Past Paper Mistakes Flashcards
1
Q
What is in the 6 in 1 vaccine ?
A
- Diptheria
- Tetanus
- Pertussis
- Polio
- Haemophilus influenza type B (Hib)
- Hepatitis B
1
Q
When is the 6 in 1 offered ?
A
8 weeks
12 weeks
16 weeks
2
Q
when is Men B vaccination offered ?
A
- 8 weeks
- 16 weeks
- 1 year
3
Q
When rotavirus vaccine offered ?
A
8 weeks
12 weeks
4
Q
what are the 8 weeks vaccinations ?
A
- 6-in-1
- men B
- rota virsu
5
Q
what the 12 weeks vaccinations ?
A
- 6-in-1
- Roat virus
- pneumococcal
6
Q
what are the 16 week vaccinations ?
A
6-in1
men B
7
Q
what vaccine are there at 1 year ?
A
- 2-in-1 (Hib and Men C)
- Pneumococcal
- MMR
- Men B
8
Q
What vaccinations offered in secondary school ?
A
- 12/13 yrs: HPV
- 14 yrs: 3 in 1 (tetanus, diphtheria, polio)
- Meningococcal groups AC WY
9
Q
when should child be able to sit unsupported ? when refer ?
A
7-8 months
(refer at 12 months)
10
Q
when should a child be able to walk unsupported ? when refer ?
A
walks unsupported 13-15 months
(refer at 18 months)
11
Q
When can a child run ? what else can they do at this age ? (gross motor)
A
run at 2 yrs
(walks upstairs and downstairs holding on to rail)
12
Q
when can a child pass objects from one hand to another ?
A
6 months (fine motor)
13
Q
When can a child draw a circle ?
A
3yrs (copies circle)
14
Q
at what age would you expect a child to respond to their own name ?
A
12 months
15
Q
describe the speech developmental milsteons of a 3 year old ?
A
- talks in short sentences (3-5 words)
- asds what and who questions
- identifies colours
- counts to 10
16
Q
When would you expect a baby to start smiling ? when refer ?
A
6 weeks
(refer at 10 weeks)
17
Q
At what age can a child dress and undress independently ?
A
4 years
(except for laces and buttons)
18
Q
how long after taking AP is acute dystonia ? Mx ? (2)
A
4 hrs
anticholinergic - Benadryl (benzatropine)
(also procycldine)
19
Q
how long after taking AP is akathisia ? Mx ?
A
4 days
propanolol
20
Q
neuroleptic malignant syndrome mamangment ?
A
dantrolene
21
Q
serotonin syndrome triad ?
A
- neuromuscular excitation (hyperreflexia, myoclonus, rigidity)
- Autonomic nervous system excitation
(hyperthermia, sweating) - altered mental state (confusion)
22
Q
serotonin syndrome Mx ?
A
- supportive IV fluids
- Benzodiazepines
- (more severe cases use serotonin antagonists)
23
Q
describe how often the clozapine bloods are ? initially ? ongoing ?
A
- WBC monitoring weekly for 18 weeks
- then fortnightly for up to one year
- then monthly as part of the clozapine patient monitoring services
24
What is a missed misscariage ? what is seen on US ?
baby has died in the womb, but the mother hasn't had any symptoms (like bleeding or pain)
- US scan (baby has no heartbeat of that the baby is too small for the date of the pregnancy)
25
When do Parkinsonism symptoms occur in Lewy body dementia ?
progressive cognitive impairment occurs usually first
- Parkinsonism occurs then within a year
26
describe the relation between cognitive impairment and Parkinsonism that would point towards Parkinson's disease ?
motor symptoms typically present at least on year before cognitive symptoms
27
DKA managment: how is defect fluid calculated? based on what measurements
Starting fluid rate = (deficit + maintenance)/48
(after the initial bolus- that can be different depending if in shock of not)
- based on pH (mild/mod => 5%, severe => 10%)
- ((%dehydration x kg x 10) - initial bolus)/48
28
how do you work out DKA maintenance fluids ? what does it depend on ?
100ml/day for 1st 10kg
50ml/day for next 10kg
20ml/day thereafter up to 80kg max
29
what is conns syndrome ?
adrenal adenoma producing too much aldosterone (hyperaldosteronism)
30
conns syndrome Mx ?
(aldosterone antagonist)
- eplerenone
- spironolactone
31
what is 6CIT ? what score is significant ?
