phase 2 saq 2

Question 1

Which spirometry results indicate an obstructive respiratory disease?

Answer 1

Obstructive pattern = FEV1 <0.8

FEV1/FVC <0.7

Question 2

common organisms that can cause an infective exacerbation of COPD

Answer 2

Most common organism in COPD exacerbation = haemophilus influenzae

Others = strep pneumoniae (2), Moraxella catarrhalis

Question 3

which antibodies are sensnitive and specific for RA

Answer 3

Sensitive: Rheumatoid Factor
Specific: Anti-ccp antibody

Question 4

1 life-threatening complication of RA

Answer 4

feltys syndrome

Question 5

extra-articular manifestations of RA

Answer 5

Skin: Nodules, vasculitis (ulcers, splinter haemorrhages) Ocular, Oral: Sjogren’s
Pulmonary: Pleuritis, effusions
Renal: Glomerulonephritis
Neuro: peripheral neuropathy (rare)
Haematology: deranged bloods
Cardiac: atherosclerosis, pericarditis, MI

Question 6

causes of cauda equina

Answer 6

Tumours (1), spinal metastases (1), spondylolisthesis (displacement of vertebra) (1), abscess (1), trauma (1)

Question 7

name of the symptom causing loss of sensation in the genital region

Answer 7

Saddle anaesthesia

Question 8

whats it called when nails have some thin red lines on them

Answer 8

Splinter haemorrhages

Question 9

with infective endcarditis and Considering his history of IV drug use, which valve is most-likely affected, and
why?

Answer 9

Tricuspid valve (2) because the tricuspid valve is the first valve contacted in the heart with venous return

Question 10

possible complications from inective endorcarditis

Answer 10

ulmonary embolism (1), kidney damage (1), spleen damage (1), abscess formation (1), sepsis (1), heart failure

Question 11

investigations for mallory weiss tear

Answer 11

Upper GI endoscopy

FBC (1), U&Es (1), Coagulation profile (1), LFTs (1), Erect CXR

Question 12

what does glasgow Blatchford Score for upper gi bleeds include

Answer 12

Haemoglobin (1), Urea (1), Systolic blood pressure (1), Gender (1), Heart rate (tachycardia) (1), Melaena (1), History of syncope (1), History of hepatic disease (1), cardiac failure (1).

Question 13

What is the first-line management of an upper GI bleed caused by an oesophageal tear, if the bleeding is persistent?

Answer 13

Surgical: Upper GI endoscopy and clipping +/- adrenaline OR thermal coagulation (2)

High-dose proton pump inhibitor post-surgery

Question 14

What radiological intervention can be used to treat renal tract stones

Answer 14

Ultrasound shock wave therapy (2) or ultrasound shock wave lithotripsy (3)

Question 15

Name 3 substances that urinary tract stones can be formed by

Answer 15

Bilirubin (2), uric acid (2), calcium (2), cholesterol (2)

Question 16

side effects of biphosphnates

Answer 16

Oesophagitis, osteonecrosis of jaw, oesophageal ulcers

Question 17

how should biphosphonates be taken

Answer 17

Take first thing in the morning (1) on an empty stomach (1), with a full glass of water (1), stand or sit upright for 30 minutes after taking them (1), don’t eat for at least 30 minutes before eating food / drinking fluids (1), for up to 2 hours (1).

Question 18

GP medication for meningits

Answer 18

intramuscular (1) Benzylpenicillin (

Question 19

gold-standard investigation for meningits

Answer 19

Lumbar puncture

Question 20

what antibiotics for meningitis

Answer 20

Cefotaxime (2) or ceftriaxone (2), 3rd generation Cephalosporin

Question 21

chest x ray for aortic stenosis?

Answer 21

Cardiomegaly (1), dilated ascending aorta (1), pulmonary oedema (1) calcification of aortic valve

Question 22

4 symptoms of septic infection

Answer 22

Fevers (1), rigors (1), night sweats (1), weight loss (1), anaemia (1), splenomegaly (1), clubbing (1)

Question 23

What is the most likely infection (disease name) to occur after valve
replacement surgery?

Answer 23

Infective Endocarditis

Question 24

pathologies on hand with infective endocarditis

Answer 24

splinter haemorrhages (1), Janeway lesions (1), Osler’s nodes (1)

Question 25

which LFT raised in alcoholic liver disease

Answer 25

Gamma-glutamyl Transferase / Gamma-GT. (1).

Question 26

what does excessive alochol abuse lead to

Answer 26

Vitamin B1 / Thiamine deficiney (1).

Wernicke-Korsakoff syndrome (2).

Question 27

Which benzodiazepine may be used to manage the effects of alcohol withdrawal?

Answer 27

Chlordiazepoxide

Question 28

presentations of delirium tremens.

Answer 28

Acute confusion (1), severe agitation (1), delusions and hallucinations (1), tremor (1), tachycardia (1), hypertension (1), hyperthermia (1), ataxia (1), arrhythmias

Question 29

What kind of bacteria is Staphylococcus Aureu

Answer 29

Gram positive (1 mark) beta-haemolytic (1 mark) cocci / clusters