Past Exam Q's

Question 1

Amoxicillin dose in infective COPD exacerbation?

Answer 1

Amoxicillin 500 mg TDS for 5 days.

Question 2

How long must patient be on metformin for before considering increasing dose?

Answer 2

At least 1 week

500mg OD for at least one week
500mg BD for at least one week
500mg TDS for at least one week
Max 2g daily

Question 3

Initial and max dose of ramipril?

Answer 3

Initial: 2.5 mg once a day

Max: 5 mg twice a day or 10 mg once a day

Question 4

What is checked before the induction of anaesthesia in the WHO surgical safety checklist?

Answer 4

1) Has the patient confirmed his/her identity, site, procedure and consent?

2) Is the site marked?

3) Is the anaesthesia machine and medication check complete?

4) Is the pulse ox on the patient and functioning?

5) Allergy status of patient

6) Difficult airway or aspiration risk?

7) Risk of >500ml blood loss (7ml/kg in children?

Question 5

What is checked before skin incision in the WHO surgical safety checklist?

Answer 5

1) Confirm all team members have introduced themselves by name and role

2) Confirm patient’s name, procedure, and where the incision will be made

3) Has abx prophylaxis been given within the last 60 mins?

4) Anticipated critical concerns e.g. any anaesthetic concerns?

5) Is essential imaging displayed?

Question 6

Before the patient is put to sleep in the anaesthetic room, who confirms the patient’s identity and the procedure they have been consented +/- marked for?

Answer 6

The anaesthetist

Question 7

In a patient with septic shock with hypotension, what is given after fluids to raise BP?

Answer 7

Vasopressors

Question 8

What is the most common type of SVT?

Answer 8

AVNRT

Question 9

What assessment is done to assess acute delirium?

Answer 9

4AT

Question 10

Mx of different foetal blood sampling results:

1) ≤7.20

2) 7.21-7.24

3) 7.25

Answer 10

1) Abnormal - Inform consultant with the aim of expediting delivery

2) Borderline - Repeat in 30 mins

3) Normal - Repeat in 60 mins

Question 11

When is foetal blood sampling indicated?

Answer 11

In abnormal CTG

Question 12

Give some contraindications to the MMR

Answer 12

1) severe immunosuppression e.g. high dose steroids

2) allergy to neomycin

3) children who have received another live vaccine by injection within 4 weeks

4) pregnancy should be avoided for at least 1 month following vaccination

5) immunoglobulin therapy within the past 3 months (there may be no immune response to the measles vaccine if antibodies are present)

Question 13

What is a pica a significant cause of?

Answer 13

1) Anaemia

2) Lead poisoning

Question 14

What 8 conditions are screened for on the newborn blood spot?

Answer 14

1) congenital hypothyroidism

2) cystic fibrosis

3) sickle cell disease

4) phenylketonuria

5) medium chain acyl-CoA dehydrogenase deficiency (MCADD)

6) maple syrup urine disease (MSUD)
isovaleric acidaemia (IVA)

7) glutaric aciduria type 1 (GA1)

8) homocystinuria (pyridoxine unresponsive) (HCU)

Question 15

What is raised on newborn blood spot test in patients with CF?

Answer 15

IRT - immunoreactive trypsinogen

Question 16

How are pre and post-ductal sats measured in babies?

Answer 16

The saturation probe is applied to the baby’s right hand (pre-ductal reading) and either foot (post-ductal reading).

Question 17

What pre & post ductal sats result is normal?

Answer 17

Both readings of ≥ 95% and difference less than 3% normal (test negative) and constitutes no concerns.

Question 18

Next step if Barlow & Ortolani tests are positive?

Answer 18

US both hips at 6 weeks

Question 19

What questionnaire for depression can be used in 1ary care?

Answer 19

PHQ-9

Question 20

What test is used to assess if treatment is working in colorectal cancer?

Answer 20

CEA

Question 21

At what aortic valve gradient should aortic valve replacement be considered?

Answer 21

≥50mmHg

+ symptoms, or
+ reduced LV EF (<50%)

Question 22

is there a role of medications in aortic stenosis?

Answer 22

No - only surgery

Question 23

Typical creatine kinase levels in rhabdo?

