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MRCP 2 > Past paper > Flashcards

Past paper Flashcards

1
Q

pulmonary embolism in a 34-year-old woman who also has livedo reticularis and a prolonged activated partial thromboplastin time =

A

Antiphospholipid syndome

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2
Q

widespread skin eruption 2 weeks after having had a sore throat.
5-mm diameter, scaly, erythematous papules over her trunk and limbs

A

guttate psoriasis

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3
Q

broad spectrum Abx therapy now diarrhoea
CT - thickened sigmoid colon

A

pseudomembranous colitis ie C diff

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4
Q

When is someone immunocompromised with if taking prednisolone?

A

prednisolone 40 mg (or more) for longer than 7 days,

prednisolone 20 mg (or more) for longer than 14 days

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5
Q

End-stage renal disease and this in fingers?

A

secondary hyperparathyroidism

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6
Q

4-year history of acute intermittent pain and swelling of the knees one at a time. Normal serum urate during attack.
Obese, hepatomegaly. Swollen metacarpophalangeal joints on right hand. Urinalysis showed glucose 3+. BM 14

A

haemochromatosis

As systemic disease, asymetrical arthiritis

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7
Q

Pancreatitis due to ++ hypertriglycerides prevention?

A

Fibrates Eg ciprofibrate

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8
Q

43-year-old woman was investigated for increasing abdominal girth, nausea and alteration of bowel habit.

A

pseudomyxoma peritonei

not a HCC as tumour from outside liver

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9
Q

leg weakness and tenderness, which was worse on exercise.
Raised MCV
Raised CK
anti-thyroid peroxidase antibodies positive
anti-gastric parietal cell antibodies positive
dX?

A

Hypothyroidism - mild rise in CK in 90%
[wouldn’t see this in pernicious anaemia]

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10
Q

When a pacemaker for pauses

A

> 3s in someone awake
<3s if definite symptoms associated

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11
Q

when can you classify AF as paroxysmal

A

> 30 seconds

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12
Q

Immunocompromised with CAP - CXR patchy shaddowing right base rx?

A

Oral amox and clary

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13
Q

pain and swelling of his left knee 4 weeks after a holiday in Spain. 38.1°C
CRP 210

A

Reactive

[Reactive Run - rash on soles]
keratoderma blennorrhagica

Gonococcal
-Migratatory and tendosynovitis - no rash palm soles

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14
Q

baseline spirometry:
FEV1 90% predicted
FVC 91% predicted

20 minutes after exercise:
FEV1 63% predicted
FVC 84% predicted

A

exercise-induced asthma

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15
Q

4-cm thyroid swelling
Previous adrenalectomy for a benign pheochromocytoma
What is the thyroid swelling?

A

MEN2
Calcitonin producing medullary Thyroid Ca

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16
Q

hypokalaemic, hypochloraemic metabolic alkalosis with hypertension
Raised renin

A

Fibromuscular dysplasia of the renal artery leads to renal artery stenosis

Conns = low renin

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17
Q

right-sided shoulder weakness when his R scapula “stuck out” painlessly during weightlifting.
Previous injury
Cousin has a muscular dystrophy
Isolated right serratus anterior muscle weakness.

A

Brachial neuritis

Muscular dystrophies are symmetrical
Radiculopathy wouldn’t do just specific serratus anterior

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18
Q

50-year-old woman has evidence of purpura and peripheral sensorimotor neuropathy.
Positive anti-MPO antibodies

A

microscopic polyangiitis

Not GPA - neither the purpura nor the neuropathy is suggestive of granulomatous involvement

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19
Q

Which sleep disorder has risk of Parkinson’s disease

A

Rapid eye movement-sleep behaviour disorder

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20
Q

29F 12-hour history of severe throbbing headache and right-sided weakness.
COCP and extacy use.
LP - mild raised pressure

A

cerebral venous thrombosis

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21
Q

Hypertension Rx options in preg

A

Labetalol, methyldopa and nifedipine

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22
Q

10 year history - right conductive deafness, a right palatal palsy, dysphonia, a non-explosive (bovine) cough and wasting of the right side of her tongue

A

glomus jugulare tumour
[Insidious over years with lower MN signs]

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23
Q
A

Sinus rhythm with normal PR and QT intervals.

Partial right bundle branch block pattern
STE, leading to T-wave inversion in leads V1 and V2.