(six-item cognitive impairment test)
dementia screening tool in primary care
>8 => significant
0-7/28 => normal
32
Edwards syndrome: what chromosome ? what features ?
trisomy 18 - little head ed
- low birth weight
- small head and jaw (little head ed)
33
what might you find on bloods tests in neuroleptic malignant syndrome ? (2)
- raised creatinine kinase
- leukocytosis
34
when can activated charcoal be given ? in what overdose ?
paracetamol overdose
- patients who present within 1 hour may benefit from activated charcoal to reduce absorption of the drug
35
what drug is mainly used in managmetn of paracetamol overdose ? when ? over what time frame ?
acetylcysteine
- infused over 1 hour
36
GCS: describer the 6 motor responses ?
6) obeys commands
5) localises to pain
4) withdraws from pain
3) abnormal flexion to pain (decorticate posture)
2) Extending to pain
1) None
37
GCS: describe the 5 verbal responses ?
5) orientated
4) confused
3) words
2) sounds
1) none
38
GCS: describe the 4 eye responses ?
4) spontanious
3) to speech
2) to pain
1) none
39
which nerve roots does herbs palsy effect ?
C5 and C6
40
Childs asthma is not controlled on SABA and low dose ICS. what do you add ?
step 3: add leukotriene receptor antagonist
41
Childs asthma is not controlled on SABA, low dose ICS and LTRA. what do you add ?
Step 4
stopping the LTRA and switch to LABA
(SABA, ICS, LABA)
42
Childs asthma is not controlled on SABA, ICS and LABA. what do you add ?
step 5
switch ICS/LABA for a maintenance and reliever therapy (MART)
(SABA + MART)
43
Childs asthma is not controlled on SABA + MART. What do you add ?
step 6
increase ICS dose to moderate
(SABA + paediatric moderate-dose ICS MART)
44
which antibiotic safe throughout pregnancy ? which avoided ?
cephalosporins are safe throughout pregnancy
- Avoid trimethoprim in first trimester
- avoid nitrofurantoin in third trimester
45
what can cause a raised serum Ca125 ?
- endometriosis
- menstruation
- benign ovarian cyst
(not vulval cancer)
46
what do you prescribe for first episode of c. diff ?
oral vancomycin
47
What time frame counts as opioid use disorder ?
when a harmful pattern of use is evident over a 12-moth period or at least 1 month if use is continuous
48
US shows snow storm appearance of mixed echogenicity - what does this indicate ? what else would be seen ?
complete hydatiform mole
- uterus size great than expected for gestational age
- abnormally ugh serum hCG
49
what is a complete mole pregnancy ? what is most common karyotype ?
occurs when tow sperm cells fertilise an ovum that contains no genetic material (empty ovum)
(usually XX)
50
what molar pregnancy would present with YY ?
none - this is not compatible with life
51
what could the chromosome karyotype for a partial mole be ?
two sperm cells fertilise a normal ovum at the same time
- XXX
- XYY
52
what are the 4 stages of endometrial cancer ?
stage 1 - confined to endometrium
stage 2 - carcinoma extends to the cervix but not beyond the uterus
stage 3 - carcinoma extends beyond uterus but is confined to pelvis
stage 4 - carcinoma involves bladder or bowel, or has metastasised to distant sites
53
what is used in the management of tardive dyskinesia ?
tetrabenazine
54
How does PICA present ? (3) aka ?
- ipsilateral: facial pain (pica chew) and temp loss
- contralateral: limb/torso pain and temp loss, ataxia
- nystagmus
(lateral medullary syndrome, Wallenberg syndrome)
55
how does AICA present ? aka ?
(lateral pontine syndrome)
- ipsilateral facial paralysis and deafness
- contralateral limb/tors pain and temp loss, ataxia
- nystagmus
56
what is amaurosis fugax ? what does it indicate ?
temporary loss of vision through on eye which returns to normal afterwards
- usually to due pathology of retinal/opthalmic artery
57
what is webers syndrome ? (2)
- ipsilateral CN III palsy
- contralateral weakness of upper and lower extremity
58
patient had a fall/prolonged epileptic seizure, what electrolyte abnormalities might there be ? why ?
hyperkalaemia, hypocalcaemia (myoglobin bind calcium), elevated phosphate
due to rhabdomyolysis (=> AKI with disproportionately raised creatinine)
59
how long symptoms for it to count as chronic fatigue ?
