PassMed wrong Qs

Question 1

When should you treat paracetamol OD before measuring paracetamol level?

Answer 1

1. If <4h and patient is symptomatic
2. If >150mg/kg taken
3. If patient is malnourished eg anorexia

Question 2

When should activated charcoal be given in paracetamol OD?

Answer 2

If presents <1h since overdose and has taken >150mg/kg

Question 3

What is the King’s college criteria for liver transplants?

Answer 3

If pH <7.3 >24h post ingestion

Question 4

How long should CPR be continued for following thrombolysis in ALS?

Answer 4

60-90 mins

Question 5

How should cardiovascular prevention be managed?

Answer 5

1. Primary prevention –> 20mg atorvastatin
2. Secondary –> 80mg atorvastatin
   Atorvastatin is more potent than simvastatin

Question 6

When is ticagrelor vs clopidogrel given in NSTEMIs?

Answer 6

-Ticagrelor if bleeding risk is LOW
-Clopidogrel if bleeding risk is HIGH

Question 7

What does a biconvex shape on CT head indicate?

Answer 7

Acute extradural haemorrhage

Question 8

What does a crescent shape on CT head indicate?

Answer 8

Acute subdural haemorrhage

Question 9

What is the most common cause of viral meningitis?

Answer 9

Enteroviruses eg coxsackie

Question 10

How is legionella infection diagnosed?

Answer 10

Urinary antigen test

Question 11

How is mycoplasma diagnosed?

Answer 11

Serology

Question 12

How is idiopathic intracranial hypertension managed?

Answer 12

Acetazolamide (diuretic) and weight loss

Question 13

Gout: how should patients on warfarin be managed?

Answer 13

Colchicine over NSAIDs

Question 14

What organism causes epiglottitis?

Answer 14

H influenza

Question 15

What dermatological manifestation can reactive arthritis have?

Answer 15

Keratoderma blenorragica - yellow rash on soles of feet

Question 16

What malignancy is Hashimoto’s thyroiditis associated with?

Answer 16

MALT lymphoma

Question 17

What is included in the Z score and what does it help diagnose?

Answer 17

-Age
-Gender
-Ethnicity
Used in osteoporosis

Question 18

How does the Z score differ from the T score?

Answer 18

Z score compares bone mineral density of the patient to a healthy individual of the same age and sex
T score compares bone mineral density of the patient to a healthy, young individual of the same sex

Question 19

How should OE be managed in diabetics?

Answer 19

Manage with ciprofloxacin ear drops
No improvement? –> ENT referral

Question 20

What disease is associated with postural hypotension?

Answer 20

Parkinson’s in late stages

Question 21

What is the MoA of propofol, thiopental and etomidate?

Answer 21

Potentiates GABA

Question 22

Which anaesthetic agent has the lowest risk of PONV?

Answer 22

Propofol

Question 23

Which anaesthetic agent is ideally used in RSI?

Answer 23

Thiopental - highly lipid-soluble

Question 24

Which anaesthetic agent is best to use in cases of haemodynamic instability?

Answer 24

Etomidate

Question 25

Which anaesthetic agent is most useful in trauma?

Answer 25

Ketamine

Question 26

What is ketamine’s MoA?

Answer 26

NMDA receptor blocker

Question 27

How does aspirin overdose present?

Answer 27

-Respiratory alkalosis (hyperventilation)
-Tinnitus
-Vomiting
-Dehydration

Question 28

How should encephalitis be managed?

Answer 28

IV Aciclovir + IV abx

Question 29

How should HHS be managed?

Answer 29

Fluid resuscitation over 1-2h initially (slower than DKA) initially
HHS develops over a longer time period so should be corrected more slowly

Question 30

What are signs of uraemia?

Answer 30

-Pericarditis
-Encephalitis
-Anorexia
-Pruritis
-Fatigue
-Nausea

Question 31

What is lidocaine’s MoA?

Answer 31

Blocks sodium channels disrupting the action potential

Question 32

How should broad-complex tachycardias be managed?

Answer 32

Rhythm control = amiodarone
Rate control = bisoprolol or diltiazem if contraindicated

Question 33

How should keloid scars be managed?

Answer 33

Intralesional steroids

Question 34

What class of drugs is contraindicated in aortic stenosis?

Answer 34

ACE inhibitors