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24
Q

26 breathlessness associated with chest discomfort.
Asthma

A

negative QRST complexes in lead I and aVL that look like inversions of the normal morphology
QRS complex in aVR is isoelectric (usually it is clearly negative).

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25
Q

26M Left sided chest pain
FHx angina
systolic murmur at the left sternal edge.

A

hypertrophic cardiomyopathy

inferior Q waves [ reflect prolonged depolarisation of the hypertrophied interventricular septum]
and marked T-wave inversion in leads I, aVL, V2–V5.
precordial complexes suggest left ventricular hypertrophy (LVH) (26-mm R wave in V3).

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26
Q
A

Second degree HB type 1
frequent non-conducted P waves with a progressive increase in the PR interval before the ‘dropped’ beats.

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27
Q

7-month history of a progressive, asymptomatic, slightly scaly rash. Previous topical therapy ineffective

A

pityriasis versicolor caused by the yeast Malassezia

Itraconazole

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28
Q

Rx of heparin-induced thrombocytopenia

A

anticoagulate with argatroban or danaparoid

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29
Q

anaemia and thrombocytopenia with fragmentation of red cells. Raised lactate
fever and headaches, no significant renal impairment and normal coagulation screen

A

Thrombotic thrombocytopenic purpura

HUS would have renal impairment and abnormal coag

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30
Q

2-day history of occipital headache of sudden onset, vertigo and unsteadiness, choking on solids
right-sided partial ptosis - His right pupil was smaller than the left and both reacted normally to light.
on attempting to say “aah”, his palate moved upwards and to the left.
Unsteady and fell to right when attempt to mobilise

A

vertebral artery dissection

sudden-onset headache, vertigo and unsteadiness = vascular

lateral medullary involvement (ipsilateral Horner’s syndrome, ipsilateral laryngeal, pharyngeal, and palatal hemiparalysis) and cerebellar involvement (unsteadiness).

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31
Q

36-year-old homeless woman was found unconscious in the street.

A

SAH

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32
Q

5-day history of confusion and fever
CSF:
total protein 0.60 g/L (0.15–0.45)
glucose 3.5 mmol/L (3.3–4.4)
white cell count 20/µL (≤5)
cytology predominantly lymphocytes

A

HSV encephalitis

MR scan shows evidence of increased signal in the left temporal lobe,

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33
Q

In prostate Ca what is the role of bicalutamide when you give it with goserelin?

A

reduces goserelin-induced tumour flare

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34
Q

Systemic sclerosis
Now severe headache and BP 188/132 mmHg Her optic fundi showed bilateral haemorrhages. She had no neurological deficit.
Rx?

A

Ramipril - [systemic sclerosis renal crisis]

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35
Q

drug to reduce urinary calcium excretion

A

Bendroflumethiazide

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36
Q

50 4 months of (wheeze) in the context of an eosinophilia,
very high serum IgE
pulmonary infiltrates on the chest X-ray

A

allergic bronchopulmonary aspergillosis

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37
Q

Jamacain 6-week history of cough and increasing breathlessness.
Dx? Ix?

A

Sarcoid - Caribbean
[Bi hilar lymphadenopathy ]

transbronchial needle aspiration

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38
Q

limited cutaneous systemic sclerosis antibody

A

Anticentromere

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39
Q

systemic sclerosis antibody

A

Anti-topoisomerase antibodies (Scl-70)

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40
Q

On citalopram and prescribed tramadol - what’s gonna happen?

A

Serotonin syndrome

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41
Q

Dermatomes
T4
T10
L5
S1

A

T4 - nipple
T10 - Umbilicus (belly butTEN)
L5 - Big toe (Largest of 5)
S1 - Little toe (Smallest 1)

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42
Q

Causes of dilated cardiomyopathy

A

ABCCCDD

Alcohol
Beri beri
Coxackie B virus
Cocaine
Chargras disease
Doxorubicin, Daunorubicin

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43
Q

Causes of upper lung fibrosis

A

BREASTS

Berylliosis
Radiation
Extrinsic alergic alveolitis / eosinophilic pneumonia
Ankylosing spond / allergic bronchopulmonary aspergillosis
Sarcoid
TB
Silicossis

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44
Q

Lower lung fibrosis causes

A

CABRIOS

Collagen vascular disease / cryptogenic fibrosis alveolitis
Asbestosis
Bronchiectasis
Rheum arthritis
Idiopathic
Other… (Blah never mind BNM) Bleomycin Nitrofurantoin MTX
Scleroderma

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45
Q

Drugs which cause liver enzyme inhibition? What does this mean?

