Passpapers

Question 1

Measures to increase sputum production?

Answer 1

• Physiotherapy
• Postural drainage
• Neublised saline

Question 2

Causes of low platelets in someone with cancer?

Answer 2

• Chemotherapy/radiotherapy
• Spleen/bone mets
• Platelet clumping

Question 3

What clinical factors can help assess the severity of an asthma attack from HISTORY?

Answer 3

• Usual PEFR (for comparison)
• Whether she is able to finish a sentence in one breath
• What her conscious level is (GCS)

Question 4

What clinical factors can help assess the severity of an asthma attack from EXAMINATION?

Answer 4

• HR
• RR
• Presence of breath sounds
• Presence or absence of cyanosis
• Pulsus paradoxus

Question 5

What antibiotics should be administered to someone with likely meningococcal sepsis?

Answer 5

IV benzylpenicillin and ceftriaxone

Question 6

Public health implications of meningococcal septicaemia?

Answer 6

• Bacterial meningitis is a notifiable disease
• Patient’s close contacts should be traced and offered prophylaxis

Question 7

Prophylactic measures to reduce the risk of DVT following surgery?

Answer 7

• Compression stocking
• LMWH SC prophylaxis
• Early mobilisation after surgery

Question 8

Clinical features that could indicate that a breast lesion was malignant?

Answer 8

• Peau d’orange, dimpling, ulceration
• New nipple inversion
• Bloody discharge
• Weight loss, malaise
• Cervical and axillary lymphadneopathy

Question 9

What issues need to be considered when writing a do not resuscitate order?

Answer 9

• Has the DNR been discussed with patient and the family?
• Does the patient have capacity to make the decision?
• Would resuscitation likely be successful and beneficial for the patient?

Question 10

What is the definition of a stroke?

Answer 10

Rapidly developing focal neurological deficit of vascular origin lasting over 24 hours or resulting in death

Question 11

Describe the pathogenesis of ischaemic stroke?

Answer 11

• Narrowing of blood vessels causes reduced blood flow to an area of the brain
• Central area of necrosis surrounded by a penumbra which may be salvageable if blood supply is restored
• Ischaemic cascade leads to inflammation and oedema
• Leads to activation of destructive enzymes

Question 12

Surgical management of prolapsed disc?

Answer 12

• Discectomy
• Complications:
  
  • Relieved sciatica but continuing back pain
  • Nerve damage

Question 13

Observations that should be used to confirm death?

Answer 13

• Palpation of all major pulses - absent
• Auscultation of heart for >5mins - no heart sounds
• Fixed pupil dilatation
• No respiratory effort for 1 minute

Question 14

Circumstances where it is mandatory to inform Procurator fiscal about an adult death?

Answer 14

• Sudden death
• Food poisoning
• Drug-related death
• Deaths related to neglect or complaint
• Deaths during the administration of a GA
• Legionnaire’s disease

Question 15

What is the difference between the stage and the grade of a malignant tumour?

Answer 15

• Stage
  
  • Measure of spread (eg TNM)
• Grade
  
  • Measure of histological differentiation (better differentiated = better prognosis)

Question 16

What are the causes of scrotal swelling?

Answer 16

• Epididymal cyst
• Hydrocoele
• Varicocoele
• Inguinal hernia

Question 17

What are the causes of testicular swelling?

Answer 17

• Torsion
• Epididymal-orchitis
• Cancer