passport3

Question 1

What is the Dx criteria for Anorexia nervosa? (3 things)

Answer 1

DM5 criteria:

1. Restricted dietary intake
2. Fear of gaining weight
3. Denying that they’re skinny

Question 2

What are the CF of Anorexia Nervosa? (4 things)

Answer 2

1. Low BMI
2. Bradycardia
3. Hypotension
4. ENLARGED salivary glands

Question 3

What are the physiological abn in Anorexia Nervosa? (4 low, 4 high)

Answer 3

Low:

1. Low K
2. Low FSH / LH / Oestrogen / Testosterone
3. Low T3
4. Low glucose tolerance (–> DM)

High (Gs n Cs):

1. High GH
2. High Cortisol
3. Hypercholesterolaemia
4. Hypercarotinaemia (yellow skin)

Question 4

What is the NICE tx for Anorexia Nervosa for ADULTS vs CHILDREN?

Answer 4

• Adults: Eating-Disorder Focused CBT (CBT-ED)
• Children: Family Therapy // (2nd line CBT)

Question 5

What are the RF for AAA? (3 things)

Answer 5

1. HNT
2. DM
3. Smoking

Question 6

What does presence of symptoms of AAA mean?

Answer 6

Ruptured / soon rupture

Question 7

What direction do ruptures happen in AAA?

Answer 7

80% rupture post –> Retroperitoneal space

20% rupture ant –> Peritoneal cavity (poor prognosis)

Question 8

What should you do with an AAA 3- cm?

Answer 8

Nothing, this is not an AAA

Question 9

What should you do with an AAA that is 3 - 4.4 cm?

Answer 9

Rescan every 12 months (SMALL aneurysm)

Question 10

What should you do with an AAA that is 4.5 - 5.4 cm?

Answer 10

Rescan every 3 months (MEDIUM aneursym)

Question 11

What should you do with an AAA that is 5.5+ cm?

Answer 11

Refer 2ww to Vasc surgery

(LARGE aneursym)

Question 12

What is the screening for AAA?

Answer 12

Single abd US for males 65 yrs

Question 13

What is the surgical tx for AAA? (2 options)

Answer 13

1. Elective EndoVascular Repair (EVAR)
2. Open repair (if EVAR unsuitable)

Question 14

What is EVAR? (2 things)

Answer 14

1. Tx for AAA
2. Stent put into Abd Aorta via Femoral Artery

Question 15

What are the CF of a RUPTURED AAA? (3 things)

Answer 15

1. Severe Cenntral Abd pain (–> radiating to back)
2. Pulsatile expansile mass in abd
3. Shock (hypotension + tachy or even Collapsed)

Question 16

How do you manage a RUPTURED AAA? (3 things)

Answer 16

• Haemo unstable: Str8 to theatre, emergency surgical repair
• Haemo Stable: CT angiogram to confirm Dx, see suitability for EVAR
• DONT FOTGET: organised 6 units crossmatch blood

Question 17

What is the relation between Schizophrenic n Heart Murmurs?

Answer 17

Schizophrenics have high risk of CVS diseases

(linked to antipsychotic meds n smoking rates)

Question 18

What features show POOR prognosis in Schizophrenics? (5 things)

Answer 18

1. Strong FHx
2. Low IQ
3. Gradual onset
4. Lack of obvious precipitant
5. Prodromal phase of social withdrawal

Question 19

How can Clozapine (atypical antipsychotic) cause HF?

Answer 19

HF secondary to Myocarditis / Cardiomyopathy

Question 20

What psych meds is CI in ppl with severe CVS disease?

Answer 20

Clozapine

Question 21

Which psych meds can cause a ECG change?

What is the ECG change?

Answer 21

Haloperidol (typical antipsychotic)

QT prolongation

Question 22

How long should women w UTI’s be put on Nitrofurantoin n Trimethoprim?

Answer 22

3 days course

Question 23

When should a woman w UTI send a urine culture? (3 times)

Answer 23

1. 65+ yrs
2. Visible / invisible haematuria
3. Pregnant

Question 24

What abx can you give a PREGNANT woman w UTI?

Answer 24

FIRST LINE: Nitrofurantoin (in 1st trimester, avoid in 3rd)

SECOND LINE: Amoxicillin / Cefalexin

(can give Trimethoprin, but teratogenic in 1st trimester, n Passmed says avoid during pregnancy altogether)

Question 25

What Bipolar meds are CI in pregancy?

Answer 25

Sodium valproate –> Spina bifida

Question 26

What bipolar meds require extra monitoring in pregnancy?

What does NICE say?

Answer 26

Lithium

If Lithium given in preg –> monitor serum lithium levels every 4 wks until 36th week –> then every week until delivery

Question 27

Are SSRI’s safe in pregnancy?

Answer 27

Yes