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Year 5 Specialties > Past Papers > Flashcards

Past Papers Flashcards

1
Q

Kid faltering growth, what could be the cause?

A

Coeliac

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2
Q

Croup child
given Dex 12 hours ago but still has mild stridor
Next step?

A

Repeat steroids

Nebs Adr, Salbutamol, O2

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3
Q

Kid anal itch Mx

A

Mebendazole cream

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4
Q

Child impaired taste then awareness, then sleeps for 1 hr and no memory after. Dx?

A

Focal seizure

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5
Q

Kid with yellow and grey stools and was like 4 weeks old or something. What do you test for?

A

Conjugated bilirubin levels

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6
Q

Hypochloraemic hypokalaemic pH shown, with some clinical information. What is the initial management for it?

A

Correct electrolyte imbalance

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7
Q

Question on a kid who had bloods that demonstrated: low platelets, normal white cells and normal red cells.

A

ITP

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8
Q

Voraciously hungry kid, hypotonia and almond eyes.

Dx?

A

Prader-Willi

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9
Q

neonate with reduced leg movements or something and his temperature was a bit high. What was it (?>38)?

A

Osteomyelitis

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10
Q

3 year old kid with unilateral nasal discharge with bleeding and crust or something like that, What was the most likely cause.

A

Foreign body insertion

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11
Q

unwell child where chest was clear, had a fever. Lost weight recently. What do you do next?

A

ABC

Glucose

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12
Q

Neonate
reduced leg movements
Temp 38

A

Osteomyelitis

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13
Q

Child
rashes crusted over, but still scratching
now fever and cool peripheries

A

Varicella zoster viraemia

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14
Q

Neonate

Systolic murmur on left sternal edge

A

VSD

or innocent? aSx, soft systolic, left sternal edge

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15
Q

Child
55th centile
vomiting after food
bottle and breast fed

A

Cow’s milk protein allergy

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16
Q

ADHD Mx

A

Parental training

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17
Q

Mx conduct disorder

A

Multisystemic (family) therapy

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18
Q

Child
Hip pain on exercise and climbing stairs
Prolonged history, otherwise well

A

Perthe’s

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19
Q

2 y/o intermittent limp, otherwise well

A

DDH

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20
Q

Uncle has TB
Child mantoux test 10mm
Next step?

A

Anti-TB Tx

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21
Q

Gold standard for precocious puberty

A

Gonadotrophin stimulation test

<8 in F, <9 in M

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22
Q 
Child
Fussy eater
drinks lots of cows milk
tired
Cause?
A

Fe deficiency anaemia

due to fussy eating

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23
Q

What area brain affected cerebral palsy

A

motor cortex

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24
Q

Child with SCD
No reticulocytes
cause?

A

parvovirus

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25
Q

single, acute hepatotoxic paracetamol dose (>150 mg/kg) has been ingested within the past hour

A

activated charcoal

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26
Q

paracetomal OD (>4g or 75mg/kg) 8hr since dose

A

IV acetylcysteine

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27
Q

Kid needs fluids, but you can’t get standard IV access, where do you go?

A

Intraosseus

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28
Q

Non-obese child

loss internal rotation of leg

A

SUFE

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29
Q

HIV mother
undetectable viral load
Contraindication in labour?

A

Foetal blood sampling

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30
Q

60 y/o
PMB and superficial dyspareunia
likely Dx?

A

Atrophic vaginitis

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31
Q

Woman having implant removed

likely reason?

A

irregular bleeding

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32
Q

Pre-eclampsia first line Mx

A

Labetolol

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33
Q

Intermittent pain

young woman cause

A

endometriosis

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34
Q

17 y/o emergency contraception

5 days post UPSI

A

copper IUD

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35
Q

Contraception 6 days post birth

A

none needed

PROGESTERONE PILL

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36
Q

Intrauterine growth + endometrial thickness

A

Fibroids

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37
Q

painful periods first 2 days every since menarche

A

primary dysmenorrhoea

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38
Q

Breast abscess and mastitis whilst breastfeeding Mx

A

Ciprofloxacin

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39
Q

Carry on sertraline in pregnancy?

A

yes

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40
Q

Woman in labour 4hr check 4sm dilated. Next step

A

cervical sweep

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41
Q

PPH with with BP Mx

A

Syntocinon

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42
Q

Foreign woman pregnant. Which vaccine?

A

Hep B

whooping cough for all women

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43
Q

Heavy periods first line Mx

A

IUS

if wants kids then tranexamic acid

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44
Q

Foetus transverse lie
recent SROM CTG abnormal
likely cause?

