Passpaper

Question 1

Causes of coma?

Answer 1

hypoglycaemia
hyperuraemia
hypoxaemia
trauma
meningitis
opioid overdose
alcohol

Question 2

What causes a fixed dilated pupil?

Answer 2

Compression of 3rd cranial nerve

Question 3

4 features of brainstem death?

Answer 3

No respiratory effort without ventilator
Fixed pupils unreactive to light
No corneal reflex
No cough reflex
No response to supra orbital pressure
Flat EEG

Question 4

What screening for microvascular damage in diabetes?

Answer 4

Retinal Screening

Kidney - urine albumin and serum creatinine

Foot care screening - monofilament

Question 5

What AD safe in breatfeeding?

Answer 5

paroxetine

Question 6

Features to look out for on breast axam?

Answer 6

Axial lymph node involvement

Is lump tethered or movable from the skin

Nipple discharge
Erythema
Peau D’orange
Paget’s disease of the nipple

Question 7

What artery supplied the superior and inferior vesical arteries?

Answer 7

Internal iliac

Question 8

What lymph nodes should surgeron consider when removing bladder and prostate?

Answer 8

External Iliac

Obturator

Internal iliac (hypogastric)

Common Iliac nodes

Question 9

Heart sound in pericarditis?

Answer 9

Pericardial rub

Question 10

Constrictive pericarditis vs Tamponade?

Answer 10

ff

Question 11

Two causes of floaters?

Answer 11

Retinal Detachment
Posterior vitreous detachment
Eye Injury
Vitreous degeneration
Ageing

Question 12

Investigations of retinal detachment? What would you see?

Answer 12

Fundus photography - Schaffer’s sign - thin beam of bright light without a lens and see fine pigment floating in the anterior vitreous

Opthamoscopy
USS - flying angel sign

Question 13

3 defining features of a health economic evaluation?

Answer 13

cost of both services
benefits of both services
comparison of cost and benefit of the service and alternative service

Question 14

What are two features comprising a QALY?

Answer 14

number of years

quality of life (utility)

Question 15

What system do health economists use to evaluate disability?

Answer 15

DALYS - disability adjusted life years

Question 16

Define healthcare economic efficiency?

Answer 16

getting maximum cost/health benefit outcomes from a service

Question 17

What is the term when treatment is given elsewhere and benefit foregone other patients?

Answer 17

Opportunity cost

Question 18

What are the paraneoplastic changes seen in different lung cancer?s

Answer 18

Small cell - ADH, ACTH

Squamous cell - PTH

Question 19

Salter-harris classification?

Answer 19

hh

Question 20

How would you describe a fracture?

Answer 20

complexity
type
location
comminution
displacment

mention - AP film

Question 21

3 methods of rate control?

3 methods of rhythm control?

Answer 21

i) beta-blocker, digoxin, diltiazem/verapimil

ii) amiodarone, flecanide, dc cardioversion

Question 22

What is the cause of ramsay-hunt? Where does it reside?

Answer 22

varicella zoster

geniculate ganglion

Question 23

What would it be if there was low PTH and high calcium?

Answer 23

Bony mets

Myeloma

Question 24

Complications of iron overload due to transfusion?

Answer 24

Diabetes
Hypothyroid
Hypoparathyroid
Hypogonadism
Cardiomyopathy
Liver cirrhosis

Question 25

Investigations of beta-thalassaemia?

Answer 25

FBC - microcytic hypochromic anaemia | haemoglobin electrophoresis

Question 26

What is the pathophysiology behind anaphylaxis?

Answer 26

Type I hypersensitivity - IgE and mast cells vasodilation, increases vascular permeability, bronchocoonstrictor

Question 27

RFs for bladder cancer?

Answer 27

smoking aromatic amines in indistrial dyes pelvic radiation schistomiasis (squamous cell)

Question 28

2 groups of lymph nodes which drain bladder?

Answer 28

Obturator External iliac internal iliac Common iliac

Question 29

Vesical arteries supply bladder? Where do these branch from?

Answer 29

Internal iliac arteries superior vesical artery branches from umbilical artery whcih branches from internal iliac

Question 30

Differential diagnoses for breast lump?

Answer 30

Cancer Fibroadenoma Cysts Fat necrosis Intraductal papilloma

Question 31

3 features of malignant lump?

Answer 31

hard painless fixed to surrounding nipple inversion skin changes (peau d'orange) irregular margins bloody discharge

Question 32

Treatments for ER positive, HER2 +?

Answer 32

radiotherapy tamoxifen (pre-menopause) anastrozole (post-menopause) herceptin (trastuzumab)

Question 33

Complication with cancer, thirst confusion, constipation? treatment?

Answer 33

Hypercalcaemia due to bony mets IV fluids

Question 34

Common site for bone marrow biopsy?

Answer 34

Post iliac crest

Question 35

genetic translocation for patients with CML? Name?

Answer 35

reciprocal translocation 9 and 22 philadelphia - causes increased tyrosine kinase activity. Thats why tyrosine kinase inhibitor!!! imatinib

Question 36

How can you identify philadelphia chromosome?

Answer 36

FISH karyotyping

Question 37

Test cancer, invest?

Answer 37

test USS

Question 38

Incision for orchidectomy, where and why?

Answer 38

Inguinal incision = avoid seeding in the scrotum Blood supply for scrotum and testical are different

Question 39

4 members present at MDT?

Answer 39

Radiologists Surgeron Oncologist Specialist nurse Pathologist

Question 40

Neutropenic sepsis? invest?

Answer 40

FBC, LFTs Blood culture CXR urine culture sputum culture swabs of infected wounds

Question 41

4 symptoms make you concerned about spinal cord compression?

Answer 41

lower limb weakness bladder dysfucntion loss of bowel function severe back pain

Question 42

Treatment for spinal cord compression?

Answer 42

Surgery to stabilise spine Radiotherapy Steroids