Passmedicine Qs

Question 1

What’s the difference between priamry and secondary dysmenorrhea

Answer 1

primary dysmenorrhoea there is no underlying pelvic pathology

Secondary dysmenorrhoea typically develops many years after the menarche and is the result of an underlying pathology.

Question 2

Mx of secondary dysmenorrhea

Answer 2

Refer to gynae for investigation

Question 3

Mx of primary dysmenorrhea

Answer 3

NSAIDs
Mefanemic acid

2nd line - COCP

Question 4

When do you surgically excise a fibroadenoma

Answer 4

If it is above 3cm

Question 5

Tx for hepatitis A+E

Answer 5

Supportive care

Question 6

Which genetic condtion is associated with supravalvular aortic stenosis

Answer 6

Williams syndrome

Question 7

Difference between lambert Eaton syndrome and myasthenia gravis

Answer 7

Lambert Eaton usually worse affected in the legs and associated with SMALL CELL LUNG CANCER

Question 8

What should be prescribed alongside SSRIs

Answer 8

PPI as it has gastric effects

Question 9

When would you not give topiramate in migraine prophylaxis

Answer 9

In women of child bearing age - lead to pregnancy complications

Question 10

Eron class for cellulitis

Answer 10

Eron I - no signs of systemic toxicity and no uncontrolled co-morbidities

Eron II - systemically unwell or systemically well but with a co-morbidity

Eron III - systemic upset such as acute confusion, tachycardia, tachypnoea, hypotension, or unstable co-morbidities

Eron IV - sepsis syndrome or a severe life-threatening infection such as necrotizing fasciitis

Question 11

Samters triad

Answer 11

Asthma
Nasal polyps
Aspirin/ NSAID sensitivity

Question 12

What are the shockable rhythm

Answer 12

Ventricular fibrillation
Pulse less ventricular tachycardia

Question 13

Edward’s syndrome quadruple test results

Answer 13

Alphafeto protein - low
Oestriol - low
beta HCG - low
Inhibin A - normal

Question 14

Give some medications to avoid in end stage renal failure

Answer 14

NSAIDS
Lithium
Metformin
Nitrofurantoin/tertracyclines

Question 15

Main side effect of giving magnesium

Answer 15

Diarrhoea

Question 16

Features of optic neuritis

Answer 16

CRAP

Central scotoma - blind spot in middle eye
Reduced red vision
Acuity (reduced)
Painful eye movement

Question 17

When do you use each of

Ondansetron
Haloperidol
Prochlorperazine
Metoclopramide

In treating sickness

Answer 17

Ondansetron from you Oncologist - after chemo
Haloperidol for causes in your Head - raised ICP
Prochlorperazine for when you feel Peculiar (i.e. dizzy) - vestibular causes
Metoclopramide for things attached to the Mesentry - GI causes

Question 18

Why do you give lorazepam in patients with liver cirrhosis and delirium tremens

Answer 18

Because chlordiazepoxide is not metabolised properly in patients with liver cirrhosis

Question 19

Difference between chlamydia and gonorrhoeal conjunctivitis

Answer 19

Chlamydia - 5 days/ 2 weeks - later onset
Gonorrhea - from 24 hours to 5 days - earlier onset

Question 20

What is the post exposure prophylaxis of HIV

Answer 20

Oral Antiretrovirals for 4 weeks

Question 21

HSV encephalitis CT shows?

Answer 21

temporal lobe changes

Question 22

Urea levels in upper vs lower gi bleed

Answer 22

High urea levels can indicate an upper GI bleed versus lower GI bleed

Question 23

When is carboprost CI

Answer 23

Asthma

Question 24

What differentiates mania from hypomania

Answer 24

grandiose delusions according to the DSM-5 criteria

Question 25

Pilocarpine what type of drug

Answer 25

M3 agonist

Question 26

What is the classic persistent vomiting picture with electrolyte

Answer 26

Metabolic alkalosis
-hypokalaemia
-hypochloreamia
-elevated bicarbonate

Question 27

What is the treatment for invasive diarrhoea (bloody diarrhoea and fever)

Answer 27

Ciproflaxacin

Question 28

Travellers diarrhoea treatment

Answer 28

Clarithromycin

Question 29

Most effective form of emergency contraception

Answer 29

IUD

Question 30

Different age groups for perthes and SUFE

Answer 30

Perthes = Primary school (4-8)

SUFE = secondary school + obese (10-15)

Question 31

Haemoglobin level cutoff for iron supplementation in pregnancy
1st trimester
2nd/ 3rd trimester
Postpartum

Answer 31

1st trimester - 110
2nd/ 3rd trimester - 105
Postpartum -100

Question 32

What organism is associated with erythema multiforme

Answer 32

Mycoplasma pneumonia

Question 33

Why would you not give metacloperamide for more than 5 days

Answer 33

Causes extrapyramidal side effects as it is a dopamine antagonist

Question 34

Why should oxybutinin not be used in elderly

Answer 34

As it increases risk of falls

Question 35

How do you manage with hyposplenism with coeliac disease

Answer 35

-vaccine against pneumococcal, haemophilus type B, meningococcus type C
-influenza vaccine yearly

Question 36

Fluid resuscitation amount for paeds

Answer 36

10 ml/kg bolus

Question 37

What is acute dystonia and whats its treatment

Answer 37

Acute dystonia - involuntary muscle contractions and abnormal postures, particularly affecting the face, neck, and sometimes the limbs.

Tx- procyclidine (anticholinergic)

Question 38

What is tardive dyskinesia and what is the Tx

Answer 38

involuntary repetitive body movements, which may include grimacing, sticking out the tongue or smacking the lips

Tx - tetrabenzine

Question 39

Tx for akathisia

Answer 39

Propanalol

Question 40

Tx for essential tremor

Answer 40

1st line - Propranolol
2nd line- primidone

Question 41

What diseases can cause false positive syphilis VDRL results (4)

Answer 41

Some times mistakes happen

S - SLE
T- TB
M- malaria
H- HIV

Question 42

Partial vs total stroke

Answer 42

total has all three symptoms and partial has any two.
1.hemiparesis
2.homonymous hemianopia
3.higher function loss e.g. Speech