A

cord prolapse

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45
Q

last period 10 ago, has hot flushes

Mx?

A

cyclical (sequential) combined HRT

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46
Q

planned C-S DVT Mx

A

LMWH and TED STOCKINGS

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47
Q

Woman with blocked tubes, blocked tubes on hysterosalpingogram, what treatment should you do for fertility?

A

IVF

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48
Q

heavy periods
not sexually active
Mx?

A

tranexamic acid

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49
Q

elderly woman
itching
white patch

A

lichen sclerosus

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50
Q

How to measure Hep B at booking

A

HBsAg

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51
Q

Commonest cause azoopermia (low no)

A

varicocele

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52
Q

Woman on COCP, has missed 6th and 7th day pill, UPSI two days ago
urine pregnancy is clear. What to do?

A

emergency contraception

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53
Q

Endometriosis, had laparoscopic adhesiolysis - high CRP, low Hb, constipation, bowel sounds absents etc - what’s happened?

A

intrabdo bleeding

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54
Q

FSH and LH in PCOS

A

FSH normal

LH N or high

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55
Q

Alcoholic has cellulitis, given chlordiazepoxide and Abx, what else do you give

A

Pabrinex

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56
Q

AD for depression with PMH of MI

A

Sertraline

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57
Q

Clozapine effect on WCC

A

neutropenia

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58
Q

Haloperidol, develops muscle problems

A

IM Procyclidine

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59
Q

Woman on venlafaxine, starts developing symptoms of mania

What do you do?

A

Stop venlafaxine

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60
Q

50 year old guy wanders in screaming he sees ants and tiny men running around

A

delirium tremens

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61
Q

Alcoholic wants to quit and wants something for reducing cravings

A

Acamprosate

Disulfiram, Naltrexone

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62
Q

AP that likely to cause tremor

A

Haloperidol

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63
Q

LBD given drug that makes it worse

A

Haloperidol

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64
Q

Guy writes letters to the PM, think he’s being spied on by the government for the past 10 years, shows no other symptoms

A

Delusional disorder

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65
Q

50y lady fell over gardening, comes in with paralysis of leg, no medical cause found?

A

Conversion disorder

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66
Q

Patient on ward becomes aggressive, verbal de-escalation hasn’t worked. Tx?

A

IM lorazepam

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67
Q

Husband brings in wife who has bipolar, who’s taken 20 “white” tablets - has a tremor and other sx. What tablet has she overdosed on?

A

lithium overdose

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68
Q

Lithium - what do you monitor?

A

Lithium, TFTs, U+E

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69
Q

Premature ovarian failure

Mx of menopausal Sx

A

combined HRT

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70
Q

Woman is pregnant and HIV negative at booking but her partner is HIV positive - what do you do?

A

Nothing

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71
Q

Define onset active labour

A

regular contractions
os >4cm
ROM

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72
Q

Subfertility azoospermia Mx

A

Intracytoplasmic Sperm Injection

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73
Q

Ovarian cyst ground glass appearance

A

Endometrioma

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74
Q

White discharge
Dx
Mx
Candida (topical clotrimazole, clotrimazole pessary/fluconazole orally STAT, severe two
doses oral, HIV/DM 7 days oral) – odourless, white curdy discharge ph<4.5 ; BV
(metronidazole – 400mgBD for 7days, ok in pregnancy and breastfeeding) – white/grey,
offensive fishy discharge, pH >4.5 and fishy smell on KOH to substance; Trichomoniasis
(Metronidazole 400mgBD 7 days) – yellow-green discharge pH >4.5. Cervicitis/PID due to
chlamydia/gonorrhoea (1g Azithromycin/IM Ceftriaxone + 1g Azithromycin) (inflamed cervix
bleeds easily, mucous-like discharge.

A

Candida

Topical/pessary clotrimazole
oral fluconazole (not if pregnant)
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75
Q

Child
erythematous rash flexures
satellite lesions
Mx

A

Candidal dermatitis

topical imidazole + stop barrier cream

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76
Q

Offensive, thin, white/grey
‘fishy’ discharge
clue cells/ stippled vaginal epithelial cells
vaginal pH > 4.5
positive whiff test (addition of potassium hydroxide results in fishy odour)

A

Bacterial vaginosis

Mx = Oral metronidazole

77
Q

Offensive, yellow/green, frothy discharge
Vulvovaginitis
Strawberry cervix
(erythematous cervix with pinpoint areas of exudation)