3 months
60
cottage chess discharge, vulvitis, itch
what condition ?
candida
61
offensive, yellow/green, frothy discharge, vulvovaginitis and strawberry cervix
what condition ?
trichomonas vaginalis
62
offensive, thin, white/grey, fishy discharge
what condition ?
BV
63
what is the black report ? summary ?
the extent of which ill-health and death are unequally distributed among the population of Britain
64
what are the 4 theories of the black report ?
- artefact
- selection
- behavioural/cultural
- structural
65
What 3 drugs (+ class) are used for Parkinson's disease management ?
- Levodopa
- Dopamine agonist (cabergoline)
- MAO-B inhibitors (selegiline)
- COMT inhibitors (entacapone)
66
2 tests recommended to assess patients at risk of falls ?
- turn 180 test (takes more than 4 steps to turn => increased risk of falls)
- Timed up and go test (<10 secs to get out of chair to spot 3m away)
67
How could rhabdomyolysis affect urine ? fancy name for this
myoglobinuria
- dark or reddish=brown in colour and is a sign of muscle breakdown (for example secondary to rhabdomyolysis)
68
what are the 6 stages to the transtheoretical model of change ?
- Pre-contemplation
- contemplation
- preparation
- action
- maintenance
- termination/relapse
69
What is the syphillus causative organism ?
- Treponema pallidum
70
name 2 screening tools for depression ?
- PHQ-9
- HADS
71
When is the MMR vaccine ?
- 1 yr
- 3 yrs and 4 months
72
What are the 4 beliefs in the Health belief model ?
- Believe are susceptible to disease
- Believe in serious consequences
- Believe taking action reduces susceptibility
- Believe that benefits of action outweigh the costs
73
boy presents with dull discomfort in the scrotum. What is this most likely ? how else might it present ?
varicocele
- mostly commonly assympotomattic
- can present with infertility
74
boy present with red, swollen and warm testicle. what is this most likely ?
epididymitis or orchiditis
75
boy present with severe sharp pain in the scrotum. what is this most likely ?
testicular torsion
76
How does acamprosate work ? what is it used in ?
enhances GABA transmission (reduce craving)
(used alcohol dependance)
77
what alcohol dependence drug cannot be used while continuing drinking ?
clomethiazole
78
How does disulfiram work ? used in what ?
causes a build up of acetaldehyde on consumption of alcohol causing unpleasant symptoms such as flushing, headache, anxiety (if you drink alcohol you DIE-sulfiram)
(used in alcohol dependence)
79
What congenital abnormailites can sodium valproate cause ? most common ?
- hypospadias (most common)
- spina bifida
- ASD
- cleft palate
- polydactyly
80
What inheritance is Marfans syndrome ?
autosomal dominant
81
what is the main risk of marfans syndrome ?
aortic dissection and rupture
82
what measurements are required for downs syndrome screening ? (3)
- Nuchal translucency
- bHCG
- PAPP-A
83
Gonorrhoea first line treatment ?
IM ceftriaxone
84
first line treatment of trichomonas vaginalis ?
Metronidazole
85
first line treatment for candida ?
fluconazole
86
first line treatment for chlamydia after positive NAAT testing ?
doxycycline
87
CAP treatment ?
amoxicillin
88
describe the typical finding of a right hemisection of the spinal cord ?
- ipsilateral: paralysis and loss of proprioception and vibration
- contralateral: lack of pain and temperature sensation
89
what is second line prevention of gout after allopurinol ?
febuxostat
90
most common cause of bacterial COPD exacerbation ?
Moraxella cararrhalis
91
characteristic findings of CSF in GBS ? (4)
- raised protein
- normal white cell count
- raised opening pressure
- normal glucose
92
alcohol dependance man says "I have moved from drinking wine, beer and whiskey to just win every day" what dependance symptom is this ?
narrowed repertoire
93
where do you notify a notifiable disease ?
- consultant in communicable disease control
- public health England
- local health protection team
94
what biological therapy is used for breast cancer that is HER2 positive ?
trastuzumab (Herceptin)
95
difference in OT and physio ?
- physio work mostly with mobility while OT work with function in everyday life
(physio: massage, exercise to prevent further injury and long term medication dependance)
(OT introduce equipment or recommend environmental modifications that help individuals carry out their delay activities)
96
what is deontological ethics ?
that the morality of an action should be base don whether the action itself is right or wrong under a series of rules and principles
(distinguish ring form wrong)