A

Increased effect of drug
SICKFACES.COM
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol & Grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole

Or - AODEVICES
Allopurinol
Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Cipro
Ethanol
Sulphonamide

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46
Q

Liver enzyme induction

A

CRAP GPs
Carbamazepine
Rifampicin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulphonylureas

Or PC BRAGS
Phenytoin
Carbamazepine
Barbituates
Rifampicin
Alcohol
St johns wart

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47
Q

What is Rockall score for?

A

Upper GI bleed risk
ABCDE

Age
Blood pressure drop
Co-morbidity
Diagnosis
Endoscopic finding

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48
Q

2,3,4 rule of AF

A

Cardiovert if in first 2 days
Otherwise anti coag for 3 weeks first
Anticoag for 4 weeks post cardioversion

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49
Q

High anion gap metabolic acidosis
Causes

A

GOLDMARK

Glycols (ethylene and propylene),
Oxoproline,
L-lactate,
D-lactate,
Methanol,
Aspirin,
Renal failure,
Ketoacidosis

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50
Q

Who gets D lactate acidosis

A

Short bowel syndrome

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51
Q

What makes up the anion gap?Normal range? What is usual value for raised anion gap?

A

Na - (Cl+Hco3)
8-12

> 20

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52
Q

Usual cause of normal anion gap metabolic acidosis?
Causes

A

Renal/GI loss bicarbonate

HARDUP

H -hyperalimentation (i.e. delivery of nutrients into a vein): typically due to excess normal saline solution.
A - acetazolamide: carbonic anhydrase inhibitor
R - renal tubular acidosis
D - diarrhoea: gastrointestinal bicarbonate loss (e.g. high-output fistula)
U - ureterostomies (urinary diversions): alters handling of cations/anions
P - post hypocapnic state
S - spironolactone (and hypoadrenalism / hypoaldosteronism)

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53
Q

Antibiotic classes mnemonic

A

GCPC MALT protein

Inhibit cell well synthesis
Glycopeptites
Carbapenems
Penicillin
Cephalosporins

Inhibit protein synthesis
Macrolides
Aminogycosides
Liconasmides
Tetracycline

Then remember
SulFOnamides - folic acid synthesis
FluroQUINolones - Inhibit RNA replication (making QUINtuplets)

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54
Q

Which organisms in asplenia

A

His Spleen Never Got Sick

Haemophilus influenzae type B
Streptococcus pneumoniae
Neisseria meningitides
Group B streptococcus
Salmonella typhi

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55
Q

What passes through diapragm

A

I 8 10 eggs at 12

I 8: inferior vena cava at T8
10 eggs: oesophagus at T10
at 12: aorta at T12

T8: vena cava has 8 letters, as does the abbreviation of its companion structure the phrenic nerve “phrenicN”

T10: oesophagus (UK spelling) has 10 letters, its companion structure the vagus nerve is cranial nerve X “CN 10”

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56
Q

Not painful genital ulcer causes

A

LGV
Granuloma inguinale
syphylis

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57
Q

Urethral discharge with pain on ejaculation chlamydia and gonno neg

A

Mycoplasma genitalium

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58
Q

Hepatorenal type 1 vs 2

A

1 - rapid worsening in 2 weeks
-Eg double Cr in 2 weeks due to SBP or vareceal bleed

2- Slower worsening over 3 months

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59
Q

Well-controlled T1DM - what should you do with insulin for short operation

A

Continue long-acting and just omit short acting

Sliding scale for longer operations

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60
Q

Difference between
acute demyelinating optic neuritis
and acute ischemic optic neuritis

A

Demye - MS

ischemic - Giant cell

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61
Q

Chemo long term now pain in hip

A

AVN - eg prednisolone
Steroid and alcogol make up 90% of AVN

Notice flattening of femoral head and suchondral cyst formation

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62
Q

Rx

A

SVT
Adenosine 6mg

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63
Q

Alternative to adenosine in SVT

A

Verapamil 2.5mg - causes more hypotension

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64
Q

Diastolic murmur loudest left sternal base with collapsing pulse

A

AR

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65
Q

pansystolic murmur over left middle/lower sternal border
development o RHF and jugular distension

A

Tricuspid Regurg

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66
Q

Early diastolic murmur at left upper sternal border ? how to make louder

A

Pulmonary stenosis
breath held at end expiration

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67
Q
A

Subdural

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68
Q
A

gout

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69
Q

Ferritin level to replace iron in CKD anaemia

A

<100

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70
Q
A

OA
Boney sclerosis and joint space narrowing

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71
Q

Prev lithium ongoing DI rx?