A

Trichomonas vaginalis

Mx = Oral metronidazole

78
Q

White discharge
‘Cottage cheese’ discharge
Vulvitis
Itch

A

Candida

79
Q

3 months old baby with signs of HF, systolic murmur that radiates over the praecordium

A

VSD

pan-systolic murmur

80
Q 
15 year old buy
 short stature
urine 10 times a day, no dysuria
Pale 
HR 78bpm
BP 158/88 
RR 14
What is the likely diagnosis?
A

Chronic renal failure

81
Q

Infant with episodes of throwing arms forward with fists clenched

A

Infantile spasms

present 4-8m, M>F
poor prognsosi

‘salaam’ attacks: flexion of the head, trunk and arms followed by extension of the arms
lasts 1-2 seconds, repeated up to 50 times
progressive mental handicap

EEG shows hypsarrhythmia in 2/3
CT - diffuse/localised brain disease in 70% (e.g. tuberous sclerosis)

Management = poor prognosis
vigabatrin + ACTH

82
Q 
6 year old 
24 hour history  left peri-orbital swelling
URTI last week
Left proptosis, visual acuity normal 
fever of 38.9
Ix?
A

CT nasal orbits

Peri-orbital cellulitis
unilateral, after URTI sinusitis, risk abscess and orbital cellulitis - vision loss

83
Q

Child with fever of 39, high resp rate, nurse says chest is clear, what investigation do you do?

A

Urinalysis

84
Q

Child with fever, white exudate on one tonsil

A

Quinsy

85
Q

Baby is almost a month old and jaundiced. Parents say has been jaundiced since day 2. Stools are grey or white

A

Biliary atresia

86
Q

recurrent abdominal pain associated with going to school. She is diagnosed with functional abdominal pain. What would your advice be with regards to her management?

A

GO to school, come home when pain starts

87
Q

Woman who had FGM when she was 6 and is not pregnant and said she definitely won’t do on her daughter - what do you do?

A

Police

88
Q

14 year old primary amenorrhoea + ejection systolic murmur

A

Turners
bicuspid aortic valve (15%)
coarctation of the aorta (5-10%)

89
Q

What is not a risk factor for primary PPH

A

B thalassaemia trait

90
Q

Pregnant woman previous GDM what is the best way to investigation her blood glucose?

A

OGTT
asap after booking and 24-28w

If other risk factors, just do at 24-28/40
5.6 for fasting and 7.8 for 2 hours

91
Q

GDM targets
fasting
1 hr post meal
2 hr post meal

A
  1. 3 fasting
  2. 8 1 hr post
  3. 4 2 hr post
92
Q

APH definition

possible causes

A

> 24 weeks, before labour

placenta praevia
abruption
vasa praevia

93
Q

contraception that increases risk of osteoporosis

A

Depot Provera

94
Q

When to give Fe in pregnancy

A

Give Fe if
<110 in early pregnancy

<105 after 28wk

<100 in postpartum

95
Q

HRT for

  • perimenopausal
  • postmenopausal
  • no uterus
A

perimenopausal = cyclical combined HRT
postmenopausal (no periods 12m) = continuous combined HRT
no uterus = E2 only HRT

96
Q

Mx of POF who wants to bleed

POF = <40 y/o, no/irregular periods, raised FSH at least 4-6wk apart

A

cyclical oral HRT

97
Q

Mx

Women with menopausal symptoms, hysterectomised, does not want to take oral tablets

A

transdermal oestrogen HRT

98
Q

Women with menopausal symptoms and has eczema Mx

A

oral combined HRT

99
Q

Clue cells

b. –
c. –
d. Lichen sclerosis
e. Curdy white-yellow discharge – candidiasis
f. Blue dots on cervix

A

Bacterial vaginosis

100
Q

Strawberry cervix

A

Trichomonas

101
Q

Painful multiple lesions on labia

A

herpes

102
Q

itch and white plaques on vulva

A

lichen sclerosus

103
Q

likely diagnosis

smear comes back as moderate dyskaroysis

A

CIN2

104
Q

76 year old had a single brown discharge

A

endometrial cancer

105
Q

Intermittent pain + vomiting likely Dx

A

ovarian torsion

106
Q

Mother with stillborn baby, generalized oedematous when born, mother had fever at 18w with rash on trunk

A

parvovirus

107
Q

Women going away for holiday and would like to delay her periods.

A

Continuous COCP or

Norethisteron

108
Q

32 yo has 2 children done with family, had COCP before Mx

A

Mirena

109
Q

47yo women with menorrhagia + dysmenorrhea, US showed multiple fibroids

A

Hysterectomy

110
Q

Mother being prepared for CS, sudden tingling around her mouth?

