Placement AMU

Question 1

what is functional pain syndrome FAPS

Question 2

dx of FAPS made off

Answer 2

made on the basis of positive symptom criteria and a longstanding history of symptoms; in the absence of alarm symptoms, an extensive diagnostic evaluation is not required.

Question 3

what are alarm symtpoms

Answer 3

vomiting, bleeding or anemia, abdominal mass or unintended weight loss, and dysphagia

Question 4

causes of rectal bleeding

Answer 4

hard stools (poo)
haemorrhoids (also known as piles), which are often associated with constipation
anal fissure (a small tear in the opening of the anus) or fistula (a small channel that develops between the anus and skin)
Less common causes include:

colon polyps
rectal trauma (for example, an injury caused by accident or sexual assault)
stomach or duodenal ulcers
infections of the bowel
gastroenteritis
bowel conditions, such as diverticular disease or bowel cancer, Crohn’s disease or ulcerative colitis
sexually transmitted infections
alcohol - Consuming too much alcohol may tear away at tissue and cause it to become more sensitive. These tears, called Mallory-Weiss tears, can cause significant bleeding and may lead to pooping blood. The tears can form anywhere in the digestive tract,

Question 5

what is penumobilia

Answer 5

Pneumobilia, or air within the biliary tree of the liver, suggests an abnormal communication between the biliary tract and the intestines, or infection by gas-forming bacteria. Pneumobilia usually can be distinguished from air in the portal venous system by its appearance on computed tomography (CT) scan.

Question 6

where does a pudendal nerve block enter

Answer 6

aims to block the nerve as it enters the lesser sciatic foramen, 1 cm inferior and medial relative to the attachment of the sacrospinous ligament to the ischial spine

Question 7

half life of morphine

Answer 7

2hours

Question 8

where is morphine metabolised

Answer 8

primarily metabolized in the liver by uridine-5′-diphosphate (UDP) glucoronosyltransferase

Question 9

codiene to morphine

Answer 9

divide by 10

Question 10

moa tramadol

Answer 10

inhibits ascending pain pathways by binding to mu opiate receptors in the central nervous system, l

-Tramadol inhibits serotonin reuptake and (-)-tramadol inhibits norepinephrine reuptake

Question 11

causes of recurrent stroke disease

Answer 11

In particular, hypertension and diabetes mellitus, atrial fibrillation, angina pectoris, ischemic heart disease, cardiomyopathy, and smoking

Question 12

Contraindications to thrombolysis:

Answer 12

Previous intracranial haemorrhage
- Seizure at onset of stroke
- Intracranial neoplasm
- Suspected subarachnoid haemorrhage
- Stroke or traumatic brain injury in preceding 3 months
- Lumbar puncture in preceding 7 days
- Gastrointestinal haemorrhage in preceding 3 weeks
- Active bleeding
- Pregnancy
- Oesophageal varices
- Uncontrolled hypertension >200/120mmHg

Question 13

secondary prevention of stroke

Answer 13

clopidogrel 1st line

2nd - aspirin and MR dipyridamol e

Question 14

TTO

Answer 14

to take out

Question 15

why would you order magnesium testing when blood taking

Answer 15

Magnesium testing may be a follow-up to chronically low blood calcium and potassium levels. It also may be ordered when you have symptoms possibly due to a magnesium deficiency, such as muscle weakness, twitching, cramping, confusion, cardiac arrhythmias, and seizures.

Question 16

first line investigation for a stroke

Answer 16

A non-contrast CT head scan is the first line radiological investigation for suspected stroke

Question 17

acute ischaemic strokes show what on CT

Answer 17

may show areas of low density in the grey and white matter of the territory.

These changes may take time to develop
other signs include the ‘hyperdense artery’ sign corresponding with the responsible arterial clot - this tends to visible immediately

Question 18

acute haemorrhagic strokes show what on ct

Answer 18

typically show areas of hyperdense material (blood) surrounded by low density (oedema)

Question 19

what is ischaemic penumbra

Answer 19

Ischaemic penumbra denotes the part of an acute ischaemic stroke that is at risk of progressing to infarction but is still salvageable if reperfused. It is usually located around an infarct core which represents the tissue which has already infarcted or is going to infarct regardless of reperfusion.

Question 20

penumbra

Answer 20

the partially shaded outer region of the shadow cast by an opaque object.

Question 21

when is a biers block used

Answer 21

The Bier block technique provides analgesia, muscle relaxation and a relatively bloodless field. It involves injection of local anaesthetic into the venous system of an extremity which has previously been exsanguinated by gravity or compression. The local anaesthetic diffuses into the surrounding nerves. Local ischaemia, caused by the tourniquet, contributes to the analgesic effect.

Question 22

what type of anaeatheisa is directly into the bone and whne is it used

Answer 22

The intraosseous injection allows placement of a local anesthetic solution directly into the cancellous bone adjacent to the tooth to be anesthetized.

Question 23

what is a colles fracture

Answer 23

the Colles fracture is defined as a distal radius fracture with dorsal comminution, dorsal angulation, dorsal displacement, radial shortening, and an associated ulnar styloid fracture.
radius normall 10 degrees froward tilt in lateral view
and should sit higher than ulnar nomrall

Question 24

broken wrist what things will change the way you manage this patient

Answer 24

skin tightening - could do from closed to opne
neurovasuclar copromise
open or closed

Question 25

You are teaching a man about how to use an EpiPen (adrenline auto-injector). What is the most appropriate advice about where to inject the pen?

Answer 25

Anterolateral aspect of the middle third of the thigh
76%

IM adrenaline should be injected in the anterolateral aspect of the
middle third of the thigh

Question 26

gold standard for dx of contact dermatitis

Answer 26

skin patch test

Question 27

food allergy testing

Answer 27

skin prick test

Question 28

what are stop and start meaning

Answer 28

STOPP identifies medications where the risk outweighs the therapeutic benefits in certain conditions and START suggests medications that may provide additional benefits ie proton pump inhibitors for gastroprotection in patients on medications increasing bleeding risk