PassMedicine

Question 1

what is the first line investigation for suspected acute pancreatitis

Answer 1

USS

Question 2

what might indicate a gallstone as a cause of acute pancreatitis on bloods

Answer 2

raised ALP

Question 3

what investigation is used to differentiate chronic pancreatitis and pancreatic carcinoma

Answer 3

CT

Question 4

what investigation is used for chronic pancreatitis

Answer 4

MRI

Question 5

what colour does copper turn the gums

Answer 5

green

Question 6

what would be found on examination and on bloods with alcohol toxicity

Answer 6

alcohol is a depressant
low RR
low glucose levels

Question 7

what is the triad of features associated with opioid overdose

Answer 7

CNS depression (decreased consciousness)
resp depression (decreased RR)
mioisis (constriction)

Question 8

what is the gold standard investigation and treatment for opioid overdose

Answer 8

IV naloxene

Question 9

what is the first and second line treatment for an acute asthma attack with hypoxaemia (<94%)

Answer 9

1 100% O2 until sats are between 94-98
2 SABA (salbutamol)

Question 10

what is the first line treatment for an acute asthma attack without hypoxaemia (>94%)

Answer 10

SABA (salbutamol)

Question 11

what is the mneumonic for treatment of a MI

Answer 11

MONA

morphine or GTN for pain relief
oxygen if sats <94%
nitrates
antiplatelets or anticoagulation

Question 12

what is the treatment for PE

Answer 12

1 IV heparin

2 followed by warfarin

Question 13

what is the treatment for status epilepticus

Answer 13

<30mins (benzodiazepines)
-before resuscitation: rectal diazepam
-after resuscitation: IV lorazepam
<120mins 
-IV antiepileptics (phenytoin or valproate)
>120mins
-general anaesthetics (propofol)

Question 14

what conditions produce a sweet odour

Answer 14

AKI
liver failure (older patients)

Question 15

how does chronic steroid use lead to adrenal crisis

Answer 15

chronic steroid use suppresses the HPA axis
if steroid use is suddenly stopped, this causes an adrenal crisis as there are increased levels of ACTH
the amount of ACTH exceeds the adrenal glands ability to respond

Question 16

what are features of malaria by p. falciparum

Answer 16

more severe

mental changes

Question 17

what shows first on an ECG with a MI

Answer 17

1st: hyperacute T waves
2nd: ST elevation

Question 18

why might a patient have had an MI but CK levels by normal

Answer 18

CK takes up to 12 hours to rise

Question 19

what is the gold standard investigation for SAH

Answer 19

CT

Question 20

what is crescendo/unstable angina

Answer 20

progressively worsening angina

Question 21

what is classic angina

Answer 21

chest pain on exertion relieved by rest

Question 22

what is decubitis angina

Answer 22

chest pain when the patient lies down due to LV dysfunction

Question 23

what is prinxmental/variant angina

Answer 23

completely random chest pain

Question 24

what is nocturnal angina

Answer 24

wakes patient up with chest pain

Question 25

what is the gold standard investigation for aortic dissection

Answer 25

contrast CT

Question 26

what is the gold standard investigation for suspected aortic dissection with renal failure

Answer 26

MRI

Question 27

what is the first line treatment for anaphylaxis in adults

Answer 27

0.5mg adrenaline IM

Question 28

what is the first line treatment for anaphylaxis in children aged 6-12yrs

Answer 28

0.3mg adrenaline IM

Question 29

which heparin is better for DVT

Answer 29

LMWH as it has greater efficacy