A

Low sodium and protein diet
-> thiazide like if no improvement

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72
Q

Small irregular pupils that barely contract to light

A

Argyl robertson

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73
Q

unilateral dilated pupil which reacts slowly to light

A

homes aide

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74
Q

Anaemia with ‘teardrop poikilocytes’

A

Myelofibrosis

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75
Q

Pregnant intense itching ALP raised most

A

Intrahepatic cholestasis of preg

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76
Q

Right sided facial weakness and speach disturbance
Left carotid 60% stenosis
R 40% rx?

A

Left endarctectormy -

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77
Q

19
collapse. normal heart sounds a d clear chest

A

LongQT

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78
Q

MTX overdose rx

A

calcium folinate

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79
Q

Long term feeding tube needed

A

gastrostomy

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80
Q
A

Mesothelioma

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81
Q

iron def anaemia and harmatomas

A

peutz jeger

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82
Q

When HHT not peuz jehger

A

Recurrent epistaxis (key finding I’d say)

As you’ve noted multiple telengiectasias

Visceral AVMs (classic locations can be like lung, brain, and liver I think)

First degree family member with HHT (be hard to give this in a stem without giving it away)

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83
Q

Recurrent nose bleeds and mild increase APPT

A

VWD most likely

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84
Q

Woody fibrosis of thyroid gland

A

riedels thyroiditis

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85
Q

HyperCa of malig rx

A

IV NaCl
then bisphosphonates

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86
Q

Prophylaxis agaisnts tumpr lysis

A

rasburicase

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87
Q

Ongoing air lea in PTX 4 days in rx

A

VATS
Pleurodesis if unfit for surg

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88
Q

Rapidly increasing in size

A

Keranthocoma
rapid growing solitary nodule with necrotic core

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89
Q

CV stable, lethargy and palps for 3 weeks rx?

A

Planned DC cardioversion

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90
Q
A

OA
Joint space narrowing and subchondral sclerosis

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91
Q

70s extreme lethargy nausea and anorexia
Recent anaemia and gastritis
raised eosin but normal WCC
Significant kidney impairment

A

AIN
likely omeprazole

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92
Q

High fever, salmon rash
arthriitis over 6 months Key Ix?

A

Adult onset stills
Autoantibodies - as should all be negative

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93
Q

Opiate choice for long term analgesia in those with ++ renal impairment

A

buprenophine

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94
Q

1st choice abx for sx of pyelonephritis in preg

A

cefalexin

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95
Q

Do you check for h pylori eradication usually?

A

no

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96
Q

Given haloperidol now oliguric crisis rx? class

A

procyclidine
anticholinergic

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97
Q

Mulitple small painful ulcer on anal mucosa =

A

herpes

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98
Q

1st line c diff

A

oral vanc

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99
Q

Blistering rash sun exposed
on HRT and drinks

A

Porphyria cutanea tarda

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100
Q

Primary PPH in preg mortality

A

50% - need to council mum

101
Q

Return to driving HGV after MI

A

Must complete ETT (no meds need stopping)

102
Q

Horse voice, nephrotic syndrome, enlarged tongue, hepatomegaly =

A

Amyloidosis
Can Dx with abdominal fat / rectal mucosa biposy with congo red stain

103
Q

drugs causing retroperitoneal fibrosis

A

B blockers
Ergot derived

104
Q

prominent U wave electrolyte

A

HypoK

105
Q

Hb target in renal disease

A

100-120

106
Q

Most common pulm manifesation of SLE

A

Pleuritis

107
Q

Measels incubation

A

10 days

108
Q

Staging of Hodgkins

A

PET CT

109
Q
A

Molluscum

110
Q

Renal failure, bone pain, raised ALP, rasied PO4 and normal Ca

A

Renal osteodystrophy

[PO4 low in osteomalacia

111
Q

Turkish with intermittent peritonism / chest pain, fevers, scrotal pain ? rx?