Answer 23

> 10,000

Question 24

Duloxetine vs amitriptyline for neuropathic pain in renal impairment?

Answer 24

Amitriptyline > duloxetine

Question 25

What can be used to reduce oral candidiasis with steroid inhaler?

Answer 25

Use a large volume spacer - reduces drug deposition in mouth.

Question 26

What are anticardiolipin antibodies?

Answer 26

A type of antiphospholipid antibody –> antiphospholipid syndrome.

They are associated with an increased risk of stroke.

Question 27

What are the 3 key antiphospholipid antibodies?

Answer 27

1) Anticardiolipin antibodies

2) Anti-beta-2-glycoprotein-I antibodies

3) Lupus anticoagulants

Question 28

What organism can cause bilateral pneumonia and meningitis?

Answer 28

Strep. pneumoniae

Question 29

What feature of C. diff makes it particularly difficult to destroy?

Answer 29

Spore formation

Question 30

1st line treatment for acute severe mania?

Answer 30

Antipsychotic

Question 31

Stepwise mx of urogenital prolapse?

Answer 31

1) If asymptomatic/mild –> none

2) Conservative –> weight loss, pelvic floor exercises

3) Ring/pessary

4) Surgery

Question 32

What can be given for breathlessness in end stage HF (if furosemide has already been given)?

Answer 32

Morphine

Question 33

Mechanism of neostigmine?

Answer 33

A cholinesterase inhibitor –> reduces the breakdown of ACh at the NMJ, increasing it’s availability to bind to the ACh receptor and trigger muscle contraction.

Role –> reversal agent for non-depolarising muscle relaxants.

Question 34

What can be used for palliation of dysphagia in patients with oesophageal cancer?

Answer 34

Placement of an oesophageal stent.

This involves the placement of a metal or plastic stent into the oesophagus to hold it open, allowing
food and liquid to pass through.

Question 35

What is the most appropriate initial investigation to confirm the diagnosis of myeloma?

Answer 35

Serum free light chains testing

This will detect the presence of Bence-Jones protein, characteristic of myeloma.

Question 36

Describe histology of a fibroadenoma

Answer 36

Duct-like structures lined by regular, low columnar cells separated by loose fibrous tissue, with well defined margins.

Question 37

At what hCG are you likely to see an intrauterine pregnancy on an US?

Answer 37

1500-2000

Question 38

Getting pregnant after methotrexate use?

Answer 38

Avoid getting pregnant for 3 months if ONE methotrexate dose

Avoid getting pregnant for 6 months if ≥TWO doses

Question 39

hCG levels in different mx options for ectopic?

Answer 39

<1000 - expectant

<1500 - medical

> 5000 - surgical

Question 40

What is the PCR threshold for significant proteinuria in pregnancy?

Answer 40

≥30

Question 41

When does BP peak after birth?

Answer 41

Day 4 postpartum

Question 42

What is the biggest risk factor for uterine rupture?

Answer 42

Trial of labour after previous c-section

Question 43

Is postpartum endometritis more commonly following c-section or vaginal delivery?

Answer 43

C-section

Question 44

2 most common organisms causing postpartum endometritis?

Answer 44

GBS
Staph. epidermis
GAS

Question 45

How soon before onset of labour do membranes rupture in PROM?

Answer 45

At least 1 hour prior to onset of labour

Note - PROM occurs ≥37 weeks gestation

Question 46

Role of riluzole?

Answer 46

Glutamate antagonist - used to treat amyotrophic lateral sclerosis (prolong survival).

Question 47

Define orthostatic hypotension

Answer 47

Systolic drop >20mmHg at 1 min or 3 mins

Question 48

When is colchicine indicated in pericarditis?

Answer 48

May be given alone or alongside NSAIDs for patients with RECURRENT or continued symptoms.

Question 49

Mechanism of N-acetylcysteine?

Answer 49

Replenishes body’s stores of glutathione

Question 50

How long to give PEP for?

Answer 50

Within 72h for 4 weeks

Question 51

ET tube vs tracheostomy for long term ventilation?

Answer 51

Tracheostomy recommended for ventilation >14 days.