A

Spinal block

111
Q

Mother being prepared for CS and has a regional block, sudden tachycardia, SOB, difficulty in breathing

A

Anaphylaxis

112
Q

Mother with girl who doesn’t speak

Mx

A

refer for hearing assessment

113
Q

Dehydration + ill kid – weight 15kg what do you give initially?

A

300ml bolus IV - remember bolus in DKA is 10ml/kg and only if they’re in shock

114
Q

Rash not involving flexures Mx

A

Zinc barrier cream

irritant dermatitis

115
Q

Scabies

A

permethrin 5% is first-line, malathion 0.5% is second-line

116
Q

napkin rash
satellite lesion
flexures

A

candida

117
Q

sit without support referral

A

normal 7-8m

REFER at 12m

118
Q

walking referral

A

18m

119
Q

Hops on one leg

A

normally by 4y, refer by 5y

120
Q

normal pincer

A

pincer by 10m

refer at 12m

121
Q

normal smile

refer at

A

normal - by 6wk

refer at 8wk

122
Q

Neonate getting progressively worse at breathing over first 3h with opacities

A

GBS

123
Q

Neonate Still needs oxygen

A

Bronchopulmonary dysplasia

124
Q

Neonate CXR groundglass appearance

A

RDS

125
Q

abdo mass associated with haematuria (pyrexia may occur in 50%)

A

nephroblastoma/Wilm’s

126
Q

18m
absence of red-reflex, replaced by a white pupil (leukocoria)
strabismus
visual problems

A

retinoblastoma

Management = enucleation
depending on how advanced the tumour is other options include external beam radiation therapy, chemotherapy and photocoagulation

good prognosis

127
Q

sore throat, cervical lymphademopathy, been given antibiotics, rash comes on
Virus?

A

EBV

128
Q

Child

Intermittent pain, dehydrated, vomited 3 times

A

Intususseption

129
Q

Sudden abdo pain, well child, something indentable on the L lower quadrant

A

Wilm’s

130
Q

just started on an antipsychotic and becomes tachycardia, hyperthermia, sweating, urine drug screen negative

A

NMS

131
Q

bulimia, BMI 22, well and keen to get treatment

A

Fluoxetine + CBT

132
Q

Section 4

A

72 hour assessment order
used as an emergency, when a section 2 would involve an unacceptable delay
a GP and an AMHP or NR
often changed to a section 2 upon arrival at hospital

section 5(2) is 72hr for someone already in hospital

133
Q

lost her husband 7 months ago and started hearing voices of him saying to join him a month ago

A

abnormal grief response

134
Q

78yo guy has issues with organization, troubles with understanding words

A

frontal temporal dementia

135
Q

One of the criteria for learning disability?

A

IQ <70 Mild >50, Moderate >35, Severe >20, Profound >20

136
Q

Who would you refer a schizophrenic patient to if they are being discharged and needs support in the community regarding treatment?

A

Community psychiatric nurse

137
Q

Something that works on 5HT receptors?

A

MDMA (also LSD)

138
Q

Lady has a diagnostic laparotomy. She has suprapubic pain that not even IV paracetamol is helping. What is the likely reason?

A

Urinary retention

139
Q

Child is an arsonist. Gets in fights. Attacks teachers. What is he likely to have at age 20?

A

Dissocial/antisocial personality disorder
(also high risk in ADHD)

Conduct disorder >10
Oppositional defiant disorder <10

140
Q

Ortalani positive neonate

Mx?

A

USS Hip 6wk

141
Q

What defines a mild learning disability?

A

<70

142
Q

Lady with social phobia. What feature would typically be associated with it?

A

people noticing you blush

143
Q

Two fetal poles, one gestational sac

A

Monoamniotic

144
Q

Most likely effect from cheese reaction due to MAO-I

A

Hypertension

145
Q

Common S/E of clozapine

A

hypersalivation

146
Q

Commonest type of endometrial cancer?

A

Type 1
AKA endometrioid

147
Q

Walking

A

15 months 


148
Q

2-3 word sentences

A

2 years old

149
Q

28 day child with pale stools

A

Biliary atresia

will also have prolonged jaundice, high conj bilirubin

150
Q

Child falls. Parents pick him but has a tonic-clonic seizure. Is complete well afterwards

A

Reflex Anoxic 

(pale)

)Breath holding attacks = baby blue +/- LOC)

151
Q

Gardisil protects against

A

HPV 6, 11, 16, 18

16 + 18 -> cervical cancer

152
Q

UTI Tx in pregnancy

A

Nitro or Cefalexin

CANNOT take trimethoprim

153
Q

Cystic ovaries on scan, best other indicator for PCOS?