A

familal mediterranian fever

Colchicine

112
Q

Old meningitis + diarrhoea rx?

A

Listeria
Amox + gent

113
Q

Micro vs macro pit adeoma rx

A

Micro - cabergoline

Macro with acromegaly - surgery
Macro Prolactin - Carbegoline

114
Q
A

Granuloma annulae

115
Q

24M sat 92%

A

Aspirate

116
Q

Diabetes, crp 30

A

charcots

117
Q

Capgras syndrome

A

Belief that someone close has been replaced with an imposter

118
Q

Thinks a stanger is one of their friends.family

A

De Fregoli syndrome
[seen in schitz]

119
Q

Asthma with PO2 <8

A

vENTILATE

120
Q

UTI with reduced GFR first line? 2nd ?

A

Trimethoprim
Penicilivam

121
Q

Tried 4 types of laxitive and still constipation rx?

A

Linaclotide

122
Q

How to make a quick diagnosis of ATN

A

Spot urinary Na (>40)

123
Q

Young person with GPA rx 1st line

A

Ritux + mpred

124
Q

Adrenal insufficiency normal steroid replacement

A

Hydrocortisone
20mg morning
10mg eve

125
Q

Reactive arthritis 1st line

A

NSAIDs

126
Q
A

retinal detachment

127
Q

A vs B dissection

A

A involves Ascending

128
Q

Known to have PBC ? rx? if loads?

A

Lichen planus
Topical steroids
Oral azathioprine if covers loads of body

129
Q

leigionella allergic to clari

A

Levofloxacin
[not doxy as less effective]

130
Q

Investigation of bone pain in likely myeloma

A

Whole body MRI

131
Q

Recovering from hip operation in hospital. Develops bad pneumonia - Abx choice

A

Taz - likely hospital-acquired and need pseudomonal cover

132
Q

Hyperemesis gravidum 1st line antiemetic

A

Cyclizine

133
Q

Prev lymphoma. Now pancytopenia and no hepatosplenomegaly on exam

A

Myelodysplasia

134
Q

When esophagectomy for cancer

A

Between 5-10mm

135
Q

When would a normal phenytoin level actually be toxic

A

If acidosis (increased unbound phenytoin)

136
Q

Loss of peripheral vision
Bilat retinal focal aggregates, with appearance of bone spicules

A

Retinitis pigmentosa

137
Q

/Amiodarone thyrotoxicosis type 1 vs 2 ix? rx?

A

1 - people with thyroid disease and due to increased iodine load
- Increased uptake on thyroid scan
-Anti-thyroid drugs

2 - Destructive leading to increased release rather than overproduction from the thyroid gland
-Globally reduced uptake on scan
- Steroids

138
Q

Old intermittent difficulty swallowing solids and liquids with vomiting - no weight loss

A

Achalasia

[pouch more hallitosis and couple days old rotten food vomit]

139
Q

18 stressed with exams

A

Alopecia acreta

140
Q

Thyroxine dose in preg

A

increase by 25-50%

141
Q

COPD maximal inhaled therapy what next

A

Roflumilast

142
Q

VF / pulseless VT and had 3 shocks and adrenaline next?
After 5 shocks?

A

Amiodarone 300mg
Amiodarone 150mg

143
Q

Severe rosacea 1st line

A

oral doxy

144
Q

Likely oesophageal rupture eg vomit then sub-cut emphysema Ix in order

A

CXR
Oesoph gastrograffin
CT

145
Q

50s weakness with mild raised CK

A

inclusion body myositis

146
Q

30 progressive visual loss in center of eyes.
telangectasias on fundoscopy

A

Leber optic atrophy

147
Q

bleeding gums when brushing teeth INR 8

A

omit warfarin and 3mg IV vit K

148
Q

HF on sacubitril/valsartan + b blocker with K 5.1 next line

A

Dapagliflozin

149
Q

Chest pain when walking dogs Ix?

