
late: flattening of the femoral head

76
Q

firm painless lump in the eyelid and management

A

chalazion (meiboman cyst)
resolve spontaneously but sometimes require surgical drainage

77
Q

treatment for stye

A

hot compress
antibiotics if there is associated conjunctivitis

78
Q

treatment for gatsroenteritis in severe cases +/or immunocompromised patients

A

ciprofloxacin

79
Q

causative organism of keratitis found in contact lens wearers?

A

pseudomonas
staph aureus if not contact lens wearer

80
Q

treatment for keratitis

A

stop wearing contacts until resolves
topical quinolone

81
Q

what is the antidepressant of choice in a breast feeding woman?

A

sertraline or paroxetine

82
Q

what medication should be given in patient with subarachnoid haemorrhage

A

nimodipine to prevent vasospasm

83
Q

features of pesticide poisoning

A

increase in parasympathetic acitivity i.e. drooling
bradycardia
small pupils (miosis)

84
Q

whats the earliest time external cephalic version can be offered in nuliparous and multiparous women?

A

nuliparious - 36 weeks
multiparous - 37 weeks

85
Q

what chromosomes are BRCA 1 and BRCA 2 located on?

A

BRCA 1 - chromosome 17
BRCA 2 - chromosome 13

86
Q

what cancers does BRCA 2 put men at risk of

A

breast and prostate

87
Q

when is the anomaly scan done

A

18-20 weeks

88
Q

pigmented laded macrophages suggestive of melanosis coli. what is the cause of this

A

laxative abuse

89
Q

what antiemetic is recommended in patients with mirgaine

A

prokinetic such as metoclopramide

90
Q

what type of laxative is first line in patients with IBS

A

bulk forming laxative such as isphagula husk

91
Q

what type of hearing test is done at the newborn screening

A

otoaccoustic emission test

92
Q

what type of hearing test is done at school entry age

A

pure tone audiometry

93
Q

treatment for recurrent c.diff infection within 12 weeks of prev infection

A

oral fidaxomicin

Question bank questions (4 decks)

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