A

Hirsutism

154
Q

PCOS drug to increase fertility

A

Clomifene

metformin = 2nd line/adjunct

155
Q

Marker of POF

A

Raised FSH

also high LH and low AMH

156
Q

Mx POF

A

continuous combined HRT (if 1yr amenorrhoea)
cyclical if <1yr amenorrhoea (as risk endometrial hyperplasia with continuous)

also:
testosterone
contraception
bisphosphonates

157
Q

ASx nulliparous woman
5.4cm unilocular cyst USS
no Fhx
Mx?

A

USS 3m f/u and Ca125

NB: Postmenopausal + cyst= TVUSS + Ca125
If RMI>200 = CT/MRI + MDT
RMI <200+ ASx/<5cm/unilocular unilateral = 4m TVUSS + Ca125
RMI<200 + abnormal features = salpingo-oophorectomy

158
Q

8 weeks post SVD + 2nd degree tear
bleed and mild lower abdo pain
Dx?

A

endometritis

159
Q

Cause of increased urine volume + frequency in 1st trimester

A

Increased GFR

160
Q

paroxetine risk in pregnancy

A

congenital malformations

161
Q

Effects of fluoxetine in pregnancy on baby

A

PPHN

NB avoid fluoxetine in breastfeeding as long 1/2 life. Use paroxetine or other SSRI

162
Q

Nexplanon common side effect

A

irregular bleeding

163
Q

Small painful lump inside vagina of sexually active woman

A

Bartholin’s

164
Q

Acne

Next step Mx after topical steroids

A

Retinoids

nb. isoretinoin/roaccutane in 2 care as teratogenic

165
Q

Child pain outer ear, lump behind ear

A

mastoiditis

166
Q

contraIx to 4m vaccine

A

fever >38.5

167
Q

Suicide risk. What is the highest predictor of doing it again?

A

feeling hopeless about future

>previous self harm

168
Q

80 year old man with new onset dementia, needs MRI but refuses. You need someone to make decision for him

A

ask independent mental health advocate

169
Q 
Acute onset Sx
hyperreflexia
myoclonus (rapid jerky)
ocular clonus
mydriasis/dilated pupils
normal bloods
A

Serotonin syndrome

stop ADs
IV fluid + BDZ
Cytoheptadine and Chlorpomazine in severe cases

170
Q

rigidity
decreased reflexes
increase CK, WCC, low Fe

over 1-2 weeks

A

NMS

171
Q

Management of NMS

A

stop AP
IV fluids + BDZ
DANTROLENE (if severe) and bromocriptine

172
Q

Mild/moderate/severe/profound LD

A

LD IQ <70

mild = 50-60
moderate = 35-49
severe = 20-34
profound = <20
173
Q

Treatment resistant schizophrenia on clozapine, recently stopped smoking. High level of clozapine now. Most likely consequence?

A

Seizures

agranulocytosis is NOT dose-dependent

174
Q

Dx biliary atresia

A

USS and liver biopsy

175
Q 
normal neonatal birth wt
faltering growth
prolonged jaundice
high conj bili
dark urine pale stool
A

Biliary atresia

USS and liver biopsy and ERCP

Mx = Kasai

176
Q

small slow-growing lesion

pregnant

A

HPV warts

177
Q

Lady with a viable intrauterine pregnancy. LIF pain –initially episodic, now continuous

A

ovarian torsion

178
Q

Sitting unsupported

A

8m

179
Q

Walking

A

15 months 


180
Q

2-3 word sentences

A

2 years

181
Q

Pincer Grip

A

10 months 


182
Q

28 day child with pale stool and jaundice

A

biliary atresia

183
Q

Child falls. Parents pick him but has a tonic-clonic seizure. Is complete well afterwards

A

Reflex Anoxic 


184
Q

Woman with a slow growing painless lesion on labia

A

Bartholins

185
Q

Woman with tender lump inside her vagina, sexually active

A

HPV warts

HPV 6+11 - warts

HSV = lips cold sores or genital herpes, distinct from warts and have a papulovesicular morphology - multiple painful lesions on labia

186
Q

Kid with history of anal fissure - what is your first cause of action?

A

inspect anal region

187
Q

5 month old with cough, runny nose, fever, wheeze.

pathogen?

A

RSV

188
Q

Woman wants to know what risk her baby has of getting schizophrenia, since the baby’s father has it.

A

12-15%

Year 5 Specialties (2 decks)

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