A

Coronary angiogram not ETT

150
Q

Antihypertensive causing photosensitivity

A

Thiazides

151
Q

NAFLD key Ix for assessing severity

A

Fibroscan

152
Q

Key rx in APKD

A

BP control

153
Q

Day drinking now stable atrial flutter rx

A

Flecanide

154
Q

Stable morphine dose but issues with constipation

A

Change to fentanyl patch
or senna + lactulose

155
Q

PCOS how to get more regular periods

A

COCP

156
Q

Haemochromatosis with swollen joint

A

Pseudogout

157
Q

1.8cm prolactinoma compressing optic chiasm rx

A

Dopamine agonist
[ALWAYS 1st line in prolactinoma]

158
Q

Unvaccinated and gets a hepB pos needle stick

A

IVIg
30% risk of transmission

159
Q

Asthmatic with angina and HR 85

A

Ivabradine
[CCBs only symptomatic and don’t improve outcome]

160
Q

CKD bone pain and low Ca. What would make you say osteomalacia and what secondary hyperPTH [if not given PTH levels]

A

Raised PO4 = HyperPTH

161
Q

Distal peripheral neuropathy with anaemia and thrombocytopenia

A

Alcoholic neuropathy

162
Q

2 options if fluid resriction doesnt work for HypoNa? When hypertonic saline?

A

Demeocycline
Tolvaptan

Life threatening sequale

163
Q
A

Meningioma - arrises from skull base

164
Q

which 2 lung cancers can secrete ACTH

A

Small cell
carcinoid

165
Q

Small bowel overgrown Abx

A

Rifaximin, tetracyclines, metronidazole

166
Q

Post hodgkins rx most common Ca

A

Breast

167
Q

Mixed cyroglobulinaemia which hepatitis

A

HepC
HepB is PAN

168
Q

Squamous lung Ca resected now met on sternum skin rx?

A

Local radiotherapy

169
Q

DVT in Ca rx

A

Apixaban

170
Q

COPD on tripplpe inhaled therapy rX? What if reversibility and raised eosinophils

A

Roflumilast

Mepolizumab

171
Q

Mild erythermatous and scaly lesions

A

Pytiriasis versicolour
Melsalsia

172
Q

Which stage lung Ca can have resection even if some involvement of chest wall?

A

IIB - no lymph nodes

173
Q

Overactive badder on oxybutinin but confusion rx?

A

Change to mirabegron

[tolteridine also would have anticholinergic confusion]

174
Q

Barrets low grade dysplasia rx? high grade?

A

PPI and repeat endoscopy in 6m
If persists -> ablation

Esophagectomy

175
Q

Calculated insulin dose 48 units how much at breakfast lunch and dinner

A

Should get 24 background
then 8 bolus for each meal

176
Q

After raised INR and vit K when can you begin restarting warfarin

A

INR <5

177
Q

Active cholescystitis in preg rx

A

Lap choley

178
Q

Arrow pointing at

A

Wedge fracture

179
Q
A

Keratoacathoma

180
Q

bum sex
rectal pain and passage of blood and mucus

A

LGV serovars L1, L2, L3
UK - ITs chlamydia

181
Q

rx

A

topical metronidazole

182
Q

Primary hyperaldosteronism rx

A

Spironolactone

183
Q

What medications cause lithium toxicity when co prescribed

A

Thiazides
NSAIDs
ACEi

184
Q

Seizure with an aura

A

Temporal lobe

185
Q

Which antidepressant if patient has epilepsy

A

SSRId

186
Q

1st line ix in diabetes with reduced GFR

A

Urinary albumin:creatinine ratio

187
Q

Dry cough and erythema nodosum

A

Lupus pernio
[sarcoid]

188
Q

Farmer ferver and malaise now has pneumonia and mild derranged LFTs rx?

A

Coxiella q fever
doxy

189
Q

1st line imaging bone lesions myeloma

A

MRI

190
Q

Asthma - low dose corticosteroid + Laba what next

A

Montelukast

191
Q

IVDU with endocarditis 1st lie abx

A

Fluclox

192
Q

Anaemia

A

Myelofibrosis
teardrop piokilocytes

193
Q

What Ix

A

CTAP for RCC

194
Q

Most common cause of nec fasc

A

Strep pyogenes

195
Q

Recent stent of LAD. Now upperGIB plan?

A

Stop clopi

196
Q

Bleeding gums
Thrombocytopenia, prolonged APTT, microcytic anaemia

A

Von willebrand

197
Q

37weeks pregnant with UTI Abx?

A

Trimethoprim [only CI in 1st trimester]

Nitro - risk of neonatal haemolysis when given at term

198
Q
A

Brugada
STE >2mm followed by TWI in 1 lead

199
Q

cystinuria rx

A

Hydration and urinary alkalisation

200
Q

Sore throat 2 weeks ago

A

Guttache psoriasis
[hypopigmented bits round each lesion typical]

201
Q

Diabetic sore foot rx?

A

IV abx -

[surgical washout not first line]

202
Q

Signs of heart failure and Na 120 rx?

A

IV diuretics

203
Q

SLE endocarditis called

A

Libman sacks endocarditis

204
Q

Inhaling ballons

A

Nitric oxide -> b12 deficiency -> subacute degeneration of cord

205
Q

Penicillin allergy and lepto

A

Doxy

206
Q

CF diet

A

High calorie
high fat

207
Q

78 rx?

A

Analgesia and physio
pubic rami fracture usually conservative

208
Q

History of exzema rx/=?

A

IV acicloir
eczema herpeticum

209
Q

Late systolic murmur most likely

A

Mitral valve prolapse

210
Q

CKD4 with increased hypochromic red cells >6% rx?

A

Oral iron
[IV only if on haemodialysis]

211
Q

3 MS flaires in a year rx

A

Natalizumab

212
Q
A

SCC
Nodular with raised edges and central crustigng

213
Q
A

SCC
Nodular with raised edges and central crustigng

214
Q
A

Brugada [type 2]
2mm sadleback STE in v1/2

215
Q

Solitary thyroid adeoma rx

A

radioiodine

216
Q

Zoldendronate - check what before prescribing

A

Dental exam - high risk of osteonecrosis

217
Q

Wots happened

A

hip dislocation

218
Q

Boney met pain rx

A

Radiotherapy

219
Q

Chest infections -> bronchiectasis with exhaled NO very low <250ppm =

A

primary ciliary dyskinesia

[between 250-500 could be cystic fibrosis]

220
Q

27 bleeding, splenomegaly with pancytopenia and raised ldh

A

AML
[dont get splenomegaly in aplastic anaemia’

221
Q

IBS best way to control pain

A

FODMAP diet

222
Q

Stable parkinsons but with restless leg syndrome rx?

A

Gabapentin

223
Q

Which med for recurrent cystine stones

A

Penicilamine for cystine

224
Q

Dilated aortic root in marfans sugery

A

Valve sparing as avoids needs for anticoagulation

225
Q

Agitation in Lewy body dementia first line

A

Donepazil

226
Q

? Causes

A

Bigeminy
Usually hypoK/Mg

Digox/b blocker OD
MI

227
Q

Hx suggestive of insulinoma best ix?

A

Overnight fast / exercise provocation

228
Q

Adrenal Cushings antihypertensive prior to surg

A

milotane

229
Q

Amphetamine OD with HTN rx?

A

diazepam

230
Q

SLE with lots of renal involvement rx?

A

Mycophenolate

[cyclophosphamide if really bad]

231
Q

What reduces the absorption of thyroxine

A

calcium

232
Q

anti mi 2

A

Dermatomyositis

233
Q

headaches and ataxia

A

tectal plate astrocytoma

234
Q

Myocarditis rx

A

Supportive only
eg rx of heart failure

235
Q

Stress incontinence despite pelvvic floor excercises

A

Duloxetine

236
Q

GORD with extensive eosinophilic infiltrate on biopsy rx?

A

Dispersable steroids

237
Q

Calcium oxylate stones rx

A

pOTASSIUM CITRATE

238
Q
A

Brady + j wave = hypothermia

239
Q

How does bipap help heart failure pulm oedema

A

Reduced LV afterload

240
Q

Anapylactoid sx with NAC infusion rx?

A

Steroids, chlophenamine, fluids

then restart infusion at lower rate

241
Q

CLL haemolytic anaemia rx?

A

Steroids
Add rituximab if not improving

242
Q

Which BP med worst for constipation

A

Verapamil
[CCBs]

243
Q

Dihgoin OD with HyperK 6.2 rx

A

Fab fragmenets
medical rx unlikely to work for K with digoxin in system

244
Q

Wheere is the mi

A

1 / AVL
=obtuse marginal branch of left

245
Q

Rhem A 6 months why SOB

A

Inyerstitial lung disease most common

246
Q

Constipation in preg rx

A

Ispagula husk first

247
Q

Scleroderma with sx of pulm fibrosis rx

A

Mycophenolate

248
Q

MSRA in urine but mostly well with some dysuria

A

Nitro / trimethoprim

vanc if sick

MRCP 2 (5